bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between local government economic freedom and bond ratings
Authors: Dove John
Published: September 2017

Purpose

With a newly developed measure of economic freedom across US local government jurisdictions, this paper aims to estimate the relationship between economic freedom and bond ratings.

Design/methodology/approach

The author uses a battery of cross-sectional econometric models to identify the impact that economic freedom might have on bond ratings using a sample of US municipal governments.

Findings

Overall, the results indicate that relatively more economic freedom within a local jurisdiction is associated with higher bond ratings and thus lower borrowing costs. However, similar to Roychoundhury and Lawson (2010), no specific subcomponent seems to affect bond ratings.

Originality/value

To the author’s knowledge this is the first scholarly work to address this topic at the local level.
Parametric optimization of wt.% Y2O3 modified chromium-aluminide coatings using utility concept-based Taguchi approach
Authors: Hussein Abbas Khammas
Published: September 2017

Purpose

The purpose of this paper is to obtain a single setting (optimal setting) of various input parameters of pack cementation process, i.e. halide salt activator, powder of master alloy and wt% of Y2O3 to obtain a single output characteristic as a whole namely resistance of hot corrosion for T91 steel.

Design/methodology/approach

The multi-criterion methodology based on Taguchi approach and utility concept has been used for optimization of the multiple performance characteristics namely hot corrosion rate KP1, KP2 and KP3 for pack cementation coated T91 steel in chlorine and vanadium environment.

Findings

All the three pack cementation parameters, namely, halide salt activator, powder of master alloy and wt% of Y2O3 had a significant effect on the utility function based on analysis of variance for multiple performances. The percentage contribution of halide activator (1.54 percent), master alloy powder (4.66 percent) and wt% Y2O3 (93.79 percent). The results indicated the beneficial influence of yttrium on the chemical stability of the protective layer in presence of chlorine and vanadium environments. The optimal parameter settings obtained in this study is A2B2C1, i.e. halide salt activator (NaCl), powder of master alloy (92Cr-8Al) and 1wt% of Y2O3.

Research limitations/implications

The outcome of this study shall be useful to explore the possible use of the developed coating for high temperature components. Unfortunately, the pack cementation was normally limited by the diffusion and reaction kinetics involved, which has a detrimental effect on the mechanical properties of work pieces. Therefore, reducing pack cementation temperature is required for widespread application of the pack coatings.

Social implications

Pack coating at optimum conditions can be used for surface coating technologies to economically improve high temperature oxidation, corrosion resistance of components.

Originality/value

The multi-criterion methodology based on Taguchi approach and utility concept has been used for first time for parametric optimization of wt% Y2O3 modified chromium- aluminide coatings for T91 steel.
Tie strength, absorptive capacity and innovation performance in Chinese manufacturing industries
Authors: Liu Xueyuan , Shen Muzhen , Ding Wenjing , Zhao Xiande
Published: September 2017

Purpose

In innovation networks, firm innovation performance is affected by external tie strength and internal knowledge absorptive capacity. This study aims to empirically examine the path relationship between tie strength, absorptive capacity and firm innovation performance in Chinese manufacturing industries, thus enhance our understanding on the mechanism between innovation network and innovation performance.

Design/methodology/approach

The authors have conducted a survey among Chinese manufacturers in four industries (textile and garment, household appliance, IT and electronics and motor vehicle assemblers) that are located in North, East, Central and South China, respectively, with a valid response from 278 manufacturers. Structural equation model is used to analyze the results.

Findings

This study demonstrates that in Chinese Manufacturing industry, tie strength is positively related to innovation performance. The authors also find that absorptive capacity has a positive impact on innovation performance and it mediates the relationship between tie strength and innovation performance. Then, the authors analyze the effect of ownership, industry and sub-region, and the results show that in private firms and traditional manufacturers, and the firms located in North and Eastern China, tie strength has no direct effect on innovation outcomes, but it can influence innovation indirectly through absorptive capacity.

Originality/value

This study further supports that in Chinese guanxi culture, strong ties with other innovation partners can improve the firm’s absorptive capacity and thus improve innovation performance. The results also suggest that a firm’s absorptive capacity has a significant mediating effect on the relationship between tie strength and innovation performance.
What explains the investment anomaly in the Chinese stock market?
Authors: Chen Jieting
Published: September 2017

Purpose

This paper aims to examine the Chinese investment anomaly and dissect it from a perspective of rational expectation framework.

Design/methodology/approach

Characteristic-based sorting and Fama–MacBeth two-stage cross-sectional regression are adopted to test the relationship between corporate investment and expected returns in both portfolio and individual stock levels. Under the framework of pricing kernels, an investment-based common risk factor is constructed to test the role of risk played in the negative investment-return relationship. Moreover, a Markov regime switching model is adopted to investigate the time-varying risk premium across market regimes.

Findings

Empirical results provide ample evidence showing that there is a negative relationship between investment and expected returns in the Chinese stock market. The new investment-based risk factor is found to capture the return differences across characteristic-based portfolios. In addition, risk premium of the new risk factor is not only statistically positive throughout the sample period, but also has an asymmetry that is higher during market downturn but lower under bull market.

Research limitations/implications

This paper merely tests the hypotheses derived from rational school.

Practical implications

Investment strategies based on characteristic-sorted portfolios should be adjusted to different market regimes.

Originality/value

First, this paper provides comprehensive empirical results by adopting different methodologies for investigating the investment anomaly in China. Second, an investment-based factor is constructed specifically for the Chinese stock market for the first time. Finally, this is the first paper to investigate the asymmetric risk premium across the Chinese bear and bull regimes by using a multivariate Markov regime switching model.
Maternal egg hormones in the mating context: The effect of pair personality
Authors: Ruuskanen Suvi , Groothuis Ton G. G. , Baugh Alexander T. , Schaper Sonja V. , de Vries Bonnie , van Oers Kees
Published: September 2017

Animal personality traits emerge developmentally from the interaction of genetic and early environmental factors. Maternal hormones, such as androgens (testosterone, T and androstenedione, A4), transferred to embryos and egg yolks may simultaneously organize multiple behavioural and physiological traits. Although previous studies demonstrated an association between the mother's personality and yolk androgen levels, the independent effects of the male partner's personality and pair combination remains unknown.

We test this association using an ecological model species for personality research, the great tit (Parus major) using multiple approaches: (1) a wild population, (2) a randomly mated captive population and (3) an experimental study with (dis)assortatively mated pairs from lines selected for fast exploration/boldness or slow exploration/shyness.

Egg androgen concentrations were associated with variation in female personality traits, and the experimental data suggested that this is independent of male personality: Experimental females from the slow‐shy line tended to have higher egg T concentrations than females from the fast‐bold line, with no effect of male personality. Shy females from the wild population had higher egg A4 concentration than bold females. However, in the correlative data yolk hormones were linked with male personality, as well as the interaction between female and male traits: Male handling responsiveness correlated negatively with egg A4 concentration in wild birds. In randomly mated birds, pairs that were mated assortatively for personality had lower egg T concentrations than disassortatively mated pairs.

Given that egg androgens are known mediators of avian personality, our results suggest that maternal hormones might contribute to the heritability of personality, may be sensitive to the social context of mating, and act as key drivers of individual differences.

Aplain language summaryis available for this article.
Administrative Justice in the Wake of I, Daniel Blake
Authors: O'Brien Nick
Published: September 2017

This article argues that Ken Loach's film, I, Daniel Blake, invites deep reflection on the relationship between the individual and the state, and, more particularly, on the role of administrative justice in restoring a re‐imagined sense of citizenship. Drawing on earlier debates from the 1950s, as well as on more recent advocacy of the ‘connected society’, the article proposes that to meet such an ambition, administrative justice must be recognised as an overarching set of principles and values, rooted in a framework of human rights and with a reinvigorated public‐sector ombud‐institution at its centre. In this way, administrative justice might serve as an effective and restorative counterweight to more legalistic options for responding to public grievance, whether the result of routine encounters with the state or of a major breakdown in trust, such as that occasioned by ‘Grenfell Tower’.
Statistical and Hybrid Methods Implemented in a Web Application for Predicting Reservoir Inflows during Flood Events
Authors: Zhao Tingting , Minsker Barbara , Salas Fernando , Maidment David , Diev Vesselin , Spoelstra Jacob , Dhingra Prashant
Published: September 2017

Reservoir management is a critical component of flood management, and information on reservoir inflows is particularly essential for reservoir managers to make real‐time decisions given that flood conditions change rapidly. This study's objective is to build real‐time data‐driven services that enable managers to rapidly estimate reservoir inflows from available data and models. We have tested the services using a case study of the Texas flooding events in the Lower Colorado River Basin in November 2014 and May 2015, which involved a sudden switch from drought to flooding. We have constructed two prediction models: a statistical model for flow prediction and a hybrid statistical and physics‐based model that estimates errors in the flow predictions from a physics‐based model. The study demonstrates that the statistical flow prediction model can be automated and provides acceptably accurate short‐term forecasts. However, for longer term prediction (2 h or more), the hybrid model fits the observations more closely than the purely statistical or physics‐based prediction models alone. Both the flow and hybrid prediction models have been published as Web services through Microsoft's Azure Machine Learning (AzureML) service and are accessible through a browser‐based Web application, enabling ease of use by both technical and nontechnical personnel.
In situ measurements of animal morphological features: A non‐invasive method
Authors: Mahendiran Mylswamy , Parthiban Mylswamy , Azeez Parappurath Abdul , Nagarajan Rajarathinavelu
Published: September 2017

Measurements of morphological features are important for ecological studies, especially on free‐ranging wild animal species. Conventionally, specimens either dead or in captivity are used for morphometric studies, which is difficult in the case of wild species for several reasons. Capturing would be even futile when research questions are relating to issues such as prey size selection or estimation of intake rate under field conditions, where in situ morphometric measurements are inevitable. Remotely estimating morphometric features via, avian bill and head lengths are always laden with wide variances. Hence, we developed this technique for in situ measurements of animal morphology through digital photographs.

This non‐invasive novel method for in situ estimation of individuals’ morphometric measurements uses digital photographs’ metadata. We extracted the metadata (field of view, focal length, subject‐distance, etc.,) in exchangeable image file format from digital images using freely available software, and the unknown sizes were estimated from each image. Cardboard (fish) models were, at first, used to estimate the accuracy of measurements comparing actual and estimated values, and the same protocol was repeated on museum specimens (bird). Finally, we checked the repeatability of this method under field conditions using free‐ranging Chickens (Gallus gallus domesticus). The results under different conditions were subjected to rigorous statistical testing.

Upon comparing the actual with estimated values, obtained from three distinct types of objects (1. Cardboard model, 2. Museum specimens and 3. Live birds under field conditions), variations were found non‐significant affirming the assumption that actual value (Y) = estimated value (X) with inconsequential variance of the Y from X. Moreover, both the relative and absolute errors between the actual and estimated values were so low, indicating that this method yielded neither overestimation nor underestimation.

The advantage of this non‐invasive method is that it could generate reasonably accurate morphometric measurements at a relatively low cost for routine morphometric works in field conditions. We envisage significant utility of this non‐invasive technique in different fields of science such as biology, morphology, ecology, evolution, wildlife, conservation science, agriculture, forensics and engineering design.
A simplified mark–release–recapture protocol to improve the cost effectiveness of repeated population size quantification
Authors: Turlure Camille , Pe'er Guy , Baguette Michel , Schtickzelle Nicolas
Published: September 2017

Obtaining an accurate quantification of population size is often of prime importance in ecology and conservation biology (e.g. population viability analysis, a basic step for assessing species and population status in a given area and guiding effective conservation). When obtaining a reliable quantification of absolute (vs. relative) population size is required, Mark–Release–Recapture (MRR) is a method of choice for many organisms. This is a highly reliable but costly procedure in terms of time and potential impact on species and sites. Consequently, less costly alternatives are highly desirable for conservation and population ecologists.

We present here a simplifiedMRRprotocol to mitigate this cost of repeatedMRRsampling with little compromise on the quality of the population size estimation. Using one of the largest existing butterflyMRRdatabases, collected on two fritillary species over a period of 20 years and >20 populations in Belgium, we assessed the possibility to reduce the effort of collectingMRRdata while keeping accurate quantification of total population size. By downsampling from the full datasets and calculating a range of demographic census metrics, we specifically investigated whether marking individuals is necessary, and whether the number of sampling sessions can be reduced.

We found that (1) counting individuals is not enough: some individual marking, even in a simplistic way to differentiate newly recorded from previously seen individuals, is essential for estimating population size. (2) A simple linear conversion function (number of “missed” individuals for each marked one) can be used to compute population size from the number of individuals marked over a small number ofMRRsampling sessions. (3) Parameterizing this function is system specific, because it depends on detectability of individuals, but only requires an initial effort of traditional high‐effortMRRin a few populations encompassing the expected range of population size, combined with previous knowledge on the species about potential factors affecting detectability.

Our simplifiedMRRprotocol should allow scientists to obtain absolute population size estimates almost as good as with traditional high‐effortMRR, but at a cost lowered in both the marking procedure and the intensity of field visits.
Alcohol e‐Help: study protocol for a web‐based self‐help program to reduce alcohol use in adults with drinking patterns considered harmful, hazardous or suggestive of dependence in middle‐income countries
Authors: Schaub Michael P. , Tiburcio Marcela , Martinez Nora , Ambekar Atul , Balhara Yatan Pal Singh , Wenger Andreas , Monezi Andrade André Luiz , Padruchny Dzianis , Osipchik Sergey , Gehring Elise , Poznyak Vladimir , Rekve Dag , Souza‐Formigoni Maria Lucia Oliveira ,   the WHO e‐Health Project on Alcohol and Health Investigators Group
Published: September 2017

Background and aims

Given the scarcity of alcohol prevention and alcohol use disorder treatments in many low and middle‐income countries, the World Health Organization launched an e‐health portal on alcohol and health that includes a Web‐based self‐help program. This paper presents the protocol for a multicentre randomized controlled trial (RCT) to test the efficacy of the internet‐based self‐help intervention to reduce alcohol use.

Design

Two‐arm randomized controlled trial (RCT) with follow‐up 6 months after randomization.

Setting

Community samples in middle‐income countries.

Participants

People aged 18+, with Alcohol Use Disorders Identification Test (AUDIT) scores of 8+ indicating hazardous alcohol consumption.

Intervention and comparator

Offer of an internet‐based self‐help intervention, ‘Alcohol e‐Health’, compared with a ‘waiting list’ control group. The intervention, adapted from a previous program with evidence of effectiveness in a high‐income country, consists of modules to reduce or entirely stop drinking.

Measurements

The primary outcome measure is change in the Alcohol Use Disorders Identification Test (AUDIT) score assessed at 6‐month follow‐up. Secondary outcomes include self‐reported the numbers of standard drinks and alcohol‐free days in a typical week during the past 6 months, and cessation of harmful or hazardous drinking (AUDIT < 8).

Analysis

Data analysis will be by intention‐to‐treat, using analysis of covariance to test if program participants will experience a greater reduction in their AUDIT score than controls at follow‐up. Secondary outcomes will be analysed by (generalized) linear mixed models. Complier average causal effect and baseline observations carried forward will be used in sensitivity analyses.

Comments

If the Alcohol e‐Health program is found to be effective, the potential public health impact of its expansion into countries with underdeveloped alcohol prevention and alcohol use disorder treatment systems world‐wide is considerable.
Assessing causal relationships using genetic proxies for exposures: an introduction to Mendelian randomization
Authors: Katikireddi Srinivasa Vittal , Green Michael J. , Taylor Amy E. , Davey Smith George , Munafò Marcus R.
Published: September 2017

Background and aims

Studying the consequences of addictive behaviours is challenging, with understanding causal relationships from observational data being particularly difficult. For example, people who smoke or drink excessively are often systematically different from those who do not, are less likely to participate in research and may misreport their behaviours when they do. Furthermore, the direction of causation between an addictive behaviour and outcome may be unclear. Mendelian randomization (MR) offers potential solutions to these problems.

Methods

We describe MR's principles and the criteria under which it is valid. We identify challenges and potential solutions in its application (illustrated using two applied examples) and describe methodological extensions in its application.

Results

MR is subject to certain assumptions, and requires the availability of appropriate genetic data, large sample sizes and careful design and conduct. However, it has already been applied successfully to the addiction literature. The relationship between alcohol consumption (proxied by a variant in the ADH1B gene) and cardiovascular risk has been investigated, finding that alcohol consumption increases risk, with no evidence of a cardioprotective effect at moderate consumption levels. In addition, heaviness of smoking (proxied by a variant in the CHRNA5‐A3‐B4 gene cluster) and risk of depression and schizophrenia have been investigated, with no evidence of a causal effect of smoking on depression but some evidence of a causal effect on schizophrenia.

Conclusions

Mendelian randomization analyses are already producing robust evidence for addiction‐related practice and policy. As genetic variants associated with addictive behaviours are identified, the potential for Mendelian randomization analyses will grow. Methodological developments are also increasing its applicability.
Factors associated with attrition in substance using patients enrolled in an intensive outpatient program
Authors: Mckowen James , Carrellas Nicholas , Zulauf Courtney , Ward Emin Nalan , Fried Ronna , Wilens Timothy
Published: September 2017

Background and Objectives

Data suggest individuals with substance use disorders (SUD) have high rates of attrition from treatment and exhibit impairments on measures of executive functioning (EF). The primary aim of this pilot study was to investigate if EF is associated with attrition from a 1 month intensive outpatient program (IOP) for SUD, and examine the feasibility of implementing the project.

Methods

Baseline neurocognitive functioning was assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB) and the self‐reported Behavior Rating Inventory of Executive Functioning (BRIEF‐A) questionnaire.

Results

Thirty subjects enrolled in the pilot study: including 20 “completers” (age 39.5 ± 13.1 years) and 10 “drop‐outs” who discontinued the IOP prior to completion (age 32 ± 11.1 years). IOP drop‐out was associated with earlier age of substance use onset (all p‐values <0.05) and male gender, as well as greater SUD, opiate use, and past week substance use. Overall a high level of executive dysfunction was found on the BRIEF‐A and CANTAB assessments, and specific differences emerged between completers and drop outs. However, no statistically significant differences were found between these groups on measures of depression, anxiety, or ADHD.

Conclusions and Scientific Significance

Overall, findings from this pilot study suggest high levels of self‐reported executive dysfunction, but EF's predictive association with drop‐out was limited. Measures of addiction severity were more strongly associated with attrition, suggesting potential utility of brief motivational interventions prior to commencing an IOP may improve retention. Further investigations with larger and more diverse samples are warranted. (Am J Addict 2017;26:780–787)
Expansion of CD4 phenotype among CD160 receptor‐expressing lymphocytes in murine pregnancy
Authors: Meggyes Matyas , Szereday Laszlo , Jakso Pal , Bogar Barbara , Bogdan Agnes , Nörenberg Jasper , Miko Eva , Barakonyi Aliz
Published: September 2017

Problem

CD160, a cell surface co‐receptor, is capable of up‐ or downregulating cell proliferation, cytotoxicity or cytokine production on lymphocytes. Our aim was to investigate CD160+ lymphocytes in the periphery and at the maternal‐foetal interface during murine pregnancy.

Method of study

CD4+, CD8+ and gamma/delta T‐cell phenotype, TIM3 co‐expression and cytotoxic activity of CD160+ lymphocytes of pregnant BALB/c mice were analysed by flow cytometry.

Results

The percentage of CD160+ lymphocytes in the decidua was unchanged compared to non‐pregnant endometrium; however, the ratio of CD4+ cells within the CD160 population was significantly increased. The co‐expression of TIM3 co‐inhibitory molecule and cytotoxicity of CD160+ cells were increased in the decidua.

Conclusion

The expansion of CD4‐expressing CD160+ decidual lymphocytes is a new observation suggesting a potential regulatory role of T‐cell function during mouse pregnancy. The altered immunological character of CD160+ lymphocytes could play a role in the maintenance of murine pregnancy.
Transcription factor CCAAT/enhancer‐binding protein‐β upregulates microRNA, let‐7f‐1 in human endocervical cells
Authors: Ayyar Kanchana , Reddy Kudumula Venkata Rami
Published: September 2017

Problem

In endocervical epithelial cells (End1/E6E7), miRNA let‐7f plays an important role in the control of innate immunity. The underlying molecular mechanism for let‐7f regulation in these cells remains largely unclear.

Methods of study

let‐7f was knocked down in End1/E6E7 cells using siRNA, and differential gene expression was analyzed by microarray. Differentially expressed genes were validated by qPCR and Western blot. Expression of let‐7f was studied by qPCR after inhibition of C/EBPβ with betulinic acid (BA) and pCMVβ plasmid and after overexpression of C/EBPβ with pCMVβ+ plasmid. ChIP assay was performed to confirm binding of C/EBPβ to let‐7f promoter. Levels of Lin28A/B were checked by qPCR after similar treatment.

Results

let‐7f knockdown (KD) affects the expression of many transcription factors (eg, C/EBPβ) which are important regulators of immune responses. We observed let‐7f‐1 promoter to contain 6 C/EBPβ binding sites. KD of C/EBPβ led to decreased let‐7f expression while overexpression of C/EBPβ increased its expression. Treatment of End1/E6E7 cells with TLR‐3 ligand, poly(I:C) increased binding of C/EBPβ at binding sites 3, 5, and 6. Expression of Lin28A/B also changed upon inhibition and overexpression of C/EBPβ. Its expression is opposite to that of let‐7f in End1/E6E7 cells.

Conclusion

let‐7f‐1 is a direct target of transcription factor, C/EBPβ in End1/E6E7 cells.
Unicortical and bicortical plating in the fixation of comminuted fractures of the clavicle: a biomechanical study
Authors: Looft John M. , Corrêa Lincoln , Patel Minoo , Rawlings Mathew , Ackland David C.
Published: September 2017

Background

Intraoperative neurovascular complications with clavicle fracture fixation are often due to far cortex penetration by drills and screws, but could be avoided using a unicortical construct. The objective of this study was to compare the bending and torsional strength of a unicortical locking screw plate construct and a hybrid (with central locked and outer non‐locked long oblique screws) unicortical plate construct for clavicle fracture fixation with that of a conventional bicortical locking screw construct of plate fixation.

Methods

Twenty‐four human clavicle specimens were harvested and fractured in a comminuted mid‐shaft butterfly configuration. Clavicles were randomly allocated to three surgical fixation groups: unicortical locking screw, bicortical locking screw and hybrid unicortical screw fixation. Clavicles were tested in torsion and cantilever bending. Construct bending and torsional stiffness were measured, as well as ultimate strength in bending.

Results

There were no significant differences in bending stiffness or ultimate bending moment between all three plating techniques. The unicortical locked construct had similar torsional stiffness compared with the bicortical locked construct; however, the hybrid technique was found to have significantly lower torsional stiffness to that of the bicortical locking screw construct (mean difference: 87.5 Nmm/degree, P = 0.028).

Conclusions

Unicortical locked screw plate fixation and hybrid unicortical plating fixation with centrally locked screws and outer long, oblique screws may alleviate far cortex penetration, protecting nearby anatomical structures, and may ease implant removal and conversion to bicortical fixation for revision surgery; however, use of long oblique screws may increase the risk of early loosening under torsion.
Survival improvements with adjuvant therapy in patients with glioblastoma
Authors: Jayamanne Dasantha , Wheeler Helen , Cook Raymond , Teo Charles , Brazier David , Schembri Geoff , Kastelan Marina , Guo Linxin , Back Michael F.
Published: September 2017

Background

Evaluate survival of patients diagnosed with glioblastoma multiforme (GBM) managed with adjuvant intensity modulated radiation therapy and temozolomide since the introduction of the European Organisation for Research and Treatment of Cancer and National Cancer Institute of Canada Clinical Trials Group (EORTC‐NCIC) protocol.

Methods

All patients with GBM managed between May 2007 and December 2014 with EORTC‐NCIC protocol were entered into a prospective database. The primary endpoint was the median survival. Univariate predictors of survival were evaluated with respect to tumour resection, age and Eastern Cooperative Oncology Group (ECOG) performance status using log‐rank comparisons.

Results

Two hundred and thirty‐three patients were managed under the protocol and analysed for outcome. The median age was 57 years; the rate of gross total resection, subtotal resection and biopsy were 47.2%, 35.2% and 17.6%, respectively. At progression, 49 patients had re‐resection, and in addition to second‐line chemotherapy, 86 patients had Bevacizumab including 26 with re‐irradiation. Median survival was 17.0 months (95% CI: 15.4–18.6). On univariate evaluation, extent of resection (P = 0.001), age, ECOG performance status and recursive partitioning analysis class III were shown to significantly improve survival (P < 0.0001). The median survival for gross total resection, age <50 years, ECOG 0–1 and recursive partitioning analysis class III were 21, 27, 20 and 47 months, respectively.

Conclusion

This study confirms the significant improvement in median survival in GBM that has occurred in recent years since introduction of the EORTC‐NCIC protocol. Further improvements have occurred presumably related to subspecialized care, improved resection rates, sophisticated radiotherapy targeting and early systemic salvage therapies. However, the burden of the disease within the community remains high and the median survival improvements over time have plateaued.
Comparison of perioperative, renal and oncologic outcomes in robotic‐assisted versus open partial nephrectomy
Authors: Tan Jo‐Lynn , Frydenberg Mark , Grummet Jeremy , Hanegbi Uri , Snow Ross , Mann Sarah , Begashaw Kirobel , Moon Daniel
Published: September 2017

Background

To compare perioperative, renal and oncological outcomes after robotic‐assisted partial nephrectomy (RAPN) versus open partial nephrectomy (OPN) for the treatment of renal tumours.

Methods

All partial nephrectomies performed at a Metropolitan Urology Centre between 2010 and 2016 were analysed. Baseline data was collected for patient demographics, tumour characteristics (tumour size, laterality and polarity, RENAL scores), and perioperative variables (e.g. warm ischaemic time, operation time, estimated blood loss (EBL), length of stay). Tumour characteristics included malignancy, clinical stage, Fuhrman nuclear grade and surgical margin status. Day‐1 post‐operative serum creatinine, estimated glomerular filtration rate (eGFR) and 6‐month eGFR stage were used for assessing renal function.

Results

Two hundred patients underwent partial nephrectomy between 2010 and 2016 (n = 200; 55 OPN versus 145 RAPN). Baseline data was similar between groups, except for lower age (P = 0.0001) and higher RENAL scores (P = 0.001) in the RAPN group. RAPN demonstrated significantly lower complication rates (P = 0.015), lesser EBL (P = <0.0001), shorter hospital stays (P = <0.001) and reduced positive tumour resection margins (P = 0.039). There was no significant difference in mean operation time between RAPN and OPN (137.2 (±48.0) OPN versus 146.07 (±35.91) RAPN; P = 0.16). No statistical difference was shown for post‐operative eGFR stage between groups at Day‐1 and 6‐month post‐surgery (P = 0.15 and P = 0.861, respectively).

Conclusion

We present the largest reported Australian series on partial nephrectomy, confirming that a robotic‐assisted approach is equivalent to OPN, with reduced complications, EBL, length of hospital stays and fewer positive margins, even when resecting more complex tumours.
Wound tension and ‘closability’ with keystone flaps, V‐Y flaps and primary closure: a study in fresh‐frozen cadavers
Authors: Donovan Lewis C. , Douglas Charles D. , Van Helden Dirk
Published: September 2017

Background

Previous publications have implied that the keystone flap provides mechanical benefits compared to primary closure. This has not been objectively demonstrated.

Methods

Elliptical defects were created in ‘fresh‐frozen’ cadaveric specimens. Two approaches were used to investigate the potential mechanical benefits of keystone flaps. Experiment 1 (wound closure): 18 defects were incrementally enlarged until they could not be closed primarily either with a single ‘midpoint’ suture or with a continuous suture. Attempts were then made to close these wounds with island flaps: 13 keystone flaps (seven ‘typeIIA’ and six ‘Sydney Melanoma Unit (SMU) modification’) and five V‐Y flaps. Experiment 2 (tension reduction): 28 defects were fashioned to be ‘closable’ under high tension. The ‘pre‐flap tension’ was measured with a single midpoint suture and tensiometer. Fourteen keystone flaps (seven typeIIAand sevenSMUmodifications) and seven V‐Y flaps were then developed and mobilized with no flap constructed on the remaining seven ‘primary closure’ wounds. The secondary defects resulting from flap mobilization were closed leaving the primary defect unsutured. The primary defect ‘post‐flap tension’ was then measured using the same technique.

Results

For Experiment 1, V‐Y flaps enabled closure in four of five ‘unclosable’ defects. Keystone flaps did not enable closure in any of the 13 cases (P < 0.001). For Experiment 2, the V‐Y flap (n = 7) was the only group that produced a significant drop in wound tension across the primary defect (mean ‘pre‐flap’ to ‘post‐flap’ tension change: −53%, 95%CI: −67 to −39%,P < 0.001).

Conclusion

The data raise questions about the biomechanical benefits of keystone flaps.
Changing face of robot‐assisted radical prostatectomy in Melbourne over 12 years
Authors: Sathianathen Niranjan J. , Lamb Alastair D. , Lawrentschuk Nathan L. , Goad Jeremy R. , Peters Justin , Costello Anthony J. , Murphy Declan G. , Moon Daniel A.
Published: September 2017

Background

This study aims to characterize the trends in disease presentation for robot‐assisted radical prostatectomy (RARP) over a 12‐year period in Melbourne, Australia.

Methods

All patients undergoing an RARP between 2004 and October 2016 while under the care of six high‐volume surgeons were included in this study. Data were collected prospectively regarding patient demographics and clinical details of their cancer.

Results

Over the 12‐year time span of the study, 3075 men underwent an RARP with a median age of 63.01 years. Temporal analysis demonstrated that the median age of patients undergoing prostatectomy advanced with time with the median age in 2016 being 65.51 years compared with 61.0 years in 2004 (P < 0.001). There was also a significant trend to increased D'Amico risk groups over time with the percentage procedures for high‐risk patients increasing from 12.6% to 28.10% from 2004 to 2016 (P < 0.001). Upgrade rates between biopsy and pathological Gleason grade scoring significantly trended down over the period of the study (P < 0.001). There was also a shift to increased pathological stage over the 12 years with 22.1% of men having T3 disease in 2004 compared with 49.8% in 2016.

Conclusion

Our analysis demonstrates increasing treatment of older men with higher risk tumours, consistent with international trends. While this largely reflects a shift in case selection, further work is needed to assess whether the stage shift may relate partially to a decline in screening and increased presentation of higher risk disease.
Paediatric mild head injury: is routine admission to a tertiary trauma hospital necessary?
Authors: Tallapragada Krishna , Peddada Ratna Soundarya , Dexter Mark
Published: September 2017

Background

Previous studies have shown that children with isolated linear skull fractures have excellent clinical outcomes and low risk of surgery. We wish to identify other injury patterns within the spectrum of paediatric mild head injury, which need only conservative management. Children with low risk of evolving neurosurgical lesions could be safely managed in primary hospitals.

Methods

We retrospectively analysed all children with mild head injury (i.e. admission Glasgow coma score 13–15) and skull fracture or haematoma on a head computed tomography scan admitted to Westmead Children's Hospital, Sydney over the years 2009–2014. Data were collected regarding demographics, clinical findings, mechanism of injury, head computed tomography scan findings, neurosurgical intervention, outcome and length of admission. Wilcoxon paired test was used with P value <0.05 considered significant.

Results

Four hundred and ten children were analysed. Three hundred and eighty‐one (93%) children were managed conservatively, 18 (4%) underwent evacuation of extradural haematoma (TBI surgery) and 11 (3%) needed fracture repair surgery. Two children evolved a surgical lesion 24 h post‐admission. Only 17 of 214 children transferred from peripheral hospitals needed neurosurgery. Overall outcomes: zero deaths, one needed brain injury rehabilitation and 63 needed child protection unit intervention. Seventy‐five percentage of children with non‐surgical lesions were discharged within 2 days. Eighty‐three percentage of road transfers were discharged within 3 days.

Conclusions

Children with small intracranial haematomas and/or skull fractures who need no surgery only require brief inpatient symptomatic treatment and could be safely managed in primary hospitals. Improved tertiary hospital transfer guidelines with protocols to manage clinical deterioration could have cost benefit without risking patient safety.
From ancient to avant‐garde: a review of traditional and modern multimodal approaches to surgical anatomy education
Authors: Hu Minhao , Wattchow David , de Fontgalland Dayan
Published: September 2017

The landscape of surgical anatomy education is progressively changing. Traditional methods, such as cadaveric dissection and didacticism are being increasingly phased out in undergraduate courses for multimodal approaches incorporating problem‐based learning, radiology and computer‐based simulations. Although effective at clinically contextualizing and integrating anatomical information, these approaches may be a poor substitute for fostering a grasp of foundational ‘pure’ anatomy. Dissection is ideal for this purpose and hence remains the cornerstone of anatomical education. However, novel methods and technological advancements continually give way to adjuncts such as cadaveric surgery, three‐dimensional printing, virtual simulation and live surgical streaming, which have demonstrated significant efficacy alone or alongside dissection. Therefore, although divergent paradigms of ‘new versus old’ approaches have engulfed and divided the community, educators should seek to integrate the ancient and avant‐garde to comprehensively satisfy all of the modern anatomy learner's educational needs.
Delayed cord clamping and cord gas analysis at birth
Authors: Xodo Serena , Xodo Luigi , Berghella Vincenzo
Published: September 2017

Delayed cord clamping for at least 60 s in both term and preterm babies is a major recent change in clinical care. Delayed cord clamping has several effects on other possible interventions. One of these is the effect of delayed cord clamping on umbilical artery gas analysis. When indicated, umbilical artery gas analysis can safely be done either with early cord clamping or, probably most of the times it is necessary, during delayed cord clamping with the cord still unclamped. Paired blood samples (one from the umbilical artery and one from the umbilical vein) can be taken from the pulsating and unclamped cord, immediately after birth, during delayed cord clamping, without any effect on either the accuracy of umbilical artery gas analysis or the transfusion of blood through delayed cord clamping. Umbilical artery gas analysis should instead not be done after delayed cord clamping, since delayed cord clamping alters several acid‐based parameters and lactate values.
Mechanisms of Moral Disengagement and Prisoner Abuse
Authors: Weill Joanna , Haney Craig
Published: September 2017

Bandura's research and theory on the mechanisms of moral disengagement demonstrate the various ways that persons distance themselves from their mistreatment of others to avoid or circumvent ethical constraints that should and otherwise would govern their behavior. This article examines the serious problem of prisoner abuse through the lens of moral disengagement theory to understand in part why such abuse occurs and persists. This application of moral disengagement theory underscores the importance of addressing these social psychological dynamics in any program of prison reform and the need for further research in a setting that traditionally has resisted in‐depth empirical examination.
Recent changes in the plant composition of wetlands in the Jura Mountains
Authors: Rion Vanessa , Gallandat Jean‐Daniel , Gobat Jean‐Michel , Vittoz Pascal
Published: September 2017

Aim

To assess vegetation changes in montane fens and wet meadows and their causes over 38 years.

Location

Wetlands, Jura Mountains (Switzerland and France).

Methods

Plots were inventoried in 1974 and re‐located in 2012 (quasi‐permanent plots) on the basis of sketches to assess changes in plant communities. The 110 plots belonged to five phytosociological alliances, two in oligotrophic fens (Caricion davallianae, Caricion fuscae) and three in wet meadows (Calthion, Molinion, Filipendulion). Changes between surveys were assessed with NMDS, and changes in species richness, Simpson diversity, species cover and frequency and the causes of these changes were evaluated by comparing ecological indicator values.

Results

Changes in species composition varied between alliances, with a general trend towards more nutrient‐rich flora with less light at ground level. Species diversity declined, with a marked decreasing trend for the typical species of each alliance. These species were partly replaced by species belonging to nitrophilous and mesophilous grasslands. However, no trend towards drier conditions was detected in these wetlands. The largest changes, with an important colonization by nitrophilous species, occurred in the Swiss sites, where grazing was banned 25 years ago. As a result of floral shifts, many plots previously belonging to fens or wet mesotrophic meadows shifted to an alliance of the wet meadows, generally Filipendulion. Moreover, communities showed a slight trend towards more thermophilous flora.

Conclusions

The investigated wetlands in the Jura Mountains have suffered mainly from eutrophication due to land‐use abandonment and N deposition, with a loss of typical species. Areas with constant land use (grazing or mowing) showed less marked changes in species composition. The most important action to conserve these wetlands is to maintain or reintroduce the traditional practices of extensive mowing and livestock grazing in the wetlands, especially in areas where they were abandoned 25 years ago. This previous land‐use change was intended to improve fen conservation, but it was obviously the wrong measure for conservation purposes.
Pharmacodynamics and pharmacokinetics of ticagrelor vs. clopidogrel in patients with acute coronary syndromes and chronic kidney disease
Authors: Wang Heyang , Qi Jing , Li Yi , Tang Yunbiao , Li Chao , Li Jing , Han Yaling
Published: September 2017

Background

Pivotal clinical trials found that ticagrelor reduced ischaemic complications to a greater extent than clopidogrel, and also that the benefit gradually increased with the reduction in creatinine clearance. However, the underlying mechanisms remains poorly explored.

Methods

This was a single‐centre, prospective, randomized clinical trial involving 60 hospitalized Adenosine Diphosphate (ADP) P2Y12 receptor inhibitor‐naïve patients with chronic kidney disease (CKD) (estimated glomerular filtration rate <60 ml min–1 1.73 m–2) and non‐ST‐elevation acute coronary syndromes (NSTE‐ACS). Eligible patients were randomly assigned in a 1:1 ratio to receive ticagrelor (180 mg loading dose, then followed by 90 mg twice daily) or clopidogrel (600 mg loading dose, then followed by 75 mg once daily). The primary endpoint was the P2Y12 reactive unit (PRU) value assessed by VerifyNow at 30 days. The plasma concentrations of ticagrelor and clopidogrel and their active metabolites were measured in the first 10 patients in each group at baseline, and at 1 h, 2 h, 4 h, 8 h, 12 h and 24 h after the loading dose.

Results

Baseline characteristics were well matched between the two groups. Our results indicated a markedly lower PRU in patients treated with ticagrelor vs. clopidogrel at 30 days (32.6 ± 11.29 vs. 203.7 ± 17.92; P < 0.001) as well as at 2 h, 8 h and 24 h after the loading dose (P < 0.001). Ticagrelor and its active metabolite AR‐C124910XX showed a similar time to reach maximum concentration (Cmax) of 8 h, with the maximum concentration (Cmax) of 355 (242.50–522.00) ng ml–1and 63.20 (50.80–85.15) ng ml–1, respectively. Both clopidogrel and its active metabolite approached the Cmax at 2 h, with a similar Cmax of 8.67 (6.64–27.75) ng ml–1 vs. 8.53 (6.94–15.93) ng ml–1.

Conclusion

Ticagrelor showed much more potent platelet inhibition in comparison with clopidogrel in patients with CKD and NSTE‐ACS.