bluuebunny/crossref_metadata_2025 huggingface dataset:
Antecedents and Outcomes of Quality of Work Life Among Employees in Banks
Authors: Geethanjali N. , Sindhya R. , Sabarirajan A.
Published: May 2020

Quality of work life is the major factor to be considered in working environment of any organization. The performance of employees and the organization lies on the ability of the employees based on working environment. The QWL leads to better working environment which improves the performance
of organization. The present study has made an attempt to find the level of factors causing QWL and the impact of outcome of QWL in banks. Since the profile of the banks may be associated with the level of outcomes of QWL, the present study has made an attempt to examine it with the help of
one way analysis of variance and t-test. The included outcomes of QWL are job satisfaction, job stress, organizational climate, organizational commitment, employees retention behaviour, service quality employees and service productivity of employees. The highly associated determinants of QWL
and the significant difference among the PUSBs and PRSBs have been noticed. The significantly associating important profiles of the banks regarding the existence of outcome of QWL are identified.
A Survey on Android Malwares and Defense Techniques
Authors: Beroual Abdesselam , Al-Shaikhli Imad Fakhri
Published: May 2020

Since the last few years, Android is by far the most widely utilized as an operating system for mobile devices, and this is accompanied by the development in terms of number and variety of different Android applications. Android offers a centralized market place maintained by Google
named “Google Play Store,” where official and third party application developers can submit their Android applications to make them available for users. The high popularity of Android OS and its market place is becoming a worthy target by hackers and attackers to violate users’
privacy and security. Malwares were also growing in parallel with Android applications growth. It is necessary as a first step to have a solid understanding of malwares’ characteristics to help preventing potential harmful consequences. Whithin this paper, we initially present the general
overview for Android OS architecture with application structure, then we highlight the popular Android security issues and focus on the existing solutions to detect and prevent Android malwares, finally, we present our point of view and suggestion for future works on the best solution to overcome
the Android malwares.
The Consequences of Neoliberalism in the Current Pandemic
Authors: Navarro Vicente
Published: May 2020

This article analyzes how the neoliberal policies, such as the politics of austerity (with considerable cuts to social policy expenditures including medical care and public health services) and the privatization of health services, imposed by many governments on both sides of the North Atlantic, considerably weakened the capacity of the response to the coronavirus pandemic in Italy, Spain, and the United States.
“Empty Chairs at Empty Tables”: Disenfranchisement by Association
Authors: Pitcho-Prelorentzos Shani , Mahat-Shamir Michal
Published: May 2020

The rise in research publications over the last few decades about disenfranchised grief has deepened our understanding of this field. Importantly, it raises awareness and validates human experiences of bereavement, which are often socially ignored, muted, and stigmatized. However, while researchers in the field actively engage in the task of “enfranchisement,” as they present their work at scientific conferences, they might experience what we term disenfranchisement by association in the academic sphere. Based on our own experience, this article will demonstrate the parallel pathways between disenfranchisement of bereaved individuals and disenfranchisement of disenfranchised grief researchers, as it emerges in three main expressions of disenfranchisement: reluctance to listen, shame and guilt inflicting, and demand for euphemism. A conclusive note on how to address this kind of disenfranchisement is suggested.
Delay margin computation of generator excitation control system by using fractional order controller
Authors: Erol Halil
Published: May 2020

This article is devoted to stability analysis of generator excitation control system that has some time delay with fractional order proportional integral derivative controller by using direct method. When the time delay exceeds certain critical values, the excitation control system becomes unstable. In order to obtain more delay margin, in control part of the system, fractional order proportional integral derivative controller is used. A formulation is obtained to find out the maximum time delay which is known as delay margin with which the system can tolerate without any loss in its stability. All the possible stability regions analytically in the parametric space of the time delay is obtained by using an exact method and it is presented in this study. The method is formulated in frequency domain. The time-domain simulations are implemented to validate theoretical delay margin results in Matlab/Simulink. When it is compared with previous researches in literature, better stability margin is obtained. The results have shown that fractional order PID controller gives wide stability area than integer order PID controller.
Computer vision measurement and optimization of surface roughness using soft computing approaches
Authors: Beemaraj Radha Krishnan , Chandra Sekar Mathalai Sundaram , Vijayan Venkatraman
Published: May 2020

This paper proposes an efficient methodology for predicting surface roughness using different soft computing approaches. The soft computing approaches are artificial neural network, adaptive neuro-fuzzy inference system and genetic algorithm. The proposed surface roughness prediction procedure has the following stages as feature extraction from the materials, classifications using random forests, adaptive neuro-fuzzy inference system (ANFIS). In this paper, the statistical features are extracted from material images as skewness, kurtosis, mean, variance, contrast, and energy.The surface roughness accuracy value varied between ANFIS and random forest classification in every measurement sequence. This limitation can be overcome by the genetic algorithm to optimize the best results. The optimization technique can produce more accurate surface roughness results for more than 98% and reduce the error rate up to 0.5%.
Simultaneous Malignant and Benign Nonepithelial Neoplasms of the Larynx—A Case Report and Literature Review
Authors: Krawczyk Przemyslaw , Bruzgielewicz Antoni , Niemczyk Kazimierz
Published: May 2020

Nonepithelial tumors of the larynx are relatively rare neoplasms of the head and neck. The chondrosarcoma, which develops commonly from cricoid and thyroid cartilage, stands for 0.2% of the laryngeal malignant neoplasms. The rhabdomyoma is even more uncommon benign tumor developing from the laryngeal striated muscles. The clinical manifestation and the treatment options depend on the histopathological evaluation, tumor localization, and its size. In presented case, the simultaneous occurrence of benign and malignant tumors of mesenchymal origin in the patient’s larynx was provoking hoarseness, globus sensation, and dysphagia. To the best of authors’ knowledge, no other case of the concomitance of rhabdomyoma and chondrosarcoma of the larynx have been reported in the literature.
Providing for the Young Academically Talented: A Pilot Program for Teachers and Children
Authors: Cassidy Jack , Vukelich Carol
Published: May 2020

A special summer pilot program for gifted pre-first grade children and teachers is described. Twenty-nine gifted children participated in the three-week program. Instruction focused on the development of language arts, reading, skills. A course on the identification and education of gifted children was offered to kindergarten and preschool teachers. Both teachers and children benefited greatly from participation in their respective programs.
Project Impact: Identification and Replication of Exemplary Gifted Programs in Illinois
Authors: Herche Paul
Published: May 2020

Equity in the context of education requires that schools provide programs which are appropriate to the needs of exceptional students. Through PROJECT IMPACT and other programs, Illinois is moving toward provision of a complete network of services which are differentiated in relation to gifted students' needs.
Secondary Programs for Gifted Students
Authors: Silverman Linda
Published: May 2020

More information exists on elementary programming for the gifted than on secondary programming. However, there are a multitude of creative ways of providing for the needs of gifted secondary students. These may be grouped into the following categories: acceleration, enrichment in the regular classroom, special classes, on-campus offerings outside the school day, off-campus options and special schools. Some programs use several of these arrangements concurrently. This article presents a compilation of the secondary provisions used throughout the country. Some of the more innovative approaches are discussed in greater detail. In addition, there are special sections devoted to program goals, considerations in identification, and rural programming.
The University of Denver's University for Youth
Authors: Katz Elinor , Seeley Ken
Published: May 2020

The University for Youth is an innovative program for gifted and talented children from preschool through high school level. For six weeks during the summer, and after school during the school year, the University of Denver offers a wide variety of courses to stimulate and challenge young minds.
Futures Study for the Adolescent Gifted: A Curriculum Evaluation
Authors: Wooddell Gary D. , Fletcher Geoffrey H. , Dixon Thornton E.
Published: May 2020

One of the primary purposes of this study was to examine possible differences between students identified as gifted and other students after they experienced an educational program focusing on alternative futures. A pressing—if not overriding—concern of education at this time of rapid change and mounting stress must be how education can be of most value to individuals who will live in a world which they, and we, are largely unable to imagine. The increasing strain on individuals, institutions, and societies is unsettling evidence that we may indeed be headed for what John Platt has termed “a crisis of crises all at one time” (1974). Even without such a pessimistic premise, it is not unreasonable to consider that technological advances and socio-economic-political changes will continue to shape our world in numerous and varied ways. With this hypothesis, educators must, if they are to serve their clientele, re-examine their specific goals with regard to developing in individuals skills and personal qualities most appropriate for coping with uncertainty and taking action. In this respect, this project sought, not to identify and develop all those abilities and qualities, but instead to focus on a selected few which the authors assumed to be missing in traditional educational endeavors. This study, then, documents the authors' efforts to begin to develop in a group of adolescent youth a certain set of abilities/qualities, identified as a futures perspective, self-actualization, and futuring competencies. As such, the study serves as both a quasi-research study and a rigorous and comprehensive curriculum evaluation. The authors believe that the project results have important implications in both areas.
Volunteering, Subjective Sleep Quality, and Chronic Inflammation: A 5-Year Follow-Up of the National Social Life, Health, and Aging Project
Authors: Kim Seoyoun , Yoon Hyunwoo
Published: May 2020

Studies indicate that the benefits of volunteering may extend to biological risk factors in disease development including chronic inflammation, though the pathway through which volunteer activity predicts chronic inflammation remains unclear. The current project focuses on the link between volunteering and C-reactive protein (CRP) as a measure of chronic inflammation, while paying a particular attention to sleep quality as a pathway. Using panel data from the National Social Life, Health, and Aging Project ( N = 1,124), the present study examined whether sleep quality operates indirectly linking volunteer activity and CRP (indirect pathway), compensates for the lack of volunteerism (moderation-compensation), or regulates the benefits of volunteering on CRP (moderation-regulation). The findings suggest sleep quality as a compensatory pathway, in that sufficient sleep buffers the inflammatory effect of lack of volunteerism. The findings show that helping others may be beneficial for the helpers in terms of chronic inflammation and sleep quality as interconnected health outcomes.
Enhanced rehabilitation guidance after arthroscopic capsulolabral repair of the shoulder: a randomized controlled trial
Authors: Multanen Juhani , Kiuru Pauli , Piitulainen Kirsi , Ylinen Jari , Paloneva Juha , Häkkinen Arja
Published: May 2020

Objective:

To compare the effects of a 12-month home-based exercise program to usual care in patients after arthroscopic capsulolabral repair of the shoulder.

Design:

Randomized controlled trial.

Setting:

Outpatient physical and rehabilitation medicine clinic.

Subjects:

Forty-five patients (mean age: 35 years; standard deviation (SD): 10 years) who underwent arthroscopic capsulolabral repair due to labral lesion were randomized into an exercise group (EG) or a control group (CG).

Intervention:

The EG received a 12-month home-based additional exercise program with four physiotherapy follow-up visits, while the CG received standard postoperative exercise instructions.

Main measures:

Self-reported shoulder disability was assessed with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and quality of life with the Short-Form (SF)-36 Health Survey. The function of the operated shoulder was evaluated with strength and range of motion measurements.

Results:

No between-group differences were observed in any of the outcomes at the follow-up. Mean ASES score improved by 16 (95% confidence interval (CI): 10–23) points from the baseline 78 (SD: 17) in the EG and 13 (95% CI: 7–19) points from the baseline 79 (SD: 17) in the CG. Both groups achieved a significant improvement in the dimensions of Physical Functioning, Role-Physical, and Bodily Pain of the SF-36 and in every aspect of strength and range of motion measures. In EG, exercise adherence was moderate (52%) during the first six months and poor (22%) during the last six months.

Conclusion:

Home-based additional exercises with four outpatient follow-up visits did not improve outcome after arthroscopic capsular repair of the shoulder.
A mixed-methods pilot study of ‘LIFEView’ audiovisual technology: Virtual travel to support well-being and quality of life in palliative and end-of-life care patients
Authors: Kabir Monisha , Rice Jill L , Bush Shirley H , Lawlor Peter G , Webber Colleen , Grassau Pamela A , Ghaedi Bahareh , Dhuper Misha , Hackbusch Rebekah
Published: May 2020

Background:

There is evidence that psychosocial and spiritual interventions of short duration, such as reminiscence therapy, provide positive impacts on quality of life and emotional and existential well-being in adults receiving palliative care.

Aim:

To determine (1) the feasibility of integrating ‘LIFEView’, a video-based software with >1600 videos of world destinations, in palliative care settings, and (2) positive, neutral or harmful effects of using ‘LIFEView’ videos.

Design:

A mixed-methods pre–post intervention pilot study was conducted to collect feasibility and preliminary data on physical and psychological symptoms, physiological indicators, spiritual well-being and aspects of quality of life.

Setting/participants:

Adult patients on an inpatient palliative care unit or receiving care from a community palliative care consultation team who were capable of providing consent and completing the outcome measures were eligible participants.

Results:

Overall, 27/41 (66%) participants took part in the study. Feasibility criteria, including participant acceptability, low participant burden, tool completion rate and retention rate, were fulfilled, though challenges were experienced with recruitment. Modest improvements, though non-significant, were shown on preliminary data collected on physical and psychological symptoms using the Edmonton Symptom Assessment System–revised, spiritual well-being assessed by the 12-item Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being scale and physiological measurements. Qualitative analysis revealed five themes: motivations for using ‘LIFEView’, perceptions of the technology, reminiscence, ‘LIFEView’ as an adaptable technology and ongoing or future use.

Conclusion:

A future adequately powered study to investigate the impacts of ‘LIFEView’ on patient well-being and quality of life appears to be feasible.
Statistics and Artificial Intelligence-Based Pavement Performance and Remaining Service Life Prediction Models for Flexible and Composite Pavement Systems
Authors: Kaya Orhan , Ceylan Halil , Kim Sunghwan , Waid Danny , Moore Brian P.
Published: May 2020

In their pavement management decision-making processes, U.S. state highway agencies are required to develop performance-based approaches by the Moving Ahead for Progress in the 21st Century (MAP-21) federal transportation legislation. One of the performance-based approaches to facilitate pavement management decision-making processes is the use of remaining service life (RSL) models. In this study, a detailed step-by-step methodology for the development of pavement performance and RSL prediction models for flexible and composite (asphalt concrete [AC] over jointed plain concrete pavement [JPCP]) pavement systems in Iowa is described. To develop such RSL models, pavement performance models based on statistics and artificial intelligence (AI) techniques were initially developed. While statistically defined pavement performance models were found to be accurate in predicting pavement performance at project level, AI-based pavement performance models were found to be successful in predicting pavement performance in network level analysis. Network level pavement performance models using both statistics and AI-based approaches were also developed to evaluate the relative success of these two models for network level pavement performance modeling. As part of this study, in the development of pavement RSL prediction models, automation tools for future pavement performance predictions were developed and used along with the threshold limits for various pavement performance indicators specified by the Federal Highway Administration. These RSL models will help engineers in decision-making processes at both network and project levels and for different types of pavement management business decisions.
Development of a Positioning Technique for Traffic Data Collection Using Wireless Signal Scanners
Authors: Mohammadi Shahriar , Ismail Karim , Ghods Amir H.
Published: May 2020

The study purpose is to utilize communication technologies in automated transportation data collection. The goal is to find a solution for positioning beacons transmitting wireless signals suitable for traffic data collection. The technique developed in this paper for positioning is based on the strength of Bluetooth signals transmitted by beacons, creating radio maps, and applying an algorithm called k-nearest neighbors ( k-NN). Four Bluetooth signal scanners and a beacon were used in the experiments in an intersection and its adjacent streets. Numerous stations and scanners arrangements were tested for enhanced accuracy. The results confirm the functionality of the technique in positioning based on wireless signals. The modifications in the set-ups and arrangements clearly indicate that increasing the distance between the stations on the radio maps, along with meeting the minimum positioning accuracy requirements and making the arrangement of stations and scanners asymmetric, can enhance the accuracy level of positioning by reducing the error probability of the algorithm and causing more distinction in the radio maps. It was observed that by increasing the distance between the stations in each lane, from 3 m to 5 m, and making the stations and scanners asymmetric in arrangement, the positioning percentage with an error of 5 m or less may be increased to 90% from 73.5%. Also, the accuracy of positioning tends to decrease as the distance between the beacon and the scanners increases. This paper studies both stationary and moving beacons. It was found that although positioning of stationary beacons can be done with a precision of up to 90% with an error of 5 m or less if the stations and scanners are properly arranged, the positioning of moving beacons is more challenging.
Micro-credit, trust, and social solidarity in Bangladesh: A socio-philosophical analysis
Authors: Huda Kazi ASM Nurul
Published: May 2020

Drèze and Sen are not entirely right in their apparent glorification of the roles of nongovernmental organizations in Bangladesh in An Uncertain Glory: India and Its Contradictions because they leave out and/or de-emphasize some important issues, especially those that are related to the problematic trusting relationship between nongovernmental organizations in Bangladesh and rural poor women. Nongovernmental organizations’ use of trust disturbs social solidarity in rural Bangladesh mainly because of their massive supervision mechanism that they undertake to sustain the so-called trusting relationship between them and their debtors. The massive supervision mechanism damages social solidarity also because it creates a tension between local norms and nongovernmental organizations’ neoliberalist values of “discipline, efficiency and competitiveness,” which nongovernmental organizations try to inject into villagers by their numerous social engineering programs, which are state’s responsibility. Nongovernmental organization monitoring has some psychological impacts on their clients that also contribute to shaking social solidarity. The absence of a proper trusting relationship between nongovernmental organizations and rural poor women reduces the capabilities of the latter as a result of which Drèze and Sen’s glorification of Bangladeshi nongovernmental organizations and Sen’s capabilities approach are in tension. However, there are strategies that Bangladeshi nongovernmental organizations should employ to address the issues raised due to their massive supervision mechanism.
Mapping Gendered Spaces and Women’s Mobility: A Case Study of Mitathal Village, Haryana
Authors: Siwach Prerna
Published: May 2020

The most explicit representation of gendering of space is the division between public and private space. Public space—the space of transcendence, production, politics, and power—is the sphere of men, whereas private productive space—the sphere of reproduction—is the women’s space. The spatial perspective developed here recognizes the complexities of a patriarchal society and how these define gender roles, which further help in sustaining gender stratification on the physical space. Whatever mobility women accrue is due to the nature of their work; thus, the nature of work and the gender roles a woman performs define her space of access. Age and caste are two major factors that affect mobility. The study also attempts to explore how “patriarchal bargain” takes place. They are a bargain, in that the “rules” which regulate gender relations in a region are constantly contested and renegotiated in daily life. Forms and expressions of patriarchy are undergoing changes; moreover, it can be said that the village is moving toward a kind of patriarchal bargain that allows women more mobility.
Effects of Kinesiotape vs Soft and Semirigid Ankle Orthoses on Balance in Patients With Chronic Ankle Instability: A Randomized Controlled Trial
Authors: Hadadi Mohammad , Haghighat Farzaneh , Mohammadpour Navid , Sobhani Sobhan
Published: May 2020

Background:

Chronic ankle instability (CAI) is a frequent complication of ankle sprain that may be associated with long-term consequences. Although taping and bracing are common interventions that are widely used by clinicians and athletic trainers for patients with CAI, no studies have compared the effects of kinesiotaping and bracing on balance performance in these patients. The present study aimed to compare the effects of ankle kinesiotaping, a soft ankle orthosis, and a semirigid ankle orthosis on balance performance in patients with CAI.

Methods:

Sixty patients with CAI were randomly assigned to 4 groups that received kinesiotaping, a soft orthosis, a semirigid orthosis, or no treatment (control group). Dynamic and static balance were measured with the modified Star Excursion Balance Test, single leg hop test, and single leg stance test before and after a 4-week intervention period.

Results:

Significant between-group differences were seen in all evaluated outcomes ( P ≤ .003). The lowest reach distances in all directions in the modified Star Excursion Balance Test were found in the control group, and these patients also had a significantly shorter measured distance in the single leg hop test, and more errors in the single leg stance test compared with the 3 intervention groups. No significant differences were found among the 3 intervention groups.

Conclusion:

Use of kinesiotaping and a soft or a semirigid ankle brace for 4 weeks were all beneficial in improving static and dynamic balance in individuals with CAI. None of the interventions was superior to the other 2.

Level of Evidence:

Level I, randomized controlled trial.
Adaptive attitude controller design for tail-sitter unmanned aerial vehicles
Authors: Liu Deyuan , Liu Hao , Zhang Jiansong , Lewis Frank L
Published: May 2020

Tail-sitter unmanned aerial vehicles have two flight modes: they can fly long distances at high cruising speeds as fixed-wing aircrafts; or hover, take off, and land vertically as rotary-wing aircrafts. The tail-sitter dynamics involves serious nonlinearities and high uncertainties, especially in the two flight mode transitions. In this article, an adaptive control approach is proposed for a class of tail-sitter unmanned aerial vehicles to achieve the robustness properties. The control torque allocation problem is addressed based on the dynamic pressure in the transition flight. The proposed control method does not need to switch the coordinate system, the controller structure, or the controller parameters in different flight modes. It is proven that the attitude tracking errors can converge into a given neighborhood of the origin in finite time. Simulation results are presented to show the advantages of the proposed adaptive control method.
Identifying the predictors of first-pass effect and its influence on clinical outcome in the setting of endovascular thrombectomy for acute ischemic stroke: Results from a multicentric prospective registry
Authors: Di Maria Federico , Kyheng Maéva , Consoli Arturo , Desilles Jean-Philippe , Gory Benjamin , Richard Sébastien , Rodesch Georges , Labreuche Julien , Girot Jean-Baptiste , Dargazanli Cyril , Marnat Gaultier , Lapergue Bertrand , Bourcier Romain ,   on behalf of the ETIS investigators*
Published: May 2020

Background

The first-pass effect, defined as a complete or near-complete recanalization after one pass (first-pass effect) of a mechanical thrombectomy device, has been related to better clinical outcome than good recanalization after more than one pass in acute ischemic stroke. We searched for predictors of first-pass effect by analyzing the results within a large prospective multicentric registry.

Methods

We included patients treated by mechanical thrombectomy for isolated anterior intracranial occlusions. A multi-variate logistic regression analysis was carried out to search for predictors of first-pass effect. We also analyzed the percentage of patients with 90-day modified Rankin Scale score 0 to 2, excellent outcome (90-day modified Rankin Scale 0 to 1), 24-h NIHSS change, and 90-day all-cause mortality.

Results

Among the 1832 patients included, clinical outcome at 90 days was significantly better in first-pass effect patients (50.6% vs. 38.9% in patients without first-pass effect), with a center-adjusted OR associated with first-pass effect of 1.74 (95%CI, 1.24 to 1.77). Older age, a lower systolic blood pressure, an MCA-M1 occlusion, higher DWI-ASPECTS at admission, mechanical thrombectomy under local anesthesia, and combined first-line device strategy were independent predictors of first-pass effect.

Conclusions

In this study, a strategy combining thrombectomy and thrombo-aspiration was more effective than other strategies in achieving first-pass effect. In addition, we confirm that clinical outcome was better in patients with first-pass effect compared to non-first-pass effect patients.
To hire or not to hire: the ambivalent impact of social rehire clauses on the Transfer of Undertakings Directive
Authors: Ratti Luca
Published: May 2020

Most EU countries are experiencing an increased use of Collective Labour Agreement clauses – Social Rehire Clauses – that oblige incoming service providers, while taking over a service, to employ all or part of outgoing providers’ personnel or at least give these workers priority future hiring. In the established case law of the Court of Justice, rehiring personnel is considered a crucial element, which may trigger the application of Council Directive 2001/23 on transfers of undertakings. This article defends the need to keep Social Rehire Clauses outside the material scope of the Directive, in order to respect social partners’ collective autonomy and prevent opportunistic behaviours, while promoting a fair competition between employers. Constitutionally justified under Article 3(3) TEU, and Articles 9, 147 and 151(1) TFEU, the protection of employment pursued by Social Rehire Clauses should be interpreted as legitimate limitation to the economic freedoms enshrined in the Treaties and the Charter of Fundamental Rights.
Working Out What Works: The Case of the Education Endowment Foundation in England
Authors: Edovald Triin , Nevill Camilla
Published: May 2020

Purpose:

This article gives an overview of the successes and lessons learned to date of the Education Endowment Foundation (EEF), one of the leading organizations of the What Works movement.

Design/Approach/Methods:

Starting with its history, this article covers salient components of the EEF’s unique journey including lessons learned and challenges in evidence generation.

Findings:

The EEF has demonstrated that it is feasible to rapidly expand the use of school-based randomized controlled trials (RCTs) in a country context, set high standards for research independence, transparency, and design, and generate new evidence on what works. Challenges include the need to consider alternative designs to RCTs to answer a range of practice-relevant questions, how to best test interventions at scale, and how study findings are reported and interpreted.

Originality/Value:

This article addresses some of the key components required for the success of What Works organizations globally.
Neisseria meningitidis: analysis of pili and LPS in emerging Brazilian strains
Authors: Portilho Amanda Izeli , Trzewikoswki de Lima Gabriela , De Gaspari Elizabeth
Published: May 2020

Background:

Neisseria meningitidis is the main cause of bacterial meningitis in Brazil, where the main serogroups isolated are B and C; however, the serogroup W has recently emerged. LPS and type IV pili are important virulence factors that increase meningococci pathogenicity.

Methods:

The characterization of Lipopolysaccharide (LPS) and type IV pili in 19 meningococci strains of serogroup B, 21 of serogroup C, 45 of serogroup W and 28 of serogroup Y, isolated in Brazil between 2011 and 2017, was conducted using the Enzyme-linked Immunosorbent Assay (Dot- ELISA) technique and monoclonal antibodies.

Results:

We would like to emphasize the importance of characterizing relevant antigens, such as pili and LPS, the use of monoclonal antibodies to support it, and how such studies improve vaccine development and monitoring. Most of the strains studied presented L3,7,9 LPS and type IV pili; both antigens are associated with the capacity to cause invasive disease.

Conclusion:

Due to the impact of meningococcal disease, it is important to maintain and improve vaccine studies. Epitopes characterization provides data about the virulence of circulating strains. The use of monoclonal antibodies and serological techniques are relevant and support vaccine development.
Driving Transformational Change through Organisational Culture
Authors: Venkataramani Sankaran , Kothandaraman Krishnamurthy
Published: May 2020

Culture is just like a ‘breeze’ that cannot be seen while for sure it can be felt and experienced. Often organisations believe that the success of any change initiative depends on the strength of execution focus, while on the contrary the success of transformation is sustainable only when it is driven through the organisations’ DNA. Organisations’ DNA is ingrained in its ‘culture’ dimension. Business success is not just about embracing a change one time, but it is about internalising the change in a manner to sustain and experience consistent outcomes benefiting all the associated stakeholders. This article would bring out the practical aspects of aligning culture and transformational change to attain sustainable outcomes. Exploring the cultural journey of organisations would not be complete until we deep-dive on aspects such as origin of organisational culture, impact of new technology and ways of working, dynamism of the ecosystem and the business-critical success factors. Success of transformational change is determined by the strength of its alignment with business benefits. Through our study, we have seen several organisations that in order to reap the fullest business benefits, transformational change needs to be evolved, ingrained and habituated through the dimensions of organisational culture.
13q12.2 deletions in acute lymphoblastic leukemia lead to upregulation of FLT3 through enhancer hijacking
Authors: Yang Minjun , Safavi Setareh , Woodward Eleanor L. , Duployez Nicolas , Olsson-Arvidsson Linda , Ungerbäck Jonas , Sigvardsson Mikael , Zaliova Marketa , Zuna Jan , Fioretos Thoas , Johansson Bertil , Nord Karolin H. , Paulsson Kajsa
Published: May 2020

Mutations in the FMS-like tyrosine kinase 3 (FLT3) gene in 13q12.2 are among the most common driver events in acute leukemia, leading to increased cell proliferation and survival through activation of the phosphatidylinositol 3-kinase/AKT-, RAS/MAPK-, and STAT5-signaling pathways. In this study, we examine the pathogenetic impact of somatic hemizygous 13q12.2 microdeletions in B-cell precursor (BCP) acute lymphoblastic leukemia (ALL) using 5 different patient cohorts (in total including 1418 cases). The 13q12.2 deletions occur immediately 5′ of FLT3 and involve the PAN3 locus. By detailed analysis of the 13q12.2 segment, we show that the deletions lead to loss of a topologically associating domain border and an enhancer of FLT3. This results in increased cis interactions between the FLT3 promoter and another enhancer located distally to the deletion breakpoints, with subsequent allele-specific upregulation of FLT3 expression, expected to lead to ligand-independent activation of the receptor and downstream signaling. The 13q12.2 deletions are highly enriched in the high-hyperdiploid BCP ALL subtype (frequency 3.9% vs 0.5% in other BCP ALL) and in cases that subsequently relapsed. Taken together, our study describes a novel mechanism of FLT3 involvement in leukemogenesis by upregulation via chromatin remodeling and enhancer hijacking. These data further emphasize the role of FLT3 as a driver gene in BCP ALL.
Clinical, laboratory, and genetic risk factors for thrombosis in sickle cell disease
Authors: Srisuwananukorn Andrew , Raslan Rasha , Zhang Xu , Shah Binal N. , Han Jin , Gowhari Michel , Molokie Robert E. , Gordeuk Victor R. , Saraf Santosh L.
Published: May 2020

Sickle cell disease (SCD) patients are at a four- to 100-fold increased risk for thrombosis compared with the general population, although the mechanisms and risk factors are not clear. We investigated the incidence and predictors for thrombosis in a retrospective, longitudinal cohort of 1193 pediatric and adult SCD patients treated at our institution between January 2008 and December 2017. SCD diagnosis and thrombotic complications were identified using International Classification of Diseases coding and verified through medical chart review. Clinical and laboratory data were extracted from the medical records. With a median follow-up of 6.4 years, 208 (17.4%) SCD patients experienced 352 thrombotic events (64 strokes, 288 venous thromboembolisms [VTE]). Risk factors for stroke included older age and HbSS/Sβ0-genotype and a lower hemoglobin (Hb) F% in the subset of HbSS/Sβ0-genotype patients (P < .05). VTE risk was independently associated with lower estimated glomerular filtration rate, hydroxyurea (HU) use, HbSS/Sβ0 genotype, and higher white blood cell (WBC) counts and Hb (P ≤ .03). Two thrombomodulin gene variants previously associated with thrombosis in the general African American population, THBD rs2567617 (minor allele frequency [MAF] 0.25; odds ratio [OR], 1.5; P = .049) and THBD rs1998081 (MAF, 0.24; OR, 1.5; P = .059), were associated with thrombosis in this cohort. In summary, thrombotic complications are common, and several traditional and SCD-specific risk factors are associated with thrombotic risk. Future studies integrating clinical, laboratory, and genetic risk factors may improve our understanding of thrombosis and guide intervention practices in SCD.
Transitioning to Del Nido cardioplegia for all-comers: the next switching gear?
Authors: Marzouk Mohamed , Lafreniere-Bessi Valerie , Dionne Stephanie , Simard Serge , Pigeon Christian , Dagenais François , Ad Niv , Jacques Frederic
Published: May 2020

Background

Exclusive use of Del Nido cardioplegia administration in all adult patients undergoing cardiac surgery has been studied for operative, postoperative and myocardial protection outcomes.

Methods

From November 2016 to October 2017, Del Nido cardioplegia was used in 131 consecutive patients (DN group). Using a propensity score, DN group was compared to 251 patients having received intermittent cold blood cardioplegia (CB group).

Results

Preoperative characteristics were similar in DN and CB groups. Operative outcomes were statistically different (p < 0.0001): cardiopulmonary bypass (CPB) time (DN 105.9 ± 46.5, CB 131.2 ± 38.8); aortic cross-clamp time (DN 80.8 ± 35.5, CB 102.2 ± 31.3); operative time (DN 203.1 ± 65.0, CB 241.5 ± 54.7); total cardioplegia volume (DN 1328 ± 879, CB 3773 ± 1226); and peak glycemia on CPB (DN 8.2 ± 2.3, CB 9.0 ± 1.8). No statistical differences were noted in intensive care unit stay, hospital stay and hospital death. Myocardial protection outcomes were similar: discharge left ventricular ejection fraction (DN 52 ± 11, CB 51 ± 10); Troponin levels at the end of the surgery (DN 871 ± 1623, CB 1958 ± 854), day 1 (DN 853 ± 1139, CB 993 ± 8234) and day 4 (DN 442 ± 540, CB 463 ± 317).

Conclusion

Del Nido cardioplegia use in all adult cardiac surgeries is associated with improved surgical efficiency. The design of larger trials including adults combined cardiac procedures and emergencies is needed.
Prescribing and medical non-adherence after myocardial infarction: qualitative interviews with general practitioners in Germany
Authors: Freier Christian , Heintze Christoph , Herrmann Wolfram J.
Published: May 2020

Background

An increasing prevalence of having survived a myocardial infarction increases the importance of medical secondary prevention. Although preventive medication reduces mortality, prescribing and adherence are known to be frequently insufficient. General practitioners are the most important prescriber. However, their perspective on prescribing and medical non-adherence following myocardial infarction has not yet been explored. Thus, the aim of this study was to explore the general practitioners’ perspective on long-term care after myocardial infarction focussing on medical prevention.

Methods

In this qualitative interview study we conducted episodic interviews with sixteen general practitioners from rural and urban surgeries in Germany. Framework analysis with focus on general practitioners’ prescribing and patients’ non-adherence was performed.

Results

Almost all general practitioners reported following guidelines for myocardial infarction aftercare and prescribing the medication that was initiated in the hospital; however, they described deviating from guidelines because of drugs’ side effects or patients’ intolerances. Some questioned the benefits of medical secondary prevention for the oldest of patients.

General practitioners perceived good adherence among their patients who had had an MI while they regarded their methods for assessing medical non-adherence as limited. They perceived diverse reasons for non-adherence, particularly side effects, patients’ freedom from symptoms and patients’ indifference to health. They attributed mainly negative characteristics, like lack of knowledge and understanding, to non-adherent patients. These characteristics contribute to the difficulty of convincing these patients to take medications as prescribed.

General practitioners improved adherence by preventing side effects, explaining the medication’s necessity, facilitating intake and involving patients in decision-making. However, about half of the general practitioners reported threatening their patients with negative consequences of non-adherence.

Conclusions

General practitioners should be aware that discharge medication can be insufficient and thus, should always check hospital recommendations for accordance with guideline recommendations. Improving physicians’ communication skills and informing and motivating patients in an adequate manner, for example in simple language, should be an important goal in the hospital and the general practitioner setting. General practitioners should assess patients’ motivations through motivational interviewing, which no general practitioner mentioned during the interviews, and talk with them about adherence and long-term treatment goals regularly.
Association between lifestyle factors and decreased kidney function in older adults: a community-based cross-sectional analysis of the Taipei City elderly health examination database
Authors: Chang Horng-Jinh , Lin Kuan-Reng , Lin Meng-Te , Chang Junn-Liang
Published: May 2020

Background

Impaired kidney function is the hallmark of chronic kidney disease (CKD), and is associated with increased risk of all-cause mortality in the elderly. In the present cross-sectional population-based study, we aimed to evaluate the associations between lifestyle factors (exercise habit, alcohol consumption, smoking history, and betel nut chewing) and decreased kidney function.

Methods

The data from the Taipei City Elderly Health Examination Database (2006 to 2012) were extracted. Associations between risk factors and reduced estimated Glomerular filtration rate (eGFR) were evaluated by regression and stratification analyses.

Results

A total of 297,603 participants were included in the final analysis, and 29.7% of them had reduced eGFR. Smoking was significantly associated with an elevated risk of reduced eGFR. While, physical exercise conferred to a significantly decreased adjusted odds ratio (aOR) in reduced eGFR (regular exercise, aOR = 0.79; occasional exercise, aOR = 0.87). Furthermore, the protective effect of exercise habit against reduced eGFR was not affected by comorbid conditions, such as hypertension, diabetes, obesity, and cardiovascular disease.

Conclusions

Engaging in physical exercise was beneficially associated with reduced eGFR in older individuals. Longitudinal or prospective studies are warranted for confirmation and extrapolation of the current findings.
Cigarette smoke exposure impairs lipid metabolism by decreasing low-density lipoprotein receptor expression in hepatocytes
Authors: Ma Baitao , Chen Yunfei , Wang Xuebin , Zhang Rui , Niu Shuai , Ni Leng , Di Xiao , Han Qin , Liu Changwei
Published: May 2020

Background

Cigarette smoke (CS) exposure impairs serum lipid profiles and the function of vascular endothelial cells, which accelerates the atherosclerosis. However, the precise mechanism and effect on the expression of low-density lipoprotein receptor (LDLR) in the liver by CS exposure is still unclear.

Methods

In this study, adult male C57BL/6 J mice were divided into three groups, with one group being exposed to CS for 6 weeks. HepG2 cells were treated with CS extract at concentrations of 1, 2.5, 5, and 10%.

Results

The serum levels of total cholesterol (TC), triglycerides (TGs), and low-density lipoprotein cholesterol (LDL-C) for the CS-exposure group were significantly higher than those in the control group (P < 0.05). Moreover, CS exposure decreased the LDLR expression in the hepatocytes and promoted inflammation in the blood vessel walls. Melatonin was intraperitoneally injected at 10 mg/kg/d for 6 weeks alongside CS exposure, and this significantly decreased the levels of TC, TGs, and LDL-C and decreased the expression of intercellular adhesion molecule-1 and the infiltration of cluster determinant 68-cells. In vitro, CS extract prepared by bubbling CS through phosphate-buffered saline decreased the LDLR expression in HepG2 cells in a time- and concentration-dependent manner, and this effect was prevented by pretreatment with 100 μM melatonin.

Conclusions

In conclusion, CS exposure impaired lipid metabolism and decreased LDLR expression in hepatocytes, and these effects could be prevented by melatonin supplementation. These findings implied that melatonin has the potential therapeutic applicability in the prevention of lipid metabolic disorder in smokers.