bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of PCV vaccine is primarily mediated by controlling pneumococcal colonisation density
Authors: German E.L. , Solórzano C. , Sunny S. , Dunne F. , Gritzfeld J.F. , Mitsi E. , Nikolaou E. , Hyder-Wright A.D. , Collins A.M. , Gordon S.B. , Ferreira D.M.
Published: February 2019

Widespread use of Pneumococcal Conjugate Vaccines (PCV) has resulted in a reduction in nasopharyngeal colonisation and invasive pneumococcal disease caused by vaccine-types. In a double-blind, randomised controlled trial using the Experimental Human Pneumococcal Challenge (EHPC) model, PCV-13 (Prevenar-13) conferred 78% protection against colonisation acquisition and a reduction in bacterial intensity (AUC) in experimentally colonised volunteers as measured by classical culture. In this study, we used a multiplex quantitative PCR assay targeting lytA and pneumococcal serotype 6A/B cpsA genes to re-assess the experimental colonisation status of the same trial volunteers. Increase in detection of low-density colonised volunteers by this molecular method led to a decrease of PCV efficacy against colonisation acquisition (29%), as compared to classical culture (83%). For subjects who were colonised following pneumococcal challenge, PCV had a pronounced effect on decreasing colonisation density. These results have implications for vaccine efficacy and surveillance studies as they indicate that the success of PCV vaccination could primarily be mediated by the control of vaccine-type colonisation density which results in decreased transmission and the reported herd effect of PCVs. Studies assessing the impact of PCV should account for density measurements in their design.

Clinical trial registration with ISRCTN: 45340436
Transcriptional signatures of progressive neuropathology in transgenic tau and amyloid mouse models
Authors: Castanho Isabel , Murray Tracey K. , Hannon Eilis , Jeffries Aaron , Walker Emma , Laing Emma , Baulf Hedley , Harvey Joshua , Randall Andrew , Moore Karen , O’Neill Paul , Lunnon Katie , Collier David A. , Ahmed Zeshan , O’Neil Michael J. , Mill Jonathan
Published: February 2019

The onset and progression of Alzheimer’s disease (AD) is characterized by increasing intracellular aggregation of hyperphosphorylated tau protein and accumulation of β-amyloid (Aβ) in the neocortex. Despite recent success in identifying genetic risk factors for AD the transcriptional mechanisms involved in disease progression are not fully understood. We used transgenic mice harbouring human tau (rTg4510) and amyloid precursor protein (J20) mutations to investigate transcriptional changes associated with the development of both tau and amyloid pathology. Using highly-parallel RNA sequencing we profiled transcriptional variation in the entorhinal cortex at four time points identifying robust genotype-associated differences in entorhinal cortex gene expression in both models. We quantified neuropathological burden across multiple brain regions in the same individual mice, identifying widespread changes in gene expression paralleling the development of tau pathology in rTg4510 mice. Differentially expressed transcripts included genes associated with familial AD from genetic studies of human patients, and genes annotated to both common and rare variants identified in GWAS and exome-sequencing studies of late-onset sporadic AD. Systems-level analyses identified discrete co-expression networks associated with the progressive accumulation of tau, with these enriched for genes and pathways previously implicated in the neuro-immunological and neurodegenerative processes driving AD pathology. Finally, we report considerable overlap between tau-associated networks and AD-associated co-expression modules identified in the human cortex. Our data provide further support for an immune-response component in the accumulation of tau, and reveal novel molecular pathways associated with the progression of AD neuropathology.
Plasma pNfH differentiate SBMA from ALS
Authors: Lombardi Vittoria , Alessandro Bombaci , Zampedri Luca , Lu Ching-Hua , Malik Bilal , Zetterberg Henrik , Heslegrave Amanda , Rinaldi Carlo , Greensmith Linda , Hanna Michael , Malaspina Andrea , Fratta Pietro
Published: February 2019

Background and aim:

Spinal bulbar muscular atrophy (SBMA) is a progressive adult-onset X-linked neuromuscular disease. Although traditionally considered a motor neuron disorder, recent advances have highlighted a primary myopathic component. We evaluated levels of phosphorylated neurofilament heavy chain (pNfH), a known biomarker for neurodegeneration, in SBMA.

Materials and methods:

We collected plasma and serum from 46 SBMA, 50 ALS and 50 healthy control cases, alongside with plasma from a mouse model of SBMA (AR100) and littermate controls. We measured pNfH plasma levels using Single molecule array (Simoa), we assessed functional scales and we gathered demographic data. We analysed data using Mann-Whitney U test, Kruskal-Wallis test and Cox regression analysis.

Results:

Plasma pNfH levels were significantly increased in ALS, but, intriguingly, there was no change in SBMA. These results were also confirmed in SBMA mice. The ROC curve highlighted that pNfH levels can effectively distinguish between ALS and SBMA (AUC 0.95).

Conclusions:

Unexpectedly, levels of pNfH are normal in SBMA, whilst they are increased in ALS, and suggest pNfH could serve as a biomarker to differentiate the two diseases. Further, this finding is in agreement with recent evidence showing that primary muscle damage is a crucial feature in SBMA.
Sulfide stress cracking assessment of low-alloy L80 casing steel in H2S environment
Authors: Huang Weishan , Luo Jing-Li , Henein Hani , Jordan Josiah
Published: February 2019

Purpose

This paper aims to evaluate the sulfide stress cracking (SSC) resistance of L80 casing steels with different alloying chemistries (e.g. Ti-B and Mn-Cr-Mo) by correlating the reduction in area ratio with the mechanical property, inclusion and carbide.

Design/methodology/approach

SSC tests were conducted in 5.0 Wt.% sodium chloride and 0.5 Wt.% acetic acid solution saturated with H2S using constant load tensile method. The microstructure and fracture morphology of the steel were observed using scanning electron microscope. The inclusion and carbide were identified by energy dispersive spectroscopy and auger electron microscope.

Findings

Among all the testing steels, electric resistance welding (ERW) L80-0.5Mo steel demonstrates the highest SSC resistance because of its appropriate mechanical properties, uniform microstructure and low inclusion content. The SSC resistance of L80 steels generally decreases with the rising yield strength. The fracture mode of steel with low SSC resistance is jointly dominated by transgranular and intergranular cracking, whereas that with high SSC resistance is mainly transgranular cracking. SSC is more sensitive to inclusions than carbides because the cracks are easier to be initiated from the elongated inclusions and oversized oxide inclusions, especially the inclusion clusters. Unlike the elongated carbide, globular carbide in the steel can reduce the negative effect on the SSC resistance. Especially, a uniform microstructure with fine globular carbides favors a significant improvement in SSC resistance through precluding the cracking propagation.

Originality/value

The paper provides the new insights into the improvement in SSC resistance of L80 casing steel for its application in H2S environment through optimizing its alloying compositions and microstructure.
Got political skill?
Authors: Kim Taegoo Terry , Karatepe Osman M. , Chung Ung Young
Published: February 2019

Purpose

The purpose of this study is to propose a research model in which political skill (PS) exerts a direct effect on role stress, job tension, work engagement and service performance and buffers the deleterious impact of role stress on job tension. The model also investigates the interrelationships of role stress, job tension, work engagement and service performance.

Design/methodology/approach

The sample was drawn from 261 customer-contact employees in 15 casual restaurants in South Korea. Structural equation modeling was used to assess the aforementioned relationships.

Findings

The findings illustrate that PS alleviates role stress and job tension, while it fosters work engagement and service performance. PS is a panacea to the deleterious impact of role stress on job tension. As expected, role stress heightens job tension, while job tension mitigates work engagement. The findings further reveal that work engagement exerts a positive impact on service performance.

Practical implications

Training interventions can be used to develop employees’ PS. Management should hire the individuals with high PS because such employees can work in harmony with the organizational culture and experience lower role stress and job tension.

Originality/value

The extant hospitality research implicitly demonstrates that very little is known about the outcomes of PS and its moderating role on the relationship between role stress and job tension. The current work set out to fill in this gap.
Cross-border nursing education: questions, qualms and quality assurance
Authors: Naidoo Vasanthrie , Sibiya Maureen Nokuthula
Published: February 2019

Purpose

The purpose of this paper is to share insights, research findings and discuss key issues relating to quality practices and quality assurance in cross-border nursing education program development and implementation.

Design/methodology/approach

The authors used a qualitative, multiple case-study approach, by sampling local, national and international nursing education institutions, academia and nurse graduates to identify challenges and best operating practices in implementing and facilitating cross-border education.

Findings

The authors reveal that quality assurance affects cross-border nursing education program design, delivery and implementation.

Research limitations/implications

Quality assurance plays an important role in cross-border nursing education, by enhancing the reputation and recognizing the effectiveness and capacity of the educational institution. These findings of this study can offer valuable insight to forthcoming as well as existing nursing education curriculum developers who plan to engage in national or international educational partnerships.

Practical implications

Quality assurance plays an important role in cross-border nursing education, by enhancing the reputation and recognizing the educational institution’s effectiveness and capacity. The findings offer valuable insight into forthcoming and existing nursing education for curriculum developers who plan to engage in national or international educational partnerships.

Originality/value

This paper explores inherent challenges in cross-border nursing education and maximized data collection opportunities by sampling participants from both national and international settings.
Hospital quality indicators: a systematic review
Authors: Breyer Juliana Zeni , Giacomazzi Juliana , Kuhmmer Regina , Lima Karine Margarites , Hammes Luciano Serpa , Ribeiro Rodrigo Antonini , Kops Natália Luiza , Falavigna Maicon , Wendland Eliana Marcia
Published: February 2019

Purpose

The purpose of this paper is to identify and describe hospital quality indicators, classifying them according to Donabedian’s structure, process and outcome model and in specific domains (quality, safety, infection and mortality) in two care divisions: inpatient and emergency services.

Design/methodology/approach

A systematic review identified hospital clinical indicators. Two independent investigators evaluated 70 articles/documents located in electronic databases and nine documents from the grey literature, 35 were included in the systematic review.

Findings

In total, 248 hospital-based indicators were classified as infection, safety, quality and mortality domains. Only 10.2 percent were identified in more than one article/document and 47 percent showed how they were calculated/obtained. Although there are scientific papers on developing, validating and hospital indicator assessment, most indicators were obtained from technical reports, government publications or health professional associations.

Research limitations/implications

This review identified several hospital structure, process and outcome quality indicators, which are used by different national and international groups in both research and clinical practice. Comparing performance between healthcare organizations was difficult. Common clinical care standard indicators used by different networks, programs and institutions are essential to hospital quality benchmarking.

Originality/value

To the authors’ knowledge, this is the first systematic review to identify and describe hospital quality indicators after a comprehensive search in MEDLINE/PubMed, etc., and the grey literature, aiming to identify as many indicators as possible. Few studies evaluate the indicators, and most are found only in the grey literature, and have been published mostly by government agencies. Documents published in scientific journals usually refer to a specific indicator or to constructing an indicator. However, indicators most commonly found are not supported by reliability or validity studies.
Why do natives and non-natives have different housing outcomes? Evidence from Britain
Authors: Oladiran Olayiwola , Nanda Anupam , Milcheva Stanimira
Published: February 2019

Purpose

This study aims to examine the housing outcomes of natives and multiple generations of non-natives using a longitudinal survey data in Britain.

Design/methodology/approach

The authors use longitudinal data from Britain, in which they can observe multiple generations of immigrants and their demographic and economic information.

Findings

The probability models for housing tenure reveal significant variation in the outcomes which are robust to several econometric specifications.

Research limitations/implications

As migration and its impact on local economy is a highly debated topic across several major regions of the world, the findings bring out important insights with policy implications. The research is limited by the sample size of the longitudinal survey.

Originality/value

The empirical evidence on the topic is quite limited with mixed findings. Especially, the authors’ ability to look through multiple generations is unique in identifying the variation in housing outcomes for the native and non-native citizens.
Last mile delivery to the bottom of the pyramid in Brazilian slums
Authors: Duarte André Luis de Castro Moura , Macau Flavio , Flores e Silva Cristiano , Sanches Lars Meyer
Published: February 2019

Purpose

The purpose of this paper is to explore last mile delivery (LMD) to the bottom of the pyramid in Brazilian slums, its challenges and how practitioners overcome them. Urban logistics in precarious circumstances is central to the conceptualization.

Design/methodology/approach

A qualitative, grounded theory methodology is developed, gathering data from companies delivering to slums in Sao Paulo and Rio de Janeiro, Brazil. Field notes, documents and interviews led to conceptual categories for LMD to slums.

Findings

The study indicates that while some standard urban logistics practices can be effective for LMD to slums, such unusual contexts often call for unusual solutions. A model is developed using grounded theory categorization, resulting in five dimensions for LMD to slums: employing locally, giving back, acknowledging criminals, vehicle and location.

Research limitations/implications

The model is a qualitative proposition representing LMD to slums in two major Brazilian cities. Even though slums in different cities/countries may face similar conditions, additional studies are needed to confirm and replicate the model.

Practical implications

Companies that successfully engage in LMD to slums must adapt and develop idiosyncratic practices.

Social implications

LMD to slums enables a larger portion of bottom of the pyramid consumers to access a wider range of products and work opportunities, contributing to their social inclusion.

Originality/value

The study provides an understanding of LMD in a new context. The model encourages companies to question their current practices, learning from effective LMD experiences implemented by successful practitioners.
Experiential approaches to sustainability education: towards learning landscapes
Authors: Backman Malin , Pitt Hannah , Marsden Terry , Mehmood Abid , Mathijs Erik
Published: February 2019

Purpose

This paper aims to critically reflect the current specialist discourse on experiential approaches to higher education for sustainable development (HESD). Limitations to the current discourse are identified, and as a result, an alternative approach to the study of experiential education (EE) within HESD is suggested.

Design/methodology/approach

Three research questions are addressed by analysing the literature on EE and experiential learning (EL) within HESD in specialist academic journals.

Findings

There is a consensus among authors regarding the appropriateness of experiential approaches to HESD. However, limitations to the current discourse suggest the need for an alternative approach to studying EE within HESD. Therefore, this paper proposes the application of the learning landscape metaphor to take a more student-centred and holistic perspective.

Originality/value

The learning landscape metaphor has previously not been applied to EE within HESD. This alternative conceptualisation foregrounds student perspectives to experiential initiatives within HESD. The holistic approach aims to understand the myriad influences on students learning, while allowing examination of how experiential approaches relate to other educational approaches within HESD.
Data use within an education-centered cross-sector collaboration
Authors: Hackmann Donald G. , Malin Joel R. , Ahn Joonkil
Published: February 2019

Purpose

The purpose of this paper is to examine data use practices within a cross-sector initiative involving high school career academies. It discerns how partners used data to assess the public value of academies and address equity concerns.

Design/methodology/approach

A case study methodology was applied to examine cross-sector activities supporting the district’s career academy reform. Data were collected through interviews, observations and document analysis. Datnow and Park’s (2018) conceptual framework involving key equity dimensions guided the analysis.

Findings

Partners used data for both accountability and continuous improvement. Educators were required to document student growth for state accountability purposes, while providing evidence of the public value of the academies to the community. Data use for continuous improvement included identifying annual goals to improve academy performance. There was a lack of a district-wide focus on equity, with educators taking a passive approach to academy and career pathway selections by student subgroups.

Practical implications

The findings provide insights into data use practices school and district leaders can implement to ensure equitable student participation in career academies and appropriate data use within cross-sector collaborations.

Social implications

Students who are traditionally underrepresented in career fields, including students of color and females, need intentional efforts to encourage their participation in high-skill, high-wage career fields.

Originality/value

This study identifies critical issues involved with data use for equity when promoting education-centered cross-sector collaboration, while also highlighting existing tensions between data use for accountability and continuous improvement.
Integrated care for community dwelling older Australians
Authors: Mann Jennifer , Devine Sue , McDermott Robyn
Published: February 2019

Purpose

Integrated care is gaining popularity in Australian public policy as an acceptable means to address the needs of the unwell aged. The purpose of this paper is to investigate contemporary models of integrated care for community dwelling older persons in Australia and discuss how public policy has been interpreted at the service delivery level to improve the quality of care for the older person.

Design/methodology/approach

A scoping review was conducted for peer-reviewed and grey literature on integrated care for the older person in Australia. Publications from 2007 to present that described community-based enablement models were included.

Findings

Care co-ordination is popular in assisting the older person to bridge the gap between existing, disparate health and social care services. The role of primary care is respected but communication with the general practitioner and introduction of new roles into an existing system is challenging. Older persons value the role of the care co-ordinator and while robust model evaluation is rare, there is evidence of integrated care reducing emergency department presentations and stabilising quality of life of participants. Technology is an underutilised facilitator of integration in Australia. Innovative funding solutions and a long-term commitment to health system redesign is required for integrated care to extend beyond care co-ordination.

Originality/value

This scoping review summarises the contemporary evidence base for integrated care for the community dwelling older person in Australia and proposes the barriers and enablers for consideration of implementation of any such model within this health system.
Exploring an integrated palliative care model for older people: an integrative review
Authors: Raco Marina , Burdett Teresa , Heaslip Vanessa
Published: February 2019

Purpose

Due to an international ageing population, global health organisations have recognised the challenges arising from fragmented interaction between health and social sectors in the end of life care. The purpose of this paper is to explore the existing literature on integrative palliative care services for older people.

Design/methodology/approach

An integrative review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Papers included in the review focused upon integrated care within palliative care systems (January 2007–2017). A certain number of papers were excluded when the review focused on individuals younger than 65, not written in English and not being focused on integrated palliative care.

Findings

Nine studies fitted the inclusion criteria and three themes were identified: person-centred care, co-ordination of care, and education and training. The review identifies that integrated palliative care requires co-ordinated techniques that focus upon the quality of life, individual needs and awareness of vulnerability rather than fixation on inevitable mortality.

Research limitations/implications

The emerging presence of the need for integrated palliative care requires further research in order to develop coherent models of integrated palliative care which can be incorporated into practice.

Originality/value

This review identified themes relevant to the emerging issues in the global health sector of end of life care. The literature suggests that the optimised use of an integrated care approach to a palliative model of care is required and in need of further investigation.
Justifying new employees’ trials by fire: workplace hazing
Authors: Thomas Benjamin J. , Meglich Patricia
Published: February 2019

Purpose

The purpose of this paper is to test the explanatory effects of the system justification theory on reactions to new employee hazing.

Design/methodology/approach

Three studies (N= 107, 121 and 128), all using experimental assignment, vignettes of workplace hazing and two-level repeated measures ANCOVA designs, with dispositional variables included as covariates and justification of workplace hazing processes as dependent variables, were conducted.

Findings

Onlookers are more likely to justify long-standing (cf. recently adopted) hazing systems and hazing systems used by highly cohesive (cf. loosely cohesive) teams, supporting the application of the system justification theory to workplace hazing reactions.

Research limitations/implications

The use of vignette research and onlookers (cf. hazed employees) may limit inferences drawn about employee reactions in workplaces that use hazing.

Practical implications

Despite its negative associations, hazing at work persists, with 25 percent of current sample reported being hazed at work. The system justification theory, which the authors applied to hazing, offers an explanation for stakeholders’ willingness to sustain and perpetuate hazing, and onlookers’ seeming blind-spot regarding outrage over workplace hazing. This theory holds promise for combatting passive responses to workplace hazing.

Originality/value

This is the first paper to empirically test explanations for workplace hazing’s perpetuation, by applying the system justification theory to the social system of workplace hazing. Moreover, it is the first paper to offer empirical evidence of hazing’s prevalence across at least 25 percent of sampled industries and organizational rank.
Guess who’s coming to deliver? Tough decisions about race in the workplace
Authors: Thompson Katina Williams , Dustin Susan
Published: February 2019

Theoretical basis

The authors used Sue’s (2010) microaggression process model and Freeman et al.’s (2010) stakeholder theory as a theoretical basis for this case.

Research methodology

Information for the case was gathered from publicly available sources. No formal data collection efforts were undertaken.

Case overview/synopsis

Guess Who’s Coming to Deliver is a case that examines an event that occurred at Lowe’s Home Improvement Warehouse in late July and early August of 2015. A customer who had purchased some products from Lowe’s requested that only White delivery people were dispatched to her home because she did not allow African–American people in her house. The case is factual and was written from information that was publicly available in the media. The case is designed to help instructors facilitate a meaningful classroom discussion about microaggressions from the different stakeholder perspectives.

Complexity academic level

The case is relevant for undergraduate and graduate organizational behavior and human resource management courses.
Measuring the surrogacy potential of charismatic megafauna species across taxonomic, phylogenetic and functional diversity on a megadiverse island
Authors: Sibarani Marsya C. , Di Marco Moreno , Rondinini Carlo , Kark Salit
Published: February 2019

Conservation organisations and governments often use charismatic megafauna as surrogates to represent broader biodiversity. While these species are primarily selected as “flagships” for marketing campaigns, it is important to evaluate their surrogacy potential, i.e. the extent to which their protection benefits other biodiversity elements. Four charismatic megafauna species are used as surrogates in the megadiverse island of Sumatra: the Sumatran tigerPanthera tigris sumatrae, Sumatran elephantElephas maximus sumatranus, Sumatran orangutanPongo abeliiand Sumatran rhinocerosDicerorhinus sumatrensis. We examined how well each of these species performed in representing the distribution of all co‐occurring terrestrial mammal species on the island, and the priority areas for the conservation of three facets of mammalian biodiversity (taxonomic, phylogenetic and functional).

We used habitat suitability models to represent the distribution of 184 terrestrial mammal species, 160 phylogenetic groups and 74 functional trait groups. We then identified priority conservation areas using the spatial prioritisation software Zonation.

We found that the habitat overlap between each of the four charismatic species and the other mammal species varied, ranging from a mean of 52% (SD = 27%) for the tiger to 2% (SD = 2%) for the rhino. Combining the four species together improved the representation levels only marginally compared to using the tiger only. Among the four charismatic megafauna species, the extent of suitable habitat of Sumatran tiger covered the highest proportion of priority conservation areas. The Sumatran tiger also outperformed most of other mammal species with similar range sizes.

We found that some of the top‐ranked conservation areas for taxonomic (28%), phylogenetic (8%) and functional diversity (19%) did not overlap with any of the charismatic species’ suitable habitat.

Synthesis and applications. Wide‐ranging charismatic species can represent broader mammalian biodiversity, but they may miss some key areas with high biodiversity importance. We suggest that a combination of systematic spatial prioritisation and surrogacy analyses are important in order to determine the allocation of conservation resources in biodiversity‐rich areas such as Sumatra, where an expansion of the protected area network is required.
Knowledge productivity and the returns to agricultural research: a review
Authors: Andersen Matthew A.
Published: February 2019

This paper describes the identification, specification, estimation, and evaluation of econometric models of knowledge productivity and the returns‐to‐research. General issues related to these models are discussed and placed in context of the literature. The path from R&D investment to economic benefit is complex, convoluted, generally unknown and possibly misrepresented. The complexity arises from the intricate spatial spillover relationships and the very long time periods involved, which complicate any econometric analysis. The relevant R&D investment data are typically unavailable, incomplete and poorly measured (or approximated). The appropriate calculation of the financial benefit is not entirely clear. Some parsimonious suggestions for future research are presented.
Towards a nuanced understanding of health‐supportive place using composite research methods
Authors: Thompson Susan , Paine Gregory , Judd Bruce , Randolph Bill
Published: February 2019

Chronic non‐communicable diseases comprise a major challenge for health in contemporary Australia and across the globe and, while various factors are at play, personal choices in behaviour and lifestyle are significant. The physical make‐up and ongoing management of the places where we live positively and negatively influences these lifestyle choices and subsequent health outcomes. However, responses—in research, policy, built environment design, construction, and management—frequently fail to recognise the intricacies of this people‐place‐behaviour nexus largely because those responses are highly focused and empirical. Rather, the health‐supportive environments needed to address the current chronic disease epidemic also require additional—networked, nuanced, and intuitive—understandings. Responding to that need, the study described in this paper took a comprehensive view of what constitutes a health‐supportive built environment. We detail the composite methods employed—built environment audits, interviews, and focus groups—all of which are available for use by others in similar situations. Then, using two case study examples, we reflect upon how our methodology revealed otherwise hidden aspects of the extent to which the study sites supported or hindered health‐supportive behaviours and responses. These results suggest intervention actions for policy makers and practitioners that will help them respond to the complex needs of communities in creating a health‐supportive environment.
Real‐world effectiveness and safety of rituximab in the treatment of rheumatoid arthritis: A single‐center experience in Taiwan
Authors: Wang Kai‐Chun , Liao Hsien‐Tzung , Chen Wei‐Sheng , Lai Chien‐Chih , Chou Chung‐Tei , Chen Ming‐Han , Tsai Chang‐Youh
Published: February 2019

Aim

To assess the real‐world effectiveness and safety of rituximab (RTX) at 24 months in patients with established rheumatoid arthritis (RA) and to identify predictors of low disease activity/remission and a good European League Against Rheumatism (EULAR) response.

Methods

Seventy RTX‐treated RA patients were enrolled. Predictors for low disease activity/remission and a good EULAR response at 24 months were identified by multivariate analyses.

Results

At 24 months, the mean Disease Activity Score of 28 joints—erythrocyte sedimentation rate (DAS28‐ESR) decreased from 6.88 ± 0.85 at baseline to 3.47 ± 0.85. Twenty‐nine patients (41.4%) reached low disease activity/remission, while all patients had a moderate/good EULAR response. After adjustment by multivariate analyses, we found concomitant methotrexate at a dosage >10 mg/week (odds ratio [OR] 5.17; 95% CI 1.34‐19.93; P = 0.017) predicted low disease activity/remission, and baseline DAS28 ≤6.5 (OR 4.97; 95% CI 1.22‐20.30; P = 0.026) predicted good EULAR response at 24 months. The most common adverse events were infusion‐related (5.7%), and there was no incidence of malignancy or mortality during the treatment.

Conclusions

RTX was effective and safe in real‐life management of RA patients with high disease activity. Patients taking concomitant methotrexate and with lower baseline DAS28‐ESR were more likely to benefit from RTX.
Genetic diversity and geographic distribution of Bemisia tabaci and Trialeurodes vaporariorum in Costa Rica
Authors: Barboza Natalia M. , Esker Paul , Inoue‐Nagata Alice K. , Moriones Enrique
Published: February 2019

The tobacco whitefly Bemisia tabaci (Gennadius) cryptic species complex and of the greenhouse whitefly Trialeurodes vaporariorum (Westwood) are extensively reported as destructive pests in vegetable crops worldwide. A survey was conducted in 2011 and 2012 to determine the occurrence and genetic diversity present in the populations of these whiteflies in the major vegetable production areas of Costa Rica. Insect samples were collected from sweet pepper (Capsicum annuum L.), tomato (Solanum lycopersicum L.), common bean (Phaseolus vulgaris L.) and weeds present in commercial crops either in open field or greenhouse conditions. PCR‐RFLP analysis of mitochondrial cytochrome c oxidase subunit 1 gene (mtCOI) sequences of 621 whitefly individuals confirmed the presence of the Mediterranean (MED) type of the B. tabaci and of T. vaporariorum in most sampled regions. Also, individuals of the Middle East‐Asia Minor 1 (MEAM1) type of the B. tabaci were observed in low numbers. Contingency analyses based on type of crop, geographical region, whitefly species, year of collection and production system confirmed that T. vaporariorum was the most frequent species in vegetable production areas in Costa Rica, both in greenhouses and in open fields. B. tabaci MED is likely spreading to new areas of the country, whereas B. tabaci MEAM1 was mostly absent or rarely found. Comparisons of mtCOI sequences from B. tabaci individuals revealed the presence of four B. tabaci sequence haplotypes (named MED‐i, MED‐ii, MEAM1‐i, MEAM1‐xviii) in Costa Rica, three of them identical to B. tabaci haplotypes previously reported in the Western Hemisphere and other parts of the world. Analysis of sequences of T. vaporariorum individuals revealed a more complex population with the presence of 11 haplotypes, two of which were identical to T. vaporariorum sequences reported from other countries.
Pharmacological targeting of the GABAB receptor alters Drosophila's behavioural responses to alcohol
Authors: Ranson Daniel C. , Ayoub Samir S. , Corcoran Olivia , Casalotti Stefano O.
Published: February 2019

When exposed to ethanol, Drosophila melanogaster display a variety of addiction‐like behaviours similar to those observed in mammals. Sensitivity to ethanol can be quantified by measuring the time at which 50% of the flies are sedated by ethanol exposure (ST50); an increase of ST50 following multiple ethanol exposures is widely interpreted as development of tolerance to ethanol. Sensitivity and tolerance to ethanol were measured after administration of the gamma‐aminobutyric acid receptor B (GABAB) agonist (SKF 97541) and antagonist (CGP 54626), when compared with flies treated with ethanol alone. Dose‐dependent increases and decreases in sensitivity to ethanol were observed for both the agonist and antagonist respectively. Tolerance was recorded in the presence of GABAB drugs, but the rate of tolerance development was increased by SKF 97451 and unaltered in presence of CGP 54626. This indicates that the GABAB receptor contributes to both the sensitivity to ethanol and mechanisms by which tolerance develops. The data also reinforce the usefulness of Drosophila as a model for identifying the molecular components of addictive behaviours and for testing drugs that could potentially be used for the treatment of alcohol use disorder (AUD).
The diameter of metastasis in positive sentinel lymph node biopsy affects axillary tumor load in early breast cancer
Authors: Falco Michał , Masojć Bartłomiej , Byrski Tomasz , Kram Andrzej
Published: February 2019

Introduction

Omission of axillary lymph node dissection (ALND) after positive sentinel lymph biopsy (SLNB) has become a standard procedure for breast cancer patients with one or two metastatic lymph nodes. Here the aim was model development for selection for ALND.

Material and methods

We analyzed 323 positive SLNB breast cancer patients, who afterwards underwent ALND. In 126 (39%), there were positive additional axillary lymph nodes. Specimens of resected lymph nodes were scanned and the volumes of tumors (expressed as diameter in mm) were calculated. The maximal diameter of metastasis in the sentinel lymph nodes (SLNDmax) and axillary lymph nodes (ALNDsum) indicated tumor load in the resected lymph nodes. ALNDsum higher or equal to 5 mm was defined as high and present in 62 patients (21%).

Results

Risk factors for high ALNDsum were primary tumor diameter (P = 0.0092), histopathological type (P = 0.0173), number of positive SLNs (P = 0.0012), type of metastasis (P = 0.0025), molecular type (P = 0.0037), SLNDmax (P = 0.0001), and Her‐2 status (P = 0.0093). Independent variables for high ALNDsum were SLNDmax (P < 0.0001), number of positive SLNs (P = 0.0237) and primary tumor diameter (P = 0.0296).

Conclusions

Twenty‐one percent patients with positive SLNB are at risk of high ALNDsum. SLNDmax is the strong predictive factor for high ALNDsum after positive ALND.
Patterns of follow‐up care after curative radiotherapy ± chemotherapy for stage I–III non–small cell lung cancer
Authors: Mohan Sharanya , Beydoun Nadine , Nasser Elias , Nguyen Andrew , Shafiq Jesmin , Vinod Shalini
Published: February 2019

Objectives

To describe patterns of follow‐up care for non–small cell lung cancer patients treated with curative radiotherapy and to evaluate the role of routine imaging.

Materials and methods

We retrospectively analyzed follow‐up care of patients with stage I–III non‐small cell lung cancer treated with curative radiotherapy (minimum dose of 50 Gy) between 2007 and 2011 at three Sydney institutions. Patient demographics, tumor characteristics and treatment factors were collected from oncology and hospital records. Follow‐up visits were recorded until an event (recurrence or new primary) was diagnosed or censor date was reached (December 31, 2016). Univariate and multivariate analyses were performed to identify factors associated with subsequent curative treatment and survival.

Results

Two‐hundred and eighty‐three patients were identified with a median age of 72 (36–91) years. Median number of follow‐up visits was 6, and median time to first event was 10.8 months. Follow‐up visits were by routine appointment in 74%, and symptomatic presentation in 26%. Variation in follow‐up was seen across the three institutions in terms of imaging conducted and specialist seen. Recurrences were diagnosed in 175 patients of whom 85 were symptomatic and 90 diagnosed on routine imaging. New primaries were diagnosed in 23 patients, 18 with symptoms and 5 on routine imaging. Subsequent treatment was curative in 17 (10%) patients with recurrent disease and 18 (78%) with new primaries. On multivariable analysis, symptomatic diagnosis (P = 0.006) was associated with subsequent curative treatment but not with overall survival (P > 0.05).

Conclusion

The follow‐up of patients showed considerable variation between institutions. Routine imaging was not associated with subsequent curative treatment of events or improved overall survival.
Translation and psychometric testing of Cancer Survivors’ Unmet Needs, Chinese version
Authors: Xing Weijie , So Winnie Kwok Wei , Choi Kai Chow , Wong Cho Lee , Tong Man , Choy Yin Ping , Molassiotis Alex , Yates Patsy , Chan Raymond Javan
Published: February 2019

Aim

The aim of the study was to translate the Cancer Survivors’ Unmet Needs (CaSUN) scale into Chinese, and then test its psychometric properties, for cancer survivors in Hong Kong.

Methods

The original questionnaire was translated from English into traditional Chinese (CaSUN‐Chi), following standardized procedures. An expert panel was invited to assess the items’ content validity, and pilot test on 15 patients to evaluate its readability. The sample for psychometric evaluation was drawn from a large multinational study assessing unmet needs of cancer survivors, with a convenience sample of 300 was recruited. Cronbach's α coefficient was used to assess the internal consistency of the scale, and confirmatory factor analysis to evaluate its construct validity.

Results

The CaSUN‐Chi had good readability and high content validity (S‐CVI 0.98). Cronbach's α for the entire scale was 0.93 and 0.71–0.91 for the five subscales. Confirmatory factor analysis indicated that the five‐factor structure of the CaSUN‐Chi was good fit to the data (CFI = 0.99, AGFI = 0.98, RMSEA = 0.054, SRMR = 0.071).

Conclusion

The CaSUN‐Chi showed desirable psychometric properties for assessing unmet needs of cancer survivors in Hong Kong. Using the newly translated scale to identify individual supportive care unmet needs can bridge the gap between patients’ experiences and expectations, and improve healthcare provision and resource allocation.
Endogenous circulating testosterone and sex hormone‐binding globulin levels and measures of myocardial structure and function: the Framingham Heart Study
Authors: Pencina K. M. , Travison T. G. , Bhasin S. , Li Z. , Nigam N. , Manning W. J. , Vasan R. S. , Hoffmann U. , O'Donnell C. J. , Basaria S.
Published: February 2019

Background

The relation between endogenous testosterone concentrations and myocardial mass and function remains incompletely understood.

Objectives

To determine the cross‐sectional association between endogenous hormone levels with cardiac magnetic resonance measures of myocardial mass, structure, and function in community‐dwelling men across a wide age range.

Methods

A total of 720 men from the Framingham Heart Study Offspring Cohort (age range 37–82, mean = 59.6 years) who underwent cardiac magnetic resonance imaging and had hormone levels measured. Total testosterone (measured using liquid chromatography‐tandem mass spectrometry), sex hormone‐binding globulin (measured using an immunofluorometric assay), and calculated free testosterone levels were assessed in male participants of the Framingham Heart Study Offspring Cohort at examination 7. Cardiac magnetic resonance imaging was performed between examinations 7 and 8 (2002–2006).

Results

Age‐adjusted linear regression models showed statistically significant association between total testosterone levels and left ventricular mass (p = 0.009), left ventricular mass index (p = 0.006), cardiac output (p = 0.001), and main pulmonary artery diameter (p = 0.008); the association between total testosterone and these cardiac magnetic resonance measures was weak and was not significant after adjustment for established risk factors—age, body mass index, diabetes, and hypertension. Furthermore, calculated free testosterone level was not significantly associated with any measure of myocardial mass or function. Sex hormone‐binding globulin level was significantly associated with left ventricular mass (p = 0.002), left ventricular mass index (p = 0.004), cardiac output (p = 0.003), left ventricular ejection fraction (p = 0.039), and main pulmonary artery diameter (p = 0.042) in age‐adjusted models; these associations were also rendered non‐significant after adjusting for cardiovascular risk factors.

Conclusions

Neither testosterone nor sex hormone‐binding globulin levels in men are associated significantly with myocardial mass and function independent of established cardiovascular risk factors.
Maternal outcome after complete uterine rupture
Authors: Al‐Zirqi Iqbal , Daltveit Anne Kjersti , Vangen Siri
Published: February 2019

Introduction

Complete uterine rupture, a rare peripartum complication, is often associated with a catastrophic outcome for both mother and child. However, few studies have investigated large datasets to evaluate maternal outcomes after complete ruptures, particularly in unscarred uteri. This paucity of studies is partly due to the rarity of both the event and the serious outcomes, such as peripartum hysterectomy and maternal death. The incidence of uterine rupture is expected to increase, due to increasing cesarean section rates worldwide. Thus, it is important to have more complete knowledge about the immediate maternal outcome following a complete uterine rupture. The objective was to identify maternal outcomes and their risk factors following complete uterine ruptures.

Material and methods

This was a population‐based study using data from the Medical Birth Registry of Norway, the Patient Administration System and medical records. Maternities with complete uterine rupture after start of labor in Norway during 1967‐2008 (n = 247 births), identified among 2 209 506 women. Uterine ruptures were identified from both registries and were further studied through a review of medical records. Only complete ruptures were included in analysis. The associations between maternal outcomes and demographic and labor risk factors were estimated. Odds ratios (ORs) were determined with crude logistic regressions for each risk factor. Separate multivariable logistic regressions were performed to calculate adjusted odds ratios and 95% confidence intervals (CIs).

Results

We identified 88 (35.6%) healthy mothers, 107 (43.3%) severe postpartum hemorrhages without hysterectomy, 51 (20.6%) peripartum hysterectomies, and three (1.2%) maternal deaths. Peripartum hysterectomy decreased significantly in the last years of study. Unscarred uterine ruptures significantly increased the risk of peripartum hysterectomy compared with scarred uterine ruptures (AOR 2.6, 95% CI 1.3‐5.3). Other factors that increased the risk of peripartum hysterectomy following rupture were: maternal age ≥35 years (AOR 2.3, 95% CI 1.1‐5.0), parity ≥3 vs parity 1‐2 (AOR 2.8, 95% CI 1.2‐6.7), and rupture detection after vaginal delivery (AOR 2.2, 95% CI 1.1‐4.8).

Conclusions

Unscarred uteri, older maternal age, parity ≥3, and rupture detection after vaginal delivery showed the highest associations with the risk of peripartum hysterectomy after complete uterine rupture.