bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic innovation labs: a lab for wicked problems
Authors: Zivkovic Sharon 
Published: August 2018

Purpose
The purpose of this paper is to question the appropriateness of current lab types for addressing wicked problems. A new lab type, a Systemic Innovation Lab, is proposed which combines the features of existing labs that are suited to addressing wicked problems.

Design/methodology/approach
Characteristics of initiatives that are considered appropriate for addressing wicked problems and existing lab types that contain any of these characteristics are identified. These lab types are Social Innovation Labs, Living Labs, Urban Living Labs, Urban Transition Labs and Public Sector Innovation Labs. The proposed new lab type is reasoned by combining the features of existing labs that are suited to addressing wicked problems. How the new lab would work in practice is illustrated with a case study.

Findings
When addressing wicked problems, labs need to take a systemic design and not a service design approach. They also need to focus on addressing complex problems, take a place-based and transition approach, enable coherent action by diverse actors, involve users as co-creators, support a networked governance approach and recognize government as an enabler of change.

Practical implications
This paper provides a new lab type designed specifically for addressing wicked problems. This new lab supports practitioners that take a systemic design, solution ecosystem and systemic innovation approach. Systemic design is based on a core set of principles that are a crossover between design and complexity theory.

Originality/value
For the first time, this paper analyzes different lab types to determine their appropriateness for addressing wicked problems. It also proposes a new lab type whose sole purpose is addressing wicked problems.
Bacteria inhabiting deadwood of 13 tree species are heterogeneously distributed between sapwood and heartwood
Authors: Moll Julia , Kellner Harald , Leonhardt Sabrina , Stengel Elisa , Dahl Andreas , Bässler Claus , Buscot François , Hofrichter Martin , Hoppe Björn 
Published: August 2018

SummaryDeadwood represents an important structural component of forest ecosystems, where it provides diverse niches for saproxylic biota. Although wood‐inhabiting prokaryotes are involved in its degradation, knowledge about their diversity and the drivers of community structure is scarce. To explore the effect of deadwood substrate on microbial distribution, the present study focuses on the microbial communities of deadwood logs from 13 different tree species investigated using an amplicon based deep‐sequencing analysis. Sapwood and heartwood communities were analysed separately and linked to various relevant wood physico‐chemical parameters. Overall, Proteobacteria, Acidobacteria and Actinobacteria represented the most dominant phyla. Microbial OTU richness and community structure differed significantly between tree species and between sapwood and heartwood. These differences were more pronounced for heartwood than for sapwood. The pH value and water content were the most important drivers in both wood compartments. Overall, investigating numerous tree species and two compartments provided a remarkably comprehensive view of microbial diversity in deadwood.
A prospective diagnostic study on povidone–iodine retention in lesions suspected to be squamous cell carcinoma or keratoacanthoma
Authors: Rizk Mariam , Alian Mehrnoosh , Tschandl Philipp , Gorgi Madieh , Hishon Matthew , Clark Simon , Kittler Harald , Rosendahl Clifford 
Published: August 2018

AbstractBackground and objectivesWhile dermatoscopy improves diagnostic accuracy for raised nonpigmented lesions, those with white surface keratin can be problematical. We investigated whether retention of povidone–iodine by surface keratin provides a clue to benignity.MethodsWe performed a retrospective pilot study (n = 57) followed by a prospective study (n = 117) on raised nonpigmented lesions with white surface keratin. An initial dermatoscopic image was taken of each lesion, povidone–iodine was applied and another image taken. Following lavage with 70% ethanol, a third image was acquired. The percentage surface area of residual povidone–iodine staining after lavage was recorded, and the results analysed.ResultsThe optimal cut‐off point of residual staining was 80%, where values of ≤80% pointed to malignancy. At this cut‐off, the OR for lesions with values ≤80% to be truly malignant in the retrospective set was 4.03 (95% CI: 2.1–7.6) and the AUC was 0.7 (95% CI: 0.62–0.78). For the prospective set, the corresponding OR was 2.3 (95% CI: 1.4–3.7) and the AUC was 0.62 (95% CI: 0.55–0.68).ConclusionsThis study presents evidence that povidone–iodine retention may have a degree of efficacy in distinguishing benign from malignant keratotic lesions. Further study is warranted.
Evaluation of the adequacy of drug prescriptions in patients with chronic kidney disease: results from the CKD‐REIN cohort
Authors: Laville Solène M. , Metzger Marie , Stengel Bénédicte , Jacquelinet Christian , Combe Christian , Fouque Denis , Laville Maurice , Frimat Luc , Ayav Carole , Speyer Elodie , Robinson Bruce M. , Massy Ziad A. , Liabeuf Sophie ,   on behalf of the Chronic Kidney Disease‐Renal Epidemiology and Information Network (CKD‐REIN) Study Collaborators
Published: August 2018

AbstractAimsDrug prescription is difficult to manage in patients with chronic kidney disease (CKD). We assessed the prevalence and determinants of inappropriate drug prescriptions (whether contraindications or inappropriately high doses) with regard to kidney function in patients with CKD under nephrology care. We also assessed the impact of the equation used to estimate GFR on the prevalence estimates.MethodsThe CKD‐REIN cohort includes 3033 outpatients with CKD (eGFR between 15 and 60 ml min−1 1.73 m−2). We examined the daily doses of pharmacological agents prescribed at study entry. Inappropriate prescription was defined as the reported prescription of either a contraindicated drug or an indicated drug at an inappropriately high dose level with regard to the patient's GFR, as estimated with the CKD‐EPI equation, the de‐indexed CKD‐EPI equation, or the Cockcroft–Gault (CG) equation. Multivariate logistic regression was used to assess the determinants of inappropriate prescription risk.ResultsAt baseline, patients' median [interquartile range] number of drugs prescribed per patient was 8 [5–10]. Half of the patients had been prescribed at least one inappropriate drug. Anti‐gout, cardiovascular agents and antidiabetic agents accounted for most of the inappropriate prescriptions. The percentage of inappropriate prescriptions varied from one GFR equation to another: 52% when using the CKD‐EPI equation, 47% when using the de‐indexed CKD‐EPI equation and 41% with the CG equation. A multiple logistic regression analysis showed significantly higher odds ratios [95% confidence interval] for inappropriate prescriptions in male patients (1.28 [1.07; 1.53]), patients with diabetes (1.34 [1.06; 1.70]), those with a high BMI (1.58 [1.25; 1.99]), and those with a low GFR (10.2 [6.02; 17.3]). The risk of having at least one inappropriate prescription increased with the number of drugs per patient (P for trend < 0.0001) and therefore the odds ratio was 5.88 [4.17; 8.28] for those who received at least 11 prescribed medications compared to those who received fewer than 5.ConclusionOur results emphasize the complexity of drug management for CKD patients, for whom inappropriate prescription appears to be common.
Early childhood educators’ attitudes and beliefs around the use of touchscreen technologies by children under three years of age
Authors: Hatzigianni Maria , Kalaitzidis Ioannis 
Published: August 2018

AbstractThis paper reports on an Australian study around early childhood educators’ attitudes and beliefs on the use of touchscreen technologies by very young children, under three years of age. The study adopted an ecological perspective and educators and directors of early childhood centres completed an online survey and were interviewed on this specific topic. Data were analysed to identify teachers’ competencies (eg, digital skills) but also possible factors behind attitudes and beliefs (eg, leadership styles; training; teaching philosophy). Findings suggest that early childhood teachers’ views are evolving and they are now more confident when they use technology for work/personal purposes but not as confident when integrating technology with very young children. Educators’ overall confidence and hours using technology is significantly associated with a positive attitude towards the incorporation of technology. Their teaching philosophy is also associated with their technology use with very young children. In contrast, training or lack of it is not significant. This study has direct implications for Early Childhood Education as it will contribute to better understanding educators’ views and practices on a hotly debated topic and whether they are ready to change their traditional views and embrace this new social reality. The need for more research on the influence of technological use on very young children’s development will also be underlined.
Effects of titanium oxide surface properties on bone‐forming and soft tissue‐forming cells
Authors: Wheelis Sutton E. , Montaño‐Figueroa Ana Gabriela , Quevedo‐Lopez Manuel , Rodrigues Danieli C. 
Published: August 2018

AbstractBackgroundPrevious studies have concluded that certain titanium oxide (TiO2) surface properties promote bone‐forming cell attachment. However, no comprehensive studies have investigated the effects of TiO2 surface and film morphology on hard and soft tissues.PurposeThe aim of this study is to understand the effects of TiO2 morphology on the proliferation and differentiation of murine preosteoblasts (MC3T3‐E1) and proliferation of human gingival fibroblasts (HGF‐1) using in vitro experiments.Materials and MethodsSamples were fabricated with several TiO2 thickness and crystalline structure to mimic various dental implant surfaces. in vitro analysis was performed for 1, 3, and 7 days on these samples to assess the viability of MC3T3‐E1 and HGF‐1 cells in contact with the modified oxide surfaces.ResultsResults showed that HGF‐1 cells exhibited no significant difference in viability on modified oxide surfaces versus a titanium control across experiments. MC3T3‐E1 cells exhibited a significantly higher viability for the modified oxide surface in 1 day experiments, but not in 3 or 7 day experiments. Alkaline phosphatase expression in MC3T3‐E1 was not significantly different on modified oxide surfaces versus the control across all experiments. A slight positive trend in viability was observed for cells in contact with rougher modified oxide surfaces versus a titanium control in both cell types.ConclusionsThese observations suggest that crystallinity and thickness do not affect the long‐term viability of hard or soft tissue cells when compared to a cpTi surface. Therefore, treatments like anodization on implant components may not directly affect the attachment of hard or soft tissue cells in vivo.
Short‐term report of an ongoing prospective cohort study evaluating the outcome of full‐arch implant‐supported fixed hybrid polyetheretherketone‐acrylic resin prostheses and the All‐on‐Four concept
Authors: Maló Paulo , de Araújo Nobre Miguel , Moura Guedes Carlos , Almeida Ricardo , Silva António , Sereno Nuno , Legatheaux João 
Published: August 2018

AbstractBackgroundMore research is needed on the study of new materials for fixed prosthetic implant‐supported rehabilitations.PurposeThe purpose of this study was to report the short‐term outcome of full‐arch implant‐supported fixed hybrid polyetheretherketone (PEEK)‐acrylic resin prostheses and the all‐on‐four concept.Materials and MethodsThis prospective cohort clinical study included 37 patients (29 women, eight men) with an average age of 60 years (range: 38‐78 years) with 49 full‐arch hybrid PEEK‐acrylic resin prosthesis supported by implants through the all‐on‐four concept. Primary outcome measures were prosthetic survival.ResultsTwo patients with two maxillary prostheses were lost to follow‐up. One patient with a double full‐arch rehabilitation fractured the mandibular PEEK framework, rendering a 98% prosthetic survival rate. No implants were lost. The average (SD) marginal bone remodeling after 1 year of follow‐up was 0.37 mm (0.58 mm). Technical complications concerning the veneer adhesion occurred in six patients and were resolved in all patients (with exception of the patient with prosthetic failure) through the creation of mechanical retentions and changing the bonding primer. Mechanical complications occurred in three patients and five prostheses consisting in prosthetic screw loosening (n = 2 patients) and fracture of the acrylic resin teeth (the patient with a prosthetic failure).ConclusionsWithin the limitations of this study, the results suggest that hybrid polymer (PEEK)‐acrylic resin prostheses supported by implants for full‐arch rehabilitation may represent a valid treatment option, still requiring longer‐term validation.
Re‐imagining universities as places where learners address global transformation
Authors: George Shanti 
Published: August 2018

Abstract“Learner agency for what?” is one of the key questions addressed in this article and the response distinguishes between more self‐interested responses and answers that suggest a wider orientation towards global transformation. The context is that of education at global centres of international development studies and the mid‐career professionals worldwide—whether practitioners, activists or academicians—who undertake courses of studies at such centres in order to gain insights and abilities related to social transformation that earlier education at conventional universities did not expose them to. Since such global centres tend to be located in the “Global North” but are largely attended by experienced people from the “Global South,” the article examines these binary distinctions and how learners navigate the geo‐political fault lines that the binaries represent. The pedagogical dynamic is explored in terms of the “wicked problems” that international development studies wrestle with and that can be approached using the experience of learners from across the continents in interaction with formal knowledge. One hundred twenty‐four in‐depth interviews with protagonists from 27 countries who attended one of the oldest centre of development studies in Europe open windows onto global transformation during the second half of the 20th century and illustrate both insights and challenges for learners who are struggling towards positive change around universal rights and well‐being across the planet. Traditional universities are urged to learn from pedagogies at global centres of international development studies in order to gain relevance in their societies and the world around them.
Instrumental Variables Analysis and the Role of National Culture in Corporate Finance
Authors: Nash Robert , Patel Ajay 
Published: August 2018

AbstractIn this article, we identify and review instrumental variables used to study the relation between national culture and finance. Recognizing that an effective instrument must be correlated with the endogenous variable (relevance condition) and must not be correlated with the outcome variable (exclusion condition), we conduct analysis and provide theoretical arguments to ascertain the ability of each candidate instrument to meet these criteria. We further document where to locate the data to form the actual instruments. Overall, we design this study to help future authors weigh the strengths and weaknesses of using specific instruments and to better inform empirical strategies for addressing the endogeneity concerns inherent in the “culture and finance” literature.
Are component endpoints equal? A preference study into the practice of composite endpoints in clinical trials
Authors: Vaanholt Melissa C.W. , Kok Marlies M. , von Birgelen Clemens , Weernink Marieke G.M. , van Til Janine A. 
Published: August 2018

AbstractObjectivesTo examine patients’ perspectives regarding composite endpoints and the utility patients put on possible adverse outcomes of revascularization procedures.DesignIn the PRECORE study, a stated preference elicitation method Best‐Worst Scaling (BWS) was used to determine patient preference for 8 component endpoints (CEs): need for redo percutaneous coronary intervention (PCI) within 1 year, minor stroke with symptoms <24 hours, minor myocardial infarction (MI) with symptoms <3 months, recurrent angina pectoris, need for redo coronary artery bypass grafting (CABG) within 1 year, major MI causing permanent disability, major stroke causing permanent disability and death within 24 hours.SettingA tertiary PCI/CABG centre.ParticipantsOne hundred and sixty patients with coronary artery disease who underwent PCI or CABG.Main outcome measuresImportance weights (IWs).ResultsPatients considered need for redo PCI within 1 year (IW: 0.008), minor stroke with symptoms <24 hours (IW: 0.017), minor MI with symptoms <3 months (IW: 0.027), need for redo CABG within 1 year (IW: 0.119), recurrent angina pectoris (IW: 0.300) and major MI causing permanent disability (IW: 0.726) less severe than death within 24 hours (IW: 1.000). Major stroke causing permanent disability was considered worse than death within 24 hours (IW: 1.209). Ranking of CEs and the relative values attributed to the CEs differed among subgroups based on gender, age and educational level.ConclusionPatients attribute different weight to individual CEs. This has significant implications for the interpretation of clinical trial data.
Association between household poverty dynamics and childhood overweight risk and health behaviours in the United States: a 8‐year nationally representative longitudinal study of 16 800 children
Authors: Min J. , Xue H. , Wang Y. 
Published: August 2018

SummaryBackgroundNo study has examined how the pattern of income dynamics influences both of children's body mass index (BMI) trajectory and health behaviours.ObjectivesTo examine the association between household poverty dynamics and childhood overweight risk in the USA.MethodsUsing the longitudinal data of 16 800 children (from kindergarten to the 8th grade) in the nationally representative US cohort‐Early Childhood Longitudinal Study, Kindergarten Class 1998–1999, we examined the differences in BMI trajectory, weight‐related health behaviours and risk of overweight in association with household poverty dynamics during follow‐up (never [no experience of poverty], transient [once], recurrent [≥2 times] and persistent poor [remained]) using mixed models with fractional polynomial functions and estimating equation models.ResultsOverall, children experiencing poverty were more likely to have adverse BMI growth trajectory and eating and sedentary behaviours compared with the never poor. The recurrently poor children (12.8%) had the fastest BMI trajectory, highest overweight/obesity prevalence from 5 to 16 years old and highest proportion of excessive soda/fast food consumption and irregular exercise at 8th grade than did others (p < 0.05). The persistently poor (8.4%) were the lowest in BMI growth trajectory but became the second highest in childhood obesity through a steady increase in BMI over time. Children in the recurrently poor group had a 1.5 times (95% CI = 1.0–2.2) higher risk of overweight than those having never experienced poverty during follow‐up.ConclusionsThe experience of recurrent household poverty had a significant association with children's adverse eating behaviours and increased obesity risk subsequently.
A theory‐based hybrid II implementation intervention to improve pain management in Swiss nursing homes: A mixed‐methods study protocol
Authors: Brunkert Thekla , Ruppen Wilhelm , Simon Michael , Zúñiga Franziska 
Published: August 2018

AbstractAimTo present a protocol for evaluating an implementation intervention to improve pain management in nursing homes by addressing behaviour change of the care workers.BackgroundPain management in nursing homes often is inadequate despite the availability of evidence‐based pain management guidelines. Barriers to pain management in nursing homes occur on several levels including lack of knowledge and negative beliefs towards pain of care workers. A comprehensive approach incorporating contextual and behavioural factors is needed to sustainably improve pain management practice.DesignA hybrid type II effectiveness‐implementation design comprising an incomplete non‐randomized stepped‐wedge design and concurrent focus groups is proposed.MethodsA convenience sample of six nursing homes will be included. Implementation of a facility pain management policy will be facilitated by introduction of a facility pain champion and training of all care workers in pain assessment and management. Quantitative outcomes assessed at baseline, after 3 and 6 months include self‐efficacy in pain management and attitudes to pain of care workers and functional interference from pain and pain intensity in residents. Feasibility and acceptability of the intervention and implementation strategies and potential barriers to implementation will be explored in focus groups and interviews. (Protocol approved in October 2017).ConclusionThe proposed intervention implementation has been developed in a participatory approach involving relevant stakeholders. To further improve the contextual fit, development of implementation strategies was guided by the consolidated framework of implementation research. Findings of this research are expected to inform adaptions to the implementation of the intervention.Trial registration numberClinicalTrials.gov: NCT03471390.
Are guidelines for measurement of quality of life contrary to patient‐centred care?
Authors: Disher Timothy , Beaubien Louis , Campbell‐Yeo Marsha 
Published: August 2018

AbstractAimsA discussion of how quality‐adjusted life years are used to inform resource allocation decisions and highlight how assumptions underpinning the measurement of quality of life are contrary to the principles of patient‐centred care.BackgroundCost‐effectiveness analyses (CEAs) can provide influential guidance for health resource allocation, particularly in the context of a budget‐constrained public health insurance plan. Most national economic guideline bodies recommend that quality‐adjusted life year weights for CEA be elicited indirectly (public preferences). This has potentially important implications for healthcare provision and research, as it discounts the ability of a person experiencing an illness to describe how it affects their quality of life.DesignDiscussion paper.Data sourcesGuidelines for the conduct of health economic evaluations, influential methodological and theoretical texts, and a review of PubMed conducted in April 2017.Implications for NursingNurses are increasingly interested in leveraging methods from health economics to aid in decision‐making and advocacy. In this analysis, we highlight how taken‐for‐granted approaches to the measurement of quality of life may discount the experience of patients and lead to decisions that are contrary to the principles of patient‐centred care. Nurses conducting or reading research using these methods should consider whether the approach used to measure the quality of life are appropriate for the population under consideration.ConclusionSince patient and public health preferences can differ in both magnitude and direction, guideline bodies should re‐evaluate their partiality for public preferences in the reference case.