bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge territorial behavior congruence and innovation process: the moderating role of team territorial climate
Authors: Xu Zhenting , Li Xianmiao
Published: June 2021

Purpose

Building on the territoriality perspective and innovation process theory, to the purpose of this study is to investigate the mechanism of transmission and influence of knowledge territorial behavior congruence on innovation process, which provides theoretical implications for innovative teams to execute territoriality management and create a constructive knowledge sharing climate and platform for sustainable innovation of individuals and organizations.

Design/methodology/approach

The data were collected by the paired method from 311 creative R&D members. In addition, polynomial regressions and response surface method were adopted to test the hypotheses.

Findings

The more congruent the marking behavior and defensive behavior were, the higher the creative idea generation and idea implementation became. The congruence of “high marking high defensive behavior” was more conducive to triggering creative idea generation and promoting idea implementation. Compared with the incongruence of “low marking high defensive behavior,” the incongruence of “high marking low defensive behavior” was more conducive to stimulating creative idea generation. However, there was no significant difference in the incongruence effect of marking defensive behavior on idea implementation. In addition, creative idea generation mediated the relationship between knowledge territorial behavior congruence and idea implementation. Furthermore, team territorial climate moderated the relationship between knowledge territorial behavior congruence and creative idea generation.

Originality/value

The study highlights the theoretical research of territoriality and innovation process. By deconstructing the relationship between the territorial behavior congruence and the innovation process, this study establishes that the congruence and incongruence of the marking defensive behavior in knowledge territoriality exerts different effects on creative idea generation and idea implementation.
Understanding cognitive transport mode choice structures: means-ends chains as a type of second-order cybernetics
Authors: Kolar Tomaž , Kolar Iztok
Published: June 2021

Purpose

This paper aims to inform the promotion of sustainable modes of transport. For this purpose, it deploys a means-ends framework as a type of second-order cybernetics and uses it to explore cognitive transport mode choice structures.

Design/methodology/approach

The empirical study relies on a purposive sample and a qualitative research methodology known as laddering. It is aimed at the identification and comparative analysis of the cognitive means-ends structures of transport users.

Findings

The results reveal more positive and complex associations for the car than for public transport. Two main positive means-ends structures are identified for public transport, one related with the relaxation and the other with doing useful things while travelling. Dominant positive structures for the car are related with self-confidence, satisfaction and personal freedom. Negative means-ends structures in addition reveal important justifications and rationalizations for car use.

Practical implications

Based on the identified distinct means-ends elements and structures, this study holds important implications for developing a communications strategy and policy interventions seeking to promote public transport.

Originality/value

Means-ends theory is proposed as an integrative cybernetic framework for the study of stakeholders’ (customers’) mental models. The empirical study is the first to concurrently and comparatively examine positive and negative means-ends chains for the car and for the public transport modes.
Voluntary audit committees, auditor selection and audit quality: evidence from Taiwan
Authors: Kao Mao-Feng , Shiue Min-Jeng , Tseng Chien-Hao
Published: June 2021

Purpose

This study aims to examine the Taiwan setting, where audit partners’ names are presented in the audit report and where audit committee formation is voluntary in the initial stage of audit committee reform. This paper investigates the effects of the formation of voluntary audit committees on the selection of individual audit partners, and, in turn, the audit quality. This contrasts with previous studies investigating the relationship between audit committees and auditor selection at the audit firm level.

Design/methodology/approach

This paper samples all of Taiwan’s publicly listed firms for the period 2007–2012 and uses Heckman’s (1979) two-stage estimation model to achieve our objectives.

Findings

Using different characteristics of individual engagement partners as proxies for a higher quality auditor, the main empirical results show that voluntary audit committee formation is positively related to an industry specialist lead partner and a lead partner that has a larger number of clients. In addition, this paper also finds that voluntary audit committee formation has a positive impact on audit quality (proxied by discretionary accruals). The results suggest that the voluntary formation of an audit committee contributes positively to both auditor selection and audit quality. Furthermore, an additional test shows that the main empirical results are robust to a validity threat that firms that have good corporate governance prior to the formation of voluntary audit committees tend to select high-quality audit partners.

Originality/value

The paper contributes to the audit committee literature in the following ways: this paper takes advantage of Taiwan’s unique setting, where forming an audit committee is not compulsory in the initial stage of audit committee reform, to investigate the voluntary audit committee, auditor selection and audit quality; this paper expands on Abbott and Parker’s (2000) study of audit committee characteristics and auditor selection at the audit firm level by examining this relationship at the individual audit partner level; this paper responds to the call by Church et al. (2008) and DeFond and Francis (2005) who propose more studies on audit quality at the individual engagement partner level.
Financial inclusion and the performance of microfinance institutions: does social performance affect the efficiency of microfinance institutions?
Authors: Bharti Nisha , Malik Sushant
Published: June 2021

Purpose

The purpose of this study is to evaluate whether focus on social output affects the efficiency of MFIs. Inclusive growth is the key developmental aim for many developing countries, including India. The role of microfinance institutions (MFIs) in promoting financial inclusion is widely applauded. However, to achieve financial sustainability, MFIs have become highly commercialised and are seen to have drifted away from their social mission. Various studies have shown the efficiency of MFIs on financial parameters. MFIs being a social enterprise, it is important to include social output among the efficiency parameters.

Design/methodology/approach

This study attempts to compare the efficiency of MFIs with and without social performances across the various size of MFIs based on their asset, i.e. large, medium and small. This study uses Data Envelopment Analysis (DEA) for assessing an MFI’s efficiency. For calculating the social output score, the Gutman Scale is used. Efficiency is calculated with and without social output, and the resulting scores are compared to assess the impact of social performance on the efficiency of MFIs.

Findings

The results of this study allow us to conclude that with the inclusion of social output, the efficiency of MFIs improves across various categories. In terms of social performances, it is concluded that MFIs are targeting women and mostly working in rural areas but have neglected issues like health and education.

Originality/value

The findings of this study will help MFIs in formulating their mission and vision statements and in achieving the objective of financial inclusion without experiencing mission drift.
Towards a proactive, capabilities-based continuity framework for the hospitality and tourism industry
Authors: Carty Kimberly S.
Published: June 2021

Purpose

This paper aims to provide a framework to guide tourism and hospitality businesses, tourism organizations and their communities to collaboratively develop a proactive, capabilities-based continuity plan for disaster or crisis. The framework provided incorporates the existing research and existing business continuity standards to provide actionable steps building community resilience and disaster preparedness. This plan offers the stakeholders a roadmap to adapt when faced with disaster and persist in the pursuit of a strong tourism and hospitality industry.

Design/methodology/approach

A summary of the key literature is presented alongside international guidance for developing business continuity plans. Incorporating the literature and business continuity standards, this framework offers actionable steps that stakeholders can take to develop preparedness plans for their business, organization and/or community that support disaster resilience for the tourism and hospitality industry.

Findings

The majority of tourism and hospitality businesses are micro-, small- and medium-sized businesses that often lack the capabilities and resources to dedicate to disaster preparedness planning. The available research offers important and meaningful data, yet also finds that businesses fail to plan. The available literature that guides tourism and hospitality businesses to move to action in preparing for disaster is sparse.

Originality/value

This paper brings together theoretical research literature with existing business continuity best practices to create a new framework specifically designed for the tourism and hospitality industry. The result is a practical roadmap to guide stakeholders to build community resilience that benefits tourism and hospitality businesses, tourism organizations and the wider community to build resilience, shorten recovery times and sustain a strong industry/community despite disaster. It will be of value to practitioners, researchers, policymakers and other stakeholders involved in the travel and tourism industry.
How water‐soluble saccharides drive the metabolism of lactic acid bacteria during fermentation of brewers' spent grain
Authors: Acin‐Albiac Marta , Filannino Pasquale , Coda Rossana , Rizzello Carlo Giuseppe , Gobbetti Marco , Di Cagno Raffaella
Published: June 2021

We proposed a novel phenomic approach to track the effect of short‐term exposures of Lactiplantibacillus plantarum and Leuconostoc pseudomesenteroides to environmental pressure induced by brewers' spent grain (BSG)‐derived saccharides. Water‐soluble BSG‐based medium (WS‐BSG) was chosen as model system. The environmental pressure exerted by WS‐BSG shifted the phenotypes of bacteria in species‐ and strains‐dependent way. The metabolic drift was growth phase‐dependent and likely underlay the diauxic profile of organic acids production by bacteria in response to the low availability of energy sources. Among pentosans, metabolism of arabinose was preferred by L. plantarum and xylose by Leuc. pseudomesenteroides as confirmed by the overexpression of related genes. Bayesian variance analysis showed that phenotype switching towards galactose metabolism suffered the greatest fluctuation in L. plantarum. All lactic acid bacteria strains utilized more intensively sucrose and its plant‐derived isomers. Sucrose‐6‐phosphate activity in Leuc. pseudomesenteroides likely mediated the increased consumption of raffinose. The increased levels of some phenolic compounds suggested the involvement of 6‐phospho‐β‐glucosidases in β‐glucosides degradation. Expression of genes encoding β‐glucoside/cellobiose‐specific EII complexes and phenotyping highlighted an increased metabolism for cellobiose. Our reconstructed metabolic network will improve the understanding of how lactic acid bacteria may transform BSG into suitable food ingredients.
Transcriptome analysis reveals the roles of nitrogen metabolism and sedoheptulose bisphosphatase pathway in methanol‐dependent growth of Corynebacterium glutamicum
Authors: Fan Liwen , Wang Yu , Qian Jin , Gao Ning , Zhang Zhihui , Ni Xiaomeng , Sun Letian , Yuan Qianqian , Zheng Ping , Sun Jibin
Published: June 2021

Methanol is a promising feedstock for biomanufacturing of fuels and chemicals. Although efforts have been made to engineer platform microorganisms for methanol bioconversion, the substrate uptake and cell growth rates on methanol are still unsatisfactory, suggesting certain limiting factors remain unsolved. Herein, we analysed the global metabolic regulation changes between an evolved methanol‐dependent Corynebacterium glutamicum mutant and its ancestral strain by transcriptome analysis. Many genes involved in central metabolism including glycolysis, amino acid biosynthesis and energy generation were regulated, implying the adaptive laboratory evolution reprogrammed the cellular metabolism for methanol utilization. We then demonstrated that nitrate could serve as a complementary electron acceptor for aerobic methanol metabolism, and the biosynthesis of several amino acids limited methylotrophic growth. Finally, the sedoheptulose bisphosphatase pathway for generating methanol assimilation acceptor was found effective in C. glutamicum. This study identifies limiting factors of methanol metabolism and provides engineering targets for developing superior synthetic methylotrophs.
Immunolocalization of some HOX proteins in immature and mature feline testes
Authors: Topaloğlu Uğur , Akbalik Mehmet Erdem , Sağsöz Hakan
Published: June 2021

Homeobox (HOX) proteins are known for their critical role in body shape formation and tissue differentiation of developing vertebrate embryos. Recent research has shown that HOX proteins have many physiological roles such as cell proliferation, cell cycle, apoptosis and cell differentiation in adults, as well as the development of the vertebrate nerve and reproductive system. This study was conducted to determine the possible physiological functions and expression intensities of HOXA10, HOXA11, HOXB6 and HOXC6 proteins in the male reproductive system (testes, epididymis and deferens ducts), which are important for the continuity of some specific cat breeds in different age ranges. In the study, a total of 18 testicular tissues were used, divided into two groups: less than 6 months (immature) and more than 1 year (mature). Tissue samples were then subjected to immunohistochemical staining with protein‐specific antibodies examined in the study. In the findings obtained in the research; it was observed that HOXA10, HOXA11, HOXB6 and HOXC6 produced different intensities of immunolocalization in the epididymis and ductus deferens layers in the immature and mature testicular cells. In addition, it was found that HOXA10 immunoreaction was also seen in some vascular endothelial cells. As a result, it was concluded that the HOX proteins could contribute to the physiological functions of testes, epididymis and ductus deferens and affect male fertility.
Mortality and Morbidity rounds in neonatology: Providers’ experiences and perspectives
Authors: Assaad Michael‐Andrew , Lapointe Anie , Thivierge Émilie , Janvier Annie
Published: June 2021

Aim

To describe how Canadian level III neonatal intensive care units (NICU) organise mortality and morbidity rounds (M&MR) and explore clinicians’ perspectives.

Methods

This questionnaire study, including open‐ended questions, examined the following domains: (1) M&MR format, (2) ethical issues and (3) limitations and perceived effectiveness.

Results

Sixteen out of twenty (80%) level III NICUs participated. All deaths and 64% of morbidities were discussed. M&MR occurred monthly (69%) with 3–5 patients discussed hourly (63%) and usually (75%) physician led. Wide variations of practice between centres existed for practical issues, such as administrative support and attendance. 44% of centres allowed nurses to participate. Goals reported by participants were also heterogeneous: reducing medical error (56%), educational (50%), improving communication (44%) and peer review (23%). Practical barriers were time (75%) and lack of resources/structure (25%). Four main themes were as follows: the role of M&MR, the ongoing blame culture, communication issues and the distinction between mortality and morbidity.

Conclusion

Goals and format of M&MR vary widely. M&MR remains physician‐centric, where the blame culture still endures. Neonatal M&MR models should be adapted to the modern NICU to ensure the M&MR stays relevant. It could also benefit from lessons learned in quality improvement.
Impact of pre‐eclampsia on renal outcome in sickle cell disease patients
Authors: Boudhabhay Idris , Boutin Emmanuelle , Bartolucci Pablo , Bornes Marie‐Isabelle , Habibi Anoosha , Lionnet François , Hertig Alexandre , Grimbert Philippe , Stehlé Thomas , El Karoui Khalil , Sahali Dil , Fois Elena , Rémy Philippe , Galacteros Frédéric , Haddad Bassam , Canoui-Poitrine Florence , Lecarpentier Edouard , Audard Vincent
Published: June 2021

The long‐term consequences of pre‐eclampsia (PrE) for renal function have never been determined in patients with sickle cell disease (SCD). Between 2008 and 2015, we screened 306 pregnancies in women with SCD and identified 40 with PrE (13%). The control group consisted of 65 pregnant SCD patients without PrE. In multivariable analysis, PrE events were associated with an increase of 1 log of lactate dehydrogenase level (adjusted odds ratio, aOR = 3·83, P = 0·05), a decrease of 10 g/l of haemoglobin levels (aOR = 2·48, P = 0·006) and one or more vaso‐occlusive crisis during pregnancy (aOR = 16·68, P = 0·002). Estimated glomerular filtration rate (eGFR) was similar in the two groups at steady state but was significantly lower in the PrE group after one year of follow‐up and at last follow‐up (130 vs 148 ml/min/1·73 m2, P < 0·001 and 120 vs 130 ml/min/1·73 m2, P < 0·001, respectively). In multivariable analysis, eGFR had returned to steady‐state levels one year after pregnancy in patients without PrE but continued to decrease in patients with PrE (β = −18·15 ml/min/1·73 m2, P < 0·001). This decline was more marked at the end of follow‐up (β = −31·15 ml/min, P < 0·001). In conclusion, PrE episodes are associated with a significant risk of subsequent renal function decline in SCD patients.
Immature platelets as a biomarker for disease severity and mortality in COVID‐19 patients
Authors: Welder Daniel , Jeon‐Slaughter Haekyung , Ashraf Bilal , Choi Sung‐Hee , Chen Weina , Ibrahim Ibrahim , Bat Taha
Published: June 2021

COVID‐19, caused by SARS‐CoV‐2, is a contagious life‐threatening viral disease that has killed more than three million people worldwide to date. Attempts have been made to identify biomarker(s) to stratify disease severity and improve treatment and resource allocation. Patients with SARS‐COV‐2 infection manifest with a higher inflammatory response and platelet hyperreactivity; this raises the question of the role of thrombopoiesis in COVID‐19 infection. Immature platelet fraction (IPF, %) and immature platelet counts (IPC, ×109/l) can be used to assess thrombopoiesis. This study investigates whether the level of thrombopoiesis correlates with COVID‐19 severity. A large cohort of 678 well‐characterized COVID‐19 patients was analyzed, including 658 (97%) hospitalized and 139 (21%) admitted to the intensive care unit (ICU). Elevated percentage IPF at presentation was predictive of length of hospitalization (P < 0·01) and ICU admission (P < 0·05). Additionally, percentage IPF at the peak was significantly higher among ICU patients than non‐ICU patients (6·9 ± 5·1 vs 5·3 ± 8·4, P < 0·01) and among deceased patients than recovered patients (7·9 ± 6·3 vs 5·4 ± 7·8, P < 0·01). Furthermore, IPC at the peak was significantly higher among ICU patients than non‐ICU patients (18·5 ± 16·2 vs. 13·2 ± 8·3, P < 0·05) and among patients on a ventilator than those not (22·1 ± 20·1 vs.13·4 ± 8·4, P < 0·05). Our study demonstrated that elevated initial and peak values of percentage IPF and IPC might serve as prognostic biomarkers for COVID‐19 progression to severe conditions.
Towards automatic recognition of pure and mixed stones using intra‐operative endoscopic digital images
Authors: Estrade Vincent , Daudon Michel , Richard Emmanuel , Bernhard Jean‐Christophe , Bladou Franck , Robert Grégoire , Denis de Senneville Baudouin
Published: June 2021

Objective

To assess automatic computer‐aided in situ recognition of the morphological features of pure and mixed urinary stones using intra‐operative digital endoscopic images acquired in a clinical setting.

Materials and Methods

In this single‐centre study, a urologist with 20 years' experience intra‐operatively and prospectively examined the surface and section of all kidney stones encountered. Calcium oxalate monohydrate (COM) or Ia, calcium oxalate dihydrate (COD) or IIb, and uric acid (UA) or IIIb morphological criteria were collected and classified to generate annotated datasets. A deep convolutional neural network (CNN) was trained to predict the composition of both pure and mixed stones. To explain the predictions of the deep neural network model, coarse localization heat‐maps were plotted to pinpoint key areas identified by the network.

Results

This study included 347 and 236 observations of stone surface and stone section, respectively; approximately 80% of all stones exhibited only one morphological type and approximately 20% displayed two. A highest sensitivity of 98% was obtained for the type ‘pure IIIb/UA’ using surface images. The most frequently encountered morphology was that of the type ‘pure Ia/COM’; it was correctly predicted in 91% and 94% of cases using surface and section images, respectively. Of the mixed type ‘Ia/COM + IIb/COD’, Ia/COM was predicted in 84% of cases using surface images, IIb/COD in 70% of cases, and both in 65% of cases. With regard to mixed Ia/COM + IIIb/UA stones, Ia/COM was predicted in 91% of cases using section images, IIIb/UA in 69% of cases, and both in 74% of cases.

Conclusions

This preliminary study demonstrates that deep CNNs are a promising method by which to identify kidney stone composition from endoscopic images acquired intra‐operatively. Both pure and mixed stone composition could be discriminated. Collected in a clinical setting, surface and section images analysed by a deep CNN provide valuable information about stone morphology for computer‐aided diagnosis.
Teacher Depressive Symptoms and Child Math Achievement in Head Start: The Roles of Family–Teacher Relationships and Approaches to Learning
Authors: Jeon Shinyoung , Jeon Lieny , Lang Sarah , Newell Kaitlyn
Published: June 2021

This study examined the direct and indirect associations of teachers’ depressive symptoms with children’s math achievement through teachers’ reports of family–teacher relationships and children’s approaches to learning (ATL) in Head Start. This study included 3‐ and 4‐year‐old 1,547 children (49% female; 27% White, 24% Black, 41% Hispanic/Latino, and 8% others) who attended Head Start from fall 2014 through spring 2015. Results indicated that teachers’ depressive symptoms were directly associated with lower gains in children’s math skills over a year. In addition, teachers who reported higher depressive symptoms were less likely to report positive family–teacher relationships. This, in turn, resulted in lower gains in children’s ATL and was associated with lower achievement in math skills (r2 = .69).
Encephalopathy at admission predicts adverse outcomes in patients with SARS‐CoV‐2 infection
Authors: Tang Lei , Liu Shixin , Xiao Yanhe , Tran Thi My Linh , Choi Ji Whae , Wu Jing , Halsey Kasey , Huang Raymond Y. , Boxerman Jerrold , Patel Sohil H , Kung David , Liu Renyu , Feldman Michael D. , Danoski Daniel D , Liao Wei‐hua , Kasner Scott E. , Liu Tao , Xiao Bo , Zhang Paul J. , Reznik Michael , Bai Harrison X. , Yang Li
Published: June 2021

Aims

To determine if neurologic symptoms at admission can predict adverse outcomes in patients with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2).

Methods

Electronic medical records of 1053 consecutively hospitalized patients with laboratory‐confirmed infection of SARS‐CoV‐2 from one large medical center in the USA were retrospectively analyzed. Univariable and multivariable Cox regression analyses were performed with the calculation of areas under the curve (AUC) and concordance index (C‐index). Patients were stratified into subgroups based on the presence of encephalopathy and its severity using survival statistics. In sensitivity analyses, patients with mild/moderate and severe encephalopathy (defined as coma) were separately considered.

Results

Of 1053 patients (mean age 52.4 years, 48.0% men [n = 505]), 35.1% (n = 370) had neurologic manifestations at admission, including 10.3% (n = 108) with encephalopathy. Encephalopathy was an independent predictor for death (hazard ratio [HR] 2.617, 95% confidence interval [CI] 1.481–4.625) in multivariable Cox regression. The addition of encephalopathy to multivariable models comprising other predictors for adverse outcomes increased AUCs (mortality: 0.84–0.86, ventilation/ intensive care unit [ICU]: 0.76–0.78) and C‐index (mortality: 0.78 to 0.81, ventilation/ICU: 0.85–0.86). In sensitivity analyses, risk stratification survival curves for mortality and ventilation/ICU based on severe encephalopathy (n = 15) versus mild/moderate encephalopathy (n = 93) versus no encephalopathy (n = 945) at admission were discriminative (p < 0.001).

Conclusions

Encephalopathy at admission predicts later progression to death in SARS‐CoV‐2 infection, which may have important implications for risk stratification in clinical practice.
The dynamics of the house price‐to‐income ratio: Theory and evidence
Authors: Leung Charles Ka Yui , Tang Edward Chi Ho
Published: June 2021

The house price‐to‐income ratio (PIR) is widely used as an affordability indicator. This paper complements the cross‐sectionally focused literature by proposing a tractable model for the PIR dynamics. Our model predicts that the PIR is very persistent and is correlated to the lagged aggregate output. Cross‐country analysis confirms this prediction and provides evidence for a long‐term, positive, and significant relationship between PIR and aggregate production. Our results hint at the construction of an early warning system for housing market mispricing. Our tractable formulation of a stochastic money growth rule may carry independent research interest.
Factors associated with switching from sulphonylureas to dipeptidyl peptidase 4 inhibitors among patients with type 2 diabetes in the United States
Authors: Tan Xi , Yang Lingfeng , Khunti Kamlesh , Zhang Ruya , Zhang Ye , Rajpathak Swapnil , Yu Miao
Published: June 2021

Aims

Studies examining the prevalence of and factors associated with switching from sulphonylureas (SUs) to dipeptidyl peptidase 4 (DPP‐4) inhibitors in real‐world settings are lacking. We assessed the factors associated with switching from SUs to DPP‐4 inhibitors in the United States.

Materials and Methods

This retrospective cohort study was conducted using the Optum Clinformatics® Data Mart (2009‐2018). Adults with type 2 diabetes and newly prescribed at least two SUs were included and were followed for 2 years after the initiation of SU (index date). We compared the characteristics of those who switched from SUs to DPP‐4 inhibitors (only; no additional antidiabetic drugs) with those who continued with SUs (without adding other antidiabetic drugs) using multivariate logistic regression. Multinomial regression analyses were also conducted to assess the factors associated with switching to different drug classes versus continuation with SUs.

Results

In a sample of 119 107 new SU users, 2.2% (2633) switched to DPP‐4 inhibitors, 3.8% (4542) switched to antidiabetic drugs other than DPP‐4 inhibitors, 68.3% (81 394) discontinued SUs but did not switch to another antidiabetic drug, 12.9% (15 345) continued with SUs and added other antidiabetic drugs, and 12.8% (15 193) continued with SUs only. Multivariate logistic regression showed that those who had significantly higher likelihood of switching were younger, female [vs. males; adjusted odds ratio (AOR) = 0.70], and living in the south; had previous use of DPP‐4 inhibitors (AOR = 1.71); were not using antidiabetic drugs at baseline; had more baseline diabetes‐related emergency room visits (AOR = 1.13), depression (AOR = 1.34), post‐index hypoglycaemia (AOR = 2.20), and an earlier index year; and were glyburide users (vs. glimepiride users; AOR = 1.29).

Conclusions

The discontinuation rate for SUs is high. Factors associated with switching from SUs to DPP‐4 inhibitors included age, sex, geographic region, baseline antidiabetic drug use, type of SU, baseline diabetes‐related emergency room visits, hypoglycaemia and depression.
Evaluation of sepsis teaching for medical and dental students at a British University
Authors: Ali Kamran , Venkatasami Neelam , Zahra Daniel , Brookes Zoe , Kisielewska Jolanta
Published: June 2021

Introduction

The aim of this study was to evaluate sepsis on undergraduate programmes in medicine (BMBS), dentistry (BDS) and dental therapy (BScDTH) at a university in England.

Materials and Methods

The study was carried out at the Faculty of Health, University of Plymouth. Questionnaires consisting of a series of closed and open‐ended items were designed for students and faculty by a group of academics. Following a pilot, participants were invited to complete the questionnaires online. Data collection and analyses were completed over a period of 3 months.

Results

A total of 71 students responded, including 43 were on the BDS programme, 21 on BMBS and 7 on BScDTH. The vast majority were aged between 18–24 years old (n = 61), with 9 reporting being between 25–44 years old. Of the 14 staff who responded, 13 were aged between 35 and 54 years old, with one respondent reporting being aged 25–34. The participants reported their perceptions regarding the teaching and clinical exposure of students to sepsis patients; availability of resources for students and patients to raise sepsis awareness. Students across all programmes reported limited clinical exposure to management of sepsis and lack of confidence in recognising early signs of sepsis in patients. The agreement profile between programmes only differed significantly for recognition of sepsis risk item (χ(6, n = 71) = 26.187, p < 0.001), with BDS students disagreeing with the item to a larger extent than BMBS and BScDTH students. Students and staff reported similar perceptions regarding information available to students and patients. Responses to open‐ended items provided several suggestions for improvements in the teaching of students and raising public awareness on sepsis.

Conclusion

This study identified several areas related to sepsis teaching which require improvements across all programmes. The key issues highlighted by the students included limited clinical exposure to sepsis patients and lack of confidence in recognising early signs of sepsis.
No evidence of rhythmic visuospatial attention at cued locations in a spatial cuing paradigm, regardless of their behavioural relevance
Authors: van der Werf Olof J. , Ten Oever Sanne , Schuhmann Teresa , Sack Alexander T.
Published: June 2021

Recent evidence suggests that visuospatial attentional performance is not stable over time but fluctuates in a rhythmic fashion. These attentional rhythms allow for sampling of different visuospatial locations in each cycle of this rhythm. However, it is still unclear in which paradigmatic circumstances rhythmic attention becomes evident. First, it is unclear at what spatial locations rhythmic attention occurs. Second, it is unclear how the behavioural relevance of each spatial location determines the rhythmic sampling patterns. Here, we aim to elucidate these two issues. Firstly, we aim to find evidence of rhythmic attention at the predicted (i.e. cued) location under moderately informative predictor value, replicating earlier studies. Secondly, we hypothesise that rhythmic attentional sampling behaviour will be affected by the behavioural relevance of the sampled location, ranging from non‐informative to fully informative. To these aims, we used a modified Egly‐Driver task with three conditions: a fully informative cue, a moderately informative cue (replication condition), and a non‐informative cue. We did not find evidence of rhythmic sampling at cued locations, failing to replicate earlier studies. Nor did we find differences in rhythmic sampling under different predictive values of the cue. The current data does not allow for robust conclusions regarding the non‐cued locations due to the absence of a priori hypotheses. Post‐hoc explorative data analyses, however, clearly indicate that attention samples non‐cued locations in a theta‐rhythmic manner, specifically when the cued location bears higher behavioural relevance than the non‐cued locations.
The fragile X mental retardation protein promotes adjustments in cocaine self‐administration that preserve reinforcement level
Authors: Huebschman Jessica L. , Davis Megan C. , Tovar Pensa Catherina , Guo Yuhong , Smith Laura N.
Published: June 2021

The fragile X mental retardation protein (FMRP), an RNA‐binding protein, regulates cocaine‐induced neuronal plasticity and is critical for the normal development of drug‐induced locomotor sensitization, as well as reward‐related learning in the conditioned place preference assay. However, it is unknown whether FMRP impacts behaviors that are used to more closely model substance use disorders. Utilizing a cocaine intravenous self‐administration (IVSA) assay in Fmr1 knockout (KO) and wild‐type (WT) littermate mice, we find that, despite normal acquisition and extinction learning, Fmr1 KO mice fail to make a normal upward shift in responding during dose–response testing. Later, when given access to the original acquisition dose under increasing fixed ratio (FR) schedules of reinforcement (FR1, FR3, and FR5), Fmr1 KO mice earn significantly fewer cocaine infusions than WT mice. Importantly, similar deficits are not present in operant conditioning using a palatable food reinforcer, indicating that our results do not represent broad learning or reward‐related deficits in Fmr1 KO mice. Additionally, we find an FMRP target, the activity‐regulated cytoskeleton‐associated protein (Arc), to be significantly reduced in synaptic cellular fractions prepared from the nucleus accumbens of Fmr1 KO, compared with WT, mice following operant tasks reinforced with cocaine but not food. Overall, our findings suggest that FMRP facilitates adjustments in drug self‐administration behavior that generally serve to preserve reinforcement level, and combined with our similar IVSA findings in Arc KO mice may implicate Arc, along with FMRP, in behavioral shifts that occur in drug taking when drug availability is altered.
Buoyancy of post‐fertilised Dissostichus mawsoni eggs and implications for early life history
Authors: Parker Steven J. , Sundby Svein , Stevens Darren , Di Blasi Davide , Schiaparelli Stefano , Ghigliotti Laura
Published: June 2021

Gametes from gravid Antarctic toothfish (Dissostichus mawsoni) were combined in vitro and buoyancy measurements were made on fertilised eggs during early development. Eggs were strongly positively buoyant, indicating that they would ascend quickly in the water column and reside near or in association with the underside of sea ice, which covers most of the spawning habitat during winter. An association with sea ice may provide: protection from the turbulence of ice‐free surface waters, a mechanism that modifies the velocity of advection by surface currents, and a habitat with a concentrated planktonic food source during spring months. An association with sea ice would also create spatial differences in egg advection patterns for eggs produced spanning a large geographic area. The effects of climate change on sea ice formation and melting patterns, or fishery‐induced changes in the spatial density of adults could then influence juvenile advection patterns and influence survival.
Effect of nutritional support on nutritional status and inflammation in malnourished patients undergoing maintenance hemodialysis
Authors: Gurlek Demirci Bahar , Carrero Juan Jesus , Tutal Emre , Bal Zeynep , Sezer Siren
Published: June 2021

Introduction

Protein energy wasting/malnutrition is a strong predictor of morbidity and mortality in patients on maintenance hemodialysis (MHD). We aimed to compare the effects of oral and/or intradialytic parenteral nutrition (IDPN) support on nutritional and inflammatory parameters in malnourished patients with MHD.

Methods

This is an observational study of 56 malnourished patients on MHD. We offered combined oral nutritional support (ONS) and IDPN for 12 months to all patients. Depending on patient choices for treatment, they were classified into four groups: group 1 (ONS only), group 2 (IDPN only), group 3 (both ONS and IDPN), and group 4 (patients who refused artificial nutrition support and only followed dietary advice). Normalized protein catabolic rate (nPCR), malnutrition inflammation score (MIS), and body composition (fat mass [FM], muscle mass [MM]) were assessed monthly.

Findings

The mean serum albumin levels of groups 2 and 3 significantly increased with the intervention, whereas that of group 4 significantly decreased. The mean nPCR levels of groups 2 and 3 significantly increased. Group 3 had the most significant positive change in serum albumin and nPCR levels. Mean serum C‐reactive protein (CRP) levels of groups 1, 2, and 3 decreased, whereas those of group 4 increased. A ∆ in CRP was only identified in group 3. The MIS of groups 1, 2, and 3 significantly decreased whereas that of group 4 significantly increased. The ∆% in FM was 1.1, 1.9, 9.1, and −2.9 for groups 1, 2, 3, and 4, respectively, and that in MM was −0.6, 4.4, 6.9, and −7.9 for groups 1, 2, 3, and 4, respectively.

Discussion

Compared to monotherapy or nutritional counseling, the choice of ONS plus IDPN is associated with improved nutritional status and decreased inflammation in malnourished patients on MHD. Nonetheless, interventional studies must be conducted to confirm these observations.
Elevated circulating fibrocyte levels in hemodialysis‐dependent end‐stage renal disease patients
Authors: Li Xinjian , Liu Xing , Zhang Haipeng , Zhang Ruining , Li Guangping
Published: June 2021

Introduction

Numerous studies have demonstrated that end‐stage renal disease (ESRD) patients undergoing hemodialysis (HD) have high myocardial fibrosis (MF) levels. Circulating fibrocytes are bone marrow‐derived circulating mesenchymal progenitors, and new evidence suggests a vital role for fibrocytes in the development of MF. This study aimed to investigate whether fibrocyte levels are elevated in patients undergoing HD and its influence factors.

Methods

We carried out a flow cytometry analysis to measure the proportion of peripheral blood circulating fibrocytes in a cohort of 126 healthy control individuals and 161 subjects with HD. Cardiac function and morphology were assessed by electrocardiogram and transthoracic echocardiogram.

Findings

Compared to healthy controls, individuals with ESRD had significantly higher levels of circulating fibrocytes. There was a strong correlation between the frequency of fragmented QRS (fQRS) and circulating fibrocytes in HD patients. Furthermore, higher fibrocytes correlated to increasing age, dialysis age, left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), and hypertension complication. On multivariate analysis, the dialysis age [odds ratio (OR) 1.011, 95% confidence interval (CI) 1.003–1.019, p = 0.006], LVMI (OR 1.012, 95% CI 1.002–1.022, p = 0.016), hypertension (OR 4.303, 95% CI 1.129–16.406, p = 0.033), and fQRS (OR 2.439, 95% CI 1.049–5.262, p = 0.038) were significant independent predictors of fibrocytes percentage.

Discussion

We concluded that bone marrow‐derived circulating fibrocytes were significantly increased in ESRD patients with HD compared with controls. Our data suggested that these cells might play essential roles during MF in HD patients.
Cognitive impairment in a patient with COVID‐19 on hemodialysis: Too dangerous to neglect!
Authors: Jacobs Lucas M. , Gazagnes Marie Dominique , Sanoussi Said , Collart Frederic , Mesquita Maria do Carmo F.
Published: June 2021

Neurological manifestations of coronavirus disease 2019 (COVID‐19) often have tragic repercussions. Although many reports of neurological complications of severe acute respiratory syndrome coronavirus 2 infection exist, none of them are of patients on hemodialysis, who have a fivefold greater risk of stroke than the general population. In this report, we emphasize the importance of being vigilant for mild stroke in high risk populations—such as patients on hemodialysis—with COVID‐19, since these conditions have overlapping symptoms.
Are Estimates of Non‐Standard Employment Wage Penalties Robust to Different Wage Measures? The Case of Zero‐hour Contracts in the UK
Authors: Farina Egidio , Green Colin , McVicar Duncan
Published: June 2021

Evidence suggests that non‐standard jobs are associated with wage penalties. Yet, these jobs possess a range of undesirable characteristics that should generate compensating wage differentials. This evidence relies on derived wage variables, prone to measurement error likely to be correlated with employment contract. Stated‐rate hourly wage questions are not subjected to the same measurement issues. Using zero‐hour contracts in the UK, we show that there is no conditional average ZHC wage penalty once stated‐rate hourly wage measures are used. We discuss implications for policy.
Standard risk assessment forms help reduce preventable harm in older adult inpatients: A retrospective chart review study
Authors: Han Chin‐Yen , Redley Bernice , Lin Chun‐Chih , Chen Li‐Chin , Ng Chip Jin , Wang Li‐Hsiang
Published: June 2021

Aims

To examine nurse documentation of assessments using standard risk assessment forms in older inpatients, and to determine the value of such assessment.

Design

Cross‐sectional retrospective chart review.

Methods

This retrospective review of risk evaluation documentation in patients’ medical records focused on skin, continence, medical complications, nutrition, cognition, mobility, medications and pain.

Results

A total of 1000 medical records from Taiwan hospitals were reviewed from January 2016 to December 2017, and 379 from Australian hospitals were reviewed from March 2011 to February 2012. Taiwanese patients with documented assessment of skin (aOR =2.94, 95%CI =1.88–4.54), nutrition (aOR =3.22, 95%CI =1.08–9.59), cognition (aOR =2.61, 95%CI =1.32–5.16) and pain (aOR =5.01, 95%CI=1.63–15.38) had significantly higher odds of developing new problems; while Australian patients with documented assessments of continence (aOR =11.55, 95%CI =1.48–90.45) and nutrition (aOR =12.90, 95%CI =1.67–99.06) had significantly higher odds of developing new problems.

Discussion

Nursing assessments and interventions documented in standard risk assessment forms help clinical nurses detect new preventable problems and prevent harm in older hospital inpatients across geographic locations and hospital types. Standard nursing forms can be used in clinical practice to guide proactive care by nurses to prevent harm during hospitalisation.

Impact

Older inpatients are at risk of preventable harm and new health problems. The present study found that incorporating eight factors sensitive to nursing care into standard risk assessment forms can help reduce preventable harm in older inpatients. In addition, these forms guide assessment and intervention effectively in different countries.
Extensive serum biomarker analysis in the prethrombotic state of recurrent spontaneous abortion
Authors: Wu Ying , Xin Mingwei , Han Qian , Wang Jingshang , Yin Xiaodan , He Junqin , Yin Chenghong
Published: June 2021

The prethrombotic state (PTS) is a possible cause of recurrent spontaneous abortion (RSA). The aim of this study was to identify serum biomarkers for the detection of RSA with PTS (PSRSA). A Quantibody array 440 was used to screen novel serum‐based biomarkers for PSRSA/NRSA (RSA without PTS). Proteins differentially expressed in PSRSA were analysed using bioinformatics methods and subjected to a customized array and enzyme‐linked immunosorbent assay (ELISA) validation. We used receiver operating characteristic to calculate diagnostic accuracy, and machine learning methods to establish a biomarker model for evaluation of the identified targets. 20 targets were selected for validation using a customized array, and seven targets via ELISA. The decision tree model showed that IL‐24 was the first node and eotaxin‐3 was the second node distinguishing the PSRSA and NRSA groups (an accuracy rate of 100% and an AUC of 1). Epidermal growth factor (EGF) as the node distinguished the PSRSA and NC groups (an accuracy rate of 100% and an AUC of 1). EGF as the node distinguished the NRSA and NC groups (an accuracy rate of 96.5% and an AUC of 0.998). Serum DNAM‐1, BAFF, CNTF, LAG‐3, IL‐24, Eotaxin‐3 and EGF represent a panel of promising diagnostic biomarkers to detect the PSRSA.
Immunoproteasome impairment via β5i/LMP7‐deletion leads to sustained pancreatic injury from experimental pancreatitis
Authors: de Freitas Chama Laura L. , Ebstein Frédéric , Wiesrecker Birthe , Wagh Preshit R. , Hammer Elke , Weiss Frank U. , Junker Heike , Studencka‐Turski Maja , Lerch Markus M. , Krüger Elke , Sendler Matthias
Published: June 2021

Uncovering potential new targets involved in pancreatitis may permit the development of new therapies and improvement of patient's outcome. Acute pancreatitis is a primarily sterile disease characterized by a severe systemic inflammatory response associated with extensive necrosis and a mortality rate of up to 24%. Considering that one of the reported disease mechanisms comprises the endoplasmic reticulum (ER) stress response and that the immunoproteasome is a key regulator to prevent proteotoxic stress in an inflammatory context, we investigated its role in acute pancreatitis. In this study, we demonstrate that immunoproteasome deficiency by deletion of the β5i/LMP7‐subunit leads to persistent pancreatic damage. Interestingly, immunoproteasome‐deficient mice unveil increased activity of pancreatic enzymes in the acute disease phase as well as higher secretion of Interleukin‐6 and transcript expression of the Interleukin IL‐1β, IFN‐β cytokines and the CXCL‐10 chemokine. Cell death was increased in immunoproteasome‐deficient mice, which appears to be due to the increased accumulation of ubiquitin‐protein conjugates and prolonged unfolded protein response. Accordingly, our findings suggest that the immunoproteasome plays a protective role in acute pancreatitis via its role in the clearance of damaged proteins and the balance of ER stress responses in pancreatic acini and in macrophages cytokine production.