bluuebunny/crossref_metadata_2025 huggingface dataset:
Co-creating value and developing social capital: Centre of Science for Villages (CSV), Wardha
Authors: Shukre Anagha , Verma Naresh
Published: August 2017

Subject area

Marketing management, consumer behaviour, rural marketing and integrated marketing communications.

Study level/applicability

The case is for the use of undergraduate and also postgraduate students of management in courses of marketing management, consumer behaviour, rural marketing and integrated marketing communications. This case may also be used in human resources’ management course lectures which focus on social capital.

Case overview

This case on the Centre of Science for Villages (CSV), Wardha, attempts to identify how value can be co-created through innovative technology and how social capital can be developed for rural markets through the use of integrated marketing communications tools, particularly word-of-mouth and the influence of opinion leaders. Effective campaigns can be designed for the target audience based on the 3A framework (Awareness, Adoption and Addition of Value) and McGuire’s Model of Persuasion. The CSV has been typically chosen for the study because its products are unique, innovative and eco-friendly and blend well with the rural lives. It has been able to enrich the lives of rural population by generating employment and in creating entrepreneurial opportunities. The biggest challenge, however, lies in educating rural consumers to accept and adopt its innovative technology in their daily lives.

Expected learning outcomes

The case study has been written to enable students to understand the concepts of value co-creation and social capital in the context of Indian rural markets. The students will learn the dynamics of rural markets by pondering over these points: understand the concept of value co-creation for rural markets; comprehend the creation of social ecology for managing knowledge in an organisation; identify the development and role of social capital and use it as a promotional tool, particularly word-of-mouth and opinion leaders(reference groups); recommend the use of different marketing mix variables for an organisation, operating in rural markets; and connote designing of effective campaigns for the target audience, based on the 3A framework and the Persuasion Model (6 steps) suggested by McGuire.

Supplementary materials

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.

Subject code

CSS 8: Marketing
Valuating and analyzing the patent portfolio: the patent portfolio value index
Authors: Grimaldi Michele , Cricelli Livio , Rogo Francesco
Published: August 2017

Purpose

The purpose of the paper is to advance a framework that can assess and analyze the value of patent portfolios. On this purpose, the framework develops a conceptual and comprehensive index, the patent portfolio value index (PPVI), to assess the patent innovation level and suggest economic-strategic guidelines.

Design/methodology/approach

The authors have designed and applied a framework that synthesizes into a single index the results of a multiple criteria approach, based on information derived from quantitative objective data (claims, citations, and market coverage), information related to qualitative determinants (strategic positioning and economic importance), and information derived from decision makers’ perceptions and judgments.

Findings

The authors have applied the PPVI to the 3,532 patent portfolio documents in an Italian worldwide player in aerospace and defense market. The combined analysis, provided by the PPVI and a qualitative synoptic representation, has made it possible to understand the strategic positioning and alignment of patents with the core business of the company. The results of the analysis have provided managers with the necessary suggestions regarding action items to be performed: to reinforce, license, try to dismiss, or sell some of the examined patents of the portfolios.

Practical implications

The PPVI supplies a quick procedure to ascertain the profitability of patents and accounts for the value of a patent portfolio from an internal business perspective.

Originality/value

As it is built and defined, the PPVI shows elements of novelty compared to the other indexes existing in the literature, in that it follows a multiple criteria approach by merging quantitative and qualitative information.
Business cycle and investment flows of retail and institutional mutual funds
Authors: Salganik-Shoshan Galla
Published: August 2017

Purpose

The purpose of this paper is to investigate the dynamics of mutual fund investment flows across the business cycle. To account for the differences in the flow patterns of funds catered for institutional investors and those focusing on retail investors, the author conducts this investigation separately for flows of institutional and retail funds.

Design/methodology/approach

The author uses the sample of US equity mutual funds for the period between 1999 and 2012. For the samples of each type of fund, the author performs separate analyses for expansion and recession periods. Following Sirri and Tufano (1998), the author implements the Fama MacBeth (1973) approach.

Findings

The author finds that flow patterns of both fund types vary across the business cycle. For example, the results reveal that during bad times, institutional investors demonstrate weaker return-chasing behavior, while paying higher attention to Jensen’sα, than during good times. In addition, the author reports results on the effect of fund exposure to various systematic risk factors. For instance, the author observes that during economic downturns, investors of both fund types tend to punish managers with higher market exposure. During expansions, the fund’s market exposure positively affects flows of institutional funds, while its effect on the flows of retail funds remains negative.

Originality/value

To the best of the author’s knowledge, this is the first study that investigates mutual fund investment flow patterns across the business cycle, while simultaneously accounting for differences in flow patterns between retail and institutional funds. A further contribution of this paper is that it explores the previously overlooked relationships between fund flows and their exposure to various systematic risk factors.
Quantitative appraisal of cost and time performance of construction projects in public and private universities in Osun State, Nigeria
Authors: Olatunde Nathaniel Ayinde , Alao Oluwaseyi Olalekan
Published: August 2017

Purpose

The purpose of this paper is to compare the cost and time performance of construction projects in public and private universities in Osun State, Nigeria.

Design/methodology/approach

Purposive sampling technique was adopted to select four universities (two public and two private) used for the study. Archival data on 40 completed construction projects (ten from each university) was used in the study. Data were analysed with percentile and t-test.

Findings

The study showed that only 35 per cent of the construction projects in public and 10 per cent of those in private universities were completed at the estimated cost. There were no construction projects completed within the planned time in public universities, but 20 per cent were completed within the planned time in private universities. The t-test showed there is no significant difference in performance of construction projects in public and private universities in Nigeria. The study concluded that time performance of public and private universities in Nigeria was still below acceptable international best practices.

Research limitations/implications

The findings of this study are limited to universities’ construction projects and may be of little application to other construction projects outside university settings.

Practical implications

It is recommended that construction stakeholders be more proactive in ensuring that significant improvement is achieved in cost and time performance of construction projects both in public and private universities; the clients need to be more detailed in their briefs and requirements, the designers (architects and engineers) need to be more precise and avoid varying their designs, the quantity surveyors should use their professional competency in cost engineering adequately and the contractor should avoid spurious claims that result in increase in construction cost and time so that performance of construction projects can be improved.

Originality/value

The study is an attempt to compare cost and time performance of construction projects in public and private universities in Osun State, Nigeria.
Identifying path-breaking transitions for Kenya’s marginalised communities in water and sanitation provision
Authors: Maina Wairimu , van Graan Andre
Published: August 2017

Purpose

This paper aims to illustrate relationships between stakeholders in the conceptualisation and implementation of water and sanitation services (WSS) projects in marginalised settings of Nairobi and Kiambu Counties. It outlines these relationships in a flow diagram that shows a pathway analysis in which social innovation strategies are used as markers in the program of inclusive water provision. The study’s objective is to map the processes of social innovation in an effort to highlight the role of marginalised communities in their access to the right to water.

Design/methodology/approach

The paper approached the study using a case study design, and thereafter, constructivist grounded theory was used to further delve into the comparative cases. To map the processes of social innovation, the case study design was seen to be appropriate, as it sequenced activities in a time-series analysis. From these two case studies, four comparative cases were used to pinpoint path-breaking transition in the pathway analysis. The methods used in both phases were, namely, in-depth interviews, observations and document analysis, and these were complemented by field notes.

Findings

The paper indicates an opportunity to use emergent patterns for a more context-specific analysis of WSS projects in marginalised communities. It advances the role of marginalised communities as vital stakeholders in the approach described as “the right to the city”. The model of spatial appropriation brings to the fore the binary yet separate processes that stakeholders engage in.

Research limitations/implications

Owing to the use of a grounded theory model, the results may not be transferable to other contexts. Therefore, further testing of the proposed pathway analysis and model is encouraged, as this model suggests ways of ensuring full community engagement which would result in greater success in projects involving marginalised communities.

Practical implications

The paper has implications for both the government and communities, in that more deliberate roles for the community-based organisation in the conceptualisation of WSS projects can lead to social learning opportunities for government institutions and greater success in implementation.

Originality/value

The paper justifies the need for government institutions to map and evaluate WSS projects using emergent patterns to highlight the role of marginalised communities as their right to the city.
The development of a theoretical framework of organisational rhythm
Authors: Poels Truus , Tucker Danielle A. , Kielema Joop
Published: August 2017

Purpose

The purpose of this paper is to develop a framework to understand organisational rhythm as a stimulus for further study into organisational change.

Design/methodology/approach

This paper studies the experiences of the medical discipline colleges in the Netherlands as they underwent significant reorganisation and transfer of ministerial authority. The data set consists of correspondence, reports and tapes of the meetings over 14 months and interviews with 26 employees.

Findings

This research identified five sub-themes of rhythm (emphasis, intonation, pace, period and repetition). Putting these together, the authors present a framework to understand organisational rhythm during organisational change.

Research limitations/implications

This study begins to develop understanding of how rhythms function but the authors did not compare multiple rhythms in this study.

Practical implications

The authors argue that by unpacking and exploring in more detail the sub-themes of rhythm (emphasis, intonation, pace, period and repetition), the authors can help to explain why complex change management initiatives may stall or fail to gain traction. By understanding the concept of rhythm as movement, the authors can offer recommendations to organisations about how to move forward and overcome challenges associated with progress.

Originality/value

In this paper, the authors make an important distinction between rhythm in terms of movement and flow of activity, which has often been overlooked by research, which focusses on the temporal aspects of organisations, which the authors classify as frequency – relating to the sequencing and duration of change.
Physical properties of nonwoven and woven felted fabrics
Authors: Kistamah Naraindra , Hes Lubos , Rajmun Khandini
Published: August 2017

Purpose

The use of nonwoven fabrics in garment has been, up to now, purely functional and hidden from view. In fact, their uses have been limited to garment interlining in the apparel industry. Felted structures from wool have been limited to the craft market for the production of art and craft objects of decoration. This paper aims to compare the mechanical and thermo-physical comfort properties of a woven wool, a felted wool fabric, a felted wool/polyester and two non-woven synthetic fabrics for apparel use.

Design/methodology/approach

Fabric samples were sourced locally. Five fabric samples were selected: one woolen woven, one felted woven, one polyester/wool non-woven and two non-woven synthetic fabrics. The wool fabric was felted by mechanical action using the Wascator FOM 71P machine. All fabric samples were conditioned before they were tested for their mechanical and thermal comfort properties as per standard test methods.

Findings

The comparative study of the mechanical and thermal properties of the five fabric samples have been successfully investigated as textile materials for commercial garments. In terms of fabric stiffness, drape and handle, the two non-woven synthetic fabrics were, in general, poorer than the woven wool and the felted woven wool fabrics. The synthetic non-woven fabrics also performed poorly in terms of serviceability. But it was found that the nonwoven synthetic fabrics were best suited when thermal insulation is required and were found to be better than the woven felted wool fabric of comparative weight per unit area.

Originality/value

The value of this study is that it demonstrates the scope of felted woolen structures and other synthetic nonwovens fabrics as usable materials, in part or in full, in the development of apparel for winter wear especially in cold environments and where aesthetic appeal is secondary.
Part 1
Authors: Ganguly Debojyoti , Mondal Chanchal , Roy Choudhury Asim Kumar
Published: August 2017

Purpose

In recent times, wool- and silk-blended fabrics are popular for creating glamourous products. Silk is blended to wool for creating more lustrous effect and to impart strength; on the other hand, wool is responsible for resilience, softness and warmth properties. Chemically both the fibres are protein-based, but the amount of amino acids is different. Due to this, the dye absorption behaviours of the two fibres from the same dye-bath are different. Wool is become darker than the silk fibre, if both the fibres are dyed together in a single bath dyeing process.

Design/methodology/approach

Here the wool fibres are first pre-treated with a commercial synthetic tanning agent (syntan) Mesitol HWS at three different pH values of 2.2, 3.2 and 4.2 and at three different concentrations: 5, 10 and 15 per cent. Then the syntan pre-treated wool fibres are dyed together with silk fibres maintaining the blend ratio as 80:20 by Telon Red MR, Telon Yellow M4GL and Telon Blue MRLW with sodium sulphate at three different concentrations of 10, 20 and 30 per cent.

Findings

The dye absorbency of the syntan-treated wool fibres decreased with increase in syntan concentration, whereas the colour strength of silk fibres increased. The resist effectiveness of wool fibres is increased from 6 to 59 per cent with increase of syntan concentration. So after the dyeing process, the colour strength of syntan-treated wool fibres are almost same with the colour strength of silk fibres. The washing fastness of the samples is improved, and wash fastness behaviour of both wool and silk fibres is almost same.

Originality/value

This paper gives an idea about the one bath dyeing process of wool- and silk-blended fabrics to achieve solid dyeing effect.
Understorey plant community composition reflects invasion history decades after invasive Rhododendron has been removed
Authors: Maclean Janet E. , Mitchell Ruth J. , Burslem David F. R. P. , Genney David , Hall Jeanette , Pakeman Robin J.
Published: August 2017

A growing awareness of the destructive effects of non‐native invasive species has led to a massive increase in removal programmes around the world. However, little is generally known about what happens to sites following the removal of the invasives and the implicit assumption that the native community will return, unaided, to pre‐invasion conditions is often left untested.

We assessed recovery of the native understorey plant community following removal of the non‐native invasive Rhododendron ponticum L. from Scottish Atlantic oak woodland. We recorded understorey community composition in sites covering a gradient of increasing R. ponticum density, and across a separate series of sites covering a chronosequence of time since R. ponticum removal. We then compared both of these series to the target community found in uninvaded sites. We also analysed differences in soil chemistry between the sites to test for chemical legacy effects of invasion in the soil.

Native understorey cover declined as R. ponticum density increased, with bryophytes dropping to less than a third of the cover present in uninvaded sites and forbs and grasses being completely extirpated under dense stands.

Cleared sites showed no evidence of returning to the target community, even after 30 years of recovery, and instead formed a bryophyte‐dominated “novel community,” containing few of the typical oak woodland vascular plants.

Contrary to expectation, soil pH, C:N ratio and nutrient concentrations (N, P, K, Ca and Mg) were not affected by the invasion of R. ponticum, and chemical legacy effects in the soil were not responsible for the failure of the native community to revert to pre‐invasion conditions. Instead, we hypothesise that the rapid formation of a bryophyte mat, coupled with the often substantial distances to potential seed sources, hindered vascular plant recolonisation.

Synthesis and applications. Clear evidence of invasion history can be detected in the understorey plant community even decades after the successful removal of the invasive Rhododendron ponticum L. This finding demonstrates that native communities may be unable to recover effectively of their own accord following invasive species removal, and will require further management interventions in order to achieve restoration goals.
Back to Hegel? On Gillian Rose's critique of sociological reason
Authors: Fuller Brian W.
Published: August 2017

Thirty‐five years ago, Gillian Rose articulated a significant critique of classical sociological reason, emphasizing its relationship to its philosophical forebears. In a series of works, but most significantly in her Hegel contra Sociology, Rose worked to specify the implications of sociology's failure, both in its critical Marxist and its ‘scientific’ forms, to move beyond Kant and to fully come to terms with the thought of Hegel. In this article, I unpack and explain the substance of her criticisms, developing the necessary Hegelian philosophical background on which she founded them. I argue that Rose's attempted recuperation of ‘speculative reason’ for social theory remains little understood, despite its continued relevance to contemporary debates concerning the nature and scope of sociological reason. As an illustration, I employ Rose to critique Chernilo's recent call for a more philosophically sophisticated sociology. From the vantage point of Rose, this particular account of a ‘philosophical sociology’ remains abstract and rooted in the neo‐Kantian contradictions that continue to characterize sociology.
A Molecular Method to Detect Wound Cells in Bloodstains Resultant of Sharp Force Injuries for Crime Scene Reconstruction
Authors: Johnson Donald J. , Raymond David E. , Chen Cynthia , Quon Matthew , Lis Julian , Choi Mo Re , Lopez Christopher , Han Aileen , de Leon Ray D. , Bir Cynthia
Published: August 2017

Previous research by the authors on an animal model showed that bloodstains can contain additional information about their somatic origin in the form of wound cells. Bloodstains produced by a gunshot wound to the head were distinguished from bloodstains produced by a gunshot wound to the chest by testing the stains for a brain microRNA marker. In this study, the effectiveness of the technique was examined on blood drops shed externally from a stab wound to the liver of rat carcasses. Specifically, investigations were conducted on the liver microRNA marker, rno‐mir‐122‐3p, with the QIAGEN miScript System, and PCR analysis. Between the two stabbing methods used, 67% of the scalpel blades and 57% of the blood drops tested positive for rno‐mir‐122‐3p; however, other samples tested negative giving inconclusive results as to the wound‐of‐origin. The amount of the liver cells in the bloodstains appeared to be related to the extent of trauma.
Sex Estimation from Human Cranium: Forensic and Anthropological Interest of Maxillary Sinus Volumes
Authors: Radulesco Thomas , Michel Justin , Mancini Julien , Dessi Patrick , Adalian Pascal
Published: August 2017

Sex estimation is a key objective of forensic science. We aimed to establish whether maxillary sinus volumes (MSV) could assist in estimating an individual's sex. One hundred and three CT scans were included. MSV were determined using three‐dimensional reconstructions. Two observers performed three‐dimensional MSV reconstructions using the same methods. Intra‐ and interobserver reproducibility were statistically compared using the intraclass correlation coefficient (ICC) (α = 5%). Both intra‐ and interobserver reproducibility were perfect regarding MSV; both ICCs were 100%. There were no significant differences between right and left MSV (p = 0.083). No correlation was found between age and MSV (p > 0.05). We demonstrated the existence of sexual dimorphism in MSV (p < 0.001) and showed that MSV measurements gave a 68% rate of correct allocations to sex group. MSV measurements could be useful to support sex estimation in forensic medicine.
Effects of the Maillard Reaction on the Immunoreactivity of Amandin in Food Matrices
Authors: Chhabra Guneet S. , Liu Changqi , Su Mengna , Venkatachalam Mahesh , Roux Kenneth H. , Sathe Shridhar K.
Published: August 2017

Amandin is the major storage protein and allergen in almond seeds. Foods, containing almonds, subjected to thermal processing typically experience Maillard browning reaction. The resulting destruction of amino groups, protein glycation, and/or denaturation may alter amandin immunoreactivity. Amandin immunoreactivity of variously processed almond containing foods was therefore the focus of the current investigation. Commercial and laboratory prepared foods, including those likely to have been subjected to Maillard browning, were objectively assessed by determining Hunter L*, a*, b* values. The L* values for the tested samples were in the range of 31.75 to 85.28 consistent with Maillard browning. Three murine monoclonal antibodies, 4C10, 4F10, and 2A3, were used to determine the immunoreactivity of the targeted samples using immunoassays (ELISA, Western blot, dot blot). The tested foods did not exhibit cross‐reactivity indicating that the immunoassays were amandin specific. For sandwich ELISAs, ratio (R) of sample immunoreactivity to reference immunoreactivity was calculated. The ranges of R values were 0.67 to 15.19 (4C10), 1.00 to 11.83 (4F10), and 0.77 to 23.30 (2A3). The results of dot blot and Western blot were consistent with those of ELISAs. Results of these investigations demonstrate that amandin is a stable marker protein for almond detection regardless of the degree of amandin denaturation and/or destruction as a consequence of Maillard reaction encountered under the tested processing conditions.

Practical Application

Foods containing almond are often subjected to processing prior to consumption. Amandin, the major allergen in almond, may experience Maillard reaction. Understanding the change in amandin immunoreactivity as a result of Maillard reaction is important for amandin detection and production of hypoallergenic food products.
Anthocyanins of Jambolão (Syzygium cumini): Extraction and pH‐Dependent Color Changes
Authors: do Carmo Brito Brenda de Nazaré , da Silva Pena Rosinelson , Santos Lopes Alessandra , Campos Chisté Renan
Published: August 2017

Jambolão fruits are promising sources of anthocyanins, and in this study, the jambolão fruit from the Brazilian Amazonian region was characterized and the efficiency of six ethanol‐based solutions to extract anthocyanins was determined. Moreover, the color changes of anthocyanin extracts, as influenced by different pH conditions (pH from 1.0 to 8.0), were evaluated. The fruits exhibited high contents of total anthocyanins (296 mg/100 g) and the CIELAB parameters characterized jambolão as a purple‐red colored fruit (a* = 20.30, b* = −4.17, and = 348.39). Among the six different ethanol‐based solutions, ethanol 95% with 1% of HCl (v/v) was the most efficient solution to extract anthocyanins from jambolão fruits. Furthermore, the CIELAB parameters were characterized as useful tool to monitor the color changes of anthocyanins of jambolão over the tested pH range. Therefore, jambolão fruits from Amazonian region have technological potential for the application by food, pharmaceutical, and cosmetic industries.

Practical Application

Jambolão fruits are great source of anthocyanins and the incorporation of these natural pigments as food colorants is not only valuable to improve overall appearance, but it is also beneficial to human health. The production of natural extracts with high levels of anthocyanins from jambolão can be considered a very useful approach to the food, pharmaceutical and cosmetic industries.
Tailoring an Alcohol Intervention for American Indian Alaska Native Women of Childbearing Age: Listening to the Community
Authors: Montag Annika C. , Dusek Marlené L. , Ortega Marina L. , Camp‐Mazzetti Alexandrea , Calac Dan J. , Chambers Christina D.
Published: August 2017

Background

Reduction of risky drinking in women of childbearing age is 1 strategy that may be employed to prevent fetal alcohol spectrum disorder, a sequela of prenatal alcohol exposure. Communities differ in risk and protective factors, necessitating culturally informed interventions for maximal efficacy. This article describes the modification of an existing web‐based screening, brief intervention, and referral to treatment intervention to reduce risky drinking among American Indian Alaska Native (AIAN) women of childbearing age in Southern California into a peer‐to‐peer–based intervention using motivational interviewing (MI).

Methods

The modification process was iterative and included various community focus groups, interviews, and a final review.

Results

Intervention modification was required for cultural congruence. Components of the peer‐to‐peer intervention designed by this project included a flip chart used to guide the motivational interviewing, charts of the financial and physical costs of alcohol consumption, revised baseline and follow‐up questionnaires, and guidance regarding the application of MI techniques.

Conclusions

This study may inform the modification of future interventions among AIAN communities.
Local allergic rhinitis is an independent rhinitis phenotype: The results of a 10‐year follow‐up study
Authors: Rondon C. , Campo P. , Eguiluz‐Gracia I. , Plaza C. , Bogas G. , Galindo P. , Mayorga C. , Torres M. J.
Published: August 2017

Background

The knowledge about the natural history of local allergic rhinitis (LAR) is limited. One unmet question is to demonstrate whether LAR should be considered the first step in the development of allergic rhinitis (AR) or an independent phenotype. The aim of this study was to prospectively evaluate the natural history of a population with LAR, the potential conversion to AR with systemic atopy and the development of asthma during 10 years.

Methods

This is the second phase of a 10‐year follow‐up study of a cohort of 176 patients with LAR of recent onset and 115 age‐ and sex‐matched healthy controls prospectively evaluated from 2005 to 2016. Clinical‐demographic questionnaire, spirometry, skin prick test and specific IgE were evaluated yearly. Nasal allergen provocation tests (NAPT) with Dermatophagoides pteronyssinus, Alternaria alternata, Olea europaea and grass pollen were performed at baseline, and after 5 and 10 years.

Results

After 10‐year LAR, patients experienced a significant and clinically relevant worsening of the rhinitis, with increase in emergency assistance, development of asthma, loss of allergen tolerance and impairment of the quality of life. This worsening became significant after 5 years and progressed throughout 10 years. A similar rate of development of AR with systemic atopy was detected in patients and controls (9.7% vs 7.8%, log‐rank P=.623). In 5 patients, conversion to systemic atopy occurred >10 years (3%).

Conclusions

LAR is a well‐differentiated clinical entity with a low rate of development of systemic atopy, a natural evolution towards worsening and a risk factor for suffering asthma.
Neural breathing pattern in newborn infants pre‐ and postextubation
Authors: Iyer Narayan P. , Dickson John , Ruiz Michelle E. , Chatburn Robert , Beck Jennifer , Sinderby Chister , Rodriguez Ricardo J.
Published: August 2017

Aim

To describe the neural breathing pattern before and after extubation in newborn infants.

Methods

Prospective, observational study. In infants deemed ready for extubation, the diaphragm electrical activity (EAdi) was continuously recorded from 30 minute before to two hours after extubation.

Results

Total of 25 neonates underwent 29 extubations; 10 extubations resulted in re‐intubation within 72 hours. Postextubation, there was an increase in peak EAdi (EAdi‐max) and EAdi‐delta (peak minus minimum EAdi) in both groups. The pre‐ to postextubation change in EAdi‐max (8.9–11.1 μv) and EAdi‐delta (6–8 μv) was less in the failure group in comparison with the change in EAdi‐max (10.2–13.4 μv) and EAdi‐delta (6.3–10.6 μv) in the success group, (p = 0.02 and 0.01, respectively).

Conclusion

In our neonatal cohort, extubation failure was associated with a smaller increase in peak and delta EAdi after extubation. If confirmed, these findings indicate an important cause of extubation failure in preterm infants.
Population pharmacokinetics of the MEK inhibitor selumetinib and its active N‐desmethyl metabolite: data from 10 phase I trials
Authors: Patel Parul , Howgate Eleanor , Martin Paul , Carlile David J. , Aarons Leon , Zhou Diansong
Published: August 2017

Aims

The aims of the study were to characterize the pharmacokinetics (PK) of selumetinib (AZD6244; ARRY‐142886), a mitogen‐activated protein kinase kinase (MEK) 1/2 inhibitor in clinical development for various indications, and its N‐desmethyl metabolite in healthy volunteers, and evaluate clinically important covariates.

Methods

A pooled‐population PK analysis was performed using a nonlinear mixed‐effects approach with plasma concentration data from 346 subjects who received single oral doses of selumetinib 20–75 mg across 10 phase I studies. Absolute bioavailability was determined using intravenous [14C] selumetinib.

Results

A two‐compartment linear model with sequential zero‐first order absorption and a lag time for the zero‐order process was described for selumetinib PK. N‐desmethyl metabolite disposition was described by a single compartment with linear elimination, without back transformation. The parent‐only and joint models generally described pooled data adequately. For the median subject, not taking interacting drugs, estimates for clearance (CL) and central volume of distribution (V2) for selumetinib in the final joint model were 12.7 l h–1 and 35.6 l, respectively. Food effects, comedication with itraconazole [a cytochrome P450 (CYP) 3A4 inhibitor], fluconazole (a CYP2C19 inhibitor) and rifampicin (a CYP3A4 inducer) and formulation effects were incorporated into the base model a priori. Race and hepatic function were also influential in the PK model. Additional covariates affecting selumetinib disposition identified from covariate analysis were age on V2, bilirubin on CL, and weight on CL and V2.

Conclusions

Analysis confirmed previous clinical pharmacology study findings of drug–drug interactions and food effects, with additional covariates that influence selumetinib and N‐desmethyl selumetinib PK identified. Dose modifications based on these additional covariates were not considered necessary.
Mixed state and suicide: Is the effect of mixed state on suicidal behavior more than the sum of its parts?
Authors: Persons Jane E , Coryell William H , Solomon David A , Keller Martin B , Endicott Jean , Fiedorowicz Jess G
Published: August 2017

Objective

To assess whether suicidal behavior during mixed states exceeds that expected from the manic or depressive components alone.

Methods

This study included 429 participants with bipolar disorder from the National Institute of Mental Health Collaborative Depression Study (CDS). Mood and suicidal behavior were captured using the Longitudinal Interval Follow‐up Evaluation and the Schedule of Affective Disorders and Schizophrenia. Suicidal behavior during each mood state, relative to euthymia, was analyzed using Cox regression to allow for repeated events, with a frailty term to account for intra‐participant correlation. Mixed states were modeled as a depression‐by‐mania interaction.

Results

Individuals with a history of mixed states were at higher risk of suicidal behavior and spent more time depressed, compared to subjects with no such history. In bipolar I disorder, risk increased during episodes of mania (hazard ratio [HR]: 1.96, 95% confidence interval [CI]: 1.28‐2.99, P = .0019) and depression (HR: 5.49, 95% CI: 4.01‐7.51, P < .0001) and there was a less than additive effect of mixed states. In bipolar II disorder, risk was increased during episodes of depression (HR: 3.66, 95% CI: 2.51‐5.35, P < .0001) and there was no excess risk during mixed states beyond that attributable to the depressed component. Most of the excess risk (71%) among those with a history of mixed states was attributable to a depression predominant course of illness.

Conclusions

Individuals with mixed states are at high risk of suicidal behavior, largely due to more time spent depressed. Clinicians should aggressively treat depression to mitigate suicide risk for patients with or without mixed states.
Shame and HIV: Strategies for addressing the negative impact shame has on public health and diagnosis and treatment of HIV
Authors: Hutchinson Phil , Dhairyawan Rageshri
Published: August 2017

There are five ways in which shame might negatively impact upon our attempts to combat and treat HIV.

Shame can prevent an individual from disclosing all the relevant facts about their sexual history to the clinician.

Shame can be a motivational factor in people living with HIV not engaging with or being retained in care.

Shame can prevent individuals from presenting at clinics for STI and HIV testing.

Shame can prevent an individual from disclosing their HIV (or STI) status to new sexual partners.

Shame can serve to psychologically imprison people, it makes the task of living with HIV a far more negative experience than it should, or needs to, be.

Drawing on recent philosophical work on shame, and more broadly on work in the philosophy and psychology of emotion, we (a.) propose a framework for understanding how shame operates upon those who experience the emotion, (b.) propose a strategy for combatting the negative role shame plays in the fight against HIV, and (c) suggest further study so as to identify the tactics that might be employed in pursuing the strategy here proposed.
The role of the red blood cell in host defence against falciparum malaria: an expanding repertoire of evolutionary alterations
Authors: Goheen Morgan M. , Campino Susana , Cerami Carla
Published: August 2017

The malaria parasite has co‐evolved with its human host as each organism struggles for resources and survival. The scars of this war are carried in the human genome in the form of polymorphisms that confer innate resistance to malaria. Clinical, epidemiological and genome‐wide association studies have identified multiple polymorphisms in red blood cell (RBC) proteins that attenuate malaria pathogenesis. These include well‐known polymorphisms in haemoglobin, intracellular enzymes,RBCchannels,RBCsurface markers, and proteins impacting theRBCcytoskeleton andRBCmorphology. A better understanding of how changes inRBCphysiology impact malaria pathogenesis may uncover new strategies to combat the disease.
Supradetachment basin evolution unravelled by detrital apatite fission track analysis: the Gediz Graben (Menderes Massif, Western Turkey)
Authors: Asti Riccardo , Malusà Marco Giovanni , Faccenna Claudio
Published: August 2017

The Menderes Massif is a Tertiary metamorphic core complex tectonically exhumed in the late Oligocene–Miocene during coeval development of a series of E–W‐trending basins. This study analyses the source‐to‐sink evolution of the Gediz Graben and the exhumation pattern of the Central Menderes Massif at the footwall and hanging wall of the Gediz Detachment Fault. We use a comprehensive approach to detrital apatite fission track dating combining analysis of modern river sediments, analysis of fossil sedimentary successions and mineral fertility determinations. This approach allowed us to: (i) define the modern short‐term erosion pattern of the study area, (ii) unravel the long‐term exhumation history, (iii) identify major exhumation events recorded in the sedimentary basin fill and (iv) constrain the maximum depositional age of the sedimentary succession. Three main exhumation events are recorded in the analysed detrital samples: (i) a late Oligocene/early Miocene exhumation event involving the whole Menderes Massif; (ii) a late Miocene event involving the northern edge of the Central Menderes Massif; (iii) a Plio‐Quaternary more localized event involving only the western part of the southern margin of the basin (Salihli area) and bringing to the surface the Gediz Detachment and its intrusive footwall (Salihli granodiorite). The modern short‐term erosion pattern closely reflects this latter Plio‐Quaternary event. Single grain‐age distributions in the sedimentary basin fill highlight drainage pattern reorganizations in correspondence of the transition between different stratigraphic units, and allowed to better constrain the depositional age of the sedimentary units of the basin pointing to a possible onset of sedimentation in the basin during the middle Miocene.
Features of asthma which provide meaningful insights for understanding the disease heterogeneity
Authors: Deliu M. , Yavuz T. S. , Sperrin M. , Belgrave D. , Sahiner U. M. , Sackesen C. , Kalayci O. , Custovic A.
Published: August 2017

Background

Data‐driven methods such as hierarchical clustering (HC) and principal component analysis (PCA) have been used to identify asthma subtypes, with inconsistent results.

Objective

To develop a framework for the discovery of stable and clinically meaningful asthma subtypes.

Methods

We performed HC in a rich data set from 613 asthmatic children, using 45 clinical variables (Model 1), and after PCA dimensionality reduction (Model 2). Clinical experts then identified a set of asthma features/domains which informed clusters in the two analyses. In Model 3, we reclustered the data using these features to ascertain whether this improved the discovery process.

Results

Cluster stability was poor in Models 1 and 2. Clinical experts highlighted four asthma features/domains which differentiated the clusters in two models: age of onset, allergic sensitization, severity, and recent exacerbations. In Model 3 (HC using these four features), cluster stability improved substantially. The cluster assignment changed, providing more clinically interpretable results. In a 5‐cluster model, we labelled the clusters as: “Difficult asthma” (n = 132); “Early‐onset mild atopic” (n = 210); “Early‐onset mild non‐atopic: (n = 153); “Late‐onset” (n = 105); and “Exacerbation‐prone asthma” (n = 13). Multinomial regression demonstrated that lung function was significantly diminished among children with “Difficult asthma”; blood eosinophilia was a significant feature of “Difficult,” “Early‐onset mild atopic,” and “Late‐onset asthma.” Children with moderate‐to‐severe asthma were present in each cluster.

Conclusions and clinical relevance

An integrative approach of blending the data with clinical expert domain knowledge identified four features, which may be informative for ascertaining asthma endotypes. These findings suggest that variables which are key determinants of asthma presence, severity, or control may not be the most informative for determining asthma subtypes. Our results indicate that exacerbation‐prone asthma may be a separate asthma endotype and that severe asthma is not a single entity, but an extreme end of the spectrum of several different asthma endotypes.
Efficacy of exenatide on weight loss, metabolic parameters and pregnancy in overweight/obese polycystic ovary syndrome
Authors: Liu Xin , Zhang Ying , Zheng Si‐yuan , Lin Rong , Xie Yi‐juan , Chen Hui , Zheng Yong‐xiong , Liu En , Chen Lin , Yan Jia‐he , Xu Wei , Mai Ting‐ting , Gong Yi
Published: August 2017

Context

Weight loss remains one of the most important arms in obese patients with polycystic ovary syndrome (PCOS). Further studies are needed to identify the best treatment.

Objective

To evaluate the effects of exenatide (EXE) on reproductive and metabolic function in overweight/obese (OW/OB) PCOS.

Design

This is a 24‐week open‐label prospective, randomized, clinical study.

Patients and Measurements

This study randomized 176 OW/OB women diagnosed with PCOS to receive either EXE 10 μg BID (n = 88) or metformin (MET) 1000 mg BID (n = 88) for the first 12 weeks. Then all patients were treated with MET alone during the second 12 weeks. We observed metabolic parameters at 0 and 12 weeks, and then tracked the rate of pregnancy during the second 12 weeks.

Results

After the first 12 weeks of intervention, compared with MET, subjects who received EXE had significantly decreased weight (4.29 ± 1.29 kg vs 2.28 ± 0.55 kg, P < .001) and total fat% (4.67 ± 0.09% vs 1.11 ± 0.32%, P < .001), improved the homeostasis model of assessment for insulin resistance (1.30 ± 0.58 vs 0.59 ± 0.12, P < .001) and increased the menstrual frequency ratio (0.62 ± 0.12 vs 0.37 ± 0.01, P < .001). During the second 12 weeks, the rate of natural pregnancy of EXE‐treated patients was significantly higher than MET‐treated patients (43.60% vs 18.70%, P < .05).

Conclusions

Short‐term EXE therapy was linked to significant weight loss and central adiposity reduction, which may further explain the improvements in insulin resistance, inflammatory marker and menstrual cycle, which may contribute to increasing pregnancy rates in OW/OB women with PCOS.
Partners in practice: Developing integrated learning opportunities on the Frontline child and family social work qualifying programme
Authors: Domakin Alison , Curry Liz
Published: August 2017

The Frontline programme is a social work qualifying route, in England, featuring a different approach to curriculum design and delivery. Students are based in groups of 4, learning through practicing social work in a statutory child and family social work setting, alongside a Consultant Social Worker (in the role of practice educator). They are also supported by an Academic Tutor who works in partnership with the Consultant Social Worker to facilitate learning. A weekly “unit meeting” is a foundational aspect of the programme, providing opportunities for in‐depth discussion, teaching, and reflection on practice with families.

The authors worked together over the first 2 cohorts of the programme and undertook action research to explore the learning opportunities that arise when academic staff and practitioners work side by side to support student learning in this model. Three broad themes were identified which were considered to be significant in helping students to learn which are explored in the paper:

Learning through engaging in joint dialogue about practice in a unit meeting

The influence of relationships on learning in social work

The importance of a connected model of learning which has practice with children and families at its heart
Cost‐effectiveness of sacral neuromodulation for chronic refractory constipation in children and adolescents: a Markov model analysis
Authors: van der Wilt A. A. , Groenewoud H. H. M. , Benninga M. A. , Dirksen C. D. , Baeten C. G. M. I. , Bouvy N. D. , Melenhorst J. , Breukink S. O.
Published: August 2017

Aim

This study aimed to assess the cost‐effectiveness of sacral neuromodulation (SNM) compared with conservative treatment in children and adolescents with constipation refractory to conservative management.

Method

A Markov probabilistic model was used, comparing costs and effectiveness of SNM and conservative treatment in children and adolescents aged 10–18 years with constipation refractory to conservative management. Input for the model regarding transition probabilities, utilities and healthcare costs was based on data from a cohort of patients treated in our centre. This cohort consisted of 30 female patients (mean age 16 years) with functional constipation refractory to conservative management. The mean duration of laxative use in this group was 5.9 years. All patients had a test SNM, followed by a permanent SNM in 27/30. Median follow‐up was 22.1 months (range 12.2–36.8). The model was run to simulate a follow‐up period of 3 years.

Results

The mean cumulative costs for the SNM group and the conservative treatment group were €17 789 (SD €2492) and €7574 (SD €4332) per patient, respectively. The mean quality adjusted life years (QALYs) in the SNM group was 1.74 (SD 0.19), compared with 0.86 (SD 0.14) in the conservatively managed group. The mean incremental cost‐effectiveness ratio was €12 328 per QALY (SD €4788). Sensitivity analysis showed that the outcomes were robust to a wide range of model assumptions.

Conclusion

Chronic constipation seriously affects the quality of life of children and adolescents. Preliminary evidence suggests that SNM can improve symptoms and quality of life at a reasonable cost.