bluuebunny/crossref_metadata_2025 huggingface dataset:
Look for people, not for alpha: mutual funds success and managers intellectual capital
Authors: Naidenova Iuliia , Parshakov Petr , Zavertiaeva Marina , Tomé Eduardo
Published: November 2015

Purpose

– This paper aims to explore whether individual intellectual capital of a fund manager allows mutual fund to outperform market.

Design/methodology/approach

– The sample includes 85 Russian equity funds for the period of 2013. First, Jensen’s alpha for each fund has been calculated, and then cross-sectional regression analysis has been used. While only a part of fund managers publish biographic sketches, the authors use the Heckman procedure to control for self-selection issues.

Findings

– The results support the idea that the individual characteristics indicate the possibility to earn abnormal alpha. Managers with economic education and with Moscow education perform better than others. Relationship between both fund performance measures and manager’s experience has inverted U-shape. Jensen’s alpha reaches its highest level at the point of 9 years, whereas beta – at 10 years of manager’s experience.

Research limitations/implications

– Investigation can be improved by including more variables that influence the disclosure of managers’ personal information, for example, by conducting surveys. Additionally, cross-sectional data restrict the analysis.

Practical implications

– The discovered characteristics of managers’ intellectual capital can be used as additional screening tool for the investor who is deciding on mutual fund choice in Russia. While individual intellectual capital is observable and more persistent in time in comparison with the past fund performance, such tool allows better decision-making.

Originality/value

– This is the first paper that explores which characteristics of Russian fund managers are connected with higher abnormal return (measured by Jensen’s alpha) and risk (beta) of mutual funds.
Toward a better understanding of MNEs’ local staffing decision: a multilevel analysis
Authors: Baik Youjin , Park Young-Ryeol
Published: November 2015

Purpose

– The purpose of this paper is to address the question of how regional diversification affects subsidiary staffing composition in multinational enterprises. Another important objective of this study is to examine the effects of institutional distance, specifically regulative and normative distances, on foreign subsidiary staffing composition.

Design/methodology/approach

– To estimate firm- and country-level parameters simultaneously, hierarchical linear modeling was conducted on a sample of 1,068 foreign subsidiaries of South Korean firms operating in 25 countries in 2014.

Findings

– The results reveal that intra-regional diversification has a positive effect, whereas inter-regional diversification has a negative effect on local staffing in foreign subsidiaries. In addition, there is a positive association between informal distance (such as normative distance) and local staffing of foreign subsidiaries, while formal distance (such as regulative distance) is negatively related to local staffing of foreign subsidiaries.

Research limitations/implications

– The cross-sectional nature of the data in this study may preclude examination of the relationships among institutional distance, institutional environment, and subsidiary staffing composition. The authors suggest that future researchers employ a longitudinal design to examine the effects on staffing composition of institutional distance and institutional environments over time.

Originality/value

– The paper contributes to the literature on international human resources management by highlighting the importance of combining multilevel parameters to improve assessment of the importance of firms’ competitive strategy and institutional environments in local staffing in foreign subsidiaries.
Evaluating qualitative research: past, present and future
Authors: Johnson Phil
Published: November 2015

Purpose

– The purpose of this paper is to outline certain currents in the assessment of qualitative research management and organizational research and briefly position this journal in relation to these developments.

Design/methodology/approach

– The argument draws upon contemporary debates about criteriology and its relation to underlying knowledge-constituting philosophical commitments that may be sometimes unnoticed.

Findings

– The need for a more permissive, pluralistic and reflexive approach to research evaluation that accepts difference and heterogeneity in qualitative research.

Practical implications

– The need for greater reflexivity on the part of research anyone evaluating research.

Originality/value

– The paper is of value to those who are engaged in various aspects of qualitative research evaluation either in terms of being evaluated or in terms of undertaking the evaluations.
Ten years of Qualitative Research in Organizations and Management: some reflections
Authors: Myers Michael
Published: November 2015

Purpose

– The purpose of this paper is to reflect on the progress that has been made in qualitative research in the field of information systems (IS) and across management and organizational studies more generally.

Design/methodology/approach

– This paper is an opinion piece based on the author’s experience as a qualitative researcher.

Findings

– Qualitative research in the fields of IS and management and organizational studies has come of age. Almost all of the top journals publish qualitative research.

Research limitations/implications

– Given that this paper is an opinion piece, it does not contain empirical data. However, this not detract from the strength of the argument.

Originality/value

– This paper provides a high-level assessment of the state of qualitative research across business and management for the special anniversary issue of the journal.
Analytical hierarchy process for assessing sustainability
Authors: Kumar Ravindra , Madhu Errampalli , Dahiya Amit , Sinha Sanjeev
Published: November 2015

Purpose

– The purpose of this paper is to study the analytical hierarchy process (AHP) based on assessment of sustainability indicators for public transportation system including pedestrians and feeder services in developing country.

Design/methodology/approach

– A hybrid approach based on the AHP is considered for assessment of the sustainability of public transportation system including pedestrians and feeder services. Sustainability related indicators for public transportation system (namely for metro, bus and feeder bus) and pedestrians based on past data were reviewed and subsequently, more important indicators catering needs of developing country have been added to achieve significant sustainability score and a total of 17 indicators were selected for assessment of comprehensive sustainability (seven indicators under economic, six under social and four under environmental categories).

Findings

– For quantifying the assessment, specific user interview surveys are performed in south Delhi region and accordingly perception of user and transportation-related operational characteristics of the public transport system were also collected. Preliminary result shows air pollution in environmental category, public health in social category and productivity in economic category is most influential parameters in developing country.

Originality/value

– AHP method is applied for rating the criteria and setting out the priority of designed sustainable indicators. Subsequently sustainable mitigation measures and scenarios for the study area can be evaluated utilizing developed comprehensive sustainability indicator for public transportation system including pedestrian and feeder services available in developing country.
Paleoecological studies of an archeological site in Sudan (Musawarat ElSufra)
Authors: Abdallah Amel Hassan , Ibrahim Dafaala Ali
Published: November 2015

Purpose

– The purpose of this paper is to measure the environmental changes, which took place in the study area Musawarat ElSufra and the authors try to find the causes of these changes and establish a comparison of the present and past vegetation of the area.

Design/methodology/approach

– Present vegetation was investigated using fresh plant materials for pollen analysis. Fossils were taken from the hafir (basin) to study the fossil pollen grains at different soil depths. Soil surface samples were taken to analyze the chemical and physical properties of the soil.

Findings

– The pollen analysis of the samples taken from the hafir (basin) of Musawarat reveals that there are 21 species belonging to 16 families. The dominant families were Cyperaceae, Commelinaceae, Mimosaceae and Amaranthaceae.

Originality/value

– Comparison of past and present vegetation reveal the causes of environmental change and insure sustainable development in arid region.
Influence of triclopyr and nitrogen on management of Striga hermonthica on sorghum
Authors: Amhed Suha Hassan , Abusin Rashida Mohamed Ahmed , Abdelgani Migdam Elsheikh , Babiker Abdel Gabar ELTayeb
Published: November 2015

Purpose

– The purpose of this paper is to study the effects of the herbicide triclopyr, nitrogen and their combinations on Striga incidence and sorghum growth.

Design/methodology/approach

– A greenhouse study was undertaken in season 2013. Sorghum cv Wad Ahmed, urea and triclopyr were employed. Treatments were arranged in a randomized complete design with four replicates.

Findings

– Nitrogen alone suppressed the parasite completely early in the season. Triclopyr at 0.3 and 0.4 kg a.e. ha−1 reduced Striga emergence by 92.9 and 58.3 per cent early and late in the season, respectively. Triclopyr at 0.3 kg a.e. ha−1 applied subsequent to nitrogen at 43.8 kg ha−1 effected poor control of the parasite. Unrestricted Striga parasitism reduced sorghum height and chlorophyll content by 50.38 and 16.62 per cent, respectively. Triclopyr, nitrogen and their combination improved sorghum growth considerably.

Originality/value

– The results suggest that the herbicide when applied subsequent to nitrogen afforded the most consistent performance and resulted in the highest suppression of the parasite.
Mannan‐binding lectin at supraphysiological concentrations inhibits differentiation of dendritic cells from human CD14+ monocytes
Authors: Xu Xiao‐Ying , Li Hui‐Jie , Zhang Li‐Yun , Lu Xiao , Zuo Da‐Ming , Shan Gui‐Qiu , Xu Tian‐Yu , Chen Zheng‐Liang
Published: November 2015

Mannan‐binding lectin (MBL), a circulating C‐type lectin, is an important member of the defense collagen family. It exhibits a high potential for recognizing broad categories of pathogen‐associated molecular patterns and initiating complement cascade responses. DCs are well‐known specialist antigen‐presenting cells that significantly trigger specific T cell‐mediated immune responses. In our previous study, it was observed that high concentrations of MBL significantly attenuate LPS‐induced maturation of monocyte‐derived DCs (MoDCs). In the current study, it was postulated that MBL at similar supraphysiological concentrations would affect early differentiation of MoDCs in some way. CD14+ monocytes from human peripheral blood mononuclear cells were cultured with granulocyte‐macrophage colony‐stimulating factor and IL‐4 in the presence or absence of physiological (1 µg/mL) and supraphysiological concentrations (20 µg/mL) of MBL protein, respectively. Phenotypic analysis indicated that the differentiated DCs incubated with high concentrations of MBL expressed MHC class II and costimulatory molecules (e.g., CD80 and CD40) more weakly than did control groups. The secretion of IL‐10 and IL‐6 increased markedly, whereas their mixed lymphocyte reaction‐stimulating capacity decreased. Members of the signal transducer and activator of transcription family were also found to be differentially regulated. Thus, beyond the role of MBL as an opsonin, our data reveal a possible inhibitory effect of MBL at high concentrations in monocyte‐DC transition, which probably provides one way of regulating adaptive immune responses by strict regulation of DCs, making MBL a better prospect for controlling relevant pathological events such as autoimmune diseases.
Cinema narrative therapy: utilizing family films to externalize children's ‘problems’
Authors: Turns Brie , Macey Porter
Published: November 2015

Parents frequently bring children to therapy with the notion that their child has a ‘problem’. Children can begin to internalize these labels and negative attributes created by others. This article introduces a method for marriage and family therapists to integrate cinematherapy and narrative techniques. The method provided is to be utilized after a family has viewed a film chosen conjointly by the family and the therapist. This article includes suggestions as to how the family can externalize the movie character's problem, instances when the character defeats the problem and the qualities the character demonstrates while overcoming the problem. A case example has been included demonstrating the effectiveness of the method and clinical implications for future application.

Practitioner points

Watching movies has become a popular pastime for many families, so client compliance is likely.

There are numerous situations that would allow this method to be utilized with the family unit, such as ‘problem’ children, grief and loss and childhood anxiety.

Therapists should consider keeping lists of appropriate films that accommodate clients' culture and ethnicity.
Filtering with a drill pump: an efficient method to collect suspended sediment
Authors: Kelso Julia E. , Baker Michelle A.
Published: November 2015

Water quality monitoring programs across multiple disciplines use total suspended solids (TSS), and volatile suspended solids (VSS), to assess potential impairments of surface water and groundwater. While previous methods for instream filtering have been developed, the need for rapid, cost‐effective, high volume sampling has increased with the need to verify and supplement data produced by sondes and instantaneous data loggers. We present an efficient method to filter water instream with a portable drill pump that results in reduced sample processing time, and potentially reduced error associated with sample transportation, preservation, contamination, and homogenization. This technical note outlines the advantages of filtering instream vs. in the laboratory. It also compares TSS and VSS concentrations filtered with a drill pump vs. standard filtration methods with a vacuum pump as outlined by USEPA methods 160.2 and 160.4. Samples were collected at 4 sites and filtered in the field, or transported to the laboratory and filtered within 12 or 24 h of collection. Overall TSS and VSS samples filtered instream with a drill pump vs. in the laboratory produced similar concentrations with a similar range in variability for each method. Sample filtering with a drill pump decreased processing time by five minutes per sample.
Small farm ponds: overlooked features with important impacts on watershed sediment transport
Authors: Berg Matthew D. , Popescu Sorin C. , Wilcox Bradford P. , Angerer Jay P. , Rhodes Edward C. , McAlister Jason , Fox William E.
Published: November 2015

Despite their size, small farm ponds are important features in many landscapes. Yet hydrographical databases often fail to capture these ponds, and their impacts on watershed processes remain unclear. For a 230‐km2 portion of central Texas, United States (U.S.), we created a historical inventory of ponds and quantified the accuracy of automated detection methods under varying drought conditions. In addition, we documented pond dredging/enlargement events and identified sites that had been abandoned. We also analyzed sediment cores from downstream reservoirs to track changes in watershed sediment transport. Over 75 years, pond densities increased more than 350% — to among the highest documented in the U.S. — and the ability of automated methods to detect these ponds was highly dependent on drought severity (R2 = 0.96). Approximately 5% of ponds present in the 1950s were no longer present in 2012, while 33% were dredged between 1937 and 2012. Downstream reservoir sedimentation has decreased by an average of 55% as ponds have increased in number. These findings suggest that small ponds and the maintenance of trapping efficiency have large‐scale impacts on sediment dynamics. Accurately accounting for these storage effects is vital to water resource planning efforts.
Crowdsourced geometric morphometrics enable rapid large‐scale collection and analysis of phenotypic data
Authors: Chang Jonathan , Alfaro Michael E.
Published: November 2015

Advances in genomics and informatics have enabled the production of large phylogenetic trees. However, the ability to collect large phenotypic data sets has not kept pace.

Here, we present a method to quickly and accurately gather morphometric data using crowdsourced image‐based landmarking.

We find that crowdsourced workers perform similarly to experienced morphologists on the same digitization tasks. We also demonstrate the speed and accuracy of our method on seven families of ray‐finned fishes (Actinopterygii).

Crowdsourcing will enable the collection of morphological data across vast radiations of organisms and can facilitate richer inference on the macroevolutionary processes that shape phenotypic diversity across the tree of life.
Smart nest box: a tool and methodology for monitoring of cavity‐dwelling animals
Authors: Zárybnická Markéta , Kubizňák Petr , Šindelář Jiří , Hlaváč Václav
Published: November 2015

Camera recording and video analysis have emerged as a successful non‐invasive method for collecting a wide range of biological data on many different taxa of animals. However, camera monitoring has rarely been applied to long‐term surveillance of cavity or box‐nesting species and ordinary off‐the‐shelf cameras are employed.

We present methodology and data on the effectiveness of nest box monitoring using a camera system embedded in four ‘smart nest boxes’ (SNBoxes). We applied theSNBoxes to eight Tengmalm's owl (Aegolius funereus) nests in the Czech Republic during a 5‐month period in 2014. EachSNBox consisted of a pair of cameras with infrared lighting, an event detector, a radiofrequency identification reader, auxiliary sensors and a 60 Ah 12 V battery to power the whole system. All devices used were centrally managed by an embedded computer with specifically developed software.

Using fourSNBoxes, we observed owl nesting continually during the incubation, nestling and fledgling phases, in total 309 days, resulting in 3382 owl video events. Batteries were changed every 6·5 days. A memory of 4 GB was found sufficient to store monthly data. We identified 12 types of male and female parental activities and their timing, the diet composition and frequency of prey delivery, the manner of prey storage, the light intensity at the time of each parental activity, the temperature inside the clutch and outside the box and the duration of nestling period of each young. We also produced a video on owl nesting for the general public.

TheSNBox and related methodology show enormous potential as a non‐invasive tool for monitoring animals using boxes or natural cavities. The main advantage of theSNBox is the possibility to study both nocturnal and diurnal animal species and great flexibility in use of the software and hardware for different tasks. As a result, theSNBox provides an opportunity for novel insights into the breeding, roosting, hibernating, and food storage activities of a wide range of cavity‐living birds, mammals and reptiles.
Overtesting and the Downstream Consequences of Overtreatment: Implications of “Preventing Overdiagnosis” for Emergency Medicine
Authors: Carpenter Christopher R. , Raja Ali S. , Brown Michael D.
Published: November 2015

Overtesting, the downstream consequences of overdiagnosis, and overtreatment of some patients are topics of growing debate within emergency medicine (EM). The “Preventing Overdiagnosis” conference, hosted by The Dartmouth Institute for Health Policy and Clinical Practice, with sponsorship from consumer organizations, medical journals, and academic institutions, is evidence of an expanding interest in this topic. However, EM represents a compellingly unique environment, with increased decision density tied to high stakes for patients and providers with missed or delayed diagnoses in a professional atmosphere that does not tolerate mistakes. This article reviews the relevance of this reductionist paradigm to EM, provides a first‐hand synopsis of the first “Preventing Overdiagnosis” conference, and assesses barriers to moving the concept of less test ordering to reality.
Choosing Wisely in Emergency Medicine: A National Survey of Emergency Medicine Academic Chairs and Division Chiefs
Authors: Maughan Brandon C. , Baren Jill M. , Shea Judy A. , Merchant Raina M.
Published: November 2015

Objectives

The Choosing Wisely campaign was launched in 2011 to promote stewardship of medical resources by encouraging patients and physicians to speak with each other regarding the appropriateness of common tests and procedures. Medical societies including the American College of Emergency Physicians (ACEP) have developed lists of potentially low‐value practices for their members to address with patients. No research has described the awareness or attitudes of emergency physicians (EPs) regarding the Choosing Wisely campaign. The study objective was to assess these beliefs among leaders of academic departments of emergency medicine (EM).

Methods

This was a Web‐based survey of emergency department (ED) chairs and division chiefs at institutions with allopathic EM residency programs. The survey examined awareness of Choosing Wisely, anticipated effects of the program, and discussions of Choosing Wisely with patients and professional colleagues. Participants also identified factors they associated with the use of potentially low‐value services in the ED. Questions and answer scales were refined using iterative pilot testing with EPs and health services researchers.

Results

Seventy‐eight percent (105/134) of invited participants responded to the survey. Eighty percent of respondents were aware of Choosing Wisely. A majority of participants anticipate the program will decrease costs of care (72% of respondents) and use of ED diagnostic imaging (69%) but will have no effect on EP salaries (94%) or medical–legal risks (65%). Only 45% of chairs have ever addressed Choosing Wisely with patients, in contrast to 88 and 82% who have discussed it with faculty and residents, respectively. Consultant‐requested tests were identified by 97% of residents as a potential contributor to low‐value services in the ED.

Conclusions

A substantial majority of academic EM leaders in our study were aware of Choosing Wisely, but only slightly more than half could recall any ACEP recommendations for the program. Respondents familiar with Choosing Wisely anticipated generally positive effects, but chairs reported only infrequently discussing Choosing Wisely with patients. Future research should identify potentially low‐value tests requested by consultants and objectively measure the utility and cost of these tests among ED patient populations.
Understanding Overuse of Computed Tomography for Minor Head Injury in the Emergency Department: A Triangulated Qualitative Study
Authors: Melnick Edward R. , Shafer Katherine , Rodulfo Nayeli , Shi Joyce , Hess Erik P. , Wears Robert L. , Qureshi Rija A. , Post Lori A.
Published: November 2015

Background

Overuse of computed tomography (CT) for minor head injury continues despite developed and rigorously validated clinical decision rules like the Canadian CT Head Rule (CCHR). Adherence to this sensitive and specific rule could decrease the number of CT scans performed in minor head injury by 35%. But in practice, the CCHR has failed to reduce testing, despite its accurate performance.

Objectives

The objective was to identify nonclinical, human factors that promote or inhibit the appropriate use of CT in patients presenting to the emergency department (ED) with minor head injury.

Methods

This was a qualitative study in three phases, each with interview guides developed by a multidisciplinary team. Subjects were recruited from patients treated and released with minor head injuries and providers in an urban academic ED and a satellite community ED. Focus groups of patients (four groups, 22 subjects total) and providers (three groups, 22 subjects total) were conducted until thematic saturation was reached. The findings from the focus groups were triangulated with a cognitive task analysis, including direct observation in the ED (>150 hours), and individual semistructured interviews using the critical decision method with four senior physician subject matter experts. These experts are recognized by their peers for their skill in safely minimizing testing while maintaining patient safety and engagement. Focus groups and interviews were audio recorded and notes were taken by two independent note takers. Notes were entered into ATLAS.ti and analyzed using the constant comparative method of grounded theory, an iterative coding process to determine themes. Data were double‐coded and examined for discrepancies to establish consensus.

Results

Five core domains emerged from the analysis: establishing trust, anxiety (patient and provider), constraints related to ED practice, the influence of others, and patient expectations. Key themes within these domains included patient engagement, provider confidence and experience, ability to identify and manage patient anxiety, time constraints, concussion knowledge gap, influence of health care providers, and patient expectations to get a CT.

Conclusions

Despite high‐quality evidence informing use of CT in minor head injury, multiple factors influence the decision to obtain CT in practice. Identifying and disseminating approaches and designing systems that help clinicians establish trust and manage uncertainty within the ED context could optimize CT use in minor head injury.
Policy Measures and Reimbursement for Emergency Medical Imaging in the Era of Payment Reform: Proceedings From a Panel Discussion of the 2015 Academic Emergency Medicine Consensus Conference
Authors: Berdahl Carl , Schuur Jeremiah D. , Fisher Nancy L. , Burstin Helen , Pines Jesse M.
Published: November 2015

The Affordable Care Act (ACA) of 2010 is expanding the use of quality measurement and promulgating new payment models that place downward pressure on health care utilization and costs. As emergency department (ED) computed tomography utilization has tripled in the past decade, stakeholders have identified advanced imaging as an area where quality and efficiency measures should expand. On May 12, 2015, Academic Emergency Medicine convened a consensus conference titled “Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization.” As part of the conference, a panel of health care policy leaders and emergency physicians discussed the effect of the ACA and other quality programs on ED diagnostic imaging, specifically the way that quality metrics may affect ED care and how ED diagnostic imaging fits in the broader strategy of the U.S. government. This article discusses the content of the panel's presentations.
Respiratory sinus arrhythmia as a potential measure in substance use treatment–outcome studies
Authors: Price C. J. , Crowell S. E.
Published: November 2015

Background and Aims

Dysfunction of physiological regulation systems may underlie the disrupted emotional and self‐regulatory processes among people with substance use disorder (SUD). This paper reviews evidence as to whether or not respiratory sinus arrhythmia (RSA), as a psychophysiological index of emotional regulation, could provide useful information in treatment–outcome research to provide insights into recovery processes.

Methods

We reviewed the use of RSA in clinical research and studies on SUD treatment. Search terms for the review of RSA in clinical research included respiratory sinus arrhythmia, heart rate variability, vagal, cardiac vagal control, psychophysiology, intervention, treatment, mindfulness, mind–body, mental health, substance use, chemical dependence, regulation and emotion regulation. For the review of RSA in intervention studies, we included only those that provided adequate description of psychophysiological methods, and examined RSA in the context of an intervention study.

Results

RSA appears to be able to provide an index of self‐regulatory capacity; however, it has been little used in either intervention or treatment research. Of the four intervention studies included in this review, all were mindfulness‐based interventions. Two studies were with substance‐using samples, and both showed pre–post increases in RSA and related improved substance use outcomes. Two of the three studies were randomized controlled trials (RCTs), and both showed significant increases in RSA in the experimental compared to comparison condition.

Conclusion

Respiratory sinus arrhythmia may be a useful index of emotional regulation in people with substance use disorder, and a potential measure of underlying mechanisms for SUD treatment studies, particularly mindfulness‐based interventions.
An assessment of clinical pathways and missed opportunities for the diagnosis of nodular melanoma versus superficial spreading melanoma
Authors: Cicchiello Mark , Lin Matthew J , Pan Yan , McLean Catriona , Kelly John W
Published: November 2015

Background

Missed opportunities in the diagnosis of nodular melanoma (NM) carry high prognostic penalties due to the rapid rate of NM growth. To date, an assessment of the pathways to diagnosis of NM versus superficial spreading melanoma (SSM) specifically comparing numbers of opportunities missed to undertake biopsy has not been performed.

Methods

A retrospective questionnaire of 120 patients (60 NM patients, age and sex matched to 60 SSM patients) from the Victorian Melanoma Service (VMS) database was undertaken to assess pathways to diagnosis. The numbers of opportunities missed to undertake a biopsy and doctor behaviour at such encounters were recorded. Diagnostic delay (overall, patient's and doctor's delay) in terms of time was assessed.

Results

Significant differences in opportunities missed to make a diagnosis of NM compared to SSM were found. In all, 43% of NM were biopsied at a first encounter compared to 70% of SSM. All SSM were diagnosed within three reviews. Overall, 33% of NM required at least three and up six reviews until biopsy. Patients with NM were more likely than those with SSM to be reassured that their lesions were benign. No significant differences in terms of time delay to diagnosis between NM and SSM were found.

Conclusions

NM contributes disproportionately to melanoma mortality in Australia. Addressing earlier diagnosis of NM with renewed focus may make the biggest impact on the overall mortality of melanoma. The message that a period of observation is not appropriate for patients re‐presenting with lesions of concern must be more effectively communicated.
A randomised controlled trial of peri‐operative pregabalin vs. placebo for video‐assisted thoracoscopic surgery
Authors: Konstantatos A. H. , Howard W. , Story D. , Mok L. Y. H. , Boyd D. , Chan M. T. V.
Published: November 2015

We allocated 52 participants to oral pregabalin 300 mg and 48 participants to placebo tablets before thoracoscopic surgery and for five postoperative days. The median (IQR [range]) cumulative pain scores at rest for nine postoperative months were 184 (94–274 [51–1454]) after pregabalin and 166 (66–266 [48–1628]) after placebo, p = 0.39. The corresponding scores on deep breathing were 468 (281–655 [87–2870]) and 347 (133–561 [52–3666]), respectively, p = 0.16. After three postoperative months, 29/100 participants had persistent surgical site pain, 19/52 after pregabalin and 10/48 after placebo, p = 0.12, of whom four and five, respectively, attended a pain management clinic, p = 0.24. The median (IQR [range]) morphine equivalent consumption six days after surgery was 273 (128–619 [39–2243]) mg after pregabalin and 319 (190–663 [47–2258]) mg after placebo, p = 0.35.
Ethnic patterns of hypospadias in New Zealand do not resemble those observed for cryptorchidism and testicular cancer: evidence of differential aetiology?
Authors: Gurney J. K. , Stanley J. , Shaw C. , Sarfati D.
Published: November 2015

It has been proposed that hypospadias, cryptorchidism, poor semen quality and testicular cancer might share common prenatal causes. We have previously demonstrated similar ethnic patterns for the incidence of testicular cancer and cryptorchidism – a known risk factor for testicular cancer. If the underlying exposure(s) that cause hypospadias, cryptorchidism and testicular cancer are shared, then we would expect the incidence relationship between ethnic groups to follow the same pattern across all three conditions. We followed a birth cohort of 318 345 eligible male neonates born in New Zealand between 2000–2010, and linked routinely collected maternity records with inpatient hospitalization and mortality records through to 2011. We searched hospitalization records for diagnoses of hypospadias, and used mortality records for censoring. We used Poisson regression methods to compare the relative risk of hypospadias between ethnic groups, adjusting for perinatal risk factors and total person time. We observed that European/Other children had the highest risk of hypospadias, with Māori, Pacific and Asian boys having around 40% lower risk of disease compared with this group (adjusted relative risk [RR]: Māori 0.62, 95% CI 0.55–0.70; Pacific 0.62, 95% CI 0.53–0.72; Asian 0.57, 95% CI 0.47–0.69). This contrasts substantially with our previous observations for cryptorchidism and testicular cancer, where Māori males have the greatest risk. Our observations suggest that – at least in New Zealand – the exposures that drive the development of hypospadias may differ to those that that drive the development of cryptorchidism and/or testicular cancer.
Is pregnancy planning associated with background characteristics and pregnancy‐planning behavior?
Authors: Stern Jenny , Salih Joelsson Lana , Tydén Tanja , Berglund Anna , Ekstrand Maria , Hegaard Hanne , Aarts Clara , Rosenblad Andreas , Larsson Margareta , Kristiansson Per
Published: November 2015

Introduction

Prevalence of planned pregnancies varies between countries but is often measured in a dichotomous manner. The aim of this study was to investigate to what level pregnant women had planned their pregnancies and whether pregnancy planning was associated with background characteristics and pregnancy‐planning behavior.

Material and methods

A cross‐sectional study that utilized the baseline measurements from the Swedish Pregnancy Planning study. Pregnant women (n = 3390) recruited at antenatal clinics answered a questionnaire. Data were analyzed with multinomial logistic regression, Kruskal–Wallis H and chi‐squared tests.

Results

Three of four pregnancies were very or fairly planned and 12% fairly or very unplanned. Of women with very unplanned pregnancies, 32% had considered an induced abortion. Women with planned pregnancies were more likely to have a higher level of education, higher household income, to be currently working (≥50%) and to have longer relationships than women with unplanned pregnancies. The level of pregnancy planning was associated with planning behavior, such as information‐seeking and intake of folic acid, but without a reduction in alcohol consumption. One‐third of all women took folic acid 1 month prior to conception, 17% used tobacco daily and 11% used alcohol weekly 3 months before conception.

Conclusions

A majority rated their pregnancy as very or fairly planned, with socio‐economic factors as explanatory variables. The level of pregnancy planning should be queried routinely to enable individualized counseling, especially for women with unplanned pregnancies. Preconception recommendations need to be established and communicated to the public to increase health promoting planning behavior.
The issue of consent in medical practice
Authors: Larner Elizabeth , Carter Rachel
Published: November 2015

Following a recent court judgment, legal and moral issues surrounding consent have been thrown into the spotlight. Elizabeth Larner, Solicitor, and Rachel Carter, Partner, of Wollen Michelmore LLP, look at the issues surrounding consent, including where problems arise in the fields of clinical negligence and non‐accidental injury and what health care professionals can do to ensure that their advice to a patient about a procedure or treatment is sufficiently cogent and appropriately recorded so as to avoid later criticism and possible legal action. This annotation gives an overview of the legal principles surrounding consent in medical practice including informed consent, refusal of treatment and issues of capacity.
Adult perceptions of dental fluorosis and select dental conditions‐an Asian perspective
Authors: Nair Rahul , Chuang Janice Cheah Ping , Lee Pauline Shih Jia , Leo Song Jie , Yang Naomi QiYue , Yee Robert , Tong Huei Jinn
Published: November 2015

Objective

To compare lay people's perceptions with regard to various levels of dental fluorosis and select dental defects versus normal dentition.

Methods

Adults rated digitally created photographs made showing lips (without retraction) and teeth depicting the following conditions: no apparent aesthetic defects (normal, Thylstrup– Fejerskov score 0 – TF0), 6 levels of fluorosis (TF1–6), carious lesions (two cavitated and one noncavitated), malocclusions (Class II, Class III, anterior open bite and greater spacing), extrinsic staining and an incisal chip. The photographs were displayed on colour‐calibrated iPads™. Participants used a self‐administered questionnaire to rate their perceptions on (Item 1) how normal teeth were, (Item 2) how attractive the teeth were, (Item 3) need to seek correction of teeth, (Item 4) how well the person took care of their teeth and (Item 5) whether the person was born like this. Data from Item 5 were excluded due to low reliability.

Results

Ratings for Item 1 showed that TF1–4 was similar or significantly better than TF0. For Item 2, TF1 and TF4 were significantly better than TF0, with TF2 and TF3 being similar. For Item 3, there was significantly lower need to seek correction with TF2 and TF4 versus TF0, whereas TF1 and TF3 were similar to TF0. TF5 and TF6 were rated significantly lower than TF0 for Item 1 and Item 2, and significantly higher rating for Item 3 (need to seek correction). Ratings for Item 4 were similar, with TF1, TF2 and TF4 being rated significantly higher than TF0, and TF5 and TF6 being rated lower. Cavitated caries and staining were generally perceived as being significantly less favourable than TF6, with higher need to seek correction as well. Noncavitated carious lesion and incisal chip were rated similar to TF0. Cavitated carious lesions were rated aesthetically similar or significantly worse than TF0 and TF6.

Conclusions

Severe fluorosis (TF5 and 6) was perceived to be less aesthetically pleasing and received higher ratings for need to seek correction than normal teeth. Mild‐to‐moderate fluorosis (TF1–4) showed similar or better aesthetic perceptions and similar or lower need to seek correction, when compared to normal teeth (TF0). Easily visible cavitated dental caries was rated worse than teeth with severe fluorosis (TF6) and normal teeth (TF0).
Autoantibodies and their potential roles in diseases of the nervous system
Authors: Beasley Shannon J. , Greer Judith M.
Published: November 2015

Autoantibodies are found in many disorders of the nervous system, including diseases affecting the peripheral nervous system (e.g. Guillain–Barré syndrome and other peripheral neuropathies), the central nervous system (e.g. neuromyelitis optica, multiple sclerosis and limbic encephalitis) and the neuromuscular junction (e.g. myasthenia gravis), as well as in neuropsychiatric disorders and in paraneoplastic syndromes. Some of these antibodies are likely to play an important pathogenic role in disease development, whereas others might be useful biomarkers for disease. In the present review, the features of an autoantibody that enable it to be pathogenic (e.g. the antibody isotype and the target antigen against which the antibody is directed) and some of the different mechanisms by which pathogenic autoantibodies could act will be discussed. These mechanisms include antibody‐mediated cell lysis, opsonization of target proteins for attack by macrophages, cross‐linking of Fc receptors, blocking or destroying receptors involved in neurotransmission or cellular homeostasis, and blocking of repair mechanisms such as remyelination. Examples will be given of diseases where these antibody‐mediated mechanisms are known or thought to be active. Finally, approaches to treating autoantibody‐mediated disease in the nervous system will be briefly reviewed.
In vivo evaluation of biofunctionalized implant surfaces with a synthetic peptide (P‐15) and its impact on osseointegration. A preclinical animal study
Authors: Schmitt Christian M. , Koepple Markus , Moest Tobias , Neumann Konrad , Weisel Tamara , Schlegel Karl Andreas
Published: November 2015

Objectives

The overall aim of the study was to investigate a biofunctionalized implant surface with electrochemically deposition of hydroxyapatite and the synthetic peptide (P‐15) and its effect on osseointegration.

Material and methods

Three modified implant types of ANKYLOS® C/X implants were used; (1) machined implants used as negative control (M, n = 20), (2) implants with the FRIADENT® plus surface (grit blasted and acid‐etched) used as positive control (P, n = 20), and (3) implants with a biomimetic surface consisting of hydroxyapatite and the synthetic 15 aminoacids containing peptide P‐15 (BP, n = 40). The implants were randomly inserted in the mandibles of 10 beagle dogs following 4 months after tooth extraction (P1‐P4). Three animals were sacrificed 2 and 7 days after implant insertion, respectively, and four animals were sacrificed 6 months post implant insertion. Bone‐to‐implant contacts (BICs) were analyzed via histomorphometrical analyses at five different region of interests (ROIs); two at the middle part on either side of the implant (ROI 1/4), two at the apical part of the implant at each side (ROI 2/3), and one at the tip of the implant (ROI 5).

Results

All implant surfaces showed a high level of osseointegration and osteoconductivity. The cumulative implant survival rate (CSR) was 93.8%, 100% in the M, 85% in the P, and 95% in the BP group. No statistical difference in BICs at ROI 1/4, 2/3, and 5 could be shown between implant types following 2 and 7 days of healing. BIC values increased in all groups over time. After 6 months of healing the BP group showed superiority in BIC in ROI 2/3 (73.2 ± 15.6%) compared to the P (48.3 ± 10.6%) and M group (66.3 ± 30.2%) with a significant difference between BP and P (P = 0.002).

Conclusion

It is hypothesized, that the surface biofunctionalization improves peri‐implant bone formation and remodeling, leading to an increased bone‐to implant contact. However, within the limitations of the study set‐up no benefit in the early phase of osseointegration could be established for dental implants with P‐15 containing surface in this study.
Elicitation threshold of cobalt chloride: analysis of patch test dose–response studies
Authors: Fischer Louise A. , Johansen Jeanne D. , Voelund Aage , Lidén Carola , Julander Anneli , Midander Klara , Menné Torkil , Thyssen Jacob P.
Published: November 2015

Background

Cobalt is a strong skin sensitizer (grade 5 of 5 in the guinea‐pig maximization test) that is used in various industrial and consumer applications. To prevent sensitization to cobalt and elicitation of allergic cobalt dermatitis, information about the elicitation threshold level of cobalt is important.

Objective

To identify the dermatitis elicitation threshold levels in cobalt‐allergic individuals.

Materials and methods

Published patch test dose–response studies were reviewed to determine the elicitation dose (ED) levels in dermatitis patients with a previous positive patch test reaction to cobalt. A logistic dose–response model was applied to data collected from the published literature to estimate ED values. The 95% confidence interval (CI) for the ratio of mean doses that can elicit a reaction in 10% (ED10) of a population was calculated with Fieller's method.

Results

On the basis of five included studies, the ED10 values of aqueous cobalt chloride ranged between 0.0663 and 1.95 µg cobalt/cm2, corresponding to 30.8–259 ppm.

Conclusions

Our analysis provides an overview of the doses of cobalt that are required to elicit allergic cobalt contact dermatitis in sensitized individuals, and thereby the basis for future prevention of cobalt allergy.
Drifting to oblivion? Rapid genetic differentiation in an endangered lizard following habitat fragmentation and drought
Authors: Vandergast Amy G. , Wood Dustin A. , Thompson Andrew R. , Fisher Mark , Barrows Cameron W. , Grant Tyler J.
Published: November 2015

Aim

The frequency and severity of habitat alterations and disturbance are predicted to increase in upcoming decades, and understanding how disturbance affects population integrity is paramount for adaptive management. Although rarely is population genetic sampling conducted at multiple time points, pre‐ and post‐disturbance comparisons may provide one of the clearest methods to measure these impacts. We examined how genetic properties of the federally threatened Coachella Valley fringe‐toed lizard (Uma inornata) responded to severe drought and habitat fragmentation across its range.

Location

Coachella Valley, California, USA.

Methods

We used 11 microsatellites to examine population genetic structure and diversity in 1996 and 2008, before and after a historic drought. We used Bayesian assignment methods and F‐statistics to estimate genetic structure. We compared allelic richness across years to measure loss of genetic diversity and employed approximate Bayesian computing methods and heterozygote excess tests to explore the recent demographic history of populations. Finally, we compared effective population size across years and to abundance estimates to determine whether diversity remained low despite post‐drought recovery.

Results

Genetic structure increased between sampling periods, likely as a result of population declines during the historic drought of the late 1990s–early 2000s, and habitat loss and fragmentation that precluded post‐drought genetic rescue. Simulations supported recent demographic declines in 3 of 4 main preserves, and in one preserve, we detected significant loss of allelic richness. Effective population sizes were generally low across the range, with estimates ≤100 in most sites.

Main conclusions

Fragmentation and drought appear to have acted synergistically to induce genetic change over a short time frame. Progressive deterioration of connectivity, low Ne and measurable loss of genetic diversity suggest that conservation efforts have not maintained the genetic integrity of this species. Genetic sampling over time can help evaluate population trends to guide management.