Emotion and performance

The study of emotions in organizational settings has attained considerable prominence in recent years, but I critical issue remains unresolved. This is the relationship between emotion and performance. in this special issue, 5 articles address this topic from a variety of viewpoints. Two are theoretical essays that deal, respectively, with emotion and creativity and the relationships between individual and team performance. Three are empirical studies that canvass the emotion-performance nexus across levels of analysis: within person, between persons, and in groups. Between them, the 5 articles present a strong case for the nexus of emotions and performance, but, more important, they provide a platform for potentially fruitful future research in this burgeoning area

Intraperitoneal bevacizumab for control of malignant ascites due to advanced-stage gastrointestinal cancers: A multicentre double-blind, placebo-controlled phase II study - AIO SUP-0108

PURPOSE: Malignant ascites is debilitating for patients with advanced cancer. As shown previously, tumour cell production of vascular endothelial growth factor might be a major cause of the formation of malignant ascites. Intraperitoneal bevacizumab could therefore be an option for symptom control in refractory ascites. PATIENTS AND METHODS: Patients with advanced gastrointestinal cancer and malignant ascites who had undergone paracentesis at least twice within the past 4 weeks were randomly assigned in a 2:1 ratio to intraperitoneal bevacizumab (400 mg absolute) or placebo after paracentesis. During the 8-week treatment period, a minimum interval of 14 d was kept between the applications of the study drug. Primary end-point was paracentesis-free survival (ParFS). RESULTS: Fifty-three patients (median age 63 years) were randomised. Forty-nine patients received at least one study drug application and qualified for the main analysis. The proportion of patients with at least one common toxicity criteria grade III-V event was similar with 20/33 (61%) on bevacizumab and 11/16 (69%) on placebo. Median ParFS was 14 d (95% confidence interval [CI]: 11-17) in the bevacizumab arm and 10.5 d (95% CI: 7-21) on placebo (hazard ratio 0.74, 95% CI: 0.40-1.37; P = 0.16). The longest paracentesis-free period was 19 d on bevacizumab (range 6-66 d) and 17.5 d in the placebo arm (range 4-42) (P = 0.85). Median overall survival was 64 d (95% CI: 45-103) on bevacizumab compared to 31.5 d (95% CI: 20-117) on placebo (P = 0.31). CONCLUSION: Intraperitoneal bevacizumab was well tolerated. Overall, treatment did not result in a significantly better symptom control of malignant ascites. However, patients defined by specific immune characteristics may benefit

Clinical decision making and outcome in the routine care of people with severe mental illness across Europe (CEDAR)

Aims. There is a lack of knowledge on clinical decision making and its relation to outcome in the routine treatment of people with severe mental illness. This study examined preferred and experienced clinical decision making from the perspectives of patients and staff, and how these affect treatment outcome. Methods. CEDAR (ISRCTN75841675) is a naturalistic prospective observational study with bimonthly assessments during a 12-month observation period. 588 adults with severe mental illness were consecutively recruited from caseloads of community mental health services at the six study sites (Germany, UK, Italy, Hungary, Denmark, and Switzerland). Clinical decision making was measured using two instruments (Clinical Decision Making Style Scale. CDMS;Clinical Decision Making Involvement and Satisfaction Scale, CDIS) from patient and staff perspectives. Outcomes assessed were unmet needs (Camberwell Assessment of Need Short Appraisal Schedule, CANSAS). Mixed-effects multinomial regression was used to examine differences in involvement in and satisfaction with actual decision making. The effect of clinical decision making on outcome was examined using hierarchical linear modelling controlling for covariates. Results. Shared decision making was preferred by patients (2=135.08; p<0.001) and staff (2=368.17; p<0.001). Decision making style of staff significantly affected unmet needs over time, with unmet needs decreasing more in patients whose clinicians preferred active to passive (-0.406 unmet needs per two months, p=0.007) or shared (-0.303 unmet needs per two months, p=0.015) decision making. Conclusions. A shift from shared to active involvement of patients is indicated, including the development and rigorous test of targeted interventions

Perturbing HIV-1 Ribosomal Frameshifting Frequency Reveals a cis Preference for Gag-Pol Incorporation into Assembling Virions

HIV-1 virion production is driven by Gag and Gag-Pol (GP) proteins, with Gag forming the bulk of the capsid and driving budding, while GP binds Gag to deliver the essential virion enzymes protease, reverse transcriptase, and integrase. Virion GP levels are traditionally thought to reflect the relative abundances of GP and Gag in cells (;1:20), dictated by the frequency of a 21 programmed ribosomal frameshifting (PRF) event occurring in gag-pol mRNAs. Here, we exploited a panel of PRF mutant viruses to show that mechanisms in addition to PRF regulate GP incorporation into virions. First, we show that GP is enriched ;3-fold in virions relative to cells, with viral infectivity being better maintained at subphysiological levels of GP than when GP levels are too high. Second, we report that GP is more efficiently incorporated into virions when Gag and GP are synthesized in cis (i.e., from the same gag-pol mRNA) than in trans, suggesting that Gag/GP translation and assembly are spatially coupled processes. Third, we show that, surprisingly, virions exhibit a strong upper limit to trans-delivered GP incorporation; an adaptation that appears to allow the virus to temper defects to GP/Gag cleavage that may negatively impact reverse transcription. Taking these results together, we propose a "weighted Goldilocks"scenario for HIV-1 GP incorporation, wherein combined mechanisms of GP enrichment and exclusion buffer virion infectivity over a broad range of local GP concentrations. These results provide new insights into the HIV-1 virion assembly pathway relevant to the anticipated efficacy of PRF-targeted antiviral strategies.National Institutes of Health R01AI110221, P01CA022332, R35GM118131, T32GM00834

Reducing the Impact of the Next Influenza Pandemic Using Household-Based Public Health Interventions

BACKGROUND: The outbreak of highly pathogenic H5N1 influenza in domestic poultry and wild birds has caused global concern over the possible evolution of a novel human strain [1]. If such a strain emerges, and is not controlled at source [2,3], a pandemic is likely to result. Health policy in most countries will then be focused on reducing morbidity and mortality. METHODS AND FINDINGS: We estimate the expected reduction in primary attack rates for different household-based interventions using a mathematical model of influenza transmission within and between households. We show that, for lower transmissibility strains [2,4], the combination of household-based quarantine, isolation of cases outside the household, and targeted prophylactic use of anti-virals will be highly effective and likely feasible across a range of plausible transmission scenarios. For example, for a basic reproductive number (the average number of people infected by a typically infectious individual in an otherwise susceptible population) of 1.8, assuming only 50% compliance, this combination could reduce the infection (symptomatic) attack rate from 74% (49%) to 40% (27%), requiring peak quarantine and isolation levels of 6.2% and 0.8% of the population, respectively, and an overall anti-viral stockpile of 3.9 doses per member of the population. Although contact tracing may be additionally effective, the resources required make it impractical in most scenarios. CONCLUSIONS: National influenza pandemic preparedness plans currently focus on reducing the impact associated with a constant attack rate, rather than on reducing transmission. Our findings suggest that the additional benefits and resource requirements of household-based interventions in reducing average levels of transmission should also be considered, even when expected levels of compliance are only moderate

Evaluation of the 3-Minute Diagnostic Confusion Assessment Method for identification of postoperative delirium in older patients

Importance: Delirium is a common postoperative complication in older patients that often goes undetected and might lead to worse outcomes. The 3-Minute Diagnostic Confusion Assessment Method (3D-CAM) might be a practical tool for routine clinical diagnosis of delirium. Objective: To assess the 3D-CAM for detecting postoperative delirium compared with the long-form CAM used for research purposes. Design, Setting, and Participants: This cohort study of older patients enrolled in ongoing clinical trials between 2015 and 2018 was conducted at a single tertiary US hospital. Included participants were aged 60 years or older undergoing major elective surgical procedures that required at least a 2-day hospital stay. Data were analyzed between February and April 2019. Exposures: Surgical procedures of at least 2 hours in length requiring general anesthesia with planned extubation. Main Outcomes and Measures: Patients were concurrently assessed for delirium using the 3D-CAM assessment and the long-form CAM, scored based on a standardized cognitive assessment. Agreement between these 2 methods was tested using Cohen κ with repeated measures, a generalized linear mixed-effects model, and Bland-Altman analysis. Results: Sixteen raters conducted 471 concurrent CAM and 3D-CAM interviews including 299 patients (mean [SD] age, 69 [6.5] years), the majority of whom were men (152 [50.8%]), were White (263 [88.0%]), and had noncardiac operations (211 [70.6%]). Both instruments had good intraclass correlation (0.84 for the CAM and 0.98 for the 3D-CAM). Cohen κ demonstrated good overall agreement between the CAM and 3D-CAM (κ = 0.71; 95% CI, 0.58 to 0.83). According to the mixed-effects model, there was statistically significant disagreement between the 3D-CAM and CAM (estimated difference in fixed effect, -0.68; 95% CI, -1.32 to -0.05; P = .04). Bland-Altman analysis showed the probability of a delirium diagnosis with the 3D-CAM was more than twice the probability of a delirium diagnosis with the CAM (probability ratio, 2.78; 95% CI, 2.44 to 3.23). Conclusions and Relevance: The 3D-CAM instrument demonstrated agreement with the long-form CAM and might provide a pragmatic and sensitive clinical tool for detecting postoperative delirium, with the caveat that the 3D-CAM might overdiagnose delirium

Influence of Herbal Active D on Nursery Pig Growth Performance

A total of 2,268 pigs (L337 × 1050 PIC; initially 12.1 ± 0.39 lb) were used in a 42-d growth study to evaluate the effects of herbal active D on growth performance, bone characteristics, and serum parameters of nursery pigs. Pigs were weaned at approximately 21 d of age and randomly allotted to 1 of 3 dietary treatments in a randomized complete block design. A total of 84 pens were used with 27 pigs per pen and 28 replications per treatment across 2 rooms. Pens were blocked by BW and weaning date. Dietary treatments were corn-soybean meal-based and fed in 3 phases. Treatment diets consisted of a control (contained 1,650 IU/kg of vitamin D3), or control with the addition of 120 or 200 mg/kg of herbal active D (Phytobiotics, St. Louis, MO). At the end of the study, 10 pigs per treatment were euthanized and the right fibula, metacarpal, 2nd rib, and 10th rib were collected to determine bone density, bone breaking strength, and percentage bone ash by utilizing the de-fatted processing method. Overall (d 0 to 42), there was a marginally significant (P = 0.067) worsening of feed efficiency as inclusion of herbal active D increased but no effect (P \u3e 0.10) on final BW, overall ADG, ADFI, or mortality. There was a bone × treatment interaction for bone density, where increasing herbal active D increased bone density for the 2nd rib (P = 0.012), but there was no difference between treatments for other bones (P \u3e 0.10). For bone breaking strength and bone ash, there was no evidence (P \u3e 0.10) of an interaction. For bone breaking strength, the metacarpal had greater breaking strength (P \u3c 0.001) compared to all other bones, followed by the fibula and 10th rib, with the 2nd rib having the lowest bone breaking strength. For percentage bone ash, there was significant linear increase (P = 0.026) across all bones as herbal active D increased. For bone ash weight, the metacarpals and 10th ribs had the highest bone ash weight followed by the fibula, with 2nd rib having the lowest (P \u3c 0.05) bone ash weight. Additionally, there was no difference (P \u3e 0.10) across treatments for porcine circovirus type 2 S/P ratio, porcine reproductive and respiratory syndrome, Mycoplasma hyopneumoniae, 25(OH)D3 status or circulating cytokine concentrations except for IL-8 concentrations which increased linearly (P = 0.027) as herbal active D increased. However, a day effect was observed (P \u3c 0.001) with higher values for antibodies and cytokine concentrations on d 21 compared to d 42, except for IL-1ra and IL-8 having no significant (P \u3e 0.10) day effect. In summary, herbal active D inclusion had minimal impact on growth or serum parameters; however, herbal active D increased percentage bone ash

Effect of Increasing L-Lysine-HCl and Amino Acid Ratios on Performance of Finishing Pigs From 240 to 285 lb

A total of 1,789 pigs (337 × 1050, PIC; initial BW 240.0 ± 2.51 lb) were used to determine the effects of increasing L-Lys-HCl and AA ratios on performance of late finishing pigs fed diets without DDGS. The study used 2 groups of pigs and each study lasted 18 and 27 d, respectively. Pigs were housed in mixed gender pens with 20 to 25 pigs per pen and 19 replications per treatment (10 and 9 replications per group, respectively). Pens of pigs were blocked by BW and randomly allotted to 1 of 4 dietary treatments. Treatment diets consisted of low, medium, or high levels of feed-grade AA and moderate or high AA ratios relative to Lys. Medium and high levels of feed-grade AA treatments had increased L-Lys-HCl in replacement of soybean meal to achieve CP levels of 12.0, 11.0, and 11.1%. The AA ratios were increased in the low CP diet to achieve a minimum of 60% Ile, 128% Leu, 36% Met, 70% Thr, 21.2% Trp, 72% Val, and 33% His for the high AA ratio treatment. Overall, there was a marginally significant increase in ADFI (quadratic, P = 0.097), with the greatest response observed in pigs fed medium feed-grade AA and moderate AA ratios. Treatment diets had no effect on ADG or F/G. At the end of study 2, carcass data were collected and analyzed. No differences (P \u3e 0.10) were observed for HCW, carcass yield, backfat depth, loin depth or percentage lean. In summary, differing levels of feed-grade AA and AA ratios did not impact growth performance or carcass characteristics with the exception of a marginally significant (quadratic, P = 0.097) increase in ADFI