bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical pathway efficiency for elective joint replacement surgeries: a case study
Authors: Laberge Maude , Côté André , Ruiz Angel
Published: May 2019

Purpose

The purpose of this paper is to define a clinical pathway for total joint replacement (TJR) surgery, estimate the effect of delays between steps of the pathway on wait time for surgery and to identify factors contributing to more efficient operations and challenges to their implementation.

Design/methodology/approach

This is a case study with a mixed methods approach. The authors conducted interviews with hospital staff. Data collected in the interviews and through on-site observation were analyzed to map the TJR process and identify the steps of the care pathway. The authors extracted and analyzed data (time stamps) from 60 hospital patient records for each step in the pathway and ran a regression on the duration of the whole trajectory.

Findings

There were wide variations in the delays observed between the seven steps identified. The delay between Step 1 and Step 2 was the only significant variable in predicting the total wait time to surgery. In one hospital, one delay explained 50 percent of the variation. There was misalignment between findings from the qualitative data in terms of strategies implemented to increase efficiency of the clinical pathway to the quantitative data on delays between the steps.

Research limitations/implications

The study identified the clinical pathway from the consultation with an orthopaedic surgeon to the surgery. However, it did not go beyond the surgery. Future research could investigate the relationship between specific processes and delays between steps of the process and patient outcomes, including length of stay, mobilization and functionality in activities of daily living, as well as potential complications from surgery, readmission and the services required after the patient was discharged.

Practical implications

Wait times can be addressed by implementing strategies at the health system level or at the organizational level. The authors found and discuss areas where there could be efficiency gains for health care organizations.

Social implications

Stakeholders in care processes are diverse and they each have their preferences in how they practice (in the case of providers) and how they perceive and wish to respond adequately to patients’ needs in contexts that have different norms and approaches. The approach in this study enables a better understanding of the processes, the organizational culture and how these may affect each other.

Originality/value

Our mixed methods enabled a process mapping and the identification of factors that significantly affected the efficiency of the TJR surgery process. It combines methods from process engineering with health services and management research. To some extent, this study demonstrates that although managers can define and enforce processes, organizational culture and practices are harder to influence.
Team composition and labor allocation in audit teams: a descriptive note
Authors: Che Limei , Svanström Tobias
Published: May 2019

Purpose

The purpose of this paper is to describe, illustrate and provide a deeper understanding of team composition and labor allocation in audit teams by quantifying the exact value of resources at different levels of the audit production. Audit teams have been considered as a black box in audit research. Therefore, this paper reports descriptive statistics on (levels and proportions of) hours and costs allocated to auditor ranks (and the number and value, i.e. billing rates, of auditors for different ranks and the entire team) to shed new light on audit teams.

Design/methodology/approach

This study uses a proprietary data set containing disaggregated information on hours, costs and billing rates for each team member in each of 908 audit engagements. The data are provided by a Swedish Big 4 audit firm. The study uses a purely descriptive approach and categorizes auditors into seven ranks. As size and the publicly listed status are crucial determinants of audit production, the paper splits engagements in public and private companies and reports statistics for size quartiles of both public and private clients.

Findings

The paper provides descriptive statistics for (1) client size, (2) audit team members, (3) audit hours, (4) audit costs, (5) proportion of audit hours, (6) proportion of audit costs, (7) billing rates and (8) variation of billing rates. Results show that compared to private clients, the audit firm allocates higher effort from auditors in higher ranks and lower effort from auditors in lower ranks to public clients. Another finding is that allocation varies with client size for private clients, but less so for public clients.

Originality/value

In an area with sparse literature, this descriptive study serves as a first step to improve our understanding and guide future research. It provides concrete support for previously known theory.
Setting Climate Action as the Priority for the Common Agricultural Policy: A Simulation Experiment
Authors: Himics Mihaly , Fellmann Thomas , Barreiro‐Hurle Jesus
Published: May 2019

We quantitatively assess the impacts of re‐allocating budgetary resources within Pillar 1 of the EU's Common Agricultural Policy (CAP) from direct income support to a direct greenhouse gas (GHG) reduction subsidy for EU farmers. The analysis is motivated by the discussion on the future CAP, with calls for both an increased ambition on climate action from the agricultural sector and for a more incentive‐based delivery system of direct payments under strict budgetary restrictions. By conducting a simulation experiment with an agricultural partial equilibrium model (CAPRI), we are able to factor in farmers’ supply and technology‐adjusting responses to the policy change and to estimate the potential uptake of the GHG‐reduction subsidy in EU regions. We find that a budget‐neutral re‐allocation of financial resources towards subsidised emission savings can reduce EU agricultural non‐CO2 emissions by 21% by 2030, compared to a business‐as‐usual baseline. Two‐thirds of the emission savings are due to changes in production levels and composition, implying that a significant part of the achieved GHG reduction is offset globally by emission leakage. At the aggregated level, the emission‐saving subsidy and increased producer prices compensate farmers for the foregone direct income support, but differences in regional impacts indicate accelerated structural change and heterogeneous income effects in the farm population. We conclude that the assumed regional budget‐neutrality condition introduces inefficiencies in the incentive system, and the full potential of the EU farming sector for GHG emissions reduction is not reached, leaving ample room for the design of more efficient agricultural policies for climate action.
Toward Explaining Nitrogen and Phosphorus Trends in Chesapeake Bay Tributaries, 1992–2012
Authors: Ator Scott W. , García Ana Maria , Schwarz Gregory E. , Blomquist Joel D. , Sekellick Andrew J.
Published: May 2019

Understanding trends in stream chemistry is critical to watershed management, and often complicated by multiple contaminant sources and landscape conditions changing over varying time scales. We adapted spatially referenced regression (SPARROW) to infer causes of recent nutrient trends in Chesapeake Bay tributaries by relating observed fluxes during 1992, 2002, and 2012 to contemporary inputs and watershed conditions. The annual flow‐normalized nitrogen flux to the bay from its watershed declined by 14% to 127,000 Mg (metric tons) between 1992 and 2012, due primarily (more than 80% of the decline) to reduced point sources. The remainder of the decline was due to reduced atmospheric deposition (13%) and urban nonpoint sources. Agricultural inputs, which contribute most nitrogen to the bay, changed little, although trends in the average nitrogen yield (flux per unit area) from cropland and pasture to streams in some settings suggest possible effects of evolving nutrient applications or other land management practices. Point sources of phosphorus to local streams declined by half between 1992 and 2012, while nonpoint inputs were relatively unchanged. Annual phosphorus delivery to the bay increased by 9% to 9,570 Mg between 1992 and 2012, however, due mainly to reduced retention in the Susquehanna River at Conowingo Reservoir.
Simulating Soil Water Content, Evapotranspiration, and Yield of Variably Irrigated Grain Sorghum Using AquaCrop
Authors: Masasi Blessing , Taghvaeian Saleh , Gowda Prasanna H. , Warren Jason , Marek Gary
Published: May 2019

Use of models to simulate crop production has become important in optimizing irrigation management in arid and semiarid regions. However, applicability and performance of these models differ across regions, due to differences in environmental and management factors. The AquaCrop model was used to simulate soil water content (SWC), evapotranspiration (ET), and yield for grain sorghum under different irrigation regimes and dryland conditions at two sites in Central and Southern High Plains. Prediction error (Pe), estimated as the difference between simulated and measured divided by measured, for SWC ranged from −17% to 4% in fully irrigated, −3% to −10% in limited irrigated, and −16% to 25% in dryland treatments. The Pe within ±4%, −5%, and −17% to 24% were attained for seasonal ET under fully irrigated, limited irrigated, and dryland conditions, respectively. Pe values for grain yield were within those previously reported and ranged from −10% to 12%, −12% to 7%, and 9% to 17% for fully irrigated, limited irrigated and dryland conditions, respectively. Overall performance of the AquaCrop model showed it could be used as an effective tool for evaluating the impacts of variable crop and irrigation managements on the production of grain sorghum in the study area. Finally, the application of the model in the study area revealed planting date has a significant impact on sorghum yield and irrigation requirements, but the impact of planting density was negligible. Editor's note: This paper is part of the featured series on Optimizing Ogallala Aquifer Water Use to Sustain Food Systems. See the February 2019 issue for the introduction and background to the series.
The MENA Region's Intersecting Crises: What Next?
Authors: Hiltermann Joost
Published: May 2019

Conflicts in the Middle East and North Africa have been multiplying and increasingly intersecting. This complicates and delays efforts to resolve them. Yet sooner or later they must come to an end. Once they do, it is fair to ask what comes next. Can the region recover? And if so, what shape will it take? Some patterns are already visible. National identities, which were subsumed by a series of competing sub‐national identities, are rebounding as an essential glue in uncertain times, reinforcing state borders and possibly state structures. And forms of local governance are thriving in some areas where the state has dissolved and its writ disappeared; they constitute important experiments that may prevent a return of fierce authoritarian states. Some obstacles to attempts by societies to reconstitute themselves are also evident. The current conflicts’ intersecting nature is one; the other is unremitting external interventions that do yet greater harm by militarizing solutions to political problems, further polarizing divided polities, and undermining local efforts at renegotiating social contracts. Policy makers should gain a more nuanced understanding of the current crises and shape policies that do no further harm but instead contribute to a more stable future.
Conducting social network analysis with animal telemetry data: Applications and methods using spatsoc
Authors: Robitaille Alec L. , Webber Quinn M. R. , Vander Wal Eric
Published: May 2019

We present spatsoc, an r package for conducting social network analysis with animal telemetry data.

Animal social network analysis is a method for measuring relationships between individuals to describe social structure. Proximity‐based social networks are generated from animal telemetry data by grouping relocations temporally and spatially, using thresholds that are informed by the characteristics of the species and study system.

spatsoc fills a gap in r packages by providing flexible functions, explicitly for animal telemetry data, to generate edge lists and gambit‐of‐the‐group data, perform data‐stream randomization, and generate group by individual matrices.

The implications of spatsoc are that current users of animal telemetry or otherwise georeferenced data for movement or spatial analyses will have access to efficient and intuitive functions to generate social networks.
Understanding farmers’ preference for traits of chickens in rural Ethiopia
Authors: Terfa Zelalem G. , Garikipati S. , Kassie Girma T. , Dessie Tadelle , Christley R.M.
Published: May 2019

Traditional poultry production plays an irreplaceable role in the sustenance of livelihoods in rural Ethiopia. Ironically, however, much has been done to replace indigenous poultry breeds with exotic genetic resources regardless of the importance producers and consumers attach to attributes of the resources. This study aims at informing policy to establish effective indigenous poultry breeding and conservation programs. Discrete choice experiment (DCE) was employed to generate data. Designing of the DCE involved identification, definition, and measurement of attributes of adaptive, productive, and sociocultural importance considering the multiple functions of village chickens. Random parameters logit and the generalized multinomial logit (G‐MNL) models were used to estimate taste parameters. Economic values of traits of chickens were estimated using the utility in willingness‐to‐pay (WTP) space approach, based on G‐MNL model formulation. The results show that important traits of chickens to farmers are mothering ability, diseases resistance, and meat and eggs taste. These findings question the appropriateness, at least in the prevailing production system, of the Ethiopian national government's effort to improve productivity in village poultry by targeting specialized egg‐layer improved chickens. The findings also suggest that poultry breeding programs aiming to provide readily acceptable breed technology by farmers need to prioritize traits of adaptive importance, and mothering ability, instead of focusing on egg productivity only. The key implication is that the unique qualities of the indigenous poultry breeds need to be carefully identified and prioritized before resorting to those that proved to be successful in different production systems.
The Jaipur Literature Festival and Its Critics
Authors: Ståhlberg Per
Published: May 2019

The Jaipur Literature Festival (JLF) has been held in the Indian city of Jaipur for the past ten years. The event has grown spectacularly and has provided an arena for encounters between literary worlds. It has also become a focus of debate and friction within the sphere of Indian writing. This article is based on fieldwork at the JLF 2017.
Cardiorenal AL amyloidosis: risk stratification and outcomes based upon cardiac and renal biomarkers
Authors: Rezk Tamer , Lachmann Helen J. , Fontana Marianna , Naharro Ana Martinez , Sachchithanantham Sajitha , Mahmood Shameem , Petrie Aviva , Whelan Carol J. , Pinney Jennifer H. , Foard Darren , Lane Thirusha , Youngstein Taryn , Wechalekar Ashutosh D. , Hawkins Philip N. , Gillmore Julian D.
Published: May 2019

Systemic AL amyloidosis is a cause of type 5 cardiorenal syndrome. Response to treatment is currently reported according to organ‐specific amyloidosis consensus criteria (ACC), which are not validated in cardiorenal AL amyloidosis. Of 1000 patients prospectively enrolled into the UK ALchemy study, 318 (32%) had combined cardiac and renal amyloidotic organ dysfunction at diagnosis, among whom 199 (63%) died; median survival by Kaplan–Meier analysis was 18·5 months. Fifty (16%) patients required renal replacement therapy (RRT). At diagnosis, independent predictors of death and dialysis were N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) >8500 ng/l (hazard ratio [HR] 3·30, P < 0·001; HR 3·00, P < 0·001), and estimated glomerular filtration rate (eGFR) < 30 ml/min/1·73 m2 (HR 1·89, P = 0·011; HR 6·37, P < 0·001). At 6 months, an increase in NT‐proBNP of >30% and a reduction in eGFR of ≥25% were independent predictors of death (HR 2·17, P = 0·009) and dialysis (HR 3·07, P = 0·002), respectively. At 12 months, an increase in NT‐proBNP >30% was highly predictive of death (HR 3·67, P < 0·001) and dialysis (HR 2·85, P = 0·010), whereas ACC renal response was predictive of neither. Cardiorenal AL amyloidosis is associated with high early mortality. Outcomes are dictated by NT‐proBNP and eGFR at diagnosis rather than proteinuria, and thereafter predominantly by changes in NT‐proBNP concentration.
Phase 1 study of selinexor plus carfilzomib and dexamethasone for the treatment of relapsed/refractory multiple myeloma
Authors: Jakubowiak Andrzej J. , Jasielec Jagoda K. , Rosenbaum Cara A. , Cole Craig E. , Chari Ajai , Mikhael Joseph , Nam Jennifer , McIver Amanda , Severson Erica , Stephens Leonor A. , Tinari Kathryn , Rosebeck Shaun , Zimmerman Todd M. , Hycner Tyler , Turowski Agata , Karrison Theodore , Zonder Jeffrey A.
Published: May 2019

Selinexor, an oral Selective Inhibitor of Nuclear Export, targets Exportin 1 (XPO1, also termed CRM1). Non‐clinical studies support combining selinexor with proteasome inhibitors (PIs) and corticosteroids to overcome resistance in relapsed/refractory multiple myeloma (RRMM). We conducted a phase I dose‐escalation trial of twice‐weekly selinexor in combination with carfilzomib and dexamethasone (SKd) to determine maximum tolerated dose in patients with RRMM (N = 21), with an expansion cohort to assess activity in carfilzomib‐refractory disease and identify a recommended phase II dose (RP2D). During dose escalation, there was one dose‐limiting toxicity (cardiac failure). The RP2D of twice‐weekly SKd was selinexor 60 mg, carfilzomib 20/27 mg/m2 and dexamethasone 20 mg. The most common grade 3/4 treatment‐emergent adverse events included thrombocytopenia (71%), anaemia (33%), lymphopenia (33%), neutropenia (33%) and infections (24%). Rates of ≥minimal response, ≥partial response and very good partial response were 71%, 48% and 14%, respectively; similar response outcomes were observed for dual‐class refractory (PI and immunomodulatory drug)/quad‐exposed (carfilzomib, bortezomib, lenalidomide and pomalidomide) patients (n = 17), and patients refractory to carfilzomib in last line of therapy (n = 13). Median progression‐free survival was 3·7 months, and overall survival was 22·4 months in the overall population. SKd was tolerable and re‐established disease control in RRMM patients, including carfilzomib‐refractory patients.

Registered at ClinicalTrials.gov (NCT02199665)
Results of successive EORTC‐CLG 58 881 and 58 951 trials in paediatric T‐cell acute lymphoblastic leukaemia (ALL)
Authors: Hofmans Mattias , Suciu Stefan , Ferster Alina , Van Vlierberghe Pieter , Mazingue Françoise , Sirvent Nicolas , Costa Vitor , Yakouben Karima , Paillard Catherine , Uyttebroeck Anne , Plantaz Dominique , Plat Geneviève , Simon Pauline , Millot Frédéric , Poirée Marilyne , van der Werff ten Bosch Jutte , Piette Caroline , Minckes Odile , Rohrlich Pierre , Girard Sandrine , Cavé Hélène , Bertrand Yves , De Moerloose Barbara
Published: May 2019

Outcomes in childhood T‐cell acute lymphoblastic leukaemia (T‐ALL) are steadily improving due to intensive therapy. Between 1989 and 2008, 599 children with newly diagnosed T‐ALL were enrolled in two successive European Organization for Research and Treatment of Cancer ‐ Children's Leukaemia Group trials (58881 and 58951), both based on the Berlin‐Frankfurt‐Munster protocol and without cranial irradiation. In the latter trial induction chemotherapy was intensified. The most important randomizations were Medac Escherichia coli asparaginase versus Erwinia asparaginase in trial 58881, and dexamethasone (6 mg/m2/day) versus prednisolone (60 mg/m2/day) and prolonged versus conventional asparaginase duration in trial 58951. 8‐year event‐free survival (EFS) increased from 65·1% to 74·0% in trial 58951. Improvement was most profound for patients with white blood cell (WBC) counts <100 × 109/l and “good responders” to prephase. Medac E. coli asparaginase was associated with longer EFS [hazard ratio (HR) 0·54, P = 0·0015] and overall survival (HR 0·51, P = 0·0018). Induction therapy with dexamethasone did not improve EFS compared to prednisolone. Remarkably, intensification of central nervous system (CNS)‐directed therapy in trial 58951 resulted in fewer bone marrow relapses, while the incidence of CNS relapses remained low. In summary, we showed that adequate asparaginase therapy, intensified induction treatment and intensification of CNS‐directed chemotherapy can result in an improvement of outcome in T‐ALL patients with good prephase response and initial WBC counts <100 × 109/l, representing approximately 50% of T‐ALL patients.
Utility of a routine bench cholangiogram for ex situ split liver procedure
Authors: Battula Narendra R. , Anbarasan Ravindar , Thumma Venumadhav , Perera M. Thamara P. R. , Muiesan Paolo , Isaac John R. , Sharif Khalid , Mirza Darius F.
Published: May 2019

Background

Biliary complications can result in a significant morbidity for split liver graft recipients. Biliary drainage for segment 1 and 4 is highly variable and could be the source of bile leaks. Use of a bench cholangiogram (BCH) can accurately define the segmental biliary system and identify any significant biliary radicles that need retention or repair during bench preparation of split grafts. This study evaluates the clinical relevance of routine BCH in split liver transplantation (SLT).

Methods

Retrospective review of 100 BCH images performed during ex situ deceased donor SLT between January 2009 and January 2015. The radiographs were reviewed by two surgeons and the biliary anatomy was compared using Huang and Reichert classification.

Results

100 BCH images were reviewed. Variant anatomy was frequently identified in the intrahepatic bile duct system, the number and drainage patterns of segment 1&4 duct was diverse. BCH results guided the line of parenchymal transection to obtain a single segment 2&3 duct in 15 cases. A surgical intervention in the form of suture ligation of significant segment 1 or 4 duct at bench preparation was performed in 6 cases. BCH images guided surgical control of post‐operative bile leak in 3 patients.

Conclusion

Bench cholangiogram is a useful tool to guide liver parenchymal transection and potentially reduce the incidence of biliary complications.
Glycaemic benefit of iGlarLixi in insulin‐naive type 2 diabetes patients with high HbA1c or those with inadequate glycaemic control on two oral antihyperglycaemic drugs in the LixiLan‐O randomized trial
Authors: Davies Melanie J. , Russell‐Jones David , Barber Thomas M. , Lavalle‐González Fernando J. , Galstyan Gagik R. , Zhu Dalong , Baxter Mike , Dessapt‐Baradez Cecile , McCrimmon Rory J.
Published: May 2019

In this post hoc analysis of the randomized controlled LixiLan‐O trial in insulin‐naive patients with type 2 diabetes mellitus (T2DM) not controlled with metformin, with or without a second oral antihyperglycaemic drug (OAD), the efficacy and safety of the fixed‐ratio combination, iGlarLixi (insulin glargine 100 U [iGlar] and lixisenatide [Lixi]), compared to its individual components was assessed in two patient subgroups: group 1) baseline HbA1c ≥9% (n = 134); group 2) inadequate control (HbA1c ≥7.0% and ≤9.0%) despite administration of two OADs at screening (n = 725). Treatment with iGlarLixi resulted in significantly greater reduction in least squares mean HbA1c compared to treatment with iGlar or Lixi alone in both subgroups (group 1: 2.9%, 2.5%, 1.7% and group 2: 1.5%, 1.2%, 0.7%, respectively). Target HbA1c less than 7% was achieved in more than 70% of patients using iGlarLixi in both subgroups, while mitigating the weight gain observed with use of iGlar alone. Rates of hypoglycaemic events were low overall. These results suggest that treatment with iGlarLixi achieves superior glycaemic control compared to treatment with iGlar or Lixi alone in T2DM patients with HbA1c ≥9% or in those inadequately controlled with two OADs.
Psychosis risk stigma and help‐seeking: Attitudes of Chinese and Taiwanese residing in the United States
Authors: He Emily , Eldeeb Sherief Y. , Cardemil Esteban V. , Yang Lawrence H.
Published: May 2019

Aim

Intervention during the clinical high‐risk phase for psychosis (CHR) can reduce duration of untreated psychosis and associated negative outcomes. Early treatment access and sustained engagement are important to understand for effective intervention. Understanding stigma and help‐seeking processes is particularly important for groups that experience mental healthcare disparities such as those of Chinese heritage living in the United States.

Methods

Chinese and Taiwanese participants (N = 215) residing in the United States were randomly assigned to one of three CHR vignette conditions based on the “what matters most” stigma framework for Chinese groups, which identifies capacities that define “personhood” and thereby shapes stigma for members of a particular cultural group. Participants completed measures of help‐seeking attitudes, family stigma and individual stigma.

Results

More stigma towards the CHR vignette character's family was associated with positive CHR help‐seeking attitudes. Participants who read the vignette describing CHR affecting family obligations, “what matters most” and participants who read the vignette describing CHR symptomology only had more positive CHR help‐seeking attitudes compared to participants who read the vignette describing CHR affecting individual aspirations.

Conclusions

Chinese and Taiwanese residing in the United States may perceive professional mental healthcare to be especially relevant for persons with CHR when symptoms are particularly stigmatizing for the person's family and when symptoms threaten the person's ability to fulfil family obligations (ie, “what matters most”). Clinical implications of findings include the importance of emphasizing positive treatment outcomes that increase an individual's ability to engage in valued life domains.
The risk of recurrent stroke at 24 months in patients with symptomatic carotid near‐occlusion: results from CAOS, a multicentre registry study
Authors: García‐Pastor A. , Gil-Núñez A. , Ramírez‐Moreno J. M. , González‐Nafría N. , Tejada J. , Moniche F. , Portilla‐Cuenca J. C. , Martínez‐Sánchez P. , Fuentes B. , Gamero‐García M. Á. , Alonso de Leciñana M. , Masjuán J. , Cánovas‐Verge D. , Aladro Y. , Parkhutik V. , Lago‐Martín A. , de Arce‐Borda A. M. , Usero‐Ruíz M. , Delgado‐Mederos R. , Pampliega A. , Ximenez‐Carrillo Á. , Bártulos‐Iglesias M. , Castro‐Reyes E. ,   the Stroke Project of the Spanish Cerebrovascular Diseases Study Group
Published: May 2019

Background and purpose

The risk of recurrent stroke amongst patients with symptomatic carotid near‐occlusion (SCNO) has not been clearly established, and its management remains controversial. The aim was to define the 24‐month risk of recurrent stroke and to analyse the effect of the different treatment modalities (medical treatment and revascularization) in a population of patients with SCNO.

Methods

A multicentre, nationwide, prospective study from January 2010 to May 2016 was performed. Patients with angiography‐confirmed SCNO were included. The primary end‐point was ipsilateral ischaemic stroke including periprocedural events within 24 months following the presenting event. Revascularization results and periprocedural complications, ipsilateral transient ischaemic attack, disabling or fatal stroke, and mortality were also noted.

Results

The study population comprised 141 patients from 17 Spanish centres. Seventy patients (49.6%) were treated by revascularization (carotid stenting in 47, endarterectomy in 23). Complete revascularization was achieved in 58 patients (83%). Periprocedural stroke or death occurred in 5.7%. The 24‐month cumulative incidence of the primary end‐point was 11.1% (95% confidence interval 5.8–16.4; n = 15), 12% in the medical treatment group and 10.2% in the revascularization group, log‐rank P = 0.817. The cumulative rates of ipsilateral ischaemic stroke or transient ischaemic attack, disabling or fatal stroke, and mortality, were 17%, 4.5% and 7.5%, respectively.

Conclusions

The rate of ipsilateral ischaemic stroke in patients with SCNO seems to be lower than the known rate associated with severe carotid stenosis without near‐occlusion. The potential benefit of revascularization in the prevention of stroke in patients with SCNO may be influenced by the effectiveness and safety of the procedure.
Practising academic mobilities: Bodies, networks and institutional rhythms
Authors: Hopkins Debbie , Higham James , Orchiston Caroline , Duncan Tara
Published: May 2019

Notions of what a successful academic should be doing – researching, publishing, teaching, serving the academic community – are often dependent upon particular practices of corporeal mobilities. These practices discursively and materially connect historically situated academic mobilities with the “modern,” globalised university system. At the same time, there is increasing attention being paid to the “hypocrisy of hypermobile academics” – often reliant on high‐carbon aeromobilities – in light of the unprecedented and urgent need to decarbonise transport to limit warming to 1.5°C. Using qualitative material gathered from one academic institution in Aotearoa New Zealand, we pay attention to the politics of academic mobilities at multiple scales, from the academic body, to social/family networks, and institutional rhythms. We contribute to the growing body of work that reflects on academic practice, and argue that detailed understandings of these processes are required to overcome the so‐called “climate hypocrisy” of high‐carbon academic work‐related travel.
Making sense of müsadere practice, state confiscation of elite wealth, in the Ottoman Empire, circa 1453–1839
Authors: Arslantaş Yasin
Published: May 2019

This article surveys the historiography of müsadere, that is, state confiscation of elite wealth in the Ottoman Empire (circa 1453–1839) and offers a new approach to understand this practice. The existing literature has focused on its legality, functions, methods of enforcement, or economic consequences. The lack of such comprehensive analysis supported by archival data has led not only to some misconceptions but to a failure to locate it into the larger themes of Ottoman state formation. The article first presents a critical review of the historiography of müsadere, discussing these misconceptions stemming from negligence of three crucial elements of müsadere, that is, time‐specificity, selectivity, and flexibility. Then, it introduces a political economy approach, putting the practice of müsadere into the context of survival strategies of a state with relatively limited capacity. Finally, it connects the political economy approach with the debate on the nature of Ottoman governance. The aim of the article is to help students of Ottoman history to make better sense of one of the most important institutions of Ottoman political economy and the logic of governance and state formation in general.
Evaluation of the effects of different forms of periodontal diseases on quality of life with OHIP‐14 and SF‐36 questionnaires: A cross‐sectional study
Authors: Ustaoğlu Gülbahar , Göller Bulut Duygu , Gümüş Kerem Çağlar , Ankarali Handan
Published: May 2019

Objectives

To investigate the effect of generalized aggressive periodontitis (GAP), generalized chronic periodontitis (GCP) and gingivitis (G) on oral health‐related quality of life (OHRQoL) with Oral Health Impact Profile‐14 (OHIP‐14) and Short Form‐36 (SF‐36) questionnaires.

Methods

One hundred GAP patients, 114 GCP and 109 G patients were included in the study. Age, gender, number of missing teeth, probing depth (PD), bleeding on probing (BOP), plaque index (PI) and clinical attachment level (CAL) of patients were recorded. The Turkish versions of OHIP‐14 and SF‐36 questionnaires were filled before any medication and dental treatment were approved. The one‐way ANOVA test was used to compare three groups.

Results

Generalized aggressive periodontitis and GCP groups were similar to each other (P > 0.05) in most subscales except functional limitation and social disability of the OHIP‐14 questionnaire (P = 0.034 and P = 0.018, respectively); conversely, there was no statistically difference between GAP and G groups in functional limitation and social disability subscales (P = 0.856 and P = 0.242, respectively). GAP group gave higher scores than GCP group in all subscales of SF‐36 (P < 0.05). There was a negative correlation between OHIP‐14 and SF‐36 subscale scores in all groups.

Conclusion

Study findings indicate that different forms of periodontal disease have different effects on quality of life of patients when measured by OHIP‐14 and SF‐36. Patients with GCP and GAP had poorer OHRQoL than G patients.
Structure, properties, and fabrication of calcium aluminate‐based glasses
Authors: Lin Yinan , Smedskjaer Morten M. , Mauro John C.
Published: May 2019

This review focuses on recent advances in the synthesis and characterization of calcium aluminate glasses and the effects of various ion additions/substitutions on the processing and properties of these glasses. Calcium aluminate‐based glasses are of great scientific and technological interest because of their extraordinary combination of broad spectral transparency, refractory nature, high mechanical stiffness and hardness, superior chemical durability, and low cost compared to glasses formed in many other families. Current obstacles for large‐scale manufacturing include high melting temperature and tendency for devitrification, which have so far received relatively little attention in the literature. The problem with devitrification can be partially mitigated through addition of certain oxides (MgO, GeO2, BaO, etc.) without severely impairing the optical transmission for applications as low‐loss optical materials. Suggestions for future research are also discussed, including improved understanding of composition‐structure‐property relationships, possible improvements of CaO‐Al2O3glass fiber fabrication, computational modeling to enable an improved glass‐forming ability, and detailed analysis of thermophysical properties for achieving the optimal composition without compromising performance.
Heat, wheat and CO2: The relevance of timing and the mode of temperature stress on biomass and yield
Authors: Högy Petra , Kottmann Lorenz , Schmid Iris , Fangmeier Andreas
Published: May 2019

Atmospheric CO2 enrichment affects C3 crops both directly via increased carbon gain and improved water use efficiency and indirectly via higher temperatures and more frequent climatic extremes. Here we investigated the response of spring wheat (Triticum aestivum L. cv. Triso) to CO2 enrichment (550 vs. 380 µmol/mol) and heat, applied as a constant +4°C increase or a typical heat wave either before or after anthesis, or as two typical heat waves before and after anthesis. We applied a climate chamber approach closely mimicking ambient conditions. CO2 enrichment increased above‐ground biomass and yield by c. 7 and 10%, but was not able to compensate for adverse heat stress effects, neither before nor after anthesis, with few exceptions only. Yield depression due to heat stress was most severe when two heat waves were applied (−19%). This adverse effect was, however, compensated by CO2 enrichment. Applying heat stress before or after anthesis did not exert different effects on yield for both +4°C warming and heat wave application. However, +4°C depressed yield more than a heat wave at ambient CO2, but not so at elevated CO2. Thus, the interactive effects were complex and prediction of future wheat yield under CO2 enrichment and climate extremes deserves more attention.
Enhancing the salience of free speech rights increases differential perceived free speech protections for criminal acts against Black versus White targets
Authors: Roussos Gina , Dovidio John F.
Published: May 2019

Hate crime charges offer enhanced sentences for prejudice‐motivated acts in recognition of the injury that extends beyond the victim to other members of the targeted group. The present study builds upon and extends previous work illuminating how anti‐Black prejudice influences application of free speech protections to justify criminal acts against Black (vs. White) targets, which subsequently reduces support for hate crime charges for the act by investigating the potential effects of environmental cues that increase the salience of free speech rights. The present work tested the main and interactive effects of act target (Black vs. White), anti‐Black prejudice, and the salience of freedom of speech on perceived free speech protections for a prejudice‐motivated criminal act and the consequent influence on support for hate crime charges. Replicating previous findings, greater anti‐Black prejudice predicted more perceived free speech protections for Black‐targeted acts, which predicted less support for hate crime charges. Low‐bias participants viewed Black‐ versus White‐targeted acts as less protected by free speech rights and more deserving of hate crime charges; high‐bias participants viewed the two acts similarly. Making the right to free speech (compared to protections from search and seizure) salient amplified differential perceptions of free speech protections based on prejudice and target group, which predicted support for hate crime charges. This work holds implications for justification processes and highlights the importance of studying culture‐specific values.
Same clinic, different conceptions: Drug users’ and healthcare professionals’ perceptions of how stigma may affect clinical care
Authors: Salamat Samantha , Hegarty Peter , Patton Robert
Published: May 2019

Stigma experienced by drug users by their healthcare professionals can be a barrier to treatment engagement, which in turn affects mortality and morbidity rates. Attribution theory suggests that stigma will be greatest whenever drug use is attributed to factors within personal control. Here, clients (n = 76) and healthcare professionals (n = 62) identified features that characterize good and bad clinical interactions, and responded to a vignette about a drug user who attributed his use to personal control or situational factors. Healthcare professionals completed the vignette and drug users gave their best guess of how healthcare professionals would react to this vignette. Clients and professionals held overlapping prototypes of clinical interactions. Clients overestimated both how negative healthcare professionals’ reactions would be, and the extent to which healthcare professionals’ reactions would accord with attribution theory. Despite healthcare professionals’ believing they are acting in nonstigmatizing ways, they may engender stigma in clinical situations more than they realize. Discrepancies between professionals’ hypothetical responses and clients’ anticipation of these responses are discussed in terms of the influence of self‐stigma and societal understandings of drug use and control. Attribution theory only offers a limited explanation for these discrepancies, because professionals’ beliefs about drug users are complex. Implications for theories of stigma and engagement with services are discussed, and the importance of clients’ anticipation of stigma is highlighted as a primary target for addressing treatment disengagement. Anti‐stigma campaigns may also benefit from changing their focus from individuals’ attributions to holistically addressing discrepant conceptions of treatment.
Comprehensive examination of the multilevel adverse risk and protective factors for cardiovascular disease among hypertensive African Americans
Authors: Schoenthaler Antoinette , Fei Kezhen , Ramos Michelle A. , Richardson Lynne D. , Ogedegbe Gbenga , Horowitz Carol R.
Published: May 2019

This paper describes the multilevel factors that contribute to hypertension disparities in 2052 hypertensive African Americans (mean age 52.9 ± 9.9 years; 66.3% female) who participated in a clinical trial. At the family level, participants reported average levels of life chaos and high social support. However, at the individual level, participants exhibited several adverse clinical and behavioral factors including poor blood pressure control (45% of population), obesity (61%), medication non‐adherence (48%), smoking (32%), physical inactivity (45%), and poor diet (71%). While participants rated their provider as trustworthy, they reported high levels of discrimination in the health care system. Finally, community‐level data indicate that participants reside in areas characterized by poor socio‐economic and neighborhood conditions (eg, segregation). In the context of our trial, hypertensive African Americans exhibited several adverse risks and protective factors at multiple levels of influence. Future research should evaluate the impact of these factors on cardiovascular outcomes using a longitudinal design.
An estrogen receptor (ER)‐related signature in predicting prognosis of ER‐positive breast cancer following endocrine treatment
Authors: Tang Jianing , Cui Qiuxia , Zhang Dan , Liao Xing , Zhu Jian , Wu Gaosong
Published: May 2019

Quite a few estrogen receptor (ER)‐positive breast cancer patients receiving endocrine therapy are at risk of disease recurrence and death. ER‐related genes are involved in the progression and chemoresistance of breast cancer. In this study, we identified an ER‐related gene signature that can predict the prognosis of ER‐positive breast cancer patient receiving endocrine therapy. We collected RNA expression profiling from Gene Expression Omnibus database. An ER‐related signature was developed to separate patients into high‐risk and low‐risk groups. Patients in the low‐risk group had significantly better survival than those in the high‐risk group. ROC analysis indicated that this signature exhibited good diagnostic efficiency for the 1‐, 3‐ and 5‐year disease‐relapse events. Moreover, multivariate Cox regression analysis demonstrated that the ER‐related signature was an independent risk factor when adjusting for several clinical signatures. The prognostic value of this signature was validated in the validation sets. In addition, a nomogram was built and the calibration plots analysis indicated the good performance of this nomogram. In conclusion, combining with ER status, our results demonstrated that the ER‐related prognostic signature is a promising method for predicting the prognosis of ER‐positive breast cancer patients receiving endocrine therapy.
KLF8 is associated with poor prognosis and regulates glycolysis by targeting GLUT4 in gastric cancer
Authors: Mao Anwei , Zhou Xiang , Liu Yanxia , Ding Junbin , Miao Aiyu , Pan Gaofeng
Published: May 2019

Krüppel‐like transcription factor (KLF) family is involved in tumorigenesis in different types of cancer. However, the importance of KLF family in gastric cancer is unclear. Here, we examined KLF gene expression in five paired liver metastases and primary gastric cancer tissues by RT‐PCR, and immunohistochemistry was used to study KLF8 expression in 206 gastric cancer samples. The impact of KLF8 expression on glycolysis, an altered energy metabolism that characterizes cancer cells, was evaluated. KLF8 showed the highest up‐regulation in liver metastases compared with primary tumours among all KLF members. Higher KLF8 expression associated with larger tumour size (P < 0.001), advanced T stage (P = 0.003) and N stage (P < 0.001). High KLF8 expression implied shorter survival outcome in both TCGA and validation cohort (P < 0.05). Silencing KLF8 expression impaired the glycolysis rate of gastric cancer cells in vitro. Moreover, high KLF8 expression positively associated with SUVmax in patient samples. KLF8 activated the GLUT4 promoter activity in a dose‐dependent manner (P < 0.05). Importantly, KLF8 and GLUT4 showed consistent expression patterns in gastric cancer tissues. These findings suggest that KLF8 modulates glycolysis by targeting GLUT4 and could serve as a novel biomarker for survival and potential therapeutic target in gastric cancer.
Periodontitis is associated with elevated serum levels of cardiac biomarkers—Soluble ST2 and C‐reactive protein
Authors: Torrungruang Kitti , Katudat Dissayawadee , Mahanonda Rangsini , Sritara Piyamitr , Udomsak Artit
Published: May 2019

Aim

This cross‐sectional study examined the associations between periodontitis and the serum cardiac biomarkers—soluble ST2 (sST2) and C‐reactive protein (CRP)—in systemically healthy adults.

Materials and Methods

Periodontitis severity was determined using mean probing depth (PD) or clinical attachment level (CAL) and a categorical variable (no/mild, moderate, or severe). Oral hygiene was evaluated using plaque scores. Regression analyses assessed the associations between periodontal variables and sST2 or CRP levels, adjusting for age, sex, smoking, body mass index, systolic blood pressure, fasting plasma glucose, and high‐density or low‐density lipoprotein cholesterol.

Results

The study population comprised 799 individuals, aged 50–73 years. After multivariable adjustment, greater mean PD/CAL, severe periodontitis, and poor oral hygiene were associated with elevated sST2 and CRP levels (p < 0.05). Greater mean PD or CAL was associated with increased odds of having sST2 in the top quintile (>22.7 μg/L) (odds ratio [OR] [95% confidence interval (CI)]: 1.7 [1.1–2.4] and 1.3 [1.1–1.7], respectively) and CRP > 3 mg/L (OR: 1.5 [1.1–2.1] and 1.3 [1.0–1.5], respectively). Individuals with poor oral hygiene were more likely to have sST2 > 22.7 μg/L (OR: 2.0 [1.0–4.0]) and CRP > 3 mg/L (OR: 2.0 [1.1–3.5]), compared to those with good oral hygiene.

Conclusions

Periodontitis and poor oral hygiene were associated with elevated serum sST2 and CRP levels.