bluuebunny/crossref_metadata_2025 huggingface dataset:
Cortical and thalamic connectivity of temporal visual cortical areas 20a and 20b of the domestic ferret (Mustela putorius furo).
Authors: Dell Leigh-Anne , Innocenti Giorgio M , Hilgetag Claus C , Manger Paul R
Published: December 2018

The present study describes the ipsilateral and contralateral cortico-cortical and cortico-thalamic connectivity of the temporal visual areas 20a and 20b in the ferret using standard anatomical tract-tracing methods. The two temporal visual areas are strongly interconnected, but area 20a is primarily connected to the occipital visual areas, whereas area 20b maintains more widespread connections with the occipital, parietal and suprasylvian visual areas and the secondary auditory cortex. The callosal connectivity, although homotopic, consists mainly of very weak anterograde labelling which was more widespread in area 20a than area 20b. Although areas 20a and 20b are well connected with the visual dorsal thalamus, the injection into area 20a resulted in more anterograde label, whereas more retrograde label was observed in the visual thalamus following the injection into area 20b. Most interestingly, comparisons to previous connectional studies of cat areas 20a and 20b reveal a common pattern of connectivity of the temporal visual cortex in carnivores, where the posterior parietal cortex and the central temporal region (PMLS) provide network points required for dorsal and ventral stream interaction enroute to integration in the prefrontal cortex. This pattern of network connectivity is not dissimilar to that observed in primates, which highlights the ferret as a useful animal model to understand visual sensory integration between the dorsal and ventral streams. This data will contribute to the Ferretome (www.ferretome.org) to facilitate cross species analysis of brain connectomes and wiring principles of the brain.
Identification of three sequence motifs in the transcription termination factor Sen1 that mediate direct interactions with Nrd1
Authors: Zhang Yinglu , Chun Yujin , Buratowski Stephen , Tong Liang
Published: December 2018

The Nrd1-Nab3-Sen1 (NNS) complex carries out the transcription termination of noncoding RNAs (ncRNAs) in yeast, although the detailed interactions among its subunits remain obscure. Here we have identified three sequence motifs in Sen1 that mediate direct interactions with the RNA polymerase II CTD interaction domain (CID) of Nrd1, determined the crystal structures of these Nrd1 interaction motifs (NIMs) bound to the CID, and characterized the interactionsin vitroand in yeast.
Consensus interpretation of the Met34Thr and Val37Ile variants in GJB2 by the ClinGen Hearing Loss Expert Panel
Authors: Shen Jun , Oza Andrea M. , del Castillo Ignacio , Duzkale Hatice , Matsunaga Tatsuo , Pandya Arti , Kang Hyunseok P. , Mar-Heyming Rebecca , Guha Saurav , Moyer Krista , Lo Christine , Kenna Margaret , Alexander John , Zhang Yan , Hirsch Yoel , Luo Minjie , Cao Ye , Choy Kwong Wai , Cheng Yen-Fu , Avraham Karen B. , Hu Xinhua , Garrido Gema , Moreno-Pelayo Miguel A. , Greinwald John , Zhang Kejian , Zeng Yukun , Brownstein Zippora , Basel-Vanagaite Lina , Davidov Bella , Frydman Moshe , Weiden Tzvi , Nagan Narasimhan , Willis Alecia , Hemphill Sarah E. , Grant Andrew R. , Siegert Rebecca K. , DiStefano Marina T. , Amr Sami S. , Rehm Heidi L. , Tayoun Ahmad N. Abou ,   on behalf of the ClinGen Hearing Loss Working Group
Published: December 2018

PURPOSE

Pathogenic variants in GJB2 are the most common cause of autosomal recessive sensorineural hearing loss. The classification of c.101T>C/p.Met34Thr and c.109G>A/p.Val37Ile in GJB2 are controversial. Therefore, an expert consensus is required for the interpretation of these two variants.

METHODS

The ClinGen Hearing Loss Expert Panel (HL-EP) collected published data and shared unpublished information from participating laboratories regarding the two variants. Functional, computational, allelic, and segregation data were also obtained.

RESULTS

The panel reviewed the synthesized information, and classified the Met34Thr and Val37Ile variants according to professional variant interpretation guidelines. We found that Met34Thr and Val37Ile are significantly overrepresented in hearing loss patients, compared to the general population. Met34Thr or Val37Ile homozygotes or compound heterozygotes typically manifest mild to moderate hearing loss. Several other types of evidence also support pathogenic roles for those two variants.

CONCLUSION

Resolving controversies in variant classification requires coordinated effort among a panel of international multi-institutional experts to share data, standardize classification rules, review evidence, and reach a consensus. The ClinGen HL-EP concluded that Met34Thr and Val37Ile variants in GJB2 are pathogenic for autosomal recessive nonsyndromic hearing loss with variable expressivity and age-dependent penetrance.
Investigation of the spatial heterogeneity of soil microbial biomass carbon and nitrogen under long-term fertilizations in fluvo-aquic soil
Authors: Hong-ling YE
Published: December 2018

Soils are heterogeneous and microbial spatial distribution can clearly indicate the spatial characteristics of the soil carbon and nitrogen cycle. However, it is not clear how long-term fertilization affects the spatial distribution of microbial biomass in fluvo-aquic soil. We collected fluvo-aquic soil samples (topsoil 0-7.5 cm and sub-topsoil 7.5-20 cm) using a spatially-explicit design within three 40.5 m2plots in each of four fertilization treatments. Fertilization treatments were: cropping without fertilizer inputs (CK); chemical nitrogen, phosphorus, and potassium fertilizer (NPK); chemical fertilizer with straw return (NPKS); and chemical fertilizer with animal manure (NPKM). Variables included soil microbial biomass carbon (MBC) and nitrogen (MBN), and MBC/MBN. For both soil layers, we hypothesized that: microbial biomass was lowest in CK but with the largest spatial heterogeneity; and microbial biomass was highest in NPKM and NPKS but with the lowest spatial heterogeneity. Results showed that: (1) Fertilization significantly increased MBC and MBN more in topsoil than sub-topsoil but had no MBC/MBN changes. (2) The coefficient of variation (CV) and Cochran’s C showed that variation was largest in CK in topsoil and NPK in sub-topsoil and that variation of topsoil was generally lower than in sub-topsoil. The sample size of the three variables was largest in CK in topsoil but had little variation among the other treatments. (3) The trend-surface model showed that within-plot heterogeneity varied substantially with fertilization (NPKM = NPK > NPKS > CK), but Moran’s I and the interpolation map showed that spatial variability with fertilization followed the order NPK > NPKS > CK = NPKM at a fine scale in topsoil. In sub-topsoil, the trend-surface model showed that within-plot heterogeneity followed the order NPKM = CK > NPK > NPKS and that the fine-scale pattern was NPKM>NPK=NPKS>CK. MBC had the highest spatial heterogeneity among the three variables in both soil layers. Our results indicate that the application of organic fertilizer (straw or manure) reduced the variation of MBC and MBN but increased the spatial variability of MBC and MBN. The spatial variation of the three variables was MBC > MBN > MBC/MBN regardless of whether variation was considered at the plot-scale or the fine-scale in both layers.
Plant behaviour: A mathematical approach for understanding intra-plant communication
Authors: tedone fabio , Del Dottore Emanuela , Mazzolai Barbara , Marcati Pierangelo
Published: December 2018

Plants are far from being passive organisms being able to exhibit complex behaviours in
response to environmental stimuli. How these stimuli are combined, triggered and
managed is still an open and complex issue in biology. Mathematical models have helped
in understanding some of the pieces in the complexity of intra-plant communication, but
a larger and brighter view, setting together multiple key processes, is still missing. This
paper proposes a fully coupled system of nonlinear, non-autonomous, discontinuous,
ordinary differential equations to describe with accuracy the adapting behaviour and
growth of a single plant, by deeply analysing the main stimuli affecting plant behaviour.
The proposed model was developed, and here sustained, with the knowledge at the state
of the art; and validated with a comparison among numerical results and a wide number
of biological data collected from the literature, demonstrating its robustness and
reliability. From the proposed analysis it is also shown an emerging self-optimisation of
internal resources and feedback stimuli, without the need for defining an optimisation
function for the wellness of the plant. The model is ultimately able to highlight the
stimulus-signal of the intra-communication in plant, and it can be expanded and
adopted as useful tool at the crossroads of disciplines as mathematics, robotics, biology,
for instance for validation of biological hypothesis, translation of biological principles
into control strategies or resolution of combinatorial problems.
Synthesis, crystal structure, DFT calculations and Hirshfeld surface analysis of 2-(1-decyl-2-oxoindolin-3-ylidene)propanedinitrile
Authors: Rayni Ibtissam , El Bakri Youness , Lai Chin-Hung , El Ghayati L'houssaine , Essassi El Mokhtar , Mague Joel T.
Published: December 2018

In the title molecule, C21H25N3O, the 1-decyl substituents are in an extended conformation and intercalate in the crystal packing to form hydrophobic bands. The packing is further organized by π–π-stacking interactions between pyrrole and phenyl rings [centroid–centroid distance = 3.6178 (11) Å] and a C=O...π(pyrrole) interaction [3.447 (2) Å]. Hirshfeld surface analysis indicates that the H...N/N...H interactions make the highest contribution (17.4%) to the crystal packing.
Ca2Te3O8, a new phase in the CaO–TeO2system
Authors: Weil Matthias
Published: December 2018

Single crystals of dicalcium octaoxidotritellurate(IV), Ca2Te3O8, were obtained from a CsCl/NaCl melt with CaO and TeO2as educts in the molar ratio of 1:2. Ca2Te3O8crystallizes isotypically with Pb3Te2O8and is comprised of two unique Ca, four Te and eight O sites. One calcium cation has eight and the other nine coordination partners. Both coordination polyhedra are considerably distorted. Two kinds of oxotellurate(IV) anions with the same formula [Te3O8]4−are present. One is an infinite zigzag chain anion consisting of pairs of [TeO4] bisphenoids linked to a trigonal–pyramidal [TeO3] group with a connectivity of [(TeO1/1O2/2)(TeO2/1O2/2)2]n, while the other is a finite anion made up of one central [TeO4] bisphenoid linked to two [TeO3] trigonal pyramids and has a connectivity of [(TeO2/1O1/2)2(TeO2/2O2/1)]. In the crystal, the anions are organized in layers extending parallel to (100). Adjacent layers are held together by the calcium cations to define a three-dimensional framework structure.
Determinants of banks’ profitability in Angola
Authors: Garcia Maria Teresa Medeiros , Trindade Maria José
Published: December 2018

Purpose

The purpose of this paper is to analyze the factors that influence the profitability of 17 banks in Angola between 2010 and 2016, as low profitability weakens the ability and willingness of banks to finance the wider economy.

Design/methodology/approach

The paper conducts panel data analysis, using two measures of profitability: the return on average assets and the return on average equity. Several control variables were included concerning both bank-specific and macroeconomic characteristics which have not been considered in previous studies.

Findings

The authors conclude that several independent variables have an impact which is different from expected, especially regarding ownership, which shows positive statistically significant effect on banks’ profitability.

Originality/value

To the best of the authors’ knowledge, this is the first attempt to examine determinants of banks’ profitability in Angola, both internal and external, which have not been considered in previous studies.
Regional crises and corruption: the eclipse of the quality of working life in Nigeria
Authors: Adisa Toyin Ajibade , Gbadamosi Gbolahan
Published: December 2018

Purpose

In recent years, there has been a rapid decline in the quality of working life (QWL) of Nigerian workers at all levels. This phenomenon is cryptic and knowledge thereof is inadequate due to a dearth of compelling research on QWL in Nigeria. The purpose of this paper is to a deeper understanding of QWL among Nigerian workers by investigating the impact of corruption and regional crises on QWL in this non-western context. The study also examines what QWL means to Nigerian employees.

Design/methodology/approach

The study employs qualitative data gleaned from semi-structured interviews.

Findings

The research reveals that corruption has a strongly negative effect on employees’ QWL, which in turn affects their motivation, attitude towards their job and the psychological contract between them and their employers. Furthermore, the findings revealed that regional crises (such as the heinous activities of the Boko Haram sect in the north–east, the continuing agitation of the secessionists (e.g. the Indigenous People of Biafra), in the south–east, and the tumultuous activities of the Niger Delta Avengers in the south–south) have combined to reduce employees’ QWL.

Research limitations/implications

The extent to which the findings of this research can be generalised is constrained by the selected sample of the research (public sector employees).

Originality/value

These results and the practical implications thereof will be useful to the Nigerian Government, policymakers and organisations for creating and enhancing good QWL in Nigeria.
Traveler loyalty and its antecedents in the hotel industry
Authors: Han Heesup , Kiatkawsin Kiattipoom , Kim Wansoo
Published: December 2018

Purpose

The purpose of this paper is to examine the intricate associations among the performance of ambient atmospherics, emotional experiences, overall image and guest satisfaction and test the influence of these relationships on loyalty intentions by considering the moderating impact of continuance commitment in the upscale hotel context.

Design/methodology/approach

A field survey was conducted to collect the data. A quantitative approach was used for data analysis. Structural equation modeling and a test for metric invariance were used to identify the impact of study variables.

Findings

The results of this paper indicated that the hypothesized relationships were in general significant, that the proposed theoretical framework satisfactorily predicted guests’ intentions to be loyal and that the role of satisfaction among study constructs was prominent. Findings from the test for metric invariance also showed that continuance commitment significantly affected the associations among emotional experiences, satisfaction and loyalty intentions. Moreover, emotional experiences, overall hotel image and guest satisfaction were found to play a significant mediating role in generating loyalty intentions.

Practical implications

The findings of this paper inform hotel practitioners of the clear role of atmospherics, emotional experiences, image, satisfaction and continuous commitment in building loyalty. In addition, these findings can help hotel practitioners and researchers invent thorough and strategic methods for loyalty enhancement.

Originality/value

The existing hotel literature has provided a limited view regarding the impact of these research variables. The present paper filled this research gap through the successfully development of a robust framework for hotel guest loyalty.
Coercive management behaviour causes scale: validation and reliability
Authors: Doe Frederick , Puplampu Bill Buenar
Published: December 2018

Purpose

The purpose of this study is to provide a link that will close the gap in the field in respect of the methods used to measure the causes of coercive management behaviour (CMB) in universities and analogous institutions. Second, cultural and geographical differences and absence of studies of the phenomenon in the African university context have instigated researchers’ decision to design new scales to identify and measure the causes of CMB in the workplace.

Design/methodology/approach

A total of 371 respondents were surveyed in a cross-sectional survey using a developed scale which had 20 items. The study adopted the latent variable approach to scale development.

Findings

Following an exploratory factor analysis done, five factors were extracted for the measurement of causes of CMB. A Cronbach alpha for all five factors to measure causes of CMB revealed validity for the administrative, social, organisational, cultural and governance elements. The research therefore surmised that the instrument developed to measure causes of CMB proposed is valid.

Research limitations/implications

The study provides a vital bridge in the gap between the occurrence of CMB and the identification and measurement of its causes in universities thus contributing to knowledge.

Practical implications

As a nation that is heavily imbued with culture, there is need to push for modifications in culture at the national level and within the African setting so as to ensure curtailment or total eradication of CMB for the future.

Originality/value

The study brings to research attention hitherto unmarked causes of CMB by providing a validated instrument that can be used to measure causes of the phenomenon.
Psychological identification with job: a leadership-OCB mediator
Authors: Dartey-Baah Kwasi , Addo Seth Ayisi
Published: December 2018

Purpose

This study aims to examine influence of transformational and transactional leadership styles on employees’ organisational citizenship behaviours (OCBs), as well as the mediating role of job involvement in the Ghanaian hospitality industry.

Design/methodology/approach

Data were gathered from 258 employees in some selected hotels and restaurants in the Greater Accra Region of Ghana through a survey and analysed using covariance-based structural equation modelling.

Findings

The results indicated that both leadership styles influenced employees’ OCBs positively. Furthermore, job involvement positively influenced OCB and mediated between transformational leadership and OCB but not between transactional leadership and employees’ OCBs.

Practical implications

The study reaffirms the importance of employees’ OCBs and recommends that hotels and restaurants must encourage their supervisors to exhibit more transformational leadership behaviours (motivational, inspirational and visionary behaviours), as well as a combination of transformational and transactional leadership behaviours which can influence their employees to go beyond formal requirements, and get more involved in their jobs to the benefit of the organisations.

Originality/value

This study reveals the extent to which internal motivations of employees, specifically their job involvement, causes their extra-role behaviours and influences the leaders–OCB relationships from a developing country perspective.
A typology of market-seeking investments: Swedish firms in China
Authors: Jansson Hans , Söderman Sten
Published: December 2018

Purpose

Regarding globalization trends, it is essential for multinational corporations (MNCs) to operate in China if they are to succeed in the international business environment. It is therefore vital to study how those MNCs investing in China have fared. The purpose of this paper is to devise a robust conceptual framework for the evolvement of market-seeking investments in emerging markets.

Design/methodology/approach

The typology is based on a network approach to internationalization processes, where a case study is made of Swedish MNCs’ experience of the Chinese market.

Findings

The case study contributes to the mostly static foreign direct investment (FDI) theory as well as the entry mode approach, both of which have paid little attention to the FDI carried out by MNCs in emerging markets 5–15 years after initial entry.

Originality/value

The case study also contributes to the mostly static FDI theory as well as the entry mode approach, both of which have paid little attention to the various types of FDI carried out by MNCs in emerging markets 5–15 years after initial entry.
Analyzing street crimes in Kobe city using PRISM
Authors: Kagawa Takuhiro , Saiki Sachio , Nakamura Masahide
Published: December 2018

Purpose

In a previous research, the authors proposed a security information service, called Personalized Real-time Information with Security Map (PRISM), which personalizes the incident information based on living area of individual users. The purpose of this paper is to extend PRISM to conduct sophisticated analysis of street crimes. The extended features enable to look back on past incident information and perform statistical analysis.

Design/methodology/approach

To analyze street crimes around living area in more detail, the authors add three new features to PRISM: showing a past heat map, showing a heat map focused on specified type of incidents and showing statistics of incidents for every type. Using these features, the authors visualize the dynamic transition of street crimes in a specific area and the whole region within Kobe city. They also compare different districts by statistics of street crimes.

Findings

Dynamical visualization clarifies when, where and what kind of incident occurs frequently. Most incidents occurred along three train lines in Kobe city. Wild boars are only witnessed in a certain region. Statistics shows that the characteristics of street crimes is completely different depending on living area.

Originality/value

Previously, many studies have been conducted to clarify factors relevant to street crimes. However, these previous studies mainly focus on interesting regions as a whole, but do not consider individual’s living area. In this paper, the authors analyze street crimes according to users’ living area using personalized security information service PRISM.
A gradual approach for maximising user conversion without compromising experience with high visual intensity website elements
Authors: Jankowski Jarosław , Hamari Juho , Wątróbski Jarosław
Published: December 2018

Purpose

The purpose of this paper is to develop and test a method that can gradually find a sweet spot between user experience and visual intensity of website elements to maximise user conversion with minimal adverse effect.

Design/methodology/approach

In the first phase of the study, the authors develop the method. In the second stage, the authors test and evaluate the method via an empirical study; also, an experiment was conducted within web interface with the gradual intensity of visual elements.

Findings

The findings reveal that the negative response grows faster than conversion when the visual intensity of the web interface is increased. However, a saturation point, where there is coexistence between maximum conversion and minimum negative response, can be found.

Practical implications

The findings imply that efforts to attract user attention should be pursued with increased caution and that a gradual approach presented in this study helps in finding a site-specific sweet spot for a level of visual intensity by incrementally adjusting the elements of the interface and tracking the changes in user behaviour.

Originality/value

Web marketing and advertising professionals often face the dilemma of determining the optimal level of visual intensity of interface element. Excessive use of marketing component and attention-grabbing visual elements can lead to an inferior user experience and consequent user churn due to growing intrusiveness. At the same time, too little visual intensity can fail to steer users. The present study provides a gradual approach which aids in finding a balance between user experience and visual intensity, maximising user conversion and, thus, providing a practical solution for the problem.
Wisdom extraction in knowledge-based information systems
Authors: Malik Zaki , Hashmi Khayyam , Najmi Erfan , Rezgui Abdelmounaam
Published: December 2018

Purpose

This paper aims to provide a number of distinct approaches towards this goal, i.e. to translate the information contained in the repositories into knowledge. For centuries, humans have gathered and generated data to study the different phenomena around them. Consequently, there are a variety of information repositories available in many different fields of study. However, the ability to access, integrate and properly interpret the relevant data sets in these repositories has mainly been limited by their ever expanding volumes. The goal of translating the available data to knowledge, eventually leading to wisdom, requires an understanding of the relations, ordering and associations among the data sets.

Design/methodology/approach

While the existing information repositories are rich in content, there are no easy means of understanding the relevance or influence of the different facts contained therein. Therefore, the interest of the general populace in terms of prioritizing some data items (or facts) over others is usually lost. In this paper, the goal is to provide approaches for transforming the available facts in the information repositories to wisdom. The authors target the lack of order in the facts presented in the repositories to create a hierarchical distribution based on the common understanding, expectations, opinions and judgments of the different users.

Findings

The authors present multiple approaches to extract and order the facts related to each concept, using both automatic and semi-automatic methods. The experiments show that the results of these approaches are similar and very close to the instinctive ordering of facts by users.

Originality/value

The authors believe that the work presented in this paper, with some additions, can be a feasible step to convert the available knowledge to wisdom and a step towards the future of online information systems.
Disentangling rhetorical subarenas of public health crisis communication: A study of the 2014–2015 Ebola outbreak in the news media and social media in Sweden
Authors: Rodin Pavel , Ghersetti Marina , Odén Tomas
Published: December 2018

Drawing on rhetorical arena theory, this study investigates the variations of content across communication channels (subarenas), guided by different media logics, during the 2014–2015 Ebola outbreak. Restricting the study to one country, Sweden, a content analysis was conducted of two national newspapers (in total 848 articles), their posts on branded Facebook pages (47) and user comments on these Facebook posts (1,661). Some conclusions to be made are, that content differed between subarenas, with Facebook news being more sensational and focused on human interest stories, and Facebook comments to a greater extent related to other current socio‐political issues. Also, news media were more alarmist than Facebook comments, although alarmism declined on all subarenas as the danger became more tangible.
Clinical significance of ≥ 50% PD‐L1 expression with the SP263 monoclonal antibody in non‐small cell lung cancer patients
Authors: Li Wenbin , Song Peng , Guo Lei , Liu Xiuyun , Guo Changyuan , Ying Jianming , Gao Shugeng
Published: December 2018

Background

PD‐L1 expression in tumor cells has been associated with the efficacy of immune checkpoint inhibitors in non‐small cell lung cancer (NSCLC). The aim of this study was to explore correlations between smoking, genetic profiles, patient outcomes, and PD‐L1 expression in NSCLC.

Methods

PD‐L1 expression was evaluated in 241 surgically resected specimens by immunostaining and 50% was set as the cutoff value.

Results

Of the 241 tumors analyzed, a PD‐L1 tumor proportion score (TPS) of ≥ 50% was detected in 35 cases (14.5%) and a TPS of < 50% in 206 cases (85.5%). A PD‐L1 TPS ≥ 50% was significantly associated with smoking and EGFR wild‐type status (P < 0.001 and P = 0.039, respectively). Detailed assessment of smoking variables showed that total smoking duration was a predictor of a PD‐L1 TPS ≥ 50% (P = 0.001). Univariate and multivariate survival analyses revealed that patients with a PD‐L1 TPS ≥ 50% had poorer disease‐free and overall survival than those with a PD‐L1 TPS < 50% (P = 0.001 and P < 0.001, respectively).

Conclusion

The incidence of a PD‐L1 TPS ≥ 50% was significantly higher in smoking and EGFR wild‐type NSCLC patients, particularly in long‐term smokers. A PD‐L1 TPS of ≥ 50% was an independent adverse prognostic factor for survival in patients with NSCLC.
Income trajectories prior to alcohol‐attributable death in Finland and Sweden
Authors: Tarkiainen Lasse , Rehnberg Johan , Martikainen Pekka , Fritzell Johan
Published: December 2018

Background and aims

Mortality from alcohol‐attributable causes is patterned by income. We study the income trajectories 17–19 years prior to death in order to determine: (1) whether income levels and trajectories differ between those who die of alcohol‐attributable causes, survivors with similar socio‐demographic characteristics, all survivors and those dying of other causes; (2) whether the income trajectories of these groups differ by education; and (3) whether there are differences in income trajectories between Finland and Sweden—two countries with differing levels of alcohol‐attributable mortality but similar welfare‐provision systems.

Design

Retrospective cohort study using individual‐level longitudinal register data including information on income, cause of death and socio‐economic status.

Setting

Finland and Sweden.

Participants

The subjects comprised an 11% sample of the Finnish population in 2006–07 and the total population of Sweden aged 45–64 years in 2007–08.

Measurements

Median household income trajectories by educational group were calculated by cause of death and population alive during the respective years. Additionally, propensity score matching was used to match the surviving population to those dying from alcohol‐attributable causes with regard to socio‐demographic characteristics.

Findings

The median income 17–19 years prior to death from alcohol‐attributable causes was 92% (Finland) and 91% (Sweden) of survivor income: 1 year prior to death, the respective figures were 47% and 57%. The trajectories differed substantially. Those dying of alcohol‐attributable causes had lower and decreasing incomes for substantially longer periods than survivors and people dying from other causes. These differences were more modest among the highly educated individuals. The baseline socio‐demographic characteristics of those dying of alcohol causes did not explain the different trajectories.

Conclusions

In Finland and Sweden, income appears to decline substantially before alcohol‐attributable death. Highly educated individuals may be able to buffer the negative effects of extensive alcohol use on their income level. Income trajectories are similar in Finland and Sweden, despite marked differences in the level of alcohol‐attributable mortality.
Vaginal delivery: An argument against requiring consent
Authors: Petersen Rodney W.
Published: December 2018

Birth by vaginal delivery is an evolutionary process refined over millennia to create a sustainable and safe method of human reproduction. A key argument against requiring consent for vaginal birth acknowledges that from an evolutionary point of view, vaginal delivery has successfully accompanied human development and remains the natural and default form of human birth. Concern has been raised by the Montgomery court case in the United Kingdom; however, the ruling does not mean consent is required for normal birth. What it does reaffirm is the need to engage patients in their care decisions when complications occur in pregnancy and delivery. Effective communication, rather than a legalistic consent pathway, is required for positive healthcare outcomes.
A longitudinal study of the moderating effects of social capital on the relationships between changes in human capital and ikigai among Japanese older adults
Authors: Fukuzawa Ai , Katagiri Keiko , Harada Kazuhiro , Masumoto Kouhei , Chogahara Makoto , Kondo Narihiko , Okada Shuichi
Published: December 2018

Ikigai, one of the indices of well‐being, tends to decline with age because resources relating to ikigai decline. However, there are individual differences in this decline. This study tested for maintenance of ikigai among Japanese elderly, using a longitudinal study investigating the moderating role of social capital on the effects of changes in human capital on ikigai. We conducted a panel survey targeting 1,068 people (M age = 73.01 years) in 2013, and 686 people in 2017. The variables were ikigai, changes in human capital (self‐rated financial status, physical health) and social capital (social networks, trust in others), educational level, and control variables. Multiple regression analyses revealed the interaction effects of changes in physical health and changes in social networks (strong ties, weak ties) on follow‐up ikigai. Post hoc analyses indicated that declines in physical health predicted declines in ikigai among those whose social networks (strong ties and weak ties) had declined in the 4‐year study, but these relationships were not significant among those whose social networks had increased. The results suggest that older adults can weaken the adverse effect of a decline in human capital on ikigai by maintaining or increasing social networks.
A survey demonstrates limited palliative care structures in paediatric nephrology from the perspective of a multidisciplinary healthcare team
Authors: Thumfart Julia , Bethe Dirk , Wagner Sarah , Pommer Wolfgang , Rheinländer Cornelia , Müller Dominik
Published: December 2018

Aim

Children and adolescents with end‐stage renal disease face a high morbidity and mortality. Palliative care provides a multidisciplinary approach to reduce disease burden and improve quality of life. This study evaluated concepts and current structures of palliative care from the perspective of a multidisciplinary paediatric nephrology team including physicians, nurses and psychosocial health professionals.

Methods

Evaluation was done by an online survey sent to the members of the German Society of Nephrology and to the nurse managers of German paediatric dialysis centres between April 9, 2018 and May 31, 2018.

Results

Out of the 52 respondents, 54% were physicians, 21% nurses and 25% psychosocial health professionals. The quality of actual palliative care service was rated as moderate (3.3 on a scale from one to six). Specialised palliative care teams (54%) and the caring paediatric nephrologist (50%) were considered as primarily responsible for palliative care. Two thirds wished for training in palliative care. In only 15% of the respondents’ centres, palliative care specialisation existed.

Conclusion

Palliative care structures in paediatric nephrology were not sufficient in the view of the multidisciplinary healthcare team. Therefore, efforts should be taken to integrate palliative care into the routine treatment of children and adolescents with chronic kidney diseases.
Practice variation among Dutch paediatricians in palivizumab prescription rates: the importance of parental counselling approach
Authors: Kooiman L M P , Kamps A W A , Dassel A C M , Brand P L P , Bekhof J
Published: December 2018

Aim

To investigate differences in palivizumab prescription rates between Dutch paediatricians, and the role of parent counselling in this practice variation.

Methods

A retrospective chart review of premature infants <32 weeks of gestation, aged less than six months at the start of the winter season, born between January 2012 and July 2014, in three secondary hospital‐based paediatric practices in the Netherlands.

Results

We included 208 patients, 133 (64%) of whom received palivizumab. Prescription rates varied considerably between the three hospitals: 8% (6/64), 89% (32/36) and 99% (97/98). A noticeable difference in the way parents were counselled about palivizumab was the use of the number needed to treat (NNT). In the hospital with the lowest prescription rate (8%), an NNT of 20 to prevent one hospitalisation was explicitly discussed with parents. Bronchiolitis‐related hospital admissions occurred in 11.3% of patients receiving palivizumab compared to 20.0% in nonimmunised infants (p = 0.086).

Conclusion

Considerable practice variation exists among Dutch paediatricians regarding palivizumab prescription rates. The counselling method seems to play an important role. Presenting palivizumab prophylaxis as a preference‐sensitive decision, combined with the explicit use and explanation of an NNT, leads many parents to refrain from respiratory syncytial virus immunisation.
A meta‐analysis of neurodevelopmental outcomes at 4–10 years in children born at 22–25 weeks gestation
Authors: Ding Sharon , Lemyre Brigitte , Daboval Thierry , Barrowman Nick , Moore Gregory P.
Published: December 2018

Aim

To update our meta‐analysis on neurodevelopmental disability rates in children born at 22–25 weeks gestation. The main outcome measure was rates of neurodevelopmental disability in survivors at age 4–10 years.

Methods

We used a peer‐reviewed electronic and grey search to identify articles. Two authors independently reviewed cohorts published after May 2012 with: born ≥1995 in a developed nation; assessed at 4–10 years; prospective; >65% follow‐up; definitions for neurodevelopmental disability as per the EPICure cohort; results reported by gestation. We contacted authors for clarification. Random effects meta‐analysis was used to estimate pooled proportions of neurodevelopmental disability. Within each study, the absolute change in proportions with each week was estimated and then pooled.

Results

We reviewed 3980 records; 21 articles were assessed and six were included. With the previous 9 cohorts, the meta‐analysis now contains 15. Rates of moderate‐to‐severe neurodevelopmental disability were as follows: 42% (95% CI 23,64%; I2 0%) at 22; 41% (95% CI 31,52%; I2 20%) at 23; 32% (95% CI 25,39%; I2 45%) at 24; 23% (95% CI 18,29%; I2 60%) at 25 weeks. The analysis shows a significant decrease in risk of moderate‐to‐severe neurodevelopmental disability between each week (8.1% (95% CI −11.8, −4.5%); I2 0%; p < 0.001).

Conclusion

Physicians can use this high‐quality data to support parents during decision‐making.
Effects of case characteristics on teamwork in family meetings
Authors: Kim Jangmin , Imburgia Teresa M. , Armstrong‐Richardson Eprise , Jaggers Jeremiah W. , Hall James A.
Published: December 2018

Little empirical research has examined the effects of case characteristics on high‐quality teamwork within family meetings in child welfare. We attempted to fill this gap using 497 child welfare cases in a Midwestern state in the United States. We found that overall teamwork was negatively associated with domestic violence, frequent placement moves, and a permanency plan of adoption, whereas teamwork was positively associated with the length of involvement in the child welfare system. We also examined the relationships between the case characteristics and two components of teamwork. The results showed that domestic violence and the length of the involvement were equally significant factors for both team formation and functioning. The permanency plan of adoption was a significant factor for team formation, but not for team functioning. Finally, family voices and frequent team meetings appeared to be stronger factors for improving both team formation and functioning. The results suggest that families in the child welfare system have different experiences in forming and functioning high‐quality family team meetings. Therefore, it is necessary to customize specific processes and strategies to promote teamwork depending on the child and family's characteristics and situations.
Physiological changes after colorectal surgery suggest that anastomotic leakage is an early event: a retrospective cohort study
Authors: Stearns A. T. , Liccardo F. , Tan K.‐N. , Sivrikoz E. , Aziz O. , Jenkins J. T. , Kennedy R. H.
Published: December 2018

Aim

Anastomotic leakage (AL) is often identified 7–10 days after colorectal surgery. However, in retrospect, abnormalities may be evident much earlier. This study aims to identify the clinical time point when AL occurs.

Method

This is a retrospective case‐matched cohort comparison study, assessing patients undergoing left‐sided colorectal resection between 2006 and 2015 at a specialist colorectal unit. Patients who developed AL (LEAK) were case‐matched to two CONTROL patients by procedure, gender, laparoscopic modality and diverting stoma. Case note review allowed the collection of basic observation data and blood tests (leukocyte count, C‐reactive protein, bilirubin, alanine transaminase, creatinine) up to postoperative day (POD) 4. The cohorts were compared, with the main outcome measure being changes in basic observation data.

Results

Of 554 patients, 49 developed AL. These were matched to 98 CONTROL patients. Notes were available for 105 patients (32 LEAK/73 CONTROL). Groups were similar in demographics, tumour or nodal status, preoperative radiotherapy, intra‐operative air‐leak integrity and drain usage. AL was detected clinically at a median of 7.5 days postoperatively. There was a significantly increased heart rate by the evening on POD 1 in LEAK patients (82.8 ± 14.2/min vs 75.1 ± 12.7/min, P = 0.0081) which persisted for the rest of the study. By POD 3, there was a significant increase in respiratory rate (18.0 ± 4.2/min vs 16.5 ± 1.3/min, P = 0.0069) and temperature (37.0 ± 0.4C vs 36.7 ± 0.3C, P = 0.0006) in LEAK patients. C‐reactive protein was significantly higher in LEAK patients from POD 2 (165 ± 95 mg/l vs 121 ± 75 mg/l, P = 0.023).

Conclusions

Physiological and biochemical changes associated with AL happen very early postoperatively, suggesting that AL may occur within 36 h after surgery, despite much later clinical detection.
Nomenclature of cutaneous vasculitides – German translation of the dermatologic addendum to the 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides
Authors: Sunderkötter Cord , Lamprecht Peter , Mahr Alfred , Metze Dieter , Zelger Bernhard
Published: December 2018

The nomenclature system agreed upon by the Chapel Hill Consensus Conference (CHCC) with respect to the terminology and precise definition of the various types of vasculitis has gained widespread interdisciplinary and international acceptance. As the revised version from 2012 (CHCC 2012) does not address the special features of vasculitis of the skin, it has recently been supplemented with an addendum containing the nomenclature of cutaneous vasculitides (D‐CHCC).

The present article provides the German translation of the terms and defintions of the D‐CHCC as well as additional explanatory comments. The goal is to enable German‐speaking health care providers to more readily apply these defined terms – which are based on interdisciplinary consensus – in everyday clinical practice and to facilitate assessment of their practicability and relevance in patient care.

If the majority of cutaneous vasculitides diagnosed can be matched with any of the defined entities presented herein, it might subsequently be possible to develop a classification system and diagnostic algorithms.
Patterns of infiltration and local recurrences of various types of cutaneous sarcomas following three‐dimensional histology
Authors: Welsch Katharina , Breuninger Helmut , Metzler Gisela , Sickinger Franziska , Eberle Franziska Carola , Häfner Hans‐Martin , Schnabl Saskia Maria
Published: December 2018

Background

Cutaneous sarcomas are rare and characterized by pathogenetic heterogeneity. Knowledge about local infiltration patterns and recurrence rates may be useful in improving patient care and outcomes. The objective of the present study was to compare these two characteristics in sarcomas that had been treated using the identical surgical procedure.

Patients and methods

Between 2006–2010, 84 patients with various types of sarcoma underwent surgery followed by three‐dimensional histology. Tumor entities included dermatofibrosarcoma protuberans (DFSP, 54 patients), leiomyosarcoma (ten patients), rhabdomyosarcoma (one patient), angiosarcoma (seven patients) as well as atypical fibroxanthoma (AFX, three patients) and cutaneous undifferentiated pleomorphic sarcoma (UPS, nine patients). Median follow‐up was four years (range: 2–6 years).

Results

Local recurrence rates among patients with primary DFSP were 2.2 %. All patients undergoing re‐excision were subsequently tumor free. Patients with leiomyosarcoma, rhabdomyosarcoma, AFX, and cutaneous UPS experienced no local recurrence; however, one individual developed in‐transit metastasis (UPS) (8.3 %). Three patients with angiosarcoma developed local recurrence (43 %), two of whom remained tumor free following re‐excision. Two angiosarcoma patients died from distant metastases (29 %). Both DFSP and especially angiosarcoma lesions exhibited extensive subclinical growth.

Conclusions

Recurrence rates of cutaneous sarcomas following three‐dimensional histology are low. Local recurrences are readily manageable by re‐excision. Angiosarcoma is characterized by extensive superficial growth, aggressive biological behavior, and predominantly hematogenous spread.
Infiltrationsmuster und Lokalrezidive von kutanen Sarkomen unterschiedlichen Typs nach 3D‐Histologie
Authors: Welsch Katharina , Breuninger Helmut , Metzler Gisela , Sickinger Franziska , Eberle Franziska Carola , Häfner Hans‐Martin , Schnabl Saskia Maria
Published: December 2018

Hintergrund

Kutane Sarkome sind selten und der pathogenetische Ursprung zeigt sich heterogen. Infiltrationsmuster und Rezidivraten können Erkenntnisse für die operative Patientenversorgung bringen. In der vorliegenden Arbeit wurden sie bei identischem operativem Vorgehen verglichen.

Patienten und Methodik

Bei 84 Patienten, davon 54 mit Dermatofibrosarcoma protuberans (DFSP), 11 mit Myosarkomen (10 Leiomyosarkome, 1 Rhabdomyosarkom), 7 mit Angiosarkomen und 12 mit uneinheitlichen Sarkomentitäten (3 atypische Fibroxanthome (AFX), 9 diverse dermale undifferenzierte pleomorphe Sarkome (DUPS)) wurde von 2006–2010 eine Tumorexzision mit nachfolgender kompletter Darstellung der dreidimensionalen Schnittränder (3D‐Histologie) durchgeführt. Die mediane Nachbeobachtung betrug 4 Jahre (min. 2, max. 6).

Ergebnisse

Die Lokalrezidivrate bei primärem DFSP betrug 2.2 %. In allen Rezidivfällen wurde nach Re‐Exzision Rezidivfreiheit erreicht. Leiomyo‐ und Rhabdomyosarkome und uneinheitliche Entitäten entwickelten kein Lokalrezidiv, jedoch eine Intransitmetastase (DUPS) (8.3 %). Bei 7 Patienten mit Angiosarkom traten 3 Lokalrezidive auf (43 %), 2 blieben nach der Re‐Exzision rezidivfrei. Zwei verstarben an Organmetastasen (29 %). DFSP und besonders Angiosarkome wiesen weitläufige subklinische Ausläufer mit irregulären Mustern auf.

Schlussfolgerungen

Die Rezidivraten der kutanen Sarkome sind bei Anwendung der 3D‐Histologie niedrig. Lokalrezidive konnten durch Re‐Exzisionen lokal beherrscht werden. Eine Sonderstellung hat das Angiosarkom. Es wächst oberflächlich extrem ausgedehnt, deutlich aggressiver und metastasiert bevorzugt hämatogen.