bluuebunny/crossref_metadata_2025 huggingface dataset:
Aicardi-Goutières Syndrome gene Rnaseh2c is a metastasis susceptibility gene in breast cancer
Authors: Deasy Sarah K. , Uehara Ryo , Vodnala Suman K. , Yang Howard H. , Dass Randall A. , Hu Ying , Lee Maxwell P. , Crouch Robert J. , Hunter Kent W.
Published: February 2019

Breast cancer is the second leading cause of cancer-related deaths in the United States, with the majority of these deaths due to metastatic lesions rather than the primary tumor. Thus, a better understanding of the etiology of metastatic disease is crucial for improving survival. Using a haplotype mapping strategy in mouse and shRNA-mediated gene knockdown, we identified Rnaseh2c, a scaffolding protein of the heterotrimeric RNase H2 endoribonuclease complex, as a novel metastasis susceptibility factor. We found that the role of Rnaseh2c in metastatic disease is independent of RNase H2 enzymatic activity, and immunophenotyping and RNA-sequencing analysis revealed engagement of the T cell-mediated adaptive immune response. Furthermore, the cGAS-Sting pathway was not activated in the metastatic cancer cells used in this study, suggesting that the mechanism of immune response in breast cancer is different from the mechanism proposed for Aicardi-Goutières Syndrome, a rare interferonopathy caused by RNase H2 mutation. These results suggest an important novel, non-enzymatic role for RNASEH2C during breast cancer progression and add Rnaseh2c to a panel of genes we have identified that together could determine patients with high risk for metastasis. These results also highlight a potential new target for combination with immunotherapies and may contribute to a better understanding of the etiology of Aicardi-Goutières Syndrome autoimmunity.

Author Summary

The majority of breast cancer-associated deaths are due to metastatic disease, the process where cancerous cells leave the primary tumor in the breast and spread to a new location in the body. To better understand the etiology of this process, we investigate the effects of gene expression changes in the primary tumor. In this study, we found that changing the expression of the gene Rnaseh2c changed the number of metastases that developed in the lungs of tumor-bearing mice. By investigating the enzyme complex Rnaseh2c is part of, RNase H2, we determined that Rnaseh2c’s effects may be independent of RNase H2 enzyme activity. Because Rnaseh2c is known to cause the autoimmune disease Aicardi-Goutières Syndrome (AGS), we tested whether the immune system is involved in the metastatic effect. Indeed, we found that the cytotoxic T cell response is important for mediating the effect that Rnaseh2c has on metastasis. Together these data indicate that Rnaseh2c expression contributes to a patient’s susceptibility to developing breast cancer metastasis and demonstrate that the immune system is involved in this outcome. The implications of this study suggest immunotherapy could be a viable treatment for breast cancer metastasis and may help inform the understanding of AGS and RNase H2 in cancer.
Evolution of gene regulation in ruminants differs between evolutionary breakpoint regions and homologous synteny blocks
Authors: Farré Marta , Kim Jaebum , Proskuryakova Anastasia A. , Zhang Yang , Kulemzina Anastasia I. , Li Qiye , Zhou Yang , Xiong Yingqi , Johnson Jennifer L. , Perelman Polina L. , Johnson Warren E. , Warren Wesley C. , Kukekova Anna V. , Zhang Guojie , O'Brien Stephen J. , Ryder Oliver A. , Graphodatsky Alexander S. , Ma Jian , Lewin Harris A. , Larkin Denis M.
Published: February 2019

The role of chromosome rearrangements in driving evolution has been a long-standing question of evolutionary biology. Here we focused on ruminants as a model to assess how rearrangements may have contributed to the evolution of gene regulation. Using reconstructed ancestral karyotypes of Cetartiodactyls, Ruminants, Pecorans, and Bovids, we traced patterns of gross chromosome changes. We found that the lineage leading to the ruminant ancestor after the split from other cetartiodactyls was characterized by mostly intrachromosomal changes, whereas the lineage leading to the pecoran ancestor (including all livestock ruminants) included multiple interchromosomal changes. We observed that the liver cell putative enhancers in the ruminant evolutionary breakpoint regions are highly enriched for DNA sequences under selective constraint acting on lineage-specific transposable elements (TEs) and a set of 25 specific transcription factor (TF) binding motifs associated with recently active TEs. Coupled with gene expression data, we found that genes near ruminant breakpoint regions exhibit more divergent expression profiles among species, particularly in cattle, which is consistent with the phylogenetic origin of these breakpoint regions. This divergence was significantly greater in genes with enhancers that contain at least one of the 25 specific TF binding motifs and located near bovidae-to-cattle lineage breakpoint regions. Taken together, by combining ancestral karyotype reconstructions with analysis of cis regulatory element and gene expression evolution, our work demonstrated that lineage-specific regulatory elements colocalized with gross chromosome rearrangements may have provided valuable functional modifications that helped to shape ruminant evolution.
Lattice versus structure, dimensionality versus periodicity: a crystallographic Babel?
Authors: Nespolo Massimo
Published: February 2019

In this article, several mistakes occurring in the description of crystal structures are pointed out. (1) The term `lattice' is often used instead of `structure'. (2) The two terms `superlattice' and `sublattice' are incorrectly interchanged. (3) Substructures composed of a subset of the crystallographic orbits composing the structure are incorrectly called `sublattices'. (4) Subperiodic structures are incorrectly referred to as `low-dimensional' structures.
StructureFinder
Authors: Kratzert Daniel , Krossing Ingo
Published: February 2019

With the program StructureFinder it is possible to find single-crystal diffraction measurements stored in any location on a computer. StructureFinder collects the unit-cell information and other data from previous measurements and stores them in a database. Searching is performed via a graphical user interface, and both a stand-alone program and a web interface are available.
Age at death and comorbidity of dementia-related disorders among individuals with autism spectrum disorder
Authors: Barnard-Brak Lucy , Richman David , Yang Zhanxia
Published: February 2019

Purpose

Autism spectrum disorder (ASD) is a lifelong disorder that requires intervention and support services for a growing geriatric population. The purpose of this paper is to examine the mean age at death of individuals with ASD and subsequent comorbidity with Alzheimer’s disease, and any form of dementia, as a whole and according to sex.

Design/methodology/approach

Data consisted of 1,754 individuals who had an ASD listed as one of the causes of deaths from the National Vital Statistics System with data from 1999 to 2015. In the current study, the authors present contradictory results with a mean age at death for individuals with ASD was 68 years by adjusting for changing prevalence rates.

Findings

Females with ASD had a higher mean age at death than males with ASD; consistent with the trend in the sex differences in the general population. The results of the current study also indicate that individuals with ASD were, in fact, less likely than the general population to have Alzheimer’s disease or a form of dementia. However, males with ASD were significantly more likely to have acquired Alzheimer’s disease or a form of dementia as compared to females with ASD.

Originality/value

Guan and Li (2017) reported a mean age at death of 36 years old for individuals with ASD, which was subsequently reported in the mass media, most notably CNN. The authors contend that this study provides a more accurate estimate mean age at death.
Cloud privacy objectives a value based approach
Authors: Coss David Lewis , Dhillon Gurpreet
Published: February 2019

Purpose

To effectively develop privacy policies and practices for cloud computing, organizations need to define a set of guiding privacy objectives that can be applied across their organization. It is argued that it is important to understand individuals’ privacy values with respect to cloud computing to define cloud privacy objectives.

Design/methodology/approach

For the purpose of this study, the authors adopted Keeney’s (1994) value-focused thinking approach to identify privacy objectives with respect to cloud computing.

Findings

The results of this study identified the following six fundamental cloud privacy objectives: to increase trust with cloud provider, to maximize identity management controls, to maximize responsibility of information stewardship, to maximize individual’s understanding of cloud service functionality, to maximize protection of rights to privacy, and to maintain the integrity of data.

Research limitations/implications

One limitation is generalizability of the cloud privacy objectives, and the second is research bias. As this study focused on cloud privacy, the authors felt that the research participants’ increased knowledge of technology usage, including that of cloud technology, was a benefit that outweighed risks associated with not having a random selection of the general population. The newness and unique qualities of privacy issues in cloud computing are better fitted to a qualitative study where issues can emerge naturally through a holistic approach opposed to trying to force fit an existing set of variables or constructs into the context of privacy and cloud computing.

Practical implications

The findings of this research study can be used to assist management in the process of formulating a cloud privacy policy, develop cloud privacy evaluation criteria as well as assist auditors in developing their privacy audit work plans.

Originality/value

Currently, there is little to no guidance in the literature or in practice as to what organizations need to do to ensure they protect their stakeholders privacy in a cloud computing environment. This study works at closing this knowledge gap by identifying cloud privacy objectives.
Social media, customer engagement and advocacy
Authors: Sashi C.M. , Brynildsen Gina , Bilgihan Anil
Published: February 2019

Purpose

The purpose of this study is to examine how social media facilitates the process of customer engagement in quick service restaurants (QSRs). Customers characterized as transactional customers, loyal customers, delighted customers or fans, based on the degree of relational exchange and emotional bonds, are expected to vary in their propensity to engage in advocacy and co-create value.

Design/methodology/approach

Hypotheses linking the antecedents of customer engagement to advocacy are empirically investigated with data from the Twitter social media network for the top 50 US QSRs. Multiple regression analysis is carried out with proxies for advocacy as the dependent variable and connection effort, interaction effort, satisfaction, retention effort, calculative commitment and affective commitment as independent variables.

Findings

The results indicate that retention effort and calculative commitment of customers are the most important factors influencing advocacy. Efforts to retain customers using social media communication increase advocacy. Greater calculative commitment also increases advocacy. Affective commitment mediates the relationship between calculative commitment and advocacy.

Practical implications

Fostering retention and calculative commitment by using social media communication engenders loyalty and customers become advocates. Calculative commitment fosters affective commitment, turning customers into fans who are delighted as well as loyal, enhancing advocacy.

Originality/value

This study uniquely investigates the relationship between the antecedents of customer engagement and advocacy. It develops the theory and conducts an empirical analysis with actual social media network data for a specific industry where usage of the network is widely prevalent. It confirms that calculative commitment influences advocacy. Calculative commitment not only has a direct effect but also has an indirect effect through affective commitment on advocacy in the QSR context. Further, social media efforts by QSRs to retain customers encourage advocacy. Other customer engagement antecedents do not directly influence advocacy.
Pediatric discharge against medical advice
Authors: Al-Mohammadi Emad
Published: February 2019

Purpose

The purpose of this paper is to identify the reasons for discharges against medical advice (DAMA) and the possible outcomes among pediatric patients.

Design/methodology/approach

A retrospective cohort study was conducted on all children admitted and then discharged against medical advice in two maternity and children’s hospitals in Jeddah, 2014. Phone interviews were conducted, and medical records were reviewed for DAMA and control groups; a semi-structured questionnaire was used to collect this information.

Findings

The top three reasons identified for DAMA were parent’s false assumption that their child’s condition had improved (43.8 percent), dissatisfaction with treating/managing team (16.2 percent) and difficulties arranging care for patient’s siblings at home (7.7 percent). The readmission rate was significantly higher among DAMA pediatric patients compared to the control group (28.5 percent vs 11.5 percent) at 30-day follow-up, which highlights the importance for developing interventions aimed at reducing DAMA.

Originality/value

This study helps us to better understand DAMA reasons and outcomes. Understanding these factors can encourage appropriate interventions and policies for reducing DAMA rates. In this way, pediatric patients can be protected from inappropriate discharge consequences.
Patient safety culture in Hungarian hospitals
Authors: Granel Nina , Manresa-Domínguez Josep Maria , Barth Anita , Papp Katalin , Bernabeu-Tamayo Maria Dolors
Published: February 2019

Purpose

The Hospital Survey on Patient Safety Culture (HSOPSC) is a rigorously designed tool for measuring inpatient safety culture. The purpose of this paper is to develop a cross-cultural HSOPSC for Hungary and determine its strengths and weaknesses.

Design/methodology/approach

The original US version was translated and adapted using existing guidelines. Healthcare workers (n=371) including nurses, physicians and other healthcare staff from six Hungarian hospitals participated. Answers were analyzed using exploratory factor analyses and reliability tests.

Findings

Positive responses in all dimensions were lower in Hungary than in the USA. Half the participants considered their work area “acceptable” regarding patient safety. Healthcare staff worked in “crisis mode,” trying to accomplish too much and too quickly. The authors note that a “blame culture” does not facilitate patient safety improvements in Hungary.

Practical implications

The results provide valuable information for promoting a more positive patient safety culture in Hungary and for evaluating future strategies to improve patient safety.

Originality/value

Introducing a validated scale to measure patient safety culture in Hungary improves healthcare quality.
Implementing Lean Six Sigma in a Kuwaiti private hospital
Authors: Al-Zain Yazan , Al-Fandi Lawrence , Arafeh Mazen , Salim Samar , Al-Quraini Shouq , Al-Yaseen Aisha , Abu Taleb Deema
Published: February 2019

Purpose

The purpose of this paper is to use Lean Six Sigma (LSS) to reduce patient waiting time in a Kuwaiti private hospital obstetrics and gynaecology clinic.

Approach

The define, measure, analyse, improve and control methodology was used. The “define” stage involved identifying patients’ needs, system capabilities and project objectives. The “measure” stage assessed the system’s current state through data collection on waiting times. Dunnett’s test, control charts and process capability analysis were used to ensure data accuracy. In the “analyse” stage, an Ishikawa diagram and Pareto chart were constructed, showing that overbooking appointments, doctors’ unscheduled breaks and doctors not arriving on time were the root causes of the problem. The “improve” stage used an Arena simulation model to represent current and improved system status. The proposed solutions were implemented and monitored in the “control” stage.

Findings

A sigma-level improvement of 300 per cent (0.5–2.0) was realized for appointment patients on Saturdays, with a 67 per cent reduction in waiting time. For walk-ins, the sigma level improved by 288 per cent (0.8–3.1), with a 55 per cent reduction in waiting time. For weekday appointments, the sigma level improved by 111 per cent (0.9–1.9), with a 63 per cent reduction in waiting time. For walk-ins, the sigma level improved by 69 per cent (1.6–2.7), with a 46 per cent reduction in waiting time. A cost–benefit analysis estimated the present project value at $656,459, leading to a total of $5,820,319 in savings by 2025.

Originality/value

This paper fulfils the need for process improvement, increasing patients’ satisfaction and hospitals’ profitability using LSS.
Beyond feedback: understanding how feedforward can support employee development
Authors: Budworth Marie-Hélène , Harrison Jennifer A. , Chummar Sheryl
Published: February 2019

Purpose

Recent research has found that a technique called feedforward interviewing (FFI) can be used to develop employees on the job. Currently the mechanisms and boundary conditions of the FFI-performance relationship are unexplored. Using a positive psychology framework, the purpose of this paper is to discuss how FFI supports the creation of personal and relational resources, and explores the contextual and environmental limits to the effectiveness of the technique.

Design/methodology/approach

Through a review of the literature as well as examination through appropriate theoretical lenses, moderators of FFI are proposed and the implications for the effectiveness of the technique are examined.

Findings

The FFI model explored in this paper is rooted in broaden and build theory as well as other theories from the positive psychology literature. Design recommendations and future research directions are discussed.

Originality/value

Through a scholarly review of the literature, the potential for the effective use of a new developmental technique is explored. Direct guidance on how to apply FFI in organizations is given.
The moderating effect of emotion regulation on the relationship between risk aversion and brand sensitivity
Authors: Alhosseini Almodarresi Seyed Mahdi , Rasty Fereshte
Published: February 2019

Purpose

This paper aims to examine the moderating role of positive and negative strategies of emotion regulation on the relationship between risk aversion and brand sensitivity.

Design/methodology/approach

By conducting a survey, this study has collected a total of 405 responses and the data have been examined with structural equation modeling.

Findings

The study has demonstrated that some strategies of emotion regulation have a significant moderating effect, and they can down-regulate the effect of risk aversion on brand sensitivity. These strategies are positive refocusing, refocus on planning, positive reappraisal, putting into perspective, acceptance and rumination.

Research limitations/implications

Future studies should consider a broader range of respondents to validate the results. Moreover, the role of emotion regulation in the relationships among repurchase intention, customer loyalty and customer compliant could be examined. Further research could also focus on the relationship between risk aversion and brand sensitivity with regard to different types of buying situations and consumers’ types.

Practical implications

The findings demonstrate a substantial implication regarding emotion regulation and brand management. Positive strategies of emotion regulation make risk-averse people less likely to pay attention to brands and lead them to be less brand-sensitive. New companies and businesses could use these findings to make consumers regulate their emotions positively.

Originality/value

This research provides novel findings about the influence of consumers’ emotion regulation on brand sensitivity. People who use positive strategies of emotion regulation tend to dampen the effect of their risk aversion on brand sensitivity and will become less sensitive to the brand.
A developed software agent-knowledge-assisted procurement management tool for retailing enterprise
Authors: Anthony Jnr Bokolo
Published: February 2019

Purpose

This study aims to develop a software agent-knowledge procurement management tool to address uncertainties from external and internal environments, such as record failure, slow logistics auditing and distribution delay toward improving procurement management in retailing enterprises.

Design/methodology/approach

Quantitative methodology was used to collect data using a self-administered survey from randomly selected procurement staffs, marketers and customers to measure their perception regarding the feasibility and acceptance of the implemented agent-knowledge-based procurement management tool.

Findings

Results from empirical analysis reveal that the implemented tool facilitates collaboration and interaction among buyers, sellers and procurement managers toward enhancing procurement managers’ flexibility to handle unexpected exceptions. In addition, results confirm the feasibility of the implemented tool in supporting procurement management toward handling inventory failure exception, which occurs in traditional procurement approaches. Moreover, descriptive results from user acceptance test verify that the tool was accepted by the respondents.

Research limitations/implications

The limitation of this study is that the implemented tool is evaluated using data collected from respondents in Malaysia retailing enterprise only; thus, the results cannot be generalized to other enterprises and country. In addition, research implications from this study design a methodological and comprehensive software agent-knowledge-based model that support buyers, sellers and procurement managers with information to facilitate buying and selling operations.

Practical implications

Practically, the designed software agent-knowledge-based model describes how software agents collaborate with each other to facilitate procurement tasks and also use the knowledge base in the implemented tool to provide information sharing platform that manages the dynamics of procurement operations.

Social implications

This research integrates software agents which are autonomous programs that carryout pre-defined task on behalf of end users. Socially, this study would be useful for procurement managers in developing mechanisms for instilling insights in retailing operations.

Originality/value

This research is among the first to attempt to develop a software agent-knowledge-based model to support procurement management in the retailing enterprise domain. It contributes to promote e-procurement practices by implementing a software agent-knowledge-oriented tool to address uncertainties experienced in retailing enterprise. It is envisaged that this study will provide basis for future research into e-procurement practices for retailing businesses in Malaysia and beyond.
Baseline characterization of aerobic hydrocarbon degrading microbial communities in deep‐sea sediments of the Great Australian Bight, Australia
Authors: van de Kamp Jodie , Hook Sharon E. , Williams Alan , Tanner Jason E. , Bodrossy Levente
Published: February 2019

Exploratory drilling for deep‐sea oil and gas resources is planned for the Great Australian Bight (GAB). There is scant knowledge of the region's benthic ecosystems and no baseline information of the region's indigenous oil degrading bacteria. To address this knowledge gap, we used next generation sequencing (NGS) of three marker genes (alkB, c23o and pmoA) to detect and characterize the microbial communities capable of aerobic hydrocarbon degradation. Unique, highly novel microbial communities capable of degrading hydrocarbons occur in surface sediments at depths between 200 and 2800 m. Clustering at 97% demonstrated differences in community structure with depth, changing most markedly between 400 and 1000 m depth on the continental slope, and identified putative functional ‘ecotypes’ related to depth. Observed differences in community structure showed strong correlations with temperature, other physicochemical properties of the overlying water column and are further modulated by differences in sediment grain size. This study provides important baseline data on hydrocarbon degrading microbial communities prior to the start of petroleum resource extraction. Our data will inform future ecological monitoring of the GAB deep‐sea ecosystem.
Regional assemblage and the spatial reorganisation of health and care: the case of devolution in Greater Manchester, England
Authors: Lorne Colin , McDonald Ruth , Walshe Kieran , Coleman Anna
Published: February 2019

In this paper, we examine how space is integral to the practices and politics of restructuring health and care systems and services and specifically how ideas of assemblage can help understand the remaking of a region. We illustrate our arguments by focusing on health and social care devolution in Greater Manchester, England. Emphasising the open‐ended political construction of the region, we consider the work of assembling different actors, organisations, policies and resources into a new territorial formation that provisionally holds together without becoming a fixed totality. We highlight how the governing of health and care is shaped through the interplay of local, regional and national actors and organisations coexisting, jostling and forging uneasy alliances. Our goal is to show that national agendas continued to be firmly embedded within the regional project, not least the politics of austerity. Yet through keeping the region together as if it was an integrated whole and by drawing upon new global policy networks, regional actors strategically reworked national agendas in attempts to leverage and compete for new resources and powers. We set out a research agenda that foregrounds how the political reorganisation of health and care is negotiated and contested across multiple spatial dimensions simultaneously.
The Dynamic Impact of Monetary Policy on Regional Housing Prices in the United States
Authors: Fischer Manfred M. , Huber Florian , Pfarrhofer Michael , Staufer‐Steinnocher Petra
Published: February 2019

This article uses a factor‐augmented vector autoregressive model to examine the impact of monetary policy shocks on housing prices. To simultaneously estimate the model parameters and unobserved factors, we rely on Bayesian estimation and inference. Policy shocks are identified using high‐frequency surprises around policy announcements as an external instrument. Impulse response functions reveal differences in regional housing price responses, which in some cases are substantial. The heterogeneity in policy responses is found to be significantly related to local regulatory environments and housing supply elasticities. Moreover, housing prices responses tend to be similar within states and adjacent regions in neighboring states.
Ontogeny of symbiont community structure in two carotenoid‐rich, viviparous marine sponges: comparison of microbiomes and analysis of culturable pigmented heterotrophic bacteria
Authors: Sacristán‐Soriano Oriol , Winkler Marina , Erwin Patrick , Weisz Jeremy , Harriott Olivia , Heussler Gary , Bauer Emily , West Marsden Brittany , Hill April , Hill Malcolm
Published: February 2019

Marine sponges harbour diverse communities of microbes. Mechanisms used to establish microbial symbioses in sponges are poorly understood, and the relative contributions of horizontal and vertical transmission are unknown for most species. We examined microbial communities in adults and larvae of carotenoid‐rich Clathria prolifera and Halichondria bowerbanki from the mid‐Atlantic region of the eastern United States. We sequenced microbiomes from larvae and their mothers and seawater (16S rRNA gene sequencing), and compared microbial community characteristics between species and ambient seawater. The microbial communities in sponges were significantly different than those found in seawater, and each species harboured a distinctive microbiome. Larval microbiomes exhibited significantly lower richness compared with adults, with both sponges appearing to transfer to larvae a particular subset of the adult microbiome. We also surveyed culturable bacteria isolated from larvae of both species. Due to conspicuous coloration of adults and larvae, we focused on pigmented heterotrophic bacteria. We found that the densities of bacteria, in terms of colony‐forming units and pigmented heterotrophic bacteria, were higher in larvae than in seawater. We identified a common mode of transmission (vertical and horizontal) of microbes in both sponges that might differ between species.
And yet it Moves: The Agenda against Inequalities in the G7 and G20
Authors: Martelli Simone , Bartolomucci Lawrence
Published: February 2019

Over the last years, inequality has climbed on top of the political agenda both in the G7 and G20, also as a response to the wide discontent against governments’ policies. However, discussions have developed along significantly different patterns. On one hand, the G7 managed to develop a joint understanding on the main drivers and on the domestic and global policies to tackle the multiple dimensions of inequality, with no country‐specific commitment. On the other hand, G20 countries have taken up domestic policy commitments for greater inclusiveness, but they did not accomplish agreement on any common framework. Indeed, works can be further developed in both fora; however, the development of a multilateral policy‐oriented framework on inequalities and inclusiveness in the G20 appears more pressing. Looking also at the G7 experience, this would require putting inclusive growth on top of the G20 Presidencies’ work plans, ensure a stronger political engagement by all members and tackle some of the persistent flaws in the G20 governance.
A Prospective, Multicenter Evaluation of Point‐of‐care Ultrasound for Small‐bowel Obstruction in the Emergency Department
Authors: Becker Brent A. , Lahham Shadi , Gonzales Mark A. , Nomura Jason T. , Bui Michelle K. , Truong Taylor A. , Stahlman Barbara A. , Fox John C. , Kehrl Thompson
Published: February 2019

Objective

The main objective of this study was to evaluate the accuracy of emergency physician‐performed point‐of‐care ultrasound (POCUS) for the diagnosis of small‐bowel obstruction (SBO) compared to computed tomography (CT).

Methods

We performed a prospective, multicenter, observational study examining a convenience sample of adult patients with potential SBO presenting to the emergency department (ED) between July 2014 and May 2017. Each POCUS was interpreted at the bedside by the performing emergency physician and retrospectively by an expert reviewer. Test characteristics were calculated for POCUS, blinded expert interpretation, and specific POCUS parameters.

Results

A total of 217 subjects were included in the primary analysis with an overall SBO prevalence of 42.9%. For the diagnosis of SBO, POCUS demonstrated an overall sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of 0.88 (95% confidence interval [CI] = 0.80 to 0.94), 0.54 (95% CI = 0.45 to 0.63), 1.92 (95% CI = 1.56 to 2.35), and 0.22 (95% CI = 0.12 to 0.39), respectively. Expert review yielded a similar sensitivity (0.89 [95% CI = 0.81 to 0.95]) with a significantly higher specificity (0.82 [95% CI = 0.74 to 0.88]). The more sensitive sonographic parameters for both POC sonographers and expert reviewers were small‐bowel dilation ≥ 25 mm (0.87 [95% CI = 0.79 to 0.93], 0.87 [95% CI = 0.79 to 0.93]) and abnormal peristalsis (0.82 [95% CI = 0.72 to 0.89], 0.85 [95% CI = 0.76 to 0.87]). The more specific parameters for both groups were transition point (0.82 [95% CI = 0.74 to 0.89], 0.98 [95% CI = 0.94 to 1.00]), intraperitoneal free fluid (0.82 [95% CI = 0.74 to 0.89], 0.93 [95% CI = 0.87 to 0.97]), and bowel wall edema (0.76 [95% CI = 0.67 to 0.83], 0.93 [95% CI = 0.87 to 0.97]).

Conclusion

POCUS is moderately sensitive for SBO, although less specific, when performed by a diverse group of emergency physicians across multiple EDs. Interpretation of acquired POCUS images is significantly more accurate when performed by physicians with prior emergency ultrasound fellowship training and familiarity with the sonographic appearance of SBO.
The response of cerambycid beetles (Coleoptera: Cerambycidae) to long‐term fire frequency regimes in subtropical eucalypt forest
Authors: Eliott Martyn , Lawson Simon , Hayes Andrew , Debuse Valerie , York Alan , Lewis Tom
Published: February 2019

Fire has a varied influence on plant and animal species through direct (e.g. fire‐induced mortality) and indirect (e.g. modification of habitat) effects. Our understanding of the influence of fire regime on invertebrates and their response to fire‐induced modifications to habitat is poor. We aimed to determine the response of a beetle family (Coleoptera: Cerambycidae) to varying fire treatments and hypothesised that the abundance of cerambycid beetles is influenced by fire frequency due to modifications in habitat associated with the fire treatments. Arthropods were sampled across 3 months in annually and triennially burnt areas (treatments starting in 1952 and 1973 respectively), an area unburnt since 1946, and a former unburnt treatment, burnt by wildfire in 2006. Eleven different cerambycid taxa were collected using flight intercept panel traps, dominated by three species (Ipomoria tillides, Adrium sp. and Bethelium signiferum) which made up 99% of individuals collected. Over the sampling period the long unburnt treatment had significantly lower species richness than the triennial and wildfire treatments. Cerambycid abundance was significantly higher in the triennially burnt treatment than in all other fire treatments. Ipomoria tillides was more abundant in both frequently burnt treatments, Adrium sp. was more common in triennially burnt areas, whereas B. signiferum, was more common in the wildfire affected treatment. Some, but not all, cerambycid beetles were more common in areas with a more open understorey (i.e. resulting from frequent burning), and lower tree basal area, as this likely influences their ability to fly easily between food sources. Cerambycid abundance was positively related to the volume of coarse woody debris and healthy tree crowns. Cerambycid beetles were clearly influenced by historic fire regime, suggesting that changes in fire regime can potentially have a profound influence on arthropod assemblages, and subsequent influences on ecosystem processes, which are currently poorly understood.
Australian modified Lawton's Instrumental Activities of Daily Living Scale contributes to diagnosing older adults with cognitive impairment
Authors: Harper Kristie J. , Riley Vera , Jacques Angela , MacDonald Kirsty , Spendier Nicholas
Published: February 2019

Objective

To assess the ability of the Australian Modified Lawton's Instrumental Activities of Daily Living (IADL) Scale (Modified Lawton's Scale) to screen for cognitive impairment in patients without physical or sensory deficits.

Methods

Prospective single‐blind study of diagnostic accuracy.

Results

Data were available for 249 patients. At ≤25 points on the Modified Lawton's Scale, the area under the receiver operating characteristic curve (AUC) for patients with dementia was 0.90 (95% CI 0.83, 0.96), with sensitivity of 95% and specificity of 84%. The scale had decreased ability to identify patients with mild cognitive impairment (MCI) with the AUC highest at 0.76 (95% CI 0.67, 0.84), with a sensitivity of 77% and specificity of 74% at ≤26 points. The Modified Lawton's Scale had a significant strong correlation with the Mini‐Mental State Examination (0.73) (P ≤ 0.001).

Conclusion

A score of ≤25 on the Modified Lawton's Scale may indicate cognitive impairment impacting on IADL.
Variability of allergens in commercial fish extracts for skin prick testing
Authors: Ruethers Thimo , Taki Aya C. , Nugraha Roni , Cao Trúc T. , Koeberl Martina , Kamath Sandip D. , Williamson Nicholas A. , O'Callaghan Sean , Nie Shuai , Mehr Sam S. , Campbell Dianne E. , Lopata Andreas L.
Published: February 2019

Background

Commercial allergen extracts for allergy skin prick testing (SPT) are widely used for diagnosing fish allergy. However, there is currently no regulatory requirement for standardization of protein and allergen content, potentially impacting the diagnostic reliability of SPTs. We therefore sought to analyse commercial fish extracts for the presence and concentration of fish proteins and in vitro IgE reactivity using serum from fish‐allergic patients.

Methods

Twenty‐six commercial fish extracts from five different manufacturers were examined. The protein concentrations were determined, protein compositions analysed by mass spectrometry, followed by SDS‐PAGE and subsequent immunoblotting with antibodies detecting 4 fish allergens (parvalbumin, tropomyosin, aldolase and collagen). IgE‐reactive proteins were identified using serum from 16 children with confirmed IgE‐mediated fish allergy, with focus on cod, tuna and salmon extracts.

Results

The total protein, allergen concentration and IgE reactivity of the commercial extracts varied over 10‐fold between different manufacturers and fish species. The major fish allergen parvalbumin was not detected by immunoblotting in 6/26 extracts. In 7/12 extracts, five known fish allergens were detected by mass spectrometry. For cod and tuna, almost 70% of patients demonstrated the strongest IgE reactivity to collagen, tropomyosin, aldolase A or β‐enolase but not parvalbumin.

Conclusions

Commercial fish extracts often contain insufficient amounts of important allergens including parvalbumin and collagen, resulting in low IgE reactivity. A comprehensive proteomic approach for the evaluation of SPT extracts for their utility in allergy diagnostics is presented. There is an urgent need for standardized allergen extracts, which will improve the diagnosis and management of fish allergy.
The quantitative measuring method of meibomian gland vagueness and diagnostic efficacy of meibomian gland index combination
Authors: Yin Yue , Gong Lan
Published: February 2019

Purpose

To propose and to evaluate a quantitative measuring method of meibomian gland (MG) vagueness.

Methods

A total of 47 patients (32 female and 15 male, 39.21 ± 11.07 years) with meibomian gland dysfunction (MGD) were recruited to the MGD group, and 47 healthy volunteers were recruited to the control group matched in age and gender. The clinical examinations included ocular surface evaluation, MG function indexes and MG morphological indexes (including MG vagueness value). Reliability and efficacy of MG vagueness value, correlation between vagueness value and relevant variables, and diagnostic efficacy of combining vagueness value with efficacious indexes were all evaluated.

Results

The MG vagueness value of the MGD group (19.78 ± 13.17) was significantly lower than that of the control group (31.90 ± 13.15). The vagueness value possessed good between‐reader reliability (intraclass correlation coefficient = 0.928 > 0.9), and was correlated with age (r = −0.356), most clinical indexes and the acinar shortest diameter (r = −0.278). The area under the curve (AUC) in the receiver operating characteristic (ROC) curve of vagueness value was 0.766 [95% confidence interval (CI): 0.668–0.864] with sufficient diagnostic efficacy, and the cutoff value was <21. The AUC improved to 0.956 (95% CI: 0.938–0.999), after efficacious indexes (vagueness value, meiboscore and tear breakup time) were combined.

Conclusion

Meibomian gland (MG) vagueness is quantifiable. The MG vagueness value proposed in this study has good reliability, a close relationship with MGD clinical features and sufficient diagnostic efficacy. Combining this new index with other indexes commonly used offers an exciting prospect in MGD diagnosis.
A new association: acute macular neuroretinopathy in acute optic neuritis
Authors: Deschamps Romain , Vasseur Vivien , Shor Natalia , Vignal Catherine , Salomon Laurence , Gout Olivier , Mauget‐Faÿsse Martine
Published: February 2019

Background

Acute optic neuritis (AON) is a common optic nerve disease leading to retrograde degeneration of optic nerve axons, reflected by thinning of the inner retinal layers on optical coherence tomography. On the contrary, acute macular neuroretinopathy (AMN) type 2 is a rare outer retinal disorder that leads to thinning of the outer nuclear layers and is diagnosed by multimodal imaging. The aim of this study was to report a new association between these two diseases.

Methods

Patients with a first episode of optic neuritis were invited to participate in a study that involved optical coherence tomography evaluation at baseline and the following 1, 3, 6 and 12 months. All the study patients underwent ophthalmologic evaluation that comprised of visual acuity, visual field and multimodal imaging as well as orbital and brain Magnetic Resonance Imaging. A diagnosis of multiple sclerosis was made according to the 2010 McDonald criteria.

Results

Six of the 114 patients with acute optic neuritis also had acute macular neuroretinopathy, of whom three were positive for myelin oligodendrocyte glycoprotein antibodies (MOG‐Abs), two had relapsing–remitting multiple sclerosis and one had clinical isolated syndrome.

Conclusion

Our study suggests that it is imperative to check for associatedAMNin cases ofAON, especially those associated withMOG‐Abs.
Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice
Authors: Widström Ann‐Marie , Brimdyr Kajsa , Svensson Kristin , Cadwell Karin , Nissen Eva
Published: February 2019

Aim

This paper integrates clinical expertise to earlier research about the behaviours of the healthy, alert, full‐term infant placed skin‐to‐skin with the mother during the first hour after birth following a noninstrumental vaginal birth.

Method

This state‐of‐the‐art article forms a link within the knowledge‐to‐action cycle, integrating clinical observations and practice with evidence‐based findings to guide clinicians in their work to implement safe uninterrupted skin‐to‐skin contact the first hours after birth.

Results

Strong scientific research exists about the importance of skin‐to‐skin in the first hour after birth. This unique time for both mother and infant, individually and in relation to each other, provides vital advantages to short‐ and long‐term health, regulation and bonding. However, worldwide, clinical practice lags. A deeper understanding of the implications for clinical practice, through review of the scientific research, has been integrated with enhanced understanding of the infant's instinctive behaviour and maternal responses while in skin‐to‐skin contact.

Conclusion

The first hour after birth is a sensitive period for both the infant and the mother. Through an enhanced understanding of the newborn infant's instinctive behaviour, practical, evidence‐informed suggestions strive to overcome barriers and facilitate enablers of knowledge translation. This time must be protected by evidence‐based routines of staff.
Systematic review with meta‐analysis: extrahepatic manifestations in chronic hepatitis C virus‐infected patients in East Asia
Authors: Younossi Zobair M. , Henry Linda , P. Ong Janus , Tanaka Atsushi , Eguchi Yuichiro , Mizokami Masashi , Lim Young‐Suk , Dan Yock Young , Yu Ming‐Lung , Stepanova Maria
Published: February 2019

Background

Although the prevalence of extrahepatic manifestations of chronic hepatitis C virus (HCV) infection has been reported from Western countries, their prevalence in East Asian countries is not well known.

Aim

To perform a systematic review to quantify the prevalence of selected extrahepatic manifestations ofHCVamong patients from East Asia.

Methods

Medline,CINAHL,EMBASE, Cochrane and country‐specific databases were reviewed according to standard guidelines for meta‐analyses. Only articles with patients from East Asian countries were included.

Results

After review, 34 articles were selected (Japan = 9; China = 5, Korea = 3, Taiwan = 16, multiple countries = 1) with 646 228 subjects, 66 436 withHCV. Mean age forHCV‐infected patients was 56 years (range 41‐72 years), 50% were male (range 26%‐73%). The pooled prevalence of type 2 diabetes in East AsianHCVpatients was 19.0% (95% confidence interval 15.6%‐22.9%) (n = 19 studies) with an increased risk when compared to non‐HCV: odds ratio (OR) 1.58 (1.28‐1.94). The prevalence of chronic kidney disease inHCVwas 9.2% (5.0%‐16.2%) (n = 7 studies), also with a significantly increased risk:OR=1.98 (1.41‐2.77). Pooled prevalence of cardiovascular disease inHCVwas 8.6% (3.5%‐19.9%) (n = 6 studies), also with an increased risk:OR = 1.55 (1.21‐1.98). The prevalence of lichen planus inHCVwas 8.9% (3.6%‐20.6%) (n = 6 studies) while the prevalence of rheumatoid arthritis was 4.5% (0.6%‐25.7%) (n = 4 studies).

Conclusions

These data show increased risk of developing extrahepatic manifestations in East Asian patients withHCV. Both hepatic and extrahepatic manifestations of the infection should be used to accurately determine the total burden of the disease in the region.
Consensus: guidelines: best practices for detection, assessment and management of suspected acute drug‐induced liver injury during clinical trials in patients with nonalcoholic steatohepatitis
Authors: Regev Arie , Palmer Melissa , Avigan Mark I. , Dimick‐Santos Lara , Treem William R. , Marcinak John F. , Seekins Daniel , Krishna Gopal , Anania Frank A. , Freston James W. , Lewis James H. , Sanyal Arun J. , Chalasani Naga
Published: February 2019

Background

The last decade has seen a rapid growth in the number of clinical trials enrolling patients with nonalcoholic fatty liver disease and nonalcoholic steatohepatitis (NASH). Due to the underlying chronic liver disease, patients with NASH often require different approaches to the assessment and management of suspected drug‐induced liver injury (DILI) compared to patients with healthy livers. However, currently no regulatory guidelines or position papers systematically address best practices pertaining to DILI in NASH clinical trials.

Aims

This publication focuses on best practices concerning the detection, monitoring, diagnosis and management of suspected acute DILI during clinical trials in patients with NASH.

Methods

This is one of several papers developed by the IQ DILI Initiative, comprised of members from 15 pharmaceutical companies, in collaboration with DILI experts from academia and regulatory agencies. This paper is based on extensive literature review, and discussions between industry members with expertise in drug safety and DILI experts from outside industry to achieve consensus on common questions related to this topic.

Results

Recommended best practices are outlined pertaining to hepatic inclusion and exclusion criteria, monitoring of liver tests, DILI detection, approach to a suspected DILI signal, causality assessment and hepatic discontinuation rules.

Conclusions

This paper provides a framework for the approach to assessment and management of suspected acute DILI during clinical trials in patients with NASH.