bluuebunny/crossref_metadata_2025 huggingface dataset:
Do Export Learning Processes Affect Sales Growth in Exporting Activities?
Authors: Assadinia Shahin , Boso Nathaniel , Hultman Magnus , Robson Matthew
Published: June 2019

The understanding of experiential learning through export learning process (XLP), and its outcomes, is limited in the international marketing literature. Using multisource, time-lagged data of exporting firms in the United Kingdom and China, this study finds that XLP is positively associated with marketing strategy adaptation for both U.K. and Chinese exporters. Results suggest contrasting moderating effects of experiential knowledge resources (i.e., psychic dispersion, multinationality, and duration) and strategy adaptation on the relationship between XLP and export sales growth in the two samples. In the U.K. sample, the authors observe a positive moderation effect of psychic dispersion and negative moderation effects of multinationality and duration. For the China sample, they find the exact opposite pattern of moderation effects for the experiential knowledge resources. Marketing strategy adaptation plays a negative moderation role in the China sample but has no such effect in the U.K. sample. The study has implications for theory development on, and the productive management of, processes of learning export management.
Adaptive hybrid control of unbalanced vibrations of a rotor/active magnetic bearing system with coupling misalignment using low cost instrumentation
Authors: Vashisht Rajiv Kumar , Peng Qingjin
Published: June 2019

An adaptive hybrid controller is proposed for reducing the unbalanced vibration response of a flexible rotor/active magnetic bearing system. It is observed that conventional adaptive feedforward controller (AFFC) normally used in the active noise control is very sensitive in performance for changes in rotor spin frequencies. Although frequency updating is a part of its architecture, a small practical variation in the rotor spin frequency can reduce its effectiveness drastically. A smart combination of adaptive notch filter and Goertzel filter is proposed for the frequency estimation. During changes of the rotor spin frequency, fundamental harmonics of the flexible rotor are excited. By using hybrid controllers that combine feedback control and AFFC, the amplitude of these fundamental harmonics is reduced significantly. By applying the multi-harmonic hybrid control, the multiple harmonics generated due to coupling misalignment are compensated efficiently. Fourier transform of the control signal is further used to detect the presence of the coupling misalignment.
Updates in the management of chronic lymphocytic leukemia/small lymphocytic leukemia
Authors: Hanna Kirollos S
Published: June 2019

Chronic lymphocytic leukemia is one of the most common lymphoid malignancies. Often treatment modalities are tailored to individual patients based on age, presence of comorbidities and cytogenetics. The advent of ibrutinib has significantly changed the management of the disease in all patient groups and has had the largest impact on clinical practice to date. Over the last 15 years, a series of trials have established that chemoimmunotherapy improves both progression-free survival and overall survival compared to chemotherapy alone. Despite its proven role, efficacy of ibrutinib has not been well established in young, fit patients and in comparison with standard care and as combination therapy with other agents such as venetoclax. New data have strengthened the role of ibrutinib in the front-line setting and establish its place in therapy. In addition, combination therapies are geared to achieve negative minimal residual disease and allow patients to potentially be off of therapy. The management of this leukemia has extensively changed over the past years, and this review article will aim to highlight key trials that have changed practice and led to guideline updates. It is not unlikely that treatment modalities will continue to improve in light of new data.
Cohort Change in the Prevalence of ADHD Among U.S. Adults: Evidence of a Gender-Specific Historical Period Effect
Authors: London Andrew S. , Landes Scott D.
Published: June 2019

Objective: To document inter- and intra-cohort changes in adult ADHD and examine whether changes vary by gender. Method: We analyze data from the 2007 and 2012 U.S. National Health Interview Survey. Results: The prevalence of ADHD among adults aged 18 to 64 years increased from 3.41% in 2007 to 4.25% in 2012. As expected, patterns of inter- and intra-cohort change varied by gender. At younger ages, inter-cohort gender differences are more distinct due to a spike in prevalence among boys/men born in or after 1980. Consistent with a gender-specific historical period effect, recent intra-cohort increases among women have narrowed the gender gap. Conclusion: The gender gap in the prevalence of ADHD among adults decreased by 31.1% from 2007 to 2012 due to increased prevalence among adult women of all ages. We discuss these results in relation to diagnostic practice, adult health and well-being, data limitations and needs, and directions for future research.
Multiple complications of a 14-year-old hemodialysis catheter
Authors: Mira Filipe Santos , Cabral João Pina , Rodrigues Luís , Oliveira Nuno , Agostinho Gil , Galvão Ana , Alves Rui
Published: June 2019

Introduction:

Vascular access for hemodialysis is a key factor in every patient dependent on this treatment. Maintaining a central venous catheter can be a good choice when all the other options have been exhausted, but unwanted and rare complications may arise from longer catheter dwell time.

Case report:

We describe a case of a 65-year-old woman undergoing hemodialysis treatment since 1986 after a bilateral nephrectomy due to complicated nephrolithiasis. Her last access, two Tesio® tunneled cuffed catheters implanted via the right internal jugular vein functioned correctly for 14 years without complications, and so, was not replaced in the meantime. She was referred to our hospital due to a rupture in a catheter lumen, which was corrected conservatively by creating a more proximal tunnel and excising the affected area. A few weeks later, a new rupture in the same lumen was identified, so the catheter was replaced with angiographic control. The catheter was frail, so upon its removal, the tip fractured and remained in the right ventricle, being swiftly removed by an endovascular snare without complications.

Discussion:

This case reports two rare complications associated with catheter handling and identifies a possible technique for conservative resolution of a lumen rupture.
The Estimated Pacemaker for Great Apes Supports the Hominoid Slowdown Hypothesis
Authors: Mello Beatriz , Schrago Carlos G
Published: June 2019

The recent surge of genomic data has prompted the investigation of substitution rate variation across the genome, as well as among lineages. Evolutionary trees inferred from distinct genomic regions may display branch lengths that differ between loci by simple proportionality constants, indicating that rate variation follows a pacemaker model, which may be attributed to lineage effects. Analyses of genes from diverse biological clades produced contrasting results, supporting either this model or alternative scenarios where multiple pacemakers exist. So far, an evaluation of the pacemaker hypothesis for all great apes has never been carried out. In this work, we tested whether the evolutionary rates of hominids conform to pacemakers, which were inferred accounting for gene tree/species tree discordance. For higher precision, substitution rates in branches were estimated with a calibration-free approach, the relative rate framework. A predominant evolutionary trend in great apes was evidenced by the recovery of a large pacemaker, encompassing most hominid genomic regions. In addition, the majority of genes followed a pace of evolution that was closely related to the strict molecular clock. However, slight rate decreases were recovered in the internal branches leading to humans, corroborating the hominoid slowdown hypothesis. Our findings suggest that in great apes, life history traits were the major drivers of substitution rate variation across the genome.
An assessment model of monitoring risk in deep excavation based on fuzzy theory
Authors: Long Lin , Li Zhida
Published: June 2019

In order to better evaluate the monitoring risk of deep excavation, an assessment model based on fuzzy theory was established by combining the uncertainty and membership degree of evaluation indexes with the fuzziness of experts’ comments. Firstly, considering the risk sources as evaluation indexes, the monitoring risk evaluation system for deep excavation was establish, and the risk evaluation function was constructed. Secondly, the risk assessment model based on fuzzy theory was put forward, analytic hierarchy process was used to determine the weight of evaluation indexes, and expert evaluation weight was introduced to correct the evaluation function. Finally, comprehensive risk grade in deep excavation was obtained and the risk decisions were put forward by calculating the value of modified evaluation function. Through the application of the monitoring risk assessment model in the deep excavation of World Trade Group, the results are in accordance with the engineering practice. The results suggest that the model based on fuzzy theory is efficient for evaluating the monitoring risks and can be used in the application of deep excavation evaluation. Meanwhile, the applicability and accuracy of the assessment model are verified.
Computationally efficient prediction of cycle-to-cycle variations in spark-ignition engines
Authors: Netzer Corinna , Pasternak Michal , Seidel Lars , Ravet Frédéric , Mauss Fabian
Published: June 2019

Cycle-to-cycle variations are important to consider in the development of spark-ignition engines to further increase fuel conversion efficiency. Direct numerical simulation and large eddy simulation can predict the stochastics of flows and therefore cycle-to-cycle variations. However, the computational costs are too high for engineering purposes if detailed chemistry is applied. Detailed chemistry can predict the fuels’ tendency to auto-ignite for different octane ratings as well as locally changing thermodynamic and chemical conditions which is a prerequisite for the analysis of knocking combustion. In this work, the joint use of unsteady Reynolds-averaged Navier–Stokes simulations for the analysis of the average engine cycle and the spark-ignition stochastic reactor model for the analysis of cycle-to-cycle variations is proposed. Thanks to the stochastic approach for the modeling of mixing and heat transfer, the spark-ignition stochastic reactor model can mimic the randomness of turbulent flows that is missing in the Reynolds-averaged Navier–Stokes modeling framework. The capability to predict cycle-to-cycle variations by the spark-ignition stochastic reactor model is extended by imposing two probability density functions. The probability density function for the scalar mixing time constant introduces a variation in the turbulent mixing time that is extracted from the unsteady Reynolds-averaged Navier–Stokes simulations and leads to variations in the overall mixing process. The probability density function for the inflammation time accounts for the delay or advancement of the early flame development. The combination of unsteady Reynolds-averaged Navier–Stokes and spark-ignition stochastic reactor model enables one to predict cycle-to-cycle variations using detailed chemistry in a fraction of computational time needed for a single large eddy simulation cycle.
The Relevance of Patients’ Spiritual Care in the Nigerian Cultural Context: A Health Care Chaplain’s Perspective
Authors: Aja Victoria T.
Published: June 2019

In most Nigerian hospitals, there is no evidence of formally employed health care chaplains. Personal experiences of a health care chaplain serving at a faith-based hospital in Nigeria show that the Nigerian cultural context, as it relates to individuals’ personal spirituality, as well as the abundant research on the associations between spirituality/religiosity and health, precipitate the need for services of health care chaplains in Nigerian hospitals, whether faith-based, non-faith-based, or government hospitals.
Conducting Ethnographic Research in Low Literate, Economically Weak Underserved Spaces: An Introduction to Iconic Legisigns-Guided Interviewing (ILGI)
Authors: Dutta Uttaran
Published: June 2019

This article introduces a methodology, “Iconic Legisigns-Guided Interviewing,” which aims at understanding and addressing communicative, cultural, and contextual gaps at the margins that have historically muted underserved populations. Grounded in the theories of visual and sensory research, this new method aims at overcoming the limitations of technology-dependent video-/photograph-elicitation research in geographically isolated regions and seeks to create an open and enabling dialogic environment for illiterate (and low-literate) politicoeconomically marginalized people. This method was developed with active participation of low-literate community members and iteratively tested in underserved spaces of rural Bengal. In this approach, organically cocreated images, more specifically iconic legisigns, were employed as prompts to make interview processes focused and inclusive and to complement conventional semistructured in-depth interviewing. This local-centric method helps research participants to cocreate knowledge, decide discussion pointers, and come up with respondent-generated questions/probes and also seeks to ensure inclusivity and discursive control of participants over the research.
Study on improving three-dimensional dynamic simulation model and equation of flexible fabric
Authors: Wang Meiliang , Wang Mingjun , Li Xiaobo
Published: June 2019

The use of the traditional fabric simulation model evidently shows that it cannot accurately reflect the material properties of the real fabric. This is against the background that the simulation result is artificial or an imitation, which leads to a low simulation equation. In order to solve such problems from occurring, there is need for a novel model that is designed to enhance the essential properties required for a flexible fabric, the simulation effect of the fabric, and the efficiency of simulation equation solving. Therefore, the improvement study results will offer a meaningful and practical understanding within the field of garment automation design, three-dimensional animation, virtual fitting to mention but a few.
Cone complementarity approach for dynamic analysis of multiple pendulums
Authors: Yu Xinxin , Dmitrochenko Oleg , Matikainen Marko K , Orzechowski Grzegorz , Mikkola Aki
Published: June 2019

The multibody system dynamics approach allows describing equations of motion for a dynamic system in a straightforward manner. This approach can be applied to a wide variety of applications that consist of interconnected components which may be rigid or deformable. Even though there are a number of applications in multibody dynamics, the contact description within multibody dynamics still remains challenging. A user of the multibody approach may face the problem of thousands or millions of contacts between particles and bodies. The objective of this article is to demonstrate a computationally straightforward approach for a planar case with multiple contacts. To this end, this article introduces a planar approach based on the cone complementarity problem and applies it to a practical problem of granular chains.
High expression of junctional adhesion molecule-A is associated with poor survival in patients with epithelial ovarian cancer
Authors: Ivana Boljevic , Emina Malisic , Marijana Milovic-Kovacevic , Irena Jovanic , Zoran Bukumiric , Radmila Jankovic
Published: June 2019

Purpose:

Aberrant expression of different tight junction proteins, including the junctional adhesion molecule-A (JAM-A), has been frequently reported in association with tumor progression of several malignancies. To our knowledge, this is the first study examining the clinical significance of JAM-A gene expression in epithelial ovarian cancer.

Methods:

JAM-A expression levels in 44 epithelial ovarian cancer and 12 benign formalin-fixed paraffin-embedded samples were determined by reverse transcription quantitative polymerase chain reaction. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic and prognostic potential of JAM-A. Associations between JAM-A expression and clinicopathological characteristics of epithelial ovarian cancer were analyzed using Fisher’s exact test. The Kaplan–Meier method and univariate Cox regression analysis were used for the survival analysis. P ⩽ 0.05 was considered statistically significant.

Results:

ROC curve analyses showed that JAM-A gene expression exhibits both diagnostic and prognostic performance in epithelial ovarian cancer (area under the curve (AUC) 0.640, 95% confidence interval (CI) 0.488, 0.792, sensitivity 43.18%, specificity 100% and AUC 0.621, 95% CI 0.427, 0.816, sensitivity 52.63%, specificity 85%, respectively). JAM-A expression was significantly associated with International Federation of Gynecologists and Obstetricians (FIGO) stage ( P =0.049) and the Kaplan–Meier method demonstrated that patients with high expression of JAM-A had significantly worse overall survival compared to patients with low JAM-A expression ( P =0.004). Moreover, univariate Cox regression analysis showed that FIGO stage, peritoneal metastasis, residual tumor and JAM-A expression were significantly associated with reduced overall survival in epithelial ovarian cancer.

Conclusions:

Our results indicate that high levels of JAM-A expression are associated with an advanced clinicopathological feature and may have diagnostic potential; also, it could be a predictor of poor overall survival in patients with epithelial ovarian cancer.
Federal Distributive Politics and the Unequal Distribution of Violence: Argentine Provinces in Comparative Perspective
Authors: González Lucas , Cáceres María Belén
Published: June 2019

Violence is unequally distributed across provinces. In Argentina, the least violent provinces have a murder rate similar to Sweden’s. The most violent ones have a murder rate comparable to South Sudan’s. What explains this unequal distribution of violence? This article claims that political turnover at the provincial level reduces the partisan control over police forces and challenges previous informal pacts, while being in the opposition to the president decreases the likelihood of receiving federal assistance to fight violence. When both conditions are met at the same time, crime is more likely to increase. The study examines these claims using difference-in-difference and regression analysis for panel data of the Argentine provinces between 2002 and 2015 and a case study of the province of Santa Fe (the most violent in the country). In the conclusions, it also explores the comparative implications for the discussion on the unequal distribution of violence in federal democracies.
Chemical Constituents From the Ethyl Acetate Extract of Salvia hydrangea
Authors: Kahnamoei Majid B. , Tabefam Marzieh , Ebrahimi Samad N. , Danton Ombeline , Hamburger Matthias , Farimani Mahdi M.
Published: June 2019

One new triterpenoid, 3β- O-(2-hydroxybenzoyl)-ursolic acid (1), and 11 known compounds, including 5 triterpenoids, 2 steroidal compounds, and 4 phenolic compounds were isolated from the ethyl acetate extract of the aerial parts of Salvia hydrangea. Their structures were elucidated based on the extensive spectroscopic data, including 1-dimensional and 2-dimensional nuclear magnetic resonance spectra, high resolution-electrospray ionization mass spectrometry, and by comparison with literature data. The antiprotozoal activity of compound 1 was evaluated against Trypanosoma brucei rhodesiense, Trypanosoma cruzi, Leishmania donovani, Plasmodium falciparum and showed no activities against all parasite tested.
The effect of task difficulty on decision-making
Authors: Serrano-Guerrero Estrella , Rodríguez-Testal Juan Francisco , Martín-Rodríguez Agustín , Ruiz-Veguilla Miguel
Published: June 2019

The aim was to determine whether there are differences between groups in jumping to conclusions and the number of beads required to make a decision based on task difficulty. An assessment was made of 19 patients with non-affective psychosis, 19 with obsessive–compulsive disorder (OCD), and 19 healthy controls. The Beads Task scale was used in its two versions. Patients with non-affective psychosis jumped to conclusions. There was significant interaction between group and task difficulty. Increased difficulty of the task did not affect the number of beads patients with non-affective psychosis or OCD needed to make their decision. However, healthy controls needed to see more beads before they could make a decision in the hard test than in the easy one. Patients with non-affective psychosis jump to conclusions, but neither this group nor the OCD patients benefit from the changes in task difficulty when making their decisions.
Differences in emotions and cognitions experienced in contamination aversion
Authors: Rouel Melissa , Stevenson Richard J. , Milne-Home Josephine , Smith Evelyn
Published: June 2019

A current model of contamination aversion suggests that it has distinct affective and cognitive components that interact to respond to threats. The affective component involves disgust and responds preferentially to direct contaminants (e.g., feces). The cognitive component involves obsessive beliefs and responds preferentially to indirect contaminants (e.g., money). This study examined characteristics of the two components by comparing emotional and cognitive responses to different contaminants. In total, 47 participants completed behavioral avoidance tasks with direct, indirect, and harmful contaminants. Participants rated their disgust, fear of contamination, and threat estimation while in contact with each contaminant. The contaminants produced different emotional and cognitive responses, suggesting the differential involvement of affective and cognitive factors depending on the type of threat. Additionally, it was found that disgust did not habituate over time in contact with contaminants, whereas fear of contamination and threat estimation appeared to decline. Clinical and theoretical implications are discussed.
Self-concept certainty in adaptive and maladaptive perfectionists
Authors: Lo Alice , Abbott Maree J.
Published: June 2019

The present study examined the content of self-related beliefs (i.e., the self-concept) and the level of certainty associated with these beliefs (i.e., self-concept certainty) across adaptive and maladaptive dimensions of perfectionism. A sample of 103 university students (26 adaptive perfectionists, 28 maladaptive perfectionists, and 49 non-perfectionists) completed a series of questionnaires and a reaction-timed computer task assessing their self-concept content and level of self-concept certainty. Results revealed significant differences in the content of self-beliefs about personality attributes between perfectionist groups, such that those classified as adaptive perfectionists held more positive beliefs and less negative-related beliefs about their personality attributes when compared to maladaptive perfectionists. Results regarding self-concept certainty were less clear, with adaptive perfectionists being most certain in general on self-report measures, but more certain for positive personality attributes only when compared to maladaptive perfectionists on a reaction-timed decision-making task. Findings from the present study are discussed in terms of the way that self-concept certainty may differ across adaptive and maladaptive subtypes of perfectionists.
Cardiovascular health literacy and patient–physician communication intervention in women from disadvantaged communities
Authors: Greenberg Keren L , Leiter Elisheva , Donchin Milka , Agbaria Nisreen , Karjawally Mayada , Zwas Donna R
Published: June 2019

Background

For many women in low socioeconomic status communities, limited health literacy is an obstacle to following medical guidance and engaging in health-promoting behaviours. Low health literacy skills are also associated with an increased risk of cardiovascular disease.

Design

A health literacy intervention was designed through focus groups with women in low socioeconomic status communities. The primary health literacy issue identified was communication challenges at doctors’ visits. A unique intervention tailored to the participants’ preferences was designed consisting of three workshops conducted in community women’s groups in low socioeconomic status Jerusalem communities. The intervention aimed to increase patient–physician communication skills through doctor visit preparation and better visit management, improve perceived efficacy in patient–physician interaction and expand cardiovascular disease knowledge.

Methods

Questionnaires were completed before and 3 months after the intervention, assessing knowledge of cardiovascular disease risk factors and symptoms, self-report of behaviours in preparations for a doctor’s visit, and perceived efficacy in patient–physician interaction.

Results

A total of 407 women from low socioeconomic status communities completed questionnaires. Post-intervention, the percentage of women that reported preparing for doctors’ visits increased significantly. Women with initially low levels of perceived efficacy in patient–physician interaction showed a significant increase in perceived efficacy, while initially higher perceived efficacy in patient–physician interaction participants showed a decrease. Participants also demonstrated an increase in knowledge of several risk factors for cardiovascular disease and heart attack symptoms.

Conclusions

A community-based cardiovascular health literacy intervention improved cardiovascular knowledge and reported doctor visit preparation in low socioeconomic status women as well as increased perceived efficacy in patient–physician interaction among participants with low baseline perceived efficacy in patient–physician interaction. This may lead to improved health care utilisation, preventing chronic illness. Registered at ClinicalTrials.gov, https://www.clinicaltrials.gov , registration number: NCT03203018
Modeling a cocreative process: The contributions of design and management
Authors: Dampérat Maud , Jeannot Florence , Jongmans Eline , Jolibert Alain
Published: June 2019

This research focuses on the understanding of a team creative process (or co-creative process) by adding design and management inputs to the marketing approach. It proposes and empirically tests a co-creative process based on the three stages of the design thinking method: (1) need definition, (2) idea generation, and (3) solution prototyping. This model also includes the influence of individual variables –empathy, domain-relevant familiarity, and task involvement –at different stages of the co-creative process. The results validate the mediating role of idea generation between need definition and solution prototyping and the influence of the selected individual variables. The predictive validity of the co-creative process has been tested via the evaluation of the solution by experts. Several actions are proposed at each stage of the co-creative process to enable organizations to stimulate the creativity of their new product development teams.
Digital identity: Contemporary challenges for data protection, privacy and non-discrimination rights
Authors: Beduschi Ana
Published: June 2019

The World Bank estimates that over one billion people currently lack official identity documents. To tackle this crucial issue, the United Nations included the aim to provide legal identity for all by 2030 among the Sustainable Development Goals. Technology can be a powerful tool to reach this target. In the digital age, new technologies increasingly mediate identity verification and identification of individuals. Currently, State-led and public–private initiatives use technology to provide official identification, to control and secure external borders, and to distribute humanitarian aid to populations in need. All of these initiatives have profound implications for the protection of human rights of those affected by them. Digital identity technologies may render individuals without legal documentation more visible and therefore less vulnerable to abuse and exploitation. However, they also present risks for the protection of individuals' human rights. As they build on personal data for identification and identity verification, data protection and privacy rights are most clearly affected. The prohibition of discrimination in the digital space is also of concern as these technological advances' societal impact is not yet fully understood. Accordingly, the article argues that emerging digital identity platforms will only contribute to the protection of human rights if the providers adequately mitigate any risks of potential discrimination and promote high standards of privacy and data protection.
Changing Attitudes toward Homosexuality in Ghana: The Power of Attributional Discourse
Authors: Gyasi-Gyamerah Angela A. , Amissah Christopher M. , Danquah Samuel A.
Published: June 2019

It is overwhelmingly documented that attitudes toward homosexuals in Africa are largely negative, yet there is little exploration on interventional measures for change. This study therefore examined the effectiveness of using attributional discourse to change attitudes toward homosexuals in Ghana. In a pretest–posttest between-group design, 143 university students were randomly assigned into four experimental conditions (i.e., biological, choice, biological transgender, and choice transgender) with informative vignettes serving as the intervention. Posttest evaluation results showed a significant reduction in participants’ negative attitudes toward homosexuals across all four treatment conditions. There were no significant between-group differences and no significant gender differences in attitudinal change after controlling for pretest evaluation. The findings suggest the need to encourage healthy attributional discourse over the rationality in homosexual decisions and behaviors. Particularly, educating the public on the probable reasons behind homosexuality can potentially reduce negative attitudes toward homosexuals and impact legislative policies in Ghana.
Health Information Literacy and Barriers of Online Health Information Seeking Among Digital Immigrants in Rural China: A Preliminary Survey
Authors: Fuzhi Wang , Dan Luo , Weiwei Sun , Tingting Yan , Dehua Hu , Wei Pan , Aijing Luo
Published: June 2019

To evaluate the health information literacy (HIL) level and influencing factors among digital immigrants in rural China and to investigate their obstacles of online health information seeking. Cross-sectional study. Digital immigrants aged 45 to 65 in rural China. Self-assessment questionnaires and a semi-structured interview were developed to measure HIL among 1,132 participants. Nonparametric tests and multiple linear regression were employed to explain the influencing factors. The HIL level of digital immigrants is low. Age, education level, and experience of Internet use impacted their HIL. Digital immigrants primarily accessed the Internet via mobile terminals, but their poor information skills, their lack of HIL education, and the low readability of online health information are major barriers of online health information seeking. Although respondents recognized the positive effects of health-related information on health promotion, their abilities to seek, evaluate, and apply health information were weak. The government should incorporate HIL into the national health literacy promotion program and strengthen legislative supervision of online health information.
Online Banking and Customer Satisfaction: Evidence from India
Authors: Banu A. Meharaj , Mohamed N. Shaik , Parayitam Satyanarayana
Published: June 2019

On the basis of technology acceptance model (TAM) and decomposed theory of planned behaviour (DTPB), the present study is aimed at studying customer satisfaction in online banking in India. Data collected from 750 respondents from both public and private sector banks were used to test the mediated model using the hierarchical regression. The results supported that perceived usefulness acted as a partial mediator in the relationship between various independent variables, such as awareness of online banking services, security, knowledge of Internet, self-efficacy, intention to adopt, trust, easy to use, and dependent variable, that is, customer satisfaction. Implications for research and practising managers are discussed.
Taking a Holistic Exploration of the Project Life Cycle in Public–Private Partnerships
Authors: Alexander James , Ackermann Fran , Love Peter E. D.
Published: June 2019

Operations and projects are typically treated as dichotomous concepts; projects create assets to be operated. The segregation of operations from projects is evidenced in the generic project life cycle (concept, feasibility, design, execute, and close) in which consideration of an operations stage is omitted. This article, however, suggests that this omission renders the generic project life cycle (PLC) unsuitable as a frame of reference for managing (and researching) long-term public infrastructure projects, in particular those delivered under the auspices of private participation in infrastructure initiatives such as public–private partnerships (PPPs). Drawing on the normative literature and the authors’ phenomenological research that is embedded in practice, this article demonstrates that operations are an inherent feature of PPP projects. Thus, the generic PLC model is inconsistent with the actuality of PPPs. Implications of this inconsistency for operations management and research of PPPs, particularly in relation to quality, risk, and human resource management are identified and discussed.
Long-term safety of single-agent ibrutinib in patients with chronic lymphocytic leukemia in 3 pivotal studies
Authors: Coutre Steven E. , Byrd John C. , Hillmen Peter , Barrientos Jacqueline C. , Barr Paul M. , Devereux Stephen , Robak Tadeusz , Kipps Thomas J. , Schuh Anna , Moreno Carol , Furman Richard R. , Burger Jan A. , O’Dwyer Michael , Ghia Paolo , Valentino Rudolph , Chang Stephen , Dean James P. , James Danelle F. , O’Brien Susan M.
Published: June 2019

Ibrutinib, a first-in-class once-daily oral Bruton tyrosine kinase inhibitor indicated for chronic lymphocytic leukemia (CLL), is continued until progressive disease or unacceptable toxicity. We conducted an integrated safety analysis of single-agent ibrutinib from randomized phase 3 studies PCYC-1112 (RESONATE, n = 195) and PCYC-1115/1116 (RESONATE-2, n = 135), and examined longer-term safety separately in the phase 1b/2 PCYC-1102/1103 study (n = 94, 420 mg/d). In the integrated analysis (ibrutinib treatment up to 43 months), the most common adverse events (AEs) were primarily grade 1/2; diarrhea (n = 173, 52% any-grade; n = 15, 5% grade 3) and fatigue (n = 119, 36% any-grade; n = 10, 3% grade 3). The most common grade 3/4 AEs were neutropenia (n = 60, 18%) and pneumonia (n = 38, 12%). Over time, prevalence of AEs of interest (diarrhea, fatigue, grade ≥3 infection, bleeding, and neutropenia) trended down; prevalence of hypertension increased, but incidence decreased after year 1. AEs led to dose reductions in 42 (13%) patients and permanent discontinuations in 37 (11%); dose modifications due to AEs were most common during year 1 and decreased in frequency thereafter. The most common AEs (preferred term) contributing to discontinuation included pneumonia (n = 4), anemia (n = 3), and atrial fibrillation (n = 3). With long-term follow-up on PCYC-1102/1103 (ibrutinib treatment up to 67 months), grade 3/4 AEs were generally similar to those in the integrated analysis. Overall, AEs were primarily grade 1/2 and manageable during prolonged ibrutinib treatment in patients with CLL. These trials were registered at www.clinicaltrials.gov as #NCT01578707, #NCT01722487, #NCT01724346, #NCT01105247, and #NCT01109069.
Absence of complement component 3 does not prevent classical pathway–mediated hemolysis
Authors: Zhang Lingjun , Dai Yang , Huang Ping , Saunders Thomas L. , Fox David A. , Xu Jijun , Lin Feng
Published: June 2019

Complement component 3 (C3) is emerging as a potential therapeutic target. We studied complement-mediated hemolysis using normal and C3-depleted human sera, wild-type (WT) and C3-deficient rat sera, and WT and C3 knockout rat models. In all of the in vitro and in vivo experiments, we found that the loss of C3 did not prevent classical pathway–mediated hemolysis, but it did almost abolish alternative pathway–mediated hemolysis. Experiments using preassembled classical pathway C3 convertases confirmed that C4b2a directly activated complement component 5 (C5), leading to membrane attack complex formation and hemolysis. Our results suggest that targeting C3 should effectively inhibit hemolysis and tissue damage mediated by the alternative pathway of complement activation, but this approach might have limited efficacy in treating classical pathway–mediated pathological conditions.
Radiomic measures from chest high-resolution computed tomography associated with lung function in sarcoidosis
Authors: Ryan Sarah M. , Fingerlin Tasha E. , Mroz Margaret , Barkes Briana , Hamzeh Nabeel , Maier Lisa A. , Carlson Nichole E.
Published: June 2019

Introduction

Pulmonary sarcoidosis is a rare heterogeneous lung disease of unknown aetiology, with limited treatment options. Phenotyping relies on clinical testing including visual scoring of chest radiographs. Objective radiomic measures from high-resolution computed tomography (HRCT) may provide additional information to assess disease status. As the first radiomics analysis in sarcoidosis, we investigate the potential of radiomic measures as biomarkers for sarcoidosis, by assessing 1) differences in HRCT between sarcoidosis subjects and healthy controls, 2) associations between radiomic measures and spirometry, and 3) trends between Scadding stages.

Methods

Radiomic features were computed on HRCT in three anatomical planes. Linear regression compared global radiomic features between sarcoidosis subjects (n=73) and healthy controls (n=78), and identified associations with spirometry. Spatial differences in associations across the lung were investigated using functional data analysis. A subanalysis compared radiomic features between Scadding stages.

Results

Global radiomic measures differed significantly between sarcoidosis subjects and controls (p<0.001 for skewness, kurtosis, fractal dimension and Geary'sC), with differences in spatial radiomics most apparent in superior and lateral regions. In sarcoidosis subjects, there were significant associations between radiomic measures and spirometry, with a large association found between Geary'sCand forced vital capacity (FVC) (p=0.008). Global radiomic measures differed significantly between Scadding stages (p<0.032), albeit nonlinearly, with stage IV having more extreme radiomic values. Radiomics explained 71.1% of the variability in FVC compared with 51.4% by Scadding staging alone.

Conclusions

Radiomic HRCT measures objectively differentiate disease abnormalities, associate with lung function and identify trends in Scadding stage, showing promise as quantitative biomarkers for pulmonary sarcoidosis.
Impact of the revised haemodynamic definition on the diagnosis of pulmonary hypertension in patients with systemic sclerosis
Authors: Jaafar Sara , Visovatti Scott , Young Amber , Huang Suiyuan , Cronin Paul , Vummidi Dharshan , McLaughlin Vallerie , Khanna Dinesh
Published: June 2019

Introduction

Pulmonary arterial hypertension (PAH) is one of the leading causes of mortality in systemic sclerosis (SSc). We explored the impact of the updated haemodynamic definition of pulmonary hypertension (PH), as proposed by the 6th World Symposium on Pulmonary Hypertension.

Methods

In this single-centre retrospective analysis, patients with SSc who had right heart catheterisation (RHC) were included. We compared the prior PH definition to the updated PH definition. The prior definition classified PH as mean pulmonary arterial pressure (mPAP) ≥25 mmHg and further divided into pre-capillary PH (PAH and PH due to lung disease and/or hypoxia), post-capillary PH, and combined pre- and post-capillary PH groups. For the updated definition, PH was classified as mPAP >20 mmHg and further divided into the different groups. We validated our findings in the DETECT cohort.

Results

Between 2005 and March 2019, 268 RHCs were performed in this single-centre cohort. Using the prior definition, 137 (51%) were diagnosed with PH, with 89 classified as pre-capillary PH (56 with PAH and 33 with PH due to lung disease and/or hypoxia), 29 as post-capillary PH, and 19 as combined pre- and post-capillary PH. When the updated definition was applied to the cohort, seven out of 131 (5%) with no PH were reclassified to pre-capillary PH (PAH (n=1), PH due to lung disease (n=3) and post-capillary PH (n=3)). In those with mPAP 21–24 mmHg, with no left heart or significant lung disease, one out of 28 (4%) in our cohort and four out of 36 (11%) in the DETECT cohort were reclassified as PAH.

Conclusion

The updated PH definition does not appear to have a significant impact on the diagnosis of PH in two different screening cohorts.
Fibrocyte accumulation in the airway walls of COPD patients
Authors: Dupin Isabelle , Thumerel Matthieu , Maurat Elise , Coste Florence , Eyraud Edmée , Begueret Hugues , Trian Thomas , Montaudon Michel , Marthan Roger , Girodet Pierre-Olivier , Berger Patrick
Published: June 2019

The remodelling mechanism and cellular players causing persistent airflow limitation in COPD remain largely elusive. We have recently demonstrated that circulating fibrocytes, a rare population of fibroblast-like cells produced by the bone marrow stroma, are increased in COPD patients during an exacerbation. We aimed to quantify fibrocyte densityin situin bronchial specimens from both control subjects and COPD patients, to define associations with relevant clinical, functional and computed tomography (CT) parameters, and to investigate the effect of the epithelial microenvironment on fibrocyte survivalin vitro(“Fibrochir” study).

A total of 17 COPD patients and 25 control subjects, all requiring thoracic surgery, were recruited. Using co-immunostaining and image analysis, we identified CD45+FSP1+cells as tissue fibrocytes, and quantified their density in distal and proximal bronchial specimens. Fibrocytes, cultured from the blood samples of six COPD patients, were exposed to primary bronchial epithelial cell secretions from control subjects or COPD patients.

We demonstrate that fibrocytes are increased in both distal and proximal tissue specimens of COPD patients. The density of fibrocytes is negatively correlated with lung function parameters and positively correlated with bronchial wall thickness as assessed by CT scan. A high density of distal bronchial fibrocytes predicts the presence of COPD with a sensitivity of 83% and a specificity of 70%. Exposure of fibrocytes to COPD epithelial cell supernatant favours cell survival.

Our results thus demonstrate an increased density of fibrocytes within the bronchi of COPD patients, which may be promoted by epithelial-derived survival-mediating factors.
Memorials
Authors: Dunn Virginia ,   The Family of Brian Sabin, Bakamjian Ted
Published: June 2019

David Brian Sabin (1957–2018)
Recession, recovery and suicide in mental health patients in England: time trend analysis
Authors: Ibrahim Saied , Hunt Isabelle M. , Rahman Mohammad S. , Shaw Jenny , Appleby Louis , Kapur Nav
Published: June 2019

Background

The 2008 economic recession was associated with an increase in suicide internationally. Studies have focused on the impact in the general population with little consideration of the effect on people with a mental illness.

Aims

To investigate suicide trends related to the recession in mental health patients in England.

Method

Using regression models, we studied suicide trends in mental health patients in England before, during and after the recession and examined the demographic and clinical characteristics of the patients. We used data from the National Confidential Inquiry into Suicide and Safety in Mental Health, a national data-set of all suicide deaths in the UK that includes detailed clinical information on those seen by services in the last 12 months before death.

Results

Between 2000 and 2016, there were 21 224 suicide deaths by patients aged 16 or over. For male patients, following a steady fall of 0.5% per quarter before the recession (quarterly percent change (QPC) 2000–2009 –0.46%, 95% CI –0.66 to –0.27), suicide rates showed an upward trend during the recession (QPC 2009–2011 2.37%, 95% CI –0.22 to 5.04). Recession-related rises in suicide were found in men aged 45–54 years, those who were unemployed or had a diagnosis of substance dependence/misuse. Between 2012 and 2016 there was a decrease in suicide in male patients despite an increasing number of patients treated. No significant recession-related trends were found in women.

Conclusions

Recession-associated increases in suicide were seen in male mental health patients as well as the male general population, with those in mid-life at particular risk. Support and targeted interventions for patients with financial difficulties may help reduce the risk at times of economic hardship. Factors such as drug and alcohol misuse also need to be considered. Recent decreases in suicide may be related to an improved economic context or better mental healthcare.

Declaration of interest

N.K. is supported by Greater Manchester Mental Health NHS Foundation Trust. L.A. chairs the National Suicide Prevention Strategy Advisory Group at the Department of Health (of which N.K. is also a member) and is a non-executive Director for the Care Quality Commission. N.K. chairs the National Institute for Health and Care Excellence (NICE) depression in adults guideline and was a topic expert member for the NICE suicide prevention guideline.
Addiction care in crisis: evidence should drive progressive policy and practice
Authors: Bhui Kamaldeep S. , Byrne Peter , Goslar Diane , Sinclair Julia
Published: June 2019

Addictions are challenging health and social problems that need to be addressed to preserve and promote good mental health and ensure that individuals within society lead healthy and productive lives. Tackling addictions is complex and requires communities, public health, specialist services, and local and national government to act in unison and implement evidence-based interventions. This editorial raises systemic issues that need attention and proposes a range of systemic options.