bluuebunny/crossref_metadata_2025 huggingface dataset:
Low and intermediate risk non-muscle-invasive bladder cancer
Authors: Bagrodia Aditya , Lotan Yair
Published: November 2017

Bladder cancer is a common disease that affects more males than females. Most bladder tumours are histologically typed as urothelial cell carcinoma, and these are best divided into cancers invading the muscularis propria and non-invasive malignancies confined to the bladder. The latter are the majority of cancers and include low risk, indolent cancers that may recur within the bladder but not progress to invasion or metastases, and a proportion that subsequently progress to muscle invasion. The risk of intravesical recurrence or progression to invasion from a non-invasive bladder cancer can be stratified as low, intermediate, and high using various pathological factors (such as tumour grade, stage, size, multiplicity, and the presence of carcinoma in situ). In this chapter, we will give an overview of bladder cancer and focus upon tumours at low or intermediate risk of developing future progression to invasion.
Bladder cancer
Authors: Meijer Richard P. , Zlotta Alexandre R. , van Rhijn Bas W.G.
Published: November 2017

High-grade non-muscle-invasive bladder cancer (HG-NMIBC) represents the most aggressive spectrum of this non-invasive cancer. This collective term includes all high-grade NMI urothelial carcinoma (UC), such as those without invasion (pTa), those with lamina propria invasion (pT1), and those that are only/have concomitant carcinoma in situ (CIS; pTis). These cancers have a high risk for intravesical recurrence (around 46–78% at five years) and progression (between 6–45% at five years) to muscle-invasive bladder cancer (MIBC). As with all UC, their presentation can be with visible haematuria or irritative lower urinary tract symptoms. The latter are common in patients with CIS. CIS may be detected in isolation (so-called primary CIS) or with a coexisting UC elsewhere (termed concomitant CIS). While urinary cytology has a moderate sensitivity and high specificity (>90%) for the detection of HG-NMIBC, cystoscopy is the most important diagnostic tool.
Urothelial carcinomas of the upper urinary tract
Authors: Ghoneim Tarek P. , Colin Pierre , Rouprêt Morgan
Published: November 2017

Upper urinary tract urothelial carcinomas (UTUCs) are scarce and account for only 5-10% of urothelial carcinomas. The estimated annual incidence in western countries is approximately two new cases per 100,000 inhabitants. The natural history of UTUCs differs from that of bladder cancer; 60% of UTUCs are invasive at diagnosis compared to only 15% of bladder tumours. Apart from these epidemiological considerations, one could consider urothelial carcinomas as a whole and underline that the distinction between tumours of the upper and of the lower urinary tracts should be anatomically based (i.e. upper urinary tract vs. lower urinary tract). It is now obvious that strong differences exist regarding tumour location and behaviour between the upper and lower urinary tracts. The field of evidence-based medicine has grown largely in recent years for UTUCs, demonstrating that new insights, new concepts, new clinical and basic research, and new therapeutic findings are becoming readily available.
The aetiology, epidemiology, clinical features, and investigation of kidney cancer
Authors: Patel Nilay , Cranston David , Sullivan Mark
Published: November 2017

Over 270,000 patients worldwide are diagnosed with renal cancer every year. It is the most lethal of all urological malignancies, with 33–44% of patients dying as a result of the disease. The past three decades has seen the incidence of renal cancer increasing by approximately 2% per year. This increased incidence has predominantly been within localized tumours, detected incidentally due to the increased use of cross-sectional imaging in medical practice. Despite an increase in the number of patients undergoing surgery for renal cancer, mortality rates have continued to rise. There is some evidence to suggest this may be a consequence of the overdiagnosis and overtreatment of small renal masses. At present, there is no justification for national screening programmes for renal cancer.
Penile cancer
Authors: Djajadiningrat Rosa , Horenblas Simon
Published: November 2017

Penile cancer is a rare malignancy in the Western world, but in Asia, Africa, and South Africa the incidence is much higher. Risk factors, including phimosis, human papillomavirus (HPV), smoking, chronic inflammatory conditions, psoralen ultraviolet photochemotherapy, genital warts, and HIV infection play a role in the pathogenesis of penile cancer. Approximately 95% of all penile tumours are squamous cell carcinomas (PSCC) and the large majority arise from the prepuce or glans. PSCC has a strong tendency for lymphatic dissemination, but cure can still be attained in patients with inguinal involvement. The most commonly used staging system is the 2009 TNM classification for penile cancer. Surgical resection has been the mainstay of treatment in penile carcinoma, including penile-preserving techniques, partial and total penectomy. The aim of surgery is minimizing loss of anatomy and function, without jeopardizing oncological results.
Treatment of adrenal tumours
Authors: Bagul A , Balasubramanian Saba
Published: November 2017

The incidence of adrenal tumours has risen dramatically over the last two decades, mainly due to the incidental detection of adrenal lesions on cross sectional imaging performed for other diseases. These ‘incidentalomas’ are commoner than the well-known hormonal syndromes such as Cushing’s, Conn’s, and pheochromocytoma. Suspicion or detection of an adrenal tumour should result in a detailed biochemical and structural evaluation in a multidisciplinary setting. The relatively low incidence of adrenal disease coupled with the varied nature of presentation makes concentration of volume and encouragement of expertise difficult in this area; however, these are important as it correlates directly with outcome.
Infertility
Authors: Dohle Gert R
Published: November 2017

The assessment of men with fertility problems is described in this chapter. The main causes of male infertility are testicular insufficiency due to congenital and acquired causes, obstructions of the male genital tract, genetic and endocrine abnormalities, urogenital infections, and varicoceles. Lifestyle can also have a negative influence on semen quality: smoking, obesity, drugs, and anabolic steroids influence sperm parameters and may reduce natural conception. Some chronic diseases also have a negative influence on fertility. History taking and physical examination should focus on prevalent causes of male infertility. Many decisions on diagnosis and treatment of male infertility are based on a semen analysis. It is therefore essential that the investigation is performed according to the recommendations of the world health organization manual for semen analysis.
Erectile dysfunction
Authors: Porst Hartmut
Published: November 2017

Erectile dysfunction (ED) can be improved by changing certain lifestyle factors such as sedentary lifestyle, unhealthy food, nicotine and alcohol abuse, or optimal management of risk factors/concomitant diseases causing or aggravating ED such as dyslipidaemia, hypertension, diabetes mellitus, depression, BPH/LUTS, or hypogonadism.First choice in the medical therapy of ED are PDE-5 inhibitors such as sildenafil, vardenafil, and tadalafil used p.r.n, or on a daily low-dose regimen regarding tadalafil, especially in patients suffering from ED and BPH/LUTS. Yohimbine and L-arginine may be considered in patients with mild PE, which also applies for topical alprostadil. Both transurethral alprostadil and self-injection therapy with alprostadil, papaverine/phentolamine, or the trimix combination consisting of all three compounds is mostly reserved for those patients non-or poorly responding to PDE-5 inhibitors. Finally, combination therapy with PDE-5 inhibitors and transurethral alprostadil or intracavernous self-injection therapy can be able to rescue non-responders to either monotherapy.
Erectile dysfunction
Authors: Bettocchi Carlo , Spilotros Marco
Published: November 2017

Pharmacological therapy and vacuum device don't provide satisfactory results or can be contraindicated in a limited number of patients with erectile dysfunction (ED). The sole available option to treat their condition is represented by surgery. Penile prosthetic surgery is the most common surgical approach to restore erectile function but within the other options available, venous ligation and penile arterial revascularization should be considered in selected patients. Penile prosthesis implant is recommended in patients with organ failure who don't respond to medical therapy, in case of severe corporal fibrosis due to priapism, or when both ED and Peyronie’s disease are diagnosed. In relatively young patients not affected by severe vascular disease and diabetes with a documented stenosis of the internal pudendal artery, penile arterial revascularization can be considered. In case of congenital venous leakage, a further surgical treatment is represented by venous ligation that can provide satisfactory results in young patients.
Ejaculatory disorders
Authors: McMahon Chris G
Published: November 2017

Ejaculatory/orgasmic disorders are common male sexual dysfunctions, and include premature ejaculation (PE), inhibited ejaculation, anejaculation, retrograde ejaculation, and anorgasmia.Premature ejaculation management is largely dependent upon aetiology. Life-long PE is best managed with PE pharmacotherapy (selective serotonin re-uptake inhibitor [SSRI] and/or topical anaesthetics). The management of acquired PE is aetiology-specific and may include erectile dysfunction (ED) pharmacotherapy in men with co-morbid ED. Behavioural therapy is indicated when psychogenic or relationship factors are present and is often best combined with PE pharmacotherapy in an integrated treatment programme. Delayed ejaculation, anejaculation, and/or anorgasmia may have a biogenic and/or psychogenic aetiology. Men with age-related penile hypoanesthesia should be educated, reassured, and instructed in revised sexual techniques which maximize arousal. No drugs have yet been approved by regulatory agencies for this purpose, and most drugs identified for potential use have limited efficacy, impart significant side effects, or are considered experimental in nature.
Scrotal swelling
Authors: Kadioglu Ates , Salabaş Emre
Published: November 2017

Scrotal swelling is a common urological pathology composed of both benign and malign diseases originating from testicles, epididymis, tunical layers, or the scrotum wall itself. Emergencies usually present with pain and short onset time while malign lesions are usually palpated as smooth, solid, painless masses. Hydrocele is the abnormal collection of serous fluids encapsulated between tunica albuginea and vaginalis of the testis. Hydrocele might be primary or occur secondary to trauma, infection, epididymitis, or tumours. Although physical examination is enough for diagnosis, ultrasound should be performed for malignancy exclusion. Surgery is gold standard for young patients with cosmetic problems, discomfort, disability due to hydrocele, and has high success and low complication rates. Alternative treatments such as tetracycline or polidocanol may be considered for patients with high anaesthesia risk.
Prenatal diagnosis and perinatal urology
Authors: Thomas David F.M
Published: November 2017

The kidney is formed by the interaction of the ureteric bud and metanephros during the fifth week of gestation and urine is excreted into the amniotic cavity from the ninth week onwards. The introduction of routine antenatal ultrasonography into obstetric practice has had a profound impact on the specialty of paediatric urology and the majority of urological abnormalities which pose a serious threat of morbidity are now detected prenatally. The results of foetal intervention to treat severe lower tract obstruction have been disappointing because renal damage (notably dysplasia) is largely irreversible by the time the anomaly is first identified. Indications for urgent postnatal evaluation include bilateral upper tract dilatation, thick-walled bladder, and impaired bladder emptying. A selective approach to the postnatal investigation of unilateral pelvic dilatation is required to avoid submitting healthy infants to unnecessary investigations.
Neuropathic bladder and anorectal anomalies
Authors: Steinbrecher Henrik
Published: November 2017

Neuropathic bladder and bowel are serious disabilities with a major impact on the lives of affected children and their families. A coordinated multidisciplinary approach to management is essential. Paediatric urology nurse specialists play an important role in training and supporting young patients and their families. The aims of urological management can be summarized as: protecting upper tract function; providing adequate urine storage capacity at safe pressure; and ensuring adequate emptying. As well as preserving renal function, these treatment goals are intended to provide a socially acceptable degree of urinary continence. Young neuropathic bladder patients are likely to require ongoing educational, psychological, and social support throughout childhood and adolescence into adult life.
Kidney transplantation
Authors: Lafranca Jeff A , Hesselink Dennis A , Dor Frank J. M. F.
Published: November 2017

Kidney transplantation is by far the best therapeutic option for most end-stage renal disease patients. However, there is an increased demand for donor organs worldwide, which cannot be met by the number of currently available organs. Live donation is the key to solving this problem, at least for kidneys. Besides the advantages of better patient and graft survival, short ischaemia times, and pre-emptive transplantation, live donor kidney transplantation offers many creative options to facilitate more transplants, such as paired kidney exchange programmes (or cross-over), unspecified and domino-paired donation. Due to new immunological possibilities, blood group AB0-incompatible transplantation and desensitization prior to transplantation are now a clinical reality. Over the years, the evolution of surgical techniques (from invasive towards minimally-invasive) for live donor nephrectomy has contributed tremendously to the success of the programme. This chapter gives a state-of-the-art overview of kidney donation and transplantation, with an emphasis on surgical aspects.
Radioisotopes in urology
Authors: Vinjamuri Sobhan
Published: November 2017

Ever since the first discovery of radioactivity, the medical applications of radioactive isotopes have been at the forefront of developments. There are two broad categories of medical radioisotopes; those that are predominantly diagnostic in purpose and those that are used for therapeutic benefit. Nuclear medicine studies play a key role in the imaging of the renal tracts. Due to the different physiological functions that can be assessed by different radiopharmaceuticals, the choice of a particular radioisotope test can sometimes challenge one’s thinking and thought processes. The routine functions that can be assessed by isotope renography are covered and a table to guide clinical decision-making is also provided. Positron emission tomography scanning represents a big leap in functional imaging, as it not only enables visualization of metabolism and other physiological processes at a molecular level, it also frequently provides a better quality of image compared with conventional nuclear medicine images.
Radio emission from the X-ray pulsar Her X-1: a jet launched by a strong magnetic field neutron star?
Authors: van den Eijnden J , Degenaar N , Russell T D , Miller-Jones J C A , Wijnands R , Miller J M , King A L , Rupen M P
Published: November 2017

Her X-1 is an accreting neutron star (NS) in an intermediate-mass X-ray binary. Like low-mass X-ray binaries (LMXBs), it accretes via Roche lobe overflow, but similar to many high-mass X-ray binaries containing a NS; Her X-1 has a strong magnetic field and slow spin. Here, we present the discovery of radio emission from Her X-1 with the Very Large Array. During the radio observation, the central X-ray source was partially obscured by a warped disc. We measure a radio flux density of 38.7 ± 4.8 μJy at 9 GHz but cannot constrain the spectral shape. We discuss possible origins of the radio emission, and conclude that coherent emission, a stellar wind, shocks and a propeller outflow are all unlikely explanations. A jet, as seen in LMXBs, is consistent with the observed radio properties. We consider the implications of the presence of a jet in Her X-1 on jet formation mechanisms and on the launching of jets by NSs with strong magnetic fields.
Baseline Sensitivities of New Fungicides and Their Toxicity to Selected Life Stages of Phytophthora Species from Citrus in California
Authors: Gray Morgan A. , Hao Wei , Förster Helga , Adaskaveg James E.
Published: November 2017

Phytophthora citrophthora, P. syringae, P. nicotianae, and P. hibernalis are important pathogens of citrus in California but few chemical treatments are currently available. In vitro toxicities of four new fungicides to isolates of Phytophthora spp. from California were determined. Mean effective concentration values to inhibit mycelial growth by 50% for ethaboxam, fluopicolide, mandipropamid, oxathiapiprolin, and mefenoxam were 0.068, 0.04, 0.004, 0.0003, and 0.039 µg/ml, respectively, for 62 isolates of P. citrophthora; 0.005, 0.045, 0.003, 0.0001, and 0.008 µg/ml, respectively, for 71 isolates of P. syringae; 0.016, 0.057, 0.005, 0.0005, and 0.183 µg/ml, respectively, for 31 isolates of P. nicotianae; and 0.030, 0.018, 0.005, <0.0003, and ≤0.001 µg/ml, respectively, for two isolates of P. hibernalis. Mean values for ≥90% inhibition of sporangia formation of four isolates of P. citrophthora were 0.1, 0.28, 0.026, 0.005, and 55 µg/ml for ethaboxam, fluopicolide, mandipropamid, oxathiapiprolin, and mefenoxam, respectively. Zoospore cyst germination of P. citrophthora was most inhibited by oxathiapiprolin and mandipropamid. Chlamydospore formation of P. nicotianae was most sensitive to oxathiapiprolin, with a mean ≥90% reduction (EC>90) of 0.002 µg/ml, moderately sensitive to mandipropamid (EC>90 = 0.2 µg/ml) and mefenoxam (EC>90 = 0.6 µg/ml), and least sensitive to ethaboxam and fluopicolide (EC>90 = 1 µg/ml). Oospore formation of P. nicotianae was inhibited by ≥90% using oxathiapiprolin at 0.0004 µg/ml, mandipropamid at 0.02 µg/ml, ethaboxam at 0.1 µg/ml, or fluopicolide at 0.4 µg/ml, whereas 62% inhibition was obtained by mefenoxam at 40 µg/ml.
Inert Materials as Long-Term Carriers and Disseminators of Viable Leptosphaeria maculans Ascospores and Wider Implications for Ascomycete Pathogens
Authors: Barua Papori , You Ming Pei , Bayliss Kirsty L. , Lanoiselet Vincent , Barbetti Martin J.
Published: November 2017

The viability of ascospores of the Phoma stem canker (blackleg) pathogen, Leptosphaeria maculans, was tested on a range of carrier materials, including metals, fabrics, woods, and plastics, and under different temperature conditions of 23 and 4, 36 and 14, and 45 and 15°C day and night, respectively. At 23 and 4°C (day and night, respectively), ascospores remained viable for up to 240 days on Tasmanian oak (Eucalyptus regnans) and pine wood (Pinus radiata). At 36 and 14°C (day and night, respectively), ascospores remained viable on pine wood for up to 180 days. At 45 and 15°C (day and night, respectively), ascospores remained viable up to 60 days on jute. There were also significant differences (P < 0.001) between carrier materials in their abilities to retain ascospores following washing. At least 30% of intact ascospores recovered from inert carrier materials were able to germinate on artificial growth media within 48 h of recovery and some ascospores were still viable after 240 days. These findings confirm that L. maculans ascospores remain viable for a much longer time in the absence of a host than previously considered. This demonstrates the importance of inert materials as long-term and long-distance carriers of viable L. maculans ascospores, and highlights their potential role for spread of L. maculans races to new regions and countries via farming equipment, clothing, and other associated materials. Local, national, and international biosecurity agencies need to be aware that the risks of spread of ascomycete plant, animal, and human pathogens via inert materials are significantly greater than currently assessed.
Predictors of Program Completion and NCLEX-RN Success in an Associate Degree Nursing Program
Authors: Robert Nicole
Published: November 2017

Unsuccessful nursing students have a great impact on nursing programs. The purpose of this study was to determine the relationships among preadmission HESI A2® (Health Education Systems, Incorporated Admission Assessment) score, science and math course grades, program completion, and NCLEX-RN® success in an associate degree nursing program using a retrospective, correlational research design. A statistically significant relationship was found between preadmission examination scores and successful NCLEX-RN passage on first attempt. Program completion had a positive correlation with preadmission science grades and HESI A2 scores.
Nongonococcal and Nonmeningococcal Neisseria Infection in Patients With Cancer
Authors: Chandra Vinodh , Nanjappa Sowmya , Castro-Borobio Manuel , Greene John N.
Published: November 2017

Neisseria, of the family Neisseriacea, are gram-negative, nonmotile, and non–spore-forming bacteria. The pathogens Neisseria gonorrhoeae and Neisseria meningitidis have been extensively studied and have long been recognized as human-specific pathogenic bacteria. Other members of the Neisseria genus, are nonpathogenic and are normal inhabitants of the upper respiratory tract. However, recent reports suggest that these normally nonpathogenic bacteria have the potential to produce infection. Cases of Neisseria species causing bacteremia, endocarditis, and pneumonia have been documented, as well as infection in immune-compromised hosts. Currently, there is a paucity of data regarding Neisseria species infection in patients with cancer. We report a case series of nongonococcal and nonmeningococcal Neisseria infection in patients with underlying malignancy to add to this limited body of knowledge and to provide further evidence of the opportunistic potential of these species in immune-compromised hosts.
Disseminated Adenovirus Disease Presenting as Septic Shock in an Immunocompetent Pubertal Girl
Authors: Jeong Esther , Maslyanskaya Sofya , Coupey Susan M.
Published: November 2017

Adenovirus is a common cause of respiratory illness in childhood and is associated with approximately 5% to 15% of upper and lower respiratory tract infections. Immunocompetent individuals usually have a mild and self-limited disease course, with syndromes typically including pharyngitis, bronchiolitis, keratoconjunctivitis, otitis media, and gastroenteritis. Neurologic manifestations in immunocompetent children are less common and include aseptic meningitis, myelitis, subacute focal encephalitis, seizures, paralysis, and Reye-like syndrome. Disseminated adenovirus disease is rare in immunocompetent children, occurring in approximately 1% to 1.5% of all cases of adenovirus infection compared with a 12.5% occurrence rate in immunocompromised children. Furthermore, to the best of our knowledge, disseminated adenovirus disease causing a severe sepsis–like picture in an immunocompetent child has only been described in 1 published report. Here, we present a case of a previously healthy pubertal girl who presented in severe hypotensive shock and who subsequently had adenovirus DNA detected from the cerebrospinal fluid and no other etiology identified.
Primary Peritonitis Due to Streptococcus pyogenes
Authors: Moftakhar Bahar , Patel Yesha S. , Poblete Jose E. , Myers Joseph P.
Published: November 2017

Introduction

Primary peritonitis (PP) is peritonitis occurring in patients without underlying causes such as perforated viscus, preexisting ascites, or nephrosis. We report 2 cases of primary Streptococcus pyogenes peritonitis and review the literature on this subject since January 1, 2000.

Case Reports

Patient 1 was a 45-year-old woman who presented to hospital with fever, diarrhea, and abdominal pain. Examination revealed fever, hypotension, epigastric tenderness, and guarding. Computed tomography (CT) scan was negative for signs of perforated viscus. Workup included blood cultures, parenteral antibiotics, and surgical consult. She underwent emergent operative intervention, which revealed generalized peritonitis, cloudy peritoneal fluid, and no evidence of perforated viscus. Blood cultures revealed S. pyogenes. She underwent an unremarkable recovery on parenteral ceftriaxone followed by oral ampicillin. Patient 2 was a 47-year-old woman who presented to hospital with fever, chills, anorexia, nausea, vomiting, and abdominal pain. Physical examination showed fever, hypotension, tachycardia, and diffuse abdominal tenderness but no rebound tenderness. Abdominal CT scan revealed fluid but no free air. Paracentesis revealed purulent fluid, which on Gram-stained smear showed gram-positive cocci in pairs and chains. Blood and peritoneal fluid cultures were positive for S. pyogenes. Exploratory laparotomy by surgical consultant showed purulent fluid and fibrinous exudate with multiple interloop abscesses and no perforated viscus. Postoperatively, she received parenteral penicillin G, transient hemodialysis, and ventilator support with eventual full recovery.

Review of Literature

We reviewed the medical literature from January 1, 2000, to December 31, 2016, and found 36 patients with diagnosis of S. pyogenes PP. Despite most of these case reports stating that the occurrence of S. pyogenes PP is “rare,” it seems that it is more common than previously thought. All but 3 patients underwent surgical intervention. All 38 patients presented with physical findings of an acute abdomen. There was no evidence of free air on CT scanning or ultrasound of the 33 patients who underwent one of these imaging techniques. Septic shock was common, and all but 1 patient survived.

Conclusions

Streptococcus pyogenes PP is more common than previously reported, is associated with physical findings of acute abdomen, is usually accompanied by circulatory shock, and is almost always clinically responsive to treatment with operative and antimicrobial agent interventions.
Structure of the Bacillus anthracis dTDP-L-rhamnose-biosynthetic enzyme dTDP-4-dehydrorhamnose 3,5-epimerase (RfbC)
Authors: Shornikov Aleksander , Tran Ha , Macias Jennifer , Halavaty Andrei S. , Minasov George , Anderson Wayne F. , Kuhn Misty L.
Published: November 2017

The exosporium layer of Bacillus anthracis spores is rich in L-rhamnose, a common bacterial cell-wall component, which often contributes to the virulence of pathogens by increasing their adherence and immune evasion. The biosynthetic pathway used to form the activated L-rhamnose donor dTDP-L-rhamnose consists of four enzymes (RfbA, RfbB, RfbC and RfbD) and is an attractive drug target because there are no homologs in mammals. It was found that co-purifying and screening RfbC (dTDP-6-deoxy-D-xylo-4-hexulose 3,5-epimerase) from B. anthracis in the presence of the other three B. anthracis enzymes of the biosynthetic pathway yielded crystals that were suitable for data collection. RfbC crystallized as a dimer and its structure was determined at 1.63 Å resolution. Two different ligands were bound in the protein structure: pyrophosphate in the active site of one monomer and dTDP in the other monomer. A structural comparison with RfbC homologs showed that the key active-site residues are conserved across kingdoms.
Crystal structures of 1-hydroxy-4-propyloxy-9,10-anthraquinone and its acetyl derivative
Authors: Nakagawa Hidemi , Kitamura Chitoshi
Published: November 2017

1-Hydroxy-4-propyloxy-9,10-anthraquinone, C17H14O4, (I), and its acetyl derivative, 4-acetyloxy-4-propyloxy-9,10-anthraquinone, C19H16O5, (II), were synthesized from the commercially available dye quinizarin. In both compounds, the anthraquinone frameworks are close to planarity. There is a large difference in the conformation of the propyloxy group; the molecule of (I) adopts agaucheconformation [O—C—C—C = −64.4 (2)°], although the molecule of (II) takes atrans-planar conformation (zigzag) [O—C—C—C = 176.1 (3)°]. In the molecule of (I), there is an intramolecular O—H...O hydrogen bond. In both crystals, the molecules are linked by C—H ...O hydrogen bonds. A difference in the molecular arrangements of (I) and (II) is found along the stacking directions.
The impact of central-local inter-governmental relations on cultural democracy’s development
Authors: Jiang Xuan , Choi Sun-hee
Published: November 2017

Purpose

The rise of cultural governance has made cultural democracy important in East Asia. South Korea and China have chosen to develop cultural democracy by means of developing community-based cultural houses. Cultural houses in Korea were first managed from the center but have now been decentralized, and those in China have been developed based on local financing and administration. Since central-local intergovernmental relations, as they relate to public culture, have gone untouched in East Asia, the purpose of this paper is to study how central-local intergovernmental relations have impacted the development of cultural democracy in this area, in order to better understand how public culture should be developed.

Design/methodology/approach

A comparative study of the cases of South Korea and China has been used. The materials and information collected for the study were gathered by a review and an analysis of extant literature, policy documents, data and other materials from the relevant departments of both countries. It was also based on semi-structured interviews conducted with the national cultural departments, regulatory institutions, and with officials and scholars.

Findings

This study shows that central-local intergovernmental relations can have an impact on the management of community-based cultural houses and the effectiveness of cultural democracy’s development. Only complete decentralization that directly invites democratization will provide positive local conditions for cultural democracy’s growth. In short, meaningful governmental responses to local demands and a strong civil society are critical for the advancement of cultural democracy.

Practical implications

This study seeks to provide insights into the relationship between central-local intergovernmental relations and cultural democracy. At the micro project level, cultural project management should be improved; at the medium local level, the public must be made part of any decentralization effort; and at the macro national level, the multiple impacts caused by decentralization need to be considered.

Originality/value

This study is unique in terms of both its research questions and its research area. Central-local intergovernmental relations, as they relate to public culture, have gone comparatively untouched, especially in the context of East Asia. It is in this context that studying how central-local intergovernmental relations impact the development of cultural democracy is worthwhile, in order to better understand how public culture has developed and will be developed in future. A comparative study of the cases of South Korea and China has been used to discover the impacts of different dimensions of central-local decentralization on cultural development.
Analysis of employability for the civil aviation maintenance graduates of Turkey
Authors: Denizhan Berrin , Doğru Alperen
Published: November 2017

Purpose

With every passing day, the center of gravity for air traffic for the Middle East and Turkey is shifting toward becoming a center for airway transport, maintenance, repair, overhaul (MRO) and transfer. The MRO sector is gaining importance because of this increase in Turkey. The purpose of this study is to examine the future employability of the graduates receiving civil aviation maintenance training in Turkey.

Design/methodology/approach

The paper uses past seven years’ data about maintenance personnel of Turkey. It includes all-level students, recently working personnel and retired personnel of each year. Regression analysis and Markov analysis were used to show the prediction of aviation maintenance personnel.

Findings

The paper provides quantitative results about employability of maintenance personnel under the real numbers of alumni and working and retired personnel in Turkey. The results show that the number of graduates will be greater than the number of staff members in certifying categories in 2018. Presently, Turkey meets the employment expected, but in the future, aviation maintenance personnel number is rising, and there will be an excess number of graduates left over in Turkey.

Research limitations/implications

Because of the chosen region, Turkey, the research results may lack generalizability. Therefore, researchers are encouraged to conduct analysis for other countries which have an important role in aviation.

Practical implications

The paper includes implications for the government maintenance personnel policy and educational policy for managing all types of maintenance personnel in Turkey.

Originality/value

This kind of personnel needs analysis has not been done before, and this is the originality of this paper. It will in turn lead to an analysis of planning for allocation of maintenance staff and alumni. The authors collected all official numbers about maintenance personnel from Turkish Student Selection and Placement Center of Turkey, Turkish Technic and Turkish Civil Aviation Reports.
Scale dependence of the diversity–stability relationship in a temperate grassland
Authors: Zhang Yunhai , He Nianpeng , Loreau Michel , Pan Qingmin , Han Xingguo
Published: November 2017

A positive relationship between biodiversity and ecosystem stability has been reported in many ecosystems; however, it has yet to be determined whether and how spatial scale affects this relationship. Here, for the first time, we assessed the effects of alpha, beta and gamma diversity on ecosystem stability and the scale dependence of the slope of the diversity–stability relationship.

By employing a long‐term (33 years) dataset from a temperate grassland, northern China, we calculated the all possible spatial scales with the complete combination from the basic 1‐m2 plots.

Species richness was positively associated with ecosystem stability through species asynchrony and overyielding at all spatial scales (1, 2, 3, 4 and 5 m2). Both alpha and beta diversity were positively associated with gamma stability.

Moreover, the slope of the diversity–area relationship was significantly higher than that of the stability–area relationship, resulting in a decline of the slope of the diversity–stability relationship with increasing area.

Synthesis. With the positive species diversity effect on ecosystem stability from small to large spatial scales, our findings demonstrate the need to maintain a high biodiversity and biotic heterogeneity as insurance against the risks incurred by ecosystems in the face of global environmental changes.
Non‐market Social and Political Strategies – New Integrative Approaches and Interdisciplinary Borrowings
Authors: Frynas Jedrzej George , Child John , Tarba Shlomo Y.
Published: November 2017

This paper introduces a special issue of the British Journal of Management on social and political strategies in the non‐market environment. On the one hand, it reviews the extant research on the possible forms of interaction between Corporate Social Responsibility (CSR) strategies and Corporate Political Activity (CPA): CSR‐CPA complementarity, CSR‐CPA substitution and mutual exclusion between CPA and CSR. On the other hand, the paper provides an overview of the recent contributions of non‐business disciplines – psychology, sociology, economics, politics and history – to nonmarket scholarship and, above all, the potential future scholarly contributions of these disciplines.
Increasing workplace violence in an Australian adult emergency department
Authors: Nikathil Shradha , Olaussen Alexander , Symons Evan , Gocentas Robert , O'Reilly Gerard , Mitra Biswadev
Published: November 2017

Objective

Workplace violence (WPV) is an increasingly concerning occupational hazard within the ED. The aim of the present study was to evaluate the incidence and characteristics of WPV in an adult ED.

Methods

A retrospective cohort study was conducted to identify the incidence of ED WPV in an adult metropolitan ED. Data were obtained from the activity records of security staff from 1 January 2013 to 31 December 2015 for all incidents of patient‐perpetrated violence. Data on patients identified from these records as requiring security staff intervention for violence in the ED were collected through an explicit chart review. Data on patient illicit drug or alcohol exposure and acute psychiatric diagnoses were also collected.

Results

There were 1853 episodes of patient‐perpetrated WPV identified over the study period. The incidence of WPV over the 3 years was 103 (95% CI: 98–108) per 10 000 of the presenting population, with a significant increase from 2013 to 2015 (IRR 1.07; 95% CI: 1.04–1.10; P < 0.01). Drug and/or alcohol exposure was observed in 1145 (61.8%) patients. Among the drug‐ and/or alcohol‐affected violent population, three quarters (840/1145 = 73.4%) did not have a concurrent psychiatric diagnosis that required assessment during the violent presentation.

Conclusion

The rate of WPV was increasing within this Australian ED during the study period. The majority of violent patients were affected by drugs and/or alcohol in the absence of a psychiatric diagnosis. Interventions to reduce access to and misuse of alcohol and illicit drugs could have a substantial impact on the concerning increase of violence in the ED.
Clinical characteristics of ulcerative colitis‐related colorectal cancer in Chinese patients
Authors: Wang Ya Nan , Li Ji , Zheng Wei Yang , Wu Dong , Yang Hong , Li Yue , Lv Hong , Tan Bei , Shu Hui Jun , Sun Xi Yu , Qian Jia Ming , Wu Bin , Li Jing Nan
Published: November 2017

OBJECTIVE

The prevalence of ulcerative colitis (UC) in China has been increasing, together with the incidence of ulcerative colitis‐related colorectal cancer (UCRCC). In this study we aimed to investigate the clinical features of UCRCC in Chinese UC patients.

METHODS

Clinical data of patients with UCRCC during January 2003 to December 2016 were retrieved from the Peking Union Medical College Hospital registration database and compared with that of sporadic colorectal cancer (CRC).

RESULTS

During the study period, among the 10 110 patients with CRC 25 were found to have UCRCC, with an average age of 51 years and a median disease duration of 15 years. The cumulative prevalence of UCRCC was 0.25% in all CRC patients, with a significant increase from 2003–2007 to 2013–2016 (P < 0.01). Altogether 14 (56.0%) patients with UCRCC were men, and 5 (20.0%) had a family history of UC or cancer. Four (16.0%) patients had concurrent high‐grade intraepithelial neoplasia with variable differentiated adenocarcinoma at other sites and 19 (59.4%) tumors were moderately or poorly differentiated. Twenty‐three (92.0%) patients underwent surgery, of whom 10 (40%) were at stage III and IV according to the TNM staging system. Compared with the 10 085 patients with sporadic CRC, UCRCC patients were younger (P < 0.01) and were more likely to have descending colon involvement and multifocal lesions (P < 0.01).

CONCLUSIONS

UCRCC patients have been increasing in recent years. Compared with patients with sporadic CRC, those with UCRCC are younger and are more likely to have descending colon involvement and multifocality.
C‐reactive protein as a predictor of low trough infliximab concentrations in patients who lose response to infliximab
Authors: Boyle Marie P , Moss Alan C , O'Toole Aoibhlinn M , Vaughn Byron , Cheifetz Adam S
Published: November 2017

OBJECTIVE

Low serum infliximab concentrations are associated with an increased risk of loss of response in inflammatory bowel disease (IBD). The objective of this study was to evaluate the test characteristics of C‐reactive protein (CRP) in identifying low serum infliximab concentrations in patients with IBD.

METHODS

We measured serum infliximab concentrations and CRP levels in patients who experienced deteriorating symptoms while on infliximab (the reactive cohort). Receiver operating characteristic (ROC) curves were used to determine the CRP concentration threshold that identified an infliximab concentration <3 μg/mL at the time of loss of response. These CRP thresholds for infliximab concentration <3 μg/mL were then tested in a separate validation cohort.

RESULTS

The reactive cohort contained 111 patients and the validation cohort contained 139 patients. In 41% of participants, serum infliximab concentration was <3 μg/mL. In the reactive cohort, the area under the ROC curve for CRP to identify an infliximab concentration <3 μg/mL was 0.70 (95% confidence interval [CI] 0.50–0.80, P = 0.02). A CRP level above 12 mg/L in the preceding 90 days provided a 90% specificity for the later detection of infliximab concentration <3 μg/mL. These test characteristics were similar in the validation cohort.

CONCLUSION

CRP levels over 12 mg/L exhibit a high specificity for identifying patients with an infliximab concentration <3 μg/mL. CRP may be cost‐effective for identifying patients with low concentrations of infliximab at the time of, or at risk of, loss of response.
Impaired competence in flagellar mutants of Bacillus subtilis is connected to the regulatory network governed by DegU
Authors: Hölscher Theresa , Schiklang Tina , Dragoš Anna , Dietel Anne‐Kathrin , Kost Christian , Kovács Ákos T.
Published: November 2017

The competent state is a developmentally distinct phase, in which bacteria are able to take up and integrate exogenous DNA into their genome. Bacillus subtilis is one of the naturally competent bacterial species and the domesticated laboratory strain 168 is easily transformable. In this study, we report a reduced transformation frequency of B. subtilis mutants lacking functional and structural flagellar components. This includes hag, the gene encoding the flagellin protein forming the filament of the flagellum. We confirm that the observed decrease of the transformation frequency is due to reduced expression of competence genes, particularly of the main competence regulator gene comK. The impaired competence is due to an increase in the phosphorylated form of the response regulator DegU, which is involved in regulation of both flagellar motility and competence. Altogether, our study identified a close link between motility and natural competence in B. subtilis suggesting that hindrance in motility has great impact on differentiation of this bacterium not restricted only to the transition towards sessile growth stage.
Validating performance of TRISS, TARN and NORMIT survival prediction models in a Norwegian trauma population
Authors: Skaga N. O. , Eken T. , Søvik S.
Published: November 2017

Introduction

Anatomic injury, physiological derangement, age, injury mechanism and pre‐injury comorbidity are well‐founded predictors of trauma outcome. Statistical prediction models may have poorer discrimination, calibration and accuracy when applied in new locations. We aimed to compare the TRISS, TARN and NORMIT survival prediction models in a Norwegian trauma population.

Methods

Consecutive patients admitted to Oslo University Hospital Ullevål within 24 h after injury, with Injury Severity Score ≥ 10, proximal penetrating injuries, or received by trauma team, were studied. Original NORMIT coefficients were updated in a derivation dataset (NORMIT 2; n = 5923; 2005–2009). TRISS, TARN and NORMIT prediction models were evaluated in the validation dataset (n = 6348; 2010–2013) using two different AIS editions for injury coding. Exclusion due to missing data was 0.26%. Outcome was 30‐day mortality. Validation included AUROC, scaled Brier statistics, and calibration plots.

Results

The NORMIT models had significantly better discrimination, calibration, and overall fit than the TRISS 09, TARN 09 and TARN 12 models. The updated NORMIT 2 had higher numerical values of AUROC and scaled Brier than the original NORMIT, but with overlapping 95%CI. Overlapping 95%CI for AUROCs and Discrimination slopes indicated that the TARN and TRISS models performed similarly. Calibration plots showed tight and consistent predictions over all Ps strata for NORMIT 2 run on AIS'98 coded data, and only little deterioration when AIS'08 data was substituted.

Conclusions

In a Norwegian trauma population, the updated Norwegian survival prediction model in trauma (NORMIT 2) performed better than well‐established British and US alternatives. External validation of these three models in other Nordic populations is warranted.
A prototype small‐bore ventilation catheter with a cuff: cuff inflation optimizes ventilation with the Ventrain
Authors: de Wolf M. W. P. , van der Beek T. , Hamaekers A. E. , Theunissen M. , Enk D.
Published: November 2017

Background

Ventilation through small‐diameter tubes typically precludes use of a cuff as this will impede the necessary passive outflow of gas alongside the tube's outer surface. Ventrain assists expiration and enables oxygenation and normoventilation through small‐bore cannulas or catheters, particularly in obstructed airways. A small‐bore ventilation catheter (SBVC; 40 cm long, 2.2 mm inner diameter) with a separate pressure monitoring lumen and a cuff was developed. Efficacy of oxygenation and ventilation with Ventrain through this catheter was investigated in sealed and open airways in a porcine cross‐over study.

Methods

Six pigs were ventilated with Ventrain (15 l/min oxygen, frequency 30 breaths per min, I : E‐ratio 1 : 1) through the SBVC, both with the cuff inflated and deflated. Prior to each test they were ventilated conventionally until steady state was achieved.

Results

With an inflated cuff, PaO2 rose instantly and remained elevated (median [range] PaO2 61 [52–69] kPa after 30 min; P = 0.027 compared to baseline). PaCO2 remained stable at 4.9 [4.2–6.2] kPa. After cuff deflation, PaO2 was significantly lower (9 [5–28] kPa at 10 min, P = 0.028) and interventional ventilation had to be stopped prematurely in five pigs as PaCO2 exceeded 10.6 kPa. Pulmonary artery pressures increased markedly in these pigs. Intratracheal pressures were kept between 5 and 20 cmH2O with the cuff inflated, but never exceeded 2 cmH2O after cuff deflation.

Conclusion

The SBVC combines the benefits of a small diameter airway and a cuff. Cuff inflation optimizes oxygenation and ventilation with Ventrain.