bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asset risk and leverage under information asymmetry
Authors: Nguyen Pascal 
Published: March 2017

Purpose
The purpose of this paper is to investigate whether higher asset risk can be associated with higher leverage and to provide a rationale for the relatively low debt ratios displayed by many firms.

Design/methodology/approach
A game is modeled between an informed firm and uninformed lenders. The firm knows the risk of its assets, while lenders only know the minimum level of risk. The author solves for the signaling equilibrium and derive explicit formulas for the firm’s cost of debt and optimal leverage.

Findings
In contrast to the tradeoff theory of capital structure, it is found that asset risk and leverage are positively (instead of negatively) related. Furthermore, leverage is lower than when lenders are informed about the firm’s risk. These results are illustrated with a numerical example.

Practical implications
Low-risk firms can choose a lower leverage to signal their lower risk and reduce their cost of debt. High-risk firms may prefer to pay higher interest rates and use higher leverage.

Originality/value
The paper is able to explain why some firms use surprisingly low leverage and do not appear to take advantage of their debt tax shields.
Institutional repository: access and use by academic staff at Egerton University, Kenya
Authors: Ratanya Felicitas Ciabere 
Published: March 2017

PurposeThe purpose of this paper is to examine the access and use of the institutional repository (IR) among academic staff at Egerton University.Design/methodology/approachThe paper provides a description of the building and development of the IR at the Egerton university and describes expected benefits of the repository to the University and relevant stakeholders. A survey was conducted among 84 academic staff with an aim of examining their levels of awareness on the existence of the IR at the Egerton University and assess their access and use. Through a structured questionnaire both quantitative and qualitative data were collected.FindingsThe study revealed that majority of the academic staff at the Egerton University are still not aware of the existence of the IR. Staff also faced challenges in accessing and using the content available. The paper provided suggestions on how best to enhance the access and utilization of the IRs among the academic staff.Practical implicationsFrom a practical point of view, the paper provides implications on the access and use of IRs by the academic staff. The paper points out some challenges faced by this group of users which other academic institutions may try to solve in their respective contexts.Originality/valueFindings and discussions provided in the paper will pave way to solving the challenges faced in access and use of IR by the academic staff at the Egerton University.
C5 model for the consortium management: SWOT analysis
Authors: Srinivasa Rao Y. 
Published: March 2017

Purpose
This paper elicits information, an excess of information and the stakeholders’ role in the use of information. The purpose of this paper is to create a “C5 model” (clients, connectivity, content, copyright and cost) for the consortium management to support and improve its academic and administrative decision-making skills and optimize returns.

Design/methodology/approach
The methodology used for this study was “strength, weakness, opportunity and threat” (SWOT) analysis. As a tool, it was used as one of the strategic analytical techniques to evaluate various aspects of consortium management. The purpose of choosing this method was to derive a set of strategies for comparing the internal (strengths/weaknesses) and external (opportunities/threats) forces of the “C5 model” of consortium management.

Findings
From the SWOT analysis of the “C5 model,” it was observed that four combinations, maxi-maxi (strengths/opportunities (SO), mini-maxi (weaknesses/opportunities (WO), maxi-mini (strengths/threats (ST)) and mini-mini (weaknesses/threats (WT)), were drawn to derive a set of strategies to benefit the consortium management. The SO strategies such as building a client-centric resource management system, centralized gateway, collaborative acquisition model, common copyright communication and clearance center and cost-benefit analysis were built on the basis of the strengths and opportunities identified. Likewise, the WO strategies such as organizational planning, equality in ICT infrastructure facilities, quality content, public disclosure of copyright obligations and effective economic models were drawn to minimize the weaknesses of each component by taking advantage of the identified opportunities. The ST strategies were worked out using strengths of the model to possibly mitigate its threats. Similarly, the WT strategies were created to minimize the weaknesses and avoid the threats as much as possible. However, these strategies would not only help consortium management in the decision-making process, but also optimize returns and improve the intellectual outcome of organizations.

Originality/value
Not many research studies have been developed regarding the SWOT analysis of the “C5 model” for consortium management. This study attempts to benefit a large community of library and information science professionals, consortia and their clients.
Academic library innovation through 3D printing services
Authors: Letnikova Galina , Xu Na 
Published: March 2017

Purpose
One of the most innovative library services recently introduced by public and academic libraries, the technology of 3D printing, has the potential to be used in multiple educational settings. The purpose of this paper is to examine how this novel library digital service motivates students’ learning, and to investigate managerial issues related to the introduction of 3D printing services at a medium-size urban community college library with restricted funding.

Design/methodology/approach
Since Fall 2014, the LaGuardia Library Media Resources Center has been offering a portable consumer-end 3D printer for classroom use. This paper provides historical context for the implementation of 3D printing as a service offered by librarians and discusses how the community college library managed 3D printing services to support class curriculum. At the end of the three-semester-long project students were asked to volunteer to take a survey conducted by the librarian and the class instructor.

Findings
The results of the student survey demonstrated that library 3D printing services significantly promoted students’ motivation to learn. The conceptual model of a makerspace should be an essential part of the twenty-first century academic library. To help make that possible this paper examines certain challenges and limitations faced by librarians when introducing 3D printing, including dedicated space management, professional education, and personnel availability.

Originality/value
During the project described students were able to use library services to print out and study complex engineering and biology models in 3D. The proper planning and management of this innovative service allows academic librarians to enhance class curriculum by providing the means of transforming theory into physical reality.
Efficacy comparison of adjuvants in PcrV vaccine against Pseudomonas aeruginosa pneumonia
Authors: Hamaoka Saeko , Naito Yoshifumi , Katoh Hideya , Shimizu Masaru , Kinoshita Mao , Akiyama Koichi , Kainuma Atsushi , Moriyama Kiyoshi , Ishii Ken J. , Sawa Teiji 
Published: March 2017

ABSTRACTVaccination against the type III secretion system of P. aeruginosa is a potential prophylactic strategy for reducing the incidence and improving the poor prognosis of P. aeruginosa pneumonia. In this study, the efficacies of three different adjuvants, Freund's adjuvant (FA), aluminum hydroxide (alum) and CpG oligodeoxynucleotide (ODN), were examined from the viewpoint of inducing PcrV‐specific immunity against virulent P. aeruginosa. Mice that had been immunized intraperitoneally with recombinant PcrV formulated with one of the above adjuvants were challenged intratracheally with a lethal dose of P. aeruginosa. The PcrV–FA immunized group attained a survival rate of 91%, whereas the survival rates of the PcrV–alum and PcrV–CpG groups were 73% and 64%, respectively. In terms of hypothermia recovery after bacterial instillation, PcrV–alum was the most protective, followed by PcrV–FA and PcrV–CpG. The lung edema index was lower in the PcrV–CpG vaccination group than in the other groups. PcrV–alum immunization was associated with the greatest decrease in myeloperoxidase in infected lungs, and also decreased the number of lung bacteria to a similar number as in the PcrV–FA group. There was less neutrophil recruitment in the lungs of mice vaccinated with PcrV–alum or PcrV–CpG than in those of mice vaccinated with PcrV–FA or PcrV alone. Overall, in terms of mouse survival the PcrV–CpG vaccine, which could be a relatively safe next‐generation vaccine, showed a comparable effect to the PcrV–alum vaccine.
Religion and Fertility in East Asia: Evidence from the East Asian Social Survey
Authors: Bessey Donata 
Published: March 2017

AbstractThis article analyses the effect of religious affiliation on fertility in Japan, Korea and the Republic of China (Taiwan). It adds to the sparse empirical evidence on the effects of religious affiliation on fertility in East Asia, for both Christian and other religions. It uses an identity‐economic model and analyses prescriptions among the different religions to derive testable hypotheses. In the empirical section, the East Asian Social Survey and a generalized Poisson model are used to estimate the effects of different religions on fertility. In line with theoretical predictions, the empirical results suggest that a positive effect of Catholicism on fertility is still present in East Asia. In line with the sparse previous empirical evidence on Buddhism, it seems to have no effect on fertility.
Forensic Facial Reconstruction: Relationship Between the Alar Cartilage and Piriform Aperture
Authors: Strapasson Raíssa Ananda Paim , Herrera Lara Maria , Melani Rodolfo Francisco Haltenhoff 
Published: March 2017

AbstractDuring forensic facial reconstruction, facial features may be predicted based on the parameters of the skull. This study evaluated the relationships between alar cartilage and piriform aperture and nose morphology and facial typology. Ninety‐six cone beam computed tomography images of Brazilian subjects (49 males and 47 females) were used in this study. OsiriX software was used to perform the following measurements: nasal width, distance between alar base insertion points, lower width of the piriform aperture, and upper width of the piriform aperture. Nasal width was associated with the lower width of the piriform aperture, sex, skeletal vertical pattern of the face, and age. The current study contributes to the improvement of forensic facial guides by identifying the relationships between the alar cartilages and characteristics of the biological profile of members of a population that has been little studied thus far.
Patient satisfaction with procedural sedation in the emergency department
Authors: Johnson Olivia G , Taylor David McD , Lee Marina , Ding Juen‐Li , Ashok Aadith , Johnson Damian , Peck Daniel , Knott Jonathan , Weinberg Laurence 
Published: March 2017

AbstractObjectiveThe aim of this study was to determine patient satisfaction with procedural sedation as a function of nature of the procedure and depth of sedation.MethodWe undertook a prospective observational study of adult patients who received procedural sedation in two EDs (20 month period). The level of sedation was determined by an investigator, using the Observers Assessment of Anaesthesia/Sedation Scale (1 = awake to 6 = no response to noxious stimuli). Patient satisfaction was measured with the Iowa Satisfaction with Anaesthesia Scale after full recovery. This was self‐administered, comprised 11 items (e.g. ‘I felt pain’) and has a score range of −3 (poor satisfaction) to +3 (very satisfied).ResultsA total of 163 patients were enrolled (51.2% men, mean age 50.7 years). The median (interquartile range) satisfaction score was 2.7 (0.7). Patient satisfaction was lower among patients who had orthopaedic procedures (median 2.6 vs 2.8, P < 0.01) and among patients who had a pre‐sedation opioid (2.6 vs 2.8, P = 0.03). Satisfaction was positively correlated with deeper sedation (Spearman's correlation coefficient 0.49, P < 0.001). Satisfaction also differed significantly between the four most common sedation regimens (P < 0.001). It was greatest among those who were administered propofol with or without fentanyl and least among those who were administered nitrous oxide with or without opioid. Patients sedated with propofol with or without fentanyl had the greatest depths of sedation. There was no difference in satisfaction among patients who were and were not sedated by a consultant (median 2.6 and 2.7, respectively, P = 0.84).ConclusionGenerally, the level of patient satisfaction is high. Greater satisfaction is associated with deeper sedation, sedation with propofol and non‐orthopaedic procedures.
Intensity modulated radiation therapy after extra‐pleural pneumonectomy for malignant pleural mesothelioma is feasible without fatal pulmonary toxicity and provides good survival
Authors: Jhavar Sameer , Pruszynski Jessica , Gowan Alan , Boyle Teresa , Deb Niloyjyoti , Patel Mehul 
Published: March 2017

AbstractAimTo analyze patterns of failure, toxicity, relapse‐free survival (RFS), and overall survival (OS) in malignant pleural mesothelioma (MPM) patients treated with intensity‐modulated radiation therapy following extrapleural pneumonectomy (EPP).MethodsWe reviewed 18 charts of patients with MPM from 2005 to 2014 who underwent EPP followed by hemithoracic intensity‐modulated radiation therapy. Intensity‐modulated radiation therapy dose delivery adhered to published lung dose constraints. Kaplan‐Meier curves were used to assess the RFS and OS. Median survival times are reported for both RFS and OS.ResultsMedian age was 65 years (range: 40—76 years). Chemotherapy was administered in four neo‐adjuvant and seven adjuvant patients. Pathological American Joint Committee on Cancer stages II, III, IV, surgical margin, lympho‐vascular space, pericardium, and chest wall involvement were seen in 3, 12, 3, 9, 7, 12 and 3 patients, respectively. The majority of the patients received 45 Gy in 25 fractions. The mean lung dose was 7.14 Gy (range: 5 Gy–9.3 Gy). The mean V20 was 2.23%. At a median follow‐up of 3 years, eight patients were alive (44%); 10 experienced relapse (56%). Median RFS and OS were 24.4 months (95% CI: >16.3 months) and 38.2 months (95% CI: 17.4–78.1 months), respectively. Acute toxicities were fatigue, dermatitis, nausea, esophagitis/dysphagia, cough, and dyspnea on exertion. No grade III, IV, or fatal pulmonary toxicities were observed.ConclusionIntensity‐modulated radiation therapy following EPP for MPM resulted in RFS and OS comparable to the published literature without significant toxicity.
Essential Medicines List Implementation Dynamics: A Case Study Using Brazilian Federal Medicines Expenditures
Authors: Magarinos‐Torres Rachel , Lynd Larry David , Luz Tatiana Chama Borges , Marques Paulo Eduardo Potyguara Coutinho , Osorio‐de‐Castro Claudia Garcia Serpa 
Published: March 2017

AbstractThe aim was to analyse the implementation dynamics of the essential medicines list (EML). We used the government expenditures on medicines and Brazil as a case study. Drug purchases were considered as a proxy for utilization. The essential medicines (EMs) expenditures were followed over time by Brazilian National EMLs life‐time and defined by broad therapeutic categories and by specific medicines. Brazil increased the number of the medicines during the last four editions of Brazilian National EMLs and the federal government expenditures on them. The EML implementation dynamics changed the distribution of expenditures on EMs. We identified a common set of 404 EMs present in all four editions of the Brazilian National EMLs. There was a proportional decrease in expenditures on anti‐infectives for systemic use, blood and blood‐forming organs and alimentary tract and metabolism, and increase in expenditures on antineoplastic and immunomodulating agents. The expenditures distribution per specific medicines revealed that a small set of EMs was responsible for 50% or more of expenditures considering Brazilian National EML life‐time for all four periods. The increase in expenditures on EMs in Brazil was a consequence of the newer medicines incorporated over time in the Brazilian National EMLs. The use of the medicines expenditures as a source of data and the definition of an EML life‐time permitted follow‐up of the implementation dynamics of different versions of the Brazilian National EMLs. Our results have implications for policymakers and stakeholders to gain a better understanding of the role EMLs play in health system sustainability and in the provision of the most beneficial heath care.
Safety and benefits of interventions to increase folate status in malaria‐endemic areas
Authors: Verhoef Hans , Veenemans Jacobien , Mwangi Martin N. , Prentice Andrew M. 
Published: March 2017

SummaryFor decades, folic acid has routinely been given to prevent or treat anaemia in children, pregnant women and people with sickle cell disease. However, there is no conclusive evidence that folate deficiency anaemia constitutes a public health problem in any of these groups. Industrial flour fortification is recommended and implemented in many countries to combat neural tube defects. Dietary folates or folic acid can antagonise the action of antifolate drugs that play a critical role in the prevention and treatment of malaria. Randomised trials have shown that folic acid supplementation increases the rate of treatment failures with sulfadoxine‐pyrimethamine. The efficacy of antifolate drugs against Plasmodium is maximized in the absence of exogenous folic acid, suggesting that there is no safe minimum dose of ingested folic acid. We here review the safety and benefits of interventions to increase folate status in malaria‐endemic countries. We conclude that formal cost‐benefit analyses are required.
Treating Philadelphia chromosome/BCR‐ABL1 positive patients with Glivec (Imatinib mesylate): 10 years’ experience at Patan Hospital, Nepal
Authors: Kayastha Gyan K. , Ranjitkar Nora , Gurung Radha , KC Raj K. , Karki Sanjit , Shrestha Roshan , Thapa Raj K. , Rajbhandari Piyush , Poudyal Buddhi , Acharya Paras , Roberts David J. , Hayes Bruce , Zimmerman Mark , Basnyat Buddha , Mansfield Aaron 
Published: March 2017

SummaryThe Glivec International Patient Assistance Programme makes Glivec (Imatinib mesylate) available to Philadelphia chromosome/BCR‐ABL1 positive patients with chronic myeloid leukaemia (CML) in Lower and Middle Income Countries (LMIC). We have established a large cohort of 211 CML patients who are eligible for Imatinib, in Kathmandu, Nepal. Thirty‐one patients were lost to follow‐up. We report on 180 CML patients with a median age of 38 years (range 9–81). Of these 180 patients, 162 underwent cytogenetic testing and 110 were investigated by reverse transcription polymerase chain reaction. One hundred and thirty‐nine of the 180 patients (77·2%) had at least one optimal response. Taken together, our cohort has a 95% overall survival rate and 78% of the patients were still taking Glivec at a median time of 48·8 months (range 3–140 months). The number of patients who actually failed therapy, as defined by the LeukaemiaNet 2013 criteria, was 39 (21·7%). While our cohort has some differences with those in North America or Europe, we have shown Glivec is effective in inducing an optimal response in our patients in Nepal and that it is possible to deliver a clinical service for CML patients using tyrosine kinase inhibitors in resource‐poor settings.
Increasing experience of ligation of the intersphincteric fistula tract for patients with Crohn's disease: what have we learned?
Authors: Kamiński J. P. , Zaghiyan K. , Fleshner P. 
Published: March 2017

AbstractAimLigation of the intersphincteric fistula tract (LIFT) has been proposed as a treatment of trans‐sphincteric fistula in perianal Crohn's disease (CD). The aim of this study was to look at our experience of the LIFT procedure in CD patients on long‐term follow‐up. Specifically, we aimed to determine the fistula healing rate after the LIFT procedure after more than 12 months follow‐up and to identify any prognostic factors.MethodRetrospective study of patients with trans‐sphincteric Crohn's fistula tracts treated with the LIFT procedure between January 2011 and October 2015. Complete fistula healing as well as clinical outcomes were analysed.ResultsData were available for 23 patients. After a median follow‐up of 23 months, LIFT site healing was 48%. Patients with healed LIFT had a median follow‐up time of 10.5 months, while patients with failed LIFT had a median follow‐up time of 31 months (P = 0.04). Median time to failure was 9 months for patients with follow‐up > 1 year. Most patients failed within 1 year (9/12; 75%) of the procedure. In multi‐site CD, the LIFT procedure was more likely to be successful in those with small bowel disease (P = 0.04) compared with colonic disease (P = 0.02). Other factors such as preoperative use of biological therapies, presence of a seton, previous repair attempts, fistula position, type or number of fistulas, multiple fistula tracts, smoking status and other associated perianal disease did not appear to influence LIFT healing rates.ConclusionThe LIFT procedure offers reasonable long‐term success in the treatment of perianal trans‐sphincteric fistulas associated with CD. LIFT is more likely to fail in patients with concurrent colonic CD than in patients with small bowel CD.
Alkaline phosphatase and prognosis in patients with coronary artery disease
Authors: Ndrepepa Gjin , Xhepa Erion , Braun Siegmund , Cassese Salvatore , Fusaro Massimiliano , Schunkert Heribert , Kastrati Adnan 
Published: March 2017

AbstractBackgroundThe evidence on the association between alkaline phosphatase (ALP) and prognosis of patients with coronary artery disease (CAD) is limited. The aim of this study was to assess the association of ALP with the risk of mortality or coronary events in patients with CAD.Materials and methodsThe study included 5540 patients with angiography‐proven CAD treated with catheter‐based coronary revascularization. Baseline ALP measurements were available for analysis in all patients. Patients were divided into three groups: a group with an ALP activity in the 1st tertile (ALP ≤ 65·5 U/L; n = 1855), a group with an ALP activity in the 2nd tertile (ALP > 65·5 to 85·7 U/L; n = 1839) and a group with an ALP in the 3rd tertile (ALP > 85·7 U/L; n = 1846). The primary outcome was all‐cause mortality at 3‐year follow‐up.ResultsAll‐cause deaths (number [Kaplan–Meier estimates]) occurred in 443 patients: 117 (7·2%), 130 (8·1%) and 196 deaths (11·8%) among patients of the 1st, 2nd and 3rd ALP tertiles (unadjusted hazard ratio [HR] = 1·33, 95% confidence interval [CI]: 1·19 to 1·50; P < 0·001, calculated per tertile increment in the ALP activity). After adjustment in multivariable Cox proportional hazards model, ALP was independently associated with the risk of all‐cause mortality (adjusted HR = 1·33 [1·18–1·51], P < 0·001, calculated per unit increment in log ALP). The multivariable model for all‐cause mortality with baseline variables without ALP had a C statistic of 0·820 [0·797–0·843] which increased to 0·825 [0·804–0·849] after ALP inclusion; delta C statistic 0·005 [0·001–0·011]; P < 0·001.ConclusionsIn patients with CAD, elevated ALP activity was independently associated with the risk of 3‐year all‐cause mortality.