bluuebunny/crossref_metadata_2025 huggingface dataset:
The application of an ANP-Fuzzy comprehensive evaluation model to assess lean construction management performance
Authors: Li X.K. , Wang X.M. , Lei L.
Published: August 2019

Purpose

The purpose of this paper is to propose a method for assessing the lean construction management performance (LCMP) of engineering projects using the analytic network process-fuzzy comprehensive evaluation (ANP-FCE) model.

Design/methodology/approach

Literature review and questionnaire surveys were used to achieve an evaluation index system for LCMP. The data needed to calculate the weights of the indices were derived from questionnaire surveys. The ANP and the Super Decisions (SD) software were used to calculate the weights of the indices and verify the validity of the weights. The FCE was adopted to carry out a comprehensive evaluation of LCMP, and the validity of the evaluation results was verified by applying the validity degree of maximum membership principle. The applicability of the method for evaluating LCMP was validated by empirical research.

Findings

The proposed method for assessing the LCMP using the ANP-FCE model is validated to be feasible. Decision makers can easily identify the strengths and weaknesses of lean construction (LC) management of the evaluated project from the evaluation results.

Research limitations/implications

Some subjectivity may exist in the assessment process due to questionnaire surveys, and only one case has been studied to validate the applicability of the method. Therefore, researchers are encouraged to increase the number of LC experts and cases over the world to make the proposed method more standard.

Practical implications

The research is expected to propose an assessment method of LCMP for construction enterprises, provide a reference to develop assessment standards for LCMP for building associations or governments and help decision makers know the improving path of LC management.

Originality/value

This research contributes to the literature by summarizing the commonly used lean management tools for quality, cost, time, safety and organization in practice, and proposing a novel approach for assessing the LCMP of engineering projects. The study is useful for researchers, project managers and decision makers engaged in LC.
Leading learning in content areas
Authors: Lochmiller Chad R. , Cunningham Kathleen M.W.
Published: August 2019

Purpose

The purpose of this paper is to report findings from a systematic literature review that explore how recent research on instructional leadership has addressed the role of mathematics and science instruction.

Design/methodology/approach

Using Hallinger’s (2014) approach to conducting systematic reviews, the review included 109 peer-reviewed articles published since 2008 in leading mathematics and science education journals. Ana prioricoding scheme based upon key leadership behaviors articulated in Hitt and Tucker’s (2016) unified leadership framework informed the analysis presented.

Findings

Results indicate that leaders support content area instruction by facilitating high-quality instructional experiences through curricular and assessment leadership. Leadership frequently involves establishing organizational conditions that support teachers’ efforts to improve their own practice instead of direct leadership action on the part of instructional leaders. This support takes different forms and can include distributing leadership to teacher leaders with content area experience as well as using resources strategically to provide professional development or instructional coaching.

Originality/value

The review strengthens the connections between the instructional leadership, mathematics and science literatures, and identifies some of the leadership practices that these literatures deem important for instructional improvement. The review also reveals the potential for future research exploring the influence of a particular content area on supervisory practice and leadership discourse.
CSR reporting and assurance legitimacy: a client–assuror dyad investigation
Authors: Hickman Leila Emily , Cote Jane
Published: August 2019

Purpose

Drawing on new insights from the experiences and perspectives of a prominent reporting client and its assurance team, the purpose of this paper is to explore the question: what are challenges to the legitimacy of corporate social responsibility (CSR) reporting and assurance?

Design/methodology/approach

Using a qualitative research approach, in-depth, semi-structured interviews are conducted with a Fortune 200 firm’s Vice President responsible for CSR oversight (including CSR reporting), and with the report’s assurance team from a Top 20 accounting firm. Questions are informed by existing literature, and analysis focuses on new insights that conform to, or contrast with, prior studies in areas that may challenge the legitimacy of CSR reporting.

Findings

The study documents that reporting and assurance may often serve the respective commercial and professional interests of the firm and the assuror, rather than providing accountability to the public interest. Specifically, the authors find that legitimacy-challenging instances of managerial capture of CSR reporting may co-exist in a firm with management-as-CSR-champion, in contrast with existing literature. Prior research has assumed these two constructs are not likely to co-exist within a single organization. The interviews suggest that managerial influence is fostered by the lack of reporting standards and the absence of agreement regarding the over-arching purpose of CSR reports and their assurance.

Research limitations/implications

Going forward, researchers should consider the multifaceted role management can play in CSR reporting and assurance, rather than treating managerial capture and management-as-champion as mutually exclusive. Future research could also examine how standards may balance desired comparability with flexibility in CSR reporting.

Practical implications

The study will interest report users who may assume that a seemingly supportive management would not play a restrictive role in the reporting and assurance processes. Reporters and assurors will benefit from reading the perspectives provided by professionals engaged in similar work, including the challenges they face, such as the consequences resulting from the lack of standards for CSR reporting and assurance.

Originality/value

The study is the first to provide a behind-the-scenes view of the report–assuror dyad by interviewing both the reporting firm and the assurance team engaged on the same CSR report.
A quantile regression approach to trail financial performance of manufacturing firms
Authors: Nanda Swagatika , Panda Ajaya Kumar
Published: August 2019

Purpose

The purpose of this paper is to track the financial performance of manufacturing firms at different levels of their conditional quantiles. It also analyzes the relevance of revenue and cost channels along with key firm-specific parameters that influence firm’s profitability.

Design/methodology/approach

The study analyses a sample of 1,000 manufacturing firms over a study period spanning from 2000 to 2016. It uses both quantile regression and panel ordinary linear square (OLS) models to analyze the financial performance of the firms.

Findings

The study finds large scale of heterogeneity among the firms under different quantiles of profitability. Export earnings, firm size, asset turnover and volatility of exchange rate are the decisive determinants of financial performance across all quantiles. Financing assets by current debt is negatively impacting return on assets and return on capital employed of firms from lower quantile whereas profitability is positively impacted if they are financed by long term debt. Debt financing of assets does not make any sense for firms with high quantile of profitability. The study also finds that quantile regression approach is a better method than panel OLS models in the presence of highly heterogeneous and non-normal distributions.

Research limitations/implications

This study is limited to the financial performance of manufacturing firms and does not consider service sector which is also equally competitive. However, a sector wise analysis of firm’s profitability could be more meaningful than comparing all the firms in one basket of manufacturing domain.

Practical implications

The research findings have both practical as well as policy implications. Practically, the study helps the firm managers to identify critical success factors that significantly influence firm’s financial performance at different levels of profitability. It also helps the policy makers to align policy focus to stabilize firms at lower level of profitability and also to manage conducive business environment for all firms at different levels of their profitability.

Originality/value

The study provides a deep theoretical underpinning of literatures on firm’s financial performance and empirically investigates it using advanced methodology. The robust estimates of the study ensure to analyze financial performance under revenue and cost channels at diverse level of their profitability.
Using Latin America as a research laboratory
Authors: Borda Reyes Armando , Newburry William , Carneiro Jorge , Cordova Carlos
Published: August 2019

Purpose

This paper aims to use Latin America as a laboratory to better understand the relationship between inward foreign direct investment (IFDI) and outward foreign direct investment (OFDI) (both in total as well as in regional flows) and also examine the moderating effect of trade openness on that relationship. Latin America is an ideal study context for this purpose because of the relative homogeneity of its countries, which reduces confounding effects and increases comparability.

Design/methodology/approach

This paper uses longitudinal panel regression models with moderation effects. Secondary data were gathered on IFDI (per country and per country-sector), OFDI (total per country and region-targeted per country) and on trade openness from 11 Latin American countries.

Findings

IFDI in natural resources is positively associated with OFDI in both overall total flows and regional flows. The effect of IFDI in manufacturing has a consistent negative effect on total OFDI. IFDI in services has positive effects on total OFDI. Additionally, trade openness moderates positively the relationship between total IFDI and both total OFDI and regional OFDI. As a consequence, the authors found evidence suggesting that the relation between IFDI and OFDI in Latin America is positively moderated by trade openness.

Originality/value

The authors explored the nature of the impact of IFDI on the capacity of the recipient country to compete abroad as expressed by its OFDI flows. Specifically, they elucidated whether trade openness can be considered a suitable mechanism for home country firms to leverage potential spillovers provided by foreign entrants.
Psychological barriers in the cryptocurrency market
Authors: Fonseca Vítor , Pacheco Luís , Lobão Júlio
Published: August 2019

Purpose

The purpose of this paper is to study the existence of psychological barriers in cryptocurrencies.

Design/methodology/approach

To detect psychological barriers, the authors perform a uniformity test, a barrier hump test, a barrier proximity test and conditional effects test to a sample comprised by the daily closing quotes of six of the most liquid cryptocurrencies.

Findings

The results evidence the existence of psychological barriers in four of the cryptocurrencies under scrutiny, namely, Bitcoin, Dash, NEM and Ripple.

Practical implications

The fact that the cryptocurrency market has a high share of unexperienced investors and presents several cases of psychological barriers is consistent with the hypothesis that that class of investors is particularly prone to the behavioral biases which cause psychological barriers.

Originality/value

This paper studies, for the first time, the existence of psychological barriers in the market of cryptocurrencies.
Herding in frontier markets: evidence from the Balkan region
Authors: Economou Fotini
Published: August 2019

Purpose

The purpose of this paper is to examine herding in four frontier markets in the Balkan region, namely, Bulgaria, Croatia, Romania and Slovenia, from October 2000 to December 2016.

Design/methodology/approach

The author employs Chang et al.’s (2000) cross-sectional dispersion approach to capture herding, while also testing for the global financial crisis’ effects and the European Union (EU)/Euro zone accession effects over herding. Potential asymmetric herding effects conditional on market performance, domestic volatility, German and US investor sentiment are also examined. Finally, the cross-market herding dynamics of the region are also explored.

Findings

Overall, Romania exhibits the most extensive evidence of herding across various estimations. The empirical results indicate that cross-market herding dynamics within the region generate stronger herding (compared to the herding observed within each stock market individually), suggesting that Balkan stock exchanges’ growing financial integration leads their herding to be “imported”, rather than domestically motivated.

Practical implications

The findings provide useful insights for regulators in frontier markets, considering the destabilising potential of herding; they are also of particular interest to the investment community for reasons of international asset allocation, diversification and hedging strategies.

Originality/value

This study contributes to the limited herding literature regarding frontier markets and provides novel findings regarding the herding dynamics in the Balkan region, the EU/Euro zone accession’s effect and global factors’ impact on herding estimations.
Tourism, ageing and the demographic time bomb – the implications of dementia for the visitor economy: a perspective paper
Authors: Connell Joanne , Page Stephen
Published: August 2019

Purpose

This paper aims to examine the development of research on ageing and demography and the implications for the study of tourism. It examines the demographic time bomb created by an ageing population and the implications of complex health conditions, such as dementia, for the visitor economy. Practical measures are identified with an example of a “call to action” for small to medium-sized tourism businesses.

Design/methodology/approach

This review is based on existing knowledge of ageing and draws upon a historical timeline that stretches from the nineteenth century to 2100.

Findings

The impact of complex health conditions such as dementia will pose major challenges for the visitor economy and will require behavioural change within existing business practices to accommodate the needs of people with dementia and their carers.

Research limitations/implications

Major changes in business practices and the development of more holistic views of accessibility will be needed to accommodate an ageing population in 2100. Some of the initial changes businesses can make are outlined in a “call to action” leaflet extract.

Practical implications

Businesses will need to focus more on customer care practices to ensure that they can accommodate the complex needs of people with dementia and their carers as they continue to pursue the tourism and leisure activities that they have grown accustomed to.

Social implications

Businesses will need to become more fully engaged with new agendas on accessibility, inclusivity and good business practice that raise significant ethical, financial and legal issues for the way they do business in the future.

Originality/value

The paper sets out an overarching grand societal challenge around ageing that is now confronting many countries worldwide. As part of that agenda, this paper raises the issue of hidden conditions such as dementia. The paper seeks to stimulate a wider debate for researchers and policymakers going forward, framed around the following questions which arise from the paper: How is dementia understood as a hidden condition in the visitor economy? To what extent is there awareness and action in the visitor economy sector? What can the visitor economy sector do to address issues of inclusivity and dementia?
AoStuA, an APSES transcription factor, regulates the conidiation, trap formation, stress resistance and pathogenicity of the nematode‐trapping fungus Arthrobotrys oligospora
Authors: Xie Meihua , Wang Yunchuan , Tang Liyan , Yang Le , Zhou Duanxu , Li Qing , Niu Xuemei , Zhang Ke‐Qin , Yang Jinkui
Published: August 2019

The APSES protein family comprises a conserved class of fungus‐specific transcriptional regulators. Some members have been identified in partial ascomycetes. In this study, the APSES protein StuA (AoStuA) of the nematode‐trapping fungus Arthrobotrys oligospora was characterized. Compared with the wild‐type (WT) strain, three ΔAoStuA mutants grew relatively slowly, displayed a 96% reduction in sporulation capacity and a delay in conidial germination. The reduced sporulation capacity correlated with transcriptional repression of several sporulation‐related genes. The mutants were also more sensitive to chemical stressors than the WT strain. Importantly, the mutants were unable to produce mycelial traps for nematode predation. Moreover, peroxisomes and Woronin bodies were abundant in the WT cells but hardly found in the cells of those mutants. The lack of such organelles correlated with transcriptional repression of some genes involved in the biogenesis of peroxisomes and Woronin bodies. The transcript levels of several genes involved in the cAMP/PKA signalling pathway were also significantly reduced in the mutants versus the WT strain, implicating a regulatory role of AoStuA in the transcription of genes involved in the cAMP/PKA signalling pathway that regulates an array of cellular processes and events. In particular, AoStuA is indispensable for A. oligospora trap formation and virulence.
A Comprehensive Review on Food Applications of Terahertz Spectroscopy and Imaging
Authors: Afsah‐Hejri Leili , Hajeb Parvaneh , Ara Parsa , Ehsani Reza J.
Published: August 2019

Food product safety is a public health concern. Most of the food safety analytical and detection methods are expensive, labor intensive, and time consuming. A safe, rapid, reliable, and nondestructive detection method is needed to assure consumers that food products are safe to consume. Terahertz (THz) radiation, which has properties of both microwave and infrared, can penetrate and interact with many commonly used materials. Owing to the technological developments in sources and detectors, THz spectroscopic imaging has transitioned from a laboratory‐scale technique into a versatile imaging tool with many practical applications. In recent years, THz imaging has been shown to have great potential as an emerging nondestructive tool for food inspection. THz spectroscopy provides qualitative and quantitative information about food samples. The main applications of THz in food industries include detection of moisture, foreign bodies, inspection, and quality control. Other applications of THz technology in the food industry include detection of harmful compounds, antibiotics, and microorganisms. THz spectroscopy is a great tool for characterization of carbohydrates, amino acids, fatty acids, and vitamins. Despite its potential applications, THz technology has some limitations, such as limited penetration, scattering effect, limited sensitivity, and low limit of detection. THz technology is still expensive, and there is no available THz database library for food compounds. The scanning speed needs to be improved in the future generations of THz systems. Although many technological aspects need to be improved, THz technology has already been established in the food industry as a powerful tool with great detection and quantification ability. This paper reviews various applications of THz spectroscopy and imaging in the food industry.
Development of a PCR‐based method to monitor arthropod dispersal in agroecosystems: Macrolophus pygmaeus (Hemiptera: Miridae) from banker plants to tomato crops
Authors: Agustí Nuria , Castañé Cristina , Fraile Irene , Alomar Oscar
Published: August 2019

Development of conservation biological control programs requires the identification of sources that contribute to predator colonization of crops. Macrolophus pygmaeus (Rambur) (Hemiptera: Miridae) is an efficient polyphagous predator used in biological control programs in vegetable crops in Europe. We have developed a marking method based on spraying with a solution of the brine shrimp Artemia spp. (Anostraca: Artemiidae) cysts, followed by a PCR detection of Artemia DNA to monitor M. pygmaeus dispersal from banker plants to tomato crops. Experiments conducted in climatic chambers show that the topical application of this marking solution on M. pygmaeus does not significantly reduce adult longevity and that it is detected up to 6 d after the application. When this Artemia solution was applied on Calendula officinalis L. banker plants harboring M. pygmaeus and maintained outdoors, Artemia DNA was still detected on 62% of the insects after 6 d. The conducted field applications in commercial greenhouses have confirmed the usefulness of this method to monitor M. pygmaeus dispersal from banker plants to a newly planted tomato crop. This method can be used to assess arthropod movement, being an interesting molecular approach for further improving future pest management strategies.
Purple non‐sulphur bacteria and plant production: benefits for fertilization, stress resistance and the environment
Authors: Sakarika Myrsini , Spanoghe Janne , Sui Yixing , Wambacq Eva , Grunert Oliver , Haesaert Geert , Spiller Marc , Vlaeminck Siegfried E.
Published: August 2019

Purple non‐sulphur bacteria (PNSB) are phototrophic microorganisms, which increasingly gain attention in plant production due to their ability to produce and accumulate high‐value compounds that are beneficial for plant growth. Remarkable features of PNSB include the accumulation of polyphosphate, the production of pigments and vitamins and the production of plant growth‐promoting substances (PGPSs). Scattered case studies on the application of PNSB for plant cultivation have been reported for decades, yet a comprehensive overview is lacking. This review highlights the potential of using PNSB in plant production, with emphasis on three key performance indicators (KPIs): fertilization, resistance to stress (biotic and abiotic) and environmental benefits. PNSB have the potential to enhance plant growth performance, increase the yield and quality of edible plant biomass, boost the resistance to environmental stresses, bioremediate heavy metals and mitigate greenhouse gas emissions. Here, the mechanisms responsible for these attributes are discussed. A distinction is made between the use of living and dead PNSB cells, where critical interpretation of existing literature revealed the better performance of living cells. Finally, this review presents research gaps that remain yet to be elucidated and proposes a roadmap for future research and implementation paving the way for a more sustainable crop production.
Which is the worst risk factor for the long‐term clinical outcome? Comparison of long‐term clinical outcomes between antecedent hypertension and diabetes mellitus in South Korean acute myocardial infarction patients after stent implantation
Authors: Kim Yong Hoon , Her Ae‐Young , Jeong Myung Ho , Kim Byeong‐Keuk , Hong Sung‐Jin , Kim Seunghwan , Ahn Chul‐Min , Kim Jung‐Sun , Ko Young‐Guk , Choi Donghoon , Hong Myeong‐Ki , Jang Yangsoo
Published: August 2019

Background

Hypertension and diabetes mellitus (DM) are major risk factors for the cardiovascular disease. In this retrospective cohort study, we compared the long‐term clinical outcomes between antecedent hypertension and DM in acute myocardial infarction (AMI) patients after stent implantation.

Methods

A total of 32 938 eligible AMI patients were enrolled and divided into the four groups according to the presence or absence of hypertension and DM (hypertension −/DM −[group A, 13 773 patients], hypertension +/DM −[group B, 10 395 patients], hypertension −/DM + [group C, 3050 patients], and hypertension +/DM + [group D, 5720 patients]). The clinical endpoint was the cumulative incidence of major adverse cardiac events (MACEs) defined as all‐cause death, recurrent myocardial infarction (Re‐MI) and any repeat revascularization during the 2‐year follow‐up period.

Results

After adjustment, the cumulative incidence of MACEs (adjusted hazard ratio [aHR], 1.232; 95% confidence interval [CI], 0.982‐1.567; P = .071), all‐cause death, and e‐MI Re‐MI were similar between the group B and C. However, the cumulative incidences of any repeat revascularization (aHR, 1.438; 95% CI, 1.062‐1.997; P = .007), target lesion revascularization (TLR) (aHR, 2.467; 95% CI, 1.552‐3.922; P < .001), and target vessel revascularization (TVR) (aHR, 1.671; 95% CI, 1.256‐2.222; P < .001) were significantly higher in group C compared with group B.

Conclusions

This large number of a nonrandomized and multicenter cohort study clearly demonstrated the detrimental impacts of the hypertension and diabetes on long‐term clinical outcomes. Moreover, higher incidence of repeat revascularization after PCI in diabetic AMI patients a major concern until recently.
Perineuronal nets in the insula regulate aversion‐resistant alcohol drinking
Authors: Chen Hu , Lasek Amy W.
Published: August 2019

One of the most pernicious characteristics of alcohol use disorder is the compulsion to drink despite negative consequences. The insular cortex controls decision making under conditions of risk or conflict. Cortical activity is tightly controlled by inhibitory interneurons that are often enclosed by specialized extracellular matrix structures known as perineuronal nets (PNNs), which regulate neuronal excitability and plasticity. The density of PNNs in the insula increases after repeated bouts of binge drinking, suggesting that they may play a role in the transition from social to compulsive, or aversion‐resistant, drinking. Here, we investigated whether insular PNNs play a role in aversion‐resistant alcohol drinking using a mouse model in which ethanol was adulterated with the bitter tastant quinine. Disrupting PNNs in the insula rendered mice more sensitive to quinine‐adulterated ethanol but not ethanol alone. Activation of the insula, as measured by c‐fos expression, occurred during aversion‐resistant drinking and was further enhanced by elimination of PNNs. These results demonstrate that PNNs control the activation of the insula during aversion‐resistant drinking and suggest that proper excitatory/inhibitory balance is important for decision making under conditions of conflict. Disrupting PNNs in the insula or optimizing insula activation may be a novel strategy to reduce aversion‐resistant drinking
Hypoxic ventilatory response after rocuronium‐induced partial neuromuscular blockade in men with obstructive sleep apnoea
Authors: Christensson E. , Ebberyd A. , Hårdemark Cedborg A. , Lodenius Å. , Österlund Modalen Å. , Franklin K. A. , Eriksson L. I. , Jonsson Fagerlund M.
Published: August 2019

Obstructive sleep apnoea and residual neuromuscular blockade are, independently, known to be risk factors for respiratory complications after major surgery. Residual effects of neuromuscular blocking agents are known to reduce the hypoxic ventilatory response in healthy volunteers. Patients with obstructive sleep apnoea have impaired control of breathing, but it is not known to what extent neuromuscular blocking agents interfere with the regulation of breathing in such patients. In a physiological study in 10 unsedated men with untreated obstructive sleep apnoea, we wished to examine if partial neuromuscular blockade had an effect on hypoxic ventilatory response (isocapnic hypoxia to oxygen saturation of 80%) and hypercapnic ventilatory response (normoxic inspired carbon dioxide 5%). The hypoxic ventilatory response was reduced by 32% (p = 0.016) during residual neuromuscular block (rocuronium to train‐of‐four ratio 0.7), but the hypercapnic ventilatory response was unaffected. We conclude that neuromuscular blockade specifically depresses peripheral chemosensitivity, and not respiratory muscle function since the hypercapnic ventilatory response was unaffected.
Early weaning versus prolonged administration of aqueous suppressants for prevention of hyperencapsulation in paediatric Ahmed glaucoma valve
Authors: Rateb Mahmoud F. , Eldaly Zeiad H. , Soliman Wael M.
Published: August 2019

Purpose

To investigate the role of early and prolonged administration of aqueous suppressants in reduction of hyperencapsulation and intraocular pressure (IOP) control after paediatric Ahmed glaucoma valve (AGV) implantation.

Methods

A prospective randomized interventional study recruited children who had AGV implantation for paediatric glaucoma. All patients received postoperative Timolol 0.5% for either 12 months (Group A) or 3 months (Group B). Additional IOP‐reducing medications were added if IOP exceeded 21 mmHg or hyperencapsulation developed in either group. Primary outcome measures were rate of hyperencapsulation and reduction of IOP.

Results

Eighty sex children completed the 12‐month follow‐up visits. Baseline IOP was significantly reduced from 31.95 ± 9.1 to 16.94 ± 3.4 mmHg at 12 months in Group A and from 32.7 ± 7.4 to 19.85 ± 6.9 mmHg at 12 months in Group B. IOP was significantly lower in Group A than B at 6‐, 9‐ and 12‐month follow‐up visits. In the first 4 months, the hyperencapsulation rate was similar in both Group A (six eyes, 13.3%) and Group B (seven eyes, 17.1%). However, the hyperencapsulation rate was significantly lower in Group A than B at both 6 months (22.5% versus 36.6%) and 12 months (31.1% versus 46.3%). Anti‐glaucoma medications were significantly lower in Group A than B at both 6 months (1.3 versus 3.2 drugs) and 12 months (1.5 versus 3.6 drugs).

Conclusion

Early and prolonged use of aqueous suppressants significantly reduced the rate of hyperencapsulation and provided better IOP control after paediatric AGV implantation.
Change in peripapillary and macular choroidal thickness change in children with type 1 diabetes mellitus without visual impairment or diabetic retinopathy
Authors: Li Tao , Jia Yan , Wang Shanshan , Xu Yi , Yin Yao , Wang Anken , Gao Lu , Xu Xian , Yang Chenhao , Zou Haidong
Published: August 2019

Purpose

To study the characteristics of choroid thickness (CT) of the optic disc and macula in children with type 1 diabetes mellitus (T1DM) without visual impairment and diabetic retinopathy (DR) and analyse associated factors.

Methods

A square area of 6 × 6 mm around the centre of the optic disc and macula was scanned. The indices analysed mainly included CT at the macular centre (1 mm), and temporal, superior, nasal or inferior aspect of the inner ring (1–3 mm) and outer ring of (3–6 mm) optic disc and macula. Independent risk factors were analysed using multifactor linear regression.

Results

A total of 44 children with T1DM and 48 healthy subjects were enrolled. The diabetic group showed significant increase in the inferior inner ring of parapapillary CT (100.99 ± 30.42 μm versus 89.41 ± 34.00 μm, p = 0.04) and nasal outer ring of parapapillary CT (157.02 ± 47.35 μm versus 131.15 ± 35.17 μm, p = 0.01) as compared to those values in the healthy controls. Spherical equivalent refraction and family history of hypertension are independent factors of both peripappillary choroid thickness (PPCT) and macular choroid thickness (PMCT). Spherical equivalent refraction (p = 0.01) and serum cholesterol (p = 0.03) were independent factors of the inferior inner ring of parapapillary CT, whereas family history of hypertension was an independent factor of the nasal outer ring of parapapillary CT (p = 0.001).

Conclusion

In children with diabetes without DR or visual impairment, the CT increase in nasal outer ring of parapapillary (PPNO) and the inferior inner ring of parapapillary (PPII) may be the characteristic pre‐DR alteration at the early stage of DM. For children with higher serum cholesterol and family history of hypertension, the change of the nasal outer ring of parapapillary CT and the inferior inner ring of parapapillary CT may be more advanced.
As‐indicated versus routine vision screening of preterm children: a 17‐year retrospective regional study
Authors: Welinder Lotte , Bender Lars , Eriksen Helle Højmark , Nissen Kamilla Rothe , Ebbesen Finn
Published: August 2019

Purpose

To investigate outcomes of routine vision screening compared to as‐indicated ophthalmological investigation of all children born preterm in a Danish region from 1997 to 2014.

Methods

All children born preterm (gestation age < 32 weeks or birthweight < 1500 g) screened for retinopathy of prematurity (ROP) were divided into two groups. From 1997 to 2009, only children treated for ROP or referred for visual problems received ophthalmological investigation (as‐indicated group). From 2010 to 2014, all ROP‐screened infants were offered ophthalmological investigation at 6 months and 3 years of age (screening group).

Results

A total of 560 children were included in the as‐indicated period, 41 and 87 were referred for ophthalmological investigation at 6 months and 3 years, respectively. In the screening period, 295 children were included, 251 and 150 of whom underwent vision evaluation at 6 months and 3 years, respectively. Mean visual acuity was 4.1 cycles per degree with Teller acuity cards at 6 months and 0.78 decimal at 3 years. At 3 years, 2.7%(n = 11) in the as‐indicated versus 3.5%(n = 10) screening group had visual acuity < 6/18 (p = 0.24). Cerebral palsy (n = 28) and epilepsy (n = 5) were significantly related to vision impairment (p = 0.001/0.006), while treated ROP was not (n = 13). Refractive error was common at 3 years (61%), especially astigmatism (50%). Gestational age, birthweight and ROP were not associated with vision impairment or refractive error.

Conclusion

Screening preterm children at 6 months and 3 years did not reveal more visually impaired children compared to examination when indicated.
Comparison of two different treat‐and‐extend protocols with aflibercept in wet age‐related macular degeneration
Authors: Taipale Claudia , Lindholm Juha‐Matti , Laine Ilkka , Tuuminen Raimo
Published: August 2019

Purpose

To optimize the aflibercept treat‐and‐extend protocol in wet age‐related macular degeneration (wAMD).

Methods

A prospective randomized clinical trial consisting of 52 eyes from 52 patients with treatment‐naïve wAMD. Patients received three monthly aflibercept injections and were then randomized 1:1 to two different dosing protocols. In treat‐and‐extend protocol with moderate extensions (T&Em), after the loading phase the treatment interval was extended 1 week at a time up to 12 weeks and then by 2 weeks up to 16 weeks. In treat‐and‐extend protocol with rapid extensions (T&Er), the interval was first extended to 8 weeks and then by 2 weeks at a time up to 16 weeks. Main outcome measure was the number of given aflibercept injections.

Results

Fifty (96%) patients completed the 1‐year follow‐up. Patient and ophthalmic baseline variables were comparable between the study groups. At 1 year, central subfield macular thickness reduced by 194.3 ± 153.6 μm in T&Em protocol, compared with 194.2 ± 176.6 μm in T&Er (p = 0.997). Eyes with T&Em gained 10.3 ± 11.5 letters from baseline and eyes with T&Er 11.4 ± 10.6 letters (p = 0.434), and dry macula was observed in 72% of eyes with T&Em compared to 68% with T&Er (p = 0.758). At 1 year, the treatment interval was 8.5 ± 2.2 weeks in T&Em and 10.3 ± 2.8 weeks in T&Er (p = 0.017), and the total number of injections 8.64 ± 1.58 and 6.96 ± 0.79, respectively (p < 0.001). In the rapid extensions protocol, 48% of eyes reached a 12‐week treatment interval or beyond at 1 year.

Conclusions

At one year, the anatomical and functional responses were comparable between the moderate and rapid extensions protocols, with fewer aflibercept injections in the rapid extension protocol.
Reactive oxygen species, not Ca2+, mediates methotrexate‐induced autophagy and apoptosis in spermatocyte cell line
Authors: Xiong Suping , Song Dandan , Xiang Yang , Li Yanting , Zhong Yuanyuan , Li Hongjin , Zhang Peng , Zhou Wenwen , Zeng Xuhui , Zhang Xiaoning
Published: August 2019

Methotrexate (MTX) is widely used to treat cancers and systemic autoimmune diseases. However, it is severely toxic to healthy cells, especially those of the reproductive system, and therefore poses a great risk to patient fertility. In addition, the underlying mechanism of MTX‐induced reproductive toxicity has not yet been fully elucidated. Here, a spermatocyte cell line (GC2) was used as an in vitro model system to determine whether MTX induces autophagy and apoptosis, and to elucidate the role of reactive oxygen species (ROS) and Ca2+ in these two processes. Treatment with MTX resulted in a dramatic decrease in cell viability, inhibition of cell proliferation, collapse of the mitochondrial membrane potential and activation of caspase 3, suggesting that MTX induced apoptosis. Moreover, MTX activated autophagy, as indicated by conversion of LC3‐I to LC3‐II (microtubule‐associated protein 1 light chain 3) and an increase in the number of LC3 puncta. Furthermore, MTX triggered ROS overproduction, rather than a Ca2+ burst. Intriguingly, eliminating excess ROS significantly alleviated MTX‐induced apoptosis and autophagy. In addition, inhibiting autophagy significantly reversed apoptosis and promoted cell survival, indicating that autophagy aggravated MTX‐induced apoptosis in GC2 cells. Taken together, these results suggest that ROS signalling, not Ca2+, is critical in mediating MTX‐induced autophagy and apoptosis and autophagy serves as a promoted partner of apoptosis to deteriorate MTX‐induced cytotoxicity in GC2 cells. The findings from this study provide new perspectives for evaluating the reproductive toxicity of MTX.
Fertility preservation in Turner syndrome: Karyotype does not predict ovarian response to stimulation
Authors: Vergier Julia , Bottin Pauline , Saias Jacqueline , Reynaud Rachel , Guillemain Catherine , Courbiere Blandine
Published: August 2019

Objective

Turner syndrome (TS) is responsible for gonadal dysgenesis with high risk of premature ovarian insufficiency. Little is known about fertility preservation (FP) strategies is this population.

Design

Data from women with TS consulting with a fertility specialist in our FP centre from 2014 to 2018 were retrospectively collected.

Measurement

Total number of mature oocytes cryopreserved using vitrification.

Patients

Nine women with TS were referred. Three women with different karyotypes underwent controlled ovarian stimulation (COS) for oocyte vitrification. Mean age at TS diagnosis was 13.7 years [9‐20]. Mean referral delay between TS diagnosis and fertility consultation was 9.7 years [7‐14]. First counselling for FP was provided at 23.7 years [18‐28]. Mean AMH serum level prior to COS was 53.8 pmol/L [3.6‐95].

Results

All three women succeeded in obtaining cryopreserved oocytes with a mean number of 15.3 per woman [9‐20] and 9.2 per COS cycle [2‐20]. Ovarian response to COS was unexpectedly remarkable for the woman with a complete 45,X monosomy. Procedure was well tolerated for all women. None of them have used oocytes for in vitro fertilization yet.

Conclusions

Independently of karyotype, antral follicular count, AMH and FSH levels seemed to be reliable predictive markers of oocyte cryopreservation success. In a monosomic TS woman, cryptic ovarian mosaicism could explain a successful ovarian response to stimulation with a high number of retrieved oocytes. In case of spontaneous menarche, TS adolescents should be referred during transition to adulthood for FP counselling to avoid referral delay and limit time‐related diminished ovarian reserve.
Genetic scores for BMI related to metabolically unhealthy obesity in an older Chinese population
Authors: Yang Shan‐Shan , Wang Yiyan , He Yao , Xu Lin , Jin Yali , Zhang Wei‐Sen , Jiang Chao‐Qiang , Cheng Kar Keung , Lam Tai Hing
Published: August 2019

Objective

In this study, a genetic risk score (GRS) for the body mass index (BMI) tested and built using a large sample of Chinese individuals aged at least 50 years in southern China. We collected information regarding the participants’ weights at 20 years of age and middle age and tested the BMI‐GRS effect modes.

Methods

This study involved a prospective study design. The genetic data of the participants in from the Guangzhou Biobank Cohort Study and selected BMI‐related single‐nucleotide polymorphisms (SNPs) were used to establish the GRS.

Results

We included 13 597 participants with 12 SNPs. After adjusting for covariates, the high‐GRS group was 36% (95% CI: 25%‐48%) and 34% (95% CI: 23%‐47%) more likely of being overweight at baseline and follow‐up, respectively, and 56% (95% CI: 34%‐82%) and 49% (95% CI: 29%‐72%) more likely of being obese at baseline and follow‐up, respectively, compared with the low‐GRS group (P‐value for all trends <.05). The RRs for the incidences of metabolically healthy and unhealthy obese (MHO and MUO, respectively) individuals in the high‐GRS group were 0.94 (95% CI: 0.65‐1.35) and 1.28 (95% CI: 1.00‐1.63), respectively.

Conclusion

High‐GRS participants were more likely to be overweight/obese at baseline and follow‐up, and this relationship exhibited a dose‐response relationship. The GRS was also associated with MUO.
Urogenital and pelvic complications in the Ehlers‐Danlos syndromes and associated hypermobility spectrum disorders: A scoping review
Authors: Gilliam Elizabeth , Hoffman Jodi D. , Yeh Gloria
Published: August 2019

The Ehlers‐Danlos syndromes (EDS) and associated hypermobility spectrum disorders (HSD) are a heterogenous group of connective tissue disorders associated with significant morbidity. The urogenital aspects of these disorders are understudied and there is little guidance on the prevalence, types, or outcomes of urogenital complications in EDS/HSD. Our objective was to perform a scoping review to characterize and synthesize the literature reporting urogenital and pelvic complications in EDS/HSD patients. We performed a systematic search of three databases (Medline, CINAHL, Embase) to January 2019. English language, full‐text articles reporting on urogenital or pelvic complications in EDS/HSD were included. A total of 105 studies were included (62 case reports/series, 43 observational) involving patients with hypermobile (23%), vascular (20%), classical (12%) EDS, and HSD (24%). Some studies looked at multiple subtypes (11%) or did not report subtype (33%). Reported complications included urinary (41%), gynecological (36%), obstetrical (25%), renal (9%), and men's health problems (7%), with some studies reporting on multiple areas. Urinary and gynecological complications were most prevalent in patients with HSD, while a broad range of complications were reported in EDS. While further research is required, results suggest a higher index of suspicion for urogenital problems is probably warranted in this population.
Long‐standing diabetes mellitus and pancreas transplantation: An avenue to increase utilization of an ideal treatment modality
Authors: Rohan Vinayak S. , McGillicuddy John W. , Taber David J. , Nadig Satish N. , Baliga Prabhakar K. , Bratton Charles F.
Published: August 2019

Background

Diabetes mellitus (DM) is associated with increased post‐operative complications in various surgeries. Little data exist regarding the impact of long‐standing DM (>25 years) on outcomes in pancreas transplantation (PTX). The objectives of our study were to determine if long‐standing pre‐transplant DM (>25 years) was associated with inferior outcomes following PTX.

Methods

Using a 13‐year (April, 2000‐May, 2012) retrospective analysis, we examined demographic and transplant factors, complications, and outcomes in patients without (Group A) and with (Group B) long‐standing (>25 years) pre‐PTX DM.

Results

Mean follow‐up was 4.2 years. Of 214 consecutive PTX performed, 137 (105 simultaneous PTX (SPK), 25 PTX after kidney (PAK), 7 PTX alone (PTA)) had pre‐PTX duration of DM recorded, including 65 in Group A and 72 in Group B. There were no differences between cohorts with respect to demographics. There were no differences in post‐PTX surgical/medical complications. There were no differences in outcomes between cohorts (ie, rejection, graft loss or death).

Conclusions

This large‐scale analysis demonstrated that PTX can be performed in patients with long‐standing DM with excellent patient and graft outcomes. Long‐standing DM did not lead to an increased post‐PTX infections or complications. Our study suggests that duration of DM should not impact PTX candidacy.
Behavioral phenotype and sleep problems in SATB2‐associated syndrome
Authors: Cotton Allison Pierce , Gokarakonda Srinivasa , Caffrey Aisling R , Zarate Yuri A , Kumar Nihit
Published: August 2019

Aim

To determine the nature and frequency of behavioral phenotypes and sleep disturbances in individuals with SATB2‐associated syndrome (SAS).

Method

The Strengths and Difficulties Questionnaire (SDQ) and an age‐appropriate sleep questionnaire were distributed to the parents of individuals with SAS. All scores were compared to available normative data.

Results

Thirty‐one individuals completed the assessment (18 females, 13 males; mean age 7y 4mo [SD 4y 1mo], range 2–16y). Individuals with SAS had significantly higher Total Difficulty scores than the normative sample (14.9 [SD 5.8] vs 7.1 [SD 5.7], p<0.001). A high frequency of emotional problems (22.6% vs 8%, p=0.01), peer problems (48.4% vs 10%, p<0.001), hyperactivity (48.4% vs 9%, p<0.001), and low prosocial behaviors (45.2% vs 9%, p<0.001) contribute to the behavioral profile in SAS. Concurrent sleeping difficulties were also frequently identified. Ten individuals in the 5 to 15 years age range had at least one sleep disorder (mean Sleep Disturbance Scale for Children total score 40.9 [SD 8.4] vs 35.1 [SD 7.7], p<0.001).

Interpretation

With previous limited available objective neurobehavioral data on the SAS population, we reported evidence of high‐risk for a broad spectrum of burdensome behavioral phenotype and concurrent sleeping difficulties, the latter being particularly prevalent during early childhood. Routine assessment and treatment for behavioral issues and sleep problems is recommended.

What this paper adds

Emotional and peer problems, hyperactivity, and low prosocial behavior are common in SATB2‐associated syndrome.

The Strength and Difficulties Questionnaire Total Difficulty scores are atypical in nearly half of individuals.

Behavioral difficulties are perceived as burdensome to over half of the parents.

Nearly half of individuals have at least one sleep disorder.

Sleep–wake transition disorders were most common.