bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing a collaborative HBIM to integrate tangible and intangible cultural heritage
Authors: Heesom David , Boden Paul , Hatfield Anthony , Rooble Sagal , Andrews Katie , Berwari Hadar
Published: May 2020

Purpose

The purpose of this paper is to report on the development of a collaborative Heritage Building Information Modelling (HBIM) of a 19th-century multi-building industrial site in the UK. The buildings were Grade II listed by Historic England for architectural and structural features. The buildings were also a key element of the industrial heritage and folklore of the surrounding area. As the site was due to undergo major renovation work, this project was initiated to develop a HBIM of the site that encapsulated both tangible and intangible heritage data.

Design/methodology/approach

The design of the research in this study combined multiple research methods. Building on an analysis of secondary data surrounding HBIM, a community of practice was established to shape the development of an HBIM execution plan (HBEP) and underpin the collaborative BIM development. The tangible HBIM geometry was predominantly developed using a scan to BIM methodology, whereas intangible heritage data were undertaken using unstructured interviews and a focus group used to inform the presentation approach of the HBIM data.

Findings

The project produced a collaboratively generated multi-building HBIM. The study identified the need for a dedicated HBEP that varies from prevailing BIM execution plans on construction projects. Tangible geometry of the buildings was modelled to LOD3 of the Historic England guidelines. Notably, the work identified the fluid nature of intangible data and the need to include this in an HBIM to fully support design, construction and operation of the building after renovation. A methodology was implemented to categorise intangible heritage data within a BIM context and an approach to interrogate these data from within existing BIM software tools.

Originality/Value

The paper has presented an approach to the development of HBIM for large sites containing multiple buildings/assets. The framework implemented for an HBEP can be reproduced by future researchers and practitioners wishing to undertake similar projects. The method for identifying and categorising intangible heritage information through the developed level of intangible cultural heritage was presented as new knowledge. The development of HBIM to bring together tangible and intangible data has the potential to provide a model for future work in the field and augment existing BIM data sets used during the asset lifecycle.
Resilience to economic sanctions; case study: hospital equipment cluster of Tehran (HECT)
Authors: Taslimi Mohammad Saeed , Azimi Aryan , Nazari Mohsen
Published: May 2020

Purpose

The purpose of this study is to investigate factors contributing to the development of resilience capacity and capability of industrial clusters in order for them to mitigate, absorb and adapt to the impacts of Iran’s economic sanctions.

Design/methodology/approach

The Hospital Equipment Cluster of Tehran (HECT) was selected as the case study for the research. The data were collected using the library and field research and analyzed using the thematic analysis method.

Findings

The key dimensions of resilience were grouped into socio-cultural, economic, technical-organizational and institutional–infrastructural categories. Based on the “complex adaptive system” theory, each of the abovementioned dimensions were investigated on different levels of analysis, including individual, enterprise, cluster, government and environment. Eventually, recommendations were made by considering required capacities and capabilities of resilience of the hospital equipment sector toward economic sanctions.

Originality/value

The resilience toward economic sanctions, as an extensive disaster, is a considerably new subject and few studies have been performed in the field. This research provides practical solutions for local policy-makers, authorities and enterprise managers.
Dynamic capabilities, innovation and branding capabilities and their impact on competitive advantage and SME's performance in Portugal: the moderating effects of entrepreneurial orientation
Authors: Ferreira Jorge , Coelho Arnaldo
Published: May 2020

Purpose

The purpose of this paper is to understand the impact of dynamic capabilities (DC) (in the view of exploration and exploitation) on competitiveness and performance, considering the mediating role the innovation capability (IC) and branding capabilities (BC)on competitive advantage and firm’s performance and the moderating role of entrepreneurial orientation (EO).

Design/methodology/approach

This investigation proposes a theoretical model tested using structural equation modelling (SEM). Multi-group analysis was performed to understand the moderating role of. A questionnaire survey was developed to explore the relations between DC and innovation variable. For this study, 387 valid questionnaires were collected from a sample of Portugal SME’ firms. A 90-item questionnaire which consists to study the relationships among all the variables.

Findings

The results show that exists a positive direct and indirect influence of DC on competitive advantage and performance variables and mediating impact the IC and BC.

Research limitations/implications

This study has some methodological limitations affecting its potential contributions. As a cross-sectional study that captures one image in time, its ability to identify strict causality between variables is limited. Furthermore, the results are based on log collected from a key respondent, rather than broader actual data. The results are restricted to one country, Portugal. Some variables, such as ICs, may play a different role in other countries. Future research should initially target different countries. Such research could then test the generalizability of the results.

Practical implications

This study has important implications for the managers. It highlights the necessity of firms to develop superior strategic orientation of all their members and to invest in better resources and consequently superior capabilities as a way of achieving high levels of firm performance. Another implication from the study is that the firms should develop their marketing programs by focusing on developing innovativeness.

Originality/value

This study contributes to the understanding of the indirect and direct impact of exploration and exploitation variables, and the mediating role of ICs and BC on the competitive advantage and performance and the moderating effect of EO.
Revisiting the unholy alliance of health-care operations: payor–provider integration of occupational health services
Authors: Peltokorpi Antti , Matinheikki Juri , Lehtinen Jere , Rajala Risto
Published: May 2020

Purpose

To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency problems and tilts the incentives of diverse actors toward more systematic outcomes.

Design/methodology/approach

A two stage multimethod case study of occupational health services. A qualitative stage aimed to understand the reasons, mechanisms, and outcomes of payor–provider integration. A quantitative stage evaluated the performance of the integrated hospital against fee-for-service partner hospitals with a sample of 2,726 patients.

Findings

Payor–provider integration mitigates agency problems on multiple levels of the service system by complementing formal governance mechanisms with informal mechanisms. Compared to partner hospitals, the integrated hospital yielded 9% lower the total costs of occupational injuries achieved primarily by emphasizing conservative care and faster recovery.

Research limitations/implications

Focuses on occupational health services in Finland. Provides initial evidence of the effects of payor–provider integration on the operational performance.

Practical implications

Vertical integration may provide systematic outcomes but requires mindful implementation of multiple mechanisms. Rigorous change management initiative is advised.

Social implications

For patients, the research shows payor–provider integration of health services can be implemented in a manner that it reduces care costs while not compromising care quality and customer satisfaction.

Originality/value

This study provides a rare longitudinal analysis of payor–provider integration in health-care operations management. The study adds to the knowledge of operational performance improvement of health services.
National and international R&D support programmes and technology scouting in European small and medium enterprises
Authors: Radicic Dragana
Published: May 2020

Purpose

This study aims to evaluate the effectiveness of national and international R&D support programmes on firms’ technology scouting, defined as firms’ use of external knowledge sources.

Design/methodology/approach

Drawing on a unique data set on R&D support programmes for small and medium-sized enterprises (SMEs) operating in both manufacturing and service sectors across 28 European countries, this study reports treatment effects estimated by the copula-based endogenous switching model, which takes into account unobserved firm heterogeneity.

Findings

Empirical results indicate that R&D support programmes have heterogeneous effects on technology scouting. In particular, a crowding-out effect arises in the case of informal sources of external knowledge, whereas additional effects are reported for formal, strategic sources.

Practical implications

For informal sources of external knowledge, a random distribution of R&D measures would have a substantially larger effect rather than using current selection criteria.

Originality/value

To the best of the authors’ knowledge, this is the first study to explore the policy effects on technology scouting applying a copula-based endogenous switching model. Most cross-sectional empirical studies use matching estimators, although their main disadvantage is the selection on observables.
High performance stakeholder management: what is needed?
Authors: Remme Joop , de Waal André
Published: May 2020

Purpose

Stakeholder management is often primarily seen as maintaining external relations. However, it also has specific consequences for the internal processes of an organization and the behavior of its people. The authors argue that an organization that is meeting the standards of the high-performance organization (HPO) is able to effectively maintain valuable relationships with its stakeholders. The authors discuss in this paper how high-performance stakeholder management can be achieved and applied to stakeholder relationships.

Design/methodology/approach

Based on a discussion of the stakeholder management and the HPO framework concepts the authors show that good stakeholder management requires strong communication and dialogue within an organization, which in turn requires a strong internal organization, which the HPO framework can offer. This paper is written from the assumption that the two theories reinforce each other in their aims and methodologies. This argument is based on a case study.

Findings

The authors illustrate the argument with the application of both concepts at a case company. The case study makes clear that an organization that develops stakeholder management will be wise to examine its own internal quality and strength, using the HPO framework. If the organization views the information that comes from stakeholder management as very valuable, then internal organizational consequences must follow.

Originality/value

The concepts of stakeholder management and HPO Framework have not been connected before, neither in a theoretical nor a practical way. This offers the opportunity for theorists to further deepen the connection between the two, and practitioners to benefit from strengthening their stakeholder management.
What about “U”? The influence of positive online consumer reviews on the individual's perception of consumption benefits
Authors: Hernandez-Ortega Blanca
Published: May 2020

Purpose

This study examines the influence that the positive valence intensity of online consumer reviews (OCRs) has on the benefits that individuals perceive they have derived from consumption. A distinction is made based on whether the performance obtained during the consumption was high or low, that is, whether the product/service met the objectives set by the consumer.

Design/methodology/approach

The study is a between-subjects experiment with two manipulations: the positive valence intensity of OCRs (highly positive vs neutral-indifferent) and the performance obtained by the consumer (high vs low). The manipulations were measured on 11-point Likert-type scales, the lowest perception being scored at 0 (strongly disagree) and the highest at 10 (strongly agree). A total of 249 useable questionnaires were returned.

Findings

The results demonstrated that the influence of positive OCRs on the consumer's perception of consumption benefits follows concave curvilinear functional forms for low performance (inverted U-shaped) and convex for high performance (U-shaped). Thus, highly positive OCRs not corroborated by performance lead to negative perceptions, whereas neutral-indifferent OCRs verified by performance create positive perceptions.

Originality/value

This study goes beyond the immediate influence of positive OCRs on purchases and argues that their influence remains important for the individual's final perception of the consumption benefits that she/he, in the event, received. In addition, the results of the present study show that OCRs are important reference points from which individuals make social judgments and comparisons during consumption. Finally, this study provides theoretical and empirical support to explain the U-shaped functional forms associated with the influence of OCRs.
Determination of apparent earth pressure diagram for anchored walls in c–φ soil with surcharge
Authors: Alavinezhad Seyyed Pouya , Shahir Hadi
Published: May 2020

Purpose

The purpose of this study is to present a diagram for the lateral earth pressure of c–φ soils exerted on anchored walls in presence of surcharge.

Design/methodology/approach

To this end, two-dimensional plane strain modeling of anchored wall was carried out in Plaxis software. To validate the numerical model, two excavations with different specifications were simulated and the model results were compared with the available results. Subsequently, a parametric analysis was done and based on its results, a diagram was proposed for the lateral earth pressure of c–φ soils including the surcharge effects.

Findings

The proposed diagram without the surcharge and cohesion effects is a trapezoidal with zero value at the ground surface that is linearly approaching the apparent earth pressure of sand according to Terzaghi and Peck (1967) at 0.1H (H: wall height). The surcharge and cohesion effects at the ground level is 4 Ka*q and 0, respectively, and below 0.1H, they are treated as the same way for lateral earth pressure of a retaining wall. It should be emphasized that the apparent pressure diagram for design does not resemble the real distribution of earth pressure against the wall and it is for calculating the values of the anchors loads.

Originality/value

The available diagrams to determine the earth pressure exerted on the anchored walls are related to sandy or clayey soils and do not take the presence of surcharge into account. Thus, the proposed diagram is quite original and different from the previous ones.
Contrasting patterns and drivers of soil bacterial and fungal diversity across a mountain gradient
Authors: Shen Congcong , Gunina Anna , Luo Yu , Wang Jianjun , He Ji‐Zheng , Kuzyakov Yakov , Hemp Andreas , Classen Aimée T. , Ge Yuan
Published: May 2020

Microbial elevational diversity patterns have been extensively studied, but their shaping mechanisms remain to be explored. Here, we examined soil bacterial and fungal diversity and community compositions across a 3.4 km elevational gradient (consists of five elevations) on Mt. Kilimanjaro located in East Africa. Bacteria and fungi had different diversity patterns across this extensive mountain gradient—bacterial diversity had a U shaped pattern while fungal diversity monotonically decreased. Random forest analysis revealed that pH (12.61% importance) was the most important factor affecting bacterial diversity, whereas mean annual temperature (9.84% importance) had the largest impact on fungal diversity, which was consistent with results obtained from mixed‐effects model. Meanwhile, the diversity patterns and drivers of those diversity patterns differ among taxonomic groups (phyla/classes) within bacterial or fungal communities. Taken together, our study demonstrated that bacterial and fungal diversity and community composition responded differently to climate and edaphic properties along an extensive mountain gradient, and suggests that the elevational diversity patterns across microbial groups are determined by distinct environmental variables. These findings enhanced our understanding of the formation and maintenance of microbial diversity along elevation, as well as microbial responses to climate change in montane ecosystems.
Identification of free‐living amoebas and amoeba‐resistant bacteria accumulated in Dreissena polymorpha
Authors: Goñi Pilar , Benito María , LaPlante Daniella , Fernández María T. , Sánchez Elena , Chueca Patricia , Miguel Natividad , Mosteo Rosa , Ormad María P. , Rubio Encarnación
Published: May 2020

To identify the free‐living amoeba (FLA) and amoeba‐resistant bacteria (ARB) accumulated in zebra mussels and in the water in which they are found, mussels were collected at two locations in the Ebro river basin (North East Spain). FLAs and bacteria were isolated from mussel extracts and from natural water. PCR techniques were used to identify the FLAs and endosymbiont bacteria (Legionella, Mycobacterium, Pseudomonas and cyanobacteria), and to detect Giardia and Cryptosporidium. The most frequently found FLAs were Naegleria spp. The presence of Legionella, Mycobacterium and Pseudomonas inside the FLA was demonstrated, and in some cases both Legionella and Pseudomonas were found together. Differences between FLAs and ARB identified inside the mussels and in the water were detected. In addition, Escherichia coli, Clostridium perfringens, Salmonella spp. and Enterococcus spp. were accumulated in mussels in concentrations unconnected with those found in water. The results show the ability of the zebra mussel to act as a reservoir of potentially pathogenic FLAs, which are associated with potentially pathogenic ARB, although the lack of association between microorganisms inside the mussels and in the water suggests that they are not useful for monitoring microbiological contamination at a specific time.
‘To Save a Soul’: Catholic Mission Schools, Apartheid, and the 1953 Bantu Education Act
Authors: Anderson R. Bentley
Published: May 2020

The Bantu Education Act of 1953 was enacted by the government of South Africa to bring about the election promise of apartheid (separateness) among the races. For the Roman Catholic Church in South Africa, the Education Act was a direct attack on its apostolic work in the country as the church was responsible for educating 15 per cent of the black student population by 1953. Regardless of the Catholic contribution to South Africa’s educational system, the church was viewed as a threat — die Roomse gevaar — to its architects of apartheid. Catholic precepts regarding the unity of the human race under “the Fatherhood of God and the Brotherhood of man” and the belief in the equality of all people as children of God challenged the apartheid ideology of racial separateness and differentiation. Eliminating Catholic control of Bantu education would neutralise the Roman threat. Passage of the Education Act left church leaders with two choices: fight or surrender. They chose to fight, launching the “Catholic Bishops’ Campaign for Mission Schools and Seminaries” in 1955. Although overlooked by most scholars, the campaign was an important part of a larger resistance movement that challenged the legitimacy of the apartheid regime in the 1950s.
Identification and characterization of odorant binding proteins in the diamondback moth, Plutella xylostella
Authors: Cai Li‐Jun , Zheng Li‐Shuang , Huang Yu‐Ping , Xu Wei , You Min‐Sheng
Published: May 2020

Odorant binding proteins (OBPs) are a group of soluble proteins functioning as odorant carriers in insect antennae, mouth parts and other chemosensory organs. However, multiple insect OBPs have been detected in other tissues and various functions have been proposed. Therefore, a detailed expression profile including stages, tissues and sexes where OBPs are expressed will assist in building the links to their potential functions, enhancing the functional studies of insect OBPs. Here, we identified 39 putative OBP genes from its genome and transcriptome sequences of diamondback moth (DBM), Plutella xylostella. The expression patterns of identified PxylOBPs were further investigated from eggs, larvae, pupae, virgin adults, mated adults, larval midgut, larval heads, adult antennae, adult heads and adult tarsi. Moreover, P. xylostella larvae and adults with and without host plants for 5 h were utilized to study the interactions between OBP expression and host plants. The results showed that most PxylOBPs were highly expressed in male and female adult antennae. The expression levels of certain PxyOBPs could be regulated by mating activities and feeding host plants. This study advances our knowledge of P. xylostella OBPs, which may help develop new strategies for more environmentally sustainable management of P. xylostella.
Economic benefit of prescribing an adjusted renal dose of dipeptidyl peptidase IV inhibitors in type 2 diabetes patients with chronic kidney disease
Authors: Moon Sun Joon , Cho Young Min
Published: May 2020

主要内容

二肽基肽酶IV抑制剂(DPP‐IVi)可用于2型糖尿病合并慢性肾脏病(T2D CKD)患者的治疗, 可以根据药物药代动力学特性调整或不调整剂量。鉴于DPP‐IVi是一大类药物, 在T2D CKD患者中恰当使用需根据肾功能调整用量的DPP‐IVi(RDA DPP‐IVi), 而不是使用NRDA DPP‐IVi, 将可以节约相当大的成本。

虽然一些研究揭示了T2D CKD患者DPP‐IVi的处方模式, 但这些研究没有从经济影响的角度进行分析, 也没有使用具有全国代表性的数据。作者利用国家数据进行了一项真实的观察性研究, 以评估T2D CKD患者的DPP‐IVi的处方模式, 以分析RDA DPP‐IVi代替NRDA DPP‐IVi的处方的经济影响。
Increased striatal functional connectivity is associated with improved smoking cessation outcomes: A preliminary study
Authors: Wang Chao , Huang Peiyu , Shen Zhujing , Qian Wei , Wang Shuyue , Jiaerken Yeerfan , Luo Xiao , Li Kaicheng , Zeng Qingze , Zhou Cheng , Yang Yihong , Zhang Minming
Published: May 2020

The striatum is the critical area of reward processing and has been repeatedly linked to nicotine addiction. However, it remains unclear whether different smoking cessation outcomes (relapse or not) are associated with different functional connectivity changes of the striatum during smoking cessation treatment. A total of 30 treatment‐seeking smokers were recruited in the study and underwent magnetic resonance imaging (MRI) scans immediately before and after a 12‐week treatment with varenicline. After the 12‐week treatment with varenicline, 14 subjects relapsed to smoking (relapsers), whereas 16 not relapsed (nonrelapsers). Changes in resting‐state functional connectivity (rsFC) across groups and visits were assessed using repeated measures analysis of covariance (ANCOVA). Significant interaction effects were detected: (1) between left nucleus accumbens (NAc) and left orbitofrontal cortex (OFC), insula, inferior frontal gyrus (IFG), and bilateral precuneus; (2) between right NAc and left insula, IFG, and bilateral dorsolateral prefrontal cortex (DLPFC); and (3) between bilateral putamen and left precuneus. Post hoc region‐of‐interest analyses in brain areas showing interaction effects indicated significantly decreased rsFC after treatment compared with before treatment in relapsers but opposite longitudinal changes in nonrelapers. These novel findings suggest that increased striatal rsFC is associated with improved smoking cessation outcomes. These striatal functional circuits may serve as potential therapeutic targets for more efficacious treatment of nicotine addiction.
Spatial proximity and asynchronous refuge sharing networks both explain patterns of tick genetic relatedness among lizards, but in different years
Authors: Wohlfeil Caroline K. , Godfrey Stephanie S. , Leu Stephan T. , Clayton Jessica , Gardner Michael G.
Published: May 2020

A major question for understanding the ecology of parasite infections and diseases in wildlife populations concerns the transmission pathways among hosts. Network models are increasingly used to model the transmission of infections among hosts – however, few studies have integrated host behaviour and genetic relatedness of the parasites transmitted between hosts. In a study of the Australian sleepy lizard Tiliqua rugosa and its three‐host ixodid tick (Bothriocroton hydrosauri), we asked if patterns of genetic relatedness among ticks were best explained by spatial proximity or the host transmission network. Using synchronous GPS locations of over 50 adult lizards at 10 min intervals across the three‐month activity period, over 2 years, we developed two alternative parasite transmission networks. One alternative was based on the spatial proximity of lizards (at the centre of their home ranges), and the other was based on the frequency of asynchronous shared refuge use between pairs of lizards. In each year, adult ticks were removed from lizards and their genotypes were determined at four polymorphic microsatellite loci. Adult ticks collected from the same host were more related to each other than ticks from different hosts. Similarly, adult ticks collected from different lizards had a higher relatedness if those lizards had a shorter path length connecting them on each of the two networks we explored. The predictors of tick relatedness differed between years. In the first year, the asynchronous shared refuges network was the stronger predictor of tick relatedness, whereas in year two, the spatial proximity‐based network was the stronger predictor of tick relatedness. We speculate on how changing environmental conditions might change the relative importance of alternative processes driving the transmission of parasites.
Disentangling the Social Context of Nonmedical Use of Prescription Stimulants in College Students
Authors: Wilens Timothy E. , Martelon MaryKate , Yule Amy , Kaminski Tamar A. , Burke Colin , Schepis Ty S. , McCabe Sean E.
Published: May 2020

Background and Objectives

The aim of this study was to investigate the social context of nonmedical use of prescription stimulants (NMUPS) among college students who endorsed NMUPS with co‐occurring substance use disorders (SUD) compared with those without co‐occurring SUDs.

Methods

Presented here are new analyses based on data previously collected from college students aged 18 to 28 years derived from the Boston metropolitan area who endorsed NMUPS (N = 100) at least once in their lifetime. Differences between those with lifetime history of SUD (N = 46) and without a history of SUD (N = 54) on the Massachusetts General Hospital ADHD Medication Misuse and Diversion Assessment were analyzed using the Student t test, the Pearson χ2 test, and the Wilcoxon rank‐sum test.

Results

College students who endorsed NMUPS with co‐occurring SUD were more likely than those without SUD to have bought or traded stimulants, bought or traded in their car, used at parties with drugs/alcohol, or used intranasally (all P < .05). Intranasal administration was common (38% of all students endorsing NMUPS) and was associated with misuse at a party and simultaneous use with cocaine (P = .04), marijuana (P < .001), and alcohol (P < .001), compared with only oral use.

Discussion and Conclusions

Notable characteristics were identified among individuals who engaged in NMUPS in the type, amount, cost, and ascertainment of stimulants.

Scientific Significance

The concurrence of SUD and/or intranasal administration appear to represent a more severe phenotype of NMUPS that should be considered in the implementation of future prevention and intervention protocols on college campuses. (Am J Addict 2020;29:476–484)
Orlistat attenuates obesity‐induced decline in steroidogenesis and spermatogenesis by up‐regulating steroidogenic genes
Authors: Suleiman Joseph Bagi , Nna Victor Udo , Othman Zaidatul Akmal , Zakaria Zaida , Bakar Ainul Bahiyah Abu , Mohamed Mahaneem
Published: May 2020

Background

Steroidogenesis decline is reported to be one of the mechanisms associated with obesity‐induced male factor subfertility/infertility.

Objectives

We explored the possible preventive/therapeutic effects of orlistat (a medication prescribed for weight loss) on obesity‐induced steroidogenesis and spermatogenesis decline.

Materials and methods

Twenty‐four adult maleSprague Dawleyrats weighing 250‐300 g were randomized into four groups (n = 6/group), namely; normal control, high‐fat diet, high‐fat diet plus orlistat preventive group and high‐fat diet plus orlistat treatment group. Orlistat (10 mg/kg/b.w./d suspended in distilled water) was either concurrently administered with high‐fat diet for 12 weeks (high‐fat diet plus orlistat preventive group) or administered from week 7‐12 post‐ high‐fat diet feeding (high‐fat diet plus orlistat treatment group). Thereafter, serum, testes and epididymis were collected for analyses.

Results

Obesity increased serum leptin and decreased adiponectin levels, decreased serum and intra‐testicular levels of follicle stimulating hormone, luteinising hormone and testosterone, sperm count, motility, viability, normal morphology and epididymal antioxidants, but increased epididymal malondialdehyde level and sperm nDNA fragmentation. Testicular mRNA transcript levels of androgen receptor, luteinizing hormone receptor, steroidogenic acute regulatory protein, cytochrome P450 enzyme (CYP11A1), 3β‐hydroxysteroid dehydrogenase and 17β‐hydroxysteroid dehydrogenase were significantly decreased in the testes of the high‐fat diet group. Further, the levels of steroidogenic acute regulatory protein protein and enzymatic activities of CYP11A1, 3β‐hydroxysteroid dehydrogenase and 17β‐hydroxysteroid dehydrogenase were also significantly decreased in the testes of the high‐fat diet group. Treatment with orlistat significantly decreased leptin and increased adiponectin levels, improved sperm parameters, decreased sperm DNA fragmentation, increased the levels of steroidogenic hormones, proteins and associated genes in high‐fat diet‐induced obese male rats, with the preventive group (high‐fat diet plus orlistat preventive group) having better results relative to the treatment group (high‐fat diet plus orlistat treatment group).

Discussion and Conclusion

Orlistat attenuated impaired spermatogenesis and steroidogenesis decline by up‐regulating steroidogenic genes. This may not be unconnected to its significant effect in lowering serum leptin levels, since the hormone is known to dampen fertility potential. Therefore, orlistat may improve fertility potential in overweight/obese men.
Evaluation of a novel database for quality assurance at a head and neck service in New Zealand: an audit of free flap head and neck reconstruction
Authors: Marinone Lares Silvia G. , Clark Sita , Mathy Jon A. , Chaplin John , McIvor Nick
Published: May 2020

Background

Clinical audit is a critical quality improvement exercise, yet efficient audit tools are lacking. The main objective of this study was to evaluate a recently deployed database in facilitating the process of clinical audit, and the secondary objective was to evaluate the outcomes of free flap reconstruction of the head and neck at our centre.

Methods

A head and neck cancer‐specific database was customized to suit the needs of our head and neck multidisciplinary team. Data has been entered prospectively into this database since March of 2018. An audit of free flap reconstruction of the head and neck over a 12‐month period was performed using the database and analysed as a case study to examine its efficacy as a clinical audit tool. Additionally, the outcomes of free flap reconstruction at our centre were compared to those reported in the international literature.

Results

The database allows flexible and specific queries, analysis and export of data, and can provide immediate results. However, issues with data quality and completeness were identified. In this audit, the overall 30‐day complication rate and 30‐day mortality in patients undergoing free flap reconstruction of the head and neck were 58% and 3%, respectively.

Conclusion

The database is fit for its intended purpose as an audit tool. Outcomes of free flap reconstruction of the head and neck at our centre are comparable to those of institutions overseas.
Evolution and clinical adoption of the Autologs system: An automated analysis for enhanced patient management in MCS
Authors: Brown Michael C. , Ramos Veronica , Voskoboynikov Neil
Published: May 2020

The Medtronic Autologs System allows real‐time clinician review of HeartWare HVAD System logfiles, providing supplemental pump data to aid in patient management. In its first year of availability, Autologs generated a 70% increase in logfile submissions, with 73% of all logfile requests being sent to Autologs. Within a month of its launch, Autologs submissions outnumbered the amount of logfiles submitted for manual review. Following the v1.1 release, there was a 20% increase in logfile submissions, with 77% of all logfile requests being Autologs. With the introduction of v1.2, there was another 35% increase in logfile submissions, with nearly 90% of all logfile requests being Autologs. The widespread adoption and utility of the Autologs System highlights the need for clinician access to real‐time data analysis in the field of Mechanical Circulatory Support.
Big Data Analytics and Other Emerging Technologies: The Impact on the Australian Audit and Assurance Profession
Authors: Kend Michael , Nguyen Lan Anh
Published: May 2020

The aim of this exploratory research study is to obtain the views of relevant stakeholders in relation to the impact big data analytics (BDA), artificial intelligence (AI) and robotics have had in Australia on the audit and assurance services market. Views are also sought on the impact or potential for impact of blockchain technologies. This paper reports findings from interviews and/or focus groups with 20 individuals representing key stakeholders in the market for audit and assurance services in Australia. Via a synthesis of these stakeholder perceptions and a review of the relevant accounting literature, the study finds that, overall, the impact of BDA, robotics and AI on auditing is seen as positive. BDA takes auditors away from manual, intensive tasks, and gives them more time to apply their minds and skills to more critical evaluation‐type work or key audit judgements. Participants also highlighted the need for regulators and standard setters to keep on track with the fast‐paced IT, automation evolution in the auditing field. Finally, and surprisingly given the attention surrounding blockchain technologies, the participants in this study seemed unconvinced of the application of blockchain technologies in auditing practice.
A novel statistical method for modeling covariate effects in bisulfite sequencing derived measures of DNA methylation
Authors: Zhao Kaiqiong , Oualkacha Karim , Lakhal‐Chaieb Lajmi , Labbe Aurélie , Klein Kathleen , Ciampi Antonio , Hudson Marie , Colmegna Inés , Pastinen Tomi , Zhang Tieyuan , Daley Denise , Greenwood Celia M.T.
Published: May 2020

Identifying disease‐associated changes in DNA methylation can help us gain a better understanding of disease etiology. Bisulfite sequencing allows the generation of high‐throughput methylation profiles at single‐base resolution of DNA. However, optimally modeling and analyzing these sparse and discrete sequencing data is still very challenging due to variable read depth, missing data patterns, long‐range correlations, data errors, and confounding from cell type mixtures. We propose a regression‐based hierarchical model that allows covariate effects to vary smoothly along genomic positions and we have built a specialized EM algorithm, which explicitly allows for experimental errors and cell type mixtures, to make inference about smooth covariate effects in the model. Simulations show that the proposed method provides accurate estimates of covariate effects and captures the major underlying methylation patterns with excellent power. We also apply our method to analyze data from rheumatoid arthritis patients and controls. The method has been implemented in R package SOMNiBUS.
Prognostic indices in diffuse large B‐cell lymphoma in the rituximab era: an analysis of the UK National Cancer Research Institute R‐CHOP 14 versus 21 phase 3 trial
Authors: Gleeson Mary , Counsell Nicholas , Cunningham David , Lawrie Anthony , Clifton‐Hadley Laura , Hawkes Eliza , McMillan Andrew , Ardeshna Kirit M. , Burton Cathy , Chadwick Nick , Gambell Joanna , Smith Paul , Mouncey Paul , Pocock Christopher , Radford John , Davies John , Turner Deborah , Kruger Anton , Johnson Peter , Linch David
Published: May 2020

We compared the International Prognostic Index (IPI), Revised (R)‐IPI and age‐adjusted (aa)‐IPI as prognostic indices for patients with diffuse large B‐cell lymphoma (DLBCL) in the UK National Cancer Research Institute (NCRI) R‐CHOP 14 versus 21 trial (N = 1080). The R‐IPI and aa‐IPI showed no marked improvement compared to the IPI for overall and progression‐free survival, in terms of model fit or discrimination. Similar results were observed in exploratory analyses incorporating the Grupo Español de Linfomas/Transplante de Médula Ósea (GELTAMO)‐IPI, where baseline β2‐microglobulin data were available (N = 655). Although our findings support current use of the IPI, a novel prognostic tool to better delineate a high‐risk DLBCL group in the rituximab era is needed.
Ferroptosis at the crossroads of infection, aging and cancer
Authors: Toyokuni Shinya , Yanatori Izumi , Kong Yingyi , Zheng Hao , Motooka Yashiro , Jiang Li
Published: May 2020

Despite significant developments and persistent efforts by scientists, cancer is one of the primary causes of human death worldwide. No form of life on Earth can survive without iron, although some species can live without oxygen. Iron presents a double‐edged sword. Excess iron is a risk for carcinogenesis, while its deficiency causes anemia, leading to oxygen shortage. Every cell is eventually destined to death, either through apoptosis or necrosis. Regulated necrosis is recognized in distinct forms. Ferroptosis is defined as catalytic Fe(II)‐dependent regulated necrosis accompanied by lipid peroxidation. The main observation was necrosis of fibrosarcoma cells through inhibition of cystine/glutamate antiporter with erastin, which reduced intracellular cysteine and, thus, glutathione levels. Our current understanding of ferroptosis is relative abundance of iron (catalytic Fe[II]) in comparison with sulfur (sulfhydryls). Thus, either excess iron or sulfur deficiency causes ferroptosis. Cell proliferation inevitably requires iron for DNA synthesis and energy production. Carcinogenesis is a process toward iron addiction with ferroptosis resistance. Conversely, ferroptosis is associated with aging and neurodegeneration. Ferroptosis of immune cells during infection is advantageous for infectious agents, whereas ferroptosis resistance incubates carcinogenic soil as excess iron. Cancer cells are rich in catalytic Fe(II). Directing established cancer cells to ferroptosis is a novel strategy for discovering cancer therapies. Appropriate iron regulation could be a tactic to reduce and delay carcinogenesis.
New variant (Val597Ile) in transmembrane region of the TSH receptor with human chorionic gonadotropin hypersensitivity in familial gestational hyperthyroidism
Authors: Caron Philippe , Broussaud Stéphanie , Galano‐Frutos Juan José , Sancho Javier , Savagner Frédérique
Published: May 2020

Objectives

Only two mutations at the lysine 183 amino acid in the extracellular N‐terminal domain of human TSH receptor (hTSHR) have been associated with hypersensitivity to hCG and familial gestational hyperthyroidism.

Design

Describe a new variant of the TSHR gene with hCG hypersensitivity found in two women of the same family diagnosed with gestational hyperthyroidism.

Patients

A 38‐year‐old woman was seen during the first trimester of her second pregnancy for thyrotoxicosis with increased fT3 and fT4 concentrations and low TSH levels without anti‐TSH receptor antibody. Thyrotoxicosis improved spontaneously during the 2nd trimester and persisted at the 3rd trimester. Similar clinical symptoms (weight loss, nausea, vomiting) were also reported during the first trimester of her first pregnancy and the first pregnancy of her mother.

Results

DNA sequencing of the hTSHR gene of this woman and her mother identifies a heterozygous variant changing valine to isoleucine residue at codon 597 in the transmembrane domain (TMD) of this receptor. In vitro functional studies of this variant showed increased constitutive activity in regard to the basal level of cAMP and IP3 production and to the low cell‐surface expression, while response to TSH was reduced compared to that of the wild‐type receptor. The Val597Ile variant presented a dose‐dependent increase in cAMP response to hGC and human luteinizing hormone (hLH). Simulation of the protein dynamics showed a high structural impact of the Val597Ile variant on helices 3 (TMH3) and 5 (TMH5) of the transmembrane domain participating to constitutive activity and hCG sensitivity.

Conclusion

We describe a new variant in the transmembrane region of the hTSHR gene with increased constitutive activity and hCG hypersensitivity in familial gestational hyperthyroidism.
Perihematomal brain tissue iron concentration measurement by MRI in patients with intracerebral hemorrhage
Authors: Wei Jialiang , Novakovic Nemanja , Chenevert Thomas L. , Xi Guohua , Keep Richard F. , Pandey Aditya S. , Chaudhary Neeraj
Published: May 2020

Aims

Over the past two decades, animal intracerebral hemorrhage (ICH) model studies have indicated that iron, released after hemoglobin degradation, is neurotoxic. Iron phantom and animal experiments have shown that magnetic resonance imaging (MRI) relaxivity maps correlate with iron concentration. This study expands this into patients.

Methods

Eighteen human subjects with ICH underwent MRI at 3, 14, and 30 days. R2* relaxivity maps were used to calculate perihematomal iron concentrations and T2 imaging to determine hematoma and edema volumes.

Results

Perihematomal iron concentrations were increased at all three time points and decreased with distance from the hematoma. While perihematomal iron concentrations did not vary with hematoma size, the total iron overload (increased iron concentration x volume of affected tissue) did. Total iron overload correlated with edema volume.

Conclusions

These results demonstrate the feasibility of measuring perihematomal iron in ICH patients which may be important for monitoring treatment strategies and assessing efficacy noninvasively.
A mortality analysis of septic shock, vasoplegic shock and cryptic shock classified by the third international consensus definitions (Sepsis‐3)
Authors: Yang Won S. , Kang Hui D. , Jung Sang K. , Lee You J. , Oh Se H. , Kim Youn‐Jung , Sohn Chang H. , Kim Won Y.
Published: May 2020

Introduction

This study aimed to compare the 28‐day mortality of patients with septic shock, defined by Sepsis‐3 criteria and patients with vasoplegic or cryptic shock who are excluded from this new definition.

Objectives

This retrospective observational study was performed using a tertiary emergency department's septic shock registry and investigated the records of patients managed between January 2010 and December 2015. In 2,138 total patients, 1004 (47.0%) had septic shock, 476 (22.2%) had vasoplegic shock and 655 (30.6%) had cryptic shock.

Results

There was significant variation in 28‐day mortality among the three groups: 23.4% for septic shock, 8.8% for vasoplegic shock and 12.2% for cryptic shock (P < .001). In subgroup analysis of cryptic shock or septic shock according to lactate levels (2‐3, 3‐4 and >4 mmol/L), the mortality rate increased as lactate increased (cryptic shock: 9.5%, 14.8% and 18.0%; septic shock: 18.6%, 22.6% and 27.0%, respectively; P < .001). Multivariable analysis revealed odds ratios for mortality of 0.31 (95% CI 0.22‐0.44; P < .001) for vasoplegic shock and 0.46 (95% CI 0.35‐0.61; P < .001) for cryptic shock relative to septic shock. Survival curve analysis showed significant differences among patients with septic shock, vasoplegic shock and cryptic shock (Log rank test: P < .0001).

Conclusion

The new septic shock definition may be useful for identifying high‐risk patients requiring intensive care. However, cryptic shock‐associated mortality increased to 18.0% as serum lactate increased, which suggests that some cryptic shock patients may also require intensive management.
The effect of canagliflozin on amputation risk in the CANVAS program and the CREDENCE trial
Authors: Arnott Clare , Huang Yuli , Neuen Brendon L , Di Tanna Gian Luca , Cannon Christopher P. , Oh Richard , Edwards Robert , Kavalam Mary , Rosenthal Norman , Perkovic Vlado , Jardine Meg J , Mahaffey Kenneth , Neal Bruce
Published: May 2020

Aim

To determine whether there was an explanation as to why the effects of the sodium‐glucose co‐transporter‐2 (SGLT2) inhibitor canagliflozin on amputation risk vary between the CANVAS program and the CREDENCE trial.

Methods

We performed a pooled analysis of patient‐level data from the CANVAS program and the CREDENCE trial. Patient characteristics associated with amputation risk were assessed in univariable and multivariable regression models and compared between studies. Effects of canagliflozin on amputation risk were determined from Cox proportional hazards models and compared between studies, subgroups and for a range of amputation outcomes. Effects over time were explored by cumulative event curves.

Results

In the CANVAS program (n = 10 142; median follow‐up 2.4 years) and CREDENCE trial (n = 4401; median follow‐up 2.5 years), 2.3% and 5.3% of participants, respectively, reported baseline amputation history. Key differences at baseline were the proportions with nephropathy (CREDENCE higher, 100% vs. 17.5%) and cardiovascular disease (CANVAS higher, 66% vs. 50%). There were 133 amputations in CREDENCE (3.0% annual event rate) and 187 amputations in CANVAS (1.8% annual event rate), with prior amputation being the strongest predictor of future amputation in both groups. Effects of canagliflozin on amputation risk were significantly different between trials (Pheterogeneity .02, I2 = 82%), but this was not explained by participant or trial differences. There was no evidence that foot disease management protocols instituted during CREDENCE ameliorated amputation risk.

Conclusions

We identified no explanation for the difference in amputation risk between the CREDENCE trial and the CANVAS program. In the context of null effects of SGLT2 inhibition on amputation in CREDENCE and all other large trials, there is a possibility that the finding in CANVAS was the result of chance.