bluuebunny/crossref_metadata_2025 huggingface dataset:
Technology adoption and company performance
Authors: Sawng Yeong-Wha , Park Yongjae , Jo Seok-Hong , Park Seung-Lak
Published: June 2018

Purpose

The purpose of this paper is to provide useful implications for Korean export companies to adopt the smart technology to improve their performance in the era of industrial convergence with the interdisciplinary study between trade and technology management.

Design/methodology/approach

This study followed the five-stage procedure and methods. In the first stage, measurement items were developed in four performance factors: leaning and growth, internal process, customer and finance. In the second stage, data were collected by conducting two types of surveys: first, for Korean export companies that have adopted Radio frequency identification (RFID) to test the proposed model and analyze the performance and second, for RFID experts of industry-university R&D cooperation to measure the relative importance of factors and items. In the third stage, the model was verified with structural equation modeling. In the fourth stage, AHP was used to analyze the relative importance of factors and items. In the fifth stage, post-RFID adoption performance in Korean export companies was measured by a formula for the performance index. Through these five-stage procedure and methods, the final performance improvement strategies and practical implications are presented in the conclusion.

Findings

The framework finds that the total score of RFID post-adoption on company performance proved relatively low, which indicates that the effect of this technology on export companies’ performance is still unsatisfactory. And financial performance proved to be ‘top priority’ area, which requires the most urgent effort for improvement since its importance was higher than learning and growth, internal process and customer performance—but nonetheless its performance index was the lowest. This study finds that strategic decision making is required for adopting smart technology in the perspective of technology convergence to improve the performance of companies among heterogeneous industries.

Research limitations/implications

Despite the significant results of this study alone, it also has limitations. Therefore, the direction of the future study is as follows: future research should focus on finding specific impact factors enhancing post-adoption of smart technologies including RFID performance by conducting empirical studies that identify the factors affecting post adoption of smart technologies rate directly or indirectly.

Originality/value

In the current global market environment, not only technological convergence in the same kind of industry but also industrial convergence in the different kinds of industries are essential to manufacturing and service companies including to export companies with perspective of Innovation. This study has the value as an interdisciplinary study to actually measure the performance of a company by industrial convergence through the theme of adoption of smart technology in export companies.
The Siberian Trakt – a project that forms a tourism network
Authors: Ryzhenko Leonid I. , Sheresheva Marina Y.
Published: June 2018

Purpose

This paper aims to explain the development of the Siberian Trakt (Siberian Way) project and discuss methodological, instrumental and technological questions related to its implementation. The paper also aims to explore the project’s ability to form a collaborative tourism network that boosts tourism development in the unique Siberian regions of Russia located in the very center of the Eurasian continent.

Design/methodology/approach

A multidisciplinary view and case approach are the basic methods chosen to illustrate and analyze the prospects for tourist network development in Siberia within the framework of the Siberian Trakt project.

Findings

The findings reveal the opportunities arising from the project. The Siberian Trakt helps to combine the resources of surrounding territories, brings over external resources to the investment foundations of the project and thus adds to the development of settlements that are participants in the project.

Originality/value

The main output of this paper is confirmation of useful approaches in tourism network development along the Siberian Trakt, which historically connected Central Russia with Siberia and the Far East. On the basis of the experience of the Siberian Trakt project, the problems and prospects of Siberia as new tourism destinations are shown, as well as the role of small settlements as important nodes of the regional tourism network.
Me first, then the environment: young Millennials as green consumers
Authors: Naderi Iman , Van Steenburg Eric
Published: June 2018

Purpose

This research aims to shed greater light on millennials’ green behavior by examining four psychographic variables (selfless altruism, frugality, risk aversion, and time orientation) that may be relevant to millennials’ motives to engage in environmental activities.

Design/methodology/approach

Data were collected from a sample of younger millennials (n= 276; age = 18 to 30) using a self-administered questionnaire. The data were then analyzed using structural equation modeling (SEM) technique.

Findings

Overall, the results of the study reveal that rational and self-oriented rather than emotional and others-oriented motives lead millennials to act pro-environmentally.

Practical implications

The findings of this study have implications for environmental advocates, policymakers and green marketers. For instance, the findings suggest that environmental regulators and lawmakers should continue their efforts to provide economic incentives to encourage pro-environmental purchases among millennials. Additionally, marketers of green products may pursue self-directed targeting strategies in promoting green products among millennials.

Originality/value

Millennials grasp the environmental consequences of their actions and have the education, motivation and social awareness to participate in the green movement. However, they have not truly begun to fully integrate their beliefs and actions. The present study is an initial attempt to address this issue by investigating various psychological factors that are relevant to the millennials’ core behavioral motives.
Applying television ratings to advertising: Are parents informed?
Authors: Miller Caitlyn A. , Albers-Miller Nancy D. , Knotts Tami L.
Published: June 2018

Purpose

Both television and movie rating systems are used to inform parents, caregivers and prospective viewers about the content which will appear in a program. While rating systems are fallible, they do provide information prior to viewing. Unfortunately, television advertisements are not rated. Can a parent or caregiver feel confident that a child restricted to a particular level of viewing content will avoid being exposed to advertising content which exceeds the program rating? The purpose of this paper is to explore the content of advertisements relative to an established rating system.

Design/methodology/approach

Advertisements were assigned ratings based on the TV rating criteria. Comparisons between advertisement ratings and program ratings are provided. Additionally, advertisements are examined for unrated mature themes.

Findings

More than half of the advertisements analyzed across all program ratings were deemed appropriate for all audiences. However, it was discovered that advertisement content exceeded the content rating of the program during which it aired over 20 per cent of the time.

Originality/value

The findings show that the content of about one in every five television advertisements will have content that exceeds the content rating of the program in which the advertisement appears. This has the potential to undermine parental or caregiver restrictions on a child’s viewing content.
Acute electrophysiologic effects of the polyphenols resveratrol and piceatannol in rabbit atria
Authors: Frommeyer Gerrit , Wolfes Julian , Ellermann Christian , Kochhäuser Simon , Dechering Dirk G. , Eckardt Lars
Published: June 2018

The natural polyphenol resveratrol and its analogue piceatannol have various beneficial effects including antiarrhythmic properties. The aim of the present study was to examine potential electrophysiologic effects in an experimental whole‐heart model of atrial fibrillation (AF). Simultaneous infusion of resveratrol (50 μmol/L) or piceatannol (10 μmol/L) in rabbit hearts resulted in an increase in atrial refractory period. Both agents induced a significant slowing of atrial conduction and of intrinsic heart rate. In both groups, a trend toward a reduction in AF and a regularization of AF was observed.
‘Saying no to organ donation’: an empirical typology of reluctance and rejection
Authors: Pfaller Larissa , Hansen Solveig L. , Adloff Frank , Schicktanz Silke
Published: June 2018

In Germany, as well as in other countries, organ shortages are usually explained by a relative unwillingness to donate among a population which is assumed to be caused by a lack of information and mistrust of the system. As we can see in the data of our qualitative research (focus groups and interviews), lack of information or mistrust are not the only reasons for people to be reluctant to agree to the donation of their organs after death. In fact we can identify four positions: (1) information deficit; (2) mistrust; (3) no killing; and (4) bodily integrity. The first and second are the two prominent explanations in the public discourse about low donation rates. The third and the fourth instead have neither been adequately articulated nor been discussed as a proper argument. Therefore, by means of sociology of critique, we discuss their contribution to the discourse as comprehensible reasons for reluctance and present them as credible positions of criticism: These two positions illuminate fundamental and universal values of the inviolability of the person and human dignity. Thus, both positions are consistent and morally justifiable and should be addressed with sensitivity.
The enduring legacy of black lung: environmental health and contested illness in Appalachia
Authors: Shriver Thomas E. , Bodenhamer Aysha
Published: June 2018

Over the past twenty years there has been a deadly resurgence of coal workers’ pneumoconiosis (CWP), commonly known as black lung disease. While increased prevalence of the disease is alarming, these data only capture cases where CWP has been officially recognised. We argue that many more cases of the disease are going unreported. Drawing from contested environmental illness literature, we examine issues surrounding diagnostic uncertainty and medical surveillance. We draw from qualitative data on black lung that includes in‐depth interviews, observation and document analysis. Findings indicate ongoing ambiguity and contestation over diagnosis of the disease, ranging from clinical and legal debates to concerted efforts to limit official recognition. While health screenings are currently available to miners, our results indicate low participation rates based on disincentives for early detection, logistical problems, and economic fears. Miners fear workplace discrimination and retaliation for participation in black lung screening programmes. Implications for public health policy and future research are discussed.
‘Who does this patient belong to?’ boundary work and the re/making of (NSTEMI) heart attack patients
Authors: Cramer Helen , Hughes Jacki , Johnson Rachel , Evans Maggie , Deaton Christi , Timmis Adam , Hemingway Harry , Feder Gene , Featherstone Katie
Published: June 2018

This ethnography within ten English and Welsh hospitals explores the significance of boundary work and the impacts of this work on the quality of care experienced by heart attack patients who have suspected non‐STsegment elevation myocardial infarction (NSTEMI) /non‐STelevation acute coronary syndrome. Beginning with the initial identification and prioritisation of patients, boundary work informed negotiations over responsibility for patients, their transfer and admission to different wards, and their access to specific domains in order to receive diagnostic tests and treatment. In order to navigate boundaries successfully and for their clinical needs to be more easily recognised by staff, a patient needed to become a stable boundary object. Ongoing uncertainty in fixing their clinical classification, was a key reason why manyNSTEMIpatients faltered as boundary objects. ViewingNSTEMIpatients as boundary objects helps to articulate the critical and ongoing process of classification and categorisation in the creation and maintenance of boundary objects. We show the essential, but hidden, role of boundary actors in making and re‐making patients into boundary objects. Physical location was critical and the parallel processes of exclusion and restriction of boundary object status can lead to marginalisation of some patients and inequalities of care (A virtual abstract of this paper can be viewed at:https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA).
Visual representations and verbal schemas: a case study of one student with high‐functioning autism
Authors: Buncher Amanda , Hord Casey , Weaver Kitiara , Gamel Zachary
Published: June 2018

The researchers conducted an exploratory, qualitative case study to describe a combination of mathematics teaching strategies for a sixth‐grade student with high‐functioning autism spectrum disorder as he engaged with sixth‐grade level mathematics. The interventions utilised in this study combined the use of visual representations with a variation in schema‐based strategy instruction in which the schemas were presented verbally rather than visually. Doug tended to benefit from visual representations (e.g., gestures, manipulatives and mathematical notation on paper), and he was also quick to engage in mathematical conversations: yet, he often needed some support during these conversations to organise his thinking processes. The tutor was often able to supplement her conversations with Doug about mathematics with visual representations while using verbal schemas to help Doug productively structure his thinking processes.
The Effects of Nursing Satisfaction and Turnover Cognitions on Patient Attitudes and Outcomes: A Three‐Level Multisource Study
Authors: Perry Sara Jansen , Richter Jason P. , Beauvais Brad
Published: June 2018

Objective

To explore antecedents and outcomes of nurse self‐reported job satisfaction and dissatisfaction‐based turnover cognitions, theorizing (using Self‐Determination Theory) that leaders can foster work conditions that help fulfill innate needs, thereby fostering satisfaction of nurses and patients, and reducing adverse events.

Data Sources/Study Setting

Primary and secondary data were collected within a 4‐month period in 2015, from 2,596 nurses in 110 Army treatment facilities (hospitals and clinics) across 35 health care systems.

Data Collection/Extraction

We collected individual nurse responses to the Practice Environment Scale‐Nursing Work Index, in addition to aggregated archival data from the same timeframe, including both facility‐level patient satisfaction records (the Army Provider Level Satisfaction Survey) and health care system‐level adverse events records (provided by the Army Programming, Analysis, and Evaluation office).

Principal Findings

Five predictors of nurse satisfaction and turnover cognitions emerged—supportive leadership, staffing levels, nurse–physician teamwork, adoption of nursing care practice, and advancement opportunities. Aggregated nurse satisfaction was the most consistent predictor of both patient satisfaction and adverse events.

Conclusion

These findings provide evidence of the importance of nurse attitudes in improving perceived and actual performance across facilities and health care systems; in addition to practical steps, managers can take to improve satisfaction and retention.
Macrophages are a source of IL‐17 in the human placenta
Authors: Pavlov Oleg , Selutin Aleksandr , Pavlova Oksana , Selkov Sergei
Published: June 2018

Problem

To determine if placental macrophages (Hofbauer cells) can synthesize and secrete cytokines of the IL‐17 family throughout pregnancy and to reveal the patterns of cytokine expression in early and late gestation.

Methods of study

Macrophages were isolated from the first‐trimester and term placental villous tissues from normal pregnancies. Basal and stimulated intracellular production of IL‐17A, IL‐17E, IL‐17F as well as IL‐17A secretion was quantified by flow cytometry and cytometric bead array, respectively. The expression of IL‐17 and IL‐23 receptors was determined on the surface of the placental macrophages by flow cytometry after antibody staining.

Results

In early and late gestation, a substantial proportion of the placental macrophages synthesized IL‐17A and IL‐17F, but not IL‐17E, as determined by intracellular staining of the cytokines. Neither the intracellular production nor the secretion of IL‐17 was significantly affected by LPS stimulation and spontaneous labour. The level of secretion decreased slightly but significantly at term. The IL‐23 receptor was absent on the surface of cells, whereas variable expression of the IL‐17 receptor was observed.

Conclusion

Placental macrophages constitutively produced IL‐17 at different gestational ages and represent thus a source of this cytokine in the human placenta. Patterns of the cytokine and receptor expression suggest that this cell population may participate in non‐immune processes and contribute to the regulation of placental development and function.
A comparison of two techniques for induction of anaesthesia with target‐controlled infusion of propofol
Authors: Mu J. J. , Jiang T. , Deng L. P. , Choi S. W. , Irwin M. G. , Yuen V. M.
Published: June 2018

Induction of anaesthesia with target‐controlled infusion of propofol may be achieved by stepwise increases in effect‐site concentration until the patient loses consciousness (titration method), or by setting a high effect‐site concentration target and observing the calculated effect‐site concentration at loss of consciousness (standard method). When the estimated effect‐site concentration at loss of consciousness is accurate, the difference between effect‐site concentration at loss of consciousness and at recovery of consciousness should be small. This prospective, randomised, controlled trial was designed to compare this difference (effect‐site concentration at loss of consciousness – effect‐site concentration at recovery of consciousness) associated with the two techniques. Sixty‐seven healthy patients undergoing elective hemithyroidectomy were recruited. Induction of anaesthesia was achieved using effect‐site target‐controlled infusion with the modified Marsh model and ke0 of 1.2 min−1. The median (IQR [range]) difference between effect‐site concentration at loss of consciousness and recovery of consciousness was significantly lower in patients in the titration group at 1.2 (0.8–1.5 [0.1–2.9]) μg.ml−1 compared with the standard group 2.1 (1.9–2.6 [0.2–3.6] μg.ml−1; p < 0.0001). There was a positive correlation between effect‐site concentration at loss of, and recovery of, consciousness (R = 0.41, p = 0.016) in the titration group, which was not seen in the standard group (R = −0.15, p = 0.44). In conclusion, using the modified Marsh pharmacokinetic model, the titration method for target‐controlled infusion propofol at induction of anaesthesia allows closer matching of propofol concentration to depth of anaesthesia than the standard method.
Milk compositional changes of Laoshan goat milk from partum up to 261 days postpartum
Authors: Chen Di , Zhao Xuan , Li Xiangying , Wang Jianmin , Wang Cunfang
Published: June 2018

Despite the global increasing demand for goat milk, no data exist on the nutrient potential of Laoshan goat milk and limited information exists on its composition according to lactation period. In this study, the measured indicators, including dry matter, protein, immunoglobulin, lactoferrin, fat, ash, lactose, calcium, titratable acidity and pH from partum to 261 days postpartum of Laoshan goat milk, followed the same law of change. There was a significant difference over the first 5 days postpartum, after which no significant difference was observed until days 225 postpartum. However, days 255 postpartum was like a turning point, after which their values showed either an increasing or decreasing trend. We concluded that the colostrum for Laoshan dairy goat was considered from days 1 to 5 postpartum and after 5 days it was as transitioned to milk when all measured parameters were according to the normal ranges as described in this study. This work provided updated information on the current nutritive characteristics of Laoshan goat milk, which may be of importance in the fields of milk production, food technology, and nutritional mutual replenishment.
Can doctors identify older patients at risk of medication harm following hospital discharge? A multicentre prospective study in the UK
Authors: Parekh Nikesh , Stevenson Jennifer M. , Schiff Rebekah , Graham Davies J. , Bremner Stephen , Van der Cammen Tischa , Harchowal Jatinder , Rajkumar Chakravarthi , Ali Khalid ,   on behalf of the PRIME study group
Published: June 2018

Aims

Medication‐related harm (MRH) is common in older adults following hospital discharge. In resource‐limited health systems, interventions to reduce this risk can be targeted at high‐risk patients. This study aims to determine whether (1) doctors can predict which older patients will experience MRH requiring healthcare following hospital discharge, (2) clinical experience and confidence in prediction influence the accuracy of the prediction.

Methods

This was a multicentre observational prospective study involving five teaching hospitals in England between September 2013 and November 2015. Doctors discharging patients (aged ≥65 years) from medical wards predicted the likelihood of their patient experiencing MRH requiring healthcare (hospital readmission or community healthcare) in the initial 8‐week period post‐discharge. Patients were followed up by senior pharmacists to determine MRH occurrence.

Results

Data of 1066 patients (83%) with completed predictions and follow‐up, out of 1280 recruited patients, were analysed. Patients had a median age of 82 years (65–103 years), and 58% were female. Most predictions (85%) were made by junior doctors with less than 5 years' clinical experience. There was no relationship between doctors' predictions and patient MRH (OR 1.10, 95% CI 0.82–1.46, P = 0.53), irrespective of years of clinical experience. Doctors' predictions were more likely to be accurate when they reported higher confidence in their prediction, especially in predicting MRH‐associated hospital readmissions (OR 1.58, 95% CI 1.42–1.76, P < 0.001).

Conclusions

Clinical judgement of doctors is not a reliable tool to predict MRH in older adults post‐discharge.
Sex differences in brain structure among adolescents with bipolar disorder
Authors: Mitchell Rachel HB , Metcalfe Arron WS , Islam Alvi H , Toma Simina , Patel Ronak , Fiksenbaum Lisa , Korczak Daphne , MacIntosh Bradley J , Goldstein Benjamin I
Published: June 2018

Objectives

Bipolar disorder (BD) is twice as prevalent amongst female as amongst male adolescents. Thus far, little is known regarding the neurostructural substrates underlying this disparity. We therefore examined sex differences in neurostructural magnetic resonane imaging (MRI) phenotypes amongst adolescents with BD.

Methods

T1‐weighted structural MRI was acquired from 44 BD (25 female [F] and 19 male [M]) and 58 (28 F and 30 M) healthy control (HC) adolescents (13‐21 years old). Whole‐brain and region‐of‐interest (ROI) analyses examined structural volume and cortical thickness using FreeSurfer. ROIs included the ventrolateral prefrontal cortex (vlPFC), anterior cingulate cortex (ACC), amygdala and hippocampus. General linear models evaluated sex‐by‐diagnosis interactions, controlling for age and intracranial volume.

Results

Whole‐brain analysis revealed sex‐by‐diagnosis interactions in the left supramarginal gyrus (SMG) (P = .02, η2 = 0.02) and right inferior parietal lobule (IPL) volumes (P = .04, η2 = 0.01). Sex differences in HCs were found in the SMG (M > F) and IPL (F > M). In BD, sex differences were reversed and of smaller magnitude in the SMG (M < F) and of greater magnitude in the IPL (F > M), driven by trends towards smaller SMG and IPL in BD vs HC male participants (P = .05 and .14). Whole‐brain analyses for cortical thickness, and ROI analyses for volume and cortical thickness, were not significant.

Conclusions

Normative sex differences may be disrupted in adolescent BD in the SMG and IPL, heteromodal association network hubs responsible for higher order integration of cognitive and emotional processing. Unexpectedly, these findings may inform our understanding of aberrant brain structure in adolescent BD male patients, rather than female patients. Future work should focus on replication, as well as the impact of puberty status and sex hormones on measures of brain structure and function.
The USP8 mutational status may predict long‐term remission in patients with Cushing's disease
Authors: Albani Adriana , Pérez‐Rivas Luis G. , Dimopoulou Christina , Zopp Stephanie , Colón‐Bolea Paula , Roeber Sigrun , Honegger Jürgen , Flitsch Jörg , Rachinger Walter , Buchfelder Michael , Stalla Günter K. , Herms Jochen , Reincke Martin , Theodoropoulou Marily
Published: June 2018

Objective

Almost half of the cases of Cushing's disease (CD) tumours carry recurrent activating somatic mutations in the ubiquitin‐specific protease eight gene (USP8). The USP8 mutational status could predict remission in patients with CD, so our objective was to correlate the presence of somatic USP8 mutations with the rate of recurrence after transsphenoidal surgery (TSS) retrospectively.

Design

Biochemical, radiological and clinical data were retrospectively assessed in 48 patients. USP8 mutational status was determined from corticotroph tumour samples. Association between USP8 mutational status, remission and recurrence was investigated.

Patients

Patients with Cushing's disease from a single‐centre cohort who underwent TSS between 1991 and 2012.

Measurements

Long‐term remission and recurrence rate after TSS with at least 6 months follow‐up. Biochemical, radiological and clinical data, including sex, age at diagnosis, tumour size and pre‐operative hormonal levels. USP8 mutational status.

Results

Patients with USP8 mutant corticotroph tumours (18 of 48; 37%) were diagnosed significantly earlier (mean ± SD 46 ± 10 years vs 53 ± 11 years; P = 0.028) and presented with higher pre‐operative 24‐hour urinary‐free cortisol levels (median IQR μg/24 hours 1174.0, 1184.5 vs 480.0, 405.3; P = 0.045). The incidence of recurrence in a 10‐year follow‐up was significantly higher in patients with USP8 mutant tumours after the initial remission (58% vs 18% P = 0.026). Recurrence appeared significantly earlier in these patients (months 70, 44‐97 95% CI vs 102, 86‐119 95% CI; P = 0.019).

Conclusion

Recurrence appears to be more frequent and earlier after TSS in patients with USP8 mutant corticotroph tumours.
Survivorship care for early‐stage colorectal cancer: a national survey of general surgeons and colorectal surgeons
Authors: Choi Y. , Huntley J. H. , Efron J. E. , Sato K. , Marohn M. R. , Pollack C. E.
Published: June 2018

Aim

Few data are available on the optimal long‐term care of early‐stage colorectal cancer survivors, termed survivorship care. We aimed to investigate current practice in the management of patients following treatment for early‐stage colorectal cancer.

Method

We performed an internet survey of members of the American Society for Colon and Rectal Surgeons about several aspects of long‐term care, including allocation of clinician responsibility, challenges with transitions to primary care physicians (PCPs), long‐term care plan provision and recommended surgical follow‐up duration.

Results

Overall, 251 surgeons responded. Surgeons reported taking primary responsibility for managing adverse surgical effects (93.2%) and surveillance testing (imaging and laboratories 68.6%, endoscopy 82.4%). Barriers to PCP handoffs included patient preference for surgical follow‐up (endorsed by 76.6%) and inadequate communication with PCPs (endorsed by 36.9%). Approximately one‐third of surgeons routinely provide survivorship care plans to PCPs; surgeons who received formal survivorship training were more likely to do so compared to those without such training (OR 3.29, 95% CI 1.57, 6.92). Although only 20.4% of surgeons follow their patients beyond 5 years, individuals in practice longer were more likely to continue long‐term follow‐up than those with ≤ 10 years of experience.

Conclusions

This is the largest survey of surgeons regarding long‐term management for early‐stage colorectal cancer and highlights the potential for improved coordination with PCPs and increased implementation of survivorship care plans.
Reliability of arterial stiffness indices at rest and following a single bout of moderate‐intensity exercise in older adults
Authors: Perissiou Maria , Bailey Tom G. , Windsor Mark , Leicht Anthony S. , Golledge Jonathan , Askew Christopher D.
Published: June 2018

Short‐term changes in arterial stiffness with exercise are proposed to better reflect vascular impairments than resting measures alone and are suggested as a prognostic indicator of cardiovascular risk in older adults. Arterial stiffness indices are reliable at rest, but the time‐course and reliability of postexercise changes in arterial stiffness in older adults are unknown. The precision of postexercise changes in arterial stiffness should be determined prior to their use in large prospective trials. This study assessed the between‐day reliability of the changes in pulse wave velocity (PWV), augmentation index (AIx75) and reflection magnitude (RM) following an exercise bout in older adults. Ten older adults (71 ± 5 years) were tested on three separate days, 7 days apart. PWV, AIx75 and RM were assessed at rest, immediately post and at 20, 40 and 60 min during recovery after moderate‐intensity cycling. Intraclass correlation coefficient (ICC) and reliability coefficient (RC) were used to assess the relative and absolute reliability of arterial stiffness responses. PWV increased, and RM decreased immediately after exercise (P<0·05), and returned to baseline during recovery. AIx decreased during recovery (P<0·001). Resting ICC values were 0·91 (PWV), 0·72 (AIx75) and 0·40 (RM). Reliability of the immediate changes following exercise was high for PWV (ICC:0·87, RC:1·9 m s−1) and moderate for AIx75 (ICC:0·64, RC:7%) and RM (ICC:0·59, RC:9%). Reliability of the postexercise responses was similar to that at rest for all measures of arterial stiffness. These findings indicate that postexercise changes in arterial stiffness indices are reliable in healthy older adults and supports further investigation of the prognostic value of these responses.
Arterial stiffness is associated with visceral fat mass in kidney transplanted patients—A nationwide cohort study
Authors: von Düring Marit Elizabeth , Jenssen Trond , Bollerslev Jens , Godang Kristin , Hartmann Anders , Åsberg Anders
Published: June 2018

Arterial stiffness, visceral fat, and hyperglycemia are acknowledged risk factors for adverse outcomes after transplantation, but whether arterial stiffness is associated with visceral adipose tissue and hyperglycemia is unknown. We studied 162 non‐diabetic kidney transplant recipients 8‐10 weeks after transplantation. Arterial stiffness was measured as pulse wave velocity (PWV) by SphygmoCor and visceral fat using a validated software applied on DXA scans. Also a standard oral glucose tolerance test was performed. Median PWV was 8.6 m/s (IQR 7.3‐10.4 m/s). Patients in the upper quartile of PWV had 31%‐106% higher visceral fat percentage (P < 0.001), they were older (P < 0.001) and had a fasting plasma glucose of 5.8 mmol/L that was higher than in the other quartiles (P = 0.006). In univariate analysis, visceral fat percentage and age were the parameters strongest associated with PWV (P < 0.001), but cholesterol and glucose were also significant (P < 0.05). In multivariate analysis, visceral fat was the only significant predictor of PWV along with age (P < 0.001). In conclusion, arterial stiffness is significantly associated with visceral fat but not hyperglycemia in non‐diabetic kidney transplant patients. We identified age and VAT as risk variables for arterial stiffness. A potential reversibility of arterial wall stiffness with reduction in VAT needs further study.
Giant aneurysmal benign fibrous histiocytoma (dermatofibroma)
Authors: Liu Stephanie , Lozeau Daniel
Published: June 2018

Aneurysmal benign fibrous histiocytomas are variants of dermatofibromas. These benign blood‐filled lesions can mimic malignancies due to their rapid and recurrent growth. Our patient is a 42‐year‐old Caucasian female with a past medical history of morbid obesity, diabetes, and hypertension, who presented with a mass on her left shoulder for 5 years’ duration. The mass oozed occasionally and would appear to regress but then recur replaced with progressively larger masses. Upon inspection, the patient had a large pedunculated exophytic mass with vascularity. The mass was surgically removed under general anesthesia via wide local excision. Grossly, the excised skin was purple‐tinged with an underlying fungating solid mass measuring 8.5 cm. Serial sections revealed a hemorrhagic, spongy, and granular cut surface. Histologically, the epidermis was hyperplastic, with underlying hyaline collagen bundles. The remainder of the mass was chronically inflamed and composed of spindled histiocytes, hemosiderin‐laden macrophages, and blood‐filled spaces lacking an endothelial lining. There was focal pleomorphism but no significant atypia. Immunohistochemical stains were strongly positive for vimentin and negative for CD31, CD34, and desmin. The overall architecture and immunophenotype are consistent with the diagnosis of aneurysmal benign fibrous histiocytoma.
Evolution of research ethics in a low resource setting: A case for Uganda
Authors: Ochieng Joseph , Mwaka Erisa , Kwagala Betty , Sewankambo Nelson
Published: June 2018

Background

The globalization of clinical research in the last two decades has led to a significant increase in the volume of clinical research in developing countries. As of 2016, Uganda was the third largest destination for clinical trials in Africa. This requires adequate capacity and systems to facilitate ethical practice.

Methods

This was a retrospective study involving review of laws, guidelines, policies and records from 1896 to date.

Results

Modern medicine evolved from 1896 and by the time of Uganda's independence in 1962, a 1500 bed national referral hospital was in place and a fully‐fledged medical school was established at the Makerere University. As the practice of medicine evolved in the country, so did medical research that addressed priority health issues.

The growth in modern medicine was not matched with development of research infrastructure and regulatory systems. The first documented regulation of research activities was in 1970 while the first research ethics committee established in 1986 was to facilitate review of research related to the HIV/AIDs pandemic. In 1990 an Act of Parliament was passed to facilitate development and implementation of policies, hence the development of the national guidelines in 1997, training, establishment and accreditation of research ethics committees, conferences and research site monitoring.

Conclusion

Over the past 120 years, the implementation and structural aspects of research ethics in Uganda have evolved through 70 years of no regulation, followed by 30 years of rudimentary regulation while the last 20 years have shown significant growth in the regulatory system associated with supportive laws, institutionalization of regulatory and training processes.
Power mobility for children: a survey study of American and Canadian therapists’ perspectives and practices
Authors: Kenyon Lisa K , Jones Maria , Livingstone Roslyn , Breaux Becky , Tsotsoros Jessica , Williams Kelly M
Published: June 2018

Aim

To explore the views and practices of paediatric occupational therapists and physical therapists in Canada and theUSAregarding the implementation of power mobility for children with mobility limitations.

Method

This descriptive study utilized a web‐based survey that included questions pertaining to therapists’ decisions to trial and use power mobility, agreement or disagreement with statements developed from published practice considerations regarding power mobility, and the frequency of performing tasks related to power mobility prescription and training.

Results

Most respondents reported that child characteristics (e.g. cognition, safety awareness) were important factors in decision‐making about power mobility, whereas other child characteristics (e.g. communication abilities, age) were not as important. Family resources and home accessibility were also not considered important. The average age at which respondents considered power mobility for children was 2 years 3 months. The majority of respondents agreed with statements developed from published practice considerations and most frequently performed various power mobility tasks twice a year or less.

Interpretation

Although most respondents appeared to have positive views regarding power mobility, few appeared to actively perform power mobility tasks in their practice. Resources to support therapists in the early introduction of power mobility may be beneficial.

What this paper adds

Occupational and physical therapists positively view early introduction of power mobility for children with mobility limitations.

Few therapists actively provide early power mobility experiences.

Power mobility training and monitoring power mobility devices are important therapist roles.
Meta‐analysis evaluating resting laryngeal endoscopy as a diagnostic tool for recurrent laryngeal neuropathy in the equine athlete
Authors: Elliott S. , Cheetham J.
Published: June 2018

Background

Resting endoscopy has commonly been used as a method to predict laryngeal function at exercise.

Objectives

To perform a meta‐analysis to determine the sensitivity and specificity of resting laryngeal endoscopy to predict clinical recurrent laryngeal neuropathy at exercise.

Study design

Meta‐analysis.

Methods

Manuscripts were included if data were available for both resting and exercising airway function on all or a subset of horses. Normal resting endoscopy was defined as laryngeal grades 1 or 2 on a 4‐/7‐point scale or 1, 2 or 3 on a 5‐point scale and normal dynamic endoscopy as a dynamic laryngeal grade A.

Results

Twelve studies including 1827 horses were evaluated. A small proportion of horses with grade 1 or grade 2 laryngeal function at rest, 3.5 and 11.9%, respectively, were identified as having abnormal laryngeal function at exercise. Within the horses with grade 3 laryngeal function at rest, 16% were classified as grade A, 26.4% as grade B and 57.6% as grade C at exercise. Worsening subgrades within resting grade 3 demonstrated an increasing proportion of complete or partial paralysis at exercise. The sensitivity and specificity of resting endoscopy was 74.4 and 95.1%, respectively, and the positive and negative predictive values were 85.6 and 90.5% respectively.

Main limitations

Use of two separate grading systems for evaluating resting laryngeal function. Other forms of dynamic airway collapse were not evaluated.

Conclusions

Resting endoscopy is sensitive and highly specific for predicting laryngeal function at exercise. Dynamic endoscopy is important to assess multiple causes of airway collapse.
Pulmonary arterial hypertension in patient treated for multiple sclerosis with 4‐aminopyridine
Authors: Ribeiro Baptista Bruno , Petitpain Nadine , Gomez Emmanuel , Yelehé‐Okouma Melissa , Valentin Simon , Guillaumot Anne , Chabot François , Chaouat Ari
Published: June 2018

4‐Aminopyridine (4‐AP) is a recent treatment indicated to improve walking in patient with multiple sclerosis. We report the first case of pulmonary arterial hypertension (PAH) that we attribute to the use of 4‐AP. A 64‐year‐old woman with multiple sclerosis presented with dyspnea. After excluding other secondary causes of pulmonary hypertension, a diagnosis of severe PAH due to 4‐AP was made based on right heart catheterization. History revealed that the dyspnea began with the initiation of 4‐AP. After discontinuation of 4‐AP therapy and initiation of ambrisentan and tadalafil, dyspnea and pulmonary arterial pressure have improved significantly and one specific PAH treatment was stopped. 4‐AP is an outward rectifying potassium channel blocker with a vasoconstrictor effect in animal's pulmonary artery. According to the chronological sequence of events, the lack of other etiology, and its pharmacological plausibility, 4‐AP is highly suspected to have induced our patient's PAH.
Local context and connectivity determine the response of zooplankton communities to salt contamination
Authors: Sinclair James S. , Arnott Shelley E.
Published: June 2018

Salt, primarily NaCl, is commonly used to de‐ice winter roads. The usage of road salt is steadily increasing as the area of urbanised land expands, and chloride concentrations in many lakes and flowing waters near roads have been steadily increasing through time. In some waterbodies, these concentrations are reaching levels that are toxic to freshwater organisms, such as zooplankton which are integral to the structure and function of freshwater communities.

We currently have a poor understanding of the impact of road salt contamination on zooplankton communities, and particularly the variation in response among lakes. Zooplankton communities differ in factors that could influence the impacts of elevated chloride, such as local species composition, exposure history and regional connectivity. Assessing and predicting how increasing road salt usage affects natural, freshwater zooplankton communities requires studies that investigate how communities vary in the impacts of elevated chloride, and in their response to dispersal.

We conducted a field mesocosm experiment that examined the effects of salt (NaCl) addition on two different zooplankton communities, which were also subjected to repeated introductions of zooplankton dispersers from the regional species pool. These treatments allowed us to determine whether communities differed in the impacts of salt, and how the effects of salt differed between communities that did and did not receive zooplankton dispersers.

We found variation in the effects of salt and dispersal between our experimental communities. For one lake community, salt drove zooplankton species composition towards dominance by littoral cladocerans. Zooplankton dispersal into this community ameliorated these impacts of salt by returning species composition to a state more similar to our “Control” communities. Conversely, for the other lake community, salt alone had minimal effects on zooplankton, while the combination of salt and dispersal led to declines in adult copepods.

Our experiment found that the impacts of salt varied between two zooplankton communities, causing a range of negative, positive and neutral community effects, and that dispersal from the regional species pool could serve as an ameliorating or exacerbating influence. Efforts to understand and predict the impacts of road salt on freshwater communities would therefore benefit from an evaluation of the potential role played by local (e.g., exposure history and biotic interactions) and regional (e.g., connectivity to possible sources of immigrants) context in the response of communities to elevated chloride.
Functional dentition and associated factors in Brazilian elderly people: A multilevel generalised structural equation modelling approach
Authors: Bomfim Rafael Aiello , Frias Antonio Carlos , Cascaes Andreia Morales , Pereira Antonio Carlos
Published: June 2018

Introduction

The objective of the present study was to evaluate the association of socioeconomic status (SES) as a latent variable on oral health‐related quality of life (OHRQoL) using four definitions of functional dentition (FD) for elderly people.

Methods

Four sets of multilevel generalised structural equation models (GSEM) were used: (i) WHO Functional Dentition (FDWHO); (ii) Well‐distributed teeth (WDT); (iii) FDclass5; and (iv) FDclass6. The indirect effects of SES on OHRQoL were measured in 5951 elderly participants in the São Paulo Oral Health 2015 (SBSP‐15) survey. The latent variable (OHRQoL) was extracted from the Oral Impacts on Daily Performances questionnaire, and GSEM was used to estimate the direction of association among the variables.

Results

SES was directly and strongly associated with FDWHO (Total effects [SC] = 0.56, P < .001); WDT (Total Effects [SC] = 0.55, P < .001); FDclass5 (Total effects [SC] = 0.07, P < .001); and FDclass6 (Total effects [SC] = 0.05, P = .001). All FD outcomes mediate effects of SES on OHRQoL (P < .05). SES had a direct effect on happiness which, in turn, had a direct effect on OHRQoL ([SC] = 0.05, P < .001).

Conclusions

All definitions of FD were good at mediating the effects of SES on OHRQoL, showing the importance of occlusal and periodontal statuses of elderly individuals.
Straying from breadwinning: Status and money in men's interpretations of their wives' work arrangements
Authors: Reid Erin M.
Published: June 2018

The male breadwinner identity is culturally associated with career success for men, particularly in the professions, but today, few married men's lives easily map onto this identity. This study analyses interviews with 42 married men employed in US offices of a consulting firm to examine first, how men construct their identities as spouses in relation to their wives' work arrangements and second, how men navigate straying from the male breadwinner identity. While some men interpreted their wives' work in ways that supported personal claims on the breadwinner identity, others did so in ways that supported a more egalitarian identity, labelled here breadsharer. These groups differed in how they interpreted the social status and financial value of their wives' work, as well as in how they approached their own careers. Breadsharers were aware they strayed from the expected breadwinner identity and crafted alternative claims on status. These findings advance theory on gender, work, family and masculinity.
Laser patterning of oriented LiNbO3 crystal particle arrays in NiO‐doped lithium niobium silicate glasses
Authors: Shimada Mamoru , Honma Tsuyoshi , Komatsu Takayuki
Published: June 2018

The patterning of LiNbO3 crystals was carried out at the surface of NiO‐doped 40Li2O‐32Nb2O5‐28SiO2 (LNS) glasses using continuous‐wave Yb:YVO4 fiber laser (wavelength: 1080 nm) to gain a deeper understanding of the crystal growth in the laser‐induced crystallization in glasses. It was suggested that in the conventional crystallization in an electric furnace, NiO acts as a nucleation agent in the LNS glass and the addition of NiO suppresses the c‐axis orientation of LiNbO3 at the glass surface. It was found from birefringence image observations that LiNbO3 crystals with a dot shape have a radial orientation from the center to the edge parts. Highly c‐axis oriented LiNbO3 crystal particle (diameter: 7‐11 μm) arrays were patterned along the laser scanning direction in laser irradiations (scanning mode: eg, the laser power of 1.60 W and scanning speeds of 7‐10 μm/s) in 3 mol% NiO‐doped LNS glass. It was suggested that the nucleation and crystal growth of LiNbO3 crystals are taking place repeatedly (periodically) along the laser scanning direction, consequently providing LiNbO3 crystal particle arrays.