bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of Care and Outcomes in Cardiovascular Disease After Kidney Transplantation in the United States
Authors: Mathur Amit K. , Chang Yu-Hui , Steidley D. Eric , Heilman Raymond , Khurmi Narjeet , Wasif Nabil , Etzioni David , Moss Adyr A.
Published: January 2017

Background

Cardiovascular disease (CVD) is an important driver of mortality after kidney transplantation. Its broader impact on posttransplant health care utilization in US hospitals is unknown.

Methods

We used administrative claims data from the Nationwide Inpatient Sample and the American Hospital Association Annual Survey to identify hospitalizations for kidney transplant patients with a cardiovascular diagnosis from 2005 to 2011. CVD hospitalizations were stratified by transplant hospital status to characterize patterns in inpatient health care utilization and outcomes. Based on these analyses, the domestic burden of treatment for posttransplant CVD (myocardial infarction, stroke, congestive heart failure, dysrhythmia, cardiac arrest, malignant hypertension) was estimated.

Results

The total domestic burden of post-kidney transplant hospitalization between 2005 and 2011 is estimated at 389 138 of which 26.5% of episodes were related to CVD (n = 103 118). CVD was responsible for a growing proportion of post-transplant hospitalizations over time (24.4%-30.4%, P < 0.001). Compared with nontransplant hospitals, transplant hospitals had similar length of stay (median length of stay, 3.7 days), higher median costs per hospitalization (US $10 364 vs US $8606, overall US $9324), and lower adjusted mortality (3.2% vs 3.9%, overall 3.6%; P = 0.003).

Conclusions

Inpatient CVD care is increasing over time for kidney transplant patients, accounting for 30% of all post-transplant hospitalizations. Variation exists in the inpatient care, outcomes, and costs between by hospital type. Further studies are needed to better understand the mechanisms behind these phenomena.
Rapid cerebrovascular reactivity mapping: Enabling vascular reactivity information to be routinely acquired
Authors: Blockley Nicholas P. , Harkin James W. , Bulte Daniel P.
Published: January 2017

Cerebrovascular reactivity mapping (CVR), using magnetic resonance imaging (MRI) and carbon dioxide as a stimulus, provides useful information on how cerebral blood vessels react under stress. This information has proven to be useful in the study of vascular disorders, dementia and healthy ageing. However, clinical adoption of this form of CVR mapping has been hindered by relatively long scan durations of 7 to 12 minutes. By replacing the conventional block presentation of carbon dioxide enriched air with a sinusoidally modulated stimulus, the aim of this study was to investigate whether more clinically acceptable scan durations are possible. Firstly, the conventional block protocol was compared with a sinusoidal protocol of the same duration of 7 minutes. Estimates of the magnitude of the CVR signal (CVR magnitude) and the relative timing of the CVR response (CVR phase) were found to be in good agreement between the stimulus protocols. Secondly, data from the sinusoidal protocol was reanalysed using decreasing amounts of data in the range 1 to 6 minutes. The CVR magnitude was found to tolerate this reduction in scan duration better than CVR phase. However, these analyses indicate that scan durations in the range of 3 to 5 minutes produce robust data.
Things softly attained are long retained: Dissecting the Impacts of Selection Regimes on Polymorphism Maintenance in Experimental Spatially Heterogeneous Environments
Authors: Gallet Romain , Froissart Rémy , Ravigné Virginie
Published: January 2017

This preprint has been reviewed and recommended by Peer Community In Evolutionary Biology (http://dx.doi.org/10.24072/pci.evolbiol.100020). Predicting and managing contemporary adaption requires a proper understanding of the determinants of genetic variation. Spatial heterogeneity of the environment may stably maintain polymorphism when habitat contribution to the next generation can be considered independent of the degree of adaptation of local populations within habitats (i.e., under soft selection). In contrast, when habitats contribute proportionally to the mean fitness of the populations they host (hard selection), polymorphism is not expected to be maintained by selection. Although mathematically established decades ago, this prediction had never been properly explored. Here we provide an experimental test in which polymorphic populations ofEscherichiacoli growing in heterogeneous habitats were exposed to hard and soft selection regimes. As predicted by theory, polymorphism was longer preserved under soft selection. Complementary tests established that soft selection slowed down fixation processes and could even protect polymorphism on the long term by providing a systematic advantage to rare genotypes.
The Big 4 in Bangladesh: caught between the global and the local
Authors: Belal Ataur , Spence Crawford , Carter Chris , Zhu Jingqi
Published: January 2017

Purpose

The purpose of this paper is to explore the work practices of Big 4 firms in Bangladesh with the aim of exploring the extent to which global professional service firms (GPSFs) can be thought of as being genuinely “global”.

Design/methodology/approach

Interviews were undertaken with the vast majority of Big 4 partners in Bangladesh. These interviews explored a number of themes related to the professional service work context in Bangladesh and the relationship between local and global firms.

Findings

The central finding of this paper is that although the Big 4 have a long-established presence in Bangladesh, local societal factors heavily influence the realities of work for accountants there. In most cases the Big 4 firms establish correspondent firms (instead of full member firms) in Bangladesh and tend to offer restricted service lines. Additionally, the paper identifies professional, commercial and cultural barriers to greater Big 4 involvement in the local market. Conceptually, the chief contribution of this paper is to explore how the effects of globalizing capitalism and standardised “best practices” in global professional service work are mediated through the societal effects of Bangladeshi society, resulting in the Big 4 having only a tentative presence in the Bangladeshi market.

Research limitations/implications

The findings cast doubt on the extent to which self-styled GPSFs are truly “global” in nature. Future work examining the Big 4, or accounting more generally, in the context of globalization, would do well to pay greater attention to the experience of professionals in emerging markets.

Originality/value

Whilst there has been much work looking at accounting and accountants in the context of globalization, this work has tended to privilege “core” western empirical settings. Very little is known about professional service firms in “peripheral” emerging markets. Furthermore, this study extends the application of the system, society and dominance framework by mapping the interactions and dynamics of these three sources of influence in the setting of PSFs.
Maintenance strategy for public-rented residential building: a case study in Jakarta, Indonesia
Authors: Arumsari Putri , Rarasati Ayomi Dita
Published: January 2017

Purpose

Several public-rented residential buildings in the Jakarta province are in slum conditions. The purpose of this paper is to propose an alternative maintenance strategy to be adopted by public-rented residential buildings to avoid the creation of slum conditions.

Design/methodology/approach

Qualitative and quantitative methods were adopted. The research first identified factors in maintenance management that affect the physical condition of a building through literature review and preliminary interview with the building occupants and building staffs. The factors are then used to develop a questionnaire that is distributed to 856 respondents in four buildings in East Jakarta. Only 552 completed questionnaires were used to identify the dominant factors through descriptive analysis by calculating the percentage of each answer.

Findings

The research found that the dominant factors in maintenance management, which influence the creation of slums condition in public-rented residential building are the level of damage and quality deterioration of the building material and the level of building maintenance budget availability.

Research limitations/implications

The maintenance situation and regulation regarding public-rented residential buildings in other provinces in Indonesia may not be the same with Jakarta Province due to the local autonomy and local problems. Therefore, the result from this research might not be applicable in other provinces in Indonesia.

Originality/value

This research identifies the factors in maintenance management, which affect the creation of slum conditions in public-rented residential buildings so that necessary maintenance measures can be carried out by the agency in charge.
A finite element analysis of an elastic contact between a layered cylindrical hollow roller and flat contact
Authors: Solanki Mitul Thakorbhai , Vakharia Dipak
Published: January 2017

Purpose

The purpose of this paper is to present a finite element analysis (FEA) which shows the comparison between a layered cylindrical hollow roller bearing and hollow roller bearing.

Design/methodology/approach

In this work, FEA is carried out to solve the elastic contact between a layered cylindrical hollow roller and flat contact for different hollowness percentages ranging from 10 to 80 per cent. Graphical solution is developed to determine the optimum hollowness of a cylindrical roller bearing for which induced bending stress should be within endurance limit of the material.

Findings

Different parameters such as von Mises stress, contact pressure, contact width and deformation are shown here.

Originality/value

The value of this research work is the calculation of contact width and other parameters using FEA for layered cylindrical hollow roller bearing.
Status-quo vs new strategy in intangibles
Authors: Shakina Elena , Barajas Angel , Parshakov Petr , Chadov Aleksei
Published: January 2017

Purpose

This study explores company strategies for intangibles. The authors investigate whether it is reasonable for companies to intensify intangibles when the current strategy is not intangible-intensive. The purpose of this paper is to elaborate a theoretical model to describe the strategic decision making in companies.

Design/methodology/approach

The authors use the Bellman-equation framework to find the conditions under which a change in strategy for intangibles is reasonable.

Findings

The results determine the parameters of returns on intangibles in different strategies, the optimal intangible stock and the influence of external economic shocks. The findings of the study demonstrate that many requirements have to be met to make intangible-intensive strategy beneficial for a company. Moreover negative shocks of crises force a company to postpone a new strategy on intangibles.

Practical implications

This research provides an insight into strategic behavior of companies under uncertainty. The theoretical findings demonstrate under which conditions companies should decide to switch to a strategy more intangible-intensive. This model can be used to empirically test parameters of different investment strategies of companies using structural estimation techniques.

Originality/value

This work contributes to the theory of managerial economics giving closed form solutions for the dynamic optimization of company behavior. The findings also show how this behavior might change when economic crises are faced or expected.
Philosophical connections between the classical and the modern notion of corruption
Authors: Dion Michel
Published: January 2017

Purpose

The purpose of this paper is to circumscribe the various philosophical connections between the classical and the modern notion of corruption from Enlightenment to post-modernity.

Design/methodology/approach

The paper analyzed to what extent the classical notion of corruption (Plato, Aristotle and Cicero) still influenced the way philosophers perceived the phenomenon of corruption during the Enlightenment (1625-1832), the transition period (1833-1900) and the post-modernity (1901 onward). Taking those historical periods as reference points, the author will see how literature about historical, social and political conditioning factors of corruption could convey the presence/absence of the classical or the modern notion of corruption.

Findings

The paper finds that the classical notion of corruption implies the degeneration of human relationships (Plato and Hegel), the degeneration of the body-and-mind unity (Aristotle, Pascal and Thomas Mann) or the degeneration of collective morality (Cicero, Locke, Rousseau, Hume and Kant). The modern notion of corruption as bribery was mainly introduced by Adam Smith. Nietzsche (and Musil) looked at corruption as degeneration of the will-to-power. The classical notion of corruption put the emphasis on the effects rather than on the cause itself (effects-based thinking). The modern notion of corruption as bribery insists on the cause rather than on the effects (cause-based thinking).

Research limitations/implications

In this paper, the author has taken into account the main representatives of the three historical periods. Future research could also analyze the works of other philosophers and novelists to see to what extent their philosophical and literary works are unveiling the classical or the modern notion of corruption.

Originality/value

The paper presents a philosophical and historical perspective about corruption. It sheds light on the way philosophers (and sometimes novelists) deal with the issue of corruption, whether it is from an effects-based or from a cause-based perspective.
A survey on clustering routing protocols in wireless sensor networks
Authors: Gherbi Chirihane , Aliouat Zibouda , Benmohammed Mohamed
Published: January 2017

Purpose

In particular, this paper aims to systematically analyze a few prominent wireless sensor network (WSN) clustering routing protocols and compare these different approaches according to the taxonomy and several significant metrics.

Design/methodology/approach

In this paper, the authors have summarized recent research results on data routing in sensor networks and classified the approaches into four main categories, namely, data-centric, hierarchical, location-based and quality of service (QoS)-aware, and the authors have discussed the effect of node placement strategies on the operation and performance of WSNs.

Originality/value

Performance-controlled planned networks, where placement and routing must be intertwined and everything from delays to throughput to energy requirements is well-defined and relevant, is an interesting subject of current and future research. Real-time, deadline guarantees and their relationship with routing, mac-layer, duty-cycles and other protocol stack issues are interesting issues that would benefit from further research.
The shape of success in a turbulent world: wave exposure filtering of coral reef herbivory
Authors: Bejarano Sonia , Jouffray Jean‐Baptiste , Chollett Iliana , Allen Robert , Roff George , Marshell Alyssa , Steneck Robert , Ferse Sebastian C. A. , Mumby Peter J.
Published: January 2017

While environmental filters are well‐known factors influencing community assembly, the extent to which these modify species functions, and entire ecosystem processes, is poorly understood.

Focusing on a high‐diversity system, we ask whether environmental filtering has ecosystem‐wide effects beyond community assembly. We characterise a coral reef herbivorous fish community for swimming performance based on ten functional traits derived from fish morphology. We then investigate whether wave exposure modifies the functional make‐up of herbivory, and the absolute and relative feeding frequency of distinct feeding functional groups.

Herbivorous fish species conformed to either laterally compressed or fusiform body plans, which differ in their morphological design to minimise drag. High wave exposure selectively limited the feeding function of the deepest body shapes with highest caudal thrust efficiency, and favoured fusiform bodies irrespective of pectoral fin shape.

Traditionally recognised herbivore feeding functional groups (i.e. grazers–detritivores and scrapers–small excavators) differed in swimming performance, and in their capacity to feed consistently across levels of wave exposure. We therefore emphasise the distinctness of their ecological niche and functional complementarity.

Species within the same feeding functional group also had contrasting responses to wave exposure. We thereby reveal a further ecological dimension of niche partitioning, and reiterate the risk of assuming functional redundancy among species with a common feeding mode.

Contrasting responses of species within feeding functional roles (i.e. response diversity) allowed the preservation of critical trophic functions throughout the gradient (e.g. macroalgal browsing), and likely explained why overall levels of herbivory were robust to filtering. Whether ecosystem functioning will remain robust under the additive effects of environmental stress and human‐induced disturbances remains to be tested.

A lay summary is available for this article.
From Freudian narcissism to the Buddhist notion of anatman, via Jung's idea of identity
Authors: Martin‐Vallas François
Published: January 2017

Starting from the question the youthful Carl Gustav pondered as he sat on ‘his’ stone – ‘Am I he who sits on the stone, or am I the stone on which he sits?’ – the author has attempted to show that, for Jung, the idea of identity is founded on a wilful non‐determination. This stance results in ethical and methodological repercussions that differentiate it both from the Freudian project and from Hindu and Buddhist thought, while at the same time having much in common with them. The paper refers to the notions of emergence and (Varela et al. 1992) enaction and argues that the concept of the archetype, especially in relation to the self, merits a re‐evaluation in light of the new scientific paradigm.
Supervising away from home: clinical, cultural and professional challenges
Authors: Abramovitch Henry , Wiener Jan
Published: January 2017

This paper explores some challenges of supervising clinical work of trainees, known as ‘routers’, who live in countries with diverse cultural, social and political traditions, and the analysts who travel to supervise them. It is written as an evolving dialogue between the authors, who explore together the effects of their own culture of origin, and in particular the legacy and values of their own training institutes on the styles and models of analytic supervision. Their dialogue is framed around the meaning of home and experiences of homesickness for analysts working away from home in an interactive field of strangeness in countries where analytical psychology is a relatively new discipline. The authors outline the findings from their own qualitative survey, where other supervisors working abroad, and those they have supervised, describe their experiences and their encounters with difference. The dialogue ends with both authors discussing what they have learned about teaching and supervising abroad, the implications for more flexible use of Jungian concepts, and how such visits have changed their clinical practice in their home countries.
If You Don't Know, Ask! Using Expert Knowledge to Determine What Content Is Needed in an Undergraduate Food Quality Management and Control Course
Authors: Joyner Helen S. , Stevenson Clinton D.
Published: January 2017

Quality management and quality control of food products are critical to producing food that is safe to consume and has consistent quality and sensory attributes. The extent to which undergraduate students are equipped with competencies in quality management/control, in theory, has a direct connection with their career potential to ensure food products and/or services meet the expectations of consumers and society. However, the most important quality management/control competencies for undergraduate food science students have yet to be identified. The objective of this study was to determine key knowledge and skills in quality management/control needed by food science graduates. A modified Delphi method was used to gather consensus on these knowledge and skills from experts in food quality management/control. Surveys were used to establish a framework of the most relevant quality management/control concepts for undergraduate food science students to learn and organize these concepts into core domains according to their relative importance. A course outline for teaching an undergraduate course on food quality management/control was developed that detailed relevant topics and depth of coverage for each of these topics. The needs assessment method used in this study to align course content with food industry's needs may be used for a wide variety of course topics.
Improving prospective memory performance with future event simulation in traumatic brain injury patients
Authors: Mioni Giovanna , Bertucci Erica , Rosato Antonella , Terrett Gill , Rendell Peter G. , Zamuner Massimo , Stablum Franca
Published: January 2017

Objective

Previous studies have shown that traumatic brain injury (TBI) patients have difficulties with prospective memory (PM). Considering that PM is closely linked to independent living it is of primary interest to develop strategies that can improve PM performance in TBI patients.

Method

This study employed Virtual Week task as a measure of PM, and we included future event simulation to boost PM performance. Study 1 evaluated the efficacy of the strategy and investigated possible practice effects. Twenty‐four healthy participants performed Virtual Week in a no strategy condition, and 24 healthy participants performed it in a mixed condition (no strategy – future event simulation). In Study 2, 18 TBI patients completed the mixed condition of Virtual Week and were compared with the 24 healthy controls who undertook the mixed condition of Virtual Week in Study 1. All participants also completed a neuropsychological evaluation to characterize the groups on level of cognitive functioning.

Results

Study 1 showed that participants in the future event simulation condition outperformed participants in the no strategy condition, and these results were not attributable to practice effects. Results of Study 2 showed that TBI patients performed PM tasks less accurately than controls, but that future event simulation can substantially reduce TBI‐related deficits in PM performance. The future event simulation strategy also improved the controls’ PM performance.

Conclusions

These studies showed the value of future event simulation strategy in improving PM performance in healthy participants as well as in TBI patients.

Practitioner points

TBI patients performed PM tasks less accurately than controls, confirming prospective memory impairment in these patients.

Participants in the future event simulation condition out‐performed participants in the no strategy condition.

Future event simulation can substantially reduce TBI‐related deficits in PM performance.

Future event simulation strategy also improved the controls’ PM performance.
Does hospital readmission following colorectal cancer resection and enhanced recovery after surgery affect long term survival?
Authors: Curtis N. J. , Noble E. , Salib E. , Hipkiss R. , Meachim E. , Dalton R. , Allison A. , Ockrim J. , Francis N. K.
Published: January 2017

Aim

Hospital readmission is undesirable for patients and care providers as this can affect short‐term recovery and carries financial consequences. It is unknown if readmission has long‐term implications. We aimed to investigate the impact of 30‐day readmission on long‐term overall survival (OS) following colorectal cancer resection within enhanced recovery after surgery (ERAS) care and explore the reasons for and the severity and details of readmission episodes.

Method

A dedicated, prospectively populated database was reviewed. All patients were managed within an established ERAS programme. Five‐year OS was calculated using the Kaplan–Meier method. The number, reason for and severity of 30‐day readmissions were classified according to the Clavien–Dindo (CD) system, along with total (initial and readmission) length of stay (LoS). Multivariate analysis was used to identify factors predicting readmission.

Results

A total of 1023 consecutive patients underwent colorectal cancer resection between 2002 and 2015. Of these, 166 (16%) were readmitted. Readmission alone did not have a significant impact on 5‐year OS (59% vs 70%, P = 0.092), but OS was worse in patients with longer total LoS (20 vs 14 days, P = 0.04). Of the readmissions, 121 (73%) were minor (CD I–II) and 27 (16%) required an intervention of which 16 (10%) were returned to theatre. Gut dysfunction 32 (19%) and wound complications 23 (14%) were the most frequent reasons for readmission. Prolonged initial LoS, rectal cancer and younger age predicted for hospital readmission.

Conclusion

Readmission does not have a significant impact on 5‐year OS. A broad range of conditions led to readmission, with the majority representing minor complications.
Power in methods: language to infants in structured and naturalistic contexts
Authors: Tamis‐LeMonda Catherine S. , Kuchirko Yana , Luo Rufan , Escobar Kelly , Bornstein Marc H.
Published: January 2017

Methods can powerfully affect conclusions about infant experiences and learning. Data from naturalistic observations may paint a very different picture of learning and development from those based on structured tasks, as illustrated in studies of infant walking, object permanence, intention understanding, and so forth. Using language as a model system, we compared the speech of 40 mothers to their 13‐month‐old infants during structured play and naturalistic home routines. The contrasting methods yielded unique portrayals of infant language experiences, while simultaneously underscoring cross‐situational correspondence at an individual level. Infants experienced substantially more total words and different words per minute during structured play than they did during naturalistic routines. Language input during structured play was consistently dense from minute to minute, whereas language during naturalistic routines showed striking fluctuations interspersed with silence. Despite these differences, infants' language experiences during structured play mirrored the peak language interactions infants experienced during naturalistic routines, and correlations between language inputs in the two conditions were strong. The implications of developmental methods for documenting the nature of experiences and individual differences are discussed.
A Technical/Strategic Paradigm for Online Executive Education
Authors: Smith Marlene A. , Keaveney Susan M.
Published: January 2017

This article discusses the development and delivery of online courses for the executive education audience. The goal is to introduce a new framework, the technical/strategic paradigm, that will help educators to identify the pedagogical needs of disparate executive groups and adjust their online course development plans accordingly. We describe how four key elements of online courses (course structure, content‐based learning materials, assignments, and learning assessment) should be fashioned in a way that honors the technical or strategic focus of the learning environment. How the technical/strategic paradigm molds well with many different types of executive educational audiences and settings is illustrated. Course developers seeking advice on how to put these ideas into practice will find lists of resources and implementable recommendations. Ultimately, we argue that some of the pitfalls that faculty experience when transitioning from a traditional business school environment to an online executive education environment can be attributed to a misunderstanding of the degree to which students expect technical versus strategic content.
Traditional and Online Learning in Executive Education: How Both Will Survive and Thrive
Authors: Stanton Wilbur W. , Stanton Angela D'Auria
Published: January 2017

An important component of corporate training is executive education. A sample of 90 open enrollment executive education programs in the areas of management development and leadership was reviewed to better understand the structure of the offerings. In today's marketplace, the majority of executive education offerings are of the traditional face‐to‐face classroom‐style format. More recently, the impact of rapid technological advancements is becoming more apparent in the executive education market as online learning becomes more prevalent. There is no lack of participants for either traditional or online executive education programs, which has expanded the market. While both types of program offerings are viable, the future of executive education may be a merger of the two whereby traditional programs incorporate online components to reduce students’ time away from the job and capitalize on technology to enhance their interpersonal interactions. There is no doubt that executive education will survive and thrive as its future will be the nexus of traditional and online delivery that combines the key advantages of both approaches using a hybrid model that is beginning to be more widely deployed.
Two Decades of Income Inequality in Britain: The Role of Wages, Household Earnings and Redistribution
Authors: Belfield Chris , Blundell Richard , Cribb Jonathan , Hood Andrew , Joyce Robert
Published: January 2017

We study earnings and income inequality in Britain over the past two decades, including the period of relatively ‘inclusive’ growth from 1997 to 2004, and the Great Recession. We focus on the middle 90%, where trends have contrasted strongly with the ‘new inequality’ at the very top. Household earnings inequality has risen, driven by male earnings—although a ‘catch‐up’ of female earnings did hold down individual earnings inequality and reduce within‐household inequality. Nevertheless, net household income inequality fell due to deliberate increases in redistribution, the tax and transfer system's insurance role during the Great Recession, falling household worklessness, and rising pensioner incomes.
Mapping Grey Willow (Salix cinerea) stand architecture using airborne laser scanning: implications for large‐scale tree weed control
Authors: Griffiths James W. , Howell Clayson J. , Burlace David
Published: January 2017

We investigated the potential of airborne laser scanning (ALS) for mapping the stand architecture of Grey Willow (Salix cinerea), an invasive wetland weed in New Zealand. In particular, we focused on two metrics, tree height and canopy density, both of which influence the efficacy and nontarget impacts of herbicides aerially broadcast by helicopter to control tree weeds. We compared ground‐based measures of Grey Willow height and canopy density withALS‐derived data, and the relationship between canopy density as estimated by each method and aerial herbicide deposition at three wetland sites in New Zealand. Analysis revealed strong linear relationships between ground‐based andALSmetrics, indicating thatALSdata could be used to generate accurate, high‐resolution digital maps of Grey Willow height and canopy density. These maps coupled with computer‐guided variable flow rate technologies, which enable optimal placement of herbicide, could maximise Grey Willow mortality while reducing the mortality of nontarget indigenous plants. We recommend the application ofALS‐derived maps and computer‐guided variable flow rate technology is investigated for more targeted large‐scale tree weed control.
Migrant family visits and the life course: interrelationships between age, capacity and desire
Authors: HORN VINCENT
Published: January 2017

Migrant visits to the country of origin play a crucial role in transnational family cohesion and migrant well‐being; the research on them so far has focused primarily on the relationship between migrant integration and transnational engagement. In this article, I extend the discussion by adding a life course perspective to Carling and Hoelscher's (2013) framework for studying transnational activities, which incorporates capacity and desire. I explore whether age has an independent effect on migrants' family visits and how it relates to socio‐economic resources, migration status and transnational ties. Using data from a survey of Peruvian migrants around the globe (n=7,741), I show that migrants' stage in the life course has a partial effect on their propensity to travel through the interrelationship between age, capacity and desire. The findings show that the capacity and desire of migrants to visit their country of origin are particularly strong after reaching retirement age, suggesting a favourable combination of resources at later stages in life. However, whether this expresses a positive approach to ageing, or is a strategy to balance transnational family obligations and to postpone return decisions, remains open for future research.
Evaluation of the use of rotational thromboelastometry in the assessment of FXI deficency
Authors: Pike G. N. , Cumming A. M. , Thachil J. , Hay C. R. M. , Bolton‐Maggs P. H. B. , Burthem J.
Published: January 2017

Introduction

The absence of a reliable clinical test to predict bleeding tendency leaves factor XI (FXI)‐deficient individuals at risk of overtreatment or under treatment.

Aim

To assess whether rotational thromboelastometry has value in detection of FXI deficiency and identification of bleeding tendency.

Methods

Thromboelastometry was measured in whole blood and platelet‐rich plasma (PRP) samples containing corn trypsin inhibitor (CTI) from controls (n = 50) and FXI‐deficient individuals (n = 93) at tissue factor (TF) 0.12 pm. The effect of tissue plasminogen activator was also assessed. For analysis, FXI‐deficient individuals were divided into bleeders (n = 24) and non‐bleeders (n = 44) based on experience of tonsillectomy and/or dental extraction prior to diagnosis.

Results

In whole blood, thromboelastometry distinguished those with major FXI deficiency (FXI:C ≤ 15 IU dL−1) but not partial deficiency from control populations, but did not identify bleeding phenotype. In PRP, bleeders had significantly longer clot formation time [CFT; 434 ± 179 s vs. 277 ± 70 s (mean ± SD); P < 0.05] and smaller α angle [43.8 ± 9.5° vs. 52.4 ± 5.8° (mean ± SD); P < 0.05] compared to non‐bleeders. However, these parameters were found to depend on multiple additional variables and on an individual basis, ROC analysis showed test specificity for bleeding phenotype identification to be only 38.5% at 100% sensitivity: CFT (area under first derivative curve: AUC = 0.8091, P = 0.0014), α angle (AUC = 0.7804, P = 0.006).

Conclusion

Thromboelastometry in PRP with CTI samples triggered with TF 0.12 pm was able to distinguish between bleeders and non‐bleeders in FXI deficiency, but poor specificity restricts its clinical application as a test to identify bleeding phenotype. Further technical advances to the assay may allow better discrimination.
Maltreatment‐associated neurodevelopmental disorders: a co‐twin control analysis
Authors: Dinkler Lisa , Lundström Sebastian , Gajwani Ruchika , Lichtenstein Paul , Gillberg Christopher , Minnis Helen
Published: January 2017

Background

Childhood maltreatment (CM) is strongly associated with psychiatric disorders in childhood and adulthood. Previous findings suggest that the association between CM and psychiatric disorders is partly causal and partly due to familial confounding, but few studies have investigated the mechanisms behind the association between CM and neurodevelopmental disorders (NDDs). Our objective was to determine whether maltreated children have an elevated number of NDDs and whether CM is a risk factor for an increased NDD ‘load’ and increased NDD symptoms when controlling for familial effects.

Methods

We used a cross‐sectional sample from a population‐representative Swedish twin study, comprising 8,192 nine‐year‐old twins born in Sweden between 1997 and 2005. CM was defined as parent‐reported exposure to emotional abuse/neglect, physical neglect, physical abuse, and/or sexual abuse. Four NDDs were measured with the Autism–Tics, AD/HD, and other comorbidities inventory.

Results

Maltreated children had a greater mean number of NDDs than nonmaltreated children. In a co‐twin control design, CM‐discordant monozygotic twins did not differ significantly for their number of NDDs, suggesting that CM is not associated with an increased load of NDDs when genetic and shared environmental factors are taken into account. However, CM was associated with a small increase in symptoms of attention‐deficit/hyperactivity disorder and autism spectrum disorder in CM‐discordant MZ twins, although most of the covariance of CM with NDD symptoms was explained by common genetic effects.

Conclusions

Maltreated children are at higher risk of having multiple NDDs. Our findings are, however, not consistent with the notion that CM causes the increased NDD load in maltreated children. Maltreated children should receive a full neurodevelopmental assessment, and clinicians should be aware that children with multiple NDDs are at higher risk of maltreatment.
Early involvement of lysosome dysfunction in the degeneration of cerebral cortical neurons caused by the lipid peroxidation product 4‐hydroxynonenal
Authors: Zhang Shi , Eitan Erez , Mattson Mark P.
Published: January 2017

Free radical‐mediated oxidative damage to proteins, lipids, and DNA occurs in neurons during acute brain injuries and in neurodegenerative disorders. Membrane lipid peroxidation contributes to neuronal dysfunction and death, in part by disrupting neuronal ion homeostasis and cellular bioenergetics. Emerging findings suggest that 4‐hydroxynonenal (HNE), an aldehyde produced during lipid peroxidation, impairs the function of various proteins involved in neuronal homeostasis. Here we tested the hypothesis that HNE impairs the cellular system that removes damaged proteins and organelles, the autophagy–lysosome pathway in rat primary cortical neurons. We found that HNE, at a concentration that causes apoptosis over a 48–72 h period, increases protein levels of LC3 II and p62 and within 1 and 4 h of exposure, respectively; LC3 II and p62 immunoreactive puncta were observed in the cytoplasm of HNE‐treated neurons at 6 h. The extent of up‐regulation of p62 and LC3 II in response to HNE was not affected by co‐treatment with the lysosome inhibitor bafilomycin A1, suggesting that the effects of HNE on autophagy were secondary to lysosome inhibition. Indeed, we found that neurons exposed to HNE exhibit elevated pH levels, and decreased protein substrate hydrolysis and cathepsin B activity. Neurons exposed to HNE also exhibited the accumulation of K63‐linked polyubiquitinated proteins, which are substrates targeted for lysosomal degradation. Moreover, we found that the levels of LAMP2a and constitutively active heat‐shock protein 70, and numbers of LAMP2a‐positive lysosomes, are decreased in neurons exposed to HNE. Our findings demonstrate that the lipid peroxidation product HNE causes early impairment of lysosomes which may contribute to the accumulation of damaged and dysfunctional proteins and organelles and consequent neuronal death. Because impaired lysosome function is increasingly recognized as an early event in the neuronal death that occurs in neurodegenerative disorders, our findings suggest a role for HNE in such lysosomal dysfunction.

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One mutation, two distinct disease variants: unravelling the impact of transthyretin amyloid fibril composition
Authors: Suhr O. B. , Lundgren E. , Westermark P.
Published: January 2017

Although hereditary transthyretin (h‐ATTR) amyloidosis is a monogenetic disease, a large variation in its phenotype has been observed. The common hypothesis of amyloid fibril formation involves dissociation of the transthyretin (TTR) tetramer into monomers that after misfolding reassemble into amyloid fibrils. This notion is partly challenged by the finding of two distinct types of amyloid fibrils. One of these, type A, consists of C‐terminal ATTR fragments and full‐length TTR, whereas the other, type B, consists only of full‐length TTR. All organs of an individual patient contain ATTR deposits of either type A or type B fibrils, and the composition in each individual remains unchanged over time. The finding of two distinct types of ATTR fibrils suggests that there are at least two different pathways in operation for ATTR fibril formation. For the most common European mutation, TTR Val30Met, ATTR fibril composition is related to the outcome of liver transplantation, which is the first successful treatment for the disease, and the penetrance of the trait. In addition, the presence of C‐terminal ATTR fragments has an impact on the affinity for various tracers used for noninvasive imaging of amyloid depositions such as 99 m‐technetium‐diphosphono‐propanodicarboxylic acid scintigraphy and positron emission tomography utilizing Pittsburgh component B, and even for the gold standard diagnostic procedure, tissue biopsy stained by Congo red and examined under polarized light. The importance of amyloid fibril composition needs to be taken into consideration when designing clinical trials of treatment modalities, and also in the evaluation of diagnostic methods such as imaging techniques.
Intravenous Combined with Topical Administration of Tranexamic Acid in Primary Total Hip Arthroplasty: A Randomized Controlled Trial
Authors: Zeng Yi , Si Hai‐Bo , Shen Bin , Yang Jing , Zhou Zong‐ke , Kang Peng‐de , Pei Fu‐xing
Published: January 2017

Objective

Although there are still some controversies, large previous studies have confirmed that intravenous (i.v.) tranexamic acid (TXA) can effectively reduce blood loss and transfusions in total hip arthroplasty (THA) without increasing the risk of deep venous thrombosis. However, few studies have investigated the combination of i.v. and topical application of TXA in primary THA. The purpose of our current study is to examine whether i.v. combined with topical administration of TXA decreases postoperative blood loss and transfusion rates after THA.

Methods

From December 2013 to May 2014, all adult patients undergoing primary THA at our arthroplasty center were considered for inclusion in the present study. Included patients were randomly assigned to two groups by computer‐generated list number: a TXA group and a placebo group. Patients in the TXA group received i.v. (15 mg/kg) combined with topical administration (1.0 g) of TXA during the THA procedure, and patients in the other group received the same dosage of normal saline both i.v. and topically. Our primary outcome measures were total blood loss (calculated using Gross's equation), hemoglobin, hematocrit and platelet concentration changes on the third postoperative day, the amount of drainage, the amount of intraoperative blood loss, the frequency of transfusion, and the number of blood units transfused. Secondary outcome measures were the length of postoperative stay, range of hip motion (measured by goniometer), Harris hip scores (HHS), and any perioperative complications or events such as infection, DVT or PE. Range of motion and HHS were measured at 3 week follow‐up and compared with preoperative values.

Results

This trial included 100 patients (50 in each group). Patients in the TXA group had significantly higher postoperative hemoglobin (103 vs 87.7 g/dL, P < 0.01), lower hemoglobin changes (32.2 vs 44.9 g/dL, P < 0.01), higher postoperative hematocrit (0.32 vs 0.27 L/L, P < 0.01), lower hematocrit changes (0.1 vs 0.14 L/L, P < 0.01), lower total blood loss (822 vs 1100 mL, P = 0.004), lower drainage (117.8 vs 242.4 mL, P < 0.01), lower intraoperative blood loss (193.8 vs 288.2 mL, P < 0.01), and lower transfusion rate (2% vs 34%, P < 0.01) compared with those in the placebo group. No statistical difference was found in postoperative platelets between the two groups. There were no differences in perioperative complications or venous thromboembolism (VTE) events.

Conclusions

The combined administration of i.v. and topical TXA resulted in a clinically relevant reduction in blood loss, compared with placebo group. No thromboembolic complications were observed. This randomized controlled trial supports the combined i.v. and topical administration of TXA in primary THA.
Activism without “Radicalism”: American Activism on Behalf of Conscientious Objectors during World War I
Authors: Tannenbaum Seth S.
Published: January 2017

This article explores the tactics that civilian activists used to influence U.S. War Department policies and U.S. Army procedures regarding conscientious objectors during World War I. The varying nature of civilian activists' tactics during the war points to a sustained desire to effect change and the important realization that in order to do so, activists had to remain “nonradical” in the government's eyes. Furthermore, activists operated during a time of intense government suppression of dissent, which made their desire to remain “nonradical” both more urgent and more difficult to achieve. This article concludes with analysis of an organization that activists carefully crafted to appear “nonradical” in order to effect radical change.
Quality of life and clinical correlates in older adults living in the community and in nursing homes in Macao
Authors: C. F. Kuok Kenny , Li Lu , Xiang Yu‐Tao , Nogueira Bernice O. C. Lam , Ungvari Gabor S. , Ng Chee H. , Chiu Helen F. K. , Tran Linda , Meng Li‐Rong
Published: January 2017

Aim

There have been no previous studies of quality of life (QOL) in older adults in Macao. This study aimed to examine QOL in relation to the sociodemographic and clinical characteristics of adults aged ≥50 years in Macao.

Methods

A sample of 451 subjects (203 living in the community, 248 living in nursing homes) was interviewed using standardized instruments. Basic sociodemographic and clinical data including QOL were collected.

Result

There were no significant differences between the community and nursing home groups in any of the QOL domains. Multiple linear regression analyses revealed that poor physical QOL was significantly predicted by severe depressive symptoms, insomnia, major medical conditions, unmarried status, and lower education (
F

11,438 = 26.2, P < 0.001), which accounted for 38.2% of the variance. Poor psychological QOL was significantly predicted by severe depressive symptoms and lower educational level (
F

11,438 = 24.3, P < 0.001), which accounted for 36.4% of the variance. Poor social QOL was significantly predicted by severe depressive symptoms, male gender, and unmarried status (
F

11,438 = 5.6, P < 0.001), which accounted for 12.5% of the variance. Poor environment QOL was significantly predicted by lower educational level, severe depressive symptoms, and younger age (
F

11,438 = 6.6, P < 0.001), which accounted for 12.1% of the variance.

Conclusion

Older Macanese adults had poorer scores on physical and social QOL domains than the general Hong Kong Chinese population. Their QOL was more strongly related to severe depressive symptoms, major medical conditions, and insomnia.