bluuebunny/crossref_metadata_2025 huggingface dataset:
On the development of cat swarm metaheuristic using distributed learning strategies and the applications
Authors: Mohapatra Usha Manasi , Majhi Babita , Jagadev Alok Kumar
Published: May 2019

Purpose

The purpose of this paper is to propose distributed learning-based three different metaheuristic algorithms for the identification of nonlinear systems. The proposed algorithms are experimented in this study to address problems for which input data are available at different geographic locations. In addition, the models are tested for nonlinear systems with different noise conditions. In a nutshell, the suggested model aims to handle voluminous data with low communication overhead compared to traditional centralized processing methodologies.

Design/methodology/approach

Population-based evolutionary algorithms such as genetic algorithm (GA), particle swarm optimization (PSO) and cat swarm optimization (CSO) are implemented in a distributed form to address the system identification problem having distributed input data. Out of different distributed approaches mentioned in the literature, the study has considered incremental and diffusion strategies.

Findings

Performances of the proposed distributed learning-based algorithms are compared for different noise conditions. The experimental results indicate that CSO performs better compared to GA and PSO at all noise strengths with respect to accuracy and error convergence rate, but incremental CSO is slightly superior to diffusion CSO.

Originality/value

This paper employs evolutionary algorithms using distributed learning strategies and applies these algorithms for the identification of unknown systems. Very few existing studies have been reported in which these distributed learning strategies are experimented for the parameter estimation task.
Towards more flexible approach to governance to allow innovation: the case of UK infrastructure
Authors: Sergeeva Natalya
Published: May 2019

Purpose

The purpose of this paper is to explore the governance in project organising where owner organisations interface with the temporary project organisations that they initiate. This interface between the two types of organisation represents an opportunity for innovation.

Design/methodology/approach

In total, 25 narrative interviews were conducted with managers who work in permanent owner and operator organisations and temporary project organisations. It is combined with the analysis of textual narratives represented in institutional reports (APM, IPA, PMI).

Findings

The findings show that it is the flexible and balanced approach to governance that allows innovation to emerge. Strong capable innovative owners play crucial role in creating the corporate governance framework to allow innovation in projects.

Research limitations/implications

The current research presents narratives voiced by senior managers in permanent owner and operator organisations and temporary project organisations. The ways governance can be adjusted through the life cycle of major programmes require further a more longitudinal research investigation.

Practical implications

The practical benefits for the project management community is a better understanding of corporate governance in owner and operator organisations, the role of leadership and their narratives in governing processes, and the impact of strong governance on organisational performance and project deliverables.

Social implications

Senior managers socially constructed the meaning of governance through narratives. The author learn about practices of governance through the perspectives of those involved in decision making.

Originality/value

This paper contributes to project management theory in two ways: it provides insight into the practice of corporate governance; and it develops the application of narrative enquiry to project management research.
Consequences of customer experience quality on franchises and non-franchises models
Authors: Mainardes Emerson Wagner , Gomes Vinicius Costa Amorim , Marchiori Danilo , Correa Luis Eugenio , Guss Vinicius
Published: May 2019

Purpose

The purpose of this paper is to verify the differences of the influence of customer experience quality on brand equity, brand trustworthiness, perceived quality, perceived risk and purchase intention of franchise customers and non-franchise customers.

Design/methodology/approach

After developing two questionnaires, the authors collected 523 responses from Brazilian franchise users (Questionnaire 1) and 574 of non-franchise users (Questionnaire 2). The authors proceed to a confirmatory factor analysis, based on covariance (CB-SEM). In order to compare the results between franchises and non-franchises, the authors have performed a multi-group analysis with support of AMOS.

Findings

The results show that customer experience quality of the franchise customers tends to result in a better purchase intention, giving indications of better quality and brand trustworthiness when compared to non-franchises. This comparison shows indications of the competitive advantage of franchises over non-franchises, justifying the investments that market companies have been making in the development of the customer experience quality.

Originality/value

The research contributes to the understanding of the impact of the customer experience quality on brand equity, brand trustworthiness, perceived quality, perceived risk and purchase intention that directly affects the performance of the franchises, empirically investigating the customer experience quality in the context of franchises using the adapted EXQ scale. Complementarily, it is compared with non-franchises to observe the differences between them.
The resolution of audit-detected misstatements
Authors: Ruhnke Klaus , Schmidt Martin
Published: May 2019

Purpose

The value of an audit lies in its ability to detect and correct misstatements in financial statements. The purpose of this paper is to investigate the resolution of detected misstatements.

Design/methodology/approach

Using data on a large sample of audit adjustments by a German Big 4 audit firm, this paper reports an analysis of the factors that influence the resolution of detected misstatements at the engagement level and at the level of the individual adjustment.

Findings

The auditor’s book-or-waive decision is influenced by client characteristics and characteristics of the audit adjustments that can be linked to client as well as auditor incentives to oppose (require) the recording of adjustments. Offsetting effects of the detected adjustments on client income play a key role in auditors’ decisions.

Research limitations/implications

The results may not be generalizable to Non-Big 4 audit firms. The sample includes unlisted firms which are subject to mandatory audits in the European Union. Other potential factors may not have been captured in the study.

Practical implications

The findings suggest that standard-setters and audit practice should give more attention to the offsetting effects of audit adjustments on income. The analyses at the two different levels could help practitioners to better structure their book-or-waive decisions.

Originality/value

In contrast to prior studies, the authors analyze the resolution of misstatements at the engagement level and the level of the individual adjustment. This design makes a methodological contribution by expanding the level of analysis of auditors’ book-or-waive decisions to include the engagement level. It further allows examining offsetting effects of different adjustments on client income, as well as the number and the total amount of detected adjustments.
Exploring linkages of performance with metacognition
Authors: Lyons Paul R. , Bandura Randall Paul
Published: May 2019

Purpose

In this exploratory, correlational study the authors set out to demonstrate the relationships as well as inter-correlations among direct and indirect performance measures, along with measures of knowledge of cognition, and evaluation of cognition. The information helps inform manager learning and development. The purpose of this paper is twofold: first, primary purpose, to identify linkages of performance with individual’s efforts to improve their learning processes via metacognition; and second, secondary purpose, primarily for the benefit of practitioners, is the provision of detailed information regarding performance measures and practical measures of metacognition.

Design/methodology/approach

The study made use of correlation analysis among performance measures and measures of metacognitive effort. The design is not intended to support cause and effect relationships, nor demonstrate the technical, predictive value of measures.

Findings

A majority of associations among indirect performance measures with one another and with nearly all of the measures of knowledge of cognition, and evaluation of cognition were positive and significant (mostly at the 0.01 level). Findings offer broad support for the linkage of self-efficacy (SE), and core self-evaluation (CSE) with performance.

Practical implications

Relationships identified in this study may help practitioners alter and improve their practices/methods of identifying individuals who possess attributes that are highly related to performance and learning. The new knowledge may influence decisions about recruitment, selection and training.

Originality/value

Little research has focused on relationships among indirect performance indicators such as SE, CSE and established measures of metacognition. The present study helps to identify important relationships.
Social media for outbound leisure travel: a framework based on technology acceptance model (TAM)
Authors: Singh Snigdha , Srivastava Pallavi
Published: May 2019

Purpose

The purpose of this paper is to explore the applicability of technology acceptance model (TAM) to explain the widespread acceptance and usage of social media (SM) for travel purposes by Indian outbound leisure travellers during their travel cycle.

Design/methodology/approach

The study has adopted a qualitative approach involving in-depth interviews of 30 respondents, who had taken at least one international vacation in the last 12 months. Content analysis was used to arrive at the conclusion.

Findings

Findings of the study are used to develop a conceptual model which upholds the validity of the TAM with perceived usefulness (PU) and perceived ease of use (PEU) as determinants of SM usage. The model has been extended to include perceived trust (PT) and social capital (SC) as important constructs to explain the travellers’ use of SM. Disposition readiness (DR) of the user towards SM was found to have an effect on all the four constructs.

Originality/value

Theoretically, this study suggests a modification to the existing TAM, which shows a unidirectional effect of PU and PEU on attitude. This study suggests that the effect would be bi-directional where the attitude (DR) of the traveller towards SM usage will affect PU and PEU. Furthermore, this study extends the TAM to include PT and SC as important constructs to explain SM usage by travellers. This study provides valuable insights into the hospitality and tourism sector which might help in further segmentation of travellers leading to more customised service offerings.
Non‐traumatic musculoskeletal pain in Western Australian hospital emergency departments: A clinical audit of the prevalence, management practices and evidence‐to‐practice gaps
Authors: Baker Briarley , Kessler Kenny , Kaiser Bronwyn , Waller Robert , Ingle Michael , Brambilla Simone , Viscardi Elena , Richards Karen , O'Sullivan Peter , Goucke Roger , Smith Anne , Yao Felix , Lin Ivan
Published: May 2019

Objectives

Musculoskeletal pain (MSP) conditions are a leading cause of morbidity worldwide and a common reason for ED presentation. Little is currently known about non‐traumatic MSP (NTMSP) presenting to EDs. The present study described the prevalence and management practices of NTMSP in EDs.

Methods

The design was a retrospective clinical audit in two hospital EDs in Western Australia covering 3 months beginning 1 January 2016. We defined NTMSP as pain of musculoskeletal origin occurring in the absence of external force or excessive physical loading. The outcomes measured included: patient, condition and hospital‐episode characteristics, as well as management practices. Management practices were compared to recommended care derived from guideline recommendations. These included: assessment for red flags and psychosocial risk factors, appropriate use of diagnostic imaging, provision of patient education, administration and prescription of analgesic medication, and assessment of risk factors for opioid‐related harm.

Results

Eight hundred and eighty‐eight patients were included in the present study. NTMSP accounted for 3.0% of all ED presentations. According to clinician documentation, red flag and psychosocial assessments were recorded in 73.3 and 10.5% of patients. Forty‐one percent of patients were referred for imaging, of which 39.7% were inconsistent with guideline recommendations. Education was recorded 52.0% of the time. At least one opioid medication was administered to 55.3% of patients and there was no documented assessment of risk factors for opioid‐related harm.

Conclusions

NTMSP is a relatively common reason for ED presentation. Documented management practices are discordant with guideline recommendations. Strategies to improve the concordance between management and guideline recommendations are needed.
Voluntary Disclosures When There Is an Option to Delay Disclosure
Authors: Menon Rahul
Published: May 2019

What incentives drive managers to disclose immediately when they have an option to delay disclosures? I examine this question in a two‐period setting in which public news that is positively correlated with firm value arrives periodically. I show that, when the manager's likelihood of receiving information is independent of the public news, an informed manager is more likely to disclose immediately when the public news is good. This happens even as the disclosure threshold itself increases in the public news. My model provides a potential explanation for why managers have a higher propensity to provide earnings forecasts when current earnings are high. I also show that, even when disclosures are credible, the average price reaction to a voluntary disclosure is (i) decreasing in the magnitude of the public news and (ii) lower when the manager is more myopic. These results have potential implications for studies that use stock returns to measure the news contained in management disclosures.
Conserving orangutans one classroom at a time: evaluating the effectiveness of a wildlife education program for school‐aged children in Indonesia
Authors: Freund C. A. , Achmad M. , Kanisius P. , Naruri R. , Tang E. , Knott C. D.
Published: May 2019

Environmental education is a cornerstone of many wildlife conservation programs, and measuring the impact of such education initiatives is imperative for evaluating their effectiveness in achieving conservation goals. For over 15 years, the Gunung Palung Orangutan Conservation Program (GPOCP) has been working to protect wild Bornean orangutans Pongo pygmaeus wurmbii living in and around Gunung Palung National Park in West Kalimantan, Indonesia. In 2015, we carried out a series of six Environmental Education Expeditions to communities in the remote districts surrounding the Park, engaging 1519 elementary (n = 770) and junior/senior high school (n = 749) students across 24 schools. Before and after engaging with our environmental education activities students were given surveys to assess their knowledge about and attitudes toward orangutans. We found that our educational activities led to 13.6–40.4% increases in student knowledge about orangutans and substantial shifts toward more positive attitudes about conservation, but that many students do not believe that they personally can make a difference. Empowerment may be a key need to link wildlife education to environmental action.
Codependency and Prefrontal Cortex Functioning: Preliminary Examination of Substance Use Disorder Impacted Family Members
Authors: Zielinski Mazie , Bradshaw Spencer , Mullet Natira , Hawkins Lindsey , Shumway Sterling , Story Chavez Megan
Published: May 2019

Background and Objectives

Substance use disorders (SUDs) have negative impacts on an entire family system and each family member may be at risk to develop a “codependency” on their SUD loved‐one. Research has demonstrated that SUDs in the family environment associate with altered brain functioning of family members; however, research has not examined specific associations between codependency and brain functioning.

Methods

Prefrontal cortex (PFC) activation of family members (n = 38) was assessed using functional near‐infrared spectroscopy as they viewed images of a SUD loved‐one (experimental group; n = 26) or of a “target family member” (control group; n = 12). Correlations between PFC activation and codependency were examined.

Results

A significant negative association was found between codependency and left dorsomedial PFC activation in response to images of a loved‐one with a SUD. This association was significantly larger than that found in the control group in response to a target family member, and that found in response to other affective images.

Discussion and Conclusions

The left dorsomedial PFC is associated with executive functioning during responses to emotional and social situations. Findings may suggest that family members experiencing codependency may be limited in effectively responding to their SUD loved‐one, and highlight the importance of systemic treatment and family member recovery.

Scientific Significance

Codependency is often discussed as a learned condition and research has only recently examined brain processes of family members with a loved‐one with a SUD. This research is the first to demonstrate an association between codependency and PFC functioning. (Am J Addict 2019;28:367–375)
Stress, burnout, depression and work satisfaction among UK anaesthetic trainees; a quantitative analysis of the Satisfaction and Wellbeing in Anaesthetic Training study
Authors: Looseley A. , Wainwright E. , Cook T.M. , Bell V. , Hoskins S. , O'Connor M. , Taylor G. , Mouton R. ,   the SWeAT Study investigator group
Published: May 2019

There is growing evidence that anaesthetic trainees experience, and may be particularly susceptible to, high levels of work stress, burnout and depression. This is concern for the safety and wellbeing of these doctors and for the patients they treat. To date, there has been no in‐depth evaluation of these issues among UK anaesthetic trainees to examine which groups may be most affected, and to identify the professional and personal factors with which they are associated. We conducted an anonymous electronic survey to determine the prevalence of perceived stress, risk of burnout/depression and work satisfaction among anaesthetic trainees within South‐West England and Wales, and explored in detail the influence of key baseline characteristics, lifestyle and anaesthetic training variables. We identified a denominator of 619 eligible participants and received 397 responses, a response rate of 64%. We observed a high prevalence of perceived stress; 37% (95%CI 32–42%), burnout risk 25% (21–29%) and depression risk 18% (15–23%), and found that these issues frequently co‐exist. Having no children, > 3 days sickness absence in the previous year, ≤ 1 h.week−1 of exercise and > 7.5 h.week−1 of additional non‐clinical work were independant predictors of negative psychological outcomes. Although female respondents reported higher stress, burnout risk was more likely in male respondents. This information could help in the identification of at‐risk groups as well as informing ways to support these groups and to influence resource and intervention design. Targeted interventions, such as modification of exercise behaviour and methods of reducing stressors relating to non‐clinical workloads, warrant further research.
Stress, burnout, depression and work satisfaction among UK anaesthetic trainees: a qualitative analysis of in‐depth participant interviews in the Satisfaction and Wellbeing in Anaesthetic Training study
Authors: Wainwright E. , Looseley A. , Mouton R. , O'Connor M. , Taylor G. , Cook T. M. ,   the SWeAT study investigator group
Published: May 2019

Anaesthetists experience unique stressors, and recent evidence suggests a high prevalence of stress and burnout in trainee anaesthetists. There has been no in‐depth qualitative analysis to explore this further. We conducted semi‐structured interviews to explore contributory and potentially protective factors in the development of perceived stress, burnout, depression and low work satisfaction. We sampled purposively among participants in the Satisfaction and Wellbeing in Anaesthetic Training study, reaching data saturation at 12 interviews. Thematic analysis identified three overarching themes: factors enabling work satisfaction; stressors of being an anaesthetic trainee; and suggestions for improving working conditions. Factors enabling work satisfaction were patient contact; the privilege of enabling good patient outcomes; and strong support at home and work. Stressors were demanding non‐clinical work‐loads; exhaustion from multiple commitments; a ‘love/hate’ relationship, as trainees value clinical work but find the training burden immense; feeling ‘on edge’, even unsafe at work; and the changing way society sees doctors. Nearly all trainees discussed feeling some levels of burnout (which were high and distressing for some) and also high levels of perceived stress. However, trainees also experienced distinct elements of work satisfaction and support. Suggested recommendations for improvement included: allowing contracted hours for non‐clinical work; individuals taking responsibility for self‐care in and out of work; cultural acceptance that doctors can struggle; and embedding wellbeing support more deeply in organisations and the specialty. Our study provides a foundation for further work to inform organisational and cultural changes, to help translate anaesthetic trainees’ passion for their work into a manageable and satisfactory career.
Response of the Australian Medical Services to restoration of mobile warfare on the Western Front in 1918 (part II)
Authors: Scotland Thomas
Published: May 2019

On 4 July 1918, at the Battle of Hamel, the Australian Medical Services used a Field Ambulance Resuscitation Team for the first time, delivering life‐saving blood transfusion and early definitive surgery to badly wounded soldiers very soon after their wounds had been inflicted. During the closing months of the war, many lives and limbs were saved by early resuscitation and effective surgery, an achievement that stands out in marked contrast to the situation in 1914, when inadequate resuscitation, outdated surgical methods and appalling delays in delivering treatment resulted in great numbers of unnecessary deaths.
Essential thrombocythaemia treated with recombinant interferon: ‘real world' United Kingdom referral centre experience
Authors: Desterro Joana , McLornan Donal P. , Curto Garcia Natalia , O'Sullivan Jennifer , Alimam Samah , Keohane Clodagh , Woodley Claire , Francis Yvonne , Kordasti Shahram , Radia Deepti H. , Harrison Claire N.
Published: May 2019

Standard first‐line therapy choice for essential thrombocythaemia (ET) requiring cytoreduction, supported by randomized trials, is low‐dose aspirin with hydroxycarbamide, but the role of recombinant interferon‐alfa (IFNα)‐2a/2b and pegylated (PEG)‐IFN‐α‐2a/2b is increasingly highlighted. Longer‐term outcome data, however, remains somewhat scarce, particularly in the ‘real world'. We hereby report on a large, well‐annotated cohort of ET patients from a single referral centre undergoing therapy with either IFNα or (PEG)‐IFN‐α‐2a/2b and demonstrate high rates of complete haematological responses, good tolerability and safety, low rates of thromboembolic events in compliant patients and confirm feasibility of long‐term therapy in a significant proportion of patients.
Mitigating placental injuries through up-regulating DAF in experimental APS mice: new mechanism of progesterone
Authors: Zhang Y , Jin S
Published: May 2019

Anti-phospholipid syndrome (APS) is characterized by recurrent pathological pregnancy, arterial or venous thrombosis in the presence of anti-phospholipid antibody (aPL). Complement activation is recognized as an intermediate link leading to placental thrombosis and placental inflammation in APS model mice. Decay accelerating factor (DAF, CD55), MAC-inhibitory protein (MAC-IP, CD59) and membrane co-factor protein (MCP, CD46) are important complement inhibitory proteins (CIPs) highly expressed in normal placenta to curb excessive complement activation and its mediated injuries. Anti-β2 glycoprotein I (anti-β2GPI) antibody is an important aPL. We found that placental DAF and CD46 decreased in β2GPI passively immunized APS model mice, accompanied by C3 deposition, neutrophil infiltration and increased proinflammatory cytokine levels detected in its placenta. Progesterone supplement can up-regulate DAF but not CD46 expression, curb C3 activation and decrease proinflammatory cytokines levels to reduce fetal loss frequency. Progesterone receptor antagonist (mifepristone) or knock-down DAF with specific siRNA, above the protective effects of progesterone, were significantly weakened. Another sex hormone, oestrogen, has no significant effect on placental DAF and C3 contents and fetal loss frequency in the APS mice model. This may be an important mechanism by which progesterone induces maternal–fetal immune tolerance. At the same time, it may provide evidence for the use of progesterone in APS abortion patients.
Hinted Star Coordinates for Mixed Data
Authors: Matute J. , Linsen L.
Published: May 2019

Mixed data sets containing numerical and categorical attributes are nowadays ubiquitous. Converting them to one attribute type may lead to a loss of information. We present an approach for handling numerical and categorical attributes in a holistic view. For data sets with many attributes, dimensionality reduction (DR) methods can help to generate visual representations involving all attributes. While automatic DR for mixed data sets is possible using weighted combinations, the impact of each attribute on the resulting projection is difficult to measure. Interactive support allows the user to understand the impact of data dimensions in the formation of patterns. Star Coordinates is a well‐known interactive linear DR technique for multi‐dimensional numerical data sets. We propose to extend Star Coordinates and its initial configuration schemes to mixed data sets. In conjunction with analysing numerical attributes, our extension allows for exploring the impact of categorical dimensions and individual categories on the structure of the entire data set. The main challenge when interacting with Star Coordinates is typically to find a good configuration of the attribute axes. We propose a guided mixed data analysis based on maximizing projection quality measures by the use of recommended transformations, named hints, in order to find a proper configuration of the attribute axes.
Serial Filing: How Landlords use the Threat of Eviction
Authors: Garboden Philip ME , Rosen Eva
Published: May 2019

While recent research has illustrated the frequency and deleterious consequences of eviction, the number of executed evictions pales in comparison to the number of poor families threatened with eviction. This paper uses interviews with 127 randomly sampled landlords and property managers in Baltimore, Dallas, and Cleveland to examine their strategies related to eviction, with a focus on the extended process of evicting rather than the discrete instance of eviction. We find that landlords generally try to avoid costly evictions, instead relying on the serial threat of eviction. By redefining renters as debtors, filing assists in rent collection by leveraging the state to materially and symbolically support the landlord's debt collection. At the same time, housing tenants in small amounts of arrearage aggravates the power imbalance within the landlord–tenant relationship. It gives landlords the legal pretext to remove a tenant for any reason and prevents tenants from exercising their legal rights regarding code enforcement. These findings emphasize the importance of examining the precarious and power–laden relationship of landlords and tenants while they are still in residence. Poor families live under constant threat of eviction, facing housing insecurity, fees, and legal sanction, with negative impacts for their sense of home and community.
The effect of excessive fat tissue on the measure of bone mineral density by dual X‐ray absorptiometry: the impact of substantial weight loss following sleeve gastrectomy
Authors: Maïmoun Laurent , Mariano‐Goulart Denis , Jaussent Audrey , Lefebvre Patrick , Picot Marie‐Christine , Mahadea Krishna , Boudousq Vincent , Fouillade Clémence , Nocca David , Ben Bouallègue Fayçal
Published: May 2019

Purpose

Dual‐energy X‐ray absorptiometry (DXA) is used in clinical routine to determine areal bone mineral density (aBMD). However, it is not clear whether excessive fat mass or substantial weight loss modify the aBMD measurements. The aim of this study was to evaluate the effect of soft tissue composition on aBMD measured by DXA using a clinical model (i.e. sleeve gastrectomy: SG) that induces substantial body weight loss.

Methods

Areal bone mineral density and body composition (fat mass: FM and lean tissue mass: LTM) were determined by DXA in 41 obese patients (33 women, 80.5%) just before SG and 1 month later.

Results

One month after SG, mean weight loss was −9.8 ± 2.6 kg, with a significant decrease in LTM and FM (kg) ranging from −7.3% to −9.5%. The relative variation in aBMD was increased at the lumbar spine (2.45 ± 3.44%) and decreased at the hip (−1.47 ± 2.28%), whereas no variation was observed for the whole body and radius. The variation in aBMD at the lumbar spine was inversely correlated with variations in weight, whole‐body FM and trunk FM, but not LTM.

Conclusion

This study shows evidence of a potential effect of body composition, particularly FM, on aBMD. However, given the modest change in aBMD, which was close to the precision error of aBMD measurements, it appears that significant weight loss does not have a clinically significant impact on the evaluation of aBMD using DXA.
Transcriptomics in tissue glucocorticoid sensitivity
Authors: Nicolaides Nicolas C. , Polyzos Alexandros , Koniari Eleni , Lamprokostopoulou Agaristi , Papageorgiou Ifigeneia , Golfinopoulou Eleni , Papathanasiou Chrysanthi , Sertedaki Amalia , Thanos Dimitris , Chrousos George P. , Charmandari Evangelia
Published: May 2019

Background

Synthetic glucocorticoids are widely used in the treatment of several inflammatory, autoimmune and lymphoproliferative disorders. However, considerable variation in response to therapeutic doses of glucocorticoids has been documented among individuals. The aim of our study was to identify novel glucocorticoid sensitivity‐determining genes using genome‐wide expression profiling in healthy subjects.

Methods

One hundred one healthy subjects [mean age ± standard error of the mean (SEM); 26.52 ± 0.50 years] were given 0.25 mg dexamethasone at midnight, and serum cortisol concentrations were determined at 08:00 hours the following morning. Subjects were stratified into the 10% most glucocorticoid‐sensitive and 10% most glucocorticoid‐resistant according to the serum cortisol concentrations. Genomic DNA, RNA and plasma samples were obtained in the 22 subjects one month later.

Results

Transcriptomic analysis showed variability between glucocorticoid‐resistant and glucocorticoid‐sensitive subjects. One hundred thirty‐three genes were upregulated and 49 downregulated in the glucocorticoid‐resistant compared to the glucocorticoid‐sensitive group. Further analysis revealed differences between 3 glucocorticoid‐resistant and 3 glucocorticoid‐sensitive subjects. The majority of the 1058 upregulated genes and 1139 downregulated genes were found to participate in telomere maintenance, systemic lupus erythematosus and Alzheimer's disease. Interestingly, Synuclein A, a key molecule in Parkinson's disease, was upregulated in the subgroup of glucocorticoid‐sensitive subjects.

Conclusions

We have identified differences in tissue sensitivity to glucocorticoids among healthy subjects at the transcriptomic level. These differences are associated with differential expression of genes related to autoimmune and neurological disorders.
Myelination key factor krox‐20 is downregulated in Schwann cells and murine sciatic nerves infected by Mycobacterium leprae
Authors: Casalenovo Mariane Bertolucci , Rosa Patrícia Sammarco , de Faria Bertoluci Daniele Ferreira , Barbosa Adriana Sierra Assencio Almeida , Nascimento Dejair Caitano do , de Souza Vânia Nieto Brito , Nogueira Maria Renata Sales
Published: May 2019

Schwann cells (SCs) critically maintain the plasticity of the peripheral nervous system. Peripheral nerve injuries and infections stimulate SCs in order to retrieve homeostasis in neural tissues. Previous studies indicate that Mycobacterium leprae (ML) regulates the expression of key factors related to SC identity, suggesting that alterations in cell phenotype may be involved in the pathogenesis of neural damage in leprosy. To better understand whether ML restricts the plasticity of peripheral nerves, the present study sought to determine the expression of Krox‐20, Sox‐10, c‐Jun and p75NTR in SC culture and mice sciatic nerves, both infected by ML Thai‐53 strain. Primary SC cultures were stimulated with two different multiplicities of infection (MOI 100:1; MOI 50:1) and assessed after 7 and 14 days. Sciatic nerves of nude mice (NU‐Foxn1nu) infected with ML were evaluated after 6 and 9 months. In vitro results demonstrate downregulation of Krox‐20 and Sox‐10 along with the increase in p75NTR‐immunolabelled cells. Concurrently, sciatic nerves of infected mice showed a significant decrease in Krox‐20 and increase in p75NTR. Our results corroborate previous findings on the interference of ML in the expression of factors involved in cell maturation, favouring the maintenance of a non‐myelinating phenotype in SCs, with possible implications for the repair of adult peripheral nerves.
Effectiveness of using eye mask and earplugs on sleep length and quality among intensive care patients: A quasi‐experimental study
Authors: Bani Younis Mohammad K. , Hayajneh Ferial A. , Alduraidi Hamza
Published: May 2019

Aim

This study aims to assess the effect of using a combination of eye mask and earplugs on the perceived quality of sleep among patients admitted to intensive care units.

Design

Control group, pretest and posttest, quasi‐experimental design was used.

Methods

Data were collected from 103 intensive care patients in two governmental hospitals in Jordan. The participants were assigned either an experimental or a control group. The experimental group participants received routine care in the first night and used the eye mask and earplug during their sleep in the second night. Control group participants, on the other hand, received routine care only in both nights. The number of hours slept was reported by nurses, and the perceived quality of sleep was self‐reported by participants using the Richards‐Campbell Sleep Scale.

Results

Experimental group participants slept more hours and reported significantly better perceived quality of sleep after the use of eye mask and earplugs, as compared both with themselves in the first night and with control group participants.

Conclusion

Combining eye masks and earplugs is effective in prolonging the sleep of intensive care patients and improving its quality.
The effect of a transtheoretical model–based motivational interview on self‐efficacy, metabolic control, and health behaviour in adults with type 2 diabetes mellitus: A randomized controlled trial
Authors: Selçuk‐Tosun Alime , Zincir Handan
Published: May 2019

Aim

This study aimed to determine the effect of a transtheoretical model–based motivational interview method on self‐efficacy, metabolic control, and health behaviour in adults with type 2 diabetes mellitus.

Methods

A randomized controlled study design was used. The study was conducted with 50 individuals with type 2 diabetes mellitus, divided into an intervention group and a control group. The researcher held motivational interviews with the patients in the intervention group. Both groups were observed at the beginning of the study and 6 months after the baseline interview. The study data were collected between January 8 and November 18, 2014.

Results

Comparing the intervention and the control groups, the differences in the level of self‐efficacy and participants' metabolic values were significant (P < .05). The number of participants in the action stage of the intervention group for nutrition, exercise, and medication use significantly increased compared with the control group (P < .05).

Conclusion

The transtheoretical model–based motivational interview method increased the self‐efficacy level of participants with type 2 diabetes mellitus, which helped them improve their metabolic control and health behaviour stages over this 6‐month period.
Continuous glucose monitoring in adults with type 1 diabetes: A balance between benefits and barriers: A critical incident study
Authors: Sørgård Beate , Iversen Marjolein M. , Mårtensson Jan
Published: May 2019

Aims and objectives

To describe positively and negatively perceived situations experienced by adults with type 1 diabetes using continuous glucose monitoring and the actions they take to deal with these situations.

Background

Real‐time continuous glucose monitoring has been shown to improve glycaemic control and reduce hypoglycaemia. Although many patients with type 1 diabetes report great benefits when using continuous glucose monitoring, a substantial number discontinue using the device. Little is known about the different situations and experiences with the daily use of continuous glucose monitoring that contribute to such differences.

Design

A descriptive design based on the critical incident technique was used. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ) (see File S1).

Methods

Individual interviews were conducted with a purposive sample of 23 adults with type 1 diabetes, including current and former users of continuous glucose monitoring from four different outpatient clinics.

Results

The participants described that they felt that the use of continuous glucose monitoring was a balance between benefits and barriers, and how, through their actions, they tried to adapt their use of continuous glucose monitoring to fit their lifestyles. Various life events affected and altered the balance between benefits and barriers and thus affected their use of continuous glucose monitoring.

Conclusions

Continuous glucose monitoring is perceived as an effective and important tool in the self‐management of diabetes type 1. It enables a better everyday life and increased satisfaction with treatment. At the same time, the use of continuous glucose monitoring can be both demanding and challenging.

Relevance to clinical practice

Understanding the complex interplay between perceived benefits, treatment burden and adherence to continuous glucose monitoring use is important for nurses engaged in diabetes care. Education and support regarding the use of continuous glucose monitoring must be based on the understanding and perspectives of the patient to alleviate stress and barriers and enhance self‐efficacy. As the use of continuous glucose monitoring can change over time, this must be a continuous process beyond initial training.
The Fabrication of an Acrylic Repositioning Stent for Use During Intensity Modulated Radiation Therapy: A Feasibility Study
Authors: Lee Vincent Sung Kin , Nguyen Caroline Tram , Wu Jonn
Published: May 2019

Purpose

Radiotherapy is one of the main treatment modalities for head and neck cancers. To minimize damage to normal tissues during radiotherapy, various methods of stabilization have been used, including thermoplastic facemasks and repositioning stents. The goal is to assess the effect of using a customized oral repositioning stent on patient positioning during the course of radiotherapy.

Materials and Methods

Ten consecutive patients scheduled to undergo intensity modulated radiation therapy (IMRT) for cancers of the maxillary sinus, nasal cavity, or oral cavity were recruited to participate in the study (ST group). These patients were matched to 2 retrospective cohorts, one using the original repositioning stent design (OB group), and the other with no stabilization stent (NB group). Hard baseplate wax was used to create a customized wax pattern of the proposed acrylic stent chairside, and processed in heat‐cured clear hard acrylic. Relative stability of the daily patient setup was assessed by comparing measurements from surrogate bony landmarks to radiation isocentres obtained from the initial reconstructed planning computed tomograph (CT) to each daily KeV image.

Results

There was no stent fracture or distortion throughout treatments, and no patients’ treatments were required to be aborted, delayed, or replanned. Mean 3D deviations for the ST, OB, and NB groups were 0.29 ± 0.10 cm, 0.32 ± 0.14 cm, and 0.31 ± 0.13 cm, respectively. The ANOVA test revealed no significant difference in triangulated variations between the treatment groups (F = 0.18, p = 0.84). Patient stability data demonstrated mean vertical, longitudinal, and lateral variations that did not appear different when compared to 2 retrospective cohorts. Although the deviations were not statistically significant between matched cohorts, the added durability of the stent and comfort for patients, without affecting IMRT timeline, are considered clinically significant.

Conclusion

By using a customized repositioning stent, it is possible to maintain patient stability comparable to prior protocols and within the range of clinical guidelines, while providing superior comfort and ease of insertion to the patients.
A non‐tandem CCCH‐type zinc‐finger protein, IbC3H18, functions as a nuclear transcriptional activator and enhances abiotic stress tolerance in sweet potato
Authors: Zhang Huan , Gao Xiaoru , Zhi Yuhai , Li Xu , Zhang Qian , Niu Jinbiao , Wang Jun , Zhai Hong , Zhao Ning , Li Jigang , Liu Qingchang , He Shaozhen
Published: May 2019

CCCH‐type zinc‐finger proteins play essential roles in regulating plant development and stress responses. However, the molecular and functional properties of non‐tandem CCCH‐type zinc‐finger (non‐TZF) proteins have been rarely characterized in plants.

Here, we report the biological and molecular characterization of a sweet potato non‐TZF gene, IbC3H18. We show that IbC3H18 exhibits tissue‐ and abiotic stress‐specific expression, and could be effectively induced by abiotic stresses, including NaCl, polyethylene glycol (PEG) 6000, H2O2 and abscisic acid (ABA) in sweet potato.

Accordingly, overexpression of IbC3H18 led to increased, whereas knock‐down of IbC3H18 resulted in decreased tolerance of sweet potato to salt, drought and oxidation stresses. In addition, IbC3H18 functions as a nuclear transcriptional activator and regulates the expression of a range of abiotic stress‐responsive genes involved in reactive oxygen species (ROS) scavenging, ABA signaling, photosynthesis and ion transport pathways. Moreover, our data demonstrate that IbC3H18 physically interacts with IbPR5, and that overexpression of IbPR5 enhances salt and drought tolerance in transgenic tobacco plants.

Collectively, our data indicate that IbC3H18 functions in enhancing abiotic stress tolerance in sweet potato, which may serve as a candidate gene for use in improving abiotic stress resistance in crops.
Maternal educational inequalities in measured body mass index trajectories in three European countries
Authors: McCrory Cathal , Leahy Siobhan , Ribeiro Ana Isabel , Fraga Silvia , Barros Henrique , Avendano Mauricio , Vineis Paolo , Layte Richard ,   the LIFEPATH consortium
Published: May 2019

Background

Social inequalities in the prevalence of childhood overweight and obesity are well‐established, but less is known about when the social gradient first emerges and how it evolves across childhood and adolescence.

Objective

This study examines maternal education differentials in children's body mass trajectories in infancy, childhood and adolescence using data from four contemporary European child cohorts.

Methods

Prospective data on children's body mass index (BMI) were obtained from four cohort studies—Generation XXI (G21—Portugal), Growing Up in Ireland (GUI) infant and child cohorts, and the Millennium Cohort Study (MCS—UK)—involving a total sample of 41,399 children and 120,140 observations. Children's BMI trajectories were modelled by maternal education level using mixed‐effect models.

Results

Maternal educational inequalities in children's BMI were evident as early as three years of age. Children from lower maternal educational backgrounds were characterised by accelerated BMI growth, and the extent of the disparity was such that boys from primary‐educated backgrounds measured 0.42 kg/m2 (95% CI 0.24, 0.60) heavier at 7 years of age in G21, 0.90 kg/m2(95% CI 0.60, 1.19) heavier at 13 years of age in GUI and 0.75 kg/m2 (95% CI 0.52, 0.97) heavier in MCS at 14 years of age. The corresponding figures for girls were 0.71 kg/m2 (95% CI 0.50, 0.91), 1.31 kg/m2 (95% CI 1.00, 1.62) and 0.76 kg/m2 (95% CI 0.53, 1.00) in G21, GUI and MCS, respectively.

Conclusions

Maternal education is a strong predictor of BMI across European nations. Socio‐economic differentials emerge early and widen across childhood, highlighting the need for early intervention.
Apoplastic barriers, aquaporin gene expression and root and cell hydraulic conductivity in phosphate‐limited sheepgrass plants
Authors: Li Lingyu , Pan Sirui , Melzer Rainer , Fricke Wieland
Published: May 2019

Mineral nutrient supply can affect the hydraulic property of roots. The aim of the present work on sheepgrass (Leymus chinensis L.) plants was to test whether any changes in root hydraulic conductivity (Lp; exudation analyses) in response to a growth‐limiting supply of phosphate (P) are accompanied by changes in (1) cell Lp via measuring the cell pressure, (2) the aquaporin (AQP) gene expression by performing qPCR and (3) the formation of apoplastic barriers, by analyzing suberin lamella and Casparian bands via cross‐sectional analyses in roots. Plants were grown hydroponically on complete nutrient solution, containing 250 µM P, until they were 31–36 days old, and then kept for 2–3 weeks on either complete solution, or transferred on solution containing 2.5 µM (low‐P) or no added P (no‐P). Phosphate treatments caused significant decreases in root and cell‐Lp and AQP gene expression, while the formation of apoplastic barriers increased, particularly in lateral roots. Experiments using the AQP inhibitor mercury (Hg) suggested that a significant portion of radial root water uptake in sheepgrass occurs along a path involving AQPs, and that the Lp of this path is reduced under low‐ and no‐P. It is concluded that a growth‐limiting supply of phosphate causes parallel changes in (1) cell Lp and aquaporin gene expression (decrease) and (2) apoplastic barrier formation (increase), and that the two may combine to reduce root Lp. The reduction in root Lp, in turn, facilitates an increased root‐to‐shoot surface area ratio, which allocates resources to the root, sourcing the limiting nutrient.