bluuebunny/crossref_metadata_2025 huggingface dataset:
Parental distress in response to childhood medical trauma: A mediation model
Authors: Currie Roseanne , Anderson Vicki A , McCarthy Maria C , Burke Kylie , Hearps Stephen JC , Muscara Frank
Published: April 2018

This study explored the relationship between individual and family-level risk in predicting longer-term parental distress following their child’s unexpected diagnosis of serious illness. A mediation model was tested, whereby parents’ pre-existing psychosocial risk predicts longer-term posttraumatic stress symptoms, indirectly through parents’ acute stress response. One hundred and thirty-two parents of 104 children participated. Acute stress response partially mediated the relationship between psychosocial risk and posttraumatic stress symptoms, with a moderate indirect effect ( r2 = .20, PM = .56, p < .001). Findings demonstrated that cumulative psychosocial risk factors predispose parents to acute stress and longer-term posttraumatic stress symptoms, highlighting the need for psychosocial screening in this population.
Effects of written corrective feedback and language aptitude on verb tense accuracy
Authors: Benson Susan , DeKeyser Robert
Published: April 2018

Most second language researchers agree that there is a role for corrective feedback in second language writing classes. However, many unanswered questions remain concerning the linguistic features to target and the type and amount of feedback to offer. This study examined essays by 151 learners of English as a second language (ESL), in order to investigate the effect of either direct or metalinguistic written feedback on errors with the simple past tense and the present perfect tense. This inquiry also considered the extent to which learner differences in language-analytic ability (LAA), as measured by the LLAMA F, mediated the effects of these two types of explicit written corrective feedback. Learners in both feedback groups were provided with corrective feedback on two essays whereas the control group received general comments on content. Learners in all three groups then completed two additional writing tasks to determine whether or not the provision of corrective feedback led to greater gains in accuracy compared to no feedback. Both treatment groups performed better than the comparison group on new pieces of writing immediately following the treatment sessions, yet direct feedback was more durable than metalinguistic feedback for one structure, the simple past tense. Participants with greater LAA proved more likely to achieve gains in the direct feedback group than in the metalinguistic group, whereas learners with lower LAA benefited more from metalinguistic feedback.
Visualizing the solution: An analysis of the images that accompany solutions-oriented news stories
Authors: Lough Kyser , McIntyre Karen
Published: April 2018

This study adds visual analysis to the body of work on solutions journalism. Guided by visual theory focusing on the dominating nature of messages included in visual content versus text, we use content analysis to explore the use of photos in solutions-oriented news stories, specifically to see whether the photos published alongside solutions-based news stories also represent solutions or whether they portray an incongruent message. Among our results, we found photos reflect the solution depicted in the story only 63.5 percent of the time. Photos taken by an internal source (e.g. staff photographer) are more likely to depict the solution than if obtained by an external source (e.g. wire service). In addition, the higher the emotional appeal and positive emotion found in the photo, the higher the likelihood that the photo reflects a solution. A contradictory visual may complicate the message of the solutions in the story. Our findings suggest more emphasis must be placed on the study of visuals as they relate to solutions journalism, and on the selection of photos to accompany solutions-oriented stories.
Context and entrepreneurship in Knowledge Transfer Partnerships with small business enterprises
Authors: Wynn Martin , Jones Peter
Published: April 2018

Entrepreneurship research has often focused on the capabilities and motivation of the entrepreneurs themselves, but there have also been more recent attempts to understand the contextual factors that can engender and support entrepreneurial activity. This article examines the contextual factors in evidence in four Knowledge Transfer Partnership case studies, where entrepreneurial activity has played a key role in developing and implementing significant change projects in small business enterprises. Based on a detailed analysis of these case studies, a number of contextual factors are identified that may act as a model for others researching entrepreneurship in similar contexts. The study finds that four main factors in the broader socio-economic environment were key in engendering entrepreneurial activity: the influence of the local university, availability of financial support, regional knowledge production and the presence of industry clusters pursuing similar objectives. There were also a number of influencing factors within the small business company environment: the potential to develop human and social capital, particularly evident in family businesses, and the opportunities to rapidly adopt and change technology platforms and systems that encouraged entrepreneurial thinking and initiative taking. The case studies also evidence that entrepreneurial initiatives may not always produce successful long-term outcomes.
Feeling Down(town Julie Brown): The Sense of Up and Expiring Relationality
Authors: Yapp Hentyle
Published: April 2018

During the late 1980s and 1990s, the presence of women of color dancing on film and television greatly increased: Rosie Perez in Do the Right Thing, the Fly Girls from In Living Color, and Downtown Julie Brown hosting Club MTV. These figures were highly energetic and up, marking a positivity that can be distinguished from the depressed affects that have been centralized for the 21st century. This article historicizes the sense of up to rethink the terms available for not only the affective turn but also relationality. The latter draws from the former to contend with how different communities relate to one another through shared sensations, precarity, or commons. The author examines the temporal dynamics embedded in sense and affect to analyze the theoretical bases (from Kleinian object relations to Deleuzian intensities) that produce the relational. In doing so, the author engages Rashaad Newsome’s Shade Compositions (2009), which reperforms these earlier up practices. Ultimately, this article rethinks relationality by placing an expiration on the way it is presumed to sustain itself. Relational connections cannot be stabilized nor assume that one can fully know the other. The author thus proposes an ethics for relationality that can be traced through the sense of up’s entwinement with racialized forms of rage, ‘killing it’, and exhaustion. Sense and anger produce pathways to engage one another again and again.
Urban safety: A re-reading of the sense of unsafety through individual and ecological dimensions
Authors: Ferretti Fabio , Pozza Andrea , Coluccia Anna
Published: April 2018

The issue of urban safety is a research topic that has attracted the attention of scholars for several years, particularly in relation to the effects of individual and environmental variables that influence the fear of crime. Some recent studies have redefined the study of fear of crime, widening it to a more general dimension represented by the perception of safety. However, no specific tool has been proposed to measure this construct. In this paper, a new assessment scale of the perception of unsafety has been used to examine the impact of individual factors (gender, age, etc.) and ecological factors (ethnic composition of the neighbourhood, residential stability, etc.) on the dimensions of the scale (general sense of unsafety, perception of physical and social disorder, collective efficacy perception and preoccupation with crime). Results showed a strong convergence with the existing evidence with regard to the ambiguous role of some individual variables, such as gender and age, and for the influence of the characteristics of the neighbourhood.
Emerging issues of teaching and social justice in Greater China: Neoliberalism and critical pedagogy in Hong Kong
Authors: Chang Benjamin “Benji” , McLaren Peter
Published: April 2018

From the Americas to Asia, neoliberal policy restructuring continues to present major challenges to educational equity. In Hong Kong, teacher educators grapple with training students in pedagogy they believe in, versus the daily status quo of high-stakes exam prep, privatized “shadow education,” and a system seemingly pushed to the brink of neoliberal social efficiency. Indeed, in recent years, Hong Kong has recorded top rankings on the Trends in International Mathematics and Science Study and the Programme for International Student Assessment, along with record-setting protests and student suicides. Like in the USA, neoliberalization of teacher education in Hong Kong has proffered dilemmas of standardized curricula, evaluation, and licensure, often under the guise of “21st century skills and technology.” Both regions also face perpetual threats of being under- or de-funded, based on “data-driven” decision-making and leadership that are supposedly more accountable and efficient. Unsurprisingly, neoliberal policies and practices have often exacerbated inequities in teaching and learning, especially for communities labelled as minority or working-class. Within traditions of critical pedagogy, this article’s authors engage in a discussion on how educators and students are navigating the neoliberal behemoth and developing more inclusive spaces across local contexts of language, class, and culture. Based on the authors’ research in the Americas and Greater China, this article interrogates some of the junctures and ruptures of neoliberal education in Hong Kong, long-held as bridge between “East” and “West.” The article draws from the first author Benji Chang’s action research projects with pre-and in-service teachers in the region, which examines how they are critiquing and challenging dominant discourses of neoliberalism (e.g., positivism, standardization, and market-economy), and what brings hope. Given Hong Kong’s history of colonization with Europe and the USA, and the ever-expanding dominance of mainland China, this article makes a contribution to international scholarship concerned with teacher education and social justice.
Feasibility study to assess the effect of a brief mindfulness intervention for patients with chronic obstructive pulmonary disease: A randomized controlled trial
Authors: Perkins-Porras Linda , Riaz Muhammad , Okekunle Adeoba , Zhelezna Svitlana , Chakravorty Indranil , Ussher Michael
Published: April 2018

Psychological distress is common among patients with chronic obstructive pulmonary disease (COPD). This study aimed to assess whether a 10-minute mindfulness intervention reduces distress and breathlessness, improves mood and increases mindfulness among hospital inpatients following acute exacerbation of COPD.Fifty patients were recruited following an acute admission. The immediate effects of a 10-minute mindfulness-based body scan were compared with a control intervention. Participants were randomized to receive either a mindfulness-based body scan ( n = 24) or a control condition ( n = 26) via a 10-minute audio recording. Participants completed a self-assessment survey, including the Borg scale for breathlessness, Philadelphia Mindfulness Scale and Hospital Anxiety and Depression Scale. They then completed six brief single item measures of dyspnoea, anxiety, depression, happiness, stress and mindfulness before and after the intervention daily for three consecutive days. Acceptability was rated according to ‘usefulness’ and whether they would recommend the intervention to other patients. Results showed that there was a tendency for change in most outcomes, but no significant differences between the groups. Most participants rated the intervention as useful and would recommend it. Existing knowledge of mindfulness interventions among these patients is very limited and this study may be helpful in the development of other brief interventions.
In Situ Popliteal–Tibial Bypass With the Short Saphenous Vein Through a Posterior Approach for Limb Salvage
Authors: Kuma Sosei , Morisaki Kohichi , Okazaki Jin , Mii Shinsuke
Published: April 2018

A 69-year-old female patient was admitted to our hospital with gangrene of her left first and second digits. Angiography showed a diffuse occlusive lesion from the external iliac artery to the crural arteries. Endovascular therapy to the external iliac artery, above-knee femoropopliteal bypass with a polytetrafluoroethylene graft, and popliteal–tibial bypass through a posterior approach with the short saphenous vein graft were performed in 3 stages because the length of the great saphenous vein that was suitable for grafting was insufficient. Vascular surgeons should be aware of the posterior approach as an effective alternative procedure for infragenicular revascularization.
E2F1 genetic variants and risk of cervical cancer in Indian women
Authors: Singh Sanjay , Gupta Manish , Seam Rajeev Kumar , Changotra Harish
Published: April 2018

Introduction:

Altered expression of many E2F family members have been reported in various human cancers. In this study, we investigated the role of non-synonymous single nucleotide polymorphisms (rs3213172 C/T, rs3213173 C/T, and rs3213176 G/A) of the gene E2F1 with cervical cancer.

Methods:

A total of 181 samples including 90 cervical cancer patients and 91 healthy controls were genotyped. The genotype frequencies of these polymorphisms in collected samples were determined by either PCR-RFLP or PCR-ARFLP methods. SHEsis software was used to analyze the haplotypes.

Results:

Statistically significant differences in the alleles and the genotypes frequencies were observed in rs3213172 (C/T) and rs3213173 (C/T) polymorphisms. The rs3213172 (C/T) polymorphism was a risk factor for cervical cancer in dominant model (odds ratio (OR) 1.96; 95% confidence interval (CI) 1.07, 3.60; P = 0.02) and heterozygous model (OR 1.90; 95% CI 1.01, 3.57; P = 0.04). The rs3213173 (C/T) polymorphism increased the risk of cervical cancer in the homozygous model (OR 2.71; 95% CI 1.11, 6.58; P = 0.02). The rs3213176 (G/A) polymorphism was not associated with cervical cancer risk in any of the genotypic models. In the haplotypes analysis, three haplotypes (CTG, TCG, and TTA) were associated with the cervical cancer risk.

Conclusions:

These findings revealed that rs3213172 (C/T) and rs3213173 (C/T) polymorphisms and haplotypes (CTG, TCG, and TTA) of the E2F1 gene might play role in the susceptibility of cervical cancer. This is the first report showing an association of these polymorphisms with the cervical cancer risk.
Distributed event-triggered synchronization for robotic teleoperation systems with randomly occurring gain fluctuations
Authors: Ma Chao , Kang Erlong
Published: April 2018

This article investigates the synchronization problem of robotic teleoperation systems by developing a novel event-triggered networking strategy. Furthermore, the randomly occurring controller gain fluctuations are considered for the robotic teleoperation systems, such that more robustness can be obtained in the controller implementation. Based on model transformation, sufficient synchronization conditions are derived by employing the Lyapunov–Krasovskii method. Then, distributed controllers are designed for achieving the mean square synchronization. Finally, the effectiveness and feasibility of our proposed control strategy are demonstrated by an illustrative example.
Biomechanical comparison of modified Lim/Tsai tendon repairs with intra- and extra-tendinous knots
Authors: Chang Min Kai , Wong Yoke Rung , Tay Shian Chao
Published: April 2018

We compared the Lim/Tsai tendon repair technique using an extra-tendinous knot with modification using an intra-tendinous knot. The ultimate tensile strength, load to 2 mm gap force, stiffness, mode of failure, location of failure, and time taken to repair each tendon were recorded during a single cycle loading test in 20 tendons with each repair method. We found that the ultimate tensile strength and 2 mm gap force of the modified Lim/Tsai repair with an extra-tendinous knot (56 SD 5 N and 14 SD 2 N, respectively) were statistically significantly higher than that of the modified Lim/Tsai repair with intra-tendinous knot (51 SD 7 N and 11 SD 2 N, respectively). We conclude that the modified Lim/Tsai repair with extra-tendinous knot is stronger, despite having the same number of core strands.
Metformin treatment of type 2 diabetes mellitus in pregnancy: update on safety and efficacy
Authors: Polasek Thomas M. , Doogue Matthew P. , Thynne Tilenka R.J.
Published: April 2018

With the increasing prevalence of type 2 diabetes mellitus (T2DM) in women of childbearing age, prescribing antidiabetic medications in first-trimester pregnancy is becoming more common. Metformin treatment during this time is usually avoided in countries with well-resourced healthcare. This is based on historical concerns about safety to the foetus and the widespread availability of insulin. However, there is now increasing interest in the potential benefits of metformin in pregnant women with T2DM. In this commentary, the main evidence supporting metformin safety in pregnancy is summarized, with an emphasis on the first trimester. Based on a structured literature search, the recent randomized controlled trials comparing metformin and insulin are reviewed. We then show that prescribing advice for metformin in pregnancy is inconsistent and product information/package inserts (PI) are universally out of date. This causes confusion and pushes some women and their clinicians to change from metformin to insulin. The potential advantages of metformin in pregnant women with T2DM are then discussed, including oral dosing and improved acceptability, lower resource utilization and cost, decreased insulin requirements, less maternal weight gain and less risk of maternal and neonatal hypoglycaemia. The conclusion is that metformin is a cheap and efficacious antidiabetic medication for many pregnant women with T2DM, with reasonable evidence for safety. Drug information resources should be updated so that metformin can be considered more broadly in women with T2DM who present for antenatal care.
Nutrition Considerations in the Pediatric Cardiac Intensive Care Unit Patient
Authors: Justice Lindsey , Buckley Jason R. , Floh Alejandro , Horsley Megan , Alten Jeffrey , Anand Vijay , Schwartz Steven M.
Published: April 2018

Adequate caloric intake plays a vital role in the course of illness and the recovery of critically ill patients. Nutritional status and nutrient delivery during critical illness have been linked to clinical outcomes such as mortality, incidence of infection, and length of stay. However, feeding practices with critically ill pediatric patients after cardiac surgery are variable. The Pediatric Cardiac Intensive Care Society sought to provide an expert review on provision of nutrition to pediatric cardiac intensive care patients, including caloric requirements, practical considerations for providing nutrition, safety of enteral nutrition in controversial populations, feeding considerations with chylothorax, and the benefits of feeding beyond nutrition. This article addresses these areas of concern and controversy.
The World Database for Pediatric and Congenital Heart Surgery: Update
Authors: Louis James St , Kirklin James
Published: April 2018

Following several years of planning and design, the World Database for Pediatric and Congenital Heart Surgery (WDPCHS) went live on January 1, 2017. The first operational year of this valuable database has proven very successful. As of February 28, 2018, more than 4,500 patients have been submitted from 39 centers; participation currently spans 19 countries over 6 continents, with 120 more centers in the enrollment pipeline. This update, the first in a series, is intended to provide World Society for Pediatric and Congenital Heart Surgery members and others who care for children with congenital heart disease with a broad overview of current progress and ongoing activities surrounding the WDPCHS.
Balloon Kyphoplasty in the Treatment of Neoplastic Spine Lesions: A Systematic Review
Authors: Astur Nelson , Avanzi Osmar
Published: April 2018

Study Design:

Systematic review.

Objectives:

To assess the efficacy of kyphoplasty in controlling pain and improving quality of life in oncologic patients with metastatic spinal disease and pathologic compression fractures of the spine.

Methods:

A literature search through medical database was conducted (using PubMed, EMBASE, Cochrane, and LILACS) for randomized controlled trials comparing balloon kyphoplasty versus the traditional treatment for compression fractures of the spine due to metastatic disease. Two investigators independently assessed all titles and abstracts to select potential articles to be included. Inclusion criteria consisted of randomized controlled trials involving patients with pathologic compression fractures due to spinal metastasis or multiple myeloma treated with balloon kyphoplasty procedure as one of the study interventions, while the control group was any other treatment modality. The risk of bias in individual studies was assessed.

Results:

Two studies, with a combined total of 181 patients, met inclusion criteria. Because of data heterogeneity, the meta-analysis was not possible, and individual analysis of studies was performed. There is moderate evidence that patients treated with balloon kyphoplasty displayed better scores for pain (Numeric Rating Scale), disability (Roland-Morris Disability Questionnaire), quality of life (Short Form–36 Health Survey), and functional status (Karnofsky Performance Status) compared with those undergoing the conventional treatment. Patients treated with kyphoplasty also have better recovery of vertebral height.

Conclusions:

This study concluded that balloon kyphoplasty could be considered as an early treatment option for patients with symptomatic neoplastic spinal disease, although further randomized clinical trials should be performed for improvement of the quality of evidence.
Clinical Outcomes After Four-Level Anterior Cervical Discectomy and Fusion
Authors: Kreitz Tyler M. , Hollern Douglas A. , Padegimas Eric M. , Schroeder Gregory D. , Kepler Christopher K. , Vaccaro Alexander R. , Hilibrand Alan S.
Published: April 2018

Study Design:

Retrospective cohort study.

Objectives:

Anterior cervical discectomy and fusion (ACDF) demonstrates reliable improvement in neurologic symptoms associated with anterior compression of the cervical spine. There is a paucity of data on outcomes following 4-level ACDFs. The purpose of this study was to evaluate clinical outcomes for patients undergoing 4-level ACDF.

Methods:

All 4-level ACDFs with at least 1-year clinical follow-up were identified. Clinical outcomes, including fusion rates, neurologic outcomes, and reoperation rates were determined.

Results:

Retrospective review of our institutional database revealed 25 patients who underwent 4-level ACDF with at least 1-year clinical follow-up. Average age was 57.5 years (range 38.2-75.0 years); 14 (56%) were male, and average body mass index was 30.2 kg/m2 (range 19.9-43.4 kg/m2). Two (8%) required secondary cervical surgery at an average of 94.5 days postoperatively while the remaining 23 did not with an average follow-up of 19 months. Of 23 patients not requiring revision surgery, 16 (69%) patients fused by definition of less than 1 mm of spinous process motion per fused level in flexion and extension. Fifteen (65%) had at least one muscle group with one grade of weakness preoperatively. Nineteen of these patients (83%) had improved to full strength while no patients lost muscle strength.

Conclusions:

Review of our institution’s experience demonstrated a low rate of revision cervical surgery for any reason of 8% at mean 19 months follow-up, and neurological examinations consistently improved, despite a high rate of radiographic nonunion (31%).
Using Storytelling as a Job-Search Strategy
Authors: Smart Karl L. , DiMaria Jerry
Published: April 2018

This article demonstrates and reinforces the role that well-told stories play in the success of the job-search process. Building on narrative theory, impression management, and an increased use of behavioral-based questions in interviews, well-crafted stories about work and educational experiences demonstrate skills applicants possess and convey them to interviewers in memorable ways. The article shows how to construct stories based on an applicant’s experiences and shaped to the needs of a potential employer. Additionally, the article demonstrates how a job seeker can create a collection of personal stories that can be adapted to varying job interview situations.
Are Socioeconomic Inequalities in Physical Health Mediated by Embodied Environmental Toxins?
Authors: Brailsford Jennifer M. , Hill Terrence D. , Burdette Amy M. , Jorgenson Andrew K.
Published: April 2018

Although established theoretical models suggest that socioeconomic inequalities in physical health are partially mediated or explained by exposures to environmental toxins, there is little empirical evidence to support these processes. Building on previous research, we analyze data from the National Health and Nutrition Examination Surveys (2007–2008) to formally test whether associations between socioeconomic status and self-rated physical health are mediated by direct biological assessments of environmental toxins. We find that the embodiment of environmental toxins is disproportionate in individuals of lower socioeconomic status. Although toxins in general and lead in particular are unrelated to self-rated health, socioeconomic differences in self-rated physical health are partially mediated by embodied cadmium. Our mediation analyses suggest that education and income may promote physical health by reducing exposures to cadmium. This study contributes to previous work by bridging the fields of social epidemiology and environmental inequality and by formally testing established theoretical models.
Novel role of prostate apoptosis response-4 tumor suppressor in B-cell chronic lymphocytic leukemia
Authors: McKenna Mary K. , Noothi Sunil K. , Alhakeem Sara S. , Oben Karine Z. , Greene Joseph T. , Mani Rajeswaran , Perry Kathryn L. , Collard James P. , Rivas Jacqueline R. , Hildebrandt Gerhard C. , Fleischman Roger A. , Durbin Eric B. , Byrd John C. , Wang Chi , Muthusamy Natarajan , Rangnekar Vivek M. , Bondada Subbarao
Published: April 2018

Key Points

CLL cells overexpress a well-defined tumor suppressor Par-4, which promotes malignant B-CLL growth and is regulated through BCR signaling. Robust regulation of cell-cycle modulator p21/WAF1 by Par-4 in CLL cells.
The neuropsychiatry of multiple sclerosis
Authors: Ron Maria A.
Published: April 2018

Multiple sclerosis (MS), an immune-mediated demyelinating condition, is the most common neurological disease affecting young adults in the UK. It has a high psychiatric comorbidity and over half of patients have some degree of cognitive impairment that adds to the burden of disability. This article reviews the psychiatric and cognitive manifestations of MS and their detection and treatment. Recent advances in the treatment of the disease are briefly reviewed and the impact of disease-modifying therapies on psychiatric morbidity and cognitive impairment is discussed.

LEARNING OBJECTIVES

•

Understand the psychiatric morbidity in MS and its biological counterparts

•

Understand the cognitive impairment and its biological counterparts

•

Become familiar with the detection and treatment of the psychiatric and cognitive manifestations of MS

DECLARATION OF INTEREST

None.
Clozapine use in old age psychiatry
Authors: Kirrane Amey , Majumdar Biswadeep , Richman Anna
Published: April 2018

Clozapine is one of the most effective drugs available to psychiatrists for treating psychosis. It is currently licensed for use in treatment-resistant schizophrenia and psychosis in Parkinson's disease, but its use in old age psychiatry is very uncommon. With the ageing population, and the increased incidence of psychosis in older patients, it is important to consider whether this is a drug that is not being used to its full advantage.

LEARNING OBJECTIVES

•

Appreciate the differences in titration and monitoring of clozapine in older adults, compared with working-age adults

•

Consider the efficacy of clozapine in older people and its impact on mortality

•

Understand the side-effect profile of clozapine in older adults

DECLARATION OF INTEREST

None.
Do patterns of synaptic pruning underlie psychoses, autism and ADHD?
Authors: de Silva Prasanna N.
Published: April 2018

This review of available longitudinal structural imaging and immunological findings in first-onset schizophrenia, bipolar disorder, attention-deficit hyperactivity disorder (ADHD) and autism suggests that different patterns of synaptic pruning lead to various phenotypes. Proposals for future research strategies to try to replicate these findings are suggested, potential biomarkers to assist in diagnosis and determining the optimum duration of maintenance treatment are considered and ideas of potential immunotherapy augmentation are outlined.

LEARNING OBJECTIVES

•

Understand the immunological basis of synaptic pruning

•

Comprehend the available research on longitudinal brain imaging

•

Be aware of future immunological therapeutic strategies in psychosis, ADHD and autism

DECLARATION OF INTEREST

None.
‘We've had enough of experts’: the enduring charm of quackery
Authors: Ross Nick
Published: April 2018

Broadcaster and journalist. FRCP (hon)
Association of Neuraxial Anesthesia With Postoperative Venous Thromboembolism After Noncardiac Surgery: A Propensity-Matched Analysis of ACS-NSQIP Database
Authors: Turan Alparslan , Bajracharya Gausan R. , Leung Steve , Yazici Kara Merve , Mao Guangmei , Botsford Thomas , Ruetzler Kurt , Maheshwari Kamal , Ali Sakr Esa Wael , Elsharkawy Hesham , Sessler Daniel I.
Published: April 2018

BACKGROUND:

Neuraxial anesthesia improves components of the Virchow’s triad (hypercoagulability, venous stasis, and endothelial injury) which are key pathogenic contributors to venous thrombosis in surgical patients. However, whether neuraxial anesthesia reduces the incidence of venous thromboembolism (VTE) remain unclear. We therefore tested the primary hypothesis that neuraxial anesthesia reduces the incidence of 30-day VTE in adults recovering from orthopedic surgery. Secondarily, we tested the hypotheses that neuraxial anesthesia reduces 30-day readmission, 30-day mortality, and the duration of postoperative hospitalization.

METHODS:

Inpatient orthopedic surgeries from American College of Surgeons National Surgical Quality Improvement Program database (2011–2015) in adults lasting more than 1 hour with either neuraxial or general anesthesia were included. Groups were matched 1:1 by propensity score matching for appropriate confounders. Logistic regression model was used to assess the effect of neuraxial anesthesia on 30-day VTE, 30-day mortality, and readmission, while Cox proportional hazard regression model was used to assess its effect on length of stay.

RESULTS:

Neuraxial anesthesia decreased odds of 30-day VTE (odds ratio 0.85, 95% confidence interval, 0.78–0.95; P = .002) corresponding to number-needed-to-treat of 500. Although there was no difference in 30-day mortality, neuraxial anesthesia reduced 30-day readmission (odds ratio 0.90, 98.3% confidence interval, 0.85–0.95; P < .001) corresponding to number-needed-to-treat of 250 and had a shortened hospitalization (2.87 vs 3.11; P < .001).

CONCLUSIONS:

Neuraxial anesthesia appears to provide only weak VTE prophylaxis, but can be offered as an adjuvant to current thromboprophylaxis in high-risk patients.
Aquatic–terrestrial transitions of feeding systems in vertebrates: a mechanical perspective
Authors: Heiss Egon , Aerts Peter , Van Wassenbergh Sam
Published: April 2018

Transitions to terrestrial environments confront ancestrally aquatic animals with several mechanical and physiological problems owing to the different physical properties of water and air. As aquatic feeders generally make use of flows of water relative to the head to capture, transport and swallow food, it follows that morphological and behavioral changes were inevitably needed for the aquatic animals to successfully perform these functions on land. Here, we summarize the mechanical requirements of successful aquatic-to-terrestrial transitions in food capture, transport and swallowing by vertebrates and review how different taxa managed to fulfill these requirements. Amphibious ray-finned fishes show a variety of strategies to stably lift the anterior trunk, as well as to grab ground-based food with their jaws. However, they still need to return to the water for the intra-oral transport and swallowing process. Using the same mechanical perspective, the potential capabilities of some of the earliest tetrapods to perform terrestrial feeding are evaluated. Within tetrapods, the appearance of a mobile neck and a muscular and movable tongue can safely be regarded as key factors in the colonization of land away from amphibious habitats. Comparative studies on taxa including salamanders, which change from aquatic feeders as larvae to terrestrial feeders as adults, illustrate remodeling patterns in the hyobranchial system that can be linked to its drastic change in function during feeding. Yet, the precise evolutionary history in form and function of the hyolingual system leading to the origin(s) of a muscular and adhesive tongue remains unknown.
Suppression of reactive oxygen species generation in heart mitochondria from anoxic turtles: the role of complex I S-nitrosation
Authors: Bundgaard Amanda , James Andrew M. , Joyce William , Murphy Michael P. , Fago Angela
Published: April 2018

Freshwater turtles (Trachemys scripta) are among the very few vertebrates capable of tolerating severe hypoxia and reoxygenation without suffering from damage to the heart. As myocardial ischemia and reperfusion causes a burst of mitochondrial reactive oxygen species (ROS) in mammals, the question arises as to whether, and if so how, this ROS burst is prevented in the turtle heart. We find here that heart mitochondria isolated from turtles acclimated to anoxia produce less ROS than mitochondria from normoxic turtles when consuming succinate. As succinate accumulates in the hypoxic heart and is oxidised when oxygen returns this suggest an adaptation to lessen ROS production. Specific S-nitrosation of complex I can lower ROS in mammals and here we show that turtle complex I activity and ROS production can also be strongly depressed in vitro by S-nitrosation. While we can detect in vivo endogenous S-nitrosated complex I in turtle heart mitochondria, these levels are unaffected upon anoxia acclimation. Thus while heart mitochondria from anoxia-acclimated turtles generate less ROS and have a lower aerobic capacity than those from normoxic turtles, this is not due to decreases in complex I activity or expression levels. Interestingly, in-gel activity staining reveals that most complex I of heart mitochondria from normoxic and anoxic turtles forms stable supercomplexes with other respiratory enzymes and, in contrast to mammals, these are not disrupted by dodecyl maltoside. Taken together, these results show that, although S-nitrosation of complex I is a potent mechanism to prevent ROS formation upon reoxygenation after anoxia in vitro, this is not a major cause of the suppression of ROS production by anoxic turtle heart mitochondria.
Controlling vs. Enabling
Authors: Hagiu Andrei , Wright Julian
Published: April 2018

How does a firm decide whether to employ professionals and control how they deliver services to clients, or to operate as a platform enabling independent professionals to provide services directly to clients? Similarly, how does a manufacturer decide whether to allow sales agents to choose certain costly actions (e.g., kickbacks to clients) or to take control of these actions itself? We answer this question using a principal–agent framework in which both the principal and the agent must be incentivized to carry out investments (or effort) that increase the revenue they jointly create. Our theory explains when the principal should take control over a particular decision (“control”) or should instead allow the agent to make the decision (“enable”). It does so both for the case when there are multiple such transferable decisions for a single agent, and for the case when there are many agents and one transferable decision for each. We also consider the possibility of cost asymmetries between the principal and the agent, spillovers across agents, and the misclassification of the principal as an employer even though agents are allocated the relevant control rights. Finally, we explain how the “control versus enable” choice and its associated trade-offs differ from the classic “make versus buy” choice.

The online appendix is available at https://doi.org/10.1287/mnsc.2017.2956 .

This paper was accepted by Joshua Gans, business strategy.
Umweltberichterstattung: Give the good news and the bad! Forschungsschwerpunkt des IÖW beschäftigt sich mit einer zentralen Zukunftsaufgabe von Unternehmen
Authors: Clausen Jens , Fichter Klaus
Published: April 2018

Was leisten sich Unternehmen in puncto Umweltverbrauch und was leisten sie an Umweltschutz? Während bis 1990 weltweit noch nicht einmal zehn Unternehmen einen umfassenden Bericht über ihre Aktivitäten und Ergebnisse im Umweltschutz vorgelegt hatten, ist die Zahl von Umweltberichten deutscher Unternehmen mittlerweile auf rund 60 angestiegen. Gemessen an der Gesamtzahl von Unternehmen eine nach wie vor verschwindend kleine Zahl. Umweltberichterstattung ist noch keine gängige Praxis und eine dialog- und problemorientierte Kommunikation über Umweltfragen schon gar nicht. Mehr Transparenz über die von Unternehmen und ihren Produkten ausgehenden Umweltbelastungen und der zu ihrer Vermeidung oder Verminderung ergriffenen Maßnahmen fordern nicht nur Umweltverbände und -Wissenschaftler. Auch die eigenen Mitarbeiter, Kunden/Lieferanten, die Nachbarn oder auch Versicherungen verlangen zunehmend mehr Umweltinformationen von Unternehmen. Und sie fordern nicht nur »die guten«, sondern auch »die schlechten« Umweltinformationen. Die aktive Kommunikation über Umweltfragen stellt sowohl eine Notwendigkeit als auch eine Chance für Unternehmen dar. Dabei muß aber gelten: Give the good news and the bad! Das IÖW beschäftigt sich seit Jahren mit der Frage, wie eine sach- und zielgruppengerechte Umweltberichterstattung gestaltet und abgesichert werden kann. In den vergangenen zwei Jahren wurden dazu eine Reihe von Forschungsergebnissen und Publikationen vorgelegt. Diese werden durch das im Oktober erscheinde Buch »Umweltbericht - Umwelterklärung - Leitfaden für eine glaubwürdige Kommunikation von Unternehmen« (Hanser-Verlag) abgerundet. Wir nehmen den erreichten Zwischenstand zum Anlaß, die derzeitigen Entwicklungen und zukünftigen Perspektiven der Umweltberichterstattung von Unternehmen zu betrachten und haben dazu eine Reihe von Aktiven der Umweltberichterstattung eingeladen, das Thema aus ihrer jeweiligen »Akteurssicht« zu beleuchten. Auch wenn aus Platzgründen nur ein Teil der Akteure zu Wort kommen kann, so hoffen wir doch, mit dieser Auswahl einige anregende Ein- und Aussichten liefern zu können!
Evolutorische Ökonomik und Ecological Economics
Authors: Pasche Markus
Published: April 2018

Die beiden Forschungsrichtungen Evolutorische Ökonomik und Ecological Economics kann man als Antwort auf die Defizite der neoklassischen Theorie bzw. speziell der traditionellen Um-weltökonomik verstehen. Insbesondere im Be-reich Ecological Economics führt der erweiterte Blickwinkel, der interdisziplinäre Rahmen und der Methodenpluralismus zu positiven Anstößen, aber auch zu Defiziten in der wissenschaftlichen Konkurrenzfähigkeit. Zudem ist die Kritik der traditionellen Theorie angesichts neuerer Ent-wicklungen auf den Prüfstand zu stellen. Die Ein-bindung in eine evolutorische Perspektive, die stärkere Verwendung formaler Methoden und der Abbau von Berührungsängsten gegenüber neo-klassischen Erklärungsmustern kann helfen, die-se Defizite zu überwinden.
Zukunft durch ökologische Dienstleistungen?
Authors: Lucas Rainer , Knothe Bettina
Published: April 2018

Zusammen mit dem Umzug des Regierungssitzes von Bonn nach Berlin werden auch Teile des dienstleistungsorientierten Umfeldes ihren Standort verlagern. Diese Entwicklung ist mit erheblichen wirtschaftlichen und sozialen Risiken verbunden. Das Institut für ökologische Wirtschaftsforschung untersuchte deshalb, welche Rolle ökologische Dienstleistungen zur Abmilderung dieses Prozesses spielen können.
Die Wuppertal-Studie als Herausforderung für die Arbeitssoziologie: Welche Zukunft hat die Arbeit?
Authors: Hildebrandt Eckart
Published: April 2018

Die Leitbilder der Wuppertal-Studie beschreiben einen ökologischen Wohlstand, aber nicht die Zukunft der Arbeit. Schon an einigen Beispielen zeigt sich die Vielfalt der provokativen und riskanten Infragestellungen, die die Studie für Arbeitspolitik enthält. Gleichzeitig wird offenbar, wie wenig die arbeitspolitische Debatte auf Fragen dieser Art vorbereitet ist.
Tourismus und Verkehr auf der ITB: Reisegewohnheiten ändern
Authors: Kehren Markus
Published: April 2018

Auf dem Wissenschaftsforum der Internationalen Tourismus Börse in Berlin vom 9. bis 13. März rankten sich in diesem Jahr zahlreiche Vorträge und Diskussionen um das Thema "Tourismus und Verkehr". Vor allem der Anstieg kurzer Fernreisen im Massentourismus setzt der Umwelt heftig zu.
Benchmarking mit Umweltkennzahlen bei Banken: Standardisierung erwünscht
Authors: Rauberger Rainer
Published: April 2018

Ohne eine einheitliche Definition von Umweltkennzahlen, so das Ergerbnis eines Expertenkreises im Verein für Umweltmanagement in Banken, Sparkassen und Versicherungen (VfU), ist eine seriöse Vergleichbarkeit nicht gewährleistet. Daher wird ein standardisiertes Kern-Umweltkennzahlenset als Grundlage für ein zukünftiges Benchmarking vorgeschlagen. Dieses könnte auch bei anderen Dienstleistungsunternehmen Verwendung finden.
Rankings von Umwelterklärungen: Systeme mit Schwachstellen
Authors: Nissen Ulrich , Falk Heiko
Published: April 2018

Bewertende Vergleiche von Umwelterklärungen (Rankings) entfalten dann eine umweltschutzfördernde Wirkung, wenn sie in der Öffentlichkeit und bei betroffenen Unternehmen auf Akzeptanz stoßen. Voraussetzung hierzu ist ein ausdifferenziertes und zugleich leicht nachvollziehbares Bewertungssystem. Bisher veröffentlichte Öko-Rankings weisen hier noch einige Schwächen auf.
Orientierungshilfe für Konsum
Authors: Scholl Gerd
Published: April 2018

Im Auftrag der IKEA-Stiftung, Hofheim-Wallau, hat das IÖW eine vergleichende Übersicht über produktbezogene Kennzeichen erstellt. Ziel der Untersuchung war es, eine ausgewählte Anzahl von Labels zu beschreiben und zu bewerten.
Das Projekt Umweltkennzahlen in norwegischen und schwedischen Unternehmen: Umweltschutzleistung als Orientierungsmaßgabe
Authors: Kleivane Tron
Published: April 2018

Will die Industrie in der Umweltdebatte mitreden, mufl sie Systeme und Instrumente zur eigenen Verbesserung entwickeln. Auf europäischer Ebene wurde aus diesem Grund das EPI-Projekt (Environmental Performance Indicators) zur Entwicklung von Umweltkennzahlen gestartet. Der norwegische Industrie- und Handelsverband hat die Verantwortung für die noch andauernde Testphase des Projekts.
Niederländischer Umweltplan: Die Erfolge staatlicher Förderung
Authors: Kuijjer Hugo H.
Published: April 2018

Die Niederlande streben mit ihrem Umwelt-Unternehmens-Plan konkrete Umweltziele an. Dazu gehören auch Veränderungen, die in enger Zusammenarbeit mit der Industrie durchgeführt werden müssen. Die bisherigen Ergebnisse zeigen, daß eine Stärkung des Umweltmanagements in den Unternehmen durch eine sinnvolle Zusammenarbeit mit den Behörden ergänzt werden muß.
Wechselnde Stimmungen
Authors: Glotz-Richter Michael
Published: April 2018

Die Entwicklung des städtischen Verkehrs in Bremen zeigt, wie sehr die verkehrlichen Leitbilder in Abhängigkeit von Politik, Einzelinteressen und Interessen einem stetigen Wandel unterliegen. Die Bürger der Stadt zeigen sich jedoch weitgehend zufrieden.
Steinzeit-Liberalisierun
Authors: Matthes Felix
Published: April 2018

Nach vielen gescheiterten Anläufen soll die deutsche Energiewirtschaft umfas-send dereguliert werden. Die mangelnde politische Entschlußkraft läßt jedoch nicht nur ökologische Rückschläge befürchten.
Balanceakt zwischen Mißtrauen und Kooperation
Authors: Helm Carsten
Published: April 2018

Im internationalen Wettbewerb der Standorte spielen auch Umweltschutzbe-stimmungen eine bedeutende Rolle. Um globale Umweltprobleme gemeinsam lösen zu können, herrscht besonderer Regelungsbedarf, Welche Vorschläge hat der Ausschuß zu Handel und Umwelt der WTO vorgelegt? Wie sind diese zu beurteilen?
Ökologische Werkstoffentwicklung im Team
Authors: Lucas Rainer
Published: April 2018

Seit zwei Jahren existiert in der Bergischen Region ein Netzwerk von Unter-nehmen und Institutionen mit dem Namen K.I.W.I. (1). Eines der gemeinsamen Handlungsfelder ist die "ökologische Werkstoffentwicklung", bei der es u.a. um das Recycling thermoplastischer Kunststoffe der Autozulieferer geht. Eine der zentralen Fragen der Zukunft ist dabei, ob die integrative Problemstellung einer ökologischen Werkstoffentwicklung zu neuen Akteurskonstellationen führt, die quer zu den eingefahrenen Beziehungsmustern liegen.
Der fiktive Charakter des Ökoinlandsproduktes
Authors: Leipert Christian
Published: April 2018

Ist es möglich, durch Einbeziehung der bisher nicht berücksichtigten Umweltkosten einen Indikator für eine ökologisch nachhaltige Produktion zu entwickeln? Diese Frage war das Thema eines Forschungsprojektes zur Berechnung eines Ökoinlandproduktes, das im Auftrag der Europäischen Union u.a. unter Beteiligung des IOW durchgeführt wurde. Die Autoren plädieren in ihrem Endbericht dafür, als Grundlage für die Berechnung eines derartigen Indikators Umweltnormen zu setzen.
Hebelwirkung für die Umwelt
Authors: Reinhard Dirk
Published: April 2018

Die ökologische Unternehmensbewertung hat sich als Informationsinstrument für interessierte Investoren etabliert. Selbst Großanleger entdecken Umweltinformationen als Entscheidungskriterium. Bei der Beschaffung der Informationen steht das Öko-Rating allerdings immer noch vor bürokratischen Hürden.
Höhere Rationalität durch Bewertung?
Authors: Ankele Kathrin , Rubik Frieder
Published: April 2018

Am Beispiel der produktbezogenen Ökobilanz behandelt der folgende Beitrag vor allem die Frage, wie vielfältige, komplexe Informationen bewältigt werden können. Außerdem wird erörtert,
Ökonomisch-ökologische Bewertung
Authors: Ankele Kathrin , Meyerhoff Jürgen
Published: April 2018

Die Bewertung von Produkten, Unternehmen oder auch Infrastrukturprojekten spielt eine bedeutende Rolle für die umweltpolitische Zielfindung. Die Notwendigkeit der Entscheidung erfordert die Abschätzung von Handlungsfolgen, seien sie beabsichtigt oder unbeabsichtigt. Zunächst wird ein Überblick über ver-schiedene Bewertungsverfahren und ihre jeweiligen Grundannahmen gegeben, um anschließend vertieft einige spezielle Aspekte zu diskutieren.
Ökofeministisch wirtschaften?
Authors: Knapp Ulla
Published: April 2018

Die Durchsetzung ökonomischer Gleichberechtigung der Geschlechter ist vor-wiegend ein politökonomisches Problem. Neuartige ethische Fragen, auf die die Prinzipien der Hausarbeit eine Antwort geben müßten, spielen demgegenüber nur eine untergeordnete Rolle. Vielmehr geht es um die Frage, mittels welcher Bündnisse Ansätze zur Umsteuerung durchgesetzt werden können.