bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors influencing multifactor productivity of equipment-intensive activities
Authors: Gerami Seresht Nima , Fayek Aminah Robinson
Published: July 2019

Purpose

Due to its key role in the successful delivery of construction projects, construction productivity is one of the most researched topics in construction domain. While the majority of previous research is focused on the productivity of labor-intensive activities, there is a lack of research on the productivity of equipment-intensive activities. The purpose of this paper is to address this research gap by developing a comprehensive list of factors influencing the productivity of equipment-intensive activities and determining the most influential factors through interview surveys.

Design/methodology/approach

A list of 201 factors influencing the productivity of equipment-intensive activities was developed through the review of 287 articles, selected from the ten top-ranked construction journals, by searching for construction productivity in the articles’ titles, abstracts or keywords. Next, the most influential factors were determined by conducting interview surveys with 35 construction experts. To ensure that the interviewees were aware of the research objectives and the distinction between labor- and equipment-intensive activities, an information session was held prior to conducting the surveys, and the surveys were conducted in interview format to allow for clarification and discussion throughout the process.

Findings

Project management respondents identified foreman-, safety- and crew-related factors as the categories with the most influence on productivity; tradespeople respondents identified foreman-, equipment- and crew-related factors as the most influential categories. In total, 14 factors were identified, for which there was a significant difference between the perspectives of project management and tradespeople regarding the factors’ influence on productivity.

Originality/value

This paper provides a comprehensive list of factors influencing the productivity of equipment-intensive activities. It identifies the most influential factors through an interview survey of 35 construction experts, who are familiar with the challenges of equipment-intensive activities based on their experience with such activities in the industrial construction sector of Alberta, Canada. Additionally, the differences between the factors that influence the productivity of labor- and equipment-intensive activities are discussed by comparing the findings of this paper with previous research focused on labor intensive activities.
ISO 9001-certified public healthcare center’s efficiency and re-certification
Authors: Nurcahyo Rahmat , Kristiningrum Ellia , Sumaedi Sik
Published: July 2019

Purpose

The purpose of this paper is to measure the efficiency of ISO 9001-certified public healthcare center in Jakarta, Indonesia and examine the impact of “re-certification“ on the efficiency.

Design/methodology/approach

The sample of the research is 30 ISO 9001-certified district public healthcare centers in Jakarta. The data envelopment analysis (DEA) and the Man–Whitney U test were applied.

Findings

The research result showed that there is a variation in efficiency values of ISO 9001-certified public healthcare centers that this research studied. There are only 23 percent of the public healthcare centers that can be categorized as the technically efficient public healthcare center. Furthermore, this research also found that there are no significant efficiency value differences among the groups of public healthcare center based on the number of “re-certification” the center experienced.

Research limitations/implications

This research only involved ISO 9001-certified public healthcare center from Jakarta, Indonesia.

Practical implications

Registering ISO 9001 for the public healthcare center does not guarantee that the public healthcare center will have better efficiency. The government and the public healthcare center management should ensure that the ISO 9001 implementation method used by the public healthcare center is appropriate for improving the efficiency of the public healthcare center.

Originality/value

There is a lack of research that studied the efficiency of ISO 9001-certified public healthcare center. Furthermore, there is no research that investigates the effect of “re-certification“ on efficiency. This research fulfills the literature gaps.
Dominant discourses of workplace curriculum in Iranian organizations
Authors: Doosti Hooman , Fathi Vajargah Kourosh , Khorasani Abasalt , Safaee Movahed Saied
Published: July 2019

Purpose

The purpose of this paper is to investigate and analyze the dominant discourses of the workplace curriculum in Iranian organizations.

Design/methodology/approach

The research data were collected through in-depth interviews with 30 professionals working in the field of workplace curriculum in three groups of consultants, managers and experts who were selected purposefully and with a theoretical sampling strategy. To analyze the data, thematic analysis method was used. The themes are extracted and categorized into three phases, namely, descriptive coding, interpretive coding and determination of overarching theme. To validate the data, collaborative research technique, member checking and researcher review and, to make sure of findings’ reliability, reliability index between two coders were used.

Findings

Based on the findings, the kind of planner’s look at the workplace curriculum commonplaces will shape the nature of the curriculum and in terms of this look define and redefine the workplace curriculum discourses. Therefore, based on perceptions and attitudes in these areas, 11 different discourses are recognizable from the workplace curriculum. These include suppression discourse, justification discourse, ceremonial/ formality discourse, administrative discourse, engineering discourse, economical discourse, psychological discourse, partnership discourse, research discourse, developmental discourse and, finally, multi-cultural discourse.

Practical implications

The common goal of all learning professionals in the workplace is to play the role of a strategic partner, or at least be a good partner for the organization. One of the main challenges of learning and development professionals in the workplace is increase in integration and alignment between learning programs and developmental opportunities with business organization strategies. Achieving this important goal is possible when we have a proper understanding of the current situation and condition. Various situations and conditions are identified and described in the form of 11 discourses. If the authors do not look at the context and proper understanding of the main concepts – The main concepts of each discourse are put into a quill – in which any discourse that was created, the authors will not be able to make the appropriate strategies. A good doctor will hear and understand well before the first thing.

Originality/value

To the best of the authors’ knowledge, this study is one of the few studies that offer a variety of discourses for the workplace curriculum.
From parallel to partnership
Authors: Orr Debra E. , Bravo Gutiérrez Gloria , Fette Don
Published: July 2019

Purpose

In the USA, there has recently been an unprecedented convergence of complementary/alternative medicine (CAM) with mainstream biomedical care. This confluence may lead to a deeply rooted philosophical conflict. This qualitative study works to identify factors that health-care leaders can use, which will build a pathway to greater integrative practice between medical doctors and CAM practitioners – from parallel existence to partnership – by examining the tensions between biomedical medicine and naturopathic medicine. The purpose of this study is to offer short-term suggestions for partnership and long-term recommendations for better understanding.

Design/methodology/approach

An original qualitative study using semi-structured with CAM practitioners and biomedical practitioners.

Findings

Areas of conflict that are preventing synergy are identified and a pathway for health-care leaders to follow to create greater integration and partnerships is suggested.

Research limitations/implications

This is a qualitative and exploratory study that has significant limitations on generalizability.

Practical implications

This study suggest steps that both types of health-care practitioners can take to increase their success at working together on an individual level, a group level, an organizational level and on an industry-wide basis, as well as provide a specific pathway to create greater integrative practice for health-care leaders.

Social implications

The results indicate that stronger partnerships between different types of medical practitioners increase patient choice, patient satisfaction and outcomes.

Originality/value

Increasing interested in CAM modalities is driving more contact between CAM practitioners and biomedical practitioners. This contact is best established in partnership between practitioners rather than in parallel. This original research outlines the sources of conflict and provides recommendations for encouraging greater synergy.
Business model design and performance in nascent markets
Authors: Rask Morten , Günzel-Jensen Franziska
Published: July 2019

Purpose

The purpose of this paper is to investigate the nascent market settings from a business model innovation perspective with the research questions: How do incumbents and start-ups make sense of an emerging technology through business model design in a nascent market setting, and how does business model choice influence firm performance?

Design/methodology/approach

The authors have tracked the development of four case companies in the nascent electric vehicle market from 2009 to 2018 and have conducted interviews and analyzed the archival data.

Findings

The authors propose a typology of business model choices and performance where the four types of business models distinguish themselves by how the companies innovate or imitate the value proposition of the current industry as well as how they innovate or imitate the business model archetype. In accordance with these different business model choices, the actors express different logics behind their new to the product market space business model choice. These logics represent different understandings of technology potential, customer needs as well as potential for value capture and contribute to and limit the translation of emerging technologies into dominant designs in diverse ways.

Originality/value

The business model is conceived as a focusing device that can be used to identify market applications for emerging technologies. As new disruptive technologies often require a new to the product market space business model, literature has in recent years put a premium on business model innovation. However, the linkages between emergent technologies and the choice of a novel business model are under investigated especially in relation to how business model choice affects business performance in nascent market settings. This paper aims at filling this gap.
Consumption of energy drink and associated factors
Authors: Hasan Towhid , Sultana Marjia , Shill Lincon Chandra , Sultana Sara
Published: July 2019

Purpose

Energy drink (ED) consumption has become a common trend, especially among the youth. Hence, the purpose of this study was undertaken to assess the ED consumption pattern among the university students and investigate the independent predictors for their preference of such drinks.

Design/methodology/approach

It was a cross-sectional study conducted among 323 students from various departments of Noakhali Science and Technology University, Bangladesh.

Findings

Among students, about 57 per cent were male, and mostly between 21-23 years. About 31 per cent of the students had never consumed ED, while 69 per cent had consumed such drinks at least once in their lifetime. Only 31.4 per cent of the ever consumer had knowledge of its components, and 14.3 per cent of them did not know the negative effects of ED. Bivariate analysis identified the variables that were significantly associated with students’ consumption of ED. Taking the significant factors into a multivariate model, the risks of ED consumption were male gender (OR = 3.82; 95 per cent CI = 2.24 − 6.52), longer study duration in university (OR = 1.02; 95 per cent CI = 1.00 − 1.03) and doing regular physical activity (OR = 1.69; 95 per cent CI = 1.04 − 2.75).

Originality/value

High consumption of ED among university students is evident, yet their perception regarding components and potential health hazards of such drinks is opaque. This study results suggest the necessity of formulating policy and intervention strategies concentrating on the predictors of ED consumption to promote consciousness about ingredients and related health effects of ED among students of all levels in Bangladesh and other countries as well.
Vitamin D deficiency in Pakistani population: critical overview from 2008 to 2018
Authors: Syed Faiza , Latif Malik Shah Zaman , Ahmed Iftikhar , Bibi Sadia , Ullah Saif , Khalid Nauman
Published: July 2019

Purpose

The purpose of this paper is to access the present situation of the Pakistani population that suffers from vitamin D deficiency.

Design/methodology/approach

A review-based study was conducted based on publications from Pakistan between the years 2008 and 2018. The publications were archived from Pub Med and Google Scholar databases. A total of 18 publications were shortlisted, based on the cutoff values of vitamin D sufficiency, insufficiency and deficiency.

Findings

As per the data, 38.5 per cent of the participants were males, 48.7 per cent were females and 12.8 per cent of the studies have not mentioned the genders of the participants. The cumulative results show that 58.17 per cent (95 per cent CI: 52.17, 64.16) of the population is vitamin D-deficient and 26.65 per cent (95 per cent CI: 21.63, 31.66) is insufficient in vitamin D. The highest level of vitamin D deficiency was reported from Sindh (62.15 per cent), followed by Khyber Pakhtunkhwa (60.57 per cent), Punjab (51.75 per cent) and the Federal Capital (49.25 per cent). Moreover, Cochran’s Q test indicated considerable heterogeneity (p= >0.001) with regard to Vitamin D deficiency (VDD) prevalence found among samples from the selected studies.

Originality/value

The present analysis suggests that more than half of the Pakistani population suffers from VDD, which, thus, should be considered as an epidemic and treated likewise.
Firm size, market conditions and takeover likelihood
Authors: Tunyi Abongeh
Published: July 2019

Purpose

The firm size hypothesis – takeover likelihood (TALI) decreases with target firm size (SIZE) – has enjoyed little traction in theTALImodelling literature; hence, this paper aims to redevelop this hypothesis while taking account of prevailing market conditions – capital liquidity and market performance.

Design/methodology/approach

The study uses a logit modelling framework to modelTALI. Model performance is assessed using receiver operating characteristic (ROC) curve analysis. The empirical analysis is based on a UK sample of 34,661 firm-year observations drawn from 3,105 firms and 1,396 M&A deals over a 30-year period (1987-2016).

Findings

While acquirers generally seek smaller targets because of transaction cost constraints, the paper shows that the documented negative relation betweenSIZEandTALIarises from sampling bias. Over a full sample, mid-sized firms are most at risk of takeovers. Additionally, market conditions moderate theSIZE–TALIrelationship, with acquirers more inclined to pursue comparatively larger targets when financing costs are low and market growth or sentiment is high. The results are generally robust to endogeneity.

Research limitations/implications

Sample truncation on the basis ofSIZEleads to empirical misspecification of theTALI–SIZErelation. In an unbiased sample, an inverse U-shaped specification betweenTALIandSIZEsufficiently models the underlying relation and leads to improvements in the predictive ability ofTALImodels.

Originality/value

This study advances a new firm size hypothesis which is consistent with classic M&A theories. The study also evidences market conditions as a moderator of the acquirer’s choice of targetSIZE. A new model specification which recognises the non-linear relation betweenTALIandSIZEand accounts for the moderating effect of market conditions on theSIZE-TALIrelationship leads to improvements in the performance ofTALIprediction models.
Investing in lottery-like stocks in India
Authors: Sharma Udayan , Chakraborty Madhumita
Published: July 2019

Purpose

In the current study, the significance of extreme positive returns has been investigated in the pricing of stocks in the Indian equity market. This study aims to understand if investors in India have a preference for lottery-like stocks. The existing literature provides support for MAX effect in several countries, where risk seeking in the form of gambling is an acceptable form of social behavior, suggesting a preference for lottery-like stocks. This motivates the authors to investigate whether such preference for lottery-like stocks is prevalent in a country such as India with a different cultural setting, where gambling is not socially and legally encouraged.

Design/methodology/approach

The MAX effect is tested in the Indian market for the period from January 2003 to March 2017. The average number of firms per month in this study is 2,949. Univariate and bivariate portfolio-level analyses, as well as Fama MacBeth regressions, are conducted to observe the difference between average raw and risk-adjusted returns between the stocks lying in the highest and lowest MAX deciles. Several tests have been performed for checking the robustness of the findings.

Findings

Unlike the extant literature, the authors have not found any evidence of a negative relationship between extreme positive returns and expected returns. The univariate and bivariate analyses suggest that high MAX deciles over-perform low MAX deciles. Fama Macbeth regressions also do not support the negative relationship documented for other markets. This suggests that investors are not euphoric about lottery-like stocks in India. One may devise profitable trading strategies by going long on high MAX deciles and short on low MAX deciles.

Originality/value

This study finds a behavioral aspect of Indian investors, which seems to be in contrast to that of other countries. While there is a strong preference for lottery-like stocks in other markets, investors in India do not end up overpaying for such stocks in the market. This tendency might be an outcome of a different social and regulatory setting in India. In view of the fact that India is increasingly becoming an important investment destination, it becomes important to devise investment strategies based on the peculiarities of this market rather than simply extrapolating the findings of other markets.
Mutual fund alpha and daily market-timing ability
Authors: Bu Qiang
Published: July 2019

Purpose

This study aims to examine whether mutual funds can earn daily alpha and time daily market return.

Design/methodology/approach

Based on the Treynor and Mazuy (1966) model and the Henriksson and Merton (1981) model, the author tests the daily market-timing ability of actual mutual funds and bootstrapped mutual funds.

Findings

The author finds that daily alpha and daily market-timing ability can come from pure luck. In addition, the relation between fund alpha and market-timing ability is at best minimal.

Originality/value

Using bootstrapped funds as the benchmark, this study shows that daily fund market is overall efficient.
Overconfidence and forecast accuracy
Authors: Liu Bin , Tan Monica
Published: July 2019

Purpose

This paper aims to investigate how overconfidence bias affects financial market participants’ forecast accuracy based on the hard–easy effect concept of overconfidence research.

Design/methodology/approach

The authors adopt an experimental method for behavioural finance studies. In the experiment, the authors measure and capture participants’ forecast accuracy as well as their individual confidence level. In particular, participants make incentive-compatible forecasts, that is, the elicited forecast determines the participants’ financial rewards in real monetary gain/loss.

Findings

The results show that the hard–easy effect causes optimistic forecasts for hard-to-predict stocks, indicating that overconfident investors tend to make over-optimistic and less accurate price forecasts when making judgements on hard tasks. Consistent with the literature, the authors find evidence of a negative relationship between forecast accuracy and confidence level. The results also indicate that the overall relationship between overconfidence and forecast accuracy is driven by the price forecasts made for hard-to-predict stocks.

Originality/value

As per the authors’ knowledge, this paper is one of the first studies that provides empirical evidence directly showing the hard–easy effect in the relation between overconfidence and forecast ability in an experimental setting. This study uses an experimental design that specifically measures the hard–easy effect in a stock market scenario using professional financial information and real monetary incentives, which have not been used in any previous studies of the hard–easy effect.
Threshold concept acquisition in occupational therapy: A mixed methods study of students and clinicians
Authors: Nicola‐Richmond Kelli , Pépin Geneviève , Larkin Helen , Mohebbi Mohammedreza
Published: July 2019

Background/aim

Demand for occupational therapy graduates able to work in complex and diverse workplaces is increasing. The threshold concepts framework has emerged as one pathway to assist in the development of work‐ready graduates. A previous Australian study identified 10 threshold concepts for occupational therapy; the aim of this study was to explore the acquisition of these.

Method

A mixed‐methods study using observational, cross sectional design and a triangulation design convergence model was undertaken. A survey using Likert scales and open response questions was developed by the authors. Seventy‐three surveys were completed by 13 first and 20 final year Victorian occupational therapy students. Twenty recent graduates and 20 experienced clinicians from across Australia also participated. Seven first and 10 final year occupational therapy students, 10 recent graduates and 10 experienced clinicians also took part in in‐depth interviews. Likert scales were used by participants to rate confidence that they had acquired the threshold concepts, they also answered open‐response questions (via survey or interview) asking them to provide examples of how they would use threshold concepts in practice.

Results

Fourth year students were statistically significantly less confident than experienced clinicians for the threshold concepts Understanding the models and theories of occupational therapy and Applying clinical reasoning (P < 0.05). When whole group data were analysed, participants were most confident for Occupation and Client centred practice (P < 0.05). These results resonated with the qualitative findings which demonstrated a shift from surface to deep knowledge with increased experience. Fourth year students reported responses that suggested some threshold concepts were still in development, while experienced clinicians used a web of threshold concepts.

Conclusion

This exploratory study provides provisional data to suggest that students appear to still be acquiring some threshold concepts at graduation and experienced clinicians make use of a web of threshold concepts in their clinical practice.
Robotic‐assisted therapy with bilateral practice improves task and motor performance in the upper extremities of chronic stroke patients: A randomised controlled trial
Authors: Hsu Hsiu‐Yun , Chiu Haw‐Yen , Kuan Ta‐Shen , Tsai Ching‐Liang , Su Fong‐Chin , Kuo Li‐Chieh
Published: July 2019

Background/Aim

Task‐specific repetitive training, a usual care in occupational therapy practice, and robotic‐aided rehabilitation with bilateral practice are used to improve upper limb motor and task performance. The difference in effects of two strategies requires exploration. This study compared the impact of robotic‐assisted therapy with bilateral practice (RTBP) and usual task‐specific training facilitated by therapists on task and motor performance for stroke survivors.

Methods

Forty‐three community‐dwelling stroke survivors (20 males; 23 females; 53.3 ± 13.1 years; post‐stroke duration 14.2 ± 10.9 months) were randomised into RTBP and usual care. All participants received a 10‐minute per‐protocol sensorimotor stimulation session prior to interventions as part of usual care. Primary outcome was different in the amount of use (AOU) and quality of movement (QOM) on the Motor Activity Log (MAL) scale at endpoint. Secondary outcomes were AOU and QOM scores at follow‐up, and pre‐post and follow‐up score differences on the Fugl‐Meyer Assessment (FMA) and surface electromyography (sEMG). Friedman and Mann–Whitney U tests were used to calculate difference.

Results

There were no baseline differences between groups. Both conditions demonstrated significant within‐group improvements in AOU‐MAL and FMA scores following treatment (P < 0.05) and improvements in FMA scores at follow‐up (P < 0.05). The training‐induced improvement in AOU (30.0%) following treatment was greater than the minimal detectable change (16.8%) in the RTBP group. RTBP demonstrated better outcomes in FMA wrist score (P = 0.003) and sEMG of wrist extensor (P = 0.043) following treatment and in AOU (P < 0.001), FMA total score (P = 0.006), FMA wrist score (P < 0.001) and sEMG of wrist extensor (P = 0.017) at follow‐up compared to the control group. Control group boost more beneficial effects on FMA hand score (P = 0.049) following treatment.

Conclusions

RTBP demonstrated superior upper limb motor and task performance outcomes compared to therapists‐facilitated task training when both were preceded by a 10‐minute sensorimotor stimulation session.

Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT03847103.
Review of glucagon‐like peptide‐1 receptor agonists for the treatment of type 2 diabetes mellitus in patients with chronic kidney disease and their renal effects
Authors: Sloan Lance A.
Published: July 2019

Type 2 diabetes mellitus (T2DM) is the most common cause of chronic kidney disease (CKD), and when it causes CKD it is collectively referred to as diabetic kidney disease. One of the newer therapies for managing hyperglycemia is the glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) drug class. This review summarizes the effects of GLP‐1RAs in patients with T2DM with CKD and evidence for renoprotection with GLP‐1RAs using data from observational studies, prospective clinical trials, post hoc analyses, and meta‐analyses. Evidence from some preclinical studies was also reviewed. Taken together, subgroup analyses of patients with varying degrees of renal function demonstrated that glycemic control with GLP‐1RAs was not markedly less effective in patients with mild or moderate renal impairment vs that in patients with normal function. GLP‐1RAs were associated with improvements in some cardiorenal risk factors, including systolic blood pressure and body weight. Furthermore, several large cardiovascular outcome studies showed reduced risks of composite renal outcomes, mostly driven by a reduction in macroalbuminuria, suggesting potential renoprotective effects of GLP‐1RAs. In conclusion, GLP‐1RAs effectively reduced hyperglycemia in patients with mild or moderately impaired kidney function in the limited number of studies to date. GLP‐1RAs may be considered in combination with other glucose‐lowering medications because of their ability to lower glucose in a glucose‐dependent manner, lowering their risk for hypoglycemia, while improving some cardiorenal risk factors. Potential renoprotective effects of GLP‐1RAs, and their renal mechanisms of action, warrant further investigation.
Silencing of RAD51AP1 suppresses epithelial–mesenchymal transition and metastasis in non‐small cell lung cancer
Authors: Wu Yuanyuan , Wang Huifeng , Qiao Lijiao , Jin Xiangming , Dong Hui , Wang Yan
Published: July 2019

Background

Non‐small cell lung cancer (NSCLC) is a major cause of cancer‐related mortality and is frequently accompanied by metastasis. The crucial roles of genes in lung cancer have attracted attention. Thus, this study aimed to investigate the effects of RAD51AP1 on the epithelial–mesenchymal transition (EMT) and metastasis of NSCLC.

Methods

The positive expression rate of the RAD51AP1 protein was examined. NSCLC cells were transfected with a series of plasmids to alter the expression of RAD51AP1 to clarify the influence of RAD51AP1 on EMT and metastasis in NSCLC, as well as NSCLC cell migration, invasion, apoptosis, proliferation, and cloning. An in vivo experiment was conducted to determine the oncogenicity of human NSCLC cells in nude mice.

Results

RAD51AP1 was highly expressed in NSCLC tissues. Furthermore, we found promotion of N‐cadherin, vimentin, fibronectin, MMP‐2, OPN, CD62, and TMP‐2, but inhibition of E‐cadherin, occludin, cytokeratin in the context of elevated RAD51AP1 expression. An in vivo experiment also confirmed that silencing of RAD51AP1 could inhibit NSCLC tumor formation and growth.

Conclusion

Our results revealed that RAD51AP1 silencing suppressed the EMT and metastasis of NSCLC, thereby highlighting its potential as a promising novel target for NSCLC treatment.
Nomogram to predict cause‐specific mortality in extensive‐stage small cell lung cancer: A competing risk analysis
Authors: Zhong Jia , Zheng Qiwen , An Tongtong , Zhao Jun , Wu Meina , Wang Yuyan , Zhuo Minglei , Li Jianjie , Zhao Xinghui , Yang Xue , Jia Bo , Chen Hanxiao , Dong Zhi , Wang Jingjing , Chi Yujia , Zhai Xiaoyu , Wang Ziping
Published: July 2019

Background

Small‐cell lung cancer (SCLC) is one of the most aggressive types of lung cancer. The prognosis for SCLC patients depends on many factors. The intent of this study was to construct a nomogram model to predict mortality for extensive‐stage SCLC.

Methods

Original data was collected from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute in the United States. A nomogram prognostic model was constructed to predict death probability for extensive‐stage SCLC.

Results

A total of 16 554 extensive‐stage SCLC patients from 2004 to 2014 in the SEER database were included in this study. Gender, race, age, TNM staging (including tumor extent, nodal status, and metastasis), and treatment (surgery, chemotherapy, and radiotherapy) were identified as independent predictors for lung cancer‐specific death for extensive‐stage SCLC patients. A nomogram model was constructed based on multivariate models for lung cancer related death and other cause related death. Performance of the two models was validated by calibration and discrimination, with C‐index values of 0.714 and 0.638, respectively.

Conclusion

A prognostic nomogram model was established to predict death probability for extensive‐stage SCLC. This validated prognostic model may be beneficial for treatment strategy choice and survival prediction.
Worse lung cancer outcome in patients with lower respiratory tract infection confirmed at time of diagnosis
Authors: Nagy Attila , Müller Veronika , Kolonics‐Farkas Abigel M. , Eszes Noemi , Vincze Krisztina , Horvath Gabor
Published: July 2019

Background

Pulmonary malignancy is one of the most frequent and fatal cancers in older patients. As data on lower respiratory tract infection (LRTI) and the outcome of lung cancer are scarce, our objective was to determine the impact of LRTI on therapeutic possibilities and one‐year mortality.

Methods

Patients undergoing bronchoscopy in 2017 who had bronchial microbial sampling at the time of the lung cancer diagnosis (n= 143) were included. Group 1 (LRTI+) included patients with confirmed infection (n= 74) while Group 2 (LRTI‐) included patients without infection (n= 69). Clinical characteristics, pathogen profile and one‐year survival were analyzed.

Results

Age, gender, TNM stage, histology type, comorbidities or underlying lung disease did not differ among groups. The most common LRTI pathogens included aerobic (n= 49), anaerobic (n= 14) and fungal (n= 26) infections. Chemo/immune/target therapy alone, or in combination with radiotherapy were significantly less frequently used, whilst palliative care was more common in Group 1 (LRTI+). Multiple pathogen LRTI patients were significantly older, less frequently diagnosed with adenocarcinoma and had worse performance status compared to solitary pathogen LRTI patients. One‐year median survival was 274 days (235 vs. 305 days Group 1 vs. Group 2). Risk factors for increased one‐year mortality included performance status ≥2 (OR 30.00, CI 95% 5.23–313.00), performance status 1 (OR 11.87, CI 95% 4.12–33.78), male gender (OR 4.04, CI 2.03–8.04), LRTI with multiple pathogens (OR 2.72, CI 1.01–6.81) and nonadenocarcinoma histology (OR 2.26, CI 1.15–4.56).

Conclusion

LRTIs in lung cancer patients, especially multiple pathogen infections, are associated with less oncotherapeutic possibilities and significant risk for lower one‐year median survival.
A new approach to study local adaptation in long‐lived woody species: Virtual transplant experiments
Authors: Manzanedo Rubén D. , Fischer Markus , María Navarro‐Cerrillo Rafael , Allan Eric
Published: July 2019

Despite the importance of local adaptation and the extended literature that has addressed it, there are few methods available to explore local adaptation across large temporal scales. However, long‐term patterns are likely to be essential to understanding adaptation in long‐lived species, such as trees.

Here, we propose a methodology named ‘virtual transplant experiment' (VTE), which uses long‐term climatic variability to explore local adaptation to climate in natural tree populations. VTEs evaluate the historical response of populations to their local climate and to climates representative of conditions in other populations. We tested our methodology using simulated data and applied it in two case studies on: (a) Pinus nigra populations at the edge of the species distribution, where previous research has suggested strong climate adaptation, and (b) Fagus sylvatica mesic populations, where parallel experiments showed no adaptation to macroclimate.

VTE results from simulated and real‐world data matched our expectations, suggesting that the method accurately identified the patterns of local adaptation to climate in tree populations. VTEs consistently discriminated locally adapted populations in synthetic data with a known degree of local adaptation. As expected, P. nigra populations showed adaptation to local climate in the VTE, while F. sylvatica populations showed no overall local advantage.

Our method provides a new way to test for local adaptation over time scales encompassing the complete lifespan of trees. VTEs can complement current methods to study local adaptation by adding the ability to explore the long‐term response to local climate in natural populations. The advantages and limitations of the different approaches to studying local adaptation stress the importance of combining multiple approaches to test for local adaptation in long‐lived organisms.
Wnt/β‐catenin/RAS signaling mediates age‐related renal fibrosis and is associated with mitochondrial dysfunction
Authors: Miao Jinhua , Liu Jiafeng , Niu Jing , Zhang Yunfang , Shen Weiwei , Luo Congwei , Liu Yahong , Li Chuanjiang , Li Hongyan , Yang Peiliang , Liu Youhua , Hou Fan Fan , Zhou Lili
Published: July 2019

Renal fibrosis is the common pathological feature in a variety of chronic kidney diseases. Aging is highly associated with the progression of renal fibrosis. Among several determinants, mitochondrial dysfunction plays an important role in aging. However, the underlying mechanisms of mitochondrial dysfunction in age‐related renal fibrosis are not elucidated. Herein, we found that Wnt/β‐catenin signaling and renin–angiotensin system (RAS) activity were upregulated in aging kidneys. Concomitantly, mitochondrial mass and functions were impaired with aging. Ectopic expression of Klotho, an antagonist of endogenous Wnt/β‐catenin activity, abolished renal fibrosis in d‐galactose (d‐gal)‐induced accelerated aging mouse model and significantly protected renal mitochondrial functions by preserving mass and diminishing the production of reactive oxygen species. In an established aging mouse model, dickkopf 1, a more specific Wnt inhibitor, and the mitochondria‐targeted antioxidant mitoquinone restored mitochondrial mass and attenuated tubular senescence and renal fibrosis. In a human proximal tubular cell line (HKC‐8), ectopic expression of Wnt1 decreased biogenesis and induced dysfunction of mitochondria, and triggered cellular senescence. Moreover, d‐gal triggered the transduction of Wnt/β‐catenin signaling, which further activated angiotensin type 1 receptor (AT1), and then decreased the mitochondrial mass and increased cellular senescence in HKC‐8 cells and primary cultured renal tubular cells. These effects were inhibited by AT1 blocker of losartan. These results suggest inhibition of Wnt/β‐catenin signaling and the RAS could slow the onset of age‐related mitochondrial dysfunction and renal fibrosis. Taken together, our results indicate that Wnt/β‐catenin/RAS signaling mediates age‐related renal fibrosis and is associated with mitochondrial dysfunction.
Incidence of direct oral anticoagulant use in patients with nonvalvular atrial fibrillation and characteristics of users in 6 European countries (2008–2015): A cross‐national drug utilization study
Authors: Ibáñez Luisa , Sabaté Mònica , Vidal Xavier , Ballarin Elena , Rottenkolber Marietta , Schmiedl Sven , Heeke Andreas , Huerta Consuelo , Martin Merino Elisa , Montero Dolores , Leon‐Muñoz Luz María , Gasse Christiane , Moore Nicholas , Droz Cécile , Lassalle Régis , Aakjær Mia , Andersen Morten , De Bruin Marie Louise , Groenwold Rolf , van den Ham Hendrika A. , Souverein Patrick , Klungel Olaf , Gardarsdottir Helga
Published: July 2019

Aims

To estimate the incidence of direct oral anticoagulant drug (DOAC) use in patients with nonvalvular atrial fibrillation and to describe user and treatment characteristics in 8 European healthcare databases representing 6 European countries.

Methods

Longitudinal drug utilization study from January 2008 to December 2015. A common protocol approach was applied. Annual period incidences and direct standardisation by age and sex were performed. Dose adjustment related to change in age and by renal function as well as concomitant use of potentially interacting drugs were assessed.

Results

A total of 186 405 new DOAC users (age ≥18 years) were identified. Standardized incidences varied from 1.93–2.60 and 0.11–8.71 users/10 000 (2011–2015) for dabigatran and rivaroxaban, respectively, and from 0.01–8.12 users/10 000 (2012–2015) for apixaban. In 2015, the DOAC incidence ranged from 9 to 28/10 000 inhabitants in SIDIAP (Spain) and DNR (Denmark) respectively. There were differences in population coverage among the databases. Only 1 database includes the total reference population (DNR) while others are considered a population representative sample (CPRD, BIFAP, SIDIAP, EGB, Mondriaan). They also varied in the type of drug data source (administrative, clinical). Dose adjustment ranged from 4.6% in BIFAP (Spain) to 15.6% in EGB (France). Concomitant use of interacting drugs varied between 16.4% (SIDIAP) and 70.5% (EGB). Cardiovascular comorbidities ranged from 25.4% in Mondriaan (The Netherlands) to 82.9% in AOK Nordwest (Germany).

Conclusion

Overall, apixaban and rivaroxaban increased its use during the study period while dabigatran decreased. There was variability in patient characteristics such as comorbidities, potentially interacting drugs and dose adjustment. (EMA/2015/27/PH).
The relationship between death anxiety and severity of mental illnesses
Authors: Menzies Rachel E. , Sharpe Louise , Dar‐Nimrod Ilan
Published: July 2019

Objectives

Death anxiety has been implicated theoretically and empirically in mental health and has been proposed to be a transdiagnostic construct. However, it has largely been investigated in relation to specific disorders, such as obsessive–compulsive disorder. Few studies have assessed the relationship between death anxiety and psychopathology using heterogeneous treatment‐seeking clinical samples.

Methods

In the present study, the relationships between death anxiety and broad markers of psychopathology were explored in 200 treatment‐seeking participants with various diagnosed mental disorders.

Results

Across the sample, death anxiety was a strong predictor of psychopathology, including the number of lifetime diagnoses, medications, hospitalizations, distress/impairment, depression, anxiety, and stress. This relationship was not accounted for by neuroticism. Large to very large correlations were also consistently found between a measure of death anxiety and the symptom severity of 12 disorders. Neither meaning in life nor attachment style moderated the associations between death fears and psychopathology.

Conclusions

The findings reveal a strong relationship between death anxiety and psychopathology across numerous disorders, further supporting the transdiagnostic role of fears of death. As such, clinical implications revolve around the potential need for innovative treatments which address death fears directly, in order to produce long‐term improvements in mental health. However, experimental research is needed to ascertain causal relationships.

Practitioner points

Across a large treatment‐seeking sample, death anxiety was a significant predictor of broad psychopathology, including distress and number of lifetime diagnoses.

Across 12 different disorders, death anxiety significantly predicted symptom severity.

Results may suggest the need for novel treatments which specifically target fears of death.

Due to the correlational design, future experimental research is needed to establish causal relationships with increased confidence.
How Early Maternal Language Input Varies by Race and Education and Predicts Later Child Language
Authors: Vernon‐Feagans Lynne , Bratsch‐Hines Mary , Reynolds Elizabeth , Willoughby Michael
Published: July 2019

The maternal language input literature suggests that mothers with more education use a greater quantity and complexity of language with their young children compared to mothers with less education although race and socioeconomic status have been confounded in most studies because of small sample sizes. The current Family Life study included a representative sample of 1,292 children, oversampling for poverty and African American, followed from birth. This study found no race differences within maternal education levels on five measures of maternal language input from 6 to 36 months. Maternal language input variables of number of different words, mean length of utterance and number of wh‐questions were partial mediators of the relationship between maternal education and later child language at school age.
From early adversities to immune activation in psychiatric disorders: the role of the sympathetic nervous system
Authors: Mondelli V , Vernon A C
Published: July 2019

Increased peripheral levels of cytokines and central microglial activation have been reported in patients with psychiatric disorders. The degree of both innate and adaptive immune activation is also associated with worse clinical outcomes and poor treatment response in these patients. Understanding the possible causes and mechanisms leading to this immune activation is therefore an important and necessary step for the development of novel and more effective treatment strategies for these patients. In this work, we review the evidence of literature pointing to childhood trauma as one of the main causes behind the increased immune activation in patients with psychiatric disorders. We then discuss the potential mechanisms linking the experience of early life adversity (ELA) to innate immune activation. Specifically, we focus on the innervation of the bone marrow from sympathetic nervous system (SNS) as a new and emerging mechanism that has the potential to bridge the observed increases in both central and peripheral inflammatory markers in patients exposed to ELA. Experimental studies in laboratory rodents suggest that SNS activation following early life stress exposure causes a shift in the profile of innate immune cells, with an increase in proinflammatory monocytes. In turn, these cells traffic to the brain and influence neural circuitry, which manifests as increased anxiety and other relevant behavioural phenotypes. To date, however, very few studies have been conducted to explore this candidate mechanism in humans. Future research is also needed to clarify whether these pathways could be partially reversible to improve prevention and treatment strategies in the future.
Enamel matrix derivative in liquid form as adjunct to natural bovine bone grafting at buccal bone dehiscence defects at implant sites: An experimental study in beagle dogs
Authors: Ikawa Takahiro , Akizuki Tatsuya , Shujaa Addin Ammar , Fukuba Shunsuke , Stavropoulos Andreas , Izumi Yuichi
Published: July 2019

Objectives

To evaluate the effect of enamel matrix derivative in liquid form (EMD‐liquid) as adjunct to grafting with natural bovine bone (NBB), on new bone formation and osseointegration in buccal dehiscence defects at dental implants.

Material and methods

In six beagles, 3 months after extraction of the mandibular premolars and first molars. Three titanium implants (3.3 Ø × 8.0 mm) were inserted, and dehiscence‐type defects (mesiodistal width 3 mm × 5 mm depth) were created on their buccal aspect. The defects were randomly assigned to one of the following three treatment groups: Group 1: NBB, Group 2: NBB/EMD‐L, Group 3: Control. All sites were covered with a collagen membrane. Histomorphometric measurements were performed after 3 months of healing.

Results

New bone area, bone‐to‐implant contact (BIC), and first BIC (fBIC) in the NBB and NBB/EMD‐L groups were significantly greater than in the control group (p < .05). Further, f‐BIC was at a significantly more coronal position in the NBB + EMD‐liquid group (0.4 ± 0.1 mm) compared with the NBB group (1.2 ± 0.2 mm).

Conclusions

Natural bovine bone grafting enhances bone regeneration and osseointegration at implants with buccal bone dehiscences compared with no grafting, and adjunct use of EMD‐liquid appears to further enhance bone formation and osseointegration.