bluuebunny/crossref_metadata_2025 huggingface dataset:
Using the UTAUT, personal innovativeness and perceived financial cost to examine student’s intention to use E-learning
Authors: Twum Kojo Kakra , Ofori Daniel , Keney Gabriel , Korang-Yeboah Bright
Published: August 2021

Purpose

This study aims to examine the factors affecting behavioural intention to use E-learning during the COVID-19 pandemic. The study applies the unified theory of acceptance and use of technology 2 (UTAUT2) to identify the factors that predict intention to use E-learning. Also, the study examines the effect of personal innovativeness in information technology and perceived financial cost on intention to use E-learning.

Design/methodology/approach

The study adopted a cross-sectional quantitative study design involving 617 university students. The data was collected through an online survey due to the COVID-19 restrictions. The proposed hypotheses were analysed using partial least squares structural equation modelling.

Findings

The study found that personal innovativeness in information technology, perceived financial cost, performance expectancy, hedonic motivation and social influence have a significant effect on the intention to use E-learning. Contrary to expectation, habits, effort expectancy and facilitating conditions did not predict intention to use E-learning.

Research limitations/implications

The study was conducted on university students and did not include other school-going students and working professionals. Also, the study sample was not drawn from many universities. The study used a quantitative approach. The use of a mixed-methods approach could provide deeper insights into the factors affecting the intention to use E-learning in developing countries.

Practical implications

The practical implications inform policymakers and educational institutions on how E-learning adoption can be enhanced. In this context, social influence, performance expectancy, hedonic motivation, personal innovativeness and perceived financial cost are identified as predictors of intention to use E-learning. This study has implications for the development of E-learning systems and the promotion of the use of E-learning in the context of developing countries.

Originality/value

The study is amongst the few studies from a developing economy to use the UTAUT2 model to examine students’ intention to use E-learning. The study proposes the inclusion of personal innovativeness in information technology and perceived financial cost as factors predicting intention to use E-learning. Again, the study adopts importance-performance matrix analysis to provide decisional areas where management may improve for successful E-learning acceptance and use.
Deconstructing the ABC’s of leadership for successful curriculum development and implementation in residency education
Authors: Sonnenberg Lyn Kathryn , Do Victor , Maniate Jerry , Chan Ming-Ka , Kvern Brent , Prevost Brittany , Busari Jamiu
Published: August 2021

Purpose

Leadership decisions occur frequently throughout the day, yet as clinicians, who balance multiple roles and responsibilities, the authors seldom label them explicitly. This translates to missed opportunities to foster the requisite skill sets junior trainees to require in their current and future contexts. While there is clear evidence for a purposeful leadership curriculum, developing, implementing and assessing these competencies remains challenging. The purpose of this paper is to provide educators with a curricular approach to incorporate leadership opportunities in their own teaching and supervisory practices.

Design/methodology/approach

A dyadic “teaching and assessment” strategy may overcome leadership curricular challenges. The authors propose a new framework that breaks down leadership opportunities into their requisite learning settings. Like fine wine and cheese, these learning experiences are paired with assessment strategies to provide further formative and summative feedback, all in the context of educational theories and frameworks.

Findings

In this paper, the authors recommend six unique learning environments for educators to consider, captured in the abbreviation ABC’S3 for administrative, bedside, classroom, simulation, self-awareness and summarization, all of which lend themselves to leadership development opportunities for resident physicians. The authors provide tested examples and pair these teaching options with a variety of assessment strategies to choose from.

Practical implications

Three practical implications are put forth in this paper, namely, leadership competencies are needed for everyone, not just for those with leadership titles or positions; multiple learning settings (and all aspects of work) can be harnessed to provide diverse leadership opportunities; and advancement beyond Miller’s knows is needed to create opportunities to hone practical leadership competencies in the shows how and does levels.

Originality/value

This paper uniquely pairs learning opportunities with assessment strategies across diverse practical settings and environments. These techniques and opportunities will serve to stimulate ideas and kick-start dialogue about incorporating a practical leadership curriculum within clinical training programs.
Transformational leadership and non-family employee intrapreneurial behaviour in family-owned firms: the mediating role of adaptive culture and psychological empowerment
Authors: Giang Huynh Thi Thuy , Dung Luu Tien
Published: August 2021

Purpose

The purpose of the present study is to examine the direct impact of transformational leadership on non-family employee intrapreneurial behaviour and through a mediating role of corporate adaptive culture and psychological empowerment in family-owned firms.

Design/methodology/approach

The study’s sample consisted of 368 key role non-family employees at 109 family export and import firms in the Ho Chi Minh City of Vietnam. The data is analysed using a partial least square–structural equation model (PLS-SEM).

Findings

This paper shows that transformational leadership had a positive and significant influence on non-family employee intrapreneurial behaviour directly and via adaptive corporate culture and psychological empowerment as a mediating influence mechanism.

Practical implications

Family-owned firms might balance the need to maintain traditional core values and requires innovation through the development of human capital with non-family employee intrapreneurship.

Originality/value

This paper grants a unique approach to studying intrapreneurial behaviour in the context of the family-owned business.
Inclusive leadership: scale validation and potential consequences
Authors: Al-Atwi Amer Ali , Al-Hassani Kamal Kadhim
Published: August 2021

Purpose

This study aims both to develop and validate a measure for inclusive leadership and to test some its potential consequences by examining the relationship between inclusive leadership and different dimensions of work performance (proficiency, adaptivity, and proactivity) through the mediating role of the perceptions of inclusion.

Design/methodology/approach

We use data generated from an expert panel (n = 20) and two surveys (n = 235;n = 333) to generate items and establish convergent and discriminant validity. Data were gathered from 363 faculty to examine inclusive leadership's consequences.

Findings

The results empirically support Randelet al.’s conceptualization of inclusive leadership and evidence the psychometric properties of the study's scale. The results also empirically support the proposed relationships between inclusive leadership and various work-performance dimensions.

Originality/value

We develop and validate a more comprehensive measure of inclusive leadership and test some of its potential consequences.
Market reactions to the internal control reporting presentation format: combined vs separate audit reports
Authors: Chung Hyeesoo (Sally) , Krishnan Sudha , Lauck John , Wynn Jinyoung
Published: August 2021

Purpose

This paper aims to investigate whether the stock market reacts to presentation options available to auditors under AS 2 (providing separate financial statement audit and internal control over financial reporting [ICOFR] audit reports, or presenting a combined report with both audit opinions).

Design/methodology/approach

Drawing on psychology theory, the authors hypothesize that presenting material weaknesses in ICOFR with an unqualified financial statement audit in a combined report effectively dilutes the weight placed on the material weaknesses perceived by investors. The authors further hypothesize the presentation format effect to vary by type of material weaknesses since some material weaknesses are considered more serious than others. The authors examine ICOFR and audit reporting and cumulative abnormal return data from 2007 to 2017 using two-stage least squares regression analysis.

Findings

The results show that a combined report of ineffective ICOFR and unqualified financial statement audit reduces the negative impact of material weakness disclosures on stock price reactions, but only when the weaknesses involve more serious entity-wide controls, as opposed to controls over specific accounts.

Practical implications

The findings help inform preparers, auditors, regulators and investors about the potentially unintended consequences of reporting format choice.

Originality/value

The findings contribute to the literature on internal control disclosures by demonstrating that market reactions to these disclosures depend not only on the types of material weaknesses disclosed but also on their presentation format.
The influence of family culture on the development of corporate social responsibility (CSR) initiative of immigrant enterprise: a case of Korean business in Vietnam
Authors: Nguyen Hieu Thanh , Hoang Thinh Gia , Nguyen Loan Thi Quynh , Nguyen Giang Tinh Ngo , Nguyen Nga Thi
Published: August 2021

Purpose

This paper aims to explore how family culture can contribute to support the development of corporate social responsibility (CSR) initiatives in a Korean immigrant enterprise in Vietnam.

Design/methodology/approach

This research highlighted a critical case, in which entrepreneurs and most of the organisational members share a common family culture and the culture support management capability of an entrepreneur, during the introduction of a new organisation initiative. In addition, Bourdieu’s tripartite analytical framework of field, capitals and habitus was adopted to facilitate the case analysis.

Findings

Firstly, the motivation behind the development of CSR came from the intention to gain access to the local capital market. Secondly, family culture plays an important role in maintaining the support of organisational actors to support the decision of the entrepreneur.

Research limitations/implications

This research contributes to the emerging literature about CSR and immigrant entrepreneurship. This study sheds light on how family culture can aid the leadership of CSR initiatives and CSR practices in the context of the immigrant organisation.

Practical implications

This study identifies processes that immigrant entrepreneurs can use to inspire organisational members to engage in a new initiative in which organisational culture and norms can help to overcome challenges to enable engagement with a novel initiative.

Originality/value

This paper explains how family culture supports the leading role of an entrepreneur, in which the absolute pressures inherited from family values and traditions in the place of origin help an organisation to overcome existing barriers such as lack of time and financial support towards a new initiative.
“Sustainability-contents SEO”: a semantic algorithm to improve the quality rating of sustainability web contents
Authors: Confetto Maria Giovanna , Covucci Claudia
Published: August 2021

Purpose

For companies that intend to respond to the modern conscious consumers' needs, a great competitive advantage is played on the ability to incorporate sustainability messages in marketing communications. The aim of this paper is to address this important priority in the web context, building a semantic algorithm that allows content managers to evaluate the quality of sustainability web contents for search engines, considering the current semantic web development.

Design/methodology/approach

Following the Design Science (DS) methodological approach, the study develops the algorithm as an artefact capable of solving a practical problem and improving the operation of content managerial process.

Findings

The algorithm considers multiple factors of evaluation, grouped in three parameters: completeness, clarity and consistency. An applicability test of the algorithm was conducted on a sample of web pages of the Google blog on sustainability to highlight the correspondence between the established evaluation factors and those actually used by Google.

Practical implications

Studying content marketing for sustainability communication constitutes a new field of research that offers exciting opportunities. Writing sustainability contents in an effective way is a fundamental step to trigger stakeholder engagement mechanisms online. It could be a positive social engineering technique in the hands of marketers to make web users able to pursue sustainable development in their choices.

Originality/value

This is the first study that creates a theoretical connection between digital content marketing and sustainability communication focussing, especially, on the aspects of search engine optimization (SEO). The algorithm of “Sustainability-contents SEO” is the first operational software tool, with a regulatory nature, that is able to analyse the web contents, detecting the terms of the sustainability language and measuring the compliance to SEO requirements.
Enhancing library performance by exploiting the potentials of disruptive innovations
Authors: Adekoya Clement Ola , Adedimeji Akeem Adedayo
Published: August 2021

Purpose

The purpose of this paper is to investigate enhancement of library performance by exploiting the potentials of disruptive innovations.

Design/methodology/approach

Descriptive survey research design was used for this study. The population of the study was 167 respondents, consisting of 83 professional and 84 para-professional librarians in the libraries of the public higher institutions in Ekiti and Ondo States, Nigeria. Total enumeration sampling technique was used for the study. Data were collected using the questionnaire. Descriptive statistical tools were used for data analysis.

Findings

It was found that disruptive innovation has influence on library operations, the extent of application of disruptive innovation in library operation is low, the extent of using the by-products of disruptive innovation in the libraries is low and the challenges facing the adoption of disruptive innovations in libraries include: high cost of acquiring technological infrastructure, high cost of training library personnel, high costs of internet, inadequate technical know-how and high costs of system maintenance and upgrades.

Practical implications

Libraries should embrace the influence of disruptive innovations in their operations and service delivery.

Originality/value

This study is novel, as it approaches library performance from the perspective of the disruptive innovation. Very few studies emanate from Africa in this area. Most of the previous narratives around disruptive innovation centred around the Western countries such USA, UK, France, Italy, etc., which maintain a lead in library innovation and development. The current study demonstrated that the performance of libraries in Nigeria is not immune from being boosted by disruptive innovations.
Above‐ground net primary productivity in regenerating seasonally dry tropical forest: Contributions of rainfall, forest age and soil
Authors: Becknell Justin M. , Vargas G. German , Pérez‐Aviles Daniel , Medvigy David , Powers Jennifer S.
Published: August 2021

Identifying factors controlling forest productivity is critical to understanding forest‐climate change feedbacks, modelling vegetation dynamics and carbon finance schemes. However, little research has focused on productivity in regenerating tropical forests which are expanding in their fraction of global area have an order of magnitude larger carbon uptake rates relative to older forest.

We examined above‐ground net primary productivity (ANPP) and its components (wood production and litterfall) over 10 years in forest plots that vary in successional age, soil characteristics and species composition using band dendrometers and litterfall traps in regenerating seasonally dry tropical forests in northwestern Costa Rica.

We show that the components of ANPP are differentially driven by age and annual rainfall and that local soil variation is important. Total ANPP was explained by a combination of age, annual rainfall and soil variation. Wood production comprised 35% of ANPP on average across sites and years, and was explained by annual rainfall but not forest age. Conversely, litterfall increased with forest age and soil fertility yet was not affected by annual rainfall. In this region, edaphic variability is highly correlated with plant community composition. Thus, variation in ecosystem processes explained by soil may also be partially explained by species composition.

These results suggest that future changes in annual rainfall can alter the secondary forest carbon sink, but this effect will be buffered by the litterfall flux which varies little among years. In determining the long‐term strength of the secondary forest carbon sink, both rainfall and forest age will be critical variables to track. We also conclude that detailed understanding of local site variation in soils and plant community may be required to accurately predict the impact of changing rainfall on forest carbon uptake.

Synthesis. We show that in seasonally dry tropical forest, annual rainfall has a positive relationship with the growth of above‐ground woody tissues of trees and that droughts lead to significant reductions in above‐ground productivity. These results provide evidence for climate change—carbon cycle feedbacks in the seasonal tropics and highlight the value of longitudinal data on forest regeneration.
The effect of a mobile integrated health program on health care cost and utilization
Authors: Gingold Daniel B. , Liang Yuanyuan , Stryckman Benoit , Marcozzi David
Published: August 2021

Objective

To measure the effect of a mobile integrated health community paramedicine (MIH‐CP) transitional care program on hospital utilization, emergency department visits, and charges.

Data Sources

Retrospective secondary data from the electronic health record and regional health information exchange were used to analyze patients discharged from a large academic medical center and an affiliated community hospital in Baltimore, Maryland, May 2018–October 2019.

Study Design

We performed an observational study comparing patients enrolled in an MIH‐CP program to propensity‐matched controls. Propensity scores were calculated using measures of demographics, clinical characteristics, social determinants of health, and prior health care utilization. The primary outcome is inpatient readmission within 30 days of discharge. Secondary outcomes include excess days in acute care 30 days after discharge and emergency department visits, observation hospitalizations, and total health care charges within 30 and 60 days of discharge.

Data Collection

Included patients were over 18 years old, discharged to home from internal/family medicine services, and live in eligible ZIP codes. The intervention group was enrolled in the MIH‐CP program; controls met inclusion criteria but were not enrolled during the study period.

Principal Findings

The adjusted model showed no difference in 30‐day inpatient readmission between 464 enrolled patients and propensity‐matched controls (adjusted incidence rate ratio = 1.19, 95% confidence interval [CI] [0.89, 1.60]). There was a higher rate of observation hospitalizations within 30 days of index discharge for MIH‐CP patients (adjusted incidence rate ratio = 1.78, 95% CI = [1.01, 3.14]). This difference did not persist at 60 days, and there were no differences in other secondary outcomes.

Conclusions

We found no significant difference in short‐term health care utilization or charges between patients enrolled in an MIH‐CP transitional care program and propensity‐matched controls. This highlights the importance of well‐controlled, robust evaluations of effectiveness in novel care‐delivery systems.
Infra‐cranial radiographic comparison for human identification: A study of analyst expertise
Authors: Hona Te Wai Pounamu T. , Olditch Chelsea , Byrd John E. , Stephan Carl N.
Published: August 2021

Radiographic comparison for identification is widely utilized. However, these methods are qualitative and subject to analyst ability to correctly read and interpret radiographs. With regards to infra‐cranial radiographs, few studies have been conducted to explore the role of practitioner expertize on correct classification rates (CCRs). Here, we undertake two such studies using forensic anthropologists [American Board of Forensic Anthropology (ABFA) certified, practicing but not board‐certified anthropologists, and chest radiograph comparison (CXR) anthropologists trained via the Defense POW/MIA Accounting Agency CXR competency training program] and compare their results to novices. To ensure participants only referred to the same skeletal morphology, we cropped radiographs to single bones. An array of four simulated antemortem radiographs was presented to each assessor with each postmortem radiograph. Assessors evaluated arrays for a correct match, which was always present, yielding a 25% rate for random correct selections. Study 1 used anteroposterior C7, posteroanterior second metacarpal, and lateral calcaneus radiographs (three arrays each for nine arrays total), which yielded 86, 81, 69, and 68% mean CCRs for CXR experts, ABFA anthropologists, non‐ABFA anthropologists and novices, respectively. Study 2 used anteroposterior C7 and left clavicles (three arrays each for six arrays total), yielding mean CCRs of 100, 96, and 84% for CXR experts, ABFA anthropologists and novices, respectively. As reflected by the CCRs, expertise is clearly a factor for radiographic comparisons, evident not just between novices and anthropologists, but also between anthropologists. We recommend all radiographic comparison analysts be subject to competency/proficiency tests prior to their engagement for forensic casework.
Factors associated with dropout from physical function assessment programs among participants receiving maintenance hemodialysis: A retrospective observational cohort study
Authors: Yamaguchi Tomoya , Yabe Hiroki , Mitake Yuya , Fujii Takayuki
Published: August 2021

We aimed to investigate the factors associated with dropout from a physical function assessment program among participants receiving outpatient hemodialysis (HD). The participants were divided into continuation and dropout groups and followed up for 3 years after the initial physical function assessment. Multivariate logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the dropout group to determine the factors associated with dropout from the physical function assessment program. The continuation and dropout groups included 43 and 58 participants, respectively. The continuation group had a significantly higher self‐efficacy (SE) and age than the dropout group (p = 0.001, p = 0.047). Multivariate logistic regression analysis indicated that only SE (OR: 1.202, 95% CI: 1.082–1.334) remained a significant predictor after adjustment (p < 0.05). There is a need to evaluate SE to prevent dropout from physical functioning assessment programs.
Synthesis of aromatic amino acids from 2G lignocellulosic substrates
Authors: Godoy Patricia , García‐Franco Ana , Recio María‐Isabel , Ramos Juan‐Luis , Duque Estrella
Published: August 2021

Pseudomonas putida is a highly solvent‐resistant microorganism and useful chassis for the production of value‐added compounds from lignocellulosic residues, in particular aromatic compounds that are made from phenylalanine. The use of these agricultural residues requires a two‐step treatment to release the components of the polysaccharides of cellulose and hemicellulose as monomeric sugars, the most abundant monomers being glucose and xylose. Pan‐genomic studies have shown that Pseudomonas putida metabolizes glucose through three convergent pathways to yield 6‐phosphogluconate and subsequently metabolizes it through the Entner–Doudoroff pathway, but the strains do not degrade xylose. The valorization of both sugars is critical from the point of view of economic viability of the process. For this reason, a P. putida strain was endowed with the ability to metabolize xylose via the xylose isomerase pathway, by incorporating heterologous catabolic genes that convert this C5 sugar into intermediates of the pentose phosphate cycle. In addition, the open reading frame T1E_2822, encoding glucose dehydrogenase, was knocked‐out to avoid the production of the dead‐end product xylonate. We generated a set of DOT‐T1E‐derived strains that metabolized glucose and xylose simultaneously in culture medium and that reached high cell density with generation times of around 100 min with glucose and around 300 min with xylose. The strains grew in 2G hydrolysates from diluted acid and steam explosion pretreated corn stover and sugarcane straw. During growth, the strains metabolized > 98% of glucose, > 96% xylose and > 85% acetic acid. In 2G hydrolysates P. putida 5PL, a DOT‐T1E derivative strain that carries up to five independent mutations to avoid phenylalanine metabolism, accumulated this amino acid in the medium. We constructed P. putida 5PLΔgcd (xylABE) that produced up to 250 mg l−1 of phenylalanine when grown in 2G pretreated corn stover or sugarcane straw. These results support as a proof of concept the potential of P. putida as a chassis for 2G processes.
The potential of aquatic bloodfeeding and nonbloodfeeding leeches as a tool for iDNA characterisation
Authors: Lynggaard Christina , Oceguera‐Figueroa Alejandro , Kvist Sebastian , Gilbert M. Thomas P. , Bohmann Kristine
Published: August 2021

Leeches play important roles in food webs due to their abundance, diversity and feeding habits. Studies using invertebrate‐derived DNA (iDNA) extracted from leech gut contents to target vertebrate DNA have focused on the Indo‐Pacific region and mainly leveraged the leech family Haemadipsidae, composed of bloodfeeding terrestrial leeches, while predatory, fluid/tissue‐feeding and aquatic bloodfeeding species have been largely disregarded. While there is some general knowledge regarding the taxonomic groups that leeches prefer to feed on, detailed taxonomic resolution is missing and, therefore, their potential use for monitoring animals is unknown. In this study, 116 leeches from 12 species (six families) and spanning the three feeding habits were collected in Mexico and Canada. We used DNA metabarcoding to investigate their diet and assess their potential use for biodiversity monitoring. We detected vertebrates from five orders including fish, turtles and birds in the diet of aquatic bloodfeeding leeches; eight invertebrate orders of annelids, arthropods and molluscs in leeches that feed on body fluids and tissues; and 10 orders of invertebrates belonging to Arthropoda and Annelida, as well as one vertebrate and one parasitic nematode, in predatory leeches. These results show the potential use of iDNA from aquatic bloodfeeding leeches for retrieving vertebrate taxa, and from predatory and fluid‐feeding leeches for invertebrates. Our study provides information about the dietary range of freshwater leeches and one terrestrial leech and contributes proof‐of‐concept for the use of these leeches for animal monitoring, expanding our knowledge of the use of iDNA from leech gut contents to North America.
Hiding in plain sight: risk mitigation by a cryptic carnivore foraging at the urban edge
Authors: Leighton Gabriella R. M. , Bishop Jacqueline M. , Merondun Justin , Winterton Deborah J. , O’Riain M. Justin , Serieys Laurel E. K.
Published: August 2021

As natural habitat is progressively transformed, effective wildlife conservation relies on understanding the phenotypic traits that allow select species to persist outside of protected areas. Through behavioural flexibility such species may trade off abundant resources with risks, both real and perceived. As highly adaptable mesocarnivores, caracals (Caracal caracal) provide an opportunity to examine development of successful foraging strategies in high‐risk developed areas. Here we investigated caracal resource selection of both anthropogenic and environmental factors relative to availability at varying levels of urbanization in and around the city of Cape Town, South Africa, using GPS cluster‐located feeding events (n = 326 prey remains, n = 384 scat). We also examined spatial and temporal risk mitigation strategies by assessing behaviours at feeding clusters. We find that, within home ranges, caracals living in the urban‐dominated region (n = 14; 548 feeding events) select for the urban edge, while caracals in the wildland‐dominated region (n = 3; 162 feeding events) avoid it. Adults selected more strongly for foraging at the urban edge than juveniles and may competitively exclude them from resources. By including back‐traced scat feeding event locations, we were able to improve model resolution. We argue that caracals foraging on the edge of a large metropole mitigate risk of detection by remaining cryptic, prolonging handling time, and maintaining high feeding site fidelity where cover was available. Along with the strong functional response to the urban edge, this strategy suggests that carnivores are being drawn into, and stay longer in, areas with potentially increased prey availability despite higher risk. While behavioural plasticity clearly enables carnivore coexistence with humans in urban ecosystems, it can also be maladaptive if it reduces fitness and leads the population into an ecological trap. We provide mitigative recommendations to promote the conservation of this predator in a spatially isolated and rapidly urbanizing landscape.
From DREAM to REALITI‐A and beyond: Mepolizumab for the treatment of eosinophil‐driven diseases
Authors: Pavord Ian D. , Bel Elisabeth H. , Bourdin Arnaud , Chan Robert , Han Joseph K. , Keene Oliver N. , Liu Mark C. , Martin Neil , Papi Alberto , Roufosse Florence , Steinfeld Jonathan , Wechsler Michael E. , Yancey Steven W.
Published: August 2021

Effective treatment of inflammatory diseases is often challenging owing to their heterogeneous pathophysiology. Understanding of the underlying disease mechanisms is improving and it is now clear that eosinophils play a complex pathophysiological role in a broad range of type 2 inflammatory diseases. Standard of care for these conditions often still includes oral corticosteroids (OCS) and/or cytotoxic immune therapies, which are associated with debilitating side effects. Selective, biological eosinophil‐reducing agents provide treatment options that improve clinical symptoms associated with eosinophilic inflammation and reduce OCS use. Mepolizumab is a humanized monoclonal antibody that binds to and neutralizes interleukin‐5, the major cytokine involved in eosinophil proliferation, activation, and survival. Mepolizumab is approved for the treatment of severe eosinophilic asthma, eosinophilic granulomatosis with polyangiitis and hypereosinophilic syndrome. Additionally, the efficacy of add‐on mepolizumab has been observed in patients with severe chronic rhinosinusitis with nasal polyposis and chronic obstructive pulmonary disease with an eosinophilic phenotype. Here, we review the development, approval, and real‐world effectiveness of mepolizumab for the treatment of patients with severe eosinophilic asthma, from the DREAM to REALITI‐A studies, and describe how knowledge from this journey extended to the use of mepolizumab and other biologics across a broad spectrum of eosinophilic diseases.
Direct platelet adhesion potentiates group 2 innate lymphoid cell functions
Authors: Orimo Keisuke , Tamari Masato , Takeda Tomohiro , Kubo Terufumi , Rückert Beate , Motomura Kenichiro , Sugiyama Hiroki , Yamada Ayako , Saito Kyoko , Arae Ken , Kuriyama Motohiro , Hara Mariko , Soyka Michael B. , Ikutani Masashi , Yamaguchi Sota , Morimoto Noriko , Nakabayashi Kazuhiko , Hata Kenichiro , Matsuda Akio , Akdis Cezmi A. , Sudo Katsuko , Saito Hirohisa , Nakae Susumu , Tamaoki Jun , Tagaya Etsuko , Matsumoto Kenji , Morita Hideaki
Published: August 2021

Background

Platelets are thought to be involved in the pathophysiology of asthma, presumably through direct adhesion to inflammatory cells, including group 2 innate lymphoid cells (ILC2s). Here, we tried to elucidate the effects of platelet adhesion to ILC2s in vitro and in vivo, as well as the mechanisms involved.

Methods

Alternaria‐induced ILC2‐dependent airway inflammation models using wild‐type and c‐mpl−/− mice were evaluated. Both purified CD41+ and CD41−ILC2s were cultured with IL‐2 and IL‐33 to determine in vitro Type 2 (T2) cytokine production and cell proliferation. RNA‐seq data of flow‐cytometry‐sorted CD41+ and CD41−ILC2s were used to isolate ILC2‐specific genes. Flow cytometry was performed to determine the expression of CD41 and adhesion‐related molecules on ILC2s in both mouse and human tissues.

Results

T2 inflammation and T2 cytokine production from ILC2s were significantly reduced in the c‐mpl−/− mice compared to wild‐type mice. Platelet‐adherent ILC2s underwent significant proliferation and showed enhanced T2 cytokine production when exposed to IL‐2 and IL‐33. The functions of ILC2‐specific genes were related to cell development and function. Upstream regulator analysis identified 15 molecules, that are thought to be involved in ILC2 activation. CD41 expression levels were higher in ILC2s from human PBMCs and mouse lung than in those from secondary lymphoid tissues, but they did not correlate with the P‐selectin glycoprotein ligand‐1 or CD24 expression level.

Conclusion

Platelets spontaneously adhere to ILC2s, probably in the peripheral blood and airways, thereby potentiating ILC2s to enhance their responses to IL‐33.
Use of plasma late on cardiopulmonary bypass in patients undergoing left ventricular assist device implantation
Authors: Nelson James A. , Diaz Soto Juan C. , Warner Matthew A. , Stulak John M. , Schulte Phillip J. , Weister Timothy J. , Mauermann William J. , Smith Mark M.
Published: August 2021

Coagulopathy is common during left ventricular assist device (LVAD) implantation, treatment of which can be challenging given the often‐limited ability for the right ventricle to accommodate volume transfusion after device initiation with 20% to 40% of patients developing right ventricular failure (RVF). Transfusion of plasma late on cardiopulmonary bypass (CPB) combined with ultrafiltration may replace clotting factors while reducing volume administration. We compared outcomes in patients undergoing LVAD implantation receiving plasma on CPB and ultrafiltration with traditional transfusion practices. Co‐primary outcomes needed for blood product transfusion in the first 6 and 24 hours after CPB. Secondary outcomes included metrics of morbidity and mortality. 396 patients were analyzed (59 plasma on CPB). Patients receiving plasma on CPB had a greater volume of blood products transfused (3764 vs. 2741 mL first 6 hours; 6059 vs. 4305 mL first 24 hours) in unadjusted analysis. In adjusted analysis, plasma transfusion on CPB with ultrafiltration had no significant effect on the primary outcomes of blood products given in the first 6 hours (estimated effect size 982 [−428, 2392] mL, P = .17) and 24 hours (estimated effect size 1076 [−904, 3057] mL, P = .29). Patients receiving plasma on CPB were more likely on either vasopressors or inotropes at 24 hours after ICU admission (P = .01), however, indices of coagulopathy and RVF were similar between groups. While prospective studies would be necessary to definitively evaluate the clinical utility of this strategy, no signal for benefit was observed suggesting plasma should not be used for this purpose.
Rupture and chemical accumulation in contact lenses with dexamethasone eye drop administration after congenital cataract surgery
Authors: De Lima Sara , Erdal Nejla , Adolfsson Karin , Hakkarainen Minna , Kugelberg Maria
Published: August 2021

Purpose

To investigate whether contact lenses used after surgery for congenital cataracts act as a depot for dexamethasone, which would allow the prescribed amount of drops to be reduced, and to examine whether the preservative benzalkonium chloride accumulates in the contact lens matrix, which would suggest a need for more frequent replacements.

Methods

Contact lenses (n = 10) worn by infants treated with dexamethasone eye drops after congenital cataract surgery were analysed with scanning electron microscopy, UV‐vis,1H‐NMR and LDI‐MS for chemical deposits and for changes on the contact lens surface. Unused lenses (n = 5) and lenses (n = 4) from patients with no eye drop treatment were analysed as reference.

Results

The treated contact lenses displayed ruptured surfaces in comparison with unused and reference lenses. Dexamethasone and BAK were not detected in any of the lenses. A polyethylene oxide component was found in the treated lenses, likely originating from the dexamethasone eye drops or the contact lens solution.

Conclusion

Dexamethasone and BAK do not accumulate in the contact lenses, and a depot effect of any clinical significance is unlikely. Therefore, the number of drops given after surgery should remain the same regardless of whether the child has contact lenses. The ruptured surface may both decrease the child’s comfort and increase the risk of microbial adhesion, and so it is recommended that contact lenses should be replaced once a month throughout the course of anti‐inflammatory eye drop treatment after surgery for congenital cataract.
Liver metabolomic analysis in broiler chicks: Profiling the metabolites after oral administration of l‐citrulline
Authors: Chowdhury Vishwajit S. , Ouchi Yoshimitsu , Haraguchi Shogo , Bungo Takashi
Published: August 2021

Hypothermia is directly linked to metabolism; however, it is still unknown how the overall metabolism is altered by oral administration of hypothermic agent, l‐citrulline (l‐Cit). The present study aimed to determine the characteristics of liver metabolites of chicks orally administered l‐Cit to provide a greater understanding of its metabolism. Capillary electrophoresis–time‐of‐flight mass spectrometry (CE‐TOFMS) and liquid chromatography–time‐of‐flight mass spectrometry (LC‐TOFMS) were conducted on liver samples after oral administration of l‐Cit. A total of 361 liver metabolites were identified. Although a small number of samples were used for each group, a principal component analysis and heatmap patterns confirmed that the composition of metabolites could be segregated from each other. Of the 361 compounds detected in the liver, 41 compounds, including amino acids related to the Cit‐arginine (Arg) cycle, argininosuccinic acid, Arg, ornithine, and Cit, as well as gamma aminobutyric acid, glycine, histidine, and nicotinamide adenine dinucleotide were abundant in l‐Cit‐treated livers. In contrast, 24 compounds containing fatty acids, amino acids, and cyclic adenosine monophosphate were lower in the l‐Cit group. These data imply that the active Cit‐Arg cycle, TCA cycle metabolism, and a low activity in fatty acid metabolism occur in l‐Cit‐treated broiler chicks.
B‐cell lymphoma/leukaemia 11B (BCL11B) expression status helps distinguish early T‐cell precursor acute lymphoblastic leukaemia/lymphoma (ETP‐ALL/LBL) from other subtypes of T‐cell ALL/LBL
Authors: Fang Hong , Wang Wei , El Hussein Siba , Morita Kiyomi , Beird Hannah C. , Mitra Akash , Loghavi Sanam , Lin Pei , Jabbour Elias J. , Khoury Joseph D.
Published: August 2021

B‐cell lymphoma/leukaemia 11B (BCL11B) is an essential transcription factor for T‐cell lineage commitment and maturation. We investigated BCL11B expression by immunohistochemistry in T‐lymphoblastic leukaemia/lymphoma (T‐ALL/LBL) (n = 115). The majority (83%) of early T‐cell precursor T‐ALL/LBL (ETP‐ALL) cases showed negative BCL11B expression, while most (84%) of non‐ETP‐ALL/LBL were positive for BCL11B. A simplified three‐marker [BCL11B, cluster of differentiation 5 (CD5), CD13] immunophenotypic score discriminated reliably between ETP‐ALL and non‐ETP‐ALL/LBL. In ETP‐ALL, patients with positive BCL11B expression had a better overall survival than those with negative BCL11B (P = 0·009). In summary, BCL11B is a valuable marker for T‐ALL/LBL subtyping and serves as a potential prognostic marker in patients with ETP‐ALL.
Longitudinal study of glomerular hyperfiltration and normalization of estimated glomerular filtration in adults with sickle cell disease
Authors: Derebail Vimal K. , Zhou Qingning , Ciccone Emily J. , Cai Jianwen , Ataga Kenneth I.
Published: August 2021

Glomerular hyperfiltration is common in sickle cell disease (SCD) and precedes proteinuria and declining kidney function. We evaluated hyperfiltration in SCD patients and its “normalization.” Routine visit data were collected retrospectively from adult SCD patients in a single centre from 2004 to 2013. Baseline was defined as first available serum creatinine and hyperfiltration as estimated glomerular filtration rates (eGFR) >130 ml/min/1·73 m2 for women and >140 ml/min/1·73 m2 for men. Normalization of hyperfiltration was eGFR reduction to 90–130 ml/min/1·73 m2 for women or 90–140 ml/min/1·73 m2 for men. Among 292 patients, median age was 27 years [interquartile range (IQR):20·0–38·0], and 56·8% had baseline hyperfiltration. Baseline hyperfiltration was inversely associated with age [odds ratio (OR):0·86, 95% confidence interval (CI): 0·82–0·90; P < 0·0001], male sex (OR:0·16, 95% CI: 0·07–0·41; P = 0·0001), haemoglobin (OR:0·76, 95% CI 0·61–0·94; P = 0·01), weight (OR:0·96, 95% CI: 0·93–0·99; P = 0·004), and angiotensin‐converting enzyme inhibitor/angiotensin receptor blocker (ACE‐I/ARB) use (OR:0·08, 95% CI: 0·01–0·75; P = 0·03), and positively with hydroxycarbamide use (OR:2·99, 95% CI: 1·18–7·56; P = 0·02). Of 89 hyperfiltration patients without baseline proteinuria, 10 (11·2%) developed new‐onset proteinuria [median 1·05 years (IQR:0·63–2·09)]. Normalization of hyperfiltration was less likely with higher baseline eGFR [hazard ratio (HR):0·90, 95% CI: 0·86–0·95; P < 0·0001] and more likely in males (HR:6·35, 95% CI:2·71–14·86, <0·0001). Hyperfiltration is common in adult SCD patients, particularly when younger. Decline to normal values is more likely in males, possibly representing kidney function loss rather than improvement in hyperfiltration.
Parsing a plethora of pollen: the role of pollen size and shape in the evolution of Boraginaceae
Authors: Noroozi Maryam , Ghahremaninejad Farrokh , Bogler David , Witherspoon Jocelyn M. , Ryan Gillian L. , Miller James S. , Riahi Mehrshid , Cohen James I.
Published: August 2021

Pollen, the microgametophyte of seed plants, has an important role in plant reproduction and, therefore, evolution. Pollen is variable in, for example, size, shape, aperture number; these features are particularly diverse in some plant taxa and can be diagnostic. In one family, Boraginaceae, the range of pollen diversity suggests the potential utility of this family as a model for integrative studies of pollen development, evolution and molecular biology. In the present study, a comprehensive survey of the diversity and evolution of pollen from 538 species belonging to 72 genera was made using data from the literature and additional scanning electron microscopy examination. Shifts in diversification rates and the evolution of various quantitative characters were detected, and the results revealed remarkable differences in size, shape and number of apertures. The pollen of one subfamily, Boraginoideae, is larger than that in Cynoglossoideae. The diversity of pollen shapes and aperture numbers in one tribe, Lithospermeae, is greater than that in the other tribes. Ancestral pollen for the family was resolved as small, prolate grains that bear three apertures and are iso‐aperturate. Of all the tribes, the greatest number of changes in pollen size and aperture number were observed in Lithospermeae and Boragineae, and the number of apertures was found to be stable throughout all tribes of Cynoglossoideae. In addition, the present study showed that diversification of Boraginaceae cannot be assigned to a single factor, such as pollen size, and the increased rate of diversification for species‐rich groups (e.g. Cynoglossum) is not correlated with pollen size or shape evolution. The palynological data and patterns of character evolution presented in the study provide better resolution of the roles of geographical and ecological factors in the diversity and evolution of pollen grains of Boraginaceae, and provide suggestions for future palynological research across the family.
3‐D tooth movement adjacent to single anterior implants and esthetic outcome. A 14‐ to 20‐year follow‐up study
Authors: Winitsky Nicole , Naimi‐Akbar Aron , Nedelcu Robert , Jemt Torsten , Smedberg Jan–Ivan
Published: August 2021

Objectives

To report three‐dimensional (3‐D) movement of teeth adjacent to single‐implant crowns (SICs) in the anterior maxilla and to relate the findings to patient characteristics and esthetic outcome.

Materials and Methods

3‐D movements of teeth adjacent to anterior maxillary SICs were measured in 30 patients with original SICs in function after 14–20 years. The movements were related to facial type, lower anterior facial height (LAFH), age at crown delivery, sex, the position of the implant, implant occlusion, cause of tooth loss, follow‐up period, orthodontic treatment prior to implant placement, and marginal bone‐level changes. The esthetic outcome and quality were assessed using Visual Analog scale (VAS) and California Dental Association (CDA) index.

Results

3‐D movement of adjacent teeth between 0 and 2.5 mm was observed at follow‐up with incisal and palatal movement being most pronounced. Incisal tooth movement of >1 mm was observed in 30% of the patients and was significantly associated with LAFH ≥70 mm. VAS rating associated poorly between patients and clinicians with scores of >80% in 63% and 20%, respectively. The CDA rating was assessed as satisfactory in 87% of the patients.

Conclusions

Significantly more extensive infraposition was observed in patients with SICs without occlusion, other causes of tooth loss than trauma, implant in lateral incisor and canine position, and a LAFH of ≥70 mm. Although infraposition occurs, patients are highly satisfied with the esthetics of their implants and the esthetic results are valued as higher by patients than dentists.
Eculizumab for antibody‐mediated rejection in heart transplantation: A case‐control study
Authors: Kittleson Michelle M. , Patel Nikhil , Chang David H. , Kransdorf Evan P. , Kobashigawa Jon A. , Patel Jignesh K.
Published: August 2021

Complement inhibition offers a novel treatment approach for antibody‐mediated rejection (AMR). We examined patients with hemodynamic compromise AMR 2010–2020, comparing eight patients supplemented with eculizumab to 10 patients without; administration was at the treating physician's discretion. There were no significant differences between groups though eculizumab patients had a non‐significantly higher inotrope score (208.8 mcg/kg/min vs. 2.6 mcg/kg/min; P = .22), more extracorporeal membrane oxygenation (ECMO) (62.5% vs. 20%; P = .066), and worse 1‐year survival (37.5% vs. 60%; P = .63). The role of eculizumab is uncertain in AMR; multicenter collaborative studies are essential to better define its role.