bluuebunny/crossref_metadata_2025 huggingface dataset:
Antecedents of Generation Y consumers’ usage frequency of online consumer reviews
Authors: Bevan-Dye Ayesha Lian
Published: June 2020

Purpose

The purpose of this paper is to examine the influence of perceived information and entertainment value, perceived credibility and perceived value on Generation Y consumers’ usage frequency of online consumer reviews.

Design/methodology/approach

The paper proposes and tests, with structural equation modelling analysis of moment structures, a research model using data from a large sample of Generation Y consumers.

Findings

The results confirm that Generation Y consumers perceive online reviews to be informative, entertaining, credible and valuable, and that they frequently consult such reviews. More specifically, the empirical analysis confirms that perceived information value, perceived entertainment value and perceived credibility significantly influenced the perceived value that Generation Y attach to online consumer reviews, which, in turn, was a significant predictor of their usage frequency of such reviews.

Practical implications

The results highlight the strategic importance of integrating online consumer reviews into the marketing communication mix when targeting Generation Y, together with the necessity of having filtering mechanisms to ensure that only authentic reviews are published and the need to implement tactics to ensure that such reviews are informative and entertaining and, consequently, of value.

Originality/value

This study contributes to marketers’ comprehension of strategically using online consumer reviews when targeting the Generation Y segment.
Online travel review rating scales and effects on hotel scoring and competitiveness
Authors: Martin-Fuentes Eva , Mellinas Juan Pedro , Parra-Lopez Eduardo
Published: June 2020

Purpose

The purpose of this paper is to determine whether different scales and ways to collect reviews and ratings found on online travel agencies (OTAs) can affect hotels, and whether hotels obtain the same or different evaluations.

Design/methodology/approach

Hotel ratings from five OTAs in four European markets were collected and compared in pairs. An initial comparison was made with the hotel scores of each OTA to show what a typical user would see. Then, a rescaled score (0-10) was used to compare all the OTA scales appropriately and to distinguish between what customers observe and what the reality is.

Findings

The results reveal that Booking.com that uses a scale (2.5-10) and Agoda with a scale (2-10) seem to give higher rating scores than Atrapalo (1-10), Travel Republic (0-10) and hotel reservation service (1-10). However, when the scores are rescaled (0-10), the worst ratings are found on Booking.com followed by Agoda.

Practical implications

OTAs should include, next to the scores, the scale used to rate hotels so as to provide users with better and clearer information. Moreover, rating questionnaires should match the verbal denominations with their numerical values to avoid biased ratings.

Social implications

OTAs and hotel managers are losing information provided by customers because customers are not aware of the scale when rating hotels. Moreover, hotel ratings are used by potential customers to obtain a clearer image of an establishment. However, if some hotels are being overrated by some scales, customers might have higher expectations, which may not be met.

Originality/value

The unique rating scales of Booking.com and Agoda provide additional insights into their hotel evaluations, which seem to be apparently higher when in fact they are not.
Hospitality technology progress towards intelligent buildings: a perspective article
Authors: Leung Rosanna
Published: June 2020

Purpose

The purpose of this study is to review the past technology in hotel and forecast the future direction of technology adoption in hotels.

Design/methodology/approach

Academic papers not only from hospitality journals but also from technology-related journals were collected and reviewed to propose the future hospitality technology development trends.

Findings

The hospitality software application has moved from local-based to server-based to Web-based to cloud-based platforms. Business data analysis methods have also undergone an evolution from descriptive analysis using historical data to predictive analysis by mining big data collected from the sensors and web-crawlers, which consolidates both commercial data and macro-environment data. Future hotel buildings could provide ambient management that responses to external environments automatically to provide an eco-friendly and cosy environment to hotel guests. Responsive building envelopes, façade systems and autonomous furniture will allow hotel managers to customised the function space layout according to customers’ needs and maximise unoccupied space utilisation.

Originality/value

Reviewed 75 years of IT evolution and forecast future hotel intelligent building with ambient intelligence to provide customizable, eco-friendly and cosy environment for hotel guests.
Effect of carbon reinforcements on selected properties of mortar
Authors: Ahmed Payman Sahbah , Ahmed Manar Nazar , Saied Samal Osman
Published: June 2020

Purpose

The purpose of this research is using materials to improve the thermal insulation, and reducing the cost. A large amount of energy is consumed by masonary due to cooling and heating. Adding material with certain percentages to the building materials is one of the ways to improve the thermal insulation, and these additives should keep as much as possible the mechanical properties of the building materials. Carbon additives are one of commonly used materials to masonry materials. In spite of the many advantages of using carbon fibers and carbon nano tubes (CNTs) to the cementitious materials, they are very expansive and their thermal conductivity is high.

Design/methodology/approach

In this research charcoal (which is a product of burning process) with very low thermal conductivity and cost in the form of micro particles will be used with mortar and compared with short carbon fibers and multiwall carbon nanotubes (MWCNTs) via thermal conductivity, density and compressive strength tests. This research includes also an effort to build a model of building to evaluate the thermal insulation of the materials used in the practical part. The main building design and performance simulation tool in this research is DesignBuilder.

Findings

Results showed that adding micro charcoal particles to mortar resulted in improving the thermal insulation and decrease the rate of reduction in the compressive strength compared to other additives, while adding short carbon fibers resulted in improving the thermal insulation and decrease the compressive strength. Adding MWCNT to the mortar had a negative effect on mechanical and physical properties, i.e. compressive strength, density and thermal insulation.

Originality/value

This paper uses DesignBuilder software to design a model of building made from the materials used in the practical part to predict and evaluate the thermal insulation.
Fruit traits of pioneer trees structure seed dispersal across distances on tropical deforested landscapes: Implications for restoration
Authors: Camargo Paulo H. S. A. , Pizo Marco A. , Brancalion Pedro H. S. , Carlo Tomás A.
Published: June 2020

Pioneer trees with fleshy fruits are typically planted in restoration projects to attract frugivores as a mean to increase dispersal and accelerate forest regeneration. However, differences in fruit traits of pioneer trees can potentially influence dispersal and their restoration outcomes.

Here we investigated the effects of bird and plant traits, and distance to forest fragments, on the seed rain using a tree‐planting experiment replicated in 12 deforested sites in Brazil. Factors were fruit traits of pioneer trees (wind‐dispersed, bird‐dispersed with lipids or with carbohydrates and controls) and distance (10, 50, 300 m) from forest fragments.

We found that density and richness of birds and seeds decreased exponentially with distance from fragments, yet these effects were minor compared to the effects of fruit traits on the structure of the seed rain.

Overall, plots with fleshy fruited pioneers attracted much greater bird activity and seed dispersal than plots with wind‐dispersal pioneers and the controls. For instance, plots with carbohydrate‐rich fruits received more than twice the average species richness and density of birds and seeds of plots with lipid‐rich pioneer trees, surpassing wind‐dispersed pioneers by more than 80%, and controls by over 90%. Furthermore, the fruit trait treatments resulted in morphological shifts in the average traits of visiting birds. Significant differences in bill gape and flight capacities (wing‐loading) were associated with the differences in the seed rain associated with each treatment.

Synthesis and applications. Understanding how trait‐matching processes mediating mutualistic seed dispersal by frugivores interact with distance‐dependent dispersal limitation on deforested tropical landscapes is critical for improving forest restoration efforts. This is especially relevant in the context of applied nucleation. As shown here, avian seed dispersal can thus be manipulated in restoration projects in order to increase connectivity and speed up forest recovery and the provision of the multiple ecosystem services that follow forest succession.
Wolbachia enhances expression of NlCYP4CE1 in Nilaparvata lugens in response to imidacloprid stress
Authors: Cai Tingwei , Zhang Yunhua , Liu Yu , Deng Xiaoqian , He Shun , Li Jianhong , Wan Hu
Published: June 2020

The brown planthopper, Nilaparvata lugens, is one of the main insect pests of rice. The N. lugens gene NlCYP4CE1 encodes cytochrome P450 monooxygenase (P450), which is a key enzyme in the metabolism of the insecticide imidacloprid. Previous research has suggested that the expression of NlCYP4CE1 is induced by imidacloprid stress, but the effect of bacterial symbionts on its expression has not been determined. The results of this study show that exposure to subtoxic imidacloprid changed the structure of the bacterial symbiont community in N. lugens. Specifically, the total bacterial content increased, but the bacterial species diversity significantly decreased. Wolbachia accounted for the largest proportion of bacteria in N. lugens; its abundance significantly increased after subtoxic imidacloprid exposure. The transcript level of NlCYP4CE1 was significantly increased by imidacloprid, but this effect was significantly weakened after Wolbachia was cleared with tetracycline. This result suggests that Wolbachia enhances the expression of NlCYP4CE1 to promote the detoxification metabolic response to imidacloprid stress. Understanding the effect of bacterial symbionts on gene expression in the host provides a new perspective on interactions between insecticides and their target insect pests, and highlights that subtoxic imidacloprid exposure may raise the risk of insecticide resistance by altering the structure of bacterial symbiont communities.
Development and characterization of an edible chitosan–whey protein nano composite film for chestnut (Castanea mollissima Bl.) preservation
Authors: Huang Yukai , Gu Caiqin , He Shan , Zhu Dongxue , Liu Xiuchun , Chen Zeyao
Published: June 2020

Chitosan (CHI) and whey protein are usually used to prepare edible films for food preservation. However, the composite film composed of the two components does not yield satisfactory properties for chestnut preservation. In this study, nano‐cellulose and cinnamaldehyde (CMA) were added to CHI and whey protein, creating a new composite film with strong water retention, bacteriostatic, and mechanical properties. The water vapor permeability (WVP) of the film decreased by 21.61% with the addition of 0.5% (w/v) nano‐cellulose, and 23.02% with the addition of 0.3% (w/v) CMA. Furthermore, water solubility (WS) decreased 22.05%, and the density of the film was significantly improved with the addition of 0.3% (w/v) CMA. The optimized formula of the film was CHI 2.5% (w/v), whey protein 3.0% (w/v), nano‐cellulose 0.5% (w/v), CMA 0.3% (w/v), and pH 3.8, as determined by orthogonal testing L9(34), with fuzzy comprehensive assessment, of WVP, WS, tensile strength, and elongation at break. The film clearly inhibited the growth of E. coli, S. aureus, and Chinese chestnut fungus, destroying the mycelial structure of the fungus. In addition, coating effectively reduced the weight loss, mildew rate, and calcification index during 16 days of storage of chestnuts at 25 °C.
Impacts of Variable Climate and Effluent Flows on the Transboundary Santa Cruz Aquifer
Authors: Tapia‐Villaseñor Elia M. , Shamir Eylon , Megdal Sharon B. , Petersen‐Perlman Jacob D.
Published: June 2020

Assessing groundwater resources in the arid and semiarid borderlands of the United States and Mexico represents a challenge for land and water managers, particularly in the Transboundary Santa Cruz Aquifer (TSCA). Population growth, residential construction, and industrial activities have increased groundwater demand in the TSCA, in addition to wastewater treatment and sanitation demands. These activities, coupled with climate variability, influence the hydrology of the TSCA and emphasize the need for groundwater assessment tools for decision‐making purposes. This study assesses the impacts of changes in groundwater demand, effluent discharge, and climate uncertainties within the TSCA from downstream of the Nogales International Wastewater Treatment Plant to the northern boundary of the Santa Cruz Active Management Area. We use a conceptual water budget model to analyze the long‐term impact of the different components of potential recharge and water losses within the aquifer. Modeling results project a future that ranges from severe long‐term drying to positive wetting. This research improves the understanding of the impact of natural and anthropogenic variables on water sustainability, with an accessible methodology that can be globally applied.
SWMM Sensitivity to LID Siting and Routing Parameters: Implications for Stormwater Regulatory Compliance
Authors: Panos Chelsea L. , Wolfand Jordyn M. , Hogue Terri S.
Published: June 2020

Cities are experiencing new growth through infill development, or “redevelopment,” where lower density land uses are redeveloped to high density with increased impervious surfaces. Cities need revised stormwater criteria to manage increases in stormwater runoff and flooding from redevelopment via low impact development (LID). Watershed‐scale hydrologic modeling in the Storm Water Management Model (SWMM) can help policy makers revise regulations to adapt to redevelopment. However, LID modeling is still relatively new and the understanding of model sensitivity to certain parameters is lacking. In particular, LID siting and routing parameters such as outflow routing from, area treated by, and placement of LID are not well studied. Using a case study of a redeveloping neighborhood in Denver, Colorado, we tested 32 configurations of these parameters in a calibrated, SWMM for PC (PCSWMM) model. We found some configurations lead to counter‐acting model processes that result in similar runoff reduction across a variety of configurations, suggesting to policy makers that reduction targets may be met in a myriad of ways. The relative sensitivity of runoff volume to area treated and LID placement was found to be on average 3.0 and 11.2 times higher than other model parameters. Given this sensitivity, practitioners and modelers should consider LID siting and routing parameters in hydrologic modeling efforts that inform regulations.
Limiting treatment in pre‐hospital care: A prospective, observational multicentre study
Authors: Kangasniemi Heidi , Setälä Piritta , Olkinuora Anna , Huhtala Heini , Tirkkonen Joonas , Kämäräinen Antti , Virkkunen Ilkka , Yli‐Hankala Arvi , Jämsen Esa , Hoppu Sanna
Published: June 2020

Background

Data are scarce on the withdrawal of life‐sustaining therapies and limitation of care orders (LCOs) during physician‐staffed Helicopter Emergency Medical Service (HEMS) missions. We investigated LCOs and the quality of information available when physicians made treatment decisions in pre‐hospital care.

Methods

A prospective, nationwide, multicentre study including all Finnish physician‐staffed HEMS bases during a 6‐month study period. All HEMS missions where a patient had pre‐existing LCOs and/or a new LCO were included.

Results

There were 335 missions with LCOs, which represented 5.7% of all HEMS missions (n = 5895). There were 181 missions with pre‐existing LCOs, and a total of 170 new LCOs were issued. Usually, the pre‐existing LCO was a do not attempt cardiopulmonary resuscitation order only (n = 133, 74%). The most frequent new LCO was ‘termination of cardiopulmonary resuscitation’ only (n = 61, 36%), while ‘no intensive care’ combined with some other LCO was almost as common (n = 54, 32%). When issuing a new LCO for patients who did not have any preceding LCOs (n = 153), in every other (49%) case the physicians thought that the patient should have already had an LCO. When the physician made treatment decisions, patients' background information from on‐scene paramedics was available in 260 (78%) of the LCO missions, while patients' medical records were available in 67 (20%) of the missions.

Conclusion

Making LCOs or treating patients with pre‐existing LCOs is an integral part of HEMS physicians' work, with every twentieth mission involving LCO patients. The new LCOs mostly concerned withholding or withdrawal of cardiopulmonary resuscitation and intensive care.
Efficacy, acceptability, and tolerability of all available treatments for insomnia in the elderly: a systematic review and network meta‐analysis
Authors: Samara M. T. , Huhn M. , Chiocchia V. , Schneider‐Thoma J. , Wiegand M. , Salanti G. , Leucht S.
Published: June 2020

Objectives

Symptoms of insomnia are highly prevalent in the elderly. A significant number of pharmacological and non‐pharmacological interventions exist, but, up‐to‐date, their comparative efficacy and safety has not been sufficiently assessed.

Methods

We integrated the randomized evidence from every available treatment for insomnia in the elderly (>65 years) by performing a network meta‐analysis. Several electronic databases were searched up to May 25, 2019. The two primary outcomes were total sleep time and sleep quality. Data for other 6 efficacy and 8 safety outcomes were also analyzed.

Results

Fifty‐three RCTs with 6832 participants (75 years old on average) were included, 43 of which examined the efficacy of one or more drugs. Ten RCTs examined the efficacy of non‐pharmacological interventions and were evaluated only with pairwise meta‐analyses because they were disconnected from the network. The overall confidence in the evidence was very low primarily due to the small amount of data per comparison and their sparse connectedness. Several benzodiazepines, antidepressants, and z‐drugs performed better in both primary outcomes, but few comparisons had data from more than one trial. The limited evidence on non‐pharmacological interventions suggested that acupressure, auricular acupuncture, mindfulness‐based stress reduction program, and tart cherry juice were better than their control interventions. Regarding safety, no clear differences were detected among interventions due to large uncertainty.

Conclusions

Insufficient evidence exists on which intervention is more efficacious for elderly patients with insomnia. More RCTs, with longer duration, making more direct interventions among active treatments and presenting more outcomes are urgently needed.
Early salvage radiotherapy in patients with biochemical recurrence after radical prostatectomy: Its impact and optimal candidate
Authors: Tomita Natsuo , Uchiyama Kaoru , Mizuno Tomoki , Imai Mikiko , Sugie Chikao , Ayakawa Shiho , Niwa Masanari , Matsui Tooru , Otsuka Shinya , Manabe Yoshihiko , Nomura Kento , Kondo Takuhito , Kosaki Katsura , Miyakawa Akifumi , Miyamoto Akihiko , Takemoto Shinya , Yasui Takahiro , Shibamoto Yuta
Published: June 2020

Aim

We aimed to identify the optimal candidates for early salvage radiotherapy (SRT) among patients with biochemical recurrence (BCR) after radical prostatectomy (RP).

Methods

This multi‐institutional retrospective study included 371 patients treated using SRT after RP. The median (range) PSA level at BCR was 0.36 (0.10‐2.00) ng/mL. The association between early SRT (ie, starting PSA level < 0.50) and BCR after SRT was tested in each subgroup according to our own risk stratification.

Results

The median follow‐up time was 51 months. By multivariate analysis, pT3b, Gleason score ≥ 8, negative surgical margins, PSA doubling time < 6 months, and non‐early SRT were associated with BCR after SRT. Patients were stratified by four risk factors other than non‐early SRT: (1) low risk (0 risk factor), (2) intermediate risk (1 risk factor), and (3) high risk (≥2 risk factors). The BCR‐free survival was higher in the early SRT group than the nonearly SRT group in the high‐risk subgroup (P = 0.020), whereas that was similar between two groups in the low‐risk and intermediate‐risk subgroups (P = .79 and .18, respectively). Multivariate analysis revealed that early SRT was beneficial for the high‐risk subgroup (P = .032), whereas early SRT was not associated with improved outcomes in the low‐risk and intermediate‐risk subgroups (P = .92 and 1.0, respectively).

Conclusions

This study suggested that early SRT seemed to contribute to better biochemical control for patients with more adverse features, whereas no benefit was observed in men with no adverse features.
Gastrostomy dependency trends over 15 years of patients at a large tertiary referral center following the insertion of a prophylactic gastrostomy for chemoradiation for mucosal head and neck cancer
Authors: Fraser Allison , Odelli Cathy , Britton Ben , Kumar Mahesh , Day Fiona , Tieu Minh Thi , Wratten Chris
Published: June 2020

Aim

The routine use of prophylactic percutaneous endoscopic gastrostomy (PEG) tubes for nutrition support during radical chemoradiation for head and neck cancer has been suggested to result in PEG dependency. This research aimed to determine the rates of gastrostomy dependency at the Calvary Mater Newcastle (CMN) where PEGs are routinely used and to identify potentially modifiable risk factors.

Methods

All patients with head and neck cancer planned for curative chemoradiation with a prophylactic PEG inserted were included in this review. Medical records of 250 patients treated between 2000 and 2015 were examined.

Results

Overall, eight patients (3%) were unable to wean. At 12 months following treatment, 16 patients (6%) still required PEG tubes for feeding. A greater T extent (T4 or synchronous head and neck tumors) and number of days Nil By Mouth (NBM) remained as significant independent risk factors for PEG dependency at 12 months (Textent OR 6.96 P < .001; NBM OR 1.01 P = .004) and overall (Textent OR8.04 P = .02; NBM OR1.01 P = .001). Associations with NBM were investigated, which demonstrated that patients had less NBM days with intensity‐modulated radiation therapy (IMRT) (β‐13.3, P = .007) and seeing a speech pathologist during treatment (β‐11.9, P = .026). More NBM days were associated with tumors with greater T extent (β+22; P < .001).

Conclusion

The routine use of prophylactic PEGs has not resulted in significant rates of PEG dependency at the CMN. Seeing a speech pathologist during treatment and IMRT may decrease time NBM, which was identified as a potentially modifiable risk factor for PEG dependency.
Retrospective analysis of hospital admissions due to immune checkpoint inhibitor‐induced immune‐related adverse events (irAE)
Authors: Ahern Elizabeth , Allen Michael J , Schmidt Andrew , Lwin Zarnie , Hughes Brett G.M.
Published: June 2020

Aim

Hospital admissions secondary to immune‐related adverse events (irAE) arising from immune checkpoint inhibitors (ICI) are likely to increase with increasing use of this class of drug. We sought to determine the characteristics and outcomes of hospital admissions due to irAE.

Methods

A retrospective analysis of patients treated with ICI at two tertiary hospitals in Queensland (Australia) was performed. Patients who received at least one dose of ICI for a nonhaematological malignancy between the 1st January 2016 and 1st January 2017 were included. All subsequent hospital admissions were analyzed.

Results

A total of 140 patients were included, with the most common malignancies being non‐small‐cell‐cell lung cancer (41%) and melanoma (18%), and most patients received anti‐PD1 treatment (78%). A sum of 76 patients accounted for 116 admissions. Comparing admissions due to irAE and non‐irAE, those admitted for irAE had a significantly longer duration on ICI prior to admission (173 vs 105 days, P = 0.04) but durations of admissions were similar (9.0 vs 8.5 days, P = 0.85). Fifteen patients (11% overall cohort) accounted for 18 admissions attributable to 16 separate irAE. irAE was not considered as a differential diagnosis on admission in 7 patients (38%). In those patients, commencement of corticosteroids was delayed (1.5 days, P = 0.01) but this did not translate into adverse outcomes such as prolonged admissions, prolonged steroid use or long‐term complications. All patients with irAE were managed with high‐dose corticosteroids. One death resulted from irAE (pneumonitis).

Conclusions

A sum of 11% patients receiving ICI required hospital admission for irAE. The relatively high rate of irAE as a missed differential diagnosis on admission suggests a need for improved cross‐discipline awareness, education, and institutional management guidelines.
The association of lung ultrasound images with COVID‐19 infection in an emergency room cohort
Authors: Bar S. , Lecourtois A. , Diouf M. , Goldberg E. , Bourbon C. , Arnaud E. , Domisse L. , Dupont H. , Gosset P.
Published: June 2020

Lung ultrasound could facilitate the triage of patients with suspected COVID‐19 infection admitted to the emergency room. We developed a predictive model for COVID‐19 diagnosis based on lung ultrasound and clinical features. We used ultrasound to image the lung bilaterally at two anterior sites, one and two hands below each clavicle, and a posterolateral site that was the posterior transverse continuation from the lower anterior site. We studied 100 patients, 31 of whom had a COVID‐19 positive reverse transcriptase polymerase chain reaction. A positive test was independently associated with: quick sequential organ failure assessment score ≥1; ≥3 B‐lines at the upper site; consolidation and thickened pleura at the lower site; and thickened pleura line at the posterolateral site. The model discrimination was an area (95%CI) under the receiver operating characteristic curve of 0.82 (0.75–0.90). The characteristics (95%CI) of the model’s diagnostic threshold, applied to the population from which it was derived, were: sensitivity, 97% (83–100%); specificity, 62% (50–74%); positive predictive value, 54% (41–98%); and negative predictive value, 98% (88–99%). This model may facilitate triage of patients with suspected COVID‐19 infection admitted to the emergency room.
How Job Insecurity Affects Political Attitudes: Identity Threat Plays a Role
Authors: Selenko Eva , De Witte Hans
Published: June 2020

This study tests the assumption that job insecurity threatens people’s work‐related identities and thereby affects their political attitudes. Work‐related identity threat in times of job insecurity is proposed to happen in two ways: people will fear to lose an important part of their identity (their identity as employed people), and they can also be afraid to gain a negative identity (their feared future self of becoming unemployed). Both identity threats are proposed to lead to more antiegalitarian attitudes and more political leaning to the right. A four‐wave study among 969 employed British employees delivers support for some of the assumptions. In line with the expectations, results of time‐stable structural equation modeling show that job insecurity indeed threatens the identity as an employed person, which leads to an increase in antiegalitarian attitudes over time. Different than expected, identity threat in the form of a heightened identification with the unemployed was not found. Also, people who identified more as unemployed people actually reported fewer antiegalitarian attitudes and shifted their political standing more to the left.
Impact of the introduction of direct‐acting anti‐viral drugs on hepatocarcinogenesis: a prospective serial follow‐up MRI study
Authors: Kumada Takashi , Toyoda Hidenori , Yasuda Satoshi , Tada Toshifumi , Ogawa Sadanobu , Takeshima Kenji , Tanaka Junko , Chayama Kazuaki , Johnson Philip J
Published: June 2020

Background

We conducted a prospective study using gadolinium‐ethoxybenzyl‐diethylenetriamine pentaacetic acid–enhanced magnetic resonance imaging (Gd‐EOB‐MRI) to determine whether sustained virological response (SVR) by direct‐acting anti‐viral (DAA) drugs suppresses hepatocarcinogenesis in patients with hepatitis C virus (HCV) infection.

Aim

To use serial Gd‐EOB‐MRI to assess the impact of DAAs on hepatocarcinogenesis.

Methods

Between February 2008 and December 2018, 1083 consecutive patients with HCV infection underwent Gd‐EOB‐MRI. Of these, 719 patients were enrolled, including 210 patients in the ‘Non‐DAA group’, who did not receive DAAs before the introduction of DAAs, and 509 patients in the ‘DAA group’, who achieved SVR after the introduction of DDAs. Factors associated with hepatocarcinogenesis were analysed by a Cox proportional hazard model. In addition, hepatocarcinogenesis was classified into two types, ‘multistep’ and ‘de novo’, on the basis of Gd‐EOB‐MRI findings. Factors associated with each type were analysed by Fine and Gray proportional hazards models.

Results

Hepatocarcinogenesis was observed in 67 of 719 (9.3%) patients. Factors associated with hepatocarcinogenesis were male gender, albumin‐bilirubin (ALBI) grade 2 or 3, Lens culinaris agglutinin–reactive fraction of alpha‐fetoprotein (AFP‐L3) ≥5%, the presence of nonhypervascular hypointense nodules (NHHNs) and Non‐DAA group. Of 67 patients, multistep hepatocarcinogenesis occurred in 58 patients (86.6%) and de novo hepatocarcinogenesis occurred in nine patients (13.4%). Factors associated with multistep hepatocarcinogenesis were male gender and Non‐DAA group.

Conclusion

The eradication of HCV by DAA therapy reduces multistep hepatocarcinogenesis.
The effect of sex on the quality of meat from farmed pheasants (Phasianus colchicus)
Authors: Daszkiewicz Tomasz , Janiszewski Paweł
Published: June 2020

The present study aimed to investigate the influence of sex on the quality of meat from farmed pheasants. Male (roosters, n = 18) and female (hens, n = 18) pheasants were slaughtered at 25 weeks of age. The breast muscles (Pectoralis major) were cut out from chilled carcasses and analyzed to determine the proximate chemical composition, fatty acid profile, and physicochemical and sensory properties of meat. Chemical analyses revealed that the meat of male had higher (p ≤ .05) content of collagen, Na, Cu, and Zn, whereas meat from females had higher (p ≤ .05) concentrations of total nitrogen of water‐soluble compounds, nitrogen of water‐soluble non‐protein compounds, K, and Mn. The meat of male was characterized by greater (p ≤ .05) cooking loss. A sensory evaluation revealed that meat from females had lower (p ≤ .05) taste intensity and aroma desirability. Meat from male and female pheasants revealed differences in the content of minerals as well as low‐molecular‐weight water‐soluble nitrogen compounds, which may affect the flavor of cooked meat. Irrespective of these differences, the analyzed pheasant meat was characterized by high quality, which indicates that it could offer an attractive alternative to other types of meat.
First‐in‐human study of the safety, tolerability, pharmacokinetics and pharmacodynamics of single and multiple oral doses of SAR247799, a selective G‐protein‐biased sphingosine‐1 phosphate receptor‐1 agonist for endothelial protection
Authors: Bergougnan Luc , Armani Sara , Golor Georg , Tardat Agnes , Vitse Olivier , Hurbin Fabrice , Scemama Michel , Poitiers Franck , Radzik David , Gaudin Christophe , Hovsepian Lionel , Muslin Anthony J. , Kirkesseli Stephane , Deutsch Paul , Parkar Ashfaq A.
Published: June 2020

Aims

SAR247799 is a selective G‐protein‐biased sphingosine‐1 phosphate receptor‐1 (S1P1) agonist with potential to restore endothelial function in vascular pathologies. SAR247799, a first‐in‐class molecule differentiated from previous S1P1‐desensitizing molecules developed for multiple sclerosis, can activate S1P1 without desensitization and consequent lymphopenia. The aim was to characterize SAR247799 for its safety, tolerability, pharmacokinetics and pharmacodynamics (activation and desensitization).

Methods

SAR247799 was administered orally to healthy subjects in a double‐blind, randomized, placebo‐controlled study with single (2.5–37.5 mg) or 2‐week once‐daily (0.5–15 mg) doses. An open‐label single dose pilot food‐interaction arm with 10 mg SAR247799 in cross‐over design was also performed.

Results

SAR247799 was well tolerated and, at the higher end of the dose ranges, caused the expected dose‐dependent pharmacodynamics associated with S1P1 activation (heart rate reduction) and S1P1 desensitization (lymphocyte count reduction). SAR247799 demonstrated dose‐proportional increases in exposure and was eliminated with an apparent terminal half‐life of 31.2–33.1 hours. Food had a small effect on the pharmacokinetics of SAR247799. SAR247799 had a low volume of distribution (7–23 L), indicating a potential to achieve dose separation for endothelial vs cardiac S1P1 activation pharmacology. A supratherapeutic dose (10 mg) of SAR247799 produced sustained heart rate reduction over 14 days, demonstrating cardiac S1P1 activation without tachyphylaxis. Sub‐lymphocyte‐reducing doses (≤5 mg) of SAR247799, which, based on preclinical data, are projected to activate S1P1 and exhibit endothelial‐protective properties, had minimal‐to‐no heart rate reduction and displayed no marked safety findings.

Conclusion

SAR247799 is suitable for exploring the biological role of endothelial S1P1 activation without causing receptor desensitization.
Optimizing patient expectations to improve therapeutic response to medical treatment: A randomized controlled trial of iron infusion therapy
Authors: Akroyd Amelia , Gunn Kerry N. , Rankin Sarah , Douglas Meihana , Kleinstäuber Maria , Rief Winfried , Petrie Keith J.
Published: June 2020

Objectives

Patient expectations have the ability to influence health outcomes and have been shown to play an important role as part of the placebo effect to influence the response to medical treatments. Increasing positive expectations have been proposed as an intervention to improve treatment response, although evidence for this to date is limited. We investigated whether a brief 10‐min intervention directly targeting patient expectations prior to an iron infusion could enhance expectations and improve treatment response, in terms of patients' reported fatigue.

Design

Randomized controlled trial.

Methods

Forty‐three patients diagnosed with iron deficiency anaemia were randomized to a brief expectation intervention or active control group prior to an intravenous iron infusion. Chalder Fatigue Scale scores were assessed prior to randomization and at one and four weeks.

Results

The expectation intervention significantly improved patients' expectations about the effectiveness of the intravenous iron infusion, t(21) = −3.95, p = .001. While there were no significant differences between groups in fatigue at the one‐week follow‐up, fatigue was significantly lower in the intervention group at the four‐week follow‐up compared to the control group, F(1, 25) = 6.25, p = .019. This was largely influenced by a significant reduction in physical, as opposed to mental fatigue scores.

Conclusions

Boosting patients' positive expectations may be an effective way of enhancing patient response to treatment. In particular, targeting patient expectations with a brief intervention prior to medical treatments may result in a greater and longer therapeutic effect.
Randomised comparison of techniques for control of the dorsal venous complex during robot‐assisted laparoscopic radical prostatectomy
Authors: Feng Tom , Heulitt Gerald , Lee Janet J. , Liao Michael , Li Hsin‐Fang , Porter James R.
Published: June 2020

Objective

To prospectively compare the effects of endoscopic stapling, division and suture ligation, and suture ligation with suspension of the dorsal venous complex (DVC) on continence during robot‐assisted laparoscopic radical prostatectomy (RARP).

Patients and methods

In all, 300 consecutive patients undergoing RARP by a single surgeon were randomised to three groups: endoscopic stapling, cut and suture ligation, and suture ligation with suspension. The only difference between the groups was the technique to control the DVC. Pad‐free continence (PFC) and overall continence (0 pads/day with or without security pad) were assessed with patient reported pad usage records and validated questionnaires (Expanded Prostate Cancer Index) at 3, 12, and 15 months. Secondary endpoints were erectile function (EF) recovery (defined as erections sufficient for sexual activity) and the rate of apical surgical margins. Univariate and multivariate analyses were conducted to determine predictors for recovery of both urinary continence and EF.

Results

The three groups were comparable in terms of age, body mass index, prostate size, American Urological Association symptom score, Sexual Health Inventory for Men, and clinical stage. There were no differences found in terms of operative times, estimated blood loss, pathological stage, and positive apical margin. There was no difference between the three groups with regard to overall continence or PFC at 3 months. However, overall continence at 15 months for ligation and suspension was 99% and was superior to stapler (88%) (P = 0.002) and cut and suture ligation (88%) (P = 0.002). Additionally, PFC at 15 months was superior for ligation and suspension (87%) as compared to stapler (73%) and cut and suture ligation (75%) (P = 0.045). The technique of DVC control did not impact EF. Men with nerve sparing had better continence compared to no nerve sparing at 3 months (62% vs 42%, P = 0.045), but not at 15 months. The median time to continence was 2 months for patients receiving nerve sparing compared to 4.5 months for non‐nerve sparing (P = 0.02).

Conclusion

Suture suspension of the DVC during RARP contributes to higher overall continence rates compared to stapling and cut and suture. Nerve sparing contributes to earlier return of continence than non‐nerve sparing.
Artesunate interacts with the vitamin D receptor to reverse sepsis‐induced immunosuppression in a mouse model via enhancing autophagy
Authors: Shang Shenglan , Wu Jiaqi , Li Xiaoli , Liu Xin , Li Pan , Zheng Chunli , Wang Yonghua , Liu Songqing , Zheng Jiang , Zhou Hong
Published: June 2020

Background and Purpose

Immunosuppression is the predominant cause of mortality for sepsis because of failure to eradicate pathogens. No effective and specific drugs capable of reversing immunosuppression are clinically available. Evidences implicate the involvement of the vitamin D receptor (NR1I1) in sepsis‐induced immunosuppression. The anti‐malarial artesunate was investigated to determine action on sepsis‐induced immunosuppression.

Experimental Approach

The effect of artesunate on sepsis‐induced immunosuppression was investigated in mice and human and mice cell lines. Bioinformatics predicted vitamin D receptor as a candidate target for artesunate, which was then identified using PCR and immunoblotting. Vdr, Atg16l1 and NF‐κB p65 were modified to investigate artesunate 's effect on pro‐inflammatory cytokines release, bacterial clearance and autophagy activities in sepsis‐induced immunosuppression.

Key Results

Artesunate significantly reduced the mortality of caecal ligation and puncture (CLP)‐induced sepsis immunosuppression mice challenged with Pseudomonas aeruginosa and enhanced pro‐inflammatory cytokine release and bacterial clearance to reverse sepsis‐induced immunosuppression in vivo and in vitro. Mechanistically, artesunate interacted with vitamin D receptor, inhibiting its nuclear translocation, which influenced ATG16L1 transcription and subsequent autophagy activity. Artesunate inhibited the physical interaction between vitamin D receptor and NF‐κB p65 in LPS‐tolerant macrophages and then promoted the nuclear translocation of NF‐κB p65, which activated the transcription of NF‐κB p65 target genes such as pro‐inflammatory cytokines.

Conclusion and Implications

Our findings provide evidence that artesunate interacted with vitamin D receptor to reverse sepsis‐induced immunosuppression in an autophagy and NF‐κB‐dependent manner, highlighting a novel approach for sepsis treatment and drug repurposing of artesunate has a bidirectional immunomodulator.
Peptide‐2 from mouse myostatin precursor protein alleviates muscle wasting in cancer‐associated cachexia
Authors: Ojima Chiharu , Noguchi Yuri , Miyamoto Tatsuki , Saito Yuki , Orihashi Hiroki , Yoshimatsu Yasuhiro , Watabe Tetsuro , Takayama Kentaro , Hayashi Yoshio , Itoh Fumiko
Published: June 2020

Cancer cachexia, characterized by continuous muscle wasting, is a key determinant of cancer‐related death; however, there are few medical treatments to combat it. Myostatin (MSTN)/growth differentiation factor 8 (GDF‐8), which is a member of the transforming growth factor‐β family, is secreted in an inactivated form noncovalently bound to the prodomain, negatively regulating the skeletal muscle mass. Therefore, inhibition of MSTN signaling is expected to serve as a therapeutic target for intractable muscle wasting diseases. Here, we evaluated the inhibitory effect of peptide‐2, an inhibitory core of mouse MSTN prodomain, on MSTN signaling. Peptide‐2 selectively suppressed the MSTN signal, although it had no effect on the activin signal. In contrast, peptide‐2 slightly inhibited the GDF‐11 signaling pathway, which is strongly related to the MSTN signaling pathway. Furthermore, we found that the i.m. injection of peptide‐2 to tumor‐implanted C57BL/6 mice alleviated muscle wasting in cancer cachexia. Although peptide‐2 was unable to improve the loss of heart weight and fat mass when cancer cachexia model mice were injected with it, peptide‐2 increased the gastrocnemius muscle weight and muscle cross‐sectional area resulted in the enhanced grip strength in cancer cachexia mice. Consequently, the model mice treated with peptide‐2 could survive longer than those that did not undergo this treatment. Our results suggest that peptide‐2 might be a novel therapeutic candidate to suppress muscle wasting in cancer cachexia.
Diagnosis of severe growth hormone deficiency in the newborn
Authors: Binder Gerhard , Weber Karin , Rieflin Nora , Steinruck Louis , Blumenstock Gunnar , Janzen Nils , Franz Axel R.
Published: June 2020

Objective

Severe neonatal growth hormone deficiency (GHD) can cause recurrent hypoglycaemia. Early diagnosis is warranted. The aim of the study was to analyse the GH content in screening cards of 25 affected and 281 healthy newborns.

Patients and Measurements

A total of 110 screening cards from ill newborns were sent to us for measuring GH content by a highly sensitive GH ELISA. Clinical information was obtainable in 61 cases. Severe GHD was defined by the presence of recurrent hypoglycaemia with a significant pituitary malformation or two additional pituitary hormone deficiencies. Screening cards from 281 healthy newborns (34.0‐37.9 weeks) were prospectively analysed.

Results

In 25 newborns (5 preterm), the definition of severe GHD was fulfilled based on recurrent hypoglycaemia in combination with malformation of the pituitary or midline structures in 21 cases and combined TSH and ACTH deficiency in four cases. The median GH concentration of those affected with severe GHD was 3.9 µg/L (range: 1.1‐11.8), significantly below the previously reported reference range (P < .001). A GH concentration of 7 µg/L was confirmed as the cut‐off for term newborns with the best accuracy (90.0% sensitivity and 98.7% specificity). The 95% reference range for healthy preterm newborns (n = 151) was 7.6‐47.1 µg/L (median: 20.3 µg/L).

Conclusions

A GH content <7.0 µg/L in the newborn screening card confirms severe GHD with high accuracy. In preterm newborns, the lower limit of the reference interval was 0.6 µg/L higher than in term newborns. The newborn screening card is a valuable source for the very early diagnosis of GH deficiency.
Anwendungsfehler bei lokaler Skabiestherapie: eine Beobachtungsstudie
Authors: Nemecek Romina , Stockbauer Anna , Lexa Martina , Poeppl Wolfgang , Mooseder Gerhard
Published: June 2020

Hintergrund

In den letzten Jahren wurde im deutschsprachigen Raum ein deutlicher Anstieg an Skabiesinfestationen beobachtet. Aufgrund häufiger Therapieversager stellt sich die Frage, ob die Anwendung der lokalen Permethrintherapie korrekt erfolgt.

Patienten und Methodik

An unserer Abteilung werden Skabiespatienten bezüglich einer korrekten Anwendung mithilfe einer fluoreszierenden Testcreme geschult. Im Rahmen einer prospektiven Anwendungsbeobachtung wurden bei 21 Patienten etwaige Anwendungsfehler systematisch erhoben und analysiert.

Ergebnisse

Die Vorgabe einer lückenlosen Applikation laut Anweisung wurde von keinem einzigen Studienteilnehmer erreicht. Die mittlere Anzahl der ausgesparten Körperareale betrug 6 (Min.: 2; Max.: 18), die mittlere ausgesparte Körperoberfläche betrug 6 % (Min.: 2 %, Max.: 30 %). Bezüglich Skabiesprädilektionsstellen waren Fußgelenke in 62 % der Fälle ausgespart, gefolgt von Zehenzwischenräumen mit 33 % und Sakralregion mit 24 %. Die durchgeführte Schulungsmaßnahme wurde von sämtlichen Patienten als äußerst hilfreich beurteilt.

Schlussfolgerungen

Die vorliegenden Ergebnisse zeigen eindrucksvoll, dass die Anwendungsgenauigkeit bei Skabiespatienten unzureichend sein kann und bieten ein (möglicherweise unterschätztes) Erklärungsmodell für die häufigen Berichte über Therapieversagen einer topischen Skabiestherapie, welche den Eindruck eines Resistenzproblems erwecken.
S1‐Leitlinie Diagnostik und Therapie des Analekzems
Authors: Weyandt Gerhard , Breitkopf Claudia , Werner Ricardo Niklas , Zidane Miriam , Furtwängler Alex , Jongen Johannes , Rothhaar Alex , Schaefer Daniel , Lenhard Bernhard
Published: June 2020

Das Analekzem (Syn.: perianale Dermatitis, perianales Ekzem) ist eine der häufigsten proktologischen Erkrankungen und tritt als Folgeerscheinung oder Teilsymptom verschiedener proktologischer, dermatologischer, allergologischer oder mikrobieller Veränderungen auf. Die drei Hauptformen des Analekzems sind das irritativ‐toxische, das atopische und das kontaktallergische Analekzem. Die diagnostische Einordnung der Ätiologie ermöglicht die angemessene und erfolgreiche Behandlung von Patienten mit Analekzem. Diese umfasst die Behandlung beziehungsweise Beseitigung ätiologischer Faktoren und die nichtmedikamentöse Therapie (Meidung aggravierender Faktoren). Unterstützend kann eine topische antientzündliche und/oder spezifische symptomatische Therapie erforderlich werden. Die vorliegende Leitlinie enthält Empfehlungen zum diagnostischen und therapeutischen Management des Analekzems und richtet sich an Ärzte der Fachrichtungen Dermatologie und Proktologie sowie aller weiteren Fachrichtungen in Klinik und Praxis, die an der Behandlung von Patienten mit Analekzem beteiligt sind.