bluuebunny/crossref_metadata_2025 huggingface dataset:
Defending the frontier: examining the impact of internal salesperson evasive knowledge hiding on perceptions of external customer outcomes
Authors: Chaker Nawar N. , Nowlin Edward L. , Walker Doug , Anaza Nwamaka A.
Published: September 2020

Purpose

Salespeople frequently face the predicament of wanting to protect their market knowledge from coworkers while not appearing recalcitrant. Considering the choice of disclosing information or refusing to disclose, they may choose a third option: appearing to share knowledge while concealing substantive information, which this study calls evasive knowledge hiding. This study surmises that the consequences of these choices impact perceptions of customer outcomes. Using social exchange theory, the purpose of this article is to examine the internal relational antecedents and perceptions of external customer outcomes of evasive knowledge hiding, as well as the moderating effects of pushover manager and environmental dynamism.

Design/methodology/approach

A moderated mediation model was used to analyze survey data from 234 business-to-business salespeople.

Findings

Internal competition and coworkers’ past opportunistic behavior increase evasive knowledge hiding. These effects are attenuated if the manager is not a pushover. Evasive knowledge hiding decreases perceptions of external customer outcomes, particularly at low levels of environmental dynamism.

Research limitations/implications

Data was collected from salespeople, which presents a look from perpetrators themselves. While directly observing salespeople was the goal, sourcing and matching customer and manager data would only strengthen the results.

Practical implications

Salespeople evasively hide their knowledge if it is in their best interest, which may unwittingly hurt perceptions of customer outcomes.

Originality/value

This study formally introduces salesperson evasive knowledge hiding into the marketing and sales literature. The research highlights the dark side of social exchange theory by demonstrating how internal coworker relationships affect perceptions of external customer relationships via evasive knowledge hiding. This study also introduces pushover manager as an enabling moderating variable.
The influence of a country’s brands and industry on its image
Authors: Lopez Carmen , Balabanis George
Published: September 2020

Purpose

Extant research has largely treated country image (CI) as an exogenous variable, focusing mostly on its consequences for consumers’ evaluations and purchases of products or brands originating from a country. Scant research has examined the instrumental role of a country’s brands and products in the evaluations of CI. This study aims to investigate how the brands of a country contribute to CI ratings and the conditions underlying their effect on CI.

Design/methodology/approach

Three experimental studies test the hypotheses, one pertaining to the effect of brands on CI (N = 227), the second to the effect of products on CI (N = 116) and the third to the effect of brands and products on industry image (N = 215). The experimental approach overcomes the limitations of cross-sectional surveys commonly used in CI studies to detect the direction of the observed effects. Furthermore, respondents (British consumers) were allowed to determine the brands and products associated with a country.

Findings

Drawing on memory schema theory, across three studies, the authors identify two types of reverse inferences: from brand to CI and from product category to CI. The reverse inference from a brand to a superordinate image is stronger for industry image than for CI.

Research limitations/implications

This research focuses on consumers’ evaluations from only one country (the UK). Further research could replicate the studies across different countries and with different countries of origin (COOs). Researchers could also examine the influence of brands misidentified with the wrong COO and mistakenly stored as such in consumers’ memories.

Practical implications

The results are relevant for managers and consultants working with country- (place-) branding campaigns. Brands and industries can help strengthen the evaluations of the economic dimension of different countries; however, these assets are underdeveloped in country-branding campaigns. Linking countries with brands and industries in campaigns could result in positive associations, which, in turn, could enhance the reputational rating of the countries.

Originality/value

This research extends previous studies on the effects of a country’s products and brands on CI by incorporating the mediating role of industry image between brands/products and CI, separating the effects of brand and product category on CI, allowing consumers to determine, which brands and products are associated with a country and adopting an experimental methodology to ascertain the causal direction of the effects.
The moderating role of audit quality on the relationship between auditor reporting and earnings management: empirical evidence from Tunisia
Authors: Imen Fakhfakh , Anis Jarboui
Published: September 2020

Purpose

The purpose of this study is to examine the interrelationship between modified audit opinions and earnings management as measured by discretionary accruals and develop a thorough understanding regarding the moderating effect of audit quality on this relation.

Design/methodology/approach

This study uses a sample of Tunisian listed firms on the Tunis Stock Exchange during 2006–2013. Four models are developed and tested by using panel logistic and Feasible Generalized Least Squares (FGLS) regressions.

Findings

The results show that earnings management increases the likelihood of receiving a modified audit opinions. Then firms receiving modified audit opinions manage earnings more than those receiving clean opinions. It is also discovered that audit quality moderates the relationship between audit opinion and earnings management.

Practical implications

This paper contributes to the literature of both audit and management studies and represents the first effort to examine the relation between audit opinion and earnings management, with audit quality as a moderating variable.

Originality/value

This study extends existing research on earnings management and audit opinion. Thus, this study has the potential to help stakeholders, board of directors, regulators and auditors, who are related with enhancing the supervision of firms and reducing the opportunities given to managers, to engage in earnings management. It constitutes an addition to previous knowledge about audit opinion in the Tunisian context before and after revolution.
Boards of directors' influences on occupational health and safety: a scoping review of evidence and best practices
Authors: Ebbevi David , Von Thiele Schwarz Ulrica , Hasson Henna , Sundberg Carl Johan , Frykman Mandus
Published: September 2020

Purpose

To review the literature and identify research gaps in the role and influence boards of directors of companies have in occupational health and safety (OHS).

Design/methodology/approach

This was done in a scoping review built on a structured search in MEDLINE (PubMed), EMBASE, PsycINFO, Sociological Abstracts, CCInfoWeb, EconLit, Web of Science, CINAHL and gray literature. Citations and reference lists were tracked. Inclusion criteria were publication in English. Exclusion criteria were studies covering companies using subcontractors to arrange OHS, or with <250 employees.

Findings

Forty-nine studies were included. The majority contained empirical data (n = 28; 57%), some were entirely normative (n = 16; 33%), and a few contained normative claims far beyond empirical data (n = 5; 10%). Empirical studies gave no insight into the scope of impact of board activities on OHS, and no studies assess the causal mechanisms by which board activities influence OHS outcomes. Most studies focused on both health and safety (n = 20; 41%) or only safety (n = 15; 31%). Context might explain the focus on safety rather than health, but is not clearly elucidated by the studies. Several studies are describing leadership behavior, although not framed as such. A narrative summary is presented to facilitate future research.

Research limitations/implications

Future research should include: (1) which board activities influence OHS, (2) how board activities influence OHS, (3) the influence of context and (4) the leadership role of boards of directors.

Originality/value

This study identifies a total lack of research on the basic mechanics of the relationship between boards and OHS.
Characteristic appearance of spindle cell hemangiomatosis, often misdiagnosed as venous malformation: A retrospective study of 11 cases
Authors: Liu Hongyuan , Rao Yamin , Gu Hao , Yang Xi , Hu Li , Sun Yi , Chen Hui , Lin Xiaoxi
Published: September 2020

Spindle cell hemangiomatosis is a benign multifocal vascular proliferation that mostly occurs in the distal extremities. It is a relatively rare disease and causes difficulties in clinical diagnosis and differential diagnosis of venous malformation. We retrospectively assessed the medical history, and clinical features, imaging features, pathological features and follow up of 11 patients diagnosed pathologically with spindle cell hemangiomatosis after surgery. There are two types of clinical appearances in spindle cell hemangiomatosis in the distal extremities: bleb‐like nodules and varix‐like nodules. Bleb‐like nodules are mostly superficially located in the palm or interphalangeal joints with obvious hemorrhage in lesions and mainly composed of cavernous spaces rather than spindle cells. Varix‐like nodules are located in the back of the hands or arms with normal skin color and mainly composed of solid areas of accumulated spindle cells. Surgery is the standard therapy for spindle cell hemangiomatosis, while sclerotherapy is invalid. Despite the tendency to develop new lesions, there are no residual lesions at the surgical site during follow up. Bleb‐like nodules in the palm and interphalangeal joints are a typical clinical appearance in spindle cell hemangiomatosis which can help make clinical and a differential diagnosis of venous malformation. Surgery is the standard therapy for spindle cell hemangiomatosis with no residual lesions remaining at the surgical sites.
Time evolution of the first‐order linear acoustic/elastic wave equation using Lie product formula and Taylor expansion
Authors: Araujo Edvaldo S. , Pestana Reynam C.
Published: September 2020

We propose a new numerical solution to the first‐order linear acoustic/elastic wave equation. This numerical solution is based on the analytic solution of the linear acoustic/elastic wave equation and uses the Lie product formula, where the time evolution operator of the analytic solution is written as a product of exponential matrices where each exponential matrix term is then approximated by Taylor series expansion. Initially, we check the proposed approach numerically and then demonstrate that it is more accurate to apply a Taylor expansion for the exponential function identity rather than the exponential function itself. The numerical solution formulated employs a recursive procedure and also incorporates the split perfectly matched layer boundary condition. Thus, our scheme can be used to extrapolate wavefields in a stable manner with even larger time‐steps than traditional finite‐difference schemes. This new numerical solution is examined through the comparison of the solution of full acoustic wave equation using the Chebyshev expansion approach for the matrix exponential term. Moreover, to demonstrate the efficiency and applicability of our proposed solution, seismic modelling results of three geological models are presented and the processing time for each model is compared with the computing time taking by the Chebyshev expansion method. We also present the result of seismic modelling using the scheme based in Lie product formula and Taylor series expansion for the first‐order linear elastic wave equation in vertical transversely isotropic and tilted transversely isotropic media as well. Finally, a post‐stack migration results are also shown using the proposed method.
Improving emergency preparedness to cascading disasters: A case‐driven risk ontology modelling
Authors: Yu Feng , Fan Bo , Li Xiangyang
Published: September 2020

With the acceleration of urbanization, cascading disaster risks (CDR) as a typical risk mode have become the main threat to cities. After experiencing several cascading disasters, such as typhoon Lekima, how to clarify the basic features of CDR and achieve risk modelling has turned to be increasingly significant for building resilient city. However, the complexity of CDR brings about the difficulty to quickly map such risk mode depending entirely on expertise. Therefore, this paper attempts to provide a CDROntology system built by concepts and relations, and make full use of the historical cases to drive the modelling of the target CDR with case‐based reasoning. Firstly, we describe the basic structure and content of CDR and give a three‐level CDROntology system with the explanation of modelling primitives. Then, taking CDROntology system as the basis, a case‐driven selection process is proposed to provide the modelling source for the target CDR. Furthermore, set covering and manual correction methods are adopted to model the evolutionary risk chain and the specific risk scenario of the target case. Finally, a case study is given to illustrate the use of CDROntology system and case‐driven method for building a predictive risk model in typhoon‐triggered cascading disasters.
What happens where during disasters? A Workflow for the multifaceted characterization of crisis events based on Twitter data
Authors: Kersten Jens , Klan Friederike
Published: September 2020

Twitter data are a valuable source of information for rescue and helping activities in case of natural disasters and technical accidents. Several methods for disaster‐ and event‐related tweet filtering and classification are available to analyse social media streams. Rather than processing single tweets, taking into account space and time is likely to reveal even more insights regarding local event dynamics and impacts on population and environment. This study focuses on the design and evaluation of a generic workflow for Twitter data analysis that leverages that additional information to characterize crisis events more comprehensively. The workflow covers data acquisition, analysis and visualization, and aims at the provision of a multifaceted and detailed picture of events that happen in affected areas. This is approached by utilizing agile and flexible analysis methods providing different and complementary views on the data. Utilizing state‐of‐the‐art deep learning and clustering methods, we are interested in the question, whether our workflow is suitable to reconstruct and picture the course of events during major natural disasters from Twitter data. Experimental results obtained with a data set acquired during hurricane Florence in September 2018 demonstrate the effectiveness of the applied methods but also indicate further interesting research questions and directions.
Maternity services in the UK during the coronavirus disease 2019 pandemic: a national survey of modifications to standard care
Authors: Jardine J , Relph S , Magee LA , von Dadelszen P , Morris E , Ross‐Davie M , Draycott T , Khalil A
Published: September 2020

Objective

To explore the modifications to maternity services across the UK, in response to the coronavirus disease 2019 (COVID‐19) pandemic, in the context of the pandemic guidance issued by the Royal College of Obstetricians and Gynaecologists (RCOG), Royal College of Midwives (RCM) and NHS England.

Design

National survey.

Setting

UK maternity services during the COVID‐19 pandemic.

Population or sample

Healthcare professionals working within maternity services.

Methods

A national electronic survey was developed to investigate local modifications to general and specialist maternity care during the COVID‐19 pandemic, in the context of the contemporaneous national pandemic guidance. After a pilot phase, the survey was distributed through professional networks by the RCOG and co‐authors. The survey results were presented descriptively in tabular and graphic formats, with proportions compared using chi‐square tests.

Main outcome measures

Service modifications made during the pandemic.

Results

A total of 81 respondent sites, 42% of the 194 obstetric units in the UK, were included. They reported substantial and heterogeneous maternity service modifications. Seventy percent of units reported a reduction in antenatal appointments and 56% reported a reduction in postnatal appointments; 89% reported using remote consultation methods. A change to screening pathways for gestational diabetes mellitus was reported by 70%, and 59% had temporarily removed the offer of births at home or in a midwife‐led unit. A reduction in emergency antenatal presentations was experienced by 86% of units.

Conclusions

This national survey documents the extensive impact of the COVID‐19 pandemic on maternity services in the UK. More research is needed to understand the impact on maternity outcomes and experience.

Tweetable abstract

A national survey showed that UK maternity services were modified extensively and heterogeneously in response to COVID‐19.
A Cutting Re-Mark
Authors: Paulden Tim
Published: September 2020

In mid-August, an algorithm spat out “synthetic” exam grades so absurd and distressing to students that they had to be ditched just four days later. But what exactly went wrong? Dr Tim Paulden explains
Suspect Peaks in Russia's “Referendum” Results
Authors: Kobak Dmitry , Shpilkin Sergey , Pshenichnikov Maxim S.
Published: September 2020

Dmitry Kobak, Sergey Shpilkin and Maxim S. Pshenichnikov find suspicious patterns in data from Russia's nationwide vote on a package of constitutional changes
Development of arrowroot flour fermented by kefir grains
Authors: de Souza Beatriz Lourdes , Magalhães‐Guedes Karina Teixeira , Lemos Paulo Vitor França , Maciel Leonardo Fonseca , Dias Disney Ribeiro , Druzian Janice Izabel , Schwan Rosane Freitas
Published: September 2020

The present study aims to produce arrowroot flour fermented by kefir grains, in addition to assessing the physicochemical, nutritional, and microbiological characteristics. Fermented arrowroot flour was produced at room temperature (approximately 25 to 28 °C). Fermentation was conducted in batch (6 kg of the substrate and 10% of kefir grains were added with homogenization every 3 hr). Samples were evaluated every 12 hr for both fermentation processes (fermentation process 1: 24 hr and fermentation process 2: 48 hr). The flours were evaluated for physicochemical, nutritional, and microbiological qualities, using a completely randomized design, considering only the variation in the duration of both fermentation processes (from 24 to 48 hr). The fermentation process positively modified the physicochemical, nutritional, and microbial characteristics of the flours. An increase in antioxidant activity (IC50: control flour [CF] = 18.9 ± 0.13; arrowroot kefir flour [24 hr of fermentation; AKF1] = 15.36 ± 0.14; and arrowroot kefir flour [48 hr of fermentation; AKF2] = 13.84 ± 0.15), protein percentage (CF = 3.08 ± 0.12; AKF1 = 4.87 ± 0.33; and AKF2 = 6.00 ± 0.07), and organic acid (lactic, acetic, and propionic acids) production was observed, as well as modification in color (browning), the conformation of starch structures, and carbohydrate reduction. These results suggested that the “arrowroot kefir flours” open a new perspective for introduction in the market as a new product that can be used as food in nature or food ingredient for making bread, biscuits, pasta, and others, showing microbiological safety and functions properties.

Practical Application

The fermented flours present improved nutritional characteristics due to the fermentation process, such as higher antioxidant activity and protein levels. Regarding the population growth and societal demand for healthier food, one possibility is to provide a fermented flour with added nutritional value and raise knowledge about the arrowroot. Thus, these flours can be used in various food items or as an ingredient in food preparations for consumers that desire a healthy diet.
Metabolic dysfunction in human skin: Restoration of mitochondrial integrity and metabolic output by nicotinamide (niacinamide) in primary dermal fibroblasts from older aged donors
Authors: Oblong John E. , Bowman Amy , Rovito Holly A. , Jarrold Bradley B. , Sherrill Joseph D. , Black Markaisa R. , Nelson Glyn , Kimball Alexa B. , Birch‐Machin Mark A.
Published: September 2020

Alterations in metabolism in skin are accelerated by environmental stressors such as solar radiation, leading to premature aging. The impact of aging on mitochondria is of interest given their critical role for metabolic output and the finding that environmental stressors cause lowered energy output, particularly in fibroblasts where damage accumulates. To better understand these metabolic changes with aging, we performed an in‐depth profiling of the expression patterns of dermal genes in face, forearm, and buttock biopsies from females of 20–70 years of age that encode for all subunits comprising complexes I‐V of the mitochondrial electron transport chain. This complements previous preliminary analyses of these changes. “Oxidative phosphorylation” was the top canonical pathway associated with aging in the face, and genes encoding for numerous subunits had decreased expression patterns with age. Investigations on fibroblasts from older aged donors also showed decreased gene expression of numerous subunits from complexes I‐V, oxidative phosphorylation rates, spare respiratory capacity, and mitochondrial number and membrane potential compared to younger cells. Treatment of older fibroblasts with nicotinamide (Nam) restored these measures to younger cell levels. Nam increased complexes I, IV, and V activity and gene expression of representative subunits. Elevated mt‐Keima staining suggests a possible mechanism of action for these restorative effects via mitophagy. Nam also improved mitochondrial number and membrane potential in younger fibroblasts. These findings show there are significant changes in mitochondrial functionality with aging and that Nam treatment can restore bioenergetic efficiency and capacity in older fibroblasts with an amplifying effect in younger cells.
Rapid Administration of Methoxyflurane to Patients in the Emergency Department (RAMPED) Study: A Randomized Controlled Trial of Methoxyflurane Versus Standard Care
Authors: Brichko Lisa , Gaddam Ravali , Roman Cristina , O’Reilly Gerard , Luckhoff Carl , Jennings Paul , Smit De Villiers , Cameron Peter , Mitra Biswadev
Published: September 2020

Objective

The objective was to evaluate the effectiveness of methoxyflurane versus standard care for the initial management of severe pain among adult emergency department (ED) patients.

Methods

This randomized parallel‐group open‐label phase IV trial of methoxyflurane was conducted in a tertiary hospital ED setting in Australia. Inclusion criteria required adult patients to have an initial pain score ≥ 8 on the 11‐point Numerical Rating Scale (NRS). Patients were randomized 1:1 to receive either inhaled methoxyflurane (3 mL) or standard analgesic treatment at ED triage. The primary outcome was the proportion of patients achieving clinically substantial pain reduction, defined as a ≥50% drop in the pain score at 30 minutes. Secondary outcomes included the pain score at multiple time points (15, 30, 60, 90 minutes) and the difference in the proportion of patients achieving a >2‐point reduction on the NRS.

Results

There were 120 patients randomized and analyzed between September 4, 2019, and January 16, 2020. The primary outcome was achieved in six (10%) patients in the methoxyflurane arm and three (5%) in the standard care arm (p = 0.49). A higher proportion of patients in the methoxyflurane arm reported a >2‐point drop on the NRS at all time points (17% vs. 5% at 15 minutes, 25% vs. 9% at 30 minutes, 30% vs. 10% at 60 minutes, and 33% vs. 13% at 90 minutes). Methoxyflurane use was also associated with lower median pain scores at all time points.

Conclusion

Initial management with inhaled methoxyflurane in the ED did not achieve the prespecified substantial reduction in pain, but was associated with clinically significant lower pain scores compared to standard therapy.
A stochastic dominance approach to program evaluation with an application to child nutritional status in Kenya
Authors: Naschold Felix , Barrett Christopher B.
Published: September 2020

Most existing program evaluation methods examine the average impact of a program. This necessarily overlooks the potential for different program impacts over different parts of the distribution of the variable of interest. To overcome this limitation, we develop a novel methodology for program evaluation which combines stochastic dominance with difference‐in‐differences methods. We use this new method to evaluate the impact of a large decentralization program in Kenya on changes in child nutritional status, where one's primary concern is about sharp adverse (i.e., negative) changes. Using standard difference‐in‐differences regression as a baseline, we find , no statistically or practically significant mean impact. In contrast, our stochastic dominance estimations reveal that project expenditures have had different impacts on different parts of the distribution. In particular, they are associated with less deterioration in children's nutritional status among the worst‐off children, indicating that the program effectively functions as a nutritional safety net.
Circulating lipidomic alterations in obese and non‐obese subjects with non‐alcoholic fatty liver disease
Authors: Jung Youngae , Lee Min Kyung , Puri Puneet , Koo Bo Kyung , Joo Sae Kyung , Jang Seo Young , Lee Dong Hyeon , Jung Yong Jin , Kim Byeong Gwan , Lee Kook Lae , Park Tae‐Sik , Kang Ki‐Tae , Ryu Do Hyun , Kang Sang Won , Kim Donghee , Oh Sohee , Kim Won , Hwang Geum‐Sook
Published: September 2020

Background

Non‐alcoholic fatty liver disease (NAFLD) affects obese and non‐obese individuals. However, mechanisms underlying non‐obese non‐alcoholic steatohepatitis (NASH) remain unclear.

Aims

To attempt to identify metabolic perturbations associated with non‐obese and obese NAFLD using a lipidomics approach.

Methods

A cross‐sectional analysis of 361 subjects with biopsy‐proven NAFLD (157 NAFL and 138 NASH) and healthy controls (n = 66) was performed. Individuals were categorised as obese or non‐obese based on the Asian cut‐off for body mass index. Circulating lipidomic profiling of sera was performed based on the histological severity of NAFLD. Circulating lipidomic alterations were validated with an independent validation set (154 NAFLD subjects [93 NAFL and 61 NASH] and 21 healthy controls).

Results

Saturated sphingomyelin (SM) species were significantly associated with visceral adiposity in non‐obese NAFLD (SM d38:0; P < 0.001) but not in obese NAFLD. Additionally, SM levels were significantly associated with systemic and adipose tissue insulin resistance (SM d38:0; P = 0.002 and <0.001, respectively). Five potential lipid metabolites for non‐obese subjects and seven potential lipids for obese subjects were selected to predict NAFLD and NASH. These lipid combinations showed good diagnostic performance for non‐obese (area under the curve [AUC] for NAFLD/NASH = 0.916/0.813) and obese (AUC for NAFLD/NASH = 0.967/0.812) subjects. Moreover, distinctly altered patterns of diacylglycerol (DAG), triacylglycerol (TAG) and SM levels were confirmed in the validation set depending on the histological severity of NAFLD.

Conclusion

Non‐obese and obese NAFLD subjects exhibit unique circulating lipidomic signatures, including DAGs, TAGs and SMs. These lipid combinations may be useful biomarkers for non‐obese and obese NAFLD patients.
Cohort study on adverse drug reactions in adults admitted to the medical wards of a tertiary hospital in Nigeria: Prevalence, incidence, risk factors and fatality
Authors: Adedapo Aduragbenro D.A. , Adedeji Waheed A. , Adedapo Ifetoluwanimi A. , Adedapo Kayode S.
Published: September 2020

Aims

Intensive monitoring of medical patients for adverse drug reactions (ADRs) to assess prevalence, incidence, risk factors and fatality of ADRs leading to hospital admission or occurring in the hospital.

Methods

Prospective cohort study on 1280 adult patients admitted to the medical wards of a tertiary institution over 12 months. Patients were assessed for ADRs during and throughout admission; causality and preventability of ADRs were assessed.

Results

Sixty‐seven (5.2%) patients had ADRs, 51 (3.9%) caused hospitalisation while 17(1.3%) occurred during hospitalisation, and 42 (62.7%) of total ADRs were preventable. Nonsteroidal anti‐inflammatory drugs, 14 (20.3%), antidiabetics, 12 (17.4%) and antibacterial, 11 (15.8%) were the most implicated drug classes. Gastrointestinal tract (37%), central nervous system (30.2%), and skin (24.7%) were the most affected organ/systems, while upper gastrointestinal bleeding and hypoglycaemia were the most observed ADRs. ADRs led to deaths in 7 (10.4%) patients, with an overall case fatality rate of 0.5%. The highest number of deaths were among patients with Stevens–Johnson syndrome 2/7 (28.6%) and hepatotoxicity 2/7 (28.6%). Risk factors, adjusted odds ratio (AOR [95% confidence interval, CI]) for ADRs leading to hospitalisation was male sex 3.11 (1.11, 8.73) while for ADRs during hospitalisation were number of drugs used before admission (AOR [95% CI] = 6.67 [1.16, 38.47]) and comorbidities (AOR [95% CI] = 3.0 [1.13, 8.01]). Patients admitted with ADRs had prolonged hospital stay (AOR [95% CI] = 3.37 [1.11, 8.71]).

Conclusion

Preventable ADRs are common and important causes of hospitalisation and inpatients' morbidity and mortality among medical patients in Nigeria. Upper gastrointestinal bleeding and hypoglycaemia, resulting from nonsteroidal anti‐inflammatory drugs and antidiabetic drugs were the most observed ADRs.
A novel GPCR target in correlation with androgen deprivation therapy for prostate cancer drug discovery
Authors: Tian Jing‐Yan , Chi Chang‐Liang , Bian Ge , Guo Feng‐Jun , Wang Xiao‐Qing , Yu Bing
Published: September 2020

Most prostate carcinomas require androgen stimulation to grow, and for nearly 70 years, androgen ablation therapy has been one of the central therapeutic strategies against advanced prostate cancer. Although most tumours initially respond to this therapy, some will be acquired resistant and progress to metastatic castration‐resistant (mCRPC) disease which clinically tends to progress more rapidly than earlier disease manifestations. The underlying molecular biology of mCRPC is highly complex, and numerous mechanisms have been proposed that promote and retain androgen independence. In various clinical and preclinical data explored, the nature of intracellular signalling pathways mediating mitogenic acquired resistant effects of GPCRs in prostate cancer is poorly defined. G‐protein‐coupled receptor kinase 2 (GRK2) contributes to the modulation of basic cellular functions—such as cell proliferation, survival or motility—and is involved in metabolic homeostasis, inflammation or angiogenic processes. Moreover, altered GRK2 levels are starting to be reported in different tumoural contexts and shown to promote breast tumourigenesis or to trigger the tumoural angiogenic switch. Thus, we are exploring recent findings that present unexpected opportunities to interfere with major tumourigenic signals by manipulating GPCR‐mediated pathways.
Impact of prolonged nicotine administration on myocardial function and susceptibility to ischaemia‐reperfusion injury in rats
Authors: Ramalingam Anand , Mohd Fauzi Norsyahida , Budin Siti Balkis , Zainalabidin Satirah
Published: September 2020

This study investigated the impact of prolonged nicotine administration on myocardial susceptibility to ischaemia‐reperfusion (I/R) injury in a rat model and determined whether nicotine affects mitochondrial reactive oxygen species (ROS) production and permeability transition in rat hearts. Sprague‐Dawley rats were administered 0.6 or 1.2 mg/kg nicotine for 28 days, and their hearts were isolated at end‐point for assessment of myocardial susceptibility to I/R injury ex vivo. Rat heart mitochondria were also isolated from a subset of rats for analysis of mitochondrial ROS production and permeability transition. Compared to the vehicle controls, rat hearts isolated from nicotine‐administered rats exhibited poorer left ventricular function that worsened over the course of I/R. Coronary flow rate was also severely impaired in the nicotine groups at baseline and this worsened after I/R. Nicotine administration significantly increased mitochondrial ROS production and permeability transition relative to the vehicle controls. Interestingly, pre‐incubation of isolated mitochondria with ROS scavengers (superoxide dismutase and mitoTEMPO) significantly abolished nicotine‐induced increase in mitochondria permeability transition in isolated rat heart mitochondria. Overall, our data showed that prolonged nicotine administration enhances myocardial susceptibility to I/R injury in rats and this is associated with mitochondrial ROS‐driven increase in mitochondrial permeability transition.
The challenge of novel abiotic conditions for species undergoing climate‐induced range shifts
Authors: Spence Austin R. , Tingley Morgan W.
Published: September 2020

Coincident with recent global warming, species have shifted their geographic distributions to cooler environments, generally by moving along thermal axes to higher latitudes, higher elevations or deeper waters. While these shifts allow organisms to track their thermal niche, these three thermal axes also covary with non‐climatic abiotic factors that could pose challenges to range‐shifting plants and animals. Such novel abiotic conditions also present an unappreciated pitfall for researchers – from both empirical and predictive viewpoints – who study the redistribution of species under global climate change. Climate, particularly temperature, is often assumed to be the primary abiotic factor in limiting species distributions, and decades of thermal biology research have made the correlative and mechanistic understanding of temperature the most accessible and commonly used response to any abiotic factor. Receiving far less attention, however, is that global gradients in oxygen, light, pressure, pH and water availability also covary with latitude, elevation, and/or ocean depth, and species show strong physiological and behavioral adaptations to these abiotic variables within their historic ranges. Here, we discuss how non‐climatic abiotic factors may disrupt climate‐driven range shifts, as well as the variety of adaptations species use to overcome abiotic conditions, emphasizing which taxa may be most limited in this capacity. We highlight the need for scientists to extend their research to incorporate non‐climatic, abiotic factors to create a more ecologically relevant understanding of how plants and animals interact with the environment, particularly in the face of global climate change. We demonstrate how additional abiotic gradients can be integrated into global climate change biology to better inform expectations and provide recommendations for addressing the challenge of predicting future species distributions in novel environments.
Changes in treatment landscape of relapsed or refractory multiple myeloma and their association with mortality: Insights from German claims database
Authors: Scheid Christof , Blau Igor W. , Sellner Leopold , Ratsch Boris A. , Basic Edin
Published: September 2020

Objectives

Emerging treatments for relapsed or refractory multiple myeloma (rrMM) have led to increasing options for many patients. This study aimed to assess changes in utilization of these options in Germany with a focus on modern triplet regimens including new agents, such as carfilzomib, ixazomib, elotuzumab and daratumumab, and to evaluate whether this had an impact on rrMM‐related outcomes over time.

Methods

The study population consisted of 1255 rrMM patients who were assigned to one of the following 6 treatment groups: immunomodulatory drug (IMiD)‐based doublets, proteasome inhibitor (PI)‐based doublets, daratumumab monotherapy, PI‐IMiD‐based triplets, monoclonal antibodies (mAbs)‐based triplets, or other treatment.

Results

Use of triplet‐based therapy regimens increased from 5.9% in 2014 to 31.4% in 2017. In parallel, use of IMiD‐based doublets decreased from 74.3% in 2014 to 37.6% in 2017. Over the same time period, the risk of death decreased by 32% and the risk of hospitalization which was reduced by 30%. The risk for serious adverse events remained unchanged.

Conclusions

Between 2014 and 2017, the use of triplet‐based therapy regimens for rrMM in Germany has significantly increased and this was associated with a significant decline in deaths and hospitalizations without an increased incidence of serious adverse events.
Sorption hysteresis on soils and sediments: Using single‐point desorption isotherms to obtain characteristic free energy values
Authors: Borisover Mikhail
Published: September 2020

Sorption–desorption hysteresis (SDH) may control distributions of chemicals across diverse environmental phases, including soils and sediments. Formation of metastable states caused by pore deformation or inelastic swelling of a sorbent and their persistence during desorption have been considered in the literature as one reason for “true” SDH. Such metastable states may lead to the lack of closure of the sorption–desorption loop at non‐zero sorbate concentrations, a phenomenon often noted in soil and environmental literature. SDH has often been characterized using single‐point desorption isotherms (DIs) that combine sorbed states reached during single desorption steps started from different points along a sorption isotherm (SI). This work aimed to demonstrate how single‐point DIs could be used to characterize SDH in the liquid phase in terms of the Gibbs free energy accumulated in some non‐relaxed sorbed states belonging to a DI, as compared with the states of the same composition (sorbed concentration) belonging to an SI. Based on the literature data on SIs and single‐point DIs of pesticides and some hydrocarbons on soils, artificial soils, minerals and sediments, these quantities of extra free energy were determined and their changes in the selected sorbate‐sorbent systems were examined. When the extent of SDH decreases with increasing solute concentration, these additional free energies decrease. They may remain constant or even increase, suggesting, in the latter case, that more work is needed to perturb a sorbent structure at higher sorbed concentrations. Magnitudes of calculated extra free energies may be helpful in examining whether irreversible pore deformation in a sorbent and formation of metastable states are the reasons for SDH. This paper proposes a novel approach for quantifying liquid‐phase SDH in cases in which a thermodynamic justification is sought. It advances the ability to predict the fate of chemicals in typical soil/sediment environments.

Highlights

Desorption from soils and sediments to solutions may be hysteretic due to formed metastable states

Hysteresis is quantified in terms of excessive free energies of metastable states

Extra free energies are sorbate‐ and sorbent‐dependent, varying across sorption isotherms

Single‐point desorption isotherms allow quantification of the free energy excess in metastable states
Cerebral Venous Thrombosis and Subdural Collection in a Comatose Patient: Do Not Forget Intracranial Hypotension. A Case Report
Authors: Paris Diane , Rousset David , Bonneville Fabrice , Fabre Nelly , Faguer Stanislas , Huguet‐Rigal Françoise , Larcher Claire , Martin Charlotte , Osinski Diane , Gaussiat François , Delamarre Louis , Brauge David , Fourcade Olivier , Geeraerts Thomas , Mrozek Ségolène
Published: September 2020

Background

The typical sign of intracranial hypotension (IH) is postural headache. However, IH can be associated with a large diversity of clinical or radiological signs leading to difficult diagnosis especially in case of coma. The association of cerebral venous thrombosis (CVT) and subdural hemorrhage is rare but should suggest the diagnosis of IH.

Methods

Case report.

Case Description

We report here a case of comatose patient due to spontaneous IH complicated by CVT and subdural hemorrhage. The correct diagnosis was delayed due to many confounding factors. IH was suspected after subdural hemorrhage recurrence and confirmed by magnetic resonance imaging (MRI). After 2 epidural patches with colloid, favorable outcome was observed.

Discussion

The most common presentation of IH is postural orthostatic headaches. In the present case report, the major clinical signs were worsening of consciousness and coma, which are a rare presentation. Diagnosis of IH is based on the association of clinical history, evocative symptomatology, and cerebral imaging. CVT occurs in 1‐2% of IH cases and the association between IH, CVT, and subdural hemorrhage is rare. MRI is probably the key imaging examination. In the present case, epidural patch was performed after confounding factors for coma had been treated. Benefit of anticoagulation had to be balanced in this case with potential hemorrhagic complications, especially within the brain.

Conclusion

Association of CVT and subdural hemorrhage should lead to suspect IH. Brain imaging can help and find specific signs of IH.
The ‘nuts and bolts’ of including service users and carers in the recruitment of health and social work students in an English university—An interdisciplinary critique
Authors: Unwin Peter , Rooney Joy
Published: September 2020

Background

The literature regarding inclusion of service users and carers (SUACs) in the recruitment processes for future health and social work professionals has primarily presented such inclusion as positive for all. This study is novel in its exploration of the detail of SUACs' involvement and in its reach across a whole university department of health and social care disciplines.

Objective

To examine the detail of ways in which SUACs were actually involved in student selection and whether they have any real influence on recruitment decisions.

Method

This co‐produced study took place in an English university. A qualitative, semi‐structured interviewing approach was undertaken with 12 staff across social work, nursing, occupational therapy, physiotherapy, paramedicine and physician associate disciplines. Thematic analysis was employed independently with both researchers agreeing resultant themes.

Findings

A range of recruitment activities which included SUACs were found, evidencing both full and partial involvement in decision making. Nine themes emerged—The quality of SUACs' inclusion; Understanding reasons for including SUACs; SUACs being more knowledgeable than academic staff; SUACs influencing final decisions; The high expectations of candidates by SUACs; SUACs' need for training; Marketization and scepticism; and Logistics and the presumption of ableism.

Conclusions

Transparent protocols are essential if SUACs are to be equitably included in student recruitment processes. A shared model of SUACs' inclusion should be attainable across disciplines, even if the ‘nuts and bolts’ of recruitment processes vary.

Patient or Public Contribution

This work was co‐produced with a SUACs' group from conception and design through to fieldwork and write‐up.
Dupilumab treatment ameliorates clinical and hematological symptoms, including blood eosinophilia, in patients with atopic dermatitis
Authors: Yamauchi Teruo , Sasaki Shun , Lee Eun Seon , Tamura Takayuki , Seki Marina , Miwa Tasuku , Kobayashi Kae , Saruta Yusuke , Kitami Yuki , Sueki Hirohiko , Watanabe Hideaki
Published: September 2020

Background

Atopic dermatitis (AD) is an allergic disease that affects individuals of various ages. Recently, the IL‐4/13 inhibitor dupilumab has gained regulatory approval for clinical use in AD patients. Dupilumab has been reported to reduce several markers of AD, including the serum levels of thymus and activation‐regulated chemokine (TARC/CCL17), blood lactate dehydrogenase (LDH), and serum total immunoglobulin E (IgE).

Methods

We retrospectively reviewed data from 40 AD patients who were treated with dupilumab. Eczema Area and Severity Index (EASI), Investigator’s Global Assessment (IGA), body surface area (BSA) scores, TARC, LDH, total IgE, and eosinophil count in peripheral blood were assessed for a total of 32 weeks.

Results

The EASI, IGA, and BSA scores improved significantly with treatment, indicating a reduction in AD severity. Serum TARC and LDH levels also significantly decreased with treatment. Serum IgE levels were unchanged at 2 weeks of treatment but decreased significantly between 4 and 32 weeks. The number of eosinophils in the peripheral blood decreased at 4, 16, and 32 weeks after treatment initiation.

Conclusions

Several studies have reported that serum TARC, LDH, and total IgE levels are reduced by dupilumab treatment. Our real‐world data are the first to demonstrate a reduction in blood eosinophilia in patients who receive clinical treatment with dupilumab.
Nebulous Intentioning – Acute hospital nurses’ struggle to deliver core nursing care
Authors: Lane Aoife , Landers Margaret , Andrews Tom
Published: September 2020

Aim

To explore the influences on nursing practice in acute hospital care.

Design

A Classic Grounded Theory study.

Methods

Data collection (2013–2015) was through interviews and non‐participant observations. Analysis was undertaken using constant comparative data analysis and theoretical sampling. Memo writing was used as an aid to understanding and conceptualizing data during analysis. Theoretical coding served to integrate emerging concepts.

Results

This theory explains core nursing as a nebulous intention, an idea which acute care nurses retain throughout each shift, that they will nurse their patients fully when they have the opportunity. It reveals this as the resolution of their main problem which is the constant deferral of core nursing care. This study explains its two sub‐core categories, accommodating and integrity eroding.

Conclusion

The theory highlights nurses’ attitudes towards their role, demonstrated by deferring it to accommodate the work of others, but offers a new perspective on the significant contribution nurses make to the safe and cohesive transition of patients through the acute healthcare system.

Impact

The theory adds a new understanding of the unique contribution nurses make to patient health and safety in acute care environments. It also provides insight into nurses’ attitudes towards their own professional work. It explains the consequences of attitudes which undermine core nursing when it competes for priority with accommodating. Accommodating indicates a greater workload for nurses than has been previously understood in explaining the activities, additional to core nursing care, which nurses undertake to contribute safety and cohesion to the patient's acute care journey. These new insights suggest a role for managers in recognizing accommodating in decisions about staffing and resources and for educators in improving the profession's regard for its theoretical underpinnings and for its self‐image.