bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Types and Effects of Clinical Interruptions and Distractions Recorded in a Multihospital Patient Safety Reporting System
Authors: Kellogg Kathryn M. , Puthumana Joseph S. , Fong Allan , Adams Katharine T. , Ratwani Raj M.
Published: July 2018

Objectives

Interruptions and distractions have been shown to be a frequent occurrence across health care and have been linked to negative outcomes that create potential patient safety risks. Although observational studies have catalogued interruption frequency and source, the impact of an interruption is difficult to observe. We analyzed patient safety event (PSE) reports related to interruptions to identify clinical processes reported to be frequently interrupted and the reported outcomes of those interruptions.

Methods

We retrospectively analyzed PSE reports entered by frontline staff between January 2013 and January 2016. Of 79,428 total PSEs entered, 220 reports were identified using keyword matching and subsequent manual review as being directly related to a clinical interruption. Categories were developed to identify the cause of the interruption, task being interrupted, and the result of the interruption. Percentages were calculated.

Results

Nurses were most often reported to be interrupted in the PSEs (50%). General distractions (43.2%) or high workload (18.6%) were most commonly noted to interrupt the individual’s work. The interrupted activity was most often a medication task (50.9%), frequently in the administration phase (24.1%), or the ordering phase (16.8%). The most common medication error was wrong dose administration (14.4% of total medication-related errors). Laboratory processes were reported to be disturbed by interruptions in 22.7% of reports, and this frequently resulted in mislabeling of specimens (75% of laboratory-related errors).

Conclusions

This retrospective review of PSE reports involving interruptions of clinical activities reveals that interruptions affect a variety of aspects of patient care and can help to guide future work on interruption management.
Setting Global Research Priorities in Pediatric and Adolescent HIV Using the Child Health and Nutrition Research Initiative (CHNRI) Methodology
Authors: Irvine Cadi , Armstrong Alice , Nagata Jason M. , Rollins Nigel , Schaaf Diddie , Doherty Meg , Penazzato Martina , Vicari Marissa
Published: July 2018

Background:

WHO and the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) of the International AIDS Society (IAS) led a collaborative process to set global prioritized research agendas, aiming to focusing future research, funding, and stakeholder's efforts. This study describes the methodology used to establish the research agendas.

Methods:

The Child Health and Nutrition Research Initiative methodology was adapted in parallel exercises on pediatric and adolescent HIV. After definition of scope by an expert working group, priority questions were collected from stakeholders through an online survey. Submitted questions were coded, analyzed, and collated. The same respondents were asked to score the collated lists through a second online survey. The top 10 ranked questions per thematic area (testing, treatment, and service delivery) were reviewed and priority themes developed with consideration of existing policy, systematic reviews, and planned, ongoing, and recently published research.

Results:

A total of 375 respondents submitted 1735 priority research questions. The majority of respondents were from Africa; 55% self-identified as researchers. The final collated lists included 51 and 61 research questions for pediatric and adolescent HIV, respectively. The response rate for the second survey was 48%. The final research agendas include 5 priority research themes per area, discussed in 2 separate publications.

Conclusions:

To date, this is the largest example of the Child Health and Nutrition Research Initiative method in pediatric and adolescent HIV in terms of stakeholders reached, and the first to incorporate top thematic areas based on current evidence. Its impact on improving outcomes for these populations will require strong political and financial commitment.
Propelling the Pediatric HIV Therapeutic Agenda With Science, Innovation, and Collaboration
Authors: Abrams Elaine J. , Ananworanich Jintanat , Archary Moherndran , Ngongondo McNeil , Brouwers Pim
Published: July 2018

Background:

A number of well-described obstacles to the pediatric therapeutic agenda have resulted in substantial delays in the introduction of new medications, formulations, strategies, and approaches to treat infants, children, and adolescents living with HIV.

Setting:

Global landscape.

Methods:

The authors will provide a summary of current and emerging initiatives to accelerate the pediatric therapeutic agenda including illustrative case studies of innovations and scientific discovery in diagnosis and treatment of very young children with HIV infection.

Results:

The challenges posed by rapid physiologic and developmental changes that characterize the trajectory of childhood as well as the complex regulatory and fiscal milieu of HIV therapeutics have hampered pediatric HIV therapeutic research. Recent efforts to accelerate this agenda include prioritizing agents and formulations, defining dosing by weight bands, applying innovative study designs, synergizing work across research networks to achieve common goals, and the establishment of a global prioritized research agenda. A case study of initiatives to diagnose and effectively treat newborns and infants will illustrate the critical role of basic science research and novel approaches to study design and implementation that are informing global efforts to end AIDS.

Conclusions:

A pediatric therapeutic agenda informed by basic science and achieved through innovation and global cooperation is essential to achieve an AIDS-free generation.
Optimizing Clinical Trial Design to Maximize Evidence Generation in Pediatric HIV
Authors: Ford Deborah , Turner Rebecca , Turkova Anna , Penazzato Martina , Musiime Victor , Bwakura-Dangarembizi Mutsa , Violari Avy , Chabala Chishala , Puthanakit Thanyawee , Sudjaritruk Tavitiya , Cressey Tim R. , Lallemant Marc , Gibb Diana M.
Published: July 2018

For HIV-infected children, formulation development, pharmacokinetic (PK) data, and evaluation of early toxicity are critical for licensing new antiretroviral drugs; direct evidence of efficacy in children may not be needed if acceptable safety and PK parameters are demonstrated in children. However, it is important to address questions where adult trial data cannot be extrapolated to children. In this fast-moving area, interventions need to be tailored to resource-limited settings where most HIV-infected children live and take account of decreasing numbers of younger HIV-infected children after successful prevention of mother-to-child HIV transmission. Innovative randomized controlled trial (RCT) designs enable several questions relevant to children's treatment and care to be answered within the same study. We reflect on key considerations, and, with examples, discuss the relative merits of different RCT designs for addressing multiple scientific questions including parallel multi-arm RCTs, factorial RCTs, and cross-over RCTs. We discuss inclusion of several populations (eg, untreated and pretreated children; children and adults) in “basket” trials; incorporation of secondary randomizations after enrollment and use of nested substudies (particularly PK and formulation acceptability) within large RCTs. We review the literature on trial designs across other disease areas in pediatrics and rare diseases and discuss their relevance for addressing questions relevant to HIV-infected children; we provide an example of a Bayesian trial design in prevention of mother-to-child HIV transmission and consider this approach for future pediatric trials. Finally, we discuss the relevance of these approaches to other areas, in particular, childhood tuberculosis and hepatitis.
18F-FDG PET/CT in a Patient With Pregnancy and Lactation-Associated Osteoporosis
Authors: Chen Jinchuan , Wang Qian , Qiu Liheng
Published: July 2018

A 33-year-old woman in the 6th month postpartum and breast-feeding period suffered from acute thoracolumbar pain for 1 month. She presented with slightly decreased serum calcium level. Other laboratory assessments were unremarkable. Considering the worsening symptom and her strong demand to exclude potential malignancy, 18F-FDG PET/CT was performed. Multiple FDG-avid foci in the thoracic and lumbar vertebra were detected on FDG PET, corresponding to vertebral compression fractures on CT, and diffuse FDG uptake was seen within bilateral breast, and dual-X ray absorptiometry showed markedly decreased bone mineral density, all of which supported the diagnosis of pregnancy and lactation-associated osteoporosis.
To Use or Not to Use 131I in Thyroid Cancer
Authors: Metter Darlene , Phillips William T. , Walker Ronald C. , Blumhardt Ralph
Published: July 2018

Purpose

The purpose of the following commentary is to discuss recent controversies in the use of radioactive iodine for differentiated thyroid cancer (DTC).

Methods

R. M. Tuttle (Thyroid 2010; 20:257–263), at Memorial Sloan Kettering Cancer Center, has enumerated the well-accepted goals of radioactive iodine therapy (RAIT) in DTC: (1) ablate residual thyroid to facilitate future surveillance, (2) “adjuvant therapy” for residual radioactive iodine–avid disease, and (3) a post-RAIT scan may reveal unknown local and/or distant metastases. Using these goals as a guide, the authors have critically reviewed a recent movement to decrease the use of RAIT in DTC that is being advocated by some investigators.

Results

As a result, a recent article has highlighted this new treatment philosophy. A 2017 publication in the Journal of Clinical Oncology (Molenaar et al, 2017 0:JCO.2017.75.0232) recommends that RAIT not be used in low- or intermediate-risk DTC. In this article, the authors claim that the RAIT risks in DTC, particularly leukemia, outweigh its potential benefits. This change, if adopted, in our opinion will have profound deleterious consequences on patient outcomes. We also have identified a major problem with the article of Molenaar et al. The authors use the American Thyroid Association's criteria for staging thyroid cancer. In our opinion, this method of staging is severely flawed. We also quantitatively compare the article's alleged risk of RAIT-induced leukemia with the benefits of RAIT for DTC.

Conclusions

In summary, this matter must be debated before eliminating RAIT in low- or intermediate-risk DTC. If RAIT is eliminated for these patients, many such patients will no longer benefit from the RAIT goals listed by R. M. Tuttle, including the critical advantage of potentially improved overall and event-free survival.
Pineal Anaplastic Ependymoma With Multifocal Intradural Extramedullary Metastases on MRI and 18FDG-PET
Authors: Ben Bouallègue Fayçal , Vauchot Fabien , Menjot de Champfleur Nicolas , Mariano-Goulart Denis
Published: July 2018

A 49-year-old woman presented to the emergency room with subacute paraparesis associated with bilateral cervicobrachial neuralgia. Brain and spine MRI revealed a heterogeneous hypervascular pineal tumor and a multifocal thoracolumbar intradural-extramedullary infiltrate with signs of medullary compression. C7-T2 laminectomy was performed on the same day for medullary decompression, allowing for partial lesion excision. Histological examination was in favor of a poorly differentiated anaplastic ependymoma. Two weeks later, FDG-PET showed markedly increased uptake in the pineal mass and significant hypermetabolism of the spinal metastases.
FET PET in Primary Central Nervous System Vasculitis
Authors: Burghaus Lothar , Kabbasch Christoph , Deckert Martina , Ruge Maximilian I. , Fink Gereon R. , Langen Karl-Josef , Galldiks Norbert
Published: July 2018

Primary central nervous system vasculitis is confined to the brain and spinal cord. While serological markers of inflammation are usually normal, conventional angiography may confirm the diagnosis. The diagnostic method of choice is central nervous system biopsy. A 57-year-old man suffered from a first generalized epileptic seizure. MRI revealed a contrast-enhancing lesion, and O-(2-[18F]fluoroethyl)-l-tyrosine amino acid PET displayed increased metabolic activity, both findings highly suggestive of a malignant glioma. Surprisingly, histology obtained following stereotactic biopsy revealed small-vessel vasculitis.
Successful Intrathecal Baclofen Therapy for Intractable Paroxysmal Sympathetic Hyperactivity in Patient with Pontine Hemorrhage: A case report
Authors: Kim Hyeon Su , Kim Na Young , Kim Yong Wook
Published: July 2018

Paroxysmal sympathetic hyperactivity (PSH) is characterized by increased activity of the sympathetic nervous system. Although several treatments have been proposed for PSH, their efficacies are uncertain. We report a case of a patient with intractable PSH after pontine hemorrhage who was treated with intrathecal baclofen (ITB). A 61-year-old man was diagnosed with pontine hemorrhage expanding to the bilateral midbrain. Beginning 2 weeks after onset, he developed paroxysmal hyperthermia, tachycardia, tachypnea, hypertension, and generalized dystonic movements. Several medications were administered to the patient, including fentanyl patch, dantrolene, gabapentin, and β blockers. Nevertheless, PSH episodes continued to occur more than twice per day. Seven months after onset, we performed a trial of ITB injection, which led to reduced severity and frequency of PSH. Therefore, the ITB therapy was implanted. Continuous ITB was initiated at a rate of 100 μg/d, which was gradually increased up to 200 μg/d. Oral medications were tapered off. No PSH episode occurred for 4 weeks. Our findings suggest that ITB therapy may be used to manage intractable PSH. Intrathecal baclofen may inhibit postsynaptic activity and suppress sympathetic activity via the stimulation of γ-aminobutyric acid B receptors the brain.
Development and Validation of an Instrument Measuring Self-Care in Persons With a Fecal Ostomy
Authors: Collado-Boira Eladio J. , Machancoses Francisco H. , Temprado Maria Dolores
Published: July 2018

PURPOSE:

The purpose of this study was to describe development of the Specific Self-Care for Ostomized Patients Questionnaire (CAESPO) instrument and evaluate its construct validity, internal reliability, and test-retest reliability (temporal stability).

DESIGN:

Prospective evaluation of psychometric properties of the instrument.

SUBJECTS AND SETTING:

The study sample comprised 125 persons (n = 89, 71.2% men) with a temporary (n = 42, 33.6%) and permanent (n = 83, 66.4%) colostomy (n = 102, 81.6%) and ileostomy (n = 23, 18.4%). Their mean age was 66.72 years; all had undergone ostomy surgery at least 3 months prior to study participation. Participants were drawn from 4 acute care facilities in the province of Castellon, Spain.

INSTRUMENT:

The CAESPO Questionnaire is completed by a nurse or health care provider. It comprises 3 sections: the first queries sociodemographic data, the second queries pertinent clinical data, and the third contains 58 scored items with 4 ordinal responses. Possible cumulative scores ranged from 58 to 232 points; scores are reported based on a derived percentage score that varies from 0 to 100, where a score of 0 indicates lower self-care and 100 indicates a high level of self-care.

METHODS:

Data were collected at baseline and retesting was completed 6 months later. Internal consistency of the CAESPO was evaluated using the Cronbach α coefficient; temporal stability (test-retest reliability) was evaluated using the test-retest procedure; confirmatory factor analysis based on conceptually hypothesized factor structure was performed to evaluate construct validity.

RESULTS:

Initial assessment of the construct validity of the CAESPO using confirmatory factory analysis revealed a poor fit, resulting in removal of multiple items from each of the subscales owing to low-factor loading values. The final model comprised 58 scored items; it was found to have a good fit based on standard indices (χ2= 43.132, P < .001; root mean square error of approximation = 0.155 [0.107-0.204]; Bentler-Bonett normed fit index = 0.957; comparative fit index = 0.967; incremental fit index = 0.968), indicating adequate construct validity. The internal consistency of the CAESPO total score was acceptable at α = 0.889. Test-retest reliability (temporal stability) was deemed excellent (α = 0.987).

CONCLUSIONS:

Psychometric tests indicate that the CAESPO is a valid and reliable instrument for measuring self-care in persons living with a fecal ostomy.
Using Alternative Light Source Technology to Enhance Visual Inspection of the Skin
Authors: Owens Lisa , Warfield Tonnie , MacDonald Ryan , Krenzischek Erudina
Published: July 2018

BACKGROUND:

The identification of deep tissue pressure injury (DTPI) in the early stages of evolution presents a challenge, as skin compromise is only visually apparent when evidence of damage reaches its outer layers.

CASE DESCRIPTION:

We describe use of an alternative light source (ALS) to enhance visual skin assessment in 3 cases. Case 1 was a 47-year-old African American man with a hyperpigmented inner buttocks and a mixture of partial- and shallow full-thickness skin loss from incontinence-associated dermatitis and friction. Case 2 was a 62-year-old African American woman with a gluteal cleft DTPI. Case 3 was a 57-year-old African American woman with a stage 3 pressure injury of the right buttock.

CONCLUSION:

The ALS enabled visualization of skin nuances not visible to the unaided eye. Based on this experience, we conclude that use of an ALS provided additional visual details when compared to traditional visual inspection. We found that as the ALS interplays with skin layers, penetrating and absorbing at differing depths, compromised skin appeared darker and more distinct when compared to adjacent, intact skin. Additional research is needed to determine whether the ALS enables earlier pressure injury detection, timelier and more effective intervention, decreased morbidity, and cost savings.
Towards fast and reliable simultaneous EEG-fMRI analysis of epilepsy with automatic spike detection
Authors: Omidvamia Amir , Kowalczyk Magdalena A. , Pedersen Mangor , Jackson Graeme D.
Published: July 2018

Objective

The process of manually marking up epileptic spikes for simultaneous electroencephalogram (EEG) and resting state functional MRI (rsfMRI) analysis in epilepsy studies is a tedious and subjective task for a human expert. The aim of this study was to evaluate whether automatic EEG spike detection can facilitate EEG-rsfMRI analysis, and to assess its potential as a clinical tool in epilepsy.

Methods

We implemented a fast algorithm for detection of uniform interictal epileptiform discharges (IEDs) in one-hour scalp EEG recordings of 19 refractory focal epilepsy datasets (from 16 patients) who underwent a simultaneous EEG-rsfMRI recording. Our method was based on matched filtering of an IED template (derived from human markup) used to automatically detect other ‘similar’ EEG events. We comprehensively compared simultaneous EEG-rsfMRI results between automatic IED detection and standard analysis with human EEG markup only.

Results

In contrast to human markup, automatic IED detection takes a much shorter time to detect IEDs and export an output text file containing spike timings. In 13/19 focal epilepsy cases, statistical EEG-rsfMRI maps based on automatic spike detection method were comparable with human markup, and in 6/19 focal epilepsy cases it revealed additional brain regions not seen with human EEG markup. Additional events detected by our automated method independently revealed similar patterns of activation to a human markup. Overall, automatic IED detection provides greater statistical power in EEG-rsfMRI analysis compared to human markup in a short timeframe.

Conclusions

Automatic spike detection is a simple and fast method that can reproduce comparable and, in some cases, even superior results compared to the common practice of manual EEG markup in EEG-rsfMRI analysis of epilepsy.

Significance

Our study shows that IED detection algorithms can be effectively used in epilepsy clinical settings. This work further helps in translating EEG-rsfMRI research into a fast, reliable and easy-to-use clinical tool for epileptologists. Our IED detection approach will be publicly available as a MATLAB package at: https://github.com/omidvarnia/Automatic_focal_spike_detection.

Highlights

Automatic spike detection increases the number of detected uniform epileptic interictal discharges and enhances statistical power of EEG-rsfMRI inter-subject variability maps,

Automatic spike detection can identify additional activated brain regions with presumed epileptogenic focus not seen in standard analysis based on human markup,

Automatic spike detection can shorten the IED identification process.
Dynamic Distribution Decomposition for Single-Cell Snapshot Time Series Identifies Subpopulations and Trajectories during iPSC Reprogramming
Authors: Taylor-King Jake P. , Riseth Asbjørn N. , Claassen Manfred
Published: July 2018

Recent high-dimensional single-cell technologies such as mass cytometry are enabling time series experiments to monitor the temporal evolution of cell state distributions and to identify dynamically important cell states, such as fate decision states in differentiation. However, these technologies are destructive, and require analysis approaches that temporally map between cell state distributions across time points. Current approaches to approximate the single-cell time series as a dynamical system suffer from too restrictive assumptions about the type of kinetics, or link together pairs of sequential measurements in a discontinuous fashion.

We propose Dynamic Distribution Decomposition (DDD), an operator approximation approach to infer a continuous distribution map between time points. On the basis of single-cell snapshot time series data, DDD approximates the continuous time Perron-Frobenius operator by means of a finite set of basis functions. This procedure can be interpreted as a continuous time Markov chain over a continuum of states. By only assuming a memoryless Markov (autonomous) process, the types of dynamics represented are more general than those represented by other common models, e.g., chemical reaction networks, stochastic differential equations. Additionally, the continuity assumption ensures that the same dynamical system maps between all time points, not arbitrarily changing at each time point. We demonstrate the ability of DDD to reconstruct dynamically important cell states and their transitions both on synthetic data, as well as on mass cytometry time series of iPSC reprogramming of a fibroblast system. We use DDD to find previously identified subpopulations of cells and to visualize differentiation trajectories.

Dynamic Distribution Decomposition allows interpreting high-dimensional snapshot time series data as a low-dimensional Markov process, thereby enabling an interpretable dynamics analysis for a variety of biological processes by means of identifying their dynamically important cell states.

Author summary

High-dimensional single-cell snapshot measurements are now increasingly utilized to study dynamic processes. Such measurements enable us to evaluate cell population distributions and their evolution over time. However, it is not trivial to map these distribution across time and to identify dynamically important cell states, i.e. bottleneck regions of state space exhibiting a high degree of change. We present Dynamic Distribution Decomposition (DDD) achieving this task by encoding single-cell measurements as linear combination of basis function distributions and evolving these as a linear system. We demonstrate reconstruction of dynamically important states for synthetic data of a bifurcated diffusion process and mass cytometry data for iPSC reprogramming.
Application of clinical genomic sequencing among Chinese advanced cancer patients to guide precision medicine decisions
Authors: Jiao Shunchang , Bai Yuxian , Dai Chun , Xu Xiaoman , Cai Xin , Wang Guan , Wei Jinwang , Wu Bing , Sun Wending , Xu Qiang
Published: July 2018

Purpose

A number of studies have suggested that high-throughput genomic analyses might improve the outcomes of cancer patients. However, whether integrative information about genomic sequencing and related clinical interpretation may benefit Chinese cancer patients with stage IV disease to date has not investigated.

Methods

Targeted gene panel and whole exome of tumor/blood samples in > 1,000 Chinese cancer patients were sequenced. Then we provided patients and their oncologists with the sequencing results and a clinical recommendation roadmap based on evidence-based medicine, defined as CWES. Only patients with stage IV disease who failed the previous treatment upon receiving the CWES reports were included for analyzing the impact of CWES on clinical outcomes in 1-year follow-ups.

Results

We identified the mutational signatures of 953 Chinese cancer patients, with some being unique. Approximately 88.6% of patients had clinically actionable somatic genomic alterations. We successfully followed up 22 stage IV patients. Of these, 11 patients treatment followed the CWES reports defined as group A. Eleven patients received the next treatment, but did not follow the CWES suggestions, and are defined as group B. The types of therapies before CWES were similar in the two groups. The median PFS of group A was 12 months and 45% patients failed this round of therapy. The median PFS of group B was 4 months and 91% of patients failed the treatment.

Conclusion

The current study suggested that CWES has the potential to help explore the clinical benefits in multiple line therapies among advanced stage tumor patients.
The draft genome sequence of mandrill (Mandrillus sphinx)
Authors: Yin Ye , Yang Ting , Liu Huan , Huang Ziheng , Zhang Yaolei , Song Yue , Wang Wenliang , Kristiansen Karsten
Published: July 2018

Background

Mandrill (Mandrillus sphinx) is a primate species which belong to Old World monkey (Cercopithecidae) family. It is closely related to human, serving as model for some human diseases researches. However, genetic researches and genomic resources of mandrill were limited, especially comparing to other primate species.

Findings

Here we sequenced 284 Gb data, providing 96-fold coverage (considering the estimate genome size of 2.9 Gb), to construct a reference genome for mandrill. The assembled draft genome was 2.79 Gb with contig N50 of 20.48 Kb and scaffold N50 of 3.56 Mb. We annotated the mandrill genome to find 43.83% repeat elements, as well as 21,906 protein coding genes. We found good quality of the draft genome and gene annotation by BUSCO analysis which revealed 98% coverage of the BUSCOs.

Conclusions

We established the first draft genome sequence of mandrill, which is valuable resource for future evolutionary and human diseases studies.
Coxiella burnetiiblocks intracellular IL-17 signaling in macrophages
Authors: Clemente Tatiana M. , Mulye Minal , Justis Anna V. , Nallandhighal Srinivas , Tran Tuan M. , Gilk Stacey D.
Published: July 2018

Coxiella burnetiiis an obligate intracellular bacterium and the etiological agent of Q fever. Successful host cell infection requires theCoxiellaType IVB Secretion System (T4BSS), which translocates bacterial effector proteins across the vacuole membrane into the host cytoplasm, where they manipulate a variety of cell processes. To identify host cell targets ofCoxiellaT4BSS effector proteins, we determined the transcriptome of murine alveolar macrophages infected with aCoxiellaT4BSS effector mutant. We identified a set of inflammatory genes that are significantly upregulated in T4BSS mutant-infected cells compared to mock-infected cells or cells infected with wild type (WT) bacteria, suggestingCoxiellaT4BSS effector proteins downregulate expression of these genes. In addition, the IL-17 signaling pathway was identified as one of the top pathways affected by the bacteria. While previous studies demonstrated that IL-17 plays a protective role against several pathogens, the role of IL-17 duringCoxiellainfection is unknown. We found that IL-17 kills intracellularCoxiellain a dose-dependent manner, with the T4BSS mutant exhibiting significantly more sensitivity to IL-17 than WT bacteria. In addition, quantitative PCR confirmed increased expression of IL-17 downstream signaling genes in T4BSS mutant-infected cells compared to WT or mock-infected cells, including the pro-inflammatory cytokinesI11a, Il1bandTnfa, the chemokinesCxcl2andCcl5, and the antimicrobial proteinLcn2. We further confirmed that theCoxiellaT4BSS downregulates macrophage CXCL2/MIP-2 and CCL5/RANTES protein levels following IL-17 stimulation. Together, these data suggest thatCoxielladownregulates IL-17 signaling in a T4BSS-dependent manner in order to escape the macrophage immune response.
Noninvasive Vagus Nerve Stimulation Alters the Neural and Physiological Response to Noxious Thermal Challenge
Authors: Lerman Imanuel , Davis Bryan , Huang Mingxiong , Huang Charles , Sorkin Linda , Proudfoot James , Zhong Edward , Kimball Donald , Rao Ramesh , Simon Bruce , Spadoni Andrea , Strigo Irina , Baker Dewleen G , Simmons Alan N
Published: July 2018

The mechanisms by which noninvasive vagal nerve stimulation (nVNS) affect central and peripheral neural circuits that subserve pain and autonomic physiology are not clear, and thus remain an area of intense investigation. Effects of nVNS vs sham stimulation on subject responses to five noxious thermal stimuli (applied to left lower extremity), were measured in 30 healthy subjects (n=15 sham and n=15 nVNS), with fMRI and physiological galvanic skin response (GSR). With repeated noxious thermal stimuli a group × time analysis showed a significantly (p < .001) decreased response with nVNS in bilateral primary and secondary somatosensory cortices (SI and SII), left dorsoposterior insular cortex, bilateral paracentral lobule, bilateral medial dorsal thalamus, right anterior cingulate cortex, and right orbitofrontal cortex. A group × time × GSR analysis showed a significantly decreased response in nVNS group (p < .0005) in bilaterally in SI, lower and mid medullary brainstem, and inferior occipital cortex. Finally, nVNS treatment showed decreased activity in pronociceptive brainstem nuclei (e.g. the reticular nucleus and rostral ventromedial medulla) and key autonomic integration nuclei (e.g. the rostroventrolateral medulla, nucleus ambiguous, and dorsal motor nucleus of the vagus nerve). In aggregate, noninvasive vagal nerve stimulation reduced the physiological response to noxious thermal stimuli and impacted neural circuits important for pain processing and autonomic output.
Dynamics of the p53 response to ionizing and ultraviolet radiation
Authors: Fedak Elizabeth A. , Adler Frederick R. , Young Erin L. , Abegglen Lisa M. , Schiffman Joshua D.
Published: July 2018

The tumor suppressor protein p53 compiles information about cellular stressors to make decisions on whether the cell should survive or undergo apoptosis. However, the p53 response depends on the source of damage, displaying a ‘digital’ oscillatory response after ionizing radiation (IR) damage and a proportional non-oscillatory response following UV damage. We propose a mathematical model that qualitatively replicates this observed behavior. The difference in p53 dynamics in the model results from two mechanisms: IR damage is fully detected minutes after exposure while UV damage is detected over several hours; and the p53-controlled transcriptional response is dominated by inactive p53 following UV damage. In particular, we hypothesize that an unidentified positive feedback loop controlled by inactive p53 is required to maintain the qualitative high p53 response to UV damage. This work proposes an explanation for two distinct responses of p53 to DNA damage and how each response can lead to cell cycle arrest or apoptosis.

Author summary

We propose a mathematical model hypothesizing how the tumor suppressor protein p53 produces two contrasting dynamical responses in response to different types of DNA damage. In particular, we predict the existence of a positive feedback loop controlled by the inactive form of p53, which allows the cell to respond to slowly detected damage. The existence of differing dynamic responses by p53 has implications for our understanding of tumor development and possibly p53-related therapeutic strategies.
Posttranscriptional regulation of intestinal epithelial cell repair by RNA binding protein IMP1
Authors: Chatterji Priya , Whelan Kelly A. , Andres Sarah F. , Samper Fernando C. , Simon Lauren A. , Mizuno Rei , Lundsmith Emma T. , Lee David S.M. , Liang Shun , Wijeratne H.R. Sagara , Marti Stefanie , Chau Lillian , Williams Patrick A. , Giroux Veronique , Wilkins Benjamin J. , Wu Gary D. , Shah Premal , Tartaglia Gian G. , Hamilton Kathryn E.
Published: July 2018

RNA binding proteins, such as IMP1, are emerging as essential regulators of intestinal development and cancer. IMP1 hypomorphic mice exhibit severe intestinal growth defects, yet it’s role in adult intestinal epithelium is unclear. We employed ribosome profiling to test the effect of IMP1 loss on the “translatome” in colon cancer cell lines. In parallel, we evaluated mice with intestinal epithelial-specific Imp1 deletion (Imp1ΔIEC) following irradiation or colitis models. Ribosome-profiling revealed translation efficiency changes for multiple pathways important for intestinal homeostasis, including autophagy, in IMP1 knockout cells. We found increased autophagy flux in Imp1ΔIEC mice, reinforced through in silico and biochemical analyses revealing direct binding of IMP1 to autophagy transcripts MAP1LC3B and ATG3. We found that Imp1ΔIEC mice exhibit enhanced recovery following irradiation, which is attenuated with genetic deletion of autophagy gene Atg7. Finally, we demonstrated that IMP1 is upregulated in Crohn’s disease patients and Imp1 loss lessened colitis severity in mice. These studies demonstrate that IMP1 acts as a posttranscriptional regulator of gut epithelial repair post-irradiation and colitis, in part through modulation of autophagy.
Price-based quality inferences for insects as food
Authors: Berger Sebastian , Christandl Fabian , Schmidt Christina , Baertsch Christian
Published: July 2018

Purpose

Entomophagy (i.e. human insect consumption) is seen as one promising route to substantially reduce food-related carbon footprints as insects can be produced at a fraction of the carbon emitted by traditional Western meat production (e.g. beef, pork, poultry). In this light, the purpose of this paper is to address how prices may affect preferences for insects as food.

Design/methodology/approach

Drawing on consumer research on “positive” functions of prices (e.g. the widely held belief that price and quality are positively correlated), the authors present two behavioural experiments that manipulated price cues to estimate the effect on expectations, eating behaviour and willingness-to-pay as central preference indicators.

Findings

Consistent with the predictions, high prices as initial anchors positively affect food preferences. Furthermore, they incur a positive spill-over effect to subsequent consumption of insects that are unprocessed (i.e. truffles in which mealworms are visible in their entity) and for which no price information is available. Additionally, the authors show that the positive effects of high prices on preferences are muted if prices are artificially lowered (e.g. by means of government subsidies, Experiment 2).

Practical implications

Taken together, the authors show that preferences for novel foods such as insects can be promoted by systematically taking into account behavioural economic theories. This suggests that behavioural theory can be used to reap environmental benefits of entomophagy.

Originality/value

This research links behavioural economics with the actual consumption of insects and therefore complements survey research on behavioural intentions.
Customer influence on supply chain management strategies
Authors: Brun Alessandro , Karaosman Hakan
Published: July 2018

Purpose

Customers influence companies’ operational strategies and supply chain (SC) processes. In this vein, signals coming from the market must be translated into proper strategies in terms of production and supply. The purpose of this paper is to provide an understanding on how to transform customers’ expectations into SC decisions. The yacht industry, encompassing both technical and emotional peculiarities, becomes this study’s driven focus to interrogate the interrelationship between supply and demand.

Design/methodology/approach

The study explores the luxury yacht industry through exploratory case studies conducted with eight companies operating in Italy.

Findings

It was found that a wide range of factors influenced customers. That is to say, brand reputation, other brands’ involvement in the final product and emotional appeal were the most distinguishing characteristics identifying emotion-oriented customers. In this sense, companies serving such customers adjusted their SC strategies to channel a direct emotional impact. It was noticed that personalization was pivotal and companies were increasingly required to customize and create unique products to attract and further satisfy the customers. Thus, multiple sourcing strategies were often employed with an increasing number of suppliers to ensure that increasing material supply need would be met. As for performance-oriented companies, cost, quality and innovation capabilities emerged as key signals to be embedded in operations management. Companies serving performance-oriented customers were characterized by low product value and medium level of customization, and kept their core activities, including design and architecture, vertically integrated. In order to generate cost advantages without compromising product quality, single sourcing strategy was largely implemented. What the findings suggested is that the customization level and the product value were positively correlated. To illustrate, companies having more exclusive products were found allowing their customization and customer involvement in higher degrees.

Originality/value

Due to a relatively unexplored nature of the phenomenon, this study opted for a method by which individual and collective reconstructions were explored in a not well-investigated area, that is, the luxury yacht industry.
The effects of soybean trade policies on domestic soybean market in China during the food crisis
Authors: Sun Lin , Qi Mingxian , Reed Michael R.
Published: July 2018

Purpose

Many grain exporting/importing countries implement temporary trade policies to intervene in grain trade volume during food crises. The purpose of this paper is to analyze the effects of Chinese soybean trade policies on the domestic soybean market during the food crisis.

Design/methodology/approach

A Markov switching error correction model is constructed for the empirical analysis. Market integration, market equilibrium and market stability are compared among three regimes: the normal state, crisis state and post-crisis state. In order to reduce the disturbance from external markets factors on the results, the US soybean market is selected as a control group in that it did not use any soybean intervention trade policies during the food crisis.

Findings

The empirical results indicate that China’s temporary soybean trade policies lead to a decrease in market integration between domestic and international soybean markets and a reduction in domestic soybean market stability.

Originality/value

It is the first time that China’s soybean market is selected as a sample and case on this issue. The regime shifting non-linear model could be more applicable because there exists a non-linear transmission relationship between grains markets during food crises. The results imply that China’s temporary soybean trade policies do not improve market integration and stability. China should reconsider implementing soybean trade intervening policies to protect the domestic market and safeguard food security.
Job satisfaction and union participation in China
Authors: Hu Enhua , Zhang Maolong , Shan Hongmei , Zhang Long , Yue Yaqing
Published: July 2018

Purpose

The purpose of this paper is to offer empirical evidence on whether and how the work experiences of employees in China influence their union-related attitudes and behaviours.

Design/methodology/approach

The authors developed a mediated moderation model to examine how job satisfaction and labour relations climate interactively affect union participation and whether union commitment mediates the interactive effects. A total of 585 employees from enterprises in Jiangsu, Zhejiang, Anhui, Jiangxi and Fujian province of China were surveyed to verify the model.

Findings

Job satisfaction was negatively related to union participation and union commitment. Labour relations climate moderated the relationship between job satisfaction and union participation; the relationship was negative and stronger when employees perceived an adverse, rather than a favourable, labour relations climate. Further, the interactive effect of job satisfaction and labour relations climate on union participation was partly mediated by union commitment.

Originality/value

By empirically examining employees’ attitudes and behaviours towards unions in the Chinese context, this study confirms that unions could provide employees with alternative work resources to cope with job dissatisfaction, even in a country where unions play a “transmission belt” role between employees and employers. This study adds value to the existing base of knowledge on union practice and labour relations construction, both inside and outside of China.
Stakeholders’ responses to school-based management in Indonesia
Authors: Bandur Agustinus
Published: July 2018

Purpose

The purpose of this paper is to explore the key determinants of effective school-based management (SBM) for improved teaching−learning environments and student achievements, while identifying the major reasons as to why poor implementation of SBM is associated with lower student achievements.

Design/methodology/approach

Both dimensions of quantitative and qualitative research were applied for the purpose of this study with active participation of 334 school stakeholders, including principals, teachers, parents, and school council members. In addition to the survey, 33 Interviews and FGDs were conducted with the participation of 61 key informants. These were followed by an examination of school documents, including students’ national examination results.

Findings

This study concludes that SBM drives the emergence of decision-making authority of principals, the presence of participatory school decision-making, and high involvement of school council for better teaching and learning environments. In turn, effective implementation of SBM policy is associated with healthier teaching−learning environment and better student academic achievements. However, less effective implementation of SBM is due to lack of proper understanding of the school stakeholders that resulted in lower academic achievement.

Practical implications

Adequate provisions of training on the part of school council members and school principals are required for significant results of SBM policy and programs for improved teaching–learning environment and increased student achievements. The training focuses on, among others: school leadership, school development planning and changing roles of school leaders under SBM reform.

Originality/value

This study builds on global and Indonesian developments of the decentralized education through SBM model. This study is highly significant in addressing the current debates in existing literature about whether or not SBM has resulted in school improvements and higher student achievements. Practically, this study provides adequate insight to educational leaders, policy makers and international donor agencies in demonstrating why SBM is effective in particular school settings as well as why SBM policy and programs are not effectively implemented in other schools that resulted in lower student achievements.
Lean Six Sigma in developing countries: evidence from a large Brazilian manufacturing firm
Authors: Scheller Alisson Christian , Sousa-Zomer Thayla T. , Cauchick-Miguel Paulo A.
Published: July 2018

Purpose

Although the literature on Lean Six Sigma (LSS) implementation has evolved, a deeper understanding of the LSS practices applied in organisations in developing countries is needed. This paper aims to analyse LSS in a manufacturing company in the context of LSS implementation in an emerging economy.

Design/methodology/approach

This paper uses case-based research. Data collected in a large manufacturing company through multiple sources of evidence were triangulated to derive the findings. This paper analyses aspects related to the implementation of both programmes and their synergy, as well as some critical and failure factors.

Findings

The main results show that Lean and Six Sigma are applied separately in two different programmes. Some aspects that are necessary to increase the integration of both approaches were identified while considering each phase of the DMAIC and the current approach applied by the company. Although some positive results have been achieved, there are many critical and failure factors that may influence the implementation of both approaches, such as employee training and changes in the organisational environment. Finally, the comprehensive integration of both approaches needs to be undertaken by the company.

Research limitations/implications

The findings from this single case study cannot be generalised.

Practical implications

This paper may be used as a guiding reference for managers and consultants to help them when working towards more successful LSS implementation.

Originality/value

First, this paper investigates LSS in a manufacturing firm located in a developing country; this issue is still seldom addressed in the literature. Second, it may contribute to practitioners’ knowledge by delivering insights into a real context, as well as the relevant issues to be addressed when implementing LSS in similar contexts.
Predicting cross-cultural intentions to engage in physical activity
Authors: Saqib Najam Us
Published: July 2018

Purpose

This research identifies cross-cultural differences between perception and behavioral intentions of Western and South Asian consumers to engage in physical activity. The theory of planned behavior is applied. It aims to provide insights to healthcare marketers and managers to address the problems of being overweight and obese in South Asia.

Design/methodology/approach

Path analysis was used to conduct this research. Two online questionnaires were used to collect data from South Asian and North American respondents. Cross-cultural differences were identified based on results from structural equation models.

Findings

Path analysis shows that the theory of planned behavior effectively predicted the behavioral intentions of North American and South Asian respondents. South Asians are more strongly influenced by subjective norms and perceived behavioral control in their intentions to engage in physical activity. On the other hand, North Americans are more strongly influenced by their attitudes.

Practical implications

A consistent campaign to increase awareness about the risks of being overweight and obese will be necessary in South Asian countries to address this problem. Healthcare marketers need to emphasize marketing messages that lead to positive attitudes toward a healthy lifestyle in society and form public opinion such that it increases the role of social norms.

Originality/value

The research establishes the utility of the theory of planned behavior for South Asian populations. It identifies cross-cultural differences in terms of how behavioral intentions to engage in physical activity are formed in North American and South Asian populations. The findings are relevant to healthcare service managers and marketers in South Asia.