bluuebunny/crossref_metadata_2025 huggingface dataset:
Industrial relations in Spain – strong conflicts, weak actors and fragmented institutions
Authors: Köhler Holm-Detlev
Published: May 2018

Purpose

The purpose of this paper is to reconstruct the development of industrial relations (IR) in Spain since the democratic transition and analyses the current dilemmas of its social and political actors in the context of the long-lasting economic downturn.

Design/methodology/approach

Combining a political economy, identifying Spain as a particular variety of modern capitalism, and actor-centred historical institutionalism approach, outlining the formation and strategies of the main social actors, the paper draws on the broad range of research on IR in Spain and its theoretical debates, including proper research in the field.

Findings

The legacies of the latecomer industrialisation and the semi-peripheral development model still shape the Spanish economy and IR. The impact of the current economic and political-institutional crisis affects the entire institutional IR system and its actors shifting power towards the individual employer thus weakening trade unions, labour rights and collective bargaining. Regarding the theoretical debate on corporatism, the Spanish case provides ambiguous results. The lack of a coherent institutional system and efficient political administration limits the effectiveness of corporatist arrangements and reduces them to contingent concertation strategies. Spain confirms that IR still largely depend on the specific national variety of capitalism that condition economic development and resources for political exchange.

Originality/value

The paper presents an original, theoretical-informed reconstruction of the Spanish IR and allows an understanding of the current institutional transformations and strategic dilemmas in the light of historical legacies. Additionally, the theoretical debates on neo-corporatism and semi-peripheral development are enriched through its application to the Spanish case.
Impact of the EIT in the creation of an open educational ecosystem: UPM experience
Authors: León Gonzalo , Leceta José Manuel , Tejero Alberto
Published: May 2018

Purpose

This paper aims to present an impact analysis in the educational dimension of the European Institute of Innovation and Technology (EIT) and specifically on its “knowledge and innovation community” (KIC), focused on the information and communications technology sector named “EIT Digital” in the university field.

Design/methodology/approach

After reviewing the current situation on education in ICT-related engineering and the need to address new professional profiles and/or complement the current ones to increase the value of the new professionals in a globalised society, the principles behind the EIT model are analysed, taking the experience accumulated in EIT Digital as a basis for discussion at master level.

Findings

The conceptual framework on “what” and “how” of the EIT described from the educational perspective constituted sound bases for ensuring the value of the EIT KICs as drivers for institutional innovation and structural reform. As the practical experience of Universidad Politécnica de Madrid (UPM) shows, the policy experimentation space provided by EIT Digital has acted as an internal transformation driver for European universities. It has played a key role to accelerate structural reforms once partner universities assumed the need of modifying or reinterpreting “any internal regulation to participate better in the EIT”.

Originality/value

This analysis is used as a basis for the design of an institutional agenda of education transformation in the rest of the UPM where the innovation and entrepreneurship vision is inserted into the technical education to give future professionals the tools and capacities to serve as catalyser agents of the innovation system.
Recognizing the practitioner-self: lessons from studying rock bands at-home
Authors: Malm Tobias
Published: May 2018

Purpose

The purpose of this paper is to explore and discuss some of the possibilities and risks that one can encounter in the process of doing ethnographic organization research with an at-home approach.

Design/methodology/approach

The paper draws on self-reflexive analyses of a four-year research process, where the author – a rock musician – investigated how rock bands within the author’s social networks organize their activities. The materials used for analysis were notes and diaries, as well as reflections on memories.

Findings

The findings illustrate aspects of the researcher’s “breaking out” process, which involved the researcher’s initial impulse to leave his practitioner-self, a subsequent lack of interest and eventually a return to what felt genuinely intriguing for him to study. The paper argues that one important aspect of the at-home researcher’s breaking out process may involve an active recognition of his/her practitioner-self as a resource – not least to avoid losing interest or getting lost in abstractions.

Originality/value

This paper conceptualizes and builds further upon previous discussions on at-home research, adding insights into the “breaking out” process and the curious paradox of the proposed necessity for the researcher to leave and utilize his/her at-home experience and familiarity.
Critical thoughts on advanced manufacturing: the experiences of Germany and USA
Authors: Daudt Gabriel , Willcox Luiz Daniel
Published: May 2018

Purpose

The purpose of this paper is to analyze the conventional approach to advanced manufacturing initiatives. Buzzwords like smart manufacturing or industrie 4.0 are directly linked to the discussions about the future of industrial activity. Little is said, however, about developed countries actively reinforcing their bets on the relevance of manufacturing.

Design/methodology/approach

This study opted for analyzing academic papers and governmental white papers. Somehow similar to those studies on compared experiences, here the US and German initiatives are put into perspective.

Findings

The critical interpretation of several works allows us to state that advanced manufacturing experiences consist in a set of policies aiming at industrial and technological leadership in a scenario of fierce competition. The initiatives seek to strengthen manufacturing activities by means of a mission-oriented approach, fostering enabling key technologies.

Originality/value

This paper fulfills an identified need to critically study the advanced manufacturing initiatives. Away from conventional approaches, the paper puts into perspectives the main ongoing initiatives on advanced manufacturing and interprets them as deliberated national efforts to strengthen manufacturing activities by means of enabling technologies. The paper also points out preliminary recommendations for Brazil.
Critical factors affecting leadership: a higher education context
Authors: Hassan Ahlam , Gallear David , Sivarajah Uthayasankar
Published: May 2018

Purpose

While the importance of leadership in various domains has been highlighted in the extant literature, effective leadership in the context of higher education sector has not been well addressed in the leadership scholarship. There is a need to address the challenge of leadership effectiveness in the education sector, including business schools, given the failures noticed in the sector attributed to poor-quality leadership. The purpose of this study was therefore to explore the factors that affected leadership in the context of higher education institutions.

Design/methodology/approach

The research is exploratory in nature as the study critically reviewed extant literature surrounding leadership practices specifically from a public-sector context to identify factors affecting leadership effectiveness.

Findings

The findings of the study pointed out that, regardless of the nation or organisation, leadership effectiveness is a factor that is dependent on how well the followers have accepted the leader. This indicates that, amongst the different challenges explored in this study, leadership effectiveness is not only a challenge by itself but is also affected by other challenges, including leadership practice and style.

Research limitations/implications

This research provides a better understanding of the critical factors affecting leadership practice of deans of business schools and how the styles’ influence on leadership practice, the relationship between leadership practice and leadership effectiveness and how leadership style translates into leadership effectiveness.

Originality/value

This research contributes to the growing body of knowledge surrounding leadership scholarship from a public-sector context about the challenges that affect leadership effectiveness in the context of HEIs and stimulates further investigation into those challenges.
Plant nitrogen and phosphorus utilization under invasive pressure in a montane ecosystem of tropical China
Authors: Hu Chao‐Chen , Lei Yan‐Bao , Tan Yun‐Hong , Sun Xin‐Chao , Xu Hao , Liu Cong‐Qiang , Liu Xue‐Yan
Published: May 2018

Exotic plant invasion has been changing the vegetation composition and function of terrestrial ecosystems. Nitrogen (N) and phosphorus (P) are often the limiting nutrients for terrestrial plants. However, under invasive pressure, in situ plant N and P usage mechanisms remain poorly understood but are pivotal for a better understanding of plant invasion and coexistence in invaded ecosystems.

Nitrogen and P concentrations, natural 15N abundance (δ15N values) were investigated in leaves and soils under different invasive pressures (here expressed as the biomass percentages of invasive plants in each plot) for two invasive species (Chromolaena odorata and Ageratina adenophora) in Xishuangbanna in tropical China.

Soil N and P concentrations revealed the relatively N‐rich but P‐poor status of our study site. Under invasion, soil inorganic N (dominated by ammonium) and available P did not increase significantly. The leaf N and P of invasive plants increased, while leaf N increased but P decreased for native species. Natural δ15N mass balance between leaves and soil inorganic N sources revealed that ammonium dominated N utilization in both natives and invaders. Invasive plants showed ammonium utilization with increasing leaf N levels, while native plants under no invasion showed nitrate utilization with increasing leaf N levels.

Synthesis. Increased soil ammonium availability contributed to preferential ammonium utilization by invasive plants and elevated ammonium utilization in natives, but the P competition of natives decreased in invaded ecosystems. These novel insights into nutrient dynamics in invaded ecosystems enhance our understanding of plant invasion and coexistence mechanisms.
n‐Ethyl Pentylone‐Related Deaths in Alabama
Authors: Atherton Daniel , Dye Daniel , Robinson C. Andrew , Beck Rachel
Published: May 2018

n‐Ethyl pentylone (NEP) is a chemical substance derived from cathinone. Synthetic cathinones are an evolving group of drugs with stimulating, mind‐altering effects sometimes referred to as novel or new psychoactive substances (NPS). There is scarce information in the medical literature regarding forensic cases in which NEP is detected in toxicological testing. We present four fatalities involving NEP from Alabama in 2017. Deaths were attributed to NEP toxicity in two cases (peripheral blood concentrations of 0.121 and 0.953 mg/L) and injuries caused by gunshot wounds in two cases (peripheral blood concentrations of 0.045 and 0.031 mg/L). One case involving NEP described an individual who exhibited classic CNS‐stimulant induced erratic behavior before being found dead. These cases enhance the forensic literature regarding specific NPS like NEP and provide contextual reference for professionals considering the significance of NEP in toxicological interpretation.
Lysyl oxidase: A colorectal cancer biomarker of lung and hepatic metastasis
Authors: Liu Yun , Wang Guanghui , Liang Zhonglin , Mei Zubing , Wu Tingyu , Cui Ang , Liu Chenying , Cui Long
Published: May 2018

Background

Colorectal cancer (CRC) is a common and lethal disease in which distant metastasis remains the primary cause of death. Paradoxical roles of LOX have been reported in CRC, and the intracellular function of LOX has also recently been determined. Correlations of LOX expression and its intracellular localization with clinicopathological features in CRC patients remain largely unknown. The aim of the present study was to explore the potential roles of LOX in CRC.

Methods

LOX messenger RNA expression was assayed by quantitative PCR in eight paired normal mucosa and tumor tissues. Immunohistochemistry was conducted using tissue arrays to investigate LOX expression in 201 CRC patients. Regulation of LOX by YAP and TEAD4 was explored by YAP or TEAD4 short hairpin RNA interference in a LoVo cell line.

Results

LOX messenger RNA expression was elevated in some CRC specimens, and LOX nuclear localization was detected in CRC tumor tissues. LOX nuclear localization was found to correlate with lung/hepatic metastasis, elevated serum carcinoembryonic antigen concentration, and mucinous tumor type (P < 0.05). Nuclear LOX expression was found to be associated with poor overall and disease‐free survival (P < 0.05), and postoperative lung/hepatic metastasis (P < 0.05). Knockdown of YAP or TEAD4 induced downregulation of LOX expression.

Conclusions

LOX nuclear localization was significantly associated with poor survival in patients with CRC. Nuclear LOX expression was correlated with synchronous or postoperative lung/hepatic metastasis. LOX may prove to be a potential target gene of YAP and TEAD4.
Financial Viability of Emergency Department Observation Unit Billing Models
Authors: Baugh Christopher W. , Suri Pawan , Caspers Christopher G. , Granovsky Michael A. , Neal Keith , Ross Michael A.
Published: May 2018

Background

Outpatients receive observation services to determine the need for inpatient admission. These services are usually provided without the use of condition‐specific protocols and in an unstructured manner, scattered throughout a hospital in areas typically designated for inpatient care. Emergency department observation units (EDOUs) use protocolized care to offer an efficient alternative with shorter lengths of stay, lower costs, and higher patient satisfaction. EDOU growth is limited by existing policy barriers that prevent a “two‐service” model of separate professional billing for both emergency and observation services. The majority of EDOUs use the “one‐service” model, where a single composite professional fee is billed for both emergency and observation services. The financial implications of these models are not well understood.

Methods

We created a Monte Carlo simulation by building a model that reflects current clinical practice in the United States and uses inputs gathered from the most recently available peer‐reviewed literature, national survey, and payer data. Using this simulation, we modeled annual staffing costs and payments for professional services under two common models of care in an EDOU. We also modeled cash flows over a continuous range of daily EDOU patient encounters to illustrate the dynamic relationship between costs and revenue over various staffing levels.

Results

We estimate the mean (±SD) annual net cash flow to be a net loss of $315,382 (±$89,635) in the one‐service model and a net profit of $37,569 (±$359,583) in the two‐service model. The two‐service model is financially sustainable at daily billable encounters above 20, while in the one‐service model, costs exceed revenue regardless of encounter count. Physician cost per hour and daily patient encounters had the most significant impact on model estimates.

Conclusions

In the one‐service model, EDOU staffing costs exceed payments at all levels of patient encounters, making a hospital subsidy necessary to create a financially sustainable practice. Professional groups seeking to staff and bill for both emergency and observation services are seldom able to do so due to EDOU size limitations and the regulatory hurdles that require setting up a separate professional group for each service. Policymakers and health care leaders should encourage universal adoption of EDOUs by removing restrictions and allowing the two‐service model to be the standard billing option. These findings may inform planning and policy regarding observation services.
Emotional hyper‐reactivity and cardiometabolic risk in remitted bipolar patients: a machine learning approach
Authors: Dargél A. A. , Roussel F. , Volant S. , Etain B. , Grant R. , Azorin J.‐M. , M'Bailara K. , Bellivier F. , Bougerol T. , Kahn J.‐P. , Roux P. , Aubin V. , Courtet P. , Leboyer M. ,   the FACE‐BD Collaborators, Kapczinski F. , Henry C.
Published: May 2018

Objective

Remitted bipolar disorder (BD) patients frequently present with chronic mood instability and emotional hyper‐reactivity, associated with poor psychosocial functioning and low‐grade inflammation. We investigated emotional hyper‐reactivity as a dimension for characterization of remitted BD patients, and clinical and biological factors for identifying those with and without emotional hyper‐reactivity.

Method

A total of 635 adult remitted BD patients, evaluated in the French Network of Bipolar Expert Centers from 2010–2015, were assessed for emotional reactivity using the Multidimensional Assessment of Thymic States. Machine learning algorithms were used on clinical and biological variables to enhance characterization of patients.

Results

After adjustment, patients with emotional hyper‐reactivity (n = 306) had significantly higher levels of systolic and diastolic blood pressure (P < 1.0 × 10−8), high‐sensitivity C‐reactive protein (P < 1.0 × 10−8), fasting glucose (P < 2.23 × 10−6), glycated hemoglobin (P = 0.0008) and suicide attempts (P = 1.4 × 10−8). Using models of combined clinical and biological factors for distinguishing BD patients with and without emotional hyper‐reactivity, the strongest predictors were: systolic and diastolic blood pressure, fasting glucose, C‐reactive protein and number of suicide attempts. This predictive model identified patients with emotional hyper‐reactivity with 84.9% accuracy.

Conclusion

The assessment of emotional hyper‐reactivity in remitted BD patients is clinically relevant, particularly for identifying those at higher risk of cardiometabolic dysfunction, chronic inflammation, and suicide.
Effects of management regimes on structure, composition and diversity of seasonally inundated herbaceous communities in the Mkomazi National Park, Tanzania
Authors: Nyakunga Oliver Castor , Del Vecchio Silvia , Buffa Gabriella
Published: May 2018

The effects of management regimes on structural composition and diversity of seasonally inundated herbaceous communities were investigated in the Mkomazi National Park, Tanzania. Three sites were selected based on management regimes, that is “fire‐grazing” (FG), “fire‐no grazing” (FNG) and “no fire‐no grazing” (NFNG), and sampled in the 2015 wet season. The studied vegetation parameters resulted significantly different across the sites, with the exceptions of species abundance betweenNFNGversusFGandNFNGversusFNGsites and species evenness, which remained constant among sites. A significantly higher species richness, Shannon diversity Index, standing biomass and percentage vegetation cover was detected atFNGsite, than in the other sites. No significant differences arose when comparingFGandNFNGsites. Although the responses we found may in part be caused by confounding underlying variables such as variation in soil type, soil moisture or elevation, the patterns found may contribute to a more general understanding of the effects of management regimes in seasonally inundated savannah, as well as to sound approaches in environmental conservation and management. However, further research is needed to support our findings, replicating the study in other areas under the same or similar management conditions and in a wider array of ecosystems.
Validation of a computerized algorithm to quantify fetal heart rate deceleration area
Authors: Gyllencreutz Erika , Lu Ke , Lindecrantz Kaj , Lindqvist Pelle G. , Nordstrom Lennart , Holzmann Malin , Abtahi Farhad
Published: May 2018

Introduction

Reliability in visual cardiotocography interpretation is unsatisfying, which has led to the development of computerized cardiotocography. Computerized analysis is well established for antenatal fetal surveillance but has yet not performed sufficiently during labor. We aimed to investigate the capacity of a new computerized algorithm compared with visual assessment in identifying intrapartum fetal heart rate baseline and decelerations.

Material and methods

In all, 312 intrapartum cardiotocography tracings with variable decelerations were analyzed by the computerized algorithm and visually examined by two observers, blinded to each other and the computer analysis. The width, depth and area of each deceleration was measured. Four cases (>100 variable decelerations) were subjected to in‐depth detailed analysis. The outcome measures were bias in seconds (width), beats per minute (depth), and beats (area) between computer and observers using Bland–Altman analysis. Interobserver reliability was determined by calculating intraclass correlation and Spearman rank analysis.

Results

The analysis (312 cases) showed excellent intraclass correlation (0.89–0.95) and very strong Spearman correlation (0.82–0.91). The detailed analysis of >100 decelerations in four cases revealed low bias between the computer and the two observers; width 1.4 and 1.4 seconds, depth 5.1 and 0.7 beats per minute, and area 0.1 and –1.7 beats. This was comparable to the bias between the two observers: 0.3 seconds (width), 4.4 beats per minute (depth) and 1.7 beats (area). The intraclass correlation was excellent (0.90–.98).

Conclusion

A novel computerized algorithm for intrapartum cardiotocography analysis is as accurate as gold standard visual assessment, with high correlation and low bias.
Gestation at birth, mode of birth, infant feeding and childhood hospitalization with infection
Authors: Bentley Jason P. , Burgner David P. , Shand Antonia W. , Bell Jane C. , Miller Jessica E. , Nassar Natasha
Published: May 2018

Introduction

Infections are a leading cause of mortality and morbidity in preschool children. We aimed to assess the impact of the co‐occurrence of cesarean section, early birth and formula feeding on hospitalization with infection in early childhood.

Material and methods

Population‐based retrospective record‐linkage cohort study of 488 603 singleton livebirths ≥32 weeks’ gestational age in New South Wales, Australia, 2007–2012. Multivariable Cox‐regression was used to estimate independent and combined adjusted associations of gestational age, mode of birth (vaginal or cesarean section by labor onset) and formula feeding with time to first and repeat hospitalization with infection for children less than five years of age.

Results

In all, 95 346 (19.5%) children were hospitalized with infection, and of these 24.8% (23 615) more than once. Median age at first and repeat hospitalization was 1.1 and 1.7 years, respectively. Earlier gestation, modes of birth other than spontaneous vaginal, and formula feeding were independently associated with an increased risk of first and repeat hospitalization with infection. At 32–36 weeks’ gestation, co‐occurrence of perinatal factors (cf. spontaneous vaginal birth at 39+ weeks without formula feeding) was associated with a 2‐fold and 1.5‐fold increased risk of first and repeat hospitalization, respectively. For births at 37–38 weeks, the increased risk was 1.5‐fold and 1.25‐fold for first and repeat hospitalization, respectively.

Conclusions

Cesarean section, labor induction, birth at <39 weeks and formula feeding increase the risk of infection‐related hospitalization in childhood, which increases further when these factors co‐occur. Reducing early planned birth and supporting breastfeeding are potentially cost‐effective approaches to reducing the risk of hospitalization.
Effects of colostrum whey on immune function in the digestive tract of goats
Authors: Matsukawa Shoko , Ueno Kazutoshi , Sugino Toshihisa , Yoshimura Yukinori , Isobe Naoki
Published: May 2018

The objective of the present study is to examine whether colostrum whey can have an effect on immune function in goats digestive tract. Two milliliters of colostrum whey (colostrum group) or water (control group) were administrated orally to goats every day for 3 weeks. Blood was collected twice a week for 3 weeks to measure immunoglobulin A (IgA), interleukin 8 (IL‐8), and IL‐10. At the end of the experimental period, the parotid glands, oral mucosa, lingua, esophagus, jejunum, and ileum were collected for immunohistochemical detection of IgA, cathelicidin‐7, and S100A8. The ratio of the length of IgA‐positive mucosal surface in the esophagus to the total esophageal length was significantly greater in the colostrum group than in the control group. The number of IgA‐positive cells in the labial gland and ileum in the colostrum group was significantly higher than that in the control group. There were no significant differences between the colostrum and control groups in the number of cathelicidin‐7‐positive cells in the jejunum and ileum and in the number of S100A8‐positive cells in the lingua, jejunum, and ileum. These results suggest that colostrum stimulates the recruitment of plasma cells into the labial gland, which then secrete more IgA into the saliva.
How do we manage iron deficiency after blood donation?
Authors: Kiss Joseph E. , Vassallo Ralph R.
Published: May 2018

Blood donors and the RBCs and other components they willingly provide are essential in the delivery of healthcare in all parts of the world. Nearly 70% of donated blood comes from repeat or committed donors. The amount of iron removed in the 10 min or so it takes to withdraw a unit of blood (500 ml, plus 25 ml for testing) requires over 24 weeks to replace on a “standard” diet, i.e., without added iron in the form of supplements The cumulative effect of repeat blood donations without adequate iron replacement or a longer wait between donations results in iron deficiency (ID) in many donors, low haemoglobin deferral (~8% of donation attempts), and frank anaemia in some. Moreover, ID can be associated with side effects that can impact a blood donor's health, such as fatigue, cognitive changes and other neuromuscular symptoms. In an effort to better identify and prevent ID, blood collection agencies are recommending various strategies, including changes in the donation interval, donation frequency, testing of iron status and iron supplementation. In this review, we present the evidence basis for these strategies and suggest our own approaches to improving iron balance in blood donors.
Azacitidine in the ‘real‐world’: an evaluation of 1101 higher‐risk myelodysplastic syndrome/low blast count acute myeloid leukaemia patients in Ontario, Canada
Authors: Mozessohn Lee , Cheung Matthew C. , Fallahpour Saber , Gill Tripat , Maloul Asmaa , Zhang Liying , Lau Olivia , Buckstein Rena
Published: May 2018

The outcome of myelodysplastic syndrome (MDS) patients with uniformly higher‐risk disease treated with azacitidine (AZA) in the ‘real‐world’ remains largely unknown. We evaluated 1101 consecutive higher‐risk MDS patients (International Prognostic Scoring System intermediate‐2/high) and low‐blast count acute myeloid leukaemia (AML; 21–30% blasts) patients treated in Ontario, Canada. By dosing schedule, 24·7% received AZA for seven consecutive days, 12·4% for six consecutive days and 62·9% by 5‐2‐2. Overall, median number of cycles was 6 (range 1–67) and 8 (range 6–14) when restricted to the 692 (63%) patients who received at least 4 cycles. The actuarial median survival was 11·6 months [95% confidence interval (CI) 10·7–12·4) for the entire cohort and 18·0 months (landmark analysis; 95% CI 16·6–19·1 months) for those receiving at least 4 cycles. There was no difference in overall survival (OS) between the 3 dosing schedules (P = 0·87). In our large ‘real‐world’ evaluation of AZA in higher‐risk MDS/low‐blast count AML, we demonstrated a lower than expected OS. Reassuringly, survival did not differ by dosing schedules. The OS was higher in the 2/3 of patients who received at least 4 cycles of treatment, reinforcing the necessity of sustained administration until therapeutic benefits are realised. This represents the largest ‘real‐world’ evaluation of AZA in higher‐risk MDS/low‐blast count AML.
JAK2 V617F‐positive acute myeloid leukaemia (AML): a comparison between de novo AML and secondary AML transformed from an underlying myeloproliferative neoplasm. A study from the Bone Marrow Pathology Group
Authors: Aynardi Jason , Manur Rashmi , Hess Paul R. , Chekol Seble , Morrissette Jennifer J. D. , Babushok Daria , Hexner Elizabeth , Rogers Heesun J. , Hsi Eric D. , Margolskee Elizabeth , Orazi Attilio , Hasserjian Robert , Bagg Adam
Published: May 2018

The JAK2 V617F mutation is characteristic of most Philadelphia chromosome‐negative myeloproliferative neoplasms (MPNs) and occurs rarely in de novo acute myeloid leukaemia (AML). We sought to characterize AMLs that harbour this mutation and distinguish those that arise de novo (AML‐DN) from those that reflect transformation of an underlying MPN (AML‐MPN). Forty‐five patients with JAK2 V617F‐mutated AML were identified; 15 were AML‐DN and 30 were AML‐MPN. AML‐MPN cases were more likely to have splenomegaly (P = 0·02), MPN‐like megakaryocytes and higher mean JAK2 V617F VAF at diagnosis (P = 0·04). Mutations involving TET2 were exclusively identified in AML‐DN patients. Mutations of genes affecting DNA methylation were more common in AML‐DN (P < 0·01). A complex karyotype was more frequent in AML‐MPN cases than in AML‐DN (P < 0·01), with AML‐DN more likely to display a normal karyotype (P = 0·02). Bone marrow histology after recovery from induction chemotherapy in AML‐DN cases revealed no morphological evidence of any previously occult MPNs, while this was evident in most of the AML‐MPN specimens (P < 0·01). These findings in this largest study of JAK2 V617F‐mutated AMLs indicate that AML‐DN is distinct from AML‐MPN.
Romiplostim for the management of perioperative thrombocytopenia
Authors: Al‐Samkari Hanny , Marshall Ariela L. , Goodarzi Katayoon , Kuter David J.
Published: May 2018

Thrombocytopenic patients requiring invasive surgery have few options to improve their platelet count preoperatively. This is a single‐centre, retrospective review of thrombocytopenic patients receiving the thrombopoietin receptor agonist romiplostim perioperatively to allow for surgical interventions. Patient characteristics, romiplostim use, and surgical and safety outcomes (bleeding, thrombosis, transfusions) were collected and analysed. Forty‐seven patients underwent 51 surgical procedures (ranging from total hip arthroplasty to open cardiac surgery) with romiplostim support. Thrombocytopenia aetiologies included immune thrombocytopenia, chronic liver disease, haematological malignancy, drug‐related thrombocytopenia, and hereditary thrombocytopenia. Median (range) platelet counts improved, from 47 × 109/l (9–120 × 109/l) at romiplostim initiation to 164 × 109/l (28–603 × 109/l) at the time of surgery (P < 0·0001). A dose of 3 μg/kg per week for 2 doses increased the platelet count to >100 × 109/l in 79% of patients within 14 days. In 96% of cases, surgery proceeded on schedule without delay or cancellation. Four patients had bleeding events unrelated to thrombocytopenia and 1 patient developed deep venous thrombosis. Six patients required red cell transfusion and 3 patients required platelet transfusion perioperatively. In conclusion, romiplostim was effective in increasing platelet counts to allow surgery to proceed safely and on schedule. Bleeding and thromboembolic events were within acceptable limits for this surgical population.
Assessing preschoolers interactive behaviour: A validation study of the “Coding System for Mother–Child Interaction”
Authors: Baiao R. , Baptista J. , Carneiro A. , Pinto R. , Toscano C. , Fearon P. , Soares I. , Mesquita A. R.
Published: May 2018

Background

The preschool years are a period of great developmental achievements, which impact critically on a child's interactive skills. Having valid and reliable measures to assess interactive behaviour at this stage is therefore crucial. The aim of this study was to describe the adaptation and validation of the child coding of the Coding System for Mother–Child Interactions and discuss its applications and implications in future research and practice.

Methods

Two hundred twenty Portuguese preschoolers and their mothers were videotaped during a structured task. Child and mother interactive behaviours were coded based on the task. Maternal reports on the child's temperament and emotional and behaviour problems were also collected, along with family psychosocial information.

Results

Interrater agreement was confirmed. The use of child Cooperation, Enthusiasm, and Negativity as subscales was supported by their correlations across tasks. Moreover, these subscales were correlated with each other, which supports the use of a global child interactive behaviour score. Convergent validity with a measure of emotional and behavioural problems (Child Behaviour Checklist 1 ½–5) was established, as well as divergent validity with a measure of temperament (Children's Behaviour Questionnaire–Short Form). Regarding associations with family variables, child interactive behaviour was only associated with maternal behaviour.

Conclusions

Findings suggest that this coding system is a valid and reliable measure for assessing child interactive behaviour in preschool age children. It therefore represents an important alternative to this area of research and practice, with reduced costs and with more flexible training requirements. Attention should be given in future research to expanding this work to clinical populations and different age groups.
Infant Motor Development in Autism Spectrum Disorder: A Synthesis and Meta‐analysis
Authors: West Kelsey L.
Published: May 2018

Studies of infant motor development in autism spectrum disorder (ASD) have increased in recent years. This article synthesized this literature through meta‐analysis to assess (a) whether infant motor ability differs in ASD relative to neurotypical controls; and (b) whether motor ability and communication are related in infants with ASD. Study 1 aggregated data from 1,953 infants with ASD (ages 3.0–42.0 months), and Study 2 included 890 infants with ASD (age 6.0–42.9 months). Study 1 revealed that infant motor ability differed significantly in ASD compared with neurotypical infants—this difference was robust to variation in measurement and design. Furthermore, this group difference amplified as age increased. Study 2 indicated that within ASD, infant motor ability and communication are related.
Ethnicity, migration status and dental caries experience among adults in East London
Authors: Delgado‐Angulo Elsa K. , Marcenes Wagner , Harding Seeromanie , Bernabé Eduardo
Published: May 2018

Objective

To assess the interrelationship between ethnicity, migration status and dental caries experience among adults in East London.

Methods

We analysed data from 1910 adults (16‐65 years) representing 9 ethnic groups, who took part in a community‐based health survey in East London. Participants completed a supervised questionnaire and were clinically examined by trained dentists. Dental caries was assessed with the number of decayed, missing and filled teeth (DMFT). The association of ethnicity, nativity status and migration history with DMFT was assessed in negative binomial regression models controlling for demographic, socioeconomic and behavioural factors.

Results

White migrants had greater DMFT than UK‐born adults, whereas every Asian and Black migrant group had lower DMFT than adults of the same ethnic group born in the UK (albeit significant only for Black Caribbean and Asian Others). Among foreign‐born adults, age at arrival (Rate Ratio: 1.03; 95% Confidence Interval: 1.01‐1.05) and length of residence (1.04; 95% CI: 1.02‐1.06) were positively associated with DMFT. A significant interaction between both factors was also found, with more pronounced differences between older and younger migrants at longer stay in the UK for White Others, Black Caribbean and Asian Others.

Conclusion

Large inequalities in caries experience were found between foreign‐ and UK‐born adults, with considerable variation across ethnic groups. Looking beyond cultural explanations, in favour of social and environmental factors, may help to explain those inequalities.
Ocular coherence tomography‐measured changes over time in anterior chamber angle and diurnal intraocular pressure after laser iridotomy: IMPACT study
Authors: Zhekov Ivailo , Pardhan Shahina , Bourne Rupert RA
Published: May 2018

Importance

The change in the anatomical dimensions over time and the effect on diurnal intraocular pressure (DIOP) following laser peripheral iridotomy is poorly understood.

Background

To evaluate change over time in anterior chamber angle anatomy following laser peripheral iridotomy (LPI) in patients with primary angle closure compared to control eyes. Additionally, the effect of LPI on DIOP fluctuation was investigated.

Design

Longitudinal, prospective, double‐randomized research study.

Participants

Adults with suspected angle closure or angle closure diagnosis referred to hospital services in the United Kingdom.

Methods

Thirty‐nine patients newly diagnosed with bilateral primary angle closure/suspects (PAC/PACS) received LPI to one eye and changes in angle morphology were measured over eight sections with swept source AS‐OCT. The other eye acted as control with intraocular pressure (IOP) measured hourly.

Main Outcome Measures

Angle opening distance (AOD), trabecular–iris angle (TIA), angle recess area (ARA), and trabecular–iris space area (TISA) at 500 and 750 μm from scleral spur.

Results

There was an increase in all angle parameters following LPI, which was maintained for 6 months (e.g. inferotemporal segment AOD500 0.041 mm (P = 0.008) at 1 week and 0.039 mm (P = 0.003) at 6 months) following LPI. Greatest effect at 6 months post‐LPI was observed opposite the iridotomy site in the inferior/inferotemporal sections (AOD500 0.039 mm, P = 0.003 and AOD750 0.075 mm, P = 0.002). There were no statistically significant differences for the overall DIOP fluctuation values in the treated group at 6 months post‐LPI compared to baseline.

Conclusions and Relevance

LPI widened all angle sections with maximum effect observed in the site opposite the iridotomy. Angle changes were maintained up to 6 months after LPI treatment without any statistically significant change in DIOP fluctuation.
Regenerative surgical therapy for peri‐implantitis using deproteinized bovine bone mineral with 10% collagen, enamel matrix derivative and Doxycycline—A prospective 3‐year cohort study
Authors: Mercado Faustino , Hamlet Stephen , Ivanovski Saso
Published: May 2018

Objectives

There is limited evidence regarding the long‐term efficacy of regenerative treatment for peri‐implantitis. The aim of this study was to evaluate a combination therapy of deproteinized bovine bone mineral with 10% collagen (DBBMC), enamel matrix derivative (EMD) and Doxycycline in the regeneration of bone defects associated with peri‐implantitis.

Methods

Thirty patients diagnosed with peri‐implantitis (BoP/suppuration, probing depth greater than 4 mm, minimum radiographic bone loss of 20%, at least 2 years in function) were enrolled in the study. Clinical measurements included probing depths, recession, radiographic bone fill, gingival inflammation and bleeding on probing/suppuration. Following surgical access and debridement, the implant surfaces were decontaminated with 24% EDTA for 2 min, and the bone defects were filled with a combined mixture of DBBMC, EMD and Doxycycline powder. The defects were covered with connective tissue grafts where necessary. Clinical measurements were recorded after 12, 24 and 36 months.

Results

The mean probing depth and bone loss at the initial visit was 8.9 mm (±1.9) and 6.92 mm (±1.26), respectively. Both mean probing depth and bone loss reduced significantly from baseline to 3.55 mm (±0.50) and 2.85 mm (±0.73) at 12 months, 3.50 (±0.50) and 2.62 mm (±0.80) at 24 months and 3.50 mm (±0.50) and 2.60 mm (±0.73) at 36 months. 56.6% of the implants were considered successfully treated (according to Successful Treatment Outcome Criterion: PD < 5 mm, no further bone loss >10%, no BoP/suppuration, no recession >0.5 mm for anterior implants and >1.5 mm for posterior implants) after 36 months.

Conclusion

Regenerative treatment of peri‐implantitis using a combined mixture of DBBMC, EMD and Doxycycline achieved promising results. The benefits of this protocol incorporating EMD should be tested in randomized clinical trials.
Biofilm in voice prosthesis: A prospective cohort study and laboratory tests using sonication and SEM analysis
Authors: Galli J. , Calo L. , Meucci D. , Giuliani M. , Lucidi D. , Paludetti G. , Torelli R. , Sanguinetti M. , Parrilla C.
Published: May 2018

Objective

The objective of the study was to compare the biofilm growing pattern and its morphological extent on silicone and a teflon‐like material using a sonication process and a Scanning Electron Microscope (SEM).

Design

A prospective cohort study and a laboratory study.

Setting

Otolaryngology ‐Head and Neck surgery Department and the Microbiology Institute.

Participants

The participants included fifteen laryngectomised patients with phonatory prostheses, which were removed because of device failure, and two different kinds of phonatory prostheses from the laboratory (Provox 2 and ActiValve) that were artificially colonised by Candida albicans.

Main outcome measures

Tracheo‐oesophageal puncture (TEP) is currently considered the gold standard for post‐laryngectomy voice rehabilitation. “Leakage” represents the most common cause of substitution and is generated by biofilm colonisation of the prosthesis by mixed mycotic and bacterial agents. New biomaterials have been developed that are deemed to be more resistant to the colonisation of micro‐organisms and material deformation.

Results

The devices showed colonisation by mixed bacterial flora (Staphylococci 13%, Streptococci 9%, and Haemophilus influenzae 5%) and by yeasts (Candida albicans 12%). Moreover, we observed a different distribution of biofilm layers in Provox ActiValve (22.56%) compared to Provox 2 (56.82%) after experimental colonisation by the previously isolated Candida strain.

Conclusion

Resident microbiological species from the upper airways unavoidably colonise the polymer surfaces, and no strategies have been effective except for the manipulation of the chemical‐physical properties of the device's polymer. Our study confirms that Provox ActiValve, which is made with a fluoroplastic material (teflon‐like), is less subject to in vitro colonisation by Candida, and thus showed a higher clinical resistance to biofilm and a longer lifespan. The sonication seems to significantly improve the knowledge of bacterial and mycotic flora in biofilm colonisation. The design of a device for the daily cleaning capable to reach and brush the oesophageal flange of the prosthesis preserving the valve mechanism could represent a practical and simple help in this still unsolved problem.
Pre‐surgical, surgical and post‐surgical experiences of weight loss surgery patients: a closer look at social determinants of health
Authors: Johnson L. P. , Asigbee F. M. , Crowell R. , Negrini A.
Published: May 2018

Using a novel qualitative approach, Photovoice, researchers assessed social, psychological, physical and economic barriers encountered by patients of weight loss surgery. Applying the Photovoice approach and Williams’ theory of narrative reconstruction for qualitative interviewing, the research team set out to investigate the bariatric patient experience from pre‐surgery to hospitalization to post‐surgery. Fifteen participants were given digital cameras and asked to take photographs that represented their weight loss journeys. Photographs and qualitative interviews were used to theorize the role played by comorbidities, social determinants of health, provider communication experiences and understanding of insurance coverage in patient outcomes. Several themes emerged from the interviews and photographs including themes centred around: (i) racial/ethnic standards of beauty; (ii) gender expectations; (iii) comorbidities, depression/disordered eating and obesity discrimination and (iv) financial hardship impacting adherence. Photographs also illuminated the impact of hospital and state‐wide policies on patient lives. Results suggest that Photovoice may be a useful adjunct to standard‐of‐care to help patients identify barriers, and to identify shortcomings in health services. Additional screening tools for gender‐ and income‐related barriers (and concomitant referrals to support services) provide an opportunity to improve patient care and reduce post‐operative readmissions.
Clinical Drug–Drug Interaction Potential of BFE1224, Prodrug of Antifungal Ravuconazole, Using Two Types of Cocktails in Healthy Subjects
Authors: Ishii Yasuyuki , Ito Yuko , Matsuki Shunji , Sanpei Kasumi , Ogawa Osamu , Takeda Kenji , Schuck Edgar L. , Uemura Naoto
Published: May 2018

BFE1224, prodrug of ravuconazole, is a novel, once‐daily, oral, triazole antifungal drug, and currently in development for the treatment of onychomycosis. The clinical drug–drug interaction (DDI) potential of BFE1224 with cytochrome P450 (CYP) and transporter was assessed by using two types of cocktails in healthy subjects in separate clinical studies. The CYP and transporter cocktails consisted of caffeine/tolbutamide/omeprazole/dextromethorphan/midazolam used in study 1 and digoxin/rosuvastatin used in study 2. In addition, repaglinide was separately administered to the same subjects in study 2. There were no major effects on the pharmacokinetics of CYP and transporter substrates, except for an approximate threefold increase in midazolam exposure after oral administration of BFE1224. The clinical DDIs of BFE1224 were mild for CYP3A and minor for other major CYPs (CYP1A2/2C8/2C9/2C19/2D6) as well as those of P‐glycoprotein (P‐gp), breast cancer resistance protein (BCRP), organic anion transporting polypeptide (OATP) 1B1, and OATP1B3.
Drinking game participation and outcomes in a sample of Australian university students
Authors: George Amanda M. , Zamboanga Byron L.
Published: May 2018

Introduction and Aims

Most drinking game (DG) research among university students has been conducted among USA college samples. The extent to which demographics and game type (e.g. team and sculling games) are linked to DG behaviours/consequences among non‐USA students is not well understood. As such, the current study investigated characteristics of DG participation (and associated outcomes) among a sample of Australian university students.

Methods

University students (N = 252; aged 18–24 years; 67% female) who had consumed alcohol in the prior year completed an online survey. Measures included demographics, DG behaviours (lifetime, frequency and consumption) and gaming‐specific consequences.

Results

Most of the students reported lifetime DG participation (85%). Among those who played a DG in the prior 6 months (69%), most had experienced a negative gaming‐specific consequence. While team games were the most popular DG played, regression analysis demonstrated that participation in games which encouraged consumption (e.g. sculling) were associated with increased alcohol consumption during play. In addition to being older, playing DGs more frequently, and consuming more alcohol while playing, participation in both consumption and dice games (e.g. 7–11, doubles) predicted more negative gaming‐specific consequences.

Discussion and Conclusions

DG participation is common among Australian university students, as it is in other parts of the world. The importance of game type is clear, particularly the risk of consumption games. Findings could help inform interventions to reduce participation in consumption games and identify students who might be especially at‐risk for experiencing negative DG consequences.