bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparisons of clinical manifestations and prognosis between giant cell arteritis patients with or without sensorineural hearing loss
Authors: Chu Xiaotian , Wang Dongmei , Zhang Yun , Yin Yue , Cao Yu , Han Xinxin , Shen Min , Jiang Hong , Zeng Xuejun
Published: April 2019

Auditory manifestations has rarely been mentioned in studies concerning giant cell arteritis (GCA). This study explores the proportion of hearing loss (HL) in Chinese GCA patients and investigates the differences in clinical features between GCA patients with and without HL.

The study retrospectively reviewed the clinical records of 91 patients diagnosed with GCA at Peking Union Medical College Hospital (PUMCH) from November 1998 to October 2017. GCA diagnoses were reconfirmed according to the American College of Rheumatology 1990 criteria. Diagnosis of HL was made based on a patient's symptoms combined with physical examination or ear-nose-throat (ENT) audiometry tests. Subgroup analysis was conducted according to the occurrence of HL.

Totally 23 patients (25.3%) had HL. A higher percentage of males (65.2% vs 38.2%, p = 0.025) was seen in HL group. Symptoms such as headache (91.3% vs 61.2%, p = 0.011), visual loss (56.5% vs 32.4%, p = 0.039) and CNS symptoms (39.1% vs 17.6%, p = 0.035) were more frequent in HL group. Moreover, they were more likely to have smoking history (p = 0.019), lower lymphocyte count (p = 0.049), positive ANA or APL (p = 0.047, p = 0.017) or negative biopsy results (p = 0.015). Symptom like myalgia (26.1% vs 66.2%, p = 0.001) as well as comorbid disease like coronary artery disease (p = 0.037) and hypertension (p = 0.040) was more frequent in patients without HL. Either C-reactive protein (90.91 ± 65.86 vs 76.05 ± 61.15 mg/L, p = 0.347) or erythrocyte sedition rate (83.04 ± 29.61 vs 93.69 ± 26.78 mm/h, p = 0.136) was high in both groups but the differences were not significant. Meanwhile, no significant differences were found in age, disease course, vascular involvement or prognosis between the two groups. Unilateral HL tended to happen at the same side with unilateral headache, visual loss, scalp tenderness or jaw claudication.

HL is probably not rare in GCA patients and is more frequently to be seen in patients presented with headache, visual loss or CNS symptoms. Differentiation of HL is necessary for specialists and GCA should be considered as a potential diagnosis especially in HL patients with high inflammatory markers. Auditory assessment should be conducted in GCA management.
The effect of ifosfamide, epirubicin, and recombinant human endostatin therapy on a cardiac angiosarcoma
Authors: Jiang Lijun , Xu Xingjie , Davies Henry , Shi Kexin
Published: April 2019

Rationale

Cardiac angiosarcoma is a rare malignant tumor, for which only surgery has been proven to be effective to date. Currently there are no reports as to whether a postoperative regimen of ifosfamide, epirubicin, and recombinant human endostatin is effective.

Patient concern

The patient presented to us with chest pain and dyspnea.

Diagnosis

Enhanced computerized tomography (CT) and positron emission tomography–computerized tomography (PET-CT) suggested pericarditis and an atrial perforation, but malignancy was suspected, so the patient underwent an operation to resect the tumor and repair. Pathology of the tumor reseccted at operation showed the tumor to be an angiosarcoma.

Intervention

After the surgery, the patient was stared on a paclitaxel chemotherapy regimen (135 mg/m2 once every 3 weeks). However, 2 cycles later, pulmonary and hepatic metastases were found. Chemotherapy was then changed to ifosfamide, epirubicin (ifosfamide 2000 mg/m2 days 1–3, epirubicin 70 mg/m2 days 1–2) and recombinant human endostatin (7.5 mg/m2 days 1–14) in 3 weekly cycles.

Outcome

Three cycles later, follow-up showed that chemotherapy had delayed progression of the pulmonary metastases, but that the hepatic node was still growing. The patient has now survived 8 months post surgery and is still on follow-up.

Lessons

This case shows us that operation on late stage cardiac angiosarcomas can alleviate a patient's symptoms; postoperative paclitaxel monotherapy was insufficient and ifosfamide and epirubicin plus recombinant human endostatin has a limited effect on late stage cardiac angiosarcoma. Studies with a larger sample size are needed for verification of these findings.
Intracranial solitary fibrous tumor
Authors: Sun Lian-Jie , Dong Jun , Gao Feng , Chen Dong-Ming , Li Ke , Liu Jiang , Zhang Cheng , Tohti Maitiyiming , Yang Xiao-Peng
Published: April 2019

Rationale:

Intracranial solitary fibrous tumor (ISFT) is a rare spindle cell tumor derived from dendritic mesenchymal cells expressing CD34 antigens, which are widely distributed in human connective tissues.

Patient concerns:

In two case reports, we describe a 61-year-old woman and a 42-year-old man who present with intracranial malignant SFTs. Computed tomography or magnetic resonance imaging of head revealed that the largest size is about 3.3 × 3.0 cm in left occipital part and 4.0 × 3.0 cm in right skull base.

Diagnosis:

Postoperative pathological results demonstrated that all of two cases are SFT. Case one: Immunohistochemical examination demonstrated a strong immunoreaction for cluster of differentiation (CD)34, B-cell lymphoma 2 (Bcl-2) and Vimentin (Vim). Case two: The tumor was distinctively positive for Bcl-2, but not for CD34 and Vim.

Interventions:

One of the two patients recurred 6 years after the first tumor resection. After the recurrence, two gamma knife treatments were given, and another operation was performed about five years later. In one case, only tumor resection was performed.

Outcomes:

Case one: The postoperative neurological status was substantially improved and regular follow-up examinations for 6 months postsurgery have shown that the patient is currently disease-free. Case two: The patient achieved a good outcome, with no epilepsy or other neurological symptoms experienced on a regular 6-month follow-up. The patient is currently disease free.

Lessons:

Imaging findings can be used to assist the diagnosis. The diagnostic method is pathology, and total surgical resection is the most effective treatment. The main treatment methods were total resection, supplemented by radiotherapy and chemotherapy if necessary.
Association of the MUTYH Gln324His (CAG/CAC) variant with cervical carcinoma and HR-HPV infection in a Chinese population
Authors: Chen Huaizeng , Wang Hanzhi , Liu Jia , Cheng Qi , Chen Xiaojing , Ye Feng
Published: April 2019

This study was performed to investigate the relationship between the MUTYH Gln324His (CAG/CAC) genotype and risk of cervical squamous cell carcinoma (CSCC) in a case-control setting. Mismatch amplification-polymerase chain reaction (MA-PCR) was applied to detect the polymorphism in 400 CSCC, 400 CIN III and 1200 control participants. The homozygous His324His (CAC/CAC) genotype of MUTYH was associated with significantly increased risk of CIN III (OR = 1.94) and CSCC (OR = 3.83). Increased risk of CIN III (OR = 1.34) and CSCC (OR = 1.97) was additionally observed with the heterozygous CAG/CAC genotype. Overall, individuals in both CAC/CAC and CAG/CAC genotype groups were at higher risk of cervical carcinoma (CINIII (OR = 1.46) and CSCC (OR = 2.34)). Within the HR-HPV infection-positive group, CAC/CAC and CAG/CAC genotypes were significantly enriched in relation to CIN III and CSCC. Moreover, we observed a positive correlation between the proportion of homozygous CAC/CAC MUTYH genotype and malignant prognostic factors of CSCC, such as cell differentiation grade and lymph node metastasis. These findings clearly highlight associations between the MUTYH Gln324His (CAG/CAC) polymorphism and susceptibility to CSCC, HR-HPV infection and specific prognostic factors, supporting the utility of this variant as an early indicator for patients at high risk of cervical carcinoma.
Do lumbar magnetic resonance imaging changes predict neuropathic pain in patients with chronic non-specific low back pain?
Authors: Vagaska Eva , Litavcova Alexandra , Srotova Iva , Vlckova Eva , Kerkovsky Milos , Jarkovsky Jiri , Bednarik Josef , Adamova Blanka
Published: April 2019

The aim of this observational, cross-sectional study was to analyse lumbar magnetic resonance imaging (MRI) findings in patients with non-specific chronic low back pain (CLBP), and to evaluate any correlation with pain intensity and their capacity to predict neuropathic pain (NP) in these patients.

Fifty-two patients with non-specific CLBP, between 21 and 62 years of age, 50% men, were investigated. Lumbar MRI was employed to assess disc degeneration, endplate changes, Modic changes, disc displacement, facet degeneration, foraminal stenosis and central lumbar spinal stenosis. The characteristics of pain were evaluated and patients were divided into 2 subgroups: with NP (24 patients) and without NP (28 patients), based on the results of a DN4-interview. Correlations between particular MRI changes and their relations to the intensity of pain were evaluated. Logistic regression was used to disclose predictors of NP.

Lumbar spine degenerative features were frequent in patients with non-specific CLBP, with L4/5 the most affected level. A significant correlation emerged between the severity of degenerative changes in particular lumbar spine structures (correlation coefficient ranging between 0.325 and 0.573), while no correlation was found between severity of degenerative changes and pain. Multivariate logistic regression revealed only 2 independent predictors of NP – female sex (odds ratio [OR] = 11.9) and a mean pain intensity of ≥4.5 in the previous 4 weeks (OR = 13.1).

Degenerative changes in the lumbar spine are frequent MRI findings, but do not correlate with the intensity of pain and do not predict NP. However, female sex and pain intensity do predict NP.
Early enteral nutrition supplemented with probiotics improved the clinical outcomes in severe head injury
Authors: Yi Li-Juan , Tian Xu , Shi Bing , Pi Yuan-Ping , Chen Wei-Qing
Published: April 2019

Background:

The role of early enteral nutrition (ENN) supplemented with probiotics (<48 hours) in improving clinical outcomes of patients with severe head injury (SHI) remains controversial. We performed this meta-analysis to investigate the efficacy of EEN supplemented with probiotics on clinical outcomes in these patients.

Methods:

Systematic searches were performed in PubMed, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang database, and Chinese Biomedical Literature to identify potential studies. Two investigators checked citations, extracted data, appraised risk of bias, and then STATA 12.0 was used to perform statistical analysis.

Results:

A total of 18 trials were eventually included in the present study. Meta-analysis indicated that EEN supplemented with probiotics was associated with decreased risk of infection (risk ratio [RR], 0.53; 95% confidence interval [CI], 0.44–0.65), decreased risk of mortality (RR, 0.56; 95% CI, 0.38–0.82), decreased risk of gastrointestinal complications (RR, 0.19; 95% CI, 0.13–0.25), and shortened stays in intensive care unit (ICU) (mean difference [MD], −4.55; 96% CI, −5.91 to −3.19).

Conclusion:

EEN supplemented with probiotics may be a promising alternative for patients with SHI because it effectively decreased the risk of infection, mortality, and gastrointestinal complications, as well as shortened the stays in ICU.
Mobilizing Education to Nurses at the Bedside
Authors: Van Ryan Velvet , Draganski Eryn , Schellbach Laurie H.
Published: April 2019

After a survey revealed practice gaps in central venous catheter care, one organization was challenged to identify a novel approach to educate nurses. Through a search for evidence, a project workgroup discovered an existing but beneficial teaching method, using a mobile cart to deliver meaningful education at the point of care. Successful outcomes and sustained practice change were realized.
Regulation of virulence and antibiotic resistance in Gram-positive microbes in response to cell wall-active antibiotics
Authors: Evans Jessica J. , Bolz Devin D.
Published: April 2019

Purpose of review

Antibiotic stress can evoke considerable genotypic and phenotypic changes in Gram-positive bacteria. Here, we review recent studies describing altered virulence expression in response to cell wall-acting antibiotics and discuss mechanisms that coordinate regulation of the antibiotic response.

Recent findings

Pleiotropic effects induced by antibiotic exposure include alterations to bacterial metabolism, cell wall structure and antibiotic resistance. In addition, subinhibitory concentrations of cell wall-active (CWA) antibiotics have increasingly been shown to induce the production of exotoxins and biofilm formation that may influence virulence. Remarkably, phenotypes associated with comparable antibiotic stresses can vary considerably, emphasizing the need to better understand the response to CWA antibiotics. Recent studies support both direct antibiotic recognition and recognition of antibiotic-induced stress to the bacterial cell wall. Specifically, bacterial two-component systems, penicillin-binding protein and serine/threonine kinase-associated kinases and conserved oxidative-stress sensors each contribute to modulating the antibiotic stress response.

Bacterial sensory systems and global regulators coordinate signaling in response to CWA antibiotics. Regulation of the antibiotic response is complex and involves integration of signals from multiple response pathways. A better definition of the antibiotic stress response among Gram-positive pathogens may yield novel therapeutic targets to counter antibiotic resistance and virulence factor expression.
Major Structural Airway Pathologies of Patient Complaining Nasal Obstruction: Analysis of Frequency, Preoperative Complaints and Benefit from Surgery
Authors: Üstün Galip Gencay , Öztürk Semih , Gürsoy Koray , Ergun Elif , Dağ Osman , Koçer Uğur
Published: April 2019

Introduction:

Modern rhinoplasty has an aesthetic and a functional component that cannot be separated. Functional rhinoplasty generally concentrates on optimizing nasal airflow. Numerous techniques have been described for correction of each pathology. There seems to be a consensus on the benefit of surgery to patients with nasal obstruction. Present study aimed to determine if specific airway pathologies have differential effects on patient complaints and techniques addressing them have differential effects on perceived benefit from surgery.

Patients/Method:

The records of 300 patients complaining nasal obstruction and had computerized tomography (CT) between April 2015 and April 2018 were retrospectively reviewed. Based on surgical notes, surgical techniques used for each patient were recorded. A survey using Nasal Obstruction Symptom Evaluation (NOSE) scale is done by phone. After descriptive statistics, preoperative complaint-diagnosed pathology, and postoperative relief-treated pathology relationships were evaluated.

Results:

Preoperative and postoperative NOSE scores showed statistically significant difference (P <0.001). The CT analysis showed that septal deviation rate among patients complaining nasal obstruction is 85%, internal valve insufficiency rate is 34.4%, mild and severe inferior turbinate hypertrophy was 71% and 6%, respectively. Bullous and total concha bullosa of middle turbinate was 17.3%. Nearly 90% of patients had 2 or more types of pathology in CT analysis. Preoperative and postoperative NOSE scores showed no statistically significant relationship with singular intranasal pathologies and techniques used for correcting them, respectively.

Conclusion:

Despite general fall in NOSE scores in the whole study group, treatment of a specific pathology does not change NOSE score more than a patient who already does not have the pathology. None of the pathologies or treatments addressing them have a dominating effect on preoperative complaints or obtained relief after the surgery. So, success of functional rhinoplasty cannot rely on correction of a specific pathology. A comprehensive analysis and correction of every pathology is paramount.
Comparison of Lip Line Cant Change After 1-Jaw and 2-Jaw Surgery
Authors: Lee Ui-Lyong , Nam Ji-Hye , Choi Won-Cheul , Kim Hye-Won , Kim Hye-Jin , Choi Young-Jun
Published: April 2019

Objectives:

The purpose of this study was to compare the lip line cant (LLC) changes after 1 and 2-jaw surgery, and to evaluate the correlations of the craniofacial factors affecting LLC.

Methods:

The study subjects were selected (LLC amount within 1.5–6.0°) from among the patients diagnosed with Class III malocclusion who underwent one (n = 20) or 2-jaw surgery (n = 20). Cone beam computed tomography images were obtained immediately before the operation (T1) and 6 months after the operation (T2). Preoperative and postoperative craniofacial measurements were obtained.

Results:

The study subjects showed 3.12° LLC on average before undergoing 1-jaw surgery, and their LLC changed to 1.27° after the surgery. As for 2-jaw surgery, the subjects showed 3.38° LLC on average before the surgery and 0.98° after the surgery. LLC at pre-treatment may be more affected by a cant of the occlusal plane in the mandible than maxilla. In the comparison of the value of changes of LLC, the value of 2-jaw surgery was bigger than the value of 1-jaw surgery but the difference was statistically insignificant.

Limitations:

This study had a limitation in that the muscles were not considered. And the metal bracket or metal crown and bridge, however, can cause noise and blurring artifacts in CT, which can lead to a low resolution. And the limited number of the patients should be considered.

Conclusions:

In correlation analysis, both pre-surgery LLC and change of LLC have correlation with almost all the craniofacial measurement. Lip-line cant of patients with facial asymmetry has higher correlation with mandibular cant than with other cants. To improve the LLC, a surgical plan should be established to minimize the mandibular cant using the computer simulation as well as the maxillary cant.
Precision Analysis of Supraorbital Transcranial Exits Using Three Dimensional Multidetector Computed Tomography
Authors: Lim Nam Kyu , Kim Young Ho , Kang Dong Hee
Published: April 2019

Purpose:

Anatomical variation in supraorbital transcranial exits, which can be divided into the lateral supraorbital exit and the medial frontal exit, has been investigated in several studies during the past few decades. However, in previous studies, inconsistent criteria were used for classifying those exits. The authors analyzed variations in supraorbital transcranial exits using 3 dimensional multidetector computed tomography (3D MDCT), and present a consistent classification of the types of those exits with precise location measurements.

Methods:

In 1181 patients (2362 orbits) who underwent facial 3D MDCT, the authors measured a set of qualitative and quantitative parameters. The qualitative parameters included an assessment of the location and type of the exit, and the number of accessory foramina. The quantitative parameters included various distance measurements.

Results:

A frontal exit was present in 2071 orbits and a supraorbital exit in 953. Neither a frontal exit nor a supraorbital exit was found in 11 orbits. The most common type of frontal exit was the notch type, followed by the foramen type and none. The mean distance from the nasion to the frontal exit was 24.70 ± 3.50 mm on the right side and 23.69 ± 3.42 mm on the left side.

Conclusion:

In conclusion, various types of supraorbital transcranial exits were observed, of which the frontal notch was the most common. This is the first study to conduct a consistent analysis of a large sample of skulls to characterize the distribution of supraorbital transcranial exit types using a comprehensive and clear set of criteria.
Neuro-Ophthalmic Symptoms of Primary Headache Disorders: Why the Patient With Headache May Present to Neuro-Ophthalmology
Authors: Smith Stacy V.
Published: April 2019

Background:

Primary headache disorders can cause many ophthalmic symptoms that lead many patients to present for neuro-ophthalmic evaluation. Neuro-ophthalmologists frequently encounter these patients in clinical practice.

Evidence Acquisition:

A literature review was completed in PubMed using the following terms paired with “migraine” and “headache:” dry eye, eye pain, monocular diplopia, binocular diplopia, photophobia, visual field defect, tunnel vision, floaters, amaurosis fugax, transient visual obscuration, autonomic symptoms, anisocoria, visual snow, Alice in Wonderland syndrome, and palinopsia.

Results:

Patients with migraine experience a wide range of visual disturbances including aura and more complex perceptual abnormalities such as Alice in Wonderland syndrome and visual snow. Visual disturbances may consist of positive and/or negative phenomena and may be binocular or monocular. Migraine and other primary headache disorders can be associated with photophobia, eye pain, dry eye, autonomic features, and anisocoria.

Conclusions:

Patients with primary headache disorders may experience a wide range of visual and ophthalmic symptoms. An understanding of the typical features of these disorders allows providers to help patients find appropriate treatment without unnecessary testing and to recognize when atypical presentations require additional evaluation.
A Comprehensive Computational Study of Amino Acid Interactions in Membrane Proteins
Authors: Mbaye Mame Ndew , Hou Qingzhen , Basu Sankar , Teheux Fabian , Pucci Fabrizio , Rooman Marianne
Published: April 2019

Transmembrane proteins play a fundamental role in a wide series of biological processes but, despite their importance, they are less studied than globular proteins, essentially because their embedding in lipid membranes hampers their experimental characterization. In this paper, we improved our understanding of their structural stability through the development of new knowledge-based energy functions describing amino acid pair interactions that prevail in the transmembrane and extramembrane regions of membrane proteins. The comparison of these potentials and those derived from globular proteins yields an objective view of the relative strength of amino acid interactions in the different protein environments, and their role in protein stabilization. Separate potentials were also derived from α-helical and β-barrel transmembrane regions to investigate possible dissimilarities. We found that, in extramembrane regions, hydrophobic residues are less frequent but interactions between aromatic and aliphatic amino acids as well as aromatic-sulfur interactions contribute more to stability. In transmembrane regions, polar residues are less abundant but interactions between residues of equal or opposite charges or non-charged polar residues as well as anion-π interactions appear stronger. This shows indirectly the preference of the water and lipid molecules to interact with polar and hydrophobic residues, respectively. We applied these new energy functions to predict whether a residue is located in the trans- or extramembrane region, and obtained an AUC score of 83% in cross validation, which demonstrates their accuracy. As their application is, moreover, extremely fast, they are optimal instruments for membrane protein design and large-scale investigations of membrane protein stability.
Modulating pathogenesis with Mobile-CRISPRi
Authors: Qu Jiuxin , Prasad Neha K. , Yu Michelle A. , Looney Mark R. , Chen Shuyan , Lyden Amy , Crawford Emily , Silvis Melanie R. , Peters Jason M. , Rosenberg Oren S.
Published: April 2019

Pathogens express a set of proteins required for establishing and maintaining an infection, termed virulence life-style genes (VLGs). Due to their outsized importance in pathogenesis, VLG products are attractive targets for the next generation of antimicrobials. However, precise manipulation of VLG expression in the context of infection is technically challenging, limiting our ability to understand the roles of VLGs in pathogenesis and accordingly design effective inhibitors. We previously developed a suite of gene knockdown tools that are transferred by conjugation and stably integrate into pathogen genomes that we call “Mobile-CRISPRi”. Here we show the efficacy of Mobile-CRISPRi in controlling VLG expression in a murine infection model. We optimize Mobile-CRISPRi inPseudomonas aeruginosafor use in a murine model of pneumonia by tuning the expression of CRISPRi components to avoid non-specific toxicity. As a proof of principle, we demonstrate that knockdown of a VLG encoding the type III secretion system (T3SS) activator ExsA blocks effector protein secretion in culture and attenuates virulence in mice. We anticipate that Mobile-CRISPRi will be a valuable tool to probe the function of VLGs across many bacterial species and pathogenesis models.

Importance

Antibiotic resistance is a growing threat to global health. To optimize the use of our existing antibiotics and identify new targets for future inhibitors, understanding the fundamental drivers of bacterial growth in the context of the host immune response is paramount. Historically these genetic drivers have been difficult to manipulate, as they are requisite for pathogen survival. Here, we provide the first application of Mobile-CRISPRi to study virulence life-style genes in mouse models of lung infection through partial gene perturbation. We envision the use of Mobile-CRISPRi in future pathogenesis models and antibiotic target discovery efforts.
Polymorphism and pseudosymmetry of 10,10′-oxybis(9-thia-10-hydro-10-boraanthracene)
Authors: Radtke Julian , Lerner Hans-Wolfram , Bolte Michael
Published: April 2019

We have encountered two polymorphs of the title compound, C24H16B2OS2, both of which display almost the same unit-cell parameters. Compound (I) crystallizes in the non-centrosymmetric space groupP21with four molecules in the asymmetric unit. These molecules are related by pseudosymmetry. As a result, the space group looks likeP21/c, but the structure cannot be refined successfully in that space group. Compound (II) on the other hand crystallizes in the centrosymmetric space groupP21/cwith only two molecules in the asymmetric unit. The crystals studied for (I) and (II) were both non-merohedral twins.
Crystal structure of 2,3,5,6-tetrabromoterephthalonitrile
Authors: Noland Wayland E. , Schneerer Andrew K. , Raberge Emilie J. , Tritch Kenneth J.
Published: April 2019

The title crystal (systematic name: 2,3,5,6-tetrabromobenzene-1,4-dicarbonitrile), C8Br4N2, is the first bromo analog in a study of cyano-halo (C[triple-bond]N...X) non-bonded contacts in crystals of halogenated dicyanobenzenes. The complete molecule is generated by a crystallographic center of symmetry. In the extended structure, each Br atom accepts one C[triple-bond]N...Br interaction, and each N atom is bisected by two. This contact network forms a nearly planar sheet structure propagating in the (\overline{1}01) plane, similar to that reported in hexamethylbenzene co-crystals of the tetrachloro analog.
1,1′-Bis(4-bromophenyl)-3,3′-diphenylferrocene
Authors: Peloquin Andrew J. , Smith Madelyn B. , Balaich Gary J. , Iacono Scott T.
Published: April 2019

In the title compound, [Fe(C17H12Br)2], the FeII atom is sandwiched between the eclipsed five-membered rings, with Fe...ring centroid distances of 1.649 (3) and 1.652 (3) Å. In one of the ligands, the Br atom is disordered over two locations [site occupancies = 0.839 (2) and 0.161 (2)].
A hospital recreation room quality improvement intervention
Authors: Dolan Lorraine , Kane Maria , Timmins Fiona , Prizeman Geraldine , Dempsey Orla
Published: April 2019

Purpose

Patients with extended hospital admissions had no recreation facilities in the ward. They were often confined to spaces around their beds, using the ward corridor for rehabilitation. The purpose of this paper is to outline a quality improvement (QI) intervention-provision of a recreational space for long-stay patients.

Design/methodology/approach

An exploratory quantitative pre-, post-test design was utilised, and executed in three phases: patients, visitors and staff survey to explore recreation and comfort needs and preferences; store room refurbishment; and patient, visitor and staff satisfaction with the recreation room.

Findings

Overall, 77 questionnaires were completed (n=49 staff; n=28 patient/visitor). Almost two-thirds (64.7 per cent; n=11) of patients had a stay greater than six weeks. Insufficient private space and concerns about disturbing other patients were identified as barriers to taking part in activities. Consequently, a store room was refurbished as a recreation room (9.0 m × 6.0 m) and furnished in three distinct areas. Following refurbishment, over 90 per cent (n=24) of respondents agreed that there was a suitable space where patients could “go and chat” and spend time with family and visitors or speak to the healthcare team.

Practical implications

The physical environment in acute hospitals is seldom prioritised. Needs-based QI projects can improve patient hospital experiences.

Originality/value

This case study highlights how nursing staff can be informed by patients’ and families’ needs and preferences, and initiate QI projects that improve patient hospital experiences.
Can Bahraini patients accept e-health systems?
Authors: Zolait Ali , Radhi Nadeen , Alhowaishi Muna Moahmmed , Sundram Veera Pandiyan Kaliani , Aldoseri Lulwa Mohammed
Published: April 2019

Purpose

The purpose of this paper is to examine whether Bahraini individuals accept e-health system and the prominent factors affecting e-health system adoption in Bahrain.

Design/methodology/approach

The authors adopted a quantitative and qualitative approach, i.e., a self-administered questionnaire, unstructured and a semi-structured interview, which were used to collect the data. A questionnaire was distributed to Bahraini residents selected randomly. The framework was based on the technology acceptance model (TAM) and theory of reasoned action (TRA). Important variables from both the TAM model and TRA theory were extracted and jointly used to build the research model.

Findings

The findings indicated that the most factors affecting e-health adoption are trust, health literacy and attitude. Additionally, people in the private and government sectors understand e-health benefits.

Practical implications

If healthcare professionals understand the factors affecting e-health system adoption from an individual and organisational perspective, then nurses, pharmacists and others will be more conscious about e-health and its adoption status.

Originality/value

E-health system adoption has become increasingly important to governments, individuals, and researchers in recent years. A novel research framework, based on TAM and TRA, was used to produce a new integrated model.
Envisioning green solutions for reducing the ecological footprint of a university campus
Authors: Genta Chiara , Favaro Silvia , Sonetti Giulia , Barioglio Caterina , Lombardi Patrizia
Published: April 2019

Purpose

This paper aims to report strategies towards a green campus project at Politecnico di Torino University, a 33,000-students Italian higher education institution (HEI), and estimate the avoided ecological footprint (EF) of different scenarios accounted for open spaces.

Design/methodology/approach

A consumption-based study has been developed to analyse the current EF of the main campus site. Data were collected from different departments and administrative units to identify the measure of the pressure exerted by the campus activities on the ecosystem. Then, possible scenarios were accounted for open spaces along five different design layers: energy, water, landscape, food and mobility. Acting on the spaces by means of biophilic design and user-driven design requires complex considerations on university’s anticipated future needs and a wide-ranging evaluation of the most appropriate pathways forward according to all university stakeholders, far beyond the mere accounting of avoided EF.

Findings

A reduction of the 21 per cent of the current EF can be achieved through the solutions envisaged in the green campus project along the open space layers. Moreover, universities have the opportunity to not only improve the sustainability of their facilities but also demonstrate how the built environment can be designed to benefit both the environment and the occupants.

Research limitations/implications

The acknowledgement of predicted behavioural change effects is a question left open to further researchers on methods and indicators for social impact accounting and reporting in truly sustainable university campuses.

Originality/value

This is the first research that estimates the EF of an Italian HEI. The research represents also an innovative approach integrating the EF reduction scenarios in the design process of the new masterplan of open spaces, trying to identify the connection between environmental impact reduction and improvement in users’ perception.
Small-scale poultry enterprises in Kenyan medium-sized cities
Authors: Omondi Samuel Onyango
Published: April 2019

Purpose

The purpose of this paper is to investigate the profitability of urban chicken production in the medium-sized cities of Kisumu and Thika, Kenya.

Design/methodology/approach

Data were collected in 2016 from a sample of 157 indigenous chicken producers in the two cities. Descriptive analyses were used to characterize indigenous chicken production, marketing and profitability. In addition, multivariate regression models were estimated to determine factors influencing profitability of the enterprise.

Findings

Urban indigenous chicken production mainly serves a dual role of food provision and income generation. The enterprise is profitable, generating an average gross margin of Ksh. 756/bird. The multivariate regression models show that access to high-value markets, household income level and the type of production system used significantly affect profitability of indigenous chicken farming. However, poultry diseases and high input costs especially feed are the major constraints to poultry farming.

Research limitations/implications

This study has used cross-sectional data that provides information for only one point in time. Future research should be able to capture the seasonality of indigenous chicken production.

Social implications

This study has shown that indigenous chicken production in urban areas is a viable and profitable enterprise, which could provide an avenue for employment and income generation.

Originality/value

Studies assessing profitability of urban agricultural enterprises are scant. Thus, this study provides insights on the profitability of a common urban agriculture enterprise.
Does corruption cause tax evasion? Evidence from an emerging economy
Authors: Amoh John Kwaku , Ali-Nakyea Abdallah
Published: April 2019

Purpose

The purpose of this study is to examine the corruption-tax evasion nexus and to establish the strength of relationships among corrupting activities.

Design/methodology/approach

The research applied structural equation modelling on selected data from the World Economic Forum Executive Opinion Survey on corruption activities and data on tax evasion triggering factors from the World Development Indicators and the Bank of Ghana to test two hypotheses.

Findings

The test of the first hypothesis suggests that corrupting activities significantly cause tax-evading activities in Ghana; hence, there is at least one corrupting activity triggering tax evasion. Testing the second hypothesis revealed that corruption in Ghana exhibits all of the five dimensions of corruption that were examined. Hence, there is correlation among the corrupting activities.

Research limitations/implications

The research is limited by the availability of data; hence, only data for selected variables for the period were examined.

Practical implications

The results are indicative that most emerging economies tend to have more than one type of dominating corruption dimension, which are tax-evading triggers.

Originality/value

The study extends the literature by examining the various dimensions of corruption, analysing the strength of their relationships and how they impact tax evasion in an emerging economy. By identifying and employing specific corrupting activities, there is a better understanding and appreciation of the corruption-tax evasion nexus in the revenue generation process. This may aid emerging economies in the drafting of tax evasion and corruption reduction policies/programmes to ensure the achievement of sustainable development goals.
Predictors for compliance with anti-terrorist financing standards
Authors: Joosten Erik , Bogers Marion , Beeres Robert , Bertrand Robert
Published: April 2019

Purpose

The purpose of this paper is to identify and test predictors for countries to comply with the Financial Action Task Force’s (FATF) anti-money laundering and terrorist financing recommendations.

Design/methodology/approach

The authors conduct a quantitative study to explore which factors predict compliance of countries. They include the compliance scores of 196 countries.

Findings

The results of a forward stepwise regression analysis show that a country’s wealth, measured as gross domestic product (GDP) per capita, is the most important predictor for compliance. This result supports earlier academic work about predictors for compliance (Simmons, 1998; Giraldo and Trinkunas, 2007; Whitaker, 2010). The other factors identified suffering from terrorist attacks, relative financial market dominance, tourism sector and the degree of democracy do not explain additional variance in compliance.

Practical implications

This research sheds light on compliance as a concept. For policymakers, accountants, companies and governments, it is important to understand why compliance occurs and why not.

Originality/value

The empirical results indicate that, in contrast to common belief, countries that suffer more from terrorism are not more compliant. Moreover, the rate of democracy, a relative dominant financial market and a strong tourism sector do not stimulate compliance with anti-terrorist financing standards.
The Origins of the Husting and the Folkmoot
Authors: NAISMITH RORY
Published: April 2019

In the central Middle Ages, London was marked out by its idiosyncratic institutions, prominent among which were two courts or assemblies: the Folkmoot and the Husting. This article re‐examines the early history and origins of both, and suggests that they should be seen as outgrowths of the entities recorded in a legal composition from the reign of King Æthelstan (924–39). The latter describes associations formed by the people of London to defend their interests against thieves from surrounding districts. Provisions made in this text for a gathering of leaders, to be held over food and drink, may be a forerunner of the Husting, while a larger judicial body hinted at in the law‐code could represent a precursor to the Folkmoot. The internal divisions of London from the twelfth century onwards, the wards, are also considered.
Optimal timing of hepatitis B virus DNA quantification and clinical predictors for higher viral load during pregnancy
Authors: Cheung Ka W. , Seto Mimi T. Y. , So Po L. , Wong Daniel , Mak Annisa S. L. , Lau Wai L. , Wang Weilan , Kan Anita S. Y. , Lee Chin P. , Ng Ernest H. Y.
Published: April 2019

Introduction

Authorities publish recommendations on the hepatitis B virus (HBV) viral load threshold to initiate antiviral treatment but the timing of quantification during pregnancy is not well defined. HBV DNA levels in pregnancy women at 28‐30 weeks predict the risk of immunoprophylaxis failure. This study compared and evaluated the correlation between HBV DNA levels before 22 and 28‐30 weeks’ gestation. Clinical predictive factors for HBV DNA >6, 7 and 8 log10 IU/mL were studied.

Material and methods

A retrospective analysis of HBV DNA levels of women <22 and 28‐30 weeks of gestation was carried out in 352 pregnant HBV carriers. HBV DNA was examined using the COBAS TaqMan HBV Monitor Test coupled with the COBAS Ampliprep extraction system (Both Roche Diagnostics, Branchburg, NJ, USA).

Results

A strong positive correlation was found between the viral loads of women <22 weeks (mean 16.7 weeks) and 28‐30 weeks of gestation, which was independent of the viral load level and gestational age of quantification (r = 0.942, P < 0.001). Univariate analysis showed that positive hepatitis B e antigen (HBeAg), maternal age <35 years old and body mass index ≤21 kg/m2 were associated with a higher mean viral load at 28‐30 weeks of gestation (P < 0.05). These factors were also associated with a higher chance of viral load >6, 7 and 8 log10 IU/mL at 28‐30 weeks (P < 0.05). In multiple regression analysis, only the viral load of <22 weeks and positive HBeAg remained predictive of a higher mean viral load at 28‐30 weeks of gestation (P < 0.05). The receiver operating characteristic curve showed that the HBV DNA of <22 weeks was an excellent predictor for different viral load cut‐offs at 28‐30 weeks. The area under curve was 0.986, 0.998 and 0.994 for viral load 6, 7 and 8 log10 IU/mL, respectively.

Conclusions

HBV DNA quantification should be performed before 22 weeks of gestation. Viral load cut‐offs similar to those at 28 weeks can be used to determine immunoprophylaxis failure at earlier gestation. Maternal positive HBeAg status was associated with a higher chance of viral load >6, 7 or 8 log10 IU/mL.
Evidence for the Impact of Organisational Resources Versus Job Characteristics in Assessments of Occupational Stress Over Time
Authors: Raper Mitchell J. , Brough Paula , Biggs Amanda
Published: April 2019

Considerable evidence demonstrates the importance of both job demands and job resources in the prediction of employee health and motivational outcomes. However, scant empirical evidence explains how broader organisational factors can also have an impact on these outcomes. Utilising the job demands‐resources (JD‐R) model as a theoretical explanation of occupational stress, we examined the impact of employees’ alignment with their organisation's strategic objectives (strategic alignment) in predicting long‐term occupational health outcomes. The sample consisted of 1,601 police officers employed in one Australian police service, who completed two self‐report surveys over 12 months. Results of the study indicated that strategic alignment was the only resource to reduce psychological strain, and to increase work engagement over time. Job demands were not found to be significantly associated with either psychological strain or work engagement over time. There was also no evidence of the moderating effects of job resources on health and motivational outcomes. The theoretical and practical implications of the inclusion of strategic alignment as an organisational resource are discussed.
Pleiotropy Informed Adaptive Association Test of Multiple Traits Using Genome-Wide Association Study Summary Data
Authors: Masotti Maria , Guo Bin , Wu Baolin
Published: April 2019

Genetic variants associated with disease outcomes can be used to develop personalized treatment. To reach this precision medicine goal, hundreds of large-scale genome-wide association studies (GWAS) have been conducted in the past decade to search for promising genetic variants associated with various traits. They have successfully identified tens of thousands of disease-related variants. However, in total these identified variants explain only part of the variation for most complex traits. There remain many genetic variants with small effect sizes to be discovered, which calls for the development of (a) GWAS with more samples and more comprehensively genotyped variants, for example, the NHLBI Trans-Omics for Precision Medicine (TOPMed) Program is planning to conduct whole genome sequencing on over 100 000 individuals; and (b) novel and more powerful statistical analysis methods. The current dominating GWAS analysis approach is the “single trait” association test, despite the fact that many GWAS are conducted in deeply phenotyped cohorts including many correlated and well-characterized outcomes, which can help improve the power to detect novel variants if properly analyzed, as suggested by increasing evidence that pleiotropy, where a genetic variant affects multiple traits, is the norm in genome-phenome associations. We aim to develop pleiotropy informed powerful association test methods across multiple traits for GWAS. Since it is generally very hard to access individual-level GWAS phenotype and genotype data for those existing GWAS, due to privacy concerns and various logistical considerations, we develop rigorous statistical methods for pleiotropy informed adaptive multitrait association test methods that need only summary association statistics publicly available from most GWAS. We first develop a pleiotropy test, which has powerful performance for truly pleiotropic variants but is sensitive to the pleiotropy assumption. We then develop a pleiotropy informed adaptive test that has robust and powerful performance under various genetic models. We develop accurate and efficient numerical algorithms to compute the analytical P-value for the proposed adaptive test without the need of resampling or permutation. We illustrate the performance of proposed methods through application to joint association test of GWAS meta-analysis summary data for several glycemic traits. Our proposed adaptive test identified several novel loci missed by individual trait based GWAS meta-analysis. All the proposed methods are implemented in a publicly available R package.
Differences in practice of ophthalmology by gender in Australia
Authors: Lo Tiffany C. S. , Rogers Sophie L. , Hall Anthony J. , Lim Lyndell L.
Published: April 2019

Importance

The number of females practising ophthalmology is rising. It is known that practice patterns between female and male ophthalmologists differ. Understanding the differences will help to inform future workforce planning.

Background

To investigate the differences in clinical practice between female and male ophthalmologists in Australia.

Design

Cross‐sectional study.

Participants

Ophthalmologists participating in the Royal Australian & New Zealand College of Ophthalmologists workforce survey, and/or Medicine in Australia: Balancing Employment and Life survey, and those who made claims from Medicare Benefits Schedule Australia.

Methods

Combined analysis of de‐identified 2014 data from the surveys and Medicare Benefits Schedule.

Main Outcome Measures

Hours worked, service provision, remuneration and social circumstances.

Results

Female ophthalmologists provided 35% fewer services per ophthalmologist per year (2834 vs 4328) than male ophthalmologists. Female ophthalmologists received approximately half the annual income of male ophthalmologists; median self‐reported net personal annual income was AUD122 500 (interquartile range [IQR] 96 000‐225 000) for females compared to AUD245 000 (IQR 180 000‐365 000) for males (P = .01). The median self‐reported hours worked per week was 35.0 (IQR 28.0‐46.0) for females and 41.8 (IQR 36.5‐48.5) for males (P = 0.04). A higher proportion of females practise in medical subspecialties, while a higher proportion of males practise in surgical subspecialties.

Conclusions and Relevance

Female ophthalmologists earn less compared to male ophthalmologists after accounting for lower service provision and hours worked. Difference in income may be partially accounted for by higher total number of services and procedural services provided by male ophthalmologists. Understanding differences between female and male ophthalmologists will help to inform future medical workforce planning.