bluuebunny/crossref_metadata_2025 huggingface dataset:
The dialectical development of “storytelling” learning organizations
Authors: Hillon Yue Cai , Boje David M.
Published: March 2017

Purpose

Calls for dialectical learning process model development in learning organizations have largely gone unheeded, thereby limiting conceptual understanding and application in the field. This paper aims to unify learning organization theory with a new understanding of Hegelian dialectics to trace the development of the storytelling learning organization. The “storytelling learning organization” is a conceptual framework presented along with criteria to evaluate different kinds of dialectical development claims in “storytelling learning organization” work that are bona fide instances of one or another dialectical ontology ranging from Marxian, to Hegelian, to Brierian, to Žižekian.

Design/methodology/approach

Ontological evaluation and critique of a variety of “storytelling learning organization” practices posit different dialectical ontology and consequences for theory and practice. Through a case example of business process reengineering (BPR) in a “public research university (PRU)”, the storytelling of “schooling” versus “education” ideas and practices, in a place, in a period and in material ways of mattering, never achieves synthesis. The dialectical development of resistance to implementation evolves toward transcendence into irreducible oppositions of ontological incompleteness – the essence of a learning organization.

Findings

This ontological analysis focuses on the use of ideas and practices by opposing storytelling agents and actants to uncover a learning organization’s dialectical development in its own storytelling, its narrative and counter-narrative enactments, and its attempts to unpack contradictions. The PRU under study has gone through a series of financial crises, and its learning organization responses were downsizing staff and faculty positions and implementing BPR in ways that worsened the situation. The process resulted in staff and faculty leaving even before the reorganization was completed and enrollment dropped dramatically, in great part due to the negative press and the excessive standardization of the curriculum that accompanies “schooling” displacing acts of “education” practices and ideations. Meanwhile, the administrators are still trying to manage the narrative and control it so as to forestall additional attrition.

Originality/value

The theory of “storytelling learning organization” is original. The question answered here has practical value because institutions have choices to make concerning the kind of dialectical narrative and counter-narrative development that is cultivated, and there are options for transforming or moving to an alternative narrative and counter-narrative development process. The analysis of the case also illustrates a pattern of intervention that is, on the one hand, unsuccessful in developing “higher” education and, on the other hand, successful in shutting down the efficacy of a PRU by centrist use of reengineering to accomplish more schooling, more downsizing and more installation of “academic capitalism” ideas and practices.
Error management practices interacting with national and organizational culture
Authors: Göktürk Söheyda , Bozoglu Oguzhan , Günçavdi Gizem
Published: March 2017

Purpose

Elements of national and organizational cultures can contribute much to the success of error management in organizations. Accordingly, this study aims to consider how errors were approached in two state university departments in Turkey in relation to their specific organizational and national cultures.

Design/methodology/approach

The study follows a qualitative case study design, and the data were collected through five focus groups. The cases under consideration were two state university departments of different organizational sizes.

Findings

The results showed that organizational and national culture elements (collectivism, high power distance and relatively low future orientation) significantly interacted with error management practices. In both of the organizations studied, there were found to be limited attempts to prevent the errors unless there was an emergent situation. Error detection was shown to be slow and hindered because of indirect communication among staff. Ultimately, effective error management in these organizations was identified as being unattainable because of negative emotional reactions to errors, lower reporting, restricted communication, potential face loss considerations and lack of feedback.

Originality/value

The findings of the current work extend earlier error management research with empirical data drawn from two cases in the higher education domain. Thus, the study offers preliminary research into the error process in education, and contributes to future research relating organizational culture to error processes.
A note on systems intelligence in knowledge management
Authors: Sasaki Yasuo
Published: March 2017

Purpose

This paper aims to show that systems intelligence (SI) can be a useful perspective in knowledge management, particularly in the context of the socialization, externalization, combination and internalization (SECI) model. SI is a recently developed systemic concept, a certain kind of human intelligence based on a systems thinking perspective.

Design/methodology/approach

This paper first provides an overview of the related literature, and then conceptually discusses the role of SI in organizational knowledge creations.

Findings

SI can work as a powerful momentum in each stage as well as the whole process of SECI.

Originality/value

This paper is the first application of SI to the field of knowledge management. It provides us with a new perspective to touch human factors in knowledge management processes, which are considered to be essential in the SECI model.
N-loop learning: part II – an empirical investigation
Authors: Simonin Bernard L.
Published: March 2017

Purpose

Through a survey of firm’s experiences with strategic alliances and a structural equation modeling approach, the aim of this study is to stimulate further interest in modeling and empirical research in the area of N-loop learning. Although the concepts of single-loop and double-loop learning, in particular, are well established in the literature, limited research has been directed toward their empirical validation and finer understanding.

Design/methodology/approach

Based on a large sample of technology firms, a MIMIC model is proposed and tested with respect to the development of collaborative know-how via the adoption and conduct of different structural choices on how to deploy strategic alliances (single-loop vs double-loop approach). Results are cross-validated.

Findings

Based on the results of two structural equation models, the findings support the fit of the proposed conceptual model and the notion that, overall, the greater the extent of double-loop over single-loop learning, the higher the level of collaborative know-how derived.

Originality/value

The call for the empirical investigation of N-loop learning is met by providing an example of survey-based research. The possible benefits of “double-loop” over “single-loop” learning are modeled and tested empirically.
Impact of Disease Prevalence Adjustment on Hospitalization Rates for Chronic Ambulatory Care–Sensitive Conditions in Germany
Authors: Pollmanns Johannes , Romano Patrick S. , Weyermann Maria , Geraedts Max , Drösler Saskia E.
Published: March 2017

Objectives

To explore effects of disease prevalence adjustment on ambulatory care–sensitive hospitalization (ACSH) rates used for quality comparisons.

Data Sources/Study Setting

County‐level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative ambulatory diagnosis data were used.

Study Design

A retrospective cross‐sectional study using in‐ and outpatient secondary data was performed.

Data Collection

Hospitalization data for hypertension, diabetes, heart failure, chronic obstructive pulmonary disease, and asthma were obtained from the German Diagnosis Related Groups (DRG) database. Prevalence estimates were obtained from the German Central Research Institute of Ambulatory Health Care.

Principal Findings

Crude hospitalization rates varied substantially across counties (coefficients of variation [CV] 28–37 percent across conditions); this variation was reduced by prevalence adjustment (CV 21–28 percent). Prevalence explained 40–50 percent of the observed variation (r = 0.65–0.70) in ACSH rates for all conditions except asthma (r = 0.07). Between 30 percent and 38 percent of areas moved into or outside condition‐specific control limits with prevalence adjustment.

Conclusions

Unadjusted ACSH rates should be used with caution for high‐stakes public reporting as differences in prevalence may have a marked impact. Prevalence adjustment should be considered in models analyzing ACSH.
Effects of Spray‐Drying Parameters on In Vitro Functional Properties of Camu‐Camu (Myrciaria dubia Mc. Vaugh): A Typical Amazonian Fruit
Authors: Fujita Alice , Souza Volnei Brito , Daza Luis Daniel , Fávaro‐Trindade Carmen Silvia , Granato Daniel , Genovese Maria Inés
Published: March 2017

Camu‐camu (Myrciaria dubia) fruit is a rich source of bioactive compounds but its shelf life is rather short. Therefore, this study was aimed to evaluate the effect of inlet air temperature (T) and concentration (C) of maltodextrin and arabic gum on the spray‐drying process of commercial camu‐camu pulps (São Paulo and Manaus). Moisture, solubility, total phenolics (TP), ascorbic acid (AA), and proanthocyanidins (PAC) contents, and in vitro antioxidant capacity of the powders (FRAP, DPPH, Folin–Ciocalteu's reducing capacity were measured). Arabic gum resulted in better yields (22% to 30%), powder solubility (84% to 90%), and lower losses of analyzed compounds than the powders manufactured with maltodextrin. Overall, inlet air temperature had a lower impact on the responses studied than the concentration of carrier agents. Polynomial equations were generated for AA (R2 = 0.993), TP (R2 = 0.735), PAC (R2 = 0.946), and for the antioxidant capacity assays (0.867 ≤ R2 ≤ 0.963). In addition, principal component analysis showed that the lowest concentration of carrier agents (6%) in spray drying resulted in the lowest losses of bioactive compounds and, consequently, the highest antioxidant capacity.
Role of amino acids in rheumatoid arthritis studied by metabolomics
Authors: He Min , Harms Amy C. , van Wijk Eduard , Wang Mei , Berger Ruud , Koval Slavik , Hankemeier Thomas , van der Greef Jan
Published: March 2017

Background

Rheumatoid arthritis (RA) is a complex, chronic autoimmune disease characterized by various inflammatory symptoms, including joint swelling, joint pain, and both structural and functional joint damage. The most commonly used animal model for studying RA is mice with collagen‐induced arthritis (CIA); the wide use of this model is due primarily to many similarities with RA in human patients. Metabolomics is used increasingly in biological studies for diagnosing disease and for predicting and evaluating drug interventions, as a large number of disease‐associated metabolites can be analyzed and interpreted from a biological perspective.

Aim

To profile free amino acids and their biogenic metabolites in CIA mice plasma.

Method

Ultra‐high‐performance liquid chromatography/tandem mass spectrometry coupled with multiple reaction monitoring (MRM) was used for metabolomics study.

Results

Profile of 45 amine metabolites, including free amino acids and their biogenic metabolites in plasma was obtained from CIA mice. We found that the plasma levels of 20 amine metabolites were significantly decreased in the CIA group.

Conclusion

The results suggest that a disordered amine response is linked to RA‐associated muscle wasting and energy expenditure.
Manipulating the baby biome: What are the issues?
Authors: Lee Lai‐yang , Garland Suzanne M. , Giles Michelle L. , Daley Andrew J.
Published: March 2017

Establishing a baby biome through the controversial practice of ‘vaginal seeding’ has generated interest among the general public and healthcare providers alike. We discuss the potential risks of this practice and offer a harm minimisation approach to managing women requesting vaginal microbiome transfer after delivery by caesarean section.
Characterization of maize chitinase‐A, a tough allergenic molecule
Authors: Volpicella M. , Leoni C. , Fanizza I. , Distaso M. , Leoni G. , Farioli L. , Naumann T. , Pastorello E. , Ceci L. R.
Published: March 2017

Food allergies are recognized as an increasing health concern. Proteins commonly identified as food allergens tend to have one of about 30 different biochemical activities. This leads to the assumption that food allergens must have specific structural features which causes their allergenicity. But these structural features are not completely understood. Uncovering the structural basis of allergenicity would allow improved diagnosis and therapy of allergies and would provide insights for safer food production. The availability of recombinant food allergens can accelerate their structural analysis and benefit specific studies in allergology. Plant chitinases are an example of food allergenic proteins for which structural analysis of allergenicity has only partially been reported. The recombinant maize chitinase, rChiA, was purified from Pichia pastoris extracellular medium by differential precipitation and cation exchange chromatography. Enzyme activity was evaluated by halo‐assays and microcalorimetric procedures. rChiA modeling was performed by a two‐step procedure, using the Swiss‐Model server and Modeller software. Allergenicity of rChiA was verified by immunoblot assays with sera from allergic subjects. rChiA is active in the hydrolysis of glycol chitin and tetra‐N‐acetylchitotetraose and maintains its activity at high temperatures (70°C) and low pH (pH 3). The molecule is also reactive with IgE from sera of maize‐allergic subjects. rChiA is a valuable molecule for further studies on structure‐allergenicity relationships and as a tool for diagnosing allergies.
Early response predicts a sustained response to eluxadoline in patients with irritable bowel syndrome with diarrhoea in two Phase 3 studies
Authors: Chey W. D. , Dove L. S. , Andrae D. A. , Covington P. S.
Published: March 2017

Background

The mixed μ‐ and κ‐opioid receptor agonist and δ‐opioid receptor antagonist, eluxadoline, is licensed in the USA for the treatment of irritable bowel syndrome with diarrhoea (IBS‐D), based on the results of two large Phase 3 clinical trials.

Aim

To understand the time course of treatment benefits with eluxadoline by comparing responder rates over the first month of treatment with responder rates over longer treatment intervals.

Methods

In this post hoc analysis of two Phase 3 studies, composite and adequate relief (AR) responder rates were calculated over month 1 and patients were stratified by their responder status. Cumulative counts over subsequent intervals (months 1–3, months 1–6, months 2 through 6) were tallied.

Results

The studies randomised 2428 patients. Over month 1, 24.6%, 22.8% and 12.5% of patients were composite responders with eluxadoline 100 mg, eluxadoline 75 mg and placebo respectively. For month 1 responders, 77.8% and 81.5% (over months 1–3) and 70.7% and 73.9% (over months 1–6) showed a continuous response with eluxadoline 100 mg and 75 mg respectively. [Correction added on 5 April 2017, after first online publication: The percentage for the responders over months 1–3 was previously wrong and has been corrected.] Of the month 1 nonresponders, <20% showed a response over months 1–3 or months 1–6. Similar results were seen for the analysis of proportions of AR responders over these time intervals.

Conclusions

Over two‐thirds of patients who respond over the first month retain a positive response over 6 months of treatment with eluxadoline, indicating that early clinical response to eluxadoline is associated with sustained benefits for up to 6 months in patients with IBS‐D.
A tropical epiphytic orchid uses a low‐light interception strategy in a spatially heterogeneous light environment
Authors: Ventre‐Lespiaucq Agustina B. , Delgado Juan A. , Ospina‐Calderón Nhora H. , Otero Joel T. , Escudero Adrián , Sánchez María A. , Balaguer Luis , Flanagan Nicola S.
Published: March 2017

Light is considered a non‐limiting factor for vascular epiphytes. Nevertheless, an epiphyte's access to light may be limited by phorophyte shading and the spatio‐temporal environmental patchiness characteristic of epiphytic habitats. We assessed the extent to which potential light interception in Rodriguezia granadensis, an epiphytic orchid, is determined by individual factors (plant size traits and leaf traits), or environmental heterogeneity (light patchiness) within the crown of the phorophyte, or both. We studied 104 adult plants growing on Psidium guajava trees in two habitats with contrasting canopy cover: a dry tropical forest edge, and isolated trees in a pasture. We recorded the number of leaves and the leaf area, the leaf position angles, and the potential exposure of the leaf surface to direct irradiance (silhouette area of the leaf blade), and the potential irradiance incident on each plant. We found the epiphytes experience a highly heterogeneous light environment in the crowns of P. guajava. Nonetheless, R. granadensis plants displayed a common light interception strategy typical of low‐light environments, resembling terrestrial, forest understory plants. Potential exposure of the total leaf surface to direct irradiance correlated positively with plant size and within‐plant variation in leaf orientation. In many‐leaved individuals, within‐plant variation in leaf angles produced complementary leaf positions that enhanced potential light interception. This light interception strategy suggests that, in contrast to current wisdom, enhancing light capture is important for vascular epiphytes in canopies with high spatio‐temporal heterogeneity in light environments.
Prospective evaluation of a week one overnight metyrapone test with subsequent dynamic assessments of hypothalamic‐pituitary‐adrenal axis function after pituitary surgery
Authors: English Katherine , Inder Warrick J. , Weedon Zara , Dimeski Goce , Sorbello Jane , Russell Anthony W. , Duncan Emma L , Cuneo Ross
Published: March 2017

Objective

To determine whether an overnight metyrapone test (OMT) within the first week postpituitary surgery can definitively assess the hypothalamic‐pituitary‐adrenal (HPA) axis, compared with subsequent dynamic tests and glucocorticoid requirement at 6 months.

Design

Prospective study measuring morning cortisol levels on days 3 and 4 post‐operatively, OMT day 5‐7 and week 6, week 6 250 μg short Synacthen test (SST) and week 7 insulin tolerance test (ITT).

Patients and Measurements

Forty participants who underwent pituitary surgery at a single centre (Cushing's disease excluded) were followed for at least 6 months. 46% had pre‐operative adrenal insufficiency.

Primary outcome: week 1 OMT compared to glucocorticoid requirement at 6 months. Secondary outcomes: the performance of ITT as a “definitive” test and all tests compared to glucocorticoid requirement at 6 months.

Results

Week 1 OMT showed concordance with ITT at week 7 of 78% and glucocorticoid requirement at 6 months of 81% respectively which was not significantly different from post‐operative morning cortisol levels; 37% of participants with an abnormal OMT on day 6 had a normal OMT at week 6. All HPA axis tests showed similar concordance with glucocorticoid requirement at 6 months of 80%‐85%.

Conclusions

Overnight metyrapone test within the first week after pituitary surgery was no better than an early morning cortisol level at predicting glucocorticoid requirement at 6 months. OMT at week 6 demonstrated recovery of HPA axis in a substantial proportion of participants who failed earlier assessments; thus, definitive testing should be delayed until 6 weeks post‐operatively.
Clinicopathological characteristics including BRAF V600E mutation status and PET/CT findings in papillary thyroid carcinoma
Authors: Choi Eun Kyoung , Chong Ari , Ha Jung‐Min , Jung Chan Kwon , O Joo Hyun , Kim Sung Hoon
Published: March 2017

Objective

We assessed the associations between FDG uptake in primary papillary thyroid carcinomas (PTCs) and clinicopathological features, including the BRAF V600E mutation, using quantitative and qualitative analyses of preoperative PET/CT data.

Design and Patients

This was a retrospective review of 106 patients with PTC who underwent PET/CT scans between February 2009 and January 2011 before undergoing total thyroidectomy. Data collected from surgical specimens were compared with FDG uptake in the primary tumour using quantitative and qualitative analyses of preoperative PET/CT data. Clinicopathological data included the primary tumour size, subtype, capsular invasion, extrathyroid extension, multifocality, BRAF V600E mutation status, lymph node metastasis and distant metastasis.

Results

The SUVmax of the primary tumour was significantly higher in patients with a primary tumour >1 cm, extrathyroid extension or the BRAF V600E mutation than in patients without these features (P<.001, .049 and <.001). Univariate analyses showed that primary tumour size, extrathyroid extension and BRAF V600E mutation status were associated with the SUVmax of the PTC. Multivariate analysis indicated that primary tumour size and the BRAF V600E mutation were associated with the SUVmax of the PTC. In a visual assessment, the primary tumour size was larger in FDG‐avid than in non‐FDG‐avid PTCs (P<.001). There was no significant difference in the presence of multifocality, thyroid capsular invasion, extrathyroid extension, BRAF V600E mutation, lymph node metastasis or distant metastasis between FDG‐avid and non‐FDG‐avid PTCs.

Conclusions

Primary tumour size and the BRAF V600E mutation are significant factors associated with the SUVmax on preoperative PET/CT in patients with PTC.
Analysis of risk factors for cluster behavior of dental implant failures
Authors: Chrcanovic Bruno Ramos , Kisch Jenö , Albrektsson Tomas , Wennerberg Ann
Published: March 2017

Background

Some studies indicated that implant failures are commonly concentrated in few patients.

Purpose

To identify and analyze cluster behavior of dental implant failures among subjects of a retrospective study.

Materials and Methods

This retrospective study included patients receiving at least three implants only. Patients presenting at least three implant failures were classified as presenting a cluster behavior. Univariate and multivariate logistic regression models and generalized estimating equations analysis evaluated the effect of explanatory variables on the cluster behavior.

Results

There were 1406 patients with three or more implants (8337 implants, 592 failures). Sixty‐seven (4.77%) patients presented cluster behavior, with 56.8% of all implant failures. The intake of antidepressants and bruxism were identified as potential negative factors exerting a statistically significant influence on a cluster behavior at the patient‐level. The negative factors at the implant‐level were turned implants, short implants, poor bone quality, age of the patient, the intake of medicaments to reduce the acid gastric production, smoking, and bruxism.

Conclusions

A cluster pattern among patients with implant failure is highly probable. Factors of interest as predictors for implant failures could be a number of systemic and local factors, although a direct causal relationship cannot be ascertained.
Incidence, recurrence and cost of hyperglycaemic crises requiring emergency treatment in Andalusia, Spain
Authors: Barranco R. J. , Gomez‐Peralta F. , Abreu C. , Delgado‐Rodriguez M. , Moreno‐Carazo A. , Romero F. , de la Cal M. A. , Barranco J. M. , Pasquel F. J. , Umpierrez G. E.
Published: March 2017

Aims

Hyperglycaemic crises (diabetic ketoacidosis and hyperosmolar hyperglycaemic state) are medical emergencies in people with diabetes. We aimed to determine their incidence, recurrence and economic impact.

Methods

An observational study of hyperglycaemic crises cases using the database maintained by the out‐of‐hospital emergency service, the Healthcare Emergency Public Service (EPES) during 2012. The EPES provides emergency medical services to the total population of Andalusia, Spain (8.5 million inhabitants) and records data on the incidence, resource utilization and cost of out‐of‐hospital medical care. Direct costs were estimated using public prices for health services updated to 2012.

Results

Among 1 137 738 emergency calls requesting medical assistance, 3157 were diagnosed with hyperglycaemic crises by an emergency coordinator, representing 2.9 cases per 1000 persons with diabetes [95% confidence intervals (CI) 2.8 to 3.0]. The incidence of diabetic ketoacidosis was 2.5 cases per 1000 persons with diabetes (95% CI 2.4 to 2.6) and the incidence of hyperosmolar hyperglycaemic state was 0.4 cases per 1000 persons with diabetes (95% CI 0.4 to 0.5). In total, 17.7% (n = 440) of people had one or more hyperglycaemic crisis. The estimated total direct cost was €4 662 151, with a mean direct cost per episode of €1476.8 ± 217.8.

Conclusions

Hyperglycaemic crises require high resource utilization of emergency medical services and have a significant economic impact on the health system.
Relationships between individual movement, trophic position and growth of juvenile pike (Esox lucius)
Authors: Nyqvist Marina J. , Cucherousset Julien , Gozlan Rodolphe E. , Britton J. Robert
Published: March 2017

Variation in movement between individuals can have important ecological effects on populations and ecosystems, yet the factors driving differences in movement and their consequences remain poorly understood. Here, individual variability in the movements of juvenile (age 0 +  and 1 +  year) pike Esox lucius was assessed using passive integrated transponder (PIT) telemetry in off‐channel nursery areas over a 26‐ month period. Differences in the movement patterns of individuals were tested against their body sizes, ages, growth rates and trophic positions using data collected through a combination of catch‐and‐release sampling and stable isotope analyses. Results revealed that variation in movement between individuals was affected by age, with 1 +  individuals moving more than individuals of age 0 + , but not length. Individuals whose TP was low on their initial capture event moved significantly less than those with a higher initial TP. Individuals that moved more grew faster and achieved a higher final TP. These results suggest that higher activity (i.e., increased movement) increases resource acquisition that enhances growth rates, which could ultimately maximise individual performances.
An Analytical Method for Groundwater Inflow into a Drained Circular Tunnel
Authors: Su Kai , Zhou Yafeng , Wu Hegao , Shi Changzheng , Zhou Li
Published: March 2017

Groundwater inflow estimation is essential for the design and construction of tunnel and the assessment of the environmental impacts. Analytical solutions used in current engineering practice do not adequately account for the effect of the excavation‐induced drawdown, which leads to significant change in pore water pressure distribution and reductions of the water level beyond tunnel. Based on the numerical analysis results, this article proposes semianalytical method to predict the height of lowered water level and groundwater tunnel inflow. The tunnel problem is conceptualized as two‐dimensional flow in a plane perpendicular to the tunnel axis. The analytical formula, considering the effect of the excavation‐induced drawdown, provides a better prediction of the tunnel inflow compared to the existing analytical formulas, even for the cases with inclined groundwater level.
Oral iron supplementation: Potential implications for the gut microbiome and metabolome in patients with CKD
Authors: Kortman Guus A. M. , Reijnders Dorien , Swinkels Dorine W.
Published: March 2017

Patients with chronic kidney disease (CKD) and loss of kidney function are at increased risk for morbidity and mortality. The risks of CKD are attributed to “uremia,” an increased concentration of uremic retention solutes (toxins) in the plasma. Recently, a colo‐renal axis became clearly apparent and uremia has been associated with an altered gut microbiome composition and metabolism. There is a high prevalence of anemia in patients with CKD, for which patients are often treated with oral or intravenous iron. Recent in vivo and in vitro studies have reported adverse effects of oral iron supplementation on the gut microbiota composition, gut metabolome, and intestinal health, which in turn may result in an increased production of uremic toxins. It may also affect circulating levels of other microbe‐derived molecules, that can act as mediators of immune regulation. Changes in body iron levels have also been reported to exert subtle effects on host immune function by modulating immune cell proliferation and differentiation, and by directly regulating cytokine formation and antimicrobial immune effector mechanisms. Based on the foregoing it is conceivable that oral iron supplementation in iron deficient predialysis CKD patients adversely changes gut microbiota composition, the gut and systemic metabolome, and host immunity and infection. Future studies are needed to confirm these hypotheses and to assess whether, compared to IV iron supplementation, oral iron supplementation negatively impacts on morbidity of CKD, and whether these adverse effects depend on the iron bioavailability of the iron formulation to the microbiota.
The corpus‐predominant gastritis index can be an early and reversible marker to identify the gastric cancer risk of Helicobacter pylori‐infected nonulcer dyspepsia
Authors: Cheng Hsiu‐Chi , Tsai Yu‐Ching , Yang Hsiao‐Bai , Yeh Yi‐Chun , Chang Wei‐Lun , Kuo Hsin‐Yu , Lu Cheng‐Chan , Sheu Bor‐Shyang
Published: March 2017

Background

Corpus‐predominant gastritis index (CGI) is an early histological marker to identify Helicobacter pylori‐infected gastric cancer relatives at risk of cancer. This study validated whether CGI is more prevalent in H. pylori‐infected nonulcer dyspepsia (NUD) subjects than in duodenal ulcer (DU) controls and whether it is reversible after H. pylori eradication or is correlated with noninvasive biomarkers.

Materials and Methods

In this longitudinal cohort study, 573 H. pylori‐infected subjects were enrolled, including 349 NUD and 224 DU. Gastric specimens were provided to assess CGI, spasmolyic polypeptide‐expressing metaplasia (SPEM), and Operative Link on Gastric Intestinal Metaplasia assessment (OLGIM). Serum pepsinogen I and II levels were assessed using enzyme‐linked immunosorbent assay. CGI subjected were followed up at least 1 year after H. pylori eradication.

Results

NUD subjects had higher prevalence rates of CGI (47.0% vs 29.9%, P<.001) and OLGIM stages III‐IV (24.1% vs 15.2%, P=.01) than controls. CGI was highly prevalent in NUD subjects after the age of 40, which was 10 years earlier than atrophic gastritis and intestinal metaplasia. NUD subjects with CGI had higher risk of SPEM (OR 2.86, P<.001) and lower serum pepsinogen I/II ratios (P<.001) than those without CGI. Serum pepsinogen I/II ratios <9 could predict CGI modestly (AUROC 0.69, 95% CI: 0.63‐0.74). CGI was regressed after eradication (P<.001).

Conclusions

CGI was more prevalent in H. pylori‐infected NUD subjects than in controls, was correlated with SPEM, and may serve as a marker earlier than OLGIM to indicate risk of gastric cancer. Moreover, CGI could be regressed after eradication.
Analysing the literature on university social responsibility: A review of selected higher education journals
Authors: Larrán Jorge Manuel , Andrades Peña Francisco Javier
Published: March 2017

In the last 30 years, different economic, political and social changes have taken place in the university sector and this has led to an extensive reform to meet the new societal challenges that these institutions are facing today. This emphasises the social dimension of universities and their important role in society as educators of future leaders and policy makers. This reveals the need to integrate social responsibility principles into the mainstream functions of universities. In view of these comments, this paper offers a review of the literature about university social responsibility during the period from 2000 to 2015. The objectives of the review are to: explore patterns in publication outlets; collect, scrutinise and critically analyse the current literature on this field; to identify gaps in the literature and make recommendations for further research in this field. To accomplish this task, data were collected from 15 specialist academic journals that focus on higher education.
User compliance with documenting on a track and trigger‐based observation and response chart: a two‐phase multi‐site audit study
Authors: Elliott Doug , Allen Emily , McKinley Sharon , Perry Lin , Duffield Christine , Fry Margaret , Gallagher Robyn , Iedema Rick , Roche Michael
Published: March 2017

Aims

To examine user compliance and completeness of documentation with a newly designed observation and response chart and whether a rapid response system call was triggered when clinically indicated.

Background

Timely recognition and responses to patient deterioration in hospital general wards remain a challenge for healthcare systems globally. Evaluating practice initiatives to improve recognition and response are required.

Design

Two‐phase audit.

Methods

Following introduction of the charts in ten health service sites in Australia, an audit of chart completion was conducted during a short trial for initial usability (Phase 1; 2011). After chart adoption as routine use in practice, retrospective and prospective chart audits were conducted (Phase 2; 2012).

Findings

Overall, 818 and 1,058 charts were audited during the two phases respectively. Compliance was mixed but improved with the new chart (4%–14%). Contrary to chart guidelines, numbers rather than dots were written in the graphing section in 60% of cases. Rates of recognition of abnormal vital signs improved slightly with new charts in use, particularly for higher levels of surveillance and clinical review. Based on local calling criteria, an emergency call was initiated in 33% of cases during the retrospective audit and in 41% of cases with the new chart.

Conclusions

User compliance was less than optimal, limiting full function of the chart sections and compliance with local calling criteria. Overcoming apparent behavioural and work culture barriers may improve chart completion, aiding identification of abnormal vital signs and triggering a rapid response system activation when clinical deterioration is detected.
A protocol for the development of a critical thinking assessment tool for nurses using a Delphi technique
Authors: Jacob Elisabeth , Duffield Christine , Jacob Darren
Published: March 2017

Aim

The aim of this study was to develop an assessment tool to measure the critical thinking ability of nurses.

Background

As an increasing number of complex patients are admitted to hospitals, the importance of nurses recognizing changes in health status and picking up on deterioration is more important. To detect early signs of complication requires critical thinking skills. Registered Nurses are expected to commence their clinical careers with the necessary critical thinking skills to ensure safe nursing practice. Currently, there is no published tool to assess critical thinking skills which is context specific to Australian nurses.

Design

A modified Delphi study will be used for the project.

Methods

This study will develop a series of unfolding case scenarios using national health data with multiple‐choice questions to assess critical thinking. Face validity of the scenarios will be determined by an expert reference group of clinical and academic nurses. A Delphi study will determine the answers to scenario questions. Panel members will be expert clinicians and educators from two states in Australia. Rasch analysis of the questionnaire will assess validity and reliability of the tool. Funding for the study and Research Ethics Committee approval were obtained in March and November 2016, respectively.

Discussion

Patient outcomes and safety are directly linked to nurses’ critical thinking skills. This study will develop an assessment tool to provide a standardized method of measuring nurses’ critical thinking skills across Australia. This will provide healthcare providers with greater confidence in the critical thinking level of graduate Registered Nurses.
Estimation of microscope drift using fluorescent nanodiamonds as fiducial markers
Authors: COLOMB W. , CZERSKI J. , SAU J.D. , SARKAR S.K.
Published: March 2017

Fiducial markers are used to correct the microscope drift and should be photostable, be usable at multiple wavelengths and be compatible for multimodal imaging. Fiducial markers such as beads, gold nanoparticles, microfabricated patterns and organic fluorophores lack one or more of these criteria. Moreover, the localization accuracy and drift correction can be degraded by other fluorophores, instrument noise and artefacts due to image processing and tracking algorithms. Estimating mechanical drift by assuming Gaussian distributed noise is not suitable under these circumstances. Here we present a method that uses fluorescent nanodiamonds as fiducial markers and uses an improved maximum likelihood algorithm to estimate the drift with both accuracy and precision within the range 1.55−5.75 nm.
An icosahedral virus as a fluorescent calibration standard: a method for counting protein molecules in cells by fluorescence microscopy
Authors: MURRAY JOHN M.
Published: March 2017

The ability to replace genes coding for cellular proteins with DNA that codes for fluorescent protein‐tagged versions opens the way to counting the number of molecules of each protein component of macromolecular assemblies in vivo by measuring fluorescence microscopically. Converting fluorescence to absolute numbers of molecules requires a fluorescent standard whose molecular composition is known precisely. In this report, the construction, properties and mode of using a set of fluorescence calibration standards are described. The standards are based on an icosahedral virus engineered to contain exactly 240 copies of one of seven different fluorescent proteins. Two applications of the fluorescent standards to counting molecules in the human parasite Toxoplasma gondii are described. Methods for improving the preciseness of the measurements and minimizing potential inaccuracies are emphasized.
Understanding maternal postpartum needs: A descriptive survey of current maternal health services
Authors: Almalik Mona MA
Published: March 2017

Aim and objective

To assess mothers' learning needs and concerns after giving birth and to examine whether these needs were met at 6–8 weeks postpartum.

Background

Women experience many physiologic and psychological changes during postpartum period, which is considered a vital transitional time. Exploring and meeting women's needs help woman to pass this period with little complications and enhance healthcare provider's ability to provide appropriate care following childbirth.

Design

A prospective cohort design was employed in this study.

Methods

A prospective cohort design was employed. A convenience sample of 150 postpartum women have completed perceived leaning needs scale prior to hospital discharge, at southern region of Jordan, and have completed perceived met learning needs scale at 6–8 weeks after giving birth.

Results

Women reported a high level of concern across all eight learning needs subscales. The most common concerns were related to new baby care, episiotomy care and breastfeeding. At 6–8 weeks postpartum, the primary unmet learning needs postpartum were danger signs post‐Caesarean section, physical changes, breastfeeding and new baby care. Attending postpartum check‐up clinic was found as a significant predictor for postpartum meeting women's needs, particularly emotional changes and family planning‐related information.

Conclusions

The current maternal health services are not at the optimum level to meet women's individual needs and concerns, which could increase the risk for postpartum complications. Some women's characteristics, such as employment status and educational level, have increased women's concerns and unmet needs in some of the learning needs.

Relevance to clinical practice

Healthcare providers and policymakers should consider women's concerns and needs at early postpartum period to establish patient‐centred postpartum care that is based on women's needs and concerns during this transitional period, with a focus on newborn baby care, episiotomy care and breastfeeding.
Clinical intuition in the nursing process and decision‐making—A mixed‐studies review
Authors: Melin‐Johansson Christina , Palmqvist Rebecca , Rönnberg Linda
Published: March 2017

Aims and objectives

To review what is characteristic of registered nurses’ intuition in clinical settings, in relationships and in the nursing process.

Background

Intuition is a controversial concept and nurses believe that there are difficulties in how they should explain their nursing actions or decisions based on intuition. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. More information on how nurses integrate intuition as a core element in daily clinical work would contribute to an improved understanding on how they go about this. Intuition deserves a place in evidence‐based activities, where intuition is an important component associated with the nursing process.

Design

An integrative review strengthened with a mixed‐studies review.

Methods

Literature searches were conducted in the databasesCINAHL, PubMed and PsycINFO, and literature published 1985–2016 were included. The findings in the studies were analysed with content analysis, and the synthesis process entailed a reasoning between the authors.

Results

After a quality assessment, 16 studies were included. The analysis and synthesis resulted in three categories. The characteristics of intuition in the nurse's daily clinical activities include application, assertiveness and experiences; in the relationships with patients’ intuition include unique connections, mental and bodily responses, and personal qualities; and in the nursing process include support and guidance, component and clues in decision‐making, and validating decisions.

Conclusion

Intuition is more than simply a “gut feeling,” and it is a process based on knowledge and care experience and has a place beside research‐based evidence. Nurses integrate both analysis and synthesis of intuition alongside objective data when making decisions. They should rely on their intuition and use this knowledge in clinical practice as a support in decision‐making, which increases the quality and safety of patient care.

Relevance to clinical practice

We find that intuition plays a key role in more or less all of the steps in the nursing process as a base for decision‐making that supports safe patient care, and is a validated component of nursing clinical care expertise.
Local changes in the wake electroencephalogram precedes lane departures
Authors: Ahlstrom Christer , Jansson Sabina , Anund Anna
Published: March 2017

The objective of this exploratory study is to investigate if lane departures are associated with local sleep, measured via source‐localized electroencephalography (EEG) theta power in the 5–9 Hz frequency range. Thirty participants drove in an advanced driving simulator, resulting in 135 lane departures at high levels of self‐reported sleepiness. These lane departures were compared to matching non‐departures at the same sleepiness level within the same individual. There was no correspondence between lane departures and global theta activity. However, at the local level an increased risk for lane departures was associated with increased theta content in brain regions related to motor function.
Predictive model for inflammation grades of chronic hepatitis B: Large‐scale analysis of clinical parameters and gene expressions
Authors: Zhou Weichen , Ma Yanyun , Zhang Jun , Hu Jingyi , Zhang Menghan , Wang Yi , Li Yi , Wu Lijun , Pan Yida , Zhang Yitong , Zhang Xiaonan , Zhang Xinxin , Zhang Zhanqing , Zhang Jiming , Li Hai , Lu Lungen , Jin Li , Wang Jiucun , Yuan Zhenghong , Liu Jie
Published: March 2017

Background

Liver biopsy is the gold standard to assess pathological features (eg inflammation grades) for hepatitis B virus‐infected patients although it is invasive and traumatic; meanwhile, several gene profiles of chronic hepatitis B (CHB) have been separately described in relatively small hepatitis B virus (HBV)‐infected samples. We aimed to analyse correlations among inflammation grades, gene expressions and clinical parameters (serum alanine amino transaminase, aspartate amino transaminase and HBV‐DNA) in large‐scale CHB samples and to predict inflammation grades by using clinical parameters and/or gene expressions.

Methods

We analysed gene expressions with three clinical parameters in 122 CHB samples by an improved regression model. Principal component analysis and machine‐learning methods including Random Forest, K‐nearest neighbour and support vector machine were used for analysis and further diagnosis models. Six normal samples were conducted to validate the predictive model.

Results

Significant genes related to clinical parameters were found enriching in the immune system, interferon‐stimulated, regulation of cytokine production, anti‐apoptosis, and etc. A panel of these genes with clinical parameters can effectively predict binary classifications of inflammation grade (area under the ROC curve [AUC]: 0.88, 95% confidence interval [CI]: 0.77‐0.93), validated by normal samples. A panel with only clinical parameters was also valuable (AUC: 0.78, 95% CI: 0.65‐0.86), indicating that liquid biopsy method for detecting the pathology of CHB is possible.

Conclusions

This is the first study to systematically elucidate the relationships among gene expressions, clinical parameters and pathological inflammation grades in CHB, and to build models predicting inflammation grades by gene expressions and/or clinical parameters as well.
Perpendicular axes of differentiation generated by mitochondrial introgression
Authors: Morales Hernán E. , Sunnucks Paul , Joseph Leo , Pavlova Alexandra
Published: March 2017

Differential introgression of mitochondrial vs. nuclear DNA generates discordant patterns of geographic variation and can promote population divergence and speciation. We examined a potential case of mitochondrial introgression leading to two perpendicular axes of differentiation. The Eastern Yellow Robin Eopsaltria australis, a widespread Australian bird, shows a deep mitochondrial split that is perpendicular to north–south nuclear DNA and plumage colour differentiation. We propose a scenario to explain this pattern: (i) first, both nuclear and mitochondrial genomes differentiated in concert during north–south population divergence; (ii) later, their histories disconnected after two mitochondrial introgression events resulting in a deep mitochondrial split perpendicular to the nuclear DNA structure. We explored this scenario by coalescent modelling of ten mitochondrial genes and 400 nuclear DNA loci. Initial mitochondrial and nuclear genome divergences were estimated to have occurred in the early Pleistocene, consistent with the proposed scenario. Subsequent climatic transitions may have driven later mitochondrial introgression. We consider neutral introgression unlikely and instead propose that the evidence is more consistent with adaptive mitochondrial introgression and selection against incompatible mitochondrial‐nuclear combinations. This likely generated an axis of coastal‐inland mitochondrial differentiation in the face of nuclear gene flow, perpendicular to the initial north–south axis of differentiation (reflected in genomewide nuclear DNA and colour variation).