bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of predation risk on cash holdings: Empirical evidence from the U.S. property‐liability insurance industry
Authors: Che Xin , Fier Stephen G. , Liebenberg Andre P.
Published: September 2019

Corporate cash holdings play a significant role in the U.S. property‐liability insurance industry yet the topic of insurer cash holdings policy has largely been overlooked by prior empirical research. While a number of studies have investigated firm‐specific factors related to cash holdings in the insurance industry, prior research has not examined how market concentration and potential predation risk impact cash holdings. We propose a new measure of market concentration and provide evidence in support of the predation risk theory. Specifically, we show that insurers exposed to more concentrated markets tend to hold more cash. Furthermore, the relation between market concentration and cash holdings is influenced by access to internal capital. While unaffiliated insurers without access to internal capital hold greater levels of cash in more concentrated markets, group insurers with access to internal capital do not hold greater levels of cash to mitigate predation risk.
The impacts of trade and self‐sufficiency policies on heterogeneous rice farms in Malaysia
Authors: Ali Roslina Binti , Luckstead Jeff , Durand‐Morat Alvaro , Wailes Eric J.
Published: September 2019

This paper develops a farm household model of heterogeneous Malaysian rice farmers. The model determines the domestic price of milled rice in equilibrium. The model is simulated to analyze the effects of free trade, self‐sufficiency achieved through trade policy, and the impact of free trade and self‐sufficiency when rice productivity expands. The ex ante results for free trade predict that total rice supply rises as the increase in imports offsets the decrease in domestic production, causing the domestic price of milled rice to fall by 15.8 percent. While this price decrease generates negative income effects for rice farmers, it leads to an expansion of consumption of milled rice by both the farm and urban populations. The results for self‐sufficiency through heightened tariffs predict that production for domestic rice farmers increases. However, with fewer imports, total rice supply falls, causing the domestic price of rice to increase by 41.5 percent. Because free trade is politically unfeasible and trade‐driven self‐sufficiency policies contract total rice consumption, boosting rice production through research and development is an effective way for Malaysia to increase the total supply of rice while limiting its dependence on imports.
Successful re‐transplantation in patient with recurrent parvovirus B19 pure red cell aplasia
Authors: Inamdar Neeraj , Nada Ritambhra , Minz Ranjana , Kenwar Deepesh Benjamin , Singh Sarabpreet , Sharma Ashish , Kumar Vivek , Rathi Manish , Kohli Harbir S. , Ramachandran Raja
Published: September 2019

Impaired cell‐mediated, as well as antibody‐mediated immunity predisposes a renal transplant recipient to a wide variety of atypical infection. With an increasing number of re‐transplant, the balance between immunosuppression and the risk of recurrent disease poses a clinical and therapeutic challenge. Here, we report a successful re‐transplantation in a case of parvovirus B19 infection leading to anaemia and collapsing glomerulopathy in the allograft managed with intravenous immunoglobulin (IVIG) and reduction of immunosuppression. This case emphasizes re‐consideration to renal transplant after clearance of the virus in a previous renal allograft lost to PVB19 infection.
Choreographing the rhythms of encounter in Singapore's maid agencies
Authors: Wee Kellynn , Goh Charmian , Yeoh Brenda S.A.
Published: September 2019

This paper builds on Lefebvre's concept of rhythmanalysis in order to extend our understanding of geographies of encounter in everyday social life. Focusing on the encounters that take place at maid agencies that match migrant domestic workers with local employers in Singapore, we develop the conceptual construct of choreography to show how bodies in spaces of encounter are rhythmically ordered to move through space in particular ways at specific speeds and times. The concept is also useful in studying encounters between migrants and citizens not just as serendipitous events but as purposively designed. Foregrounding the tangled relationalities that exist between maid agents, domestic workers, and employers, we show how employers’ interactions with the materialities of the migration industry – such as the spatial arrangement of the maid agency and the biodata used in the selection of workers – set particular diagrammatic rhythms into motion, prefiguring corporeal migrant–local encounters before they begin. We depict migrant women's punctuated rhythms of moving and waiting, revealing how the eurythmia of the maid agency both conceals and is dependent on the arrhythmia of their bodies. Finally, by emphasising that choreography requires both design and performance, we investigate how migrant women are able to overturn the ordering of rhythms through improvisational moments. Attending to the practices of the maid agency allows us to reveal how relations of power between migrants and locals are reproduced within contexts of temporary labour migration.
The macroeconomics outcome of oil shocks in the small Eurozone economies
Authors: Raduzzi Raphael , Ribba Antonio
Published: September 2019

In this work, we provide an analysis over the period 1999–2015 of the effects of oil shocks on prices and GDP in a group of small Euro‐area economies. The group includes Austria, Belgium, Finland, Greece, Ireland, Italy, Netherlands, Portugal and Spain. In order to characterise the macroeconomic outcomes of movements in oil prices, we adopt the structural vector autoregression (VAR) methodology. We find that under the European Monetary Union (EMU), oil price shocks have been important drivers of business cycle fluctuations in almost all these countries. Moreover, an increase in oil prices produces significant recessionary effects in all the countries included in the investigation. Thus, although there are different sizes in the responses of output in the investigated countries, our main conclusion is that despite the structural changes experienced by the European economies in the last decades, oil prices still matter for these countries. In the light of these results, we also stress some important challenges for the conduct of monetary policy in the Euro area.
Factors Impeding the Integration of Sustainability Elements in Built Environment Academic Curricula
Authors: Ekung Samuel , Adewuyi Timothy , Otali Monday
Published: September 2019

Development within the construction industry shows that higher education is critical in the sector’s skills improvement. However, research findings are also explicit about absent and shadow integration of core sustainable construction modules for built environment’s curricula. The study aimed to examine issues critical for the integration of sustainability element in the built environment curricula. It outlined two objectives which: (1) to determine the causes for the low integration of sustainability elements in academic curricula and, (2) to identify the principal factors inhibiting the integration of sustainability elements in academic curricula in Nigeria. Data for the study was obtained using a questionnaire survey administered to a random sample of 186 academic stakeholders related to schools of the built environment across Nigeria with factor analysis was subsequently employed to analyze the survey data. The results showed that seven principal factors inhibit and are responsible for the dearth of sustainable construction modules in built environment academic curricula in Nigeria. These are: (1) Skills and knowledge dearth, (2) Lack of empowerment to effect change, (3) Low level of awareness, (4) Lack of green building council, (5) Lack of real-life sustainable projects, (6) Non-prioritization by accreditation bodies and (7) Lack of research and industry collaboration. The findings suggest that strong government policy and viable industry and academic collaboration are imperative to effect curriculum change in support of the integration of sustainability element in the built environment curricula. The findings reported in this paper is significant as a basis to inaugurate the development of academic curricula which integrates the sustainability elements, capable of driving behavioural change to adapt sustainability practices among graduates.
Develar y apreciar la diversidad organizacional: discursos y prácticas para re-imaginar la empresa y la estrategia en función de la vida
Authors: Arévalo Viveros Juan Manuel , Mosequera Pisso Franklyn , Cáceres Barajas Diego
Published: September 2019

Partiendo de la relación empresa–desarrollo, el manuscrito aporta al tema del re-diseño de la estrategia y lo empresarial tiendo como horizontes el posdesarrollo y el contra-desarrollo vital (configuración de estadios sociales para la sustentabilidad de la vida y la diversidad socio-natural). El interrogante central es ¿Cuáles son algunos discursos y prácticas que se desarrollan actualmente en Popayán con el potencial necesario para imaginar la emergencia transicional de horizontes estratégicos posdesarrollistas? Como resultado, planteamos que la emergencia transicional de horizontes estratégicos posdesarrollistas se debate entre las propuestas de las empresas y las organizaciones sociales. Empero, en estas últimas hay mayor potencial para re-significar la estrategia. En el trabajo privilegiamos metodologías cualitativas/constructivistas/interpretativas y métodos de investigación documental, entrevistas y observación etnográfica.
Trabalho, Raça e Gênero na produção de fotografias: considerações a partir de uma experiência brasileira
Authors: Tittoni Jaqueline , Drescher de Castro Diego , Gomes de Almeida Arthur
Published: September 2019

Este artigo problematiza a relação entre produção de conhecimento, subjetividade e trabalho no contexto brasileiro. Para tal, aborda a relação entre colonialidade e descolonialidade no que tange ao campo epistemológico e suas imbricações nas relações de trabalho, tomando a subjetividade como eixo central destas análises. Do ponto de vista descolonial, evidencia os modos como se articulam os marcadores gênero e raça para mostrar os efeitos de colonização do trabalho fundamentado no modelo de homem branco ocidental. Para tanto, tomaremos estudo realizado com trabalhadoras da saúde, com a utilização de oficinas de produção de fotografia, para pensar os modos como estes marcadores aparecem nos cotidianos de trabalho.
Experimental Investigation and Numerical Modeling of Room Temperature Control in Buildings by the Implementation of Phase Change Material in the Roof
Authors: Beemkumar N. , Yuvarajan D. , Arulprakasajothi M. , Ganesan S. , Elangovan K. , Senthilkumar G.
Published: September 2019

Due to the increasing demand for air conditioners to maintain thermal comfort in buildings, it is necessary to search for alternatives that can reduce the soaring temperature and meet total air conditioning demands. There are several proven technologies for maintaining thermal comfort in buildings of which the use of phase change material (PCM) in buildings provides improved thermal comfort with fewer energy requirements. The present study analyzes the impact of the incorporation of PCM in roofs on the thermal behavior of buildings. The experiments were conducted in two identical model building roofs with and without the implementation of PCM. A numerical model was developed to find the effect of variation in the PCM layer thickness and month wise temperature variations. To get minimum variation in the results, the simulation was run continuously for 5 days assuming average climatic conditions. The results showed that temperature fluctuations in the room were reduced with the use of PCM, and also the average peak temperature rise was reduced by 2–4°C. The increased PCM layer thickness resulted in decreased energy demand for maintaining the required thermal comfort in buildings at an almost constant temperature.
Power Analysis on a 70-mm Rotor Tesla Turbine
Authors: Placco Guilherme M. , Guimarães Lamartine N. F.
Published: September 2019

The Tesla turbine built originally in 1913 by Nikola Tesla is an impulse and passive turbine. These characteristics drew the attention for its potential application for space cycle thermoelectric conversion and the possibility to improve cycle efficiency. The performance of a 70-mm rotor Tesla turbine will be presented and discussed. The turbine used saturated steam as the working fluid for experiments. The pressure range considered was between 300 to 700 kPa.
Chronic Standing Desk Use and Arterial Stiffness
Authors: Greenlund Ian M. , Suriano Piersan E. , Elmer Steven J. , Carter Jason R. , Durocher John J.
Published: September 2019

Background: Sedentary activity and sitting for at least 10 hours per day can increase the risk for cardiovascular disease by more than 60%. Use of standing desks may decrease sedentary time and improve cardiovascular health. Acute standing lowers pulse wave velocity (PWV), but chronic effects remain unknown. The purpose of this study was to determine the effect of chronic standing desk use on arterial stiffness versus seated controls. Methods: A total of 48 adults participated in this study. Twenty-four participants qualified as seated desk users (age 41 [10] y, body mass index 25 [4] kg/m2) and 24 as standing desk users (age 45 [12] y, body mass index 25 [5] kg/m2). Arterial stiffness was assessed as PWV within the aorta, arm, and leg. Results: Carotid–femoral PWV (cfPWV) was not different between seated (6.6 [1.3] m/s) and standing (6.9 [1.3] m/s) groups (P = .47). Similarly, there were no differences in arm or leg PWV between groups (P = .13 and P = .66, respectively). A secondary analysis of traditional factors of age and aerobic fitness revealed significant differences in cfPWV in seated and standing desk participants. Age also significantly influenced cfPWV across conditions. Conclusions: Standing for >50% of a workday did not affect PWV. Consistent with previous research, fitness and age are important modulators of arterial stiffness.
Morphology of the Denisovan phalanx closer to modern humans than to Neanderthals
Authors: Bennett E. Andrew , Crevecoeur Isabelle , Viola Bence , Derevianko Anatoly P. , Shunkov Michael V. , Grange Thierry , Maureille Bruno , Geigl Eva-Maria
Published: September 2019

The Denisovans had a genome close to Neanderthals, molars close to
Homo erectus
, and a phalanx close to
Homo sapiens
.
Genomically informed small-molecule drugs overcome resistance to a sustained-release formulation of an engineered death receptor agonist in patient-derived tumor models
Authors: Manzari Mandana T. , Anderson Gray R. , Lin Kevin H. , Soderquist Ryan S. , Çakir Merve , Zhang Mitchell , Moore Chandler E. , Skelton Rachel N. , Fèvre Maréva , Li Xinghai , Bellucci Joseph J. , Wardell Suzanne E. , Costa Simone A. , Wood Kris C. , Chilkoti Ashutosh
Published: September 2019

Precision medicine strategy enables rational design of small molecule/protein drug combinations to overcome intrinsic resistance.
Acupuncture attenuates alcohol dependence through activation of endorphinergic input to the nucleus accumbens from the arcuate nucleus
Authors: Chang Suchan , Kim Dan Hyo , Jang Eun Young , Yoon Seong Shoon , Gwak Young Seob , Yi Yoo Jung , Lee Jun Yeon , Ahn Song Hee , Kim Jin Mook , Ryu Yeon-Hee , Kim Seung-Nam , Roh Hyo Sun , Lee Mi-Young , Kim Sang Chan , Lee Bong Hyo , Kim Hee Young , Yang Chae Ha
Published: September 2019

We provide evidence for the effectiveness of acupuncture in an animal model of alcohol dependence.
Antibodies to the conserved region of the M protein and a streptococcal superantigen cooperatively resolve toxic shock-like syndrome in HLA-humanized mice
Authors: Pandey Manisha , Calcutt Ainslie , Ozberk Victoria , Chen Zhenjun , Croxen Matthew , Powell Jessica , Langshaw Emma , Mills Jamie-Lee , Jen Freda E.-C. , McCluskey James , Robson Jenny , Tyrrell Gregory J. , Good Michael F.
Published: September 2019

Antibodies to the M protein and SpeC resolve streptococcal toxic shock syndrome in HLA-humanized mice.
Neutrophil extracellular traps, B cells, and type I interferons contribute to immune dysregulation in hidradenitis suppurativa
Authors: Byrd Angel S. , Carmona-Rivera Carmelo , O’Neil Liam J. , Carlucci Philip M. , Cisar Cecilia , Rosenberg Avi Z. , Kerns Michelle L. , Caffrey Julie A. , Milner Stephen M. , Sacks Justin M. , Aliu Oluseyi , Broderick Kristen P. , Reichner Jonathan S. , Miller Lloyd S. , Kang Sewon , Robinson William H. , Okoye Ginette A. , Kaplan Mariana J.
Published: September 2019

Innate and adaptive immune systems are dysregulated in hidradenitis suppurativa.
Topographic modeling of early human osteoarthritis in sheep
Authors: Oláh Tamás , Reinhard Jan , Gao Liang , Haberkamp Sophie , Goebel Lars K. H. , Cucchiarini Magali , Madry Henning
Published: September 2019

Early osteoarthritis induced in a clinically relevant ovine model progresses in a highly specific spatiotemporal pattern resembling human OA.
Of mice, men, and
NLGN4
Authors: Osterweil Emily K.
Published: September 2019

Expression of the autism risk factor
NLGN4
is divergent between human and mouse neurons.
TAMpering with TIME
Authors: Sowalsky Adam G.
Published: September 2019

CXCR2 inhibition reprograms tumor-associated macrophages to suppress prostate cancer progression.
Growth Phase-Dependent Chromosome Condensation and Heat-Stable Nucleoid-Structuring Protein Redistribution in Escherichia coli under Osmotic Stress
Authors: Rafiei Nafiseh , Cordova Martha , Navarre William Wiley , Milstein Joshua N.
Published: September 2019

The heat-stable nucleoid-structuring (H-NS) protein coordinates the expression of over 200 genes in
E. coli
, with a large number involved in both bacterial virulence and drug resistance. We report on the novel observation of a dynamic compaction of the bacterial chromosome in response to exposure to high levels of salt. This stress response results in the detachment of H-NS proteins and their subsequent expulsion to the periphery of the cells. We found that this behavior is related to mechanical properties of the bacterial chromosome, in particular, to how tightly twisted and coiled is the chromosomal DNA. This behavior might act as a biomechanical response to stress that coordinates the expression of genes involved in adapting bacteria to a salty environment.
The Coxsackievirus and Adenovirus Receptor, a Required Host Factor for Recovirus Infection, Is a Putative Enteric Calicivirus Receptor
Authors: Farkas Tibor , Yang Kui , Le Pendu Jacques , Baines Joel D. , Cardin Rhonda D.
Published: September 2019

Because of the lack of a simple and robust human norovirus (HuNoV) cell culture system surrogate, caliciviruses still represent valuable research tools for norovirus research. Due to their remarkable biological similarities to HuNoVs, including the utilization of HBGAs as putative attachment receptors, we used rhesus enteric caliciviruses (ReCVs) to study enteric calicivirus host cell interactions. Using CRISPR/Cas9 library screening and functional assays, we identified and validated the coxsackievirus and adenovirus receptor (CAR) as a functional proteinaceous receptor for ReCVs. Our work demonstrated that CAR and HBGAs both are necessary to convert a nonsusceptible cell line to being susceptible to ReCV infection. Follow-up studies to evaluate the involvement of CAR in HuNoV infections are ongoing.
Aging of a Bacterial Colony Enforces the Evolvement of Nondifferentiating Mutants
Authors: Hashuel Rachel , Ben-Yehuda Sigal
Published: September 2019

Until now, bacterial cells facing nutrient deprivation were shown to enter dormancy as a strategy to survive prolonged stress, with the most established examples being sporulation, stationary phase, and persistence. Here, we uncovered an opposing strategy for long-term bacterial survival, in which mutant subpopulations cope with a challenging niche by proliferating rather than by stalling division. We show that this feature stems from mutations in genes disturbing the capability of the cells to differentiate into a quiescent state, enabling them to divide under restrictive conditions. Our study challenges the dogma of bacterial aging by highlighting an additional survival strategy resembling that of cancerous cells in animal organs.
Massive Gene Flux Drives Genome Diversity between Sympatric
Streptomyces
Conspecifics
Authors: Tidjani Abdoul-Razak , Lorenzi Jean-Noël , Toussaint Maxime , van Dijk Erwin , Naquin Delphine , Lespinet Olivier , Bontemps Cyril , Leblond Pierre
Published: September 2019

Horizontal gene transfer is a rapid and efficient way to diversify bacterial gene pools. Currently, little is known about this gene flux within natural soil populations. Using comparative genomics of
Streptomyces
strains belonging to the same species and isolated at microscale, we reveal frequent transfer of a significant fraction of the pangenome. We show that it occurs at a time scale enabling the population to diversify and to cope with its changing environment, notably, through the production of public goods.
The Origin, Succession, and Predicted Metabolism of Bacterial Communities Associated with Leaf Decomposition
Authors: Jackrel Sara L. , Gilbert Jack A. , Wootton J. Timothy
Published: September 2019

Community ecologists have traditionally treated individuals within a species as uniform, with individual-level biodiversity rarely considered as a regulator of community and ecosystem function. In our study system, we have documented clear evidence of within-species variation causing local ecosystem adaptation to fluxes across ecosystem boundaries. In this striking pattern of a “home-field advantage,” leaves from individual trees tend to decompose most rapidly when immediately adjacent to their parent tree. Here, we merge community ecology experiments with microbiome approaches to describe how bacterial communities adjust to within-species variation in leaves over spatial scales of less than a kilometer. The results show that bacterial community compositional changes facilitate rapid ecosystem responses to environmental change, effectively maintaining high rates of carbon and nutrient cycling through ecosystems.
Analytical Treatment Interruption after Short-Term Antiretroviral Therapy in a Postnatally Simian-Human Immunodeficiency Virus-Infected Infant Rhesus Macaque Model
Authors: Goswami Ria , Nelson Ashley N. , Tu Joshua J. , Dennis Maria , Feng Liqi , Kumar Amit , Mangold Jesse , Mangan Riley J. , Mattingly Cameron , Curtis Alan D. , Obregon-Perko Veronica , Mavigner Maud , Pollara Justin , Shaw George M. , Bar Katharine J. , Chahroudi Ann , De Paris Kristina , Chan Cliburn , Van Rompay Koen K. A. , Permar Sallie R.
Published: September 2019

Novel interventions that do not rely on daily adherence to ART are needed to achieve sustained viral remission for perinatally infected children, who currently rely on lifelong ART. Considering the risks and expense associated with ART interruption trials, the identification of biomarkers of viral rebound will prioritize promising therapeutic intervention strategies, including anti-HIV Env protein therapeutics. However, comprehensive studies to identify those biomarkers are logistically challenging in human infants, demanding the need for relevant nonhuman primate models of HIV rebound. In this study, we developed an infant RM model of oral infection with simian-human immunodeficiency virus expressing clade C HIV Env and short-term ART followed by ATI, longitudinally characterizing the immune responses to viral infection during ART and after ATI. Additionally, we compared this infant RM model to an analogous adult RM rebound model and identified virologic and immunologic correlates of the time to viral rebound after ATI.
Identification of Virulence-Associated Properties by Comparative Genome Analysis of Streptococcus pneumoniae, S. pseudopneumoniae, S. mitis, Three S. oralis Subspecies, and
S. infantis
Authors: Kilian Mogens , Tettelin Hervé
Published: September 2019

Streptococcus pneumoniae
is one of the most important human pathogens but is closely related to
Streptococcus mitis
, with which humans live in harmony. The fact that the two species evolved from a common ancestor provides a unique basis for studies of both infection-associated properties and properties important for harmonious coexistence with the host. By detailed comparisons of genomes of the two species and other related streptococci, we identified 224 genes associated with virulence and 25 genes unique to the mutualistic species. The exclusive presence of the virulence factors in
S. pneumoniae
enhances their potential as vaccine components, as a direct impact on beneficial members of the commensal microbiota can be excluded. Successful adaptation of
S. mitis
and other commensal streptococci to a harmonious relationship with the host relied on genetic stability and properties facilitating life in biofilms.
Complete Genome Sequence of an Equine Arteritis Virus Strain Isolated from a Lipizzaner Stallion in 2015 in Serbia
Authors: Gaudaire Delphine , Lazić Sava , Lupulović Diana , Petrovic Tamas , Lazić Gospava , Berthet Nicolas , Hans Aymeric
Published: September 2019

Here, we report the first whole-genome sequence of an equine arteritis virus (EAV) strain, RS1, isolated from the semen of a Lipizzaner stallion held in the Vojvodina region of Serbia.
First Complete Coding Sequence of a Venezuelan Equine Encephalitis Virus Strain Isolated from an Equine Encephalitis Case in Costa Rica
Authors: León Bernal , Jiménez Carlos , González Rocío , Ramirez-Carvajal Lisbeth
Published: September 2019

The first complete coding sequence of the Venezuelan equine encephalitis virus IE, isolated from a Costa Rican mare with severe encephalitis, was confirmed by histological and viral whole-genome analyses. The isolated virus grouped in the Pacific cluster.
Genome Sequences of Enteroinvasive Escherichia coli Sequence Type 6, 99, and 311 Strains Acquired in Asia Pacific
Authors: Dhakal Rajat , Wang Qinning , Howard Peter , Sintchenko Vitali
Published: September 2019

Laboratory diagnosis of enteroinvasive
Escherichia coli
(EIEC) remains difficult and limits the availability of EIEC genomes to the research community. We report the draft genome sequences of three EIEC strains which represent three distinct sequence types and serotypes circulating in Asia Pacific and causing enterocolitis in humans.
Draft Genomic Sequences of Streptomyces misionensis ACT66 and Streptomyces albidoflavus ACT77, Bacteria with Potential Application for Phytopathogen Biocontrol
Authors: Pylro Victor Satler , Dias Armando Cavalcante Franco , Andreote Fernando Dini , Varani Alessandro de Mello , Andreote Cristiane Cipolla Fasanella , Ribeiro Iron Amoreli de Figueiredo , Kitano Isabella Takahashi , Bernardo Eduardo Roberto de Almeida
Published: September 2019

Here, we report the draft genomic sequences and annotation of
Streptomyces misionensis
ACT66 and
Streptomyces albidoflavus
ACT77, which are two bacteria with potential application for phytopathogen biocontrol.
Five-year changes in anterior segment parameters in an older population in urban southern China: the Liwan Eye Study
Authors: Jiang Yu , Wang Decai , Wang Wei , Chen Feng , Wang Lanhua , Scheetz Jane , Huang Wenyong , Huang Shengsong , He Mingguang
Published: September 2019

Purpose

To investigate the 5-year changes in static and dynamic anterior segment optical coherence tomography (AS-OCT) parameters and their predictors.

Methods

This was a prospective, population-based cohort study of people aged 50 years and older residing in the Liwan District, Guangzhou, China. Standardised AS-OCT scans were performed in November 2008 and November 2013 under dark and light conditions. Customised software was used to analyse horizontal AS-OCT images. Parameters in dark and measurements of light-to-dark changes were used for analyses.

Results

A total of 186 (71.8%) subjects underwent AS-OCT twice, 5 years apart and were included for analyses. The mean age in 2008 was 64.7±7.0 years, and 60.2% were women. The anterior chamber width (ACW) decreased from 11.74±0.44 mm in 2008 to 11.60±0.37 mm in 2013 (p=0.001). There was a trend towards a decrease in dynamic capacity (light-to-dark changes) in the anterior segment, with decreased iris thickness at 750 µm (ΔIT750), ΔACW, Δ anterior chamber area (ACA) and Δ pupil diameter at 5 years (all p<0.05). After adjusting for age and sex, the following baseline parameters were associated with a greater decrease rate in trabecular iris space area at 500 µm (TISA500) at 5 years: TISA500, IT750 and ACA in dark (p<0.001 for all).

Conclusions

Anterior chamber angle width decreased and the amount of light-to-dark changes declined during 5-year follow-up. Subjects with greater height, wider angle width and thicker iris at baseline have greater angle narrowing at follow-up.
Analysis of serious adverse events in a paediatric fast breathing pneumonia clinical trial in Malawi
Authors: Nkwopara Evangelyn , Schmicker Robert , Mvalo Tisungane , Phiri Melda , Phiri Ajib , Couasnon Mari , McCollum Eric D. , Ginsburg Amy Sarah
Published: September 2019

Introduction

Pneumonia is the leading infectious killer of children. We conducted a double-blind, randomised controlled non-inferiority trial comparing placebo to amoxicillin treatment for fast breathing pneumonia in HIV-negative children aged 2–59 months in Malawi. Occurrence of serious adverse events (SAEs) during the trial were examined to assess disease progression, co-morbidities, recurrence of pneumonia and side effects of amoxicillin.

Methods

Enrolled children with fast breathing for age and a history of cough <14 days or difficult breathing were randomised to either placebo or amoxicillin for 3 days, and followed for 14 days to track clinical characteristics and outcomes. Medical history, physical exam, laboratory results and any chest radiographs collected at screening, enrolment and during hospitalisation were evaluated. All SAE reports were reviewed for additional information regarding hospitalisation, course of treatment and outcome.

Results

In total, 102/1126 (9.0%) enrolled children with fast breathing pneumonia were reported to have a SAE. Seventy-five per cent (n=77) of SAEs were pneumonia-related (p<0.01). Children<2 years of age represented the greatest proportion (61/77, 79.2%) of those with a pneumonia-related SAE. In the amoxicillin group, there were 46 SAEs and 5 (10.9%) cases were identified as possibly related to study drug (4 gastroenteritis and 1 fever). There were no life-threatening pneumonia SAEs or deaths in either group, and by the time of exit from the study, all children recovered without sequelae.

Discussion

In this fast breathing pneumonia clinical trial, SAEs occurred infrequently in both the amoxicillin and placebo groups, and amoxicillin was well tolerated.

Trial registration number

NCT02760420.https://clinicaltrials.gov/ct2/show/NCT02760420?term=ginsburg&rank=9.
Public health principles to inform testing and build trust in automated vehicles
Authors: Ehsani Johnathon P , Michael Jeffrey , Igusa Takeru
Published: September 2019

Highly publicised crashes involving self-driving or autonomous vehicles (AVs) have raised questions about safety and eroded public trust in the technology. In this State of the Art Review, we draw on previous successes in injury prevention and public health to focus attention on three strategies to reduce risk and build public confidence as AVs are being tested on public roads. Data pooling, a graduated approach to risk exposure, and harm reduction principles each offer practical lessons for AV testing. The review points out how the eventual deployment of AV technology could have a substantial impact on public health. In this regard, inclusive testing, public education and smart policy could extend the social value of AVs by improving access to mobility and by directing deployments towards scenarios with the greatest population health impact. The application of these strategies does not imply slowing down progress; rather, their implementation could accelerate adoption and result in realising the benefits of AVs more quickly and comprehensively while minimising risks.
Predictability and inconsistencies of cognitive outcome in patients with phenylketonuria and personalised therapy: the challenge for the future guidelines
Authors: Leuzzi Vincenzo , Chiarotti Flavia , Nardecchia Francesca , van Vliet Danique , van Spronsen Francjan J
Published: September 2019

Phenylketonuria (PKU) is a prototypical model of a neurodevelopmental metabolic disease that follows a cascade of pathological events affecting brain maturation and functioning. Neonatal screening and early treatment have eradicated the classical PKU phenotype in patients with early and continuously treated phenylketonuria (ECTPKU). However, effort is required to optimise the treatment of the disease to minimise the risk of lifelong neurological, cognitive and behavioural impairment, and to solve issues on the variability in clinical outcome that are rather not understood and has yet hampered a more personalised approach to its treatment. The aim of the present review is to focus on the inconsistencies in the clinical outcome of adult patients with ECTPKU unexplained by the biochemical markers adopted for the monitoring of the disease to date. The interindividual variability of clinical outcome in late as well as in early treated patients under similar biochemical control suggests the existence of disease-independent determinants influencing the individual vulnerability to the neurotoxic effect of phenylalanine. This is further supported by the low predictive power of blood phenylalanine on the clinical outcome from the second decade of life onwards. In conclusion, individual vulnerability to the metabolic alterations of PKU contributes to the prognosis of PKU, also in patients with ECTPKU. The biological factors constitutive of this vulnerability are unknown (but have not been the object of many studies so far) and should be the target of further research as prerequisite for a personalised treatment aimed at avoiding burden and costs of overtreatment and clinical consequences and risks of undertreatment in patients with PKU.
Objectives and outcomes of clinical ethics services: a Delphi study
Authors: McClimans Leah , Pressgrove Geah , Campbell Emmaling
Published: September 2019

Objectives

To explore the objectives and outcomes most appropriate for evaluating clinical ethics support services (CESs) in the USA.

Methods

A three-round e-Delphi was sent to two professional medical ethics listservs (Medical College of Wisconsin-Bioethics and American Society for Bioethics and Humanities) as well as 19 individual experts. The survey originally contained 15 objectives and 9 outcomes. In round 1, participants were asked to validate the content of these lists. In round 2, we had 17 objectives and 10 outcomes, and participants were asked to rank them for appropriateness in a top 10 list of objectives and a top 5 list of outcomes.

Results

Participants came to a high(at least 70%) level of agreement on seven objectives: mediate, educate, develop policy, improve the moral quality of a decision or action, counsel, create a moral space and manage moral distress. Participants came to a moderate (at least 51%) level of agreement on three objectives: empower, awareness of ethics and preventative ethics. Participants also came to a moderate (at least 51%) level of agreement on five outcomes: ethical justification, transformation of institution, improvement of quality of life, principled consensus and satisfaction with the expertise of a CES.

Conclusion

This e-Delphi identified 10 objectives and 5 outcomes that are a good starting point for developing outcome measures to evaluate CESs in the USA, while reminding us of the diversity of perspectives still evident in the field.
Ulysses Contracts in psychiatric care: helping patients to protect themselves from spiralling
Authors: Standing Harriet , Lawlor Rob
Published: September 2019

This paper presents four arguments in favour of respecting Ulysses Contracts in the case of individuals who suffer with severe chronic episodic mental illnesses, and who have experienced spiralling and relapse before. First, competence comes in degrees. As such, even if a person meets the usual standard for competence at the point when they wish to refuse treatment (time 2), they may still belesscompetent than they were when they signed the Ulysses Contract (time 1). As such, even if competent at time 1andtime 2, there can still be a disparity between thelevelsof competence at each time. Second, Ulysses Contracts are important to protect people’smost meaningfulconcerns. Third, on the approach defended, the restrictions to people’s liberty would be temporary, and would be consistent with soft paternalism, rather than hard paternalism: the contracts would be designed in such a way that individuals would be free to change their minds, and to change or cancel their Ulysses Contracts later. Finally, even if one rejects the equivalence thesis (the claim that allowing harm is as bad as doing harm), this is still consistent with the claim that, inparticular cases, it can be as wrong toallowa harm as to do a harm. Nevertheless, controversies remain. This paper also highlights several safeguards to minimise risks. Ultimately, we argue that people who are vulnerable to spiralling deserve a way to protect their autonomy as far as possible, using Ulysses Contracts when necessary.
Field triage for endovascular stroke therapy: a population-based comparison
Authors: Jayaraman Mahesh V , Hemendinger Morgan L , Baird Grayson L , Yaghi Shadi , Cutting Shawna , Saad Ali , Siket Matt , Madsen Tracy E , Williams Ken , Rhodes Jason , Haas Richard A , Furie Karen L , McTaggart Ryan A
Published: September 2019

Background

Endovascular therapy (EVT) for stroke improves outcomes but is time sensitive.

Objective

To compare times to treatment and outcomes between patients taken to the closest primary stroke center (PSC) with those triaged in the field to a more distant comprehensive stroke center (CSC).

Methods

During the study, a portion of our region allowed field triage of patients who met severity criteria to a more distant CSC than the closest PSC. The remaining patients were transported to the closest PSC. We compared times to treatment and clinical outcomes between those two groups. Additionally, we performed a matched-pairs analysis of patients from both groups on stroke severity and distance to CSC.

Results

Over 2 years, 232 patients met inclusion criteria and were closest from the field to a PSC; 144 were taken to the closest PSC and 88 to the more distant CSC. The median additional transport time to the CSC was 7 min. Times from scene departure to alteplase and arterial puncture were faster in the direct group (50 vs 62 min; 93 vs 152 min; p<0.001 for both). Among patients who were independent before the stroke, the OR for less disability in the direct group was 1.47 (95% CI 1.13 to 1.93, p=0.003), and 2.06 (95% CI 1.10 to 3.89, p=0.01) for the matched pairs.

Conclusions

In a densely populated setting, for patients with stroke who are EVT candidates and closest to a PSC from the field, triage to a slightly more distant CSC is associated with faster time to EVT, no delay to alteplase, and less disability at 90 days.
Persistent postoperative pain after inguinal hernia repair in relation to occupational lifting and standing/walking: a 6-month follow-up study
Authors: Vad Marie Vestergaard , Frost Poul , Rosenberg Jacob , Svendsen Susanne Wulff
Published: September 2019

Objectives

This study aims to evaluate the risk of persistent postoperative pain after inguinal hernia repair in relation to occupational lifting and standing/walking.

Methods

We conducted a 6-month follow-up study that included all men with an inguinal hernia repair registered in the Danish Hernia Database from 1 January 2015 to 31 October 2016, who were born from 1 October 1949 to 1 October 1998, and who were alive, living in Denmark, and active in the labour market in the week before surgery. Members of the cohort received a questionnaire 6 months after surgery. Exposure estimates were allocated by combining self reported job titles with a job exposure matrix. Prevalence ratios of persistent postoperative pain during activity ≥2 on a numerical rating scale (range 0–10) according to occupational lifting and standing/walking were estimated using Poisson regression.

Results

Of 4817 eligible patients, 2609 (54%) returned the questionnaire and 2508 contributed to the analyses. A total of 473 men (18.9%) reported persistent postoperative pain. In the group lifting >1000 to 6125 kg/day, the prevalence was 26.8% compared with 17.5% in the minimally exposed group; adjusted prevalence ratio: 1.44 (95% CI 1.16 to 1.79). For standing/walking >6 hours/day, the prevalence was 23.6% compared with 17.0% in the group standing <4 hours/day; adjusted prevalence ratio: 1.18 (95% CI 0.92 to 1.50).

Conclusions

The risk of persistent postoperative pain after inguinal hernia repair was elevated among men with occupational lifting exposures >1000 kg/day. This finding suggests a preventive potential.
Personalising secondary prevention: different treatments for different strokes
Authors: Markus Hugh
Published: September 2019

Stroke is a syndrome caused by many different disease mechanisms rather than being a single disease. It is important to identify the underlying mechanism accurately in individual patients in order to choose the best treatment approach. This article provides practical tips to diagnose the underlying subtype of stroke, and in particular discusses non-lacunar pathologies that can present with a clinical lacunar syndrome. It also reviews the recent advances in recurrent stroke prevention, including using more intensive antiplatelet regimens in the acute phase, and the concept that undetected cardiac arrhythmias may be important in apparently cryptogenic stroke.
Understanding why some Australian retailers have stopped selling tobacco, some might and some are unlikely
Authors: Watts Christina , Burton Suzan , Phillips Fiona , Kennington Kelly , Scollo Michelle , Lindorff Kylie , Egger Sam
Published: September 2019

Background

Widespread availability of tobacco has been shown to contribute to ongoing smoking and make quitting harder. This study investigates why some retailers in three Australian states decided to stop selling tobacco, others might stop selling and why others continue to sell in a declining market.

Methods

A telephone survey of 4527 randomly selected retailers was conducted in August 2018 (response rate=72.4%). This study examines responses to open-ended questions in the survey probing retailers’ attitudes and beliefs regarding selling (or not selling) tobacco.

Results

27.3% of the sample sold tobacco, and 13.3% had formerly sold. Outlets that had stopped selling most frequently mentioned minimal profit and/or sales as the reason for stopping selling (27.7% across all states). This was also the most frequent reason why retailers said they might stop selling. Uniquely in Western Australia (the only state in the study with a fee-based licensing scheme), 12.5% of former tobacco retailers named tobacco licensing as the reason for stopping sales—the second most frequent reason in Western Australia. Of current sellers who were unlikely to stop, the potential to lose sales was the most frequently named reason (31.0% across all states).

Conclusion

Retailers report being driven by the profitability of tobacco when deciding whether or not to stop selling, although only a small percentage discussed losing incremental sales if they stopped selling. An annual licence fee contributed to some retailers stopping selling, showing that a fee-based tobacco license can contribute to a decline in retail availability of tobacco.
Sheep pestivirus in Morocco: sero‐epidemiological and molecular study
Authors: Fassi Fihri Ouafaa , Jammar Noâma , Amrani Nadia , El Berbri Ikhlass , Alali Said
Published: September 2019

The present study is the first to investigate Border disease caused by the sheep pestivirus (SPV) in sheep herds in Morocco. Sero‐epidemiological investigations were carried out in six regions of the Kingdom, known as important in terms of sheep breeding. A total of 760 blood samples were collected including aborted ewes from 28 randomly selected farms. The samples were analysed, for the determination of anti‐pestivirus antibodies, using indirect ELISA technique. Next, reverse transcriptase PCR (RT‐PCR) was conducted on serologically negative samples to identify possible persistently infected (PI) animals, through detection of specific RNA fragment. The results revealed an overall SPV seroprevalence in studied areas of 28.9%. The difference in seroprevalence between the six investigated regions was not statistically significant (p>0.05) and varied slightly from 20.9% to 37.5%. Furthermore, 93% of investigated farms were affected with an average seroprevalence of 22.7% (with a variation of 1%–74%). RT‐PCR results were all negative, indicating the absence of PI animals in the tested samples. Nevertheless, the present study revealed that SPV is endemic in Morocco.
Effect of ground improvement on the lateral resistance of closed-end steel pipe piles in a coal ash pond
Authors: Cheng Shih-Hao , Liao Hung-Jiun , Chang Der-Wen , Quo Lih-Wen
Published: September 2019

This study assessed the effect of configuration of the ground-improved body to improve the lateral resistance of piles driven into a coal ash pond. Nine closed-end steel pipe piles were studied by lateral load tests in the investigation, which included four test piles and five reaction piles. While TP1 pile was carried out without the reinforcement, TP2, TP3, and TP4 piles were tested with various reinforcements, including grid-type, block-type, and cross-type. The lateral load test results showed that the ultimate lateral loading capacity, pile-head stiffness, and soil resistance of the reinforced piles compared with TP1 pile were increased by 26%–39%, 54%–238%, and 33%–128%, respectively. Conversely, the maximum bending moments of the reinforced piles were reduced by 48%–73%, respectively. Soil-mixing wall reinforcement was found to increase effectively the lateral resistance of the closed-end steel pipe piles in a coal ash pond. However, because a variety of ground-improved body configurations can increase the lateral resistance of piles, the choice of the type of reinforcement must be considered for reliable design, construction feasibility, and economic benefits of engineering practice.
A new mixed-integer programming model for spatial forest planning
Authors: Gharbi Chourouk , Rönnqvist Mikael , Beaudoin Daniel , Carle Marc-André
Published: September 2019

The unit restriction model and the area restriction model are the two main approaches to dealing with adjacency in forest harvest planning. In this paper, we present a new mixed-integer programming (MIP) formulation that can be classified as both a unit restriction approach and an area restriction approach. We need to generate a feasible cluster to formulate the model. However, unlike other approaches, there is no need to generate specific model constraints representing computationally burdensome clusters for large cases. We describe and analyze our approach by comparing it with the most efficient approaches presented in the literature. Comparisons are made from modeling and computational points of view. Results showed that the proposed model was competitive with regard to modeling complexity and size of formulation. Furthermore, it is easy to implement in standard modeling software.