bluuebunny/crossref_metadata_2025 huggingface dataset:
A Prospective Clinical Trial Comparing Visible Light Spectroscopy to Handheld Doppler for Postoperative Free Tissue Transfer Monitoring
Authors: Mericli Alexander F. , Wren James , Garvey Patrick B. , Liu Jun , Butler Charles E. , Selber Jesse C.
Published: June 2017

Background:

Early detection of compromised free flap perfusion is critical. A common modality of thrombosis detection, physical examination augmented with hand-held Doppler, provides only intermittent data and is insensitive to venous compromise. Visible light spectroscopy provides continuous, noninvasive evaluation of tissue perfusion. The authors hypothesized that visible light spectroscopy is a more sensitive and specific monitoring method for early detection of postoperative flap compromise than intermittent hand-held Doppler and clinical examination.

Methods:

The authors prospectively conducted a controlled study evaluating the sensitivity, specificity, and accuracy of the T-Stat Model 303 VLS oximeter versus that of intermittent Doppler and clinical examination. The authors prospectively collected and analyzed patient data, complications, reoperations, flap failures, and tissue oxygen saturation.

Results:

Sixty-eight patients with 81 flaps completed the study. The majority of flaps (86.4 percent) were either transverse rectus abdominis musculocutaneous or deep inferior epigastric artery perforator flaps. The mean tissue oxygen saturation for all flaps in the study was 56.7 ± 7.1 percent (range, 39.4 to 72.1 percent) and did not differ significantly with patient comorbidity or flap type. During the course of the study, three flaps were returned to the operating room for exploration because of a perfusion abnormality, and the resulting salvage rate was 100 percent. The sensitivity, specificity, and accuracy of visible light spectroscopy were found to be greater than both intermittent Doppler and clinical examination.

Conclusion:

Visible light spectroscopy is a reliable, continuous adjunct to free tissue transfer monitoring with advantages over intermittent hand-held Doppler and clinical examination.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Diagnostic, II.
Prepectoral Breast Reconstruction: A Safe Alternative to Submuscular Prosthetic Reconstruction following Nipple-Sparing Mastectomy
Authors: Sbitany Hani , Piper Merisa , Lentz Rachel
Published: June 2017

Background:

Nipple-sparing mastectomy with immediate prosthetic reconstruction is routinely performed because of excellent aesthetic results and safe oncologic outcomes. Typically, subpectoral expanders are placed, but in select patients, this can lead to significant postoperative pain and animation deformity, caused by pectoralis major muscle disinsertion and stretch. Prepectoral reconstruction is a technique that eliminates dissection of the pectoralis major by placing the prosthesis completely above the muscle with complete acellular dermal matrix coverage.

Methods:

A single surgeon’s experience with immediate prosthetic reconstruction following nipple-sparing mastectomy from 2012 to 2016 was reviewed. Patient demographics, adjuvant treatment, length and characteristics of the expansion, and incidence of complications during the tissue expander stage were compared between the partial submuscular/partial acellular dermal matrix (dual-plane) cohort and the prepectoral cohort.

Results:

Fifty-one patients (84 breasts) underwent immediate prepectoral tissue expander placement, compared with 115 patients (186 breasts) undergoing immediate partial submuscular expander placement. The groups had similar comorbidities and postoperative radiation exposure. There was no significant difference in overall complication rate between the two groups (17.9 percent versus 18.8 percent; p = 0.49).

Conclusions:

Prepectoral breast reconstruction provides a safe and effective alternative to partial submuscular reconstruction, that yields comparable aesthetic results with less operative morbidity. In the authors’ experience, the incidence of acute and chronic postoperative pain and animation deformity is significantly lower following prepectoral breast reconstruction. This technique is now considered for all patients who are safe oncologic candidates and are undergoing nipple-sparing mastectomy and prosthetic reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Outbreaks in the neonatal ICU: a review of the literature
Authors: Johnson Julia , Quach Caroline
Published: June 2017

Purpose of review

Neonates in the neonatal ICU (NICU) are uniquely vulnerable to colonization and infection with pathogens such as multidrug resistant Gram-negative bacteria, which in turn are associated with increased infection-related morbidities and higher case-fatality rates. We reviewed the English, French, and German language literature published between 2015 and 2017, for reports of NICU outbreaks.

Recent findings

A total of 39 outbreaks in NICUs were reported with Gram-negative bacteria (n = 21; 54%) causing most, and extended spectrum beta-lactamase-producing organisms being the most frequent resistance mechanism reported (n = 5). Five viral outbreaks were reported (respiratory syncytial virus = 3). A significant proportion of outbreaks (33%) did not identify a source. Whole genome sequencing was used more (n = 6 reports). The most common described infection prevention and control interventions included staff and parent education on hand hygiene, patient isolation, additional contact precautions, including discontinuation of ‘kangaroo care’, and cohorting. Reporting and publication bias are likely common.

NICUs must be vigilant in identifying outbreaks, conduct comprehensive investigations, and implement targeted infection prevention and control strategies. Molecular epidemiology capacities are an essential element in outbreak investigation. More studies are needed to determine the added value of active colonization screening and their impact on outbreak development.
Lorazepam Challenge for Individuals at Varying Genetic Risk for Alzheimer Disease
Authors: Stonnington Cynthia M. , Harel Brian , Locke Dona E.C. , Hentz Joseph G. , Zhang Nan , Maruff Paul , Caselli Richard J.
Published: June 2017

Introduction:

This study set out to clarify the differential acute cognitive impact of lorazepam based on varying genetic risk for Alzheimer disease.

Methods:

Fifty-seven cognitively unimpaired individuals aged 51 to 88, genotyped according to apolipoprotein E (APOE) and translocase of outer mitochondrial membrane (40 homolog) poly-T lengths, completed cognitive testing before, 2.5 and 5 hours after receiving a 1 mg dose of lorazepam.

Results:

Post-lorazepam, there were significant (P<0.05) declines from baseline in memory, psychomotor processing speed, and executive function. At 2.5 hours, the magnitude of this lorazepam-induced cognitive change was significantly greater in the APOE3/4 group than in the APOE3/3 group for tests of working memory and visuospatial memory/executive function. At 5 hours postchallenge, verbal memory and working memory deficits persisted in the APOE3/4 group compared with the APOE3/3 group. At 5 hours after lorazepam challenge, as compared with the very long/very long group, the short/short group performed slightly worse on a test of working memory (P<0.05), but no other differences were observed among translocase of the outer mitochondrial membrane 40 homolog poly-T variant groups.

Discussion:

The lorazepam challenge may be unmasking presymptomatic cognitive dysfunction associated with APOE4 carriage.
Sleep-related movement disorders and disturbances of motor control
Authors: Bargiotas Panagiotis , Bassetti Claudio L.
Published: June 2017

Purpose of review

Review of the literature pertaining to clinical presentation, classification, epidemiology, pathophysiology, diagnosis, and treatment of sleep-related movement disorders and disturbances of motor control.

Recent findings

Sleep-related movement disorders and disturbances of motor control are typically characterized by positive motor symptoms and are often associated with sleep disturbances and consequent daytime symptoms (e.g. fatigue, sleepiness). They often represent the first or main manifestation of underlying disorders of the central nervous system, which require specific work-up and treatment. Diverse and often combined cause factors have been identified. Although recent data provide some evidence regarding abnormal activation and/or disinhibition of motor circuits during sleep, for the majority of these disorders the pathogenetic mechanisms remain speculative. The differential diagnosis is sometimes difficult and misdiagnoses are not infrequent. The diagnosis is based on clinical and video-polysomnographic findings. Treatment of sleep-related motor disturbances with few exceptions (e.g. restless legs/limbs syndrome) are based mainly on anecdotal reports or small series.

More state-of-the-art studies on the cause, pathophysiology, and treatment of sleep-related movement disorders and disturbances of motor control are needed.
Interphase-arrestedDrosophilaembryos initiate Mid-Blastula Transition at a low nuclear-cytoplasmic ratio
Authors: Strong Isaac , Yuan Kai , O’Farrell Patrick H.
Published: June 2017

Externally deposited eggs begin development with an immense cytoplasm and a single overwhelmed nucleus. Rapid mitotic cycles restore normality as the ratio of nuclei to cytoplasm (N/C) increases. At the 14th cell cycle inDrosophilaembryos, the cell cycle slows, transcription increases, and morphogenesis begins at the Mid-Blastula Transition (MBT). To explore the role of N/C in MBT timing, we blocked N/C-increase by downregulating cyclin/Cdk1 to arrest early cell cycles. Embryos arrested in cell cycle 12 cellularized, initiated gastrulation movements and activated transcription of genes previously described as N/C dependent. Thus, occurrence of these events is not directly coupled to N/C-increase. However, N/C might act indirectly. Increasing N/C promotes cyclin/Cdk1 downregulation which otherwise inhibits many MBT events. By experimentally inducing downregulation of cyclin/Cdk1, we bypassed this input of N/C-increase. We describe a regulatory cascade wherein the increasing N/C downregulates cyclin/Cdk1 to promote increasing transcription and the MBT.

Impact statement

By showing that cell-cycle arrest allows earlyDrosophilaembryos to progress to later stages, this work eliminates numerous models for embryonic timing and shows the dominating influence of cell-cycle slowing.
Receptor uptake arrays for vitamin B12, siderophores and glycans shape bacterial communities
Authors: Frank Steven A.
Published: June 2017

Molecular variants of vitamin B12, siderophores and glycans occur. To take up variant forms, bacteria may express an array of receptors. The gut microbeBacteroides thetaiotaomicronhas three different receptors to take up variants of vitamin B12and 88 receptors to take up various glycans. The design of receptor arrays reflects key processes that shape cellular evolution. Competition may focus each species on a subset of the available nutrient diversity. Some gut bacteria can take up only a narrow range of carbohydrates, whereas species such asB. thetaiotaomicroncan digest many different complex glycans. Comparison of different nutrients, habitats, and genomes provide opportunity to test hypotheses about the breadth of receptor arrays. Another important process concerns fluctuations in nutrient availability. Such fluctuations enhance the value of cellular sensors, which gain information about environmental availability and adjust receptor deployment. Bacteria often adjust receptor expression in response to fluctuations of particular carbohydrate food sources. Some species may adjust expression of uptake receptors for specific siderophores. How do cells use sensor information to control the response to fluctuations? That question about regulatory wiring relates to problems that arise in control theory and artificial intelligence. Control theory clarifies how to analyze environmental fluctuations in relation to the design of sensors and response systems. Recent advances in deep learning studies of artificial intelligence focus on the architecture of regulatory wiring and the ways in which complex control networks represent and classify environmental states. I emphasize the similar design problems that arise in cellular evolution, control theory, and artificial intelligence. I connect those broad conceptual aspects to many testable hypotheses for bacterial uptake of vitamin B12, siderophores and glycans.
Recency order judgments in short term memory: Replication and extension of Hacker (1980)
Authors: Singh Inder , Howard Marc W.
Published: June 2017

The classic finding from short-term relative JOR tasks is that correct response time (RT) depends on the lag to the more recent item but not to the less recent item (Hacker, 1980). For decades, researchers have argued that this finding is consistent with a self-terminating backward scanning model (Muter, 1979; Hacker, 1980; Hockley, 1984; McElree & Dosher, 1993). This finding has taken on new importance in light of recent proposal that many forms of memory depend on a compressed representation of the past (Howard, Shankar, Aue, & Criss, 2015). This paper replicates and extends the results of the classic papers. A Bayesian t-test showed substantial evidence for the null effect of lag to the less recent item on correct RT. In addition, this paper reports that correct RT is a sub-linear function of lag to the more recent probe and replicates the classic finding that error RT depends on lag to the less recent probe. These findings place new constraints on models of short-term memory scanning.
AVarroa destructorprotein atlas reveals molecular underpinnings of developmental transitions and sexual differentiation
Authors: McAfee Alison , Chan Queenie WT , Evans Jay , Foster Leonard J
Published: June 2017

Varroa destructoris the most economically damaging honey bee pest, weakening colonies by simultaneously parasitizing bees and transmitting harmful viruses. Despite these impacts on honey bee health, surprisingly little is known about its fundamental molecular biology. Here we present aVarroaprotein atlas crossing all major developmental stages (egg, protonymph, deutonymph and adult) for both male and female mites as a web-based interactive tool (http://foster.nce.ubc.ca/varroa/index.html). By intensity-based label-free quantitation, 1,433 proteins were differentially expressed across developmental stages, including two distinct viral polyproteins. Enzymes for processing carbohydrates and amino acids were among many of these differences as well as proteins involved in cuticle formation. Lipid transport involving vitellogenin was the most significantly enriched biological process in the foundress (reproductive female) and young mites. In addition, we found that 101 proteins were sexually regulated and functional enrichment analysis suggests that chromatin remodeling may be a key feature of sex determination. In a proteogenomic effort, we identified 519 protein-coding regions (169 of which were differentially expressed) supported by 1,464 peptides which were previously unannotated. Since this is a recurring trend with annotating genomes of non-model species, we analyzed their amino acid and nucleotide composition as well as their orthology to other species to suggest reasons why they may have been missed initially. Overall, this work provides a first-of-its-kind interrogation of the patterns of gene expression that govern theVarroalife cycle and the tools we have developed will support further research on this threatening honey bee pest.
Paracrine Activin-A signaling promotes melanoma growth and metastasis through immune evasion
Authors: Donovan Prudence , Dubey Olivier A. , Kallioinen Susanna , Rogers Katherine W. , Muehlethaler Katja , Müller Patrick , Rimoldi Donata , Constam Daniel B.
Published: June 2017

The secreted growth factor Activin-A of the TGFβ family and its receptors can promote or inhibit several cancer hallmarks including tumor cell proliferation and differentiation, vascularization, lymphangiogenesis and inflammation. However, a role in immune evasion and its relationship with tumor-induced muscle wasting and tumor vascularization, and the relative contributions of autocrine versus paracrine Activin signaling remain to be evaluated. To address this, we compared the effects of truncated soluble Activin receptor II B as a ligand trap, or constitutively active mutant type IB receptor versus secreted Activin-A or the related ligand Nodal in mouse and human melanoma cell lines and tumor grafts. We found that while cell-autonomous receptor activation arrested tumor cell proliferation, Activin-A secretion stimulated melanoma cell dedifferentiation and tumor vascularization by functional blood vessels, and it increased primary and metastatic tumor burden and muscle wasting. Importantly, in mice with impaired adaptive immunity, the tumor-promoting effect of Activin-A was lost despite sustained vascularization and cachexia, suggesting that Activin-A promotes melanoma progression by inhibiting anti-tumor immunity. Paracrine Activin-A signaling emerges as a potential target for personalized therapies, both to reduce cachexia and to enhance the efficacy of immunotherapies.
Actin impacts the late stages of prion formation and prion propagation
Authors: Lyke Douglas R. , Dorweiler Jane E. , Legan Emily R. , Wisniewski Brett T. , Davis Emily E. , Manogaran Anita L.
Published: June 2017

In yeast, the [PSI+] and [PIN+] prions are aggregated forms of the Sup35 and Rnq1 proteins, respectively. The cellular mechanisms that underlie the formation and propagation of these prion states are not clearly understood. Our previous work suggested that actin networks play a role in early and late steps of the formation of [PSI+]. To further explore how actin impacts yeast prions, we turned to a set of actin point mutants. We found that the disruption of actin cables, either by an actin destabilizing drug or theact1-101mutant, can enhance prion formation during the later stages of prion formation. Our data suggest that under normal conditions, actin cables play a role in limiting the inheritance of newly made prion particles to daughter cells. We also found actin can impact prion propagation. Theact1-122mutant, which contains a substitution in the fimbrin binding region, destabilized the [PIN+] prion over time. This is the first evidence that actin has a role in [PIN+] propagation. Taken together, our findings reveal novel roles for actin in the formation and propagation of prions.
Detection of human disease conditions by single-cell morpho-rheological phenotyping of whole blood
Authors: Toepfner Nicole , Herold Christoph , Otto Oliver , Rosendahl Philipp , Jacobi Angela , Kräter Martin , Stächele Julia , Menschner Leonhard , Herbig Maik , Ciuffreda Laura , Ranford-Cartwright Lisa , Grzybek Michal , Coskun Ünal , Reithuber Elisabeth , Garriss Geneviève , Mellroth Peter , Henriques-Normark Birgitta , Tregay Nicola , Suttorp Meinolf , Bornhäuser Martin , Chilvers Edwin R. , Berner Reinhard , Guck Jochen
Published: June 2017

Blood is arguably the most important bodily fluid and its analysis provides crucial health status information. A first routine measure to narrow down diagnosis in clinical practice is the differential blood count, determining the frequency of all major blood cells. What is lacking to advance initial blood diagnostics is an unbiased and quick functional assessment of blood that can narrow down the diagnosis and generate specific hypotheses. To address this need, we introduce the continuous, cell-by-cell morpho-rheological (MORE) analysis of whole blood, without labeling, enrichment or separation, at rates of 1,000 cells/sec. In a drop of blood we can identify all major blood cells and characterize their pathological changes in several disease conditions in vitro and in patient samples. This approach takes previous results of mechanical studies on specifically isolated blood cells to the level of application directly in whole blood and adds a functional dimension to conventional blood analysis.
Relationally integrated value networks (RIVANS) for total facilities management (TFM)
Authors: De Silva Nayanthara , Weerasinghe R.P.N.P. , Madhusanka H.W.N. , Kumaraswamy Mohan
Published: June 2017

Purpose

A case is made for developing “Relationally Integrated Value Networks for Total Facilities Management” (RIVANS-TFM) by synergistically connecting significant stakeholders of the project management (PM) and facilities management (FM) phases to deliver substantially better value for the end users of built infrastructure. The paper aims to discuss these issues.

Design/methodology/approach

A structured questionnaire survey enabled identification of typically significant stakeholders in the PM and FM phases. In total, 14 key stakeholders were identified through t-test analysis in this Sri Lankan study. Semi-structured interviews unveiled relationships among the aforementioned stakeholders and the findings were used to develop the “required” RIVANS-TFM, as well as the “existing” RIVANS-TFM, using the UCINET social network analysis software package. Social network theory of relationships was applied to analyze the networks in terms of “Structural Holes” or missing links and “Brokerage Potentials.”

Findings

Structural holes analysis highlighted the existing setup to be more vulnerable to missing links than the “required”/targeted setup. Furthermore, brokerage potentials analysis revealed that owners, project managers, facility managers, maintenance engineers, main contractors, designers, principal consultants, and other specialist consultants can act as “brokers” to bridge the gaps or minimize structural holes, thereby uplifting and reinforcing the existing network to deliver better performance and value in TFM.

Originality/value

By revealing existing and required levels of integration of each stakeholder in RIVANS-TFM, clients are provided a great opportunity to identify the stakeholders who should be engaged more, or less – in order to best achieve clients’ long-term aspirations and project objectives. Furthermore, the findings also indicate appropriate levels of stakeholder relationships to target, in order to maintain efficient flows of information, material and services in the supply chains while enhancing TFM life-cycle values.
Maintaining focus on clients’ requirements using the DQI tool
Authors: Kamara John M.
Published: June 2017

Purpose

The purpose of this paper is to explore the contribution of the design quality indicator (DQI) tool in the management of client requirements in construction projects, and propose a requirements-oriented project process (ROPP) to ensure continued focus on client requirements throughout the lifecycle of a project.

Design/methodology/approach

Direct participant involvement and case studies of building projects that have used the DQI tool are used to analyse the extent to which DQI contributes to the management of client requirements.

Findings

Case study analysis suggests that the DQI enhances focus on client and project stakeholder requirements through the initial quality aspirations set out at the beginning of a project, but it is limited in its scope to address a more comprehensive requirements profile.

Research limitations/implications

The proposed ROPP model is conceptual and requires further development to test its effectiveness in enhancing focus on client requirements. However, given current developments in automated checking in BIM and other environments, this offers scope for further research in this area.

Originality/value

Maintaining focus on client requirements throughout the process is a key criterion for project success. However, given the many stakeholders involved, and the progressive translation into various project documents, there is a risk that focus on the original/evolving requirements of the client can be lost. Current approaches such as the DQI have limitations and a robust ROPP is, therefore, a key contribution to securing clients’ objectives over the project lifecycle.
Communicating with stakeholders when bad news is uncertain
Authors: Baker Scott , Hernandez Morela
Published: June 2017

Purpose

The purpose of this paper is to explore the question of if and when leaders should communicate bad news to their stakeholders. Previous research in the crisis communication literature has highlighted the need to communicate quickly and persuasively to minimize losses; however, the authors argue that such tactics assume certainty in negative outcomes and tend to generate predominantly one-way, company-centric communication. In this paper, the authors propose that under conditions of uncertainty (i.e. when the bad news has an unknown outcome or cause) different communication strategies are needed.

Design/methodology/approach

Drawing on the stakeholder theory, the authors argue that organizational decision makers have a clear moral obligation to share bad news with affected stakeholders. The authors then review the existing approach to crisis communication and discuss its limitations under conditions of uncertainty. Finally, the authors develop a set of scenarios to guide the communication of bad news under conditions of uncertainty.

Findings

The authors formulate a framework to guide leaders on how to communicate with stakeholders when the nature of the bad news is uncertain and open to multiple interpretations. The authors propose a situational approach for responding to stakeholders that emerges from the context of the bad news.

Originality/value

The authors propose a situational framework for communicating bad news that overcomes the current limitations of extant crisis communication strategies under conditions of uncertainty. This involves balancing existing crisis communication recommendations with a more collaborative sensemaking approach.
Cultural resonance of global brands in Brazilian social movements
Authors: Suarez Maribel , Belk Russell
Published: June 2017

Purpose

The research analyzes the presence of two global brands – Fiat and International Federation of Association Football – in Brazilian demonstrations in conjunction with the 2014 World Cup. The purpose of this paper is to extend the brand cultural resonance construct and highlights its boundary-straddling nature. The analysis reveals the dynamics of brand meanings established including why some brands have their meanings enriched through collective appropriation, while others become vessels of negative content and targets of anti-consumption movements.

Design/methodology/approach

A multimethod approach, which included observation, analysis of cultural texts and in-depth interviews with 21 demonstrators, was adopted for the study.

Findings

The study extends the construct of brand cultural resonance proposing an additional facet, named Institutional Resonance. This dimension relates to the meanings that arise from a brand’s institutional role and interactions with other social institutions, like governments, the economy, religious, and educational systems. Institutional Resonance occurs when a certain brand becomes the archetypal representation of a social institution. This study also presents two forms of brand cultural resonance: arrows or targets. As arrows, brands lend their symbolic resources to the construction of protesters’ messages helping them to communicate their ideas. As targets, brands become social enemies and represent negative poles of social contradictions.

Originality/value

This study investigates consumer appropriation of marketers’ actions. The research depicts Institutional Resonance as an interactive and acute phenomenon which promotes a social negotiation on a playing field where different agents forge brand meanings and reputations.
How global brands incorporating local cultural elements increase consumer purchase likelihood
Authors: He Jiaxun , Wang Cheng Lu
Published: June 2017

Purpose

The purpose of this paper is to investigate the influence of incorporating Chinese elements in global brands on consumer purchase likelihood.

Design/methodology/approach

Six global brand products from three categories that utilized Chinese elements are used to test hypotheses. The Total Effect Moderation Model is used to analyze by combining moderation and mediation under a general analytical framework.

Findings

The results show that cultural compatibility has direct positive effect, in addition to an indirect effect (through local iconness) on purchase likelihood. Meanwhile, consumer cultural identity is found to moderate the impact of brand local iconness on purchase likelihood.

Practical implications

Evaluation and improvement of cultural compatibility in a global brand that incorporates Chinese elements is recommended for multinational marketers entering Chinese consumer markets. Meanwhile, marketers should pay attention to consumer cultural identity in the market segmentation process.

Originality/value

This paper takes a unique perspective to investigate whether and how global brands can succeed when adding local cultural elements to the product design, packaging and promotion in emerging markets like China.
Consumer perceptions and willingness to pay for cassava-wheat composite bread in Ghana
Authors: Owusu Victor , Owusu-Sekyere Enoch , Donkor Emmanuel , Darkwaah Nana Ama , Adomako-Boateng Jr Derrick
Published: June 2017

Purpose

The purpose of this paper is to evaluate consumers’ willingness to pay (WTP) for composite flour bread produced with a blend of 15-40 per cent cassava flour blended with wheat flour in Ghana.

Design/methodology/approach

The analysis is based on interviews with 350 consumers in the Ashanti and Eastern Regions of Ghana to assess their awareness, perceptions and WTP for cassava-wheat composite bread. From these consumer interviews, a hedonic regression model was applied to evaluate consumers’ WTP for various attributes of composite flour bread. Price-related and health-related perceptions of consumers on cassava-wheat composite bread were investigated with perception indices. Multi-attribute preference-based contingent ratings that rate product attributes in terms of importance to consumers was employed. The implicit prices of the product attributes representing the contribution of the product attributes to the WTP amount were also computed.

Findings

The paper finds that consumers who are aware of cassava-blended flour bread and who like its taste and texture are willing to pay more than consumers who are unaware. This leads to a policy recommendation advocating increased advertising of the economic and nutritional benefits of cassava-wheat blended composite flour bread.

Research limitations/implications

Future studies should explore the choice experiments to examine preferences for the food product.

Originality/value

This paper evaluates consumers’ WTP for composite flour bread produced with a blend of 15-40 per cent cassava flour and wheat flour. Given widespread reliance on imported wheat flour and the simultaneously large volumes of locally available cassava, it is important to consider opportunities for import substitution (and possible cost reduction for consumers) of blended flour products such as cassava-wheat composite flours. Nigeria has imposed a 10 per cent blending requirement for this reason. Ghana has taken important measures recently for the development of high-quality cassava flour, and so research on its potential and actual uptake is welcomed and highly relevant to food security and agribusiness development.
Real Estate Investments, Product Market Competition and Stock Returns
Authors: Diop Moussa
Published: June 2017

By limiting operating flexibility, real estate investments are found to increase firm risk, thus expected returns. This study introduces product market competition as a critical determinant of the relation between real estate investments and stock returns. As part of capacity strategies, these investments are generally associated with increased market power and lower cash flow volatility in oligopolistic industries. I present a simple model of oligopolistic competition showing a negative relation between real estate holdings and firm beta, and empirically confirm this prediction. Controlling for product market competition enhances identification of the endogenous relation between real estate investments and stock returns.
Application of Enhanced Point Estimators to a Sample of In Vivo CT‐derived Facial Soft Tissue Thicknesses
Authors: Parks Connie L. , Kyllonen Kelsey M. , Monson Keith L.
Published: June 2017

Facial approximations based on facial soft tissue depth measurement tables often utilize the arithmetic mean as a central tendency estimator. Stephan et al. (J Forensic Sci 2013;58:1439) suggest that the shorth and 75‐shormax statistics are better suited to describe the central tendency of non‐normal soft tissue depth data, while also accommodating normal distributions. The shorth, 75‐shormax, arithmetic mean, and other central tendency estimators were evaluated using a CT‐derived facial soft tissue depth dataset. Differences between arithmetic mean and shorth mean for the tissue depths examined ranged from 0 mm to +2.3 mm (average 0.6 mm). Differences between the arithmetic mean plus one standard deviation (to approximate the same data points covered by the 75‐shormax) and 75‐shormax values ranged from −0.8 mm to +0.7 mm (average 0.2 mm). The results of this research suggest that few practical differences exist across the central tendency point estimators for the evaluated soft tissue depth dataset.
Tape Lift Sampling of Chemical Threat Agents
Authors: Brady Krista , Stilley Becky , Olds Maria , O'Neill Terry , Egan James , Durnal Evan
Published: June 2017

Commercial‐off‐the‐shelf (COTS) materials were evaluated as surface samplers for the Department of Homeland Security Chemical Forensics Program. The program helps evidence collectors identify trace chemical residues at incident scenes. COTS items are widely available, produced in large lots, and with strict controls. Chemical attribution signatures were collected from common surfaces. Eight tape lift candidates were considered, five were chosen based on performance and tested for analytical interferences and extraction efficiencies with 14 chemicals. Three products (duct tape, print lifters, command strips) were evaluated for uptake from common interior surfaces (glass, tile, ABS plastic). Duct tape provided highest recoveries across all surfaces. Even the most volatile analytes were detected in the ABS plastic samples (nondetections in others), regardless of tape lift material used. The porous plastic substrate provides better target retention than glass and tile surfaces. Forensic field operators should sample surfaces made of ABS plastic (keyboards, remotes, phones, etc.) whenever possible.
Rational clinical evaluation of suspected acute coronary syndromes: The value of more information
Authors: Hancock David G , Chuang Ming‐Yu (Anthony) , Bystrom Rebecca , Halabi Amera , Jones Rachel , Horsfall Matthew , Cullen Louise , Parsonage William A , Chew Derek P
Published: June 2017

Objective

Many meta‐analyses have provided synthesised likelihood ratio data to aid clinical decision‐making. However, much less has been published on how to safely combine clinical information in practice. We aimed to explore the benefits and risks of pooling clinical information during the ED assessment of suspected acute coronary syndrome.

Methods

Clinical information on 1776 patients was collected within a randomised trial conducted across five South Australian EDs between July 2011 and March 2013. Bayes theorem was used to calculate patient‐specific post‐test probabilities using age‐ and gender‐specific pre‐test probabilities and likelihood ratios corresponding to the presence or absence of 18 clinical factors. Model performance was assessed as the presence of adverse cardiac outcomes among patients theoretically discharged at a post‐test probability less than 1%.

Results

Bayes theorem‐based models containing high‐sensitivity troponin T (hs‐troponin) outperformed models excluding hs‐troponin, as well as models utilising TIMI and GRACE scores. In models containing hs‐troponin, a plateau in improving discharge safety was observed after the inclusion of four clinical factors. Models with fewer clinical factors better approximated the true event rate, tended to be safer and resulted in a smaller standard deviation in post‐test probability estimates.

Conclusions

We showed that there is a definable point where additional information becomes uninformative and may actually lead to less certainty. This evidence supports the concept that clinical decision‐making in the assessment of suspected acute coronary syndrome should be focused on obtaining the least amount of information that provides the highest benefit for informing the decisions of admission or discharge.
Synergistic chemo‐enzymatic hydrolysis of poly(ethylene terephthalate) from textile waste
Authors: Quartinello Felice , Vajnhandl Simona , Volmajer Valh Julija , Farmer Thomas J. , Vončina Bojana , Lobnik Alexandra , Herrero Acero Enrique , Pellis Alessandro , Guebitz Georg M.
Published: June 2017

Due to the rising global environment protection awareness, recycling strategies that comply with the circular economy principles are needed. Polyesters are among the most used materials in the textile industry; therefore, achieving a complete poly(ethylene terephthalate) (PET) hydrolysis in an environmentally friendly way is a current challenge. In this work, a chemo‐enzymatic treatment was developed to recover the PET building blocks, namely terephthalic acid (TA) and ethylene glycol. To monitor the monomer and oligomer content in solid samples, a Fourier‐transformed Raman method was successfully developed. A shift of the free carboxylic groups (1632 cm−1) of TA into the deprotonated state (1604 and 1398 cm−1) was observed and bands at 1728 and 1398 cm−1 were used to assess purity of TA after the chemo‐enzymatic PET hydrolysis. The chemical treatment, performed under neutral conditions (T = 250 °C, P = 40 bar), led to conversion of PET into 85% TA and small oligomers. The latter were hydrolysed in a second step using the Humicola insolens cutinase (HiC) yielding 97% pure TA, therefore comparable with the commercial synthesis‐grade TA (98%).
Confirmed identification and toxin profiling of Campylobacter jejuni using a thermostabilized multiplex PCR formulation
Authors: Ramachandran Nitya , Ramlal Shylaja , Batra Harsh Vardhan
Published: June 2017

Cytolethal distending toxin (CDT) producing Campylobacter jejuni species are one of the leading causes of human gastroenteritis worldwide. The main intent of the study was to develop a multiplex PCR assay for the confirmed identification and toxin profiling of C. jejuni. The genes targeted were rpo B as genus specific, hip O for species; cdt A, cdt B, cdt C encoding respective subunit proteins of CDT with Internal Amplification Control (IAC). To enhance its application as a pre‐mixed ready‐to‐use format, the master mix of developed mPCR was dried by lyophilization and stability was assessed. Thermostabilized reagents showed stability of 1.5 months at room‐temperature and upto six months at 4 °C without any loss of functionality. The assay was evaluated on a number of presumptive Campylobacter isolates along with biochemical tests. Results obtained indicated the accurate identification of C. jejuni by developed mPCR format in contrast to misconception associated with biochemical assays. The assay was also tested on spiked samples for its real‐time utility. Altogether, the room‐temperature storable and ready‐to‐ use mPCR format developed in this study could be preferred for rapid detection and confirmed identification of toxigenic strains of C. jejuni in place of conventional biochemical assays.
Systematic review with meta‐analysis: the impact of a depressive state on disease course in adult inflammatory bowel disease
Authors: Alexakis C. , Kumar S. , Saxena S. , Pollok R.
Published: June 2017

Background

Despite a higher prevalence of psychosocial morbidity in Inflammatory Bowel Disease (IBD), the association between depressive state and disease course in IBD is poorly understood.

Aim

To investigate the impact of depressive state on disease course in IBD.

Methods

We conducted a systematic review in MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews and PsychINFO for prospective studies evaluating the impact of baseline depressive state on subsequent disease course in adult IBD.

Results

Eleven studies matched our entry criteria, representing 3194 patients with IBD. Three reported on patients with ulcerative colitis (UC), four included patients with Crohn's disease (CD) exclusively, and four studies included both UC and CD. Five studies reported an association between depressive state and disease course. None of the UC‐specific studies found any association. In three of four CD‐specific studies, a relationship between depressive state and worsening disease course was found. In four of five studies including patients in remission at baseline, no association between depressive state and disease course was found. Pooled analysis of IBD studies with patients in clinical remission at baseline identified no association between depressive state and disease course (HR 1.04, 95%CI: 0.97‐1.12).

Conclusion

There is limited evidence to support an association between depressive state and subsequent deterioration in disease course in IBD, but what data that exist are more supportive of an association with CD than UC. Baseline disease activity may be an important factor in this relationship. Further studies are needed to understand the relationship between mental health and outcomes in IBD.
The Political Economy of Care: Flight Attendant Unions and the Struggle over Airline Deregulation in the 1980s
Authors: Murphy Ryan Patrick
Published: June 2017

This paper traces flight attendant union activism in the 1980s to demonstrate how the ideology of the family weighed on the practice of care. Previous scholarship, especially the work of Arlie Russell Hochschild, has demonstrated that emotional labor is a defining feature of the flight attendant profession and of other service work. Because airline managers had framed women's jobs as providing care and not as work, flight attendants had always made far less money than their male peers in the airline industry. In the early 1970s, and in conjunction with the women's, gay, and lesbian liberation movements, flight attendant unions transformed the relationship between care and work, as they won large raises that allowed flight attendants to be breadwinners for their families. With flight attendants' economic advances, caregiving was defined in political economic terms, a practice that required a robust wage and affordable benefits. After the deregulation of the airline industry, however, airline managers strove to redefine the meaning of care. Working in tandem with the ascendant “pro‐family” and pro‐business activist movements of the early 1980s that aimed to cut taxes, roll back welfare programs, and eliminate government regulation, the airlines offered “family values” as a means to make up for what neoliberal reforms were taking away. This paper analyzes the ensuing confrontation, arguing that the category of care was a fault line in the struggle over the rise of neoliberalism.
Failure of Ethical Leadership: Implications for Stakeholder Theory and “Anti‐Stakeholders”
Authors: Hill Ronald Paul
Published: June 2017

Leaders in a variety of organizations are beset by challenges that test their commitments to ethical behavior in interactions with stakeholders who make up their working environments. Situations that present themselves include complex management of expectations, people, and resources, which require novel solutions that also test the boundaries between right and wrong. Such conditions arose after the 9/11 terrorist attacks on the World Trade Center Twin Towers. President Bush asked the Central Intelligence Agency to round up persons who represented a continuing threat of harm to U.S. interests. What followed was a series of decisions and actions by a number of internal and external constituencies based on inaccurate reporting of treatment of and information gleaned from detainees. Lessons for understanding and avoiding resulting leadership ethical dilemmas and a novel stakeholder perspective are provided in the close.
Prediction of lithium response in first‐episode mania using the LITHium Intelligent Agent (LITHIA): Pilot data and proof‐of‐concept
Authors: Fleck David E , Ernest Nicholas , Adler Caleb M , Cohen Kelly , Eliassen James C , Norris Matthew , Komoroski Richard A , Chu Wen‐Jang , Welge Jeffrey A , Blom Thomas J , DelBello Melissa P , Strakowski Stephen M
Published: June 2017

Objectives

Individualized treatment for bipolar disorder based on neuroimaging treatment targets remains elusive. To address this shortcoming, we developed a linguistic machine learning system based on a cascading genetic fuzzy tree (GFT) design called the LITHium Intelligent Agent (LITHIA). Using multiple objectively defined functional magnetic resonance imaging (fMRI) and proton magnetic resonance spectroscopy (1H‐MRS) inputs, we tested whether LITHIA could accurately predict the lithium response in participants with first‐episode bipolar mania.

Methods

We identified 20 subjects with first‐episode bipolar mania who received an adequate trial of lithium over 8 weeks and both fMRI and 1H‐MRS scans at baseline pre‐treatment. We trained LITHIA using 18 1H‐MRS and 90 fMRI inputs over four training runs to classify treatment response and predict symptom reductions. Each training run contained a randomly selected 80% of the total sample and was followed by a 20% validation run. Over a different randomly selected distribution of the sample, we then compared LITHIA to eight common classification methods.

Results

LITHIA demonstrated nearly perfect classification accuracy and was able to predict post‐treatment symptom reductions at 8 weeks with at least 88% accuracy in training and 80% accuracy in validation. Moreover, LITHIA exceeded the predictive capacity of the eight comparator methods and showed little tendency towards overfitting.

Conclusions

The results provided proof‐of‐concept that a novel GFT is capable of providing control to a multidimensional bioinformatics problem—namely, prediction of the lithium response—in a pilot data set. Future work on this, and similar machine learning systems, could help assign psychiatric treatments more efficiently, thereby optimizing outcomes and limiting unnecessary treatment.
Current challenges and future prospects in oral anticoagulant therapy
Authors: Czuprynska Julia , Patel Jignesh P. , Arya Roopen
Published: June 2017

The choice for oral anticoagulant (OAC) therapy was previously limited to the vitamin K antagonists (VKAs). The advent of the direct oral anticoagulants (DOACs) brought with it the expectation that oral anticoagulation would become simpler (with the elimination of routine monitoring and introduction of a fixed‐dose anticoagulant), and that the use of VKAs would be slowly phased out. Although DOACs have made anticoagulation more convenient and accessible, we are now faced with what can be described as a tyranny of choice, together with many unanswered questions relating to DOAC use. These include optimal DOAC selection and dosing, use in complex ‘real‐world’ patients, the role for monitoring and issues surrounding adherence. Warfarin remains the anticoagulant of choice in certain scenarios (e.g. metallic heart valves). The future holds much excitement: clinical studies are underway to expand the indications for DOACs and experience continues to grow outside the trials setting.