bluuebunny/crossref_metadata_2025 huggingface dataset:
Small details that make big differences
Authors: N. Bolton Ruth , Gustafsson Anders , McColl-Kennedy Janet , J. Sirianni Nancy , K. Tse David
Published: March 2014

Purpose

– Service organizations and marketers have focussed too much of their energy on their core service's performance and too little emphasis on designing a customer journey that enhances the entire customer experience. There is nothing wrong with firms seeking continuous improvement in service quality and customer satisfaction. These efforts are needed for firms to be competitive in the marketplace. The problem occurs when performance levels and service offerings become too similar within an industry, so that price is the only competitive weapon that remains. The purpose of this paper is to argue that in order to break this deadlock, companies need to focus on the small details that make big differences to customers.

Design/methodology/approach

– The paper builds on interviews with executives in successful service organizations. It provides an analysis of differentiation strategies in diverse service organizations across consumption contexts, nations and cultures around the world.

Findings

– The paper develops three research propositions and argues for radical approaches to help service organizations truly understand customers and provide service experiences that engage and delight them. The paper argues that the new challenge for marketing is to help companies find and implement these small details to make a large impact on the overall customer experience.

Originality/value

– In order to truly understand the customer experience, we need a holistic view of all interactions customers have with a company. We need to understand the customer-firm interactions at all touch points, that is, during search, purchase, consumption and post-consumption. Customer experience involves the customers’ cognitive, affective, emotional, social and sensory responses to the firm. The originality of this research lies in the focus on the small details that make a difference to customers during the service process rather than in the final outcome of the service performance.
Systems thinking and alternative business model for responsible tourist destination
Authors: Peric Marko , Djurkin Jelena
Published: March 2014

Purpose

– Providing a new approach to the destination management oriented on the social responsibility and keeping the interests of local community at the forefront of tourism development. The paper aims to discuss these issues.

Design/methodology/approach

– Key concepts from systems theory, stakeholder management and social enterprises theories are rethought from the perspective of tourist destination. Main characteristics of the model of community-based organisational structure are identified as well as demands for socially responsible practices and a case study method is used for holistic and in-depth analysis on a real community-based tourism enterprise (CBTE).

Findings

– The paper proposed innovative socially responsible organisational business model aiming to serve the interests of local community. Interlinking the economic and social objectives in managing the tourist offer on destination level is the critical issue when cooperation of various stakeholders is concerned.

Originality/value

– The paper provides new insight on organising the tourism offer in the destination by using CBTE model. Findings might give impetus for new lines of research oriented on socially sustainable organisational models for responsible destinations. Recommendations suggested by the paper can be used in designing new destination management organisations oriented on developing community-based tourism practices in socially responsible manner.
A systems thinking-based grey model for sustainability evaluation of urban tourism
Authors: Wang Zheng-Xin , Pei Lingling
Published: March 2014

Purpose

– This research aims to establish an index system and a grey comprehensive evaluation model for analyzing the sustainability of urban tourism.

Design/methodology/approach

– The sustainability evaluation of urban tourism is regarded as a multi-level and multi-index evaluation problem in this study. The evaluation index system of urban tourism sustainable development is constructed based on the ideas of holism and systems thinking. Then based on grey system correlation analysis theory, a new evaluation model is proposed to effectively solve the complex and uncertain problems in the sustainability evaluation system of urban tourism. An actual example of the five cities (Nanjing, Zhenjiang, Changzhou, Wuxi and Suzhou) in Southern Jiangsu Province of China is adopted to demonstrate the feasibility and practicability of the proposed model.

Findings

– The grey comprehensive evaluation model can effectively convert the complex indices into comprehensive optimal membership degrees which are easy to be understood. The empirical study on the urban tourism sustainable development of South of Jiangsu found that: Suzhou, Nanjing and Wuxi were in the basic stage of sustainable development; Changzhou and Zhenjiang were in the preliminary stage of sustainable development. The social responsibility fulfillment of urban tourism in five cities fails to reach a satisfactory level, especially Zhenjiang and Changzhou remain in a low level in fulfillment of social responsibility.

Research limitations/implications

– Due to the difficulty of data collection, the authors can only use the data on 2010 to do a static evaluation in this study. If the authors can have more data on different years, it is feasible to develop a dynamic evaluation model to analyze the evolution law of the sustainability of urban tourism.

Practical implications

– The evaluation results provide the necessary support to assist the tourism management departments of the five cities with their policy making.

Originality/value

– This study not only supplements the evaluation modelling methods widely used in the area of tourism management, but also promotes the development of the grey systems theory itself.
Systemic thinking for socially responsible innovations in social tourism for people with disabilities
Authors: Zenko Zdenka , Sardi Valentina
Published: March 2014

Purpose

– Socially responsible innovative behaviour should reduce the incidence of one-sidedness in the behaviour of persons employed or active in tourism organizations. People with disabilities are often poorly integrated, even in the advanced societies. The paper aims to discuss these issues.

Design/methodology/approach

– With a requisitely holistic approach in dialectical systems theory and an overview of relevant literature, the common characteristics of tourists with disabilities are briefly described. A dialectical systemic analysis was used to determine whether people with disabilities want to travel and what their requirements are. A questionnaire was used to identify their recent travelling experiences; tourism organizations were interviewed about their experiences, too. A model of a travel agency, specialized for people with disabilities, is presented.

Findings

– The usual approach to people with special needs is too one-sided. A more requisitely holistic approach to understanding their needs in tourism, based on existing literature and an empirical analysis, is presented. A more innovative management of tourism organizations is proposed, increasing social responsibility (SR).

Research limitations/implications

– The authors contribute to the integration of people with disabilities in society, focusing on innovation in the management of tourism organizations.

Practical implications

– This new, more systemic and socially responsible innovative management in tourism is widely applicable. Tourists with disabilities, their family members, and their travelling companions could become more included in tourist activities and represent a potentially significant share of the market. A requisitely holistic approach can provide advantages for tourists with disabilities and tourism organizations.

Originality/value

– The concepts were not found in available literature neither is the selection of viewpoints of dialectical systems thinking and SR in tourism. They support understanding, designing and managing activities in tourism for people with various limitations or specific needs.
Reliability analysis of an ACA attached flex-on-board assembly for industrial application
Authors: Kiilunen Janne , Frisk Laura
Published: March 2014

Purpose

– The purpose of this paper is to examine the long-term reliability of an anisotropic conductive adhesive (ACA) attached polyethylene terephthalate (PET) flex-on-board (FOB) assembly for industrial application used in harsh environments. In addition, the possibility of reducing reliability testing time was studied.

Design/methodology/approach

– A−40/+125°C thermal cycling test with 5- and 14-minute soak times was used to study the reliability. To study the functionality of the FOB assembly during testing, a real-time resistance measurement was used together with a 90° peel strength test. Failure analysis was performed on samples using scanning electron microscopy and cross sectioning.

Findings

– No failures or noticeable increase in the measured resistance values were seen during testing. The peel strength, however, decreased significantly with both soak times used. The highest drop in the mechanical strength occurred at the start of the temperature cycling tests. The time spent at the high temperature extreme seemed to have a greater impact on the peel strength than the number of temperature cycles. The failure mode of peel tested samples changed due to temperature cycling from interfacial delamination to cohesive failure. The temperature cycling was also observed to induce voiding inside the adhesive.

Originality/value

– The paper illustrates the applicability of ACA attached PET flex in high reliability industrial applications. Additionally, testing methods for high reliability adhesive interconnections are discussed. Especially, the effect of temperature cycling soak time on peel test results and reliability testing time is studied.
Ectoparasitism and stress hormones: strategy of host exploitation, common host–parasite history and energetics matter
Authors: St. Juliana Justin R. , Khokhlova Irina S. , Wielebnowski Nadja , Kotler Burt P. , Krasnov Boris R.
Published: March 2014

Parasites are thought to have numerous negative effects on their hosts. These negative effects may be associated with stress in a host.

We evaluated the effects of four species of flea ectoparasites (Parapulex chephrenis,Synosternus cleopatrae,Xenopsylla conformisandXenopsylla ramesis) on non‐specific responses of eight species of rodents (Meriones crassus,Gerbillus dasyurus,Gerbillus andersoni,Gerbillus pyramidum,Gerbillus nanus,Acomys cahirinus,Acomys russatusandMesocricetus auratus) and measured faecal glucocorticoid metabolites concentrations (FGMC) produced by the hosts.

We found no effect of body mass of an individual rodent onFGMCs. Parasitism by fleas with a ‘stay on the host body’ exploitation strategy was associated with higher hostFGMCs than parasitism by fleas that spent most of their life ‘off‐host’.FGMCs among rodents infested by the same flea species were correlated positively with the phylogenetic distance of a given rodent from the principal host of this flea; changes inFGMCs were lower in the host species more closely related to the flea's principal host. Changes inFMGCs of a host while parasitized were correlated with a host's change in body mass, where hosts that lost more body mass had higherFGMCs.

Our results suggest that ectoparasitism can be stressful to their hosts. However, the occurrence of parasite‐induced stress seems to depend on the identity of both host and parasite species and the evolutionary history of a host–parasite association. To our knowledge, this is the first multispecies study to evaluate the effect of ectoparasites on glucocorticoid hormones in small mammals.
Racialization and Rescaling: Post‐Katrina Rebuilding and the LouisianaRoadHome Program
Authors: Gotham Kevin Fox
Published: March 2014

This article examines the interlocking nature of racialization and rescaling in post‐KatrinaNewOrleans, focusing specifically on the implementation of theLouisianaRoadHome program, the largest housing recovery program inUShistory. Based on interviews and long‐term ethnographic fieldwork, I conceptualize theRoadHome program as a racialized spatial strategy to revalorize disaster‐devastated spaces and enhance the exchangeability of damaged property. I trace the logic of rescaling in post‐KatrinaNewOrleans and reveal the ways in which state policies to accelerate the turnover time of flood‐damaged housing reflect and reinforce the racialization of space.NewOrleans stands as a valuable laboratory for the study of government intervention under conditions of widespread upscaling, downscaling and outscaling processes, pushing trends found elsewhere to their limits while revealing the negative consequences of rescaling for local institutions and residents. The article illustrates the localized dynamics of rescaling in times of crisis and offers a novel processual account of the drivers and consequences of rescaling processes in a disaster‐impacted territory.
Factors associated with the change in prevalence of cardiomyopathy at delivery in the period 2000–2009: a population‐based prevalence study
Authors: Grotegut CA , Kuklina EV , Anstrom KJ , Heine RP , Callaghan WM , Myers ER , James AH
Published: March 2014

Objective

Cardiomyopathy (CM) at delivery is increasing in prevalance. The objective of this study was to determine which medical conditions are attributable to this increasing prevalance.

Design

Population prevalence study from 2000 to 2009.

Setting

The Nationwide Inpatient Sample (NIS).

Sample

Pregnant women admitted for delivery were identified in the NIS for the years 2000–2009.

Methods

Temporal trends in pre‐existing medical conditions and in medical and obstetric complications at delivery admissions were determined by linear regression. The change in the prevalence of CM among all pregnant women was compared with the change in the prevalance of CM among pregnant women without pre‐existing conditions or complications.

Main outcome measure

Prevalence of CM.

Results

The prevalence of CM increased from 0.25 per 1000 deliveries in 2000 to 0.43 per 1000 deliveries in 2009 (P < 0.0001). Women with chronic hypertension had increased odds of developing CM compared with women without chronic hypertension (odds ratio, OR, 13.2; 95% confidence interval, 95% CI, 12.5–13.7). The linear increase in chronic hypertension over the 10‐year period was the single identified pre‐existing medical condition that explained the increasing prevalence of CM at delivery (P = 0.005 for the differences in slopes for linear trends).

Conclusions

Pregnant women with chronic hypertenion are at an increased risk for CM at delivery, and the increasing prevalence of chronic hypertension is an important factor associated with the increasing prevalence of CM at the time of delivery. Among women without chronic hypertension, the prevalence of CM at delivery did not change during the time period.
Extent of mismatch between the period of circadian clocks and light/dark cycles determines time‐to‐emergence in fruit flies
Authors: Yadav Pankaj , Choudhury Deepak , Sadanandappa Madhumala K. , Sharma Vijay Kumar
Published: March 2014

Circadian clocks time developmental stages of fruit flies Drosophila melanogaster, while light/dark (LD) cycles delimit emergence of adults, conceding only during the “allowed gate.” Previous studies have revealed that time‐to‐emergence can be altered by mutations in the core clock gene period (per), or by altering the length of LD cycles. Since this evidence came from studies on genetically manipulated flies, or on flies maintained under LD cycles with limited range of periods, inferences that can be drawn are limited. Moreover, the extent of shortening or lengthening of time‐to‐emergence remains yet unknown. In order to pursue this further, we assayed time‐to‐emergence of D. melanogaster under 12 different LD cycles as well as in constant light (LL) and constant dark conditions (DD). Time‐to‐emergence in flies occurred earlier under LL than in LD cycles and DD. Among the LD cycles, time‐to‐emergence occurred earlier under T4–T8, followed by T36–T48, and then T12–T32, suggesting that egg‐to‐emergence duration in flies becomes shorter when the length of LD cycles deviates from 24 h, bearing a strong positive and a marginally negative correlation with day length, for values shorter and longer than 24 h, respectively. These results suggest that the extent of mismatch between the period of circadian clocks and environmental cycles determines the time‐to‐emergence in Drosophila.
Role of systemic inflammation scores in pulmonary metastasectomy for colorectal cancer
Authors: Mineo Tommaso Claudio , Tacconi Federico
Published: March 2014

Background

Patients with pulmonary metastases from colorectal cancer can benefit from surgical removal. However, the biological determinants of postsurgical outcome are not completely elucidated. We evaluated the role of host systemic inflammation status in this setting.

Methods

The modified Glasgow prognostic score (based on serum C‐reactive protein and albumin levels) and the neutrophil‐to‐lymphocyte (NTL) ratio were obtained from 44 patients who received curative‐intent metastasectomy, and were used as indicators of systemic inflammation status. We tested the impact of both of these parameters on overall survival (OS) and progression‐free survival (PFS), as well as their correlation with other well‐known prognosticators.

Results

Five‐year PFS and OS rates were 18% and 49%, respectively. At univariate analysis, multiple metastases, disease‐free interval <36 months, and a Glasgow score of 2 (P = 0.031) were significantly associated to a worse PFS rate. A NTL ratio >3 predicted disease progression in the short‐term (P = 0.036), but the effect on late events was weaker (P = 0.079). Factors associated with worse OS were multiple metastasis (P = 0.002), elevated carcinoembryonic antigen (P = 0.009), a Glasgow score of 2 (P = 0.029), and a faster metastasis growth (P = 0.008). At Cox regression analysis, neither a Glasgow score of 2, nor elevated NTL ratio showed an independent effect on survival rates.

Conclusions

Systemic inflammation scores did not perform well as independent survival prognosticators in patients undergoing curative‐intent pulmonary metastasectomy. Further investigation is warranted to evaluate whether these measurements could still be useful when restricting the analysis to specific patient subcategories or to diverse postoperative phases.
Clinical and biological moderators of response to naltrexone in alcohol dependence: a systematic review of the evidence
Authors: Garbutt James C. , Greenblatt Amy M. , West Suzanne L. , Morgan Laura C. , Kampov‐Polevoy Alexei , Jordan Harmon S. , Bobashev Georgiy V.
Published: March 2014

Aim

The goal of this systematic review was to identify moderators of naltrexone efficacy in the treatment of alcohol dependence.

Methods

We searched Pubmed, CINHAL, Embase, PsycINFO and the Cochrane Library from 1990 to April 2012 and reference lists of pertinent review articles, which yielded 622 trial, pooled analysis and review articles. Using pre‐established eligibility criteria, two reviewers independently determined whether abstracts contained evidence of demographic or biological characteristics, i.e. moderators, influencing naltrexone response in alcohol dependence. We assessed each publication for risk of bias and evaluated the strength of the body of evidence for each moderator.

Results

Twenty‐eight publications (on 20 studies) met criteria for data synthesis. These included 26 publications from 12 randomized, placebo‐controlled trials, three non‐randomized, non‐placebo studies and one randomized, non‐placebo study. In addition, there were two publications from pooled analyses of four randomized, placebo‐controlled trials. Family history of alcohol problems and the Asn40Asp polymorphism of the μ‐opioid receptor gene showed a positive association with efficacy in four of five and three of five studies, respectively. Other moderators reported to be associated with efficacy included male sex (two of five studies), pre‐treatment drinking (two of two studies) and high craving (two of five studies). However, the overall risk of bias in the published literature is high.

Conclusions

The identification of naltrexone‐responsive alcohol‐dependent patients is still in development. Studies to date point to two potential moderators—family history and presence of the OPRM1 Asn40Asp polymorphism—as having the strongest evidence. However, the data to date is still insufficient to recommend that any moderator be used in determining clinical treatment.
Derivation of Indices of Left Ventricular Contractility in the Setting of Continuous‐Flow Left Ventricular Assist Device Support
Authors: Gupta Sunil , Muthiah Kavitha , Woldendorp Kei , Robson Desiree , Jansz Paul , Hayward Christopher S.
Published: March 2014

It is important to accurately monitor residual cardiac function in patients under long‐term continuous‐flow left ventricular assist device (cfLVAD) support. Two new measures of left ventricular (LV) chamber contractility in the cfLVAD‐unloaded ventricle include IQ, a regression coefficient between maximum flow acceleration and flow pulsatility at different pump speeds; and K, a logarithmic relationship between volumes moved in systole and diastole. We sought to optimize these indices. We also propose RIQ, a ratio between maximum flow acceleration and flow pulsatility at baseline pump speed, as an alternative to IQ. Eleven patients (mean age 49 ± 11 years) were studied. The K index was derived at baseline pump speed by defining systolic and diastolic onset as time points at which maximum and minimum volumes move through the pump. IQ across the full range of pump speeds was markedly different between patients. It was unreliable in three patients with underlying atrial fibrillation (coefficient of determination R2 range: 0.38–0.74) and also when calculated without pump speed manipulation (R2 range: 0.01–0.74). The K index was within physiological ranges, but poorly correlated to both IQ (P = 0.42) and RIQ (P = 0.92). In four patients there was excellent correspondence between RIQ and IQ, while four other patients showed a poor relationship between these indices. As RIQ does not require pump speed changes, it may be a more clinically appropriate measure. Further studies are required to determine the validity of these indices.
Specialist hospital study shows that septic shock and drowsiness predict mortality in children under five with diarrhoea
Authors: Sarmin Monira , Ahmed Tahmeed , Bardhan Pradip K. , Chisti Mohammod J.
Published: March 2014

Aim

To evaluate the clinical characteristics and outcome in children hospitalised with diarrhoea, comparing those developed septic shock with those who did not.

Methods

We carried out a retrospective chart review on children aged 0–59 months admitted to the Dhaka Hospital, International Centre for Diarrhoeal Diseases Research, Bangladesh, with diarrhoea between October 2010 and September 2011. They were included if they had severe sepsis defined as tachycardia plus hyperthermia or hypothermia or an abnormal white blood cell count plus poor peripheral perfusion in absence of dehydration. Patients unresponsive to fluid and boluses, who required inotropes, were categorised as having septic shock (n = 88). The controls were those without septic shock (n = 116).

Results

Death was significantly higher among the children with septic shock (67%) than the controls (14%) (p < 0.001). A logistic regression analysis, adjusted for potential confounders, found that children with septic shock were more likely to be drowsy on admission and received blood transfusions and mechanical ventilation (all p < 0.05).

Conclusion

Children hospitalised for diarrhoea with septic shock were more likely to die, be drowsy on admission and receive blood transfusions and mechanical ventilation. A randomised clinical trial on inotropes in children with diarrhoea, severe sepsis and drowsiness may expedite their use and prevent mechanical ventilation and deaths.
Circadian rhythm characteristics, poor sleep quality, daytime sleepiness and common psychiatric disorders among Thai college students
Authors: Haregu Alazar , Gelaye Bizu , Pensuksan Wipawan C. , Lohsoonthorn Vitool , Lertmaharit Somrat , Rattananupong Thanapoom , Tadesse Mahlet G. , Williams Michelle A.
Published: March 2014

Introduction

To investigate the relationship between common psychiatric disorders (CPDs) and sleep characteristics (evening chronotype, poor sleep quality and daytime sleepiness) among Thai college students.

Methods

A cross‐sectional study was conducted among 2,970 undergraduate students in Thailand. Students were asked to complete a self‐administered questionnaire that collected information about lifestyle and demographic characteristics. The Horne and Ostberg Morningness–Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to evaluate circadian preference, sleep quality and daytime sleepiness, respectively. The General Health Questionnaire‐12 (GHQ‐12) was used to evaluate presence of CPDs. Logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) of CPDs in relation to the covariates of interest.

Results

A total of 337 students were classified as having CPDs (11.2%; 95% CI 10.1–12.3%). Evening chronotype (OR = 3.35; 95% CI 2.09–5.37), poor sleep quality (OR = 4.89; 95% CI 3.66–6.54) and excessive daytime sleepiness (OR = 1.95; 95% CI 1.54–2.47) were statistically significantly associated with CPDs.

Discussion

Our study demonstrated that CPDs are common among Thai college students. Further, evening chronotype, poor sleep quality and excessive daytime sleepiness were strongly associated with increased risk of CPDs. These findings highlight the importance of educating students and school administrators about the importance of sleep and their impact on mental health.
The effects of oats on the function of gut microflora in children with coeliac disease
Authors: Tjellström B. , Stenhammar L. , Sundqvist T. , Fälth‐Magnusson K. , Hollén E. , Magnusson K.‐E. , Norin E. , Midtvedt T. , Högberg L.
Published: March 2014

Background

Faecal short chain fatty acids (SCFAs) are produced by the gut microflora. We have previously reported high faecal SCFA levels in children with coeliac disease (CD), indicating alteration in gut microfloral metabolism. Data accumulated over recent decades by us and others suggest that wheat‐free oats can safely be included in a gluten‐free diet (GFD). However, concerns have been raised with respect to the safety of oats in a subset of coeliacs.

Aim

To describe faecal SCFA patterns in children with newly diagnosed CD treated for 1 year with a GFD with or without oats.

Methods

This report is part of a randomised, double‐blind study on the effect of a GFD containing oats (GFD‐oats) vs. a standard GFD (GFD‐std). Faecal samples were received from 34 children in the GFD‐oats group and 37 in the GFD‐std group at initial diagnosis and/or after 1 year on a GFD. Faecal SCFAs were analysed.

Results

The GFD‐std group had a significantly lower total faecal SCFA concentration at 12 months compared with 0 months (P < 0.05). In contrast, total SCFA in the GFD‐oats group remained high after 1 year on the GFD. The children in the GFD‐oats group had significantly higher acetic acid (P < 0.05), n‐butyric acid (P < 0.05) and total SCFA concentration (P < 0.01) after 1‐year diet treatment compared to the GFD‐std group.

Conclusions

Our results indicate that oats do affect the gut microflora function, and that some coeliac children receiving oats may develop gut mucosal inflammation, that may present a risk for future complications.
Changes in bedrock channel morphology driven by displacement rate increase during normal fault interaction and linkage
Authors: Hopkins Michael C. , Dawers Nancye H.
Published: March 2014

We attribute changes in the morphology of relay ramp channels (increased slope and decreased width) to variations in displacement rate on ramp‐adjacent normal faults. We map the faults and fluvial channels associated with four sites in different stages of fault interaction and linkage on the Volcanic Tableland, a Late Pleistocene ash‐flow tuff in east‐central California. Because these channels are inactive today, we estimate downstream changes in channel width and depth using HEC‐RAS, a one‐dimensional open channel flow model. Our results show that channel slope must be greater than about 0.05 before there are substantial decreases in width or substantial increases in depth. Displacement rate increases during interaction between en echelon segments results in the increases in channel slope and decreases in channel width. Moreover, our data show that these changes begin to occur during the very early stages of fault interaction, well before the fault geometry would indicate ongoing or imminent linkage.
Lessons from Ideation: Where Does User Involvement Lead Us?
Authors: Schweitzer Fiona , Gassmann Oliver , Rau Christiane
Published: March 2014

Firms are increasingly involving users in new product development (NPD). Their product users frequently provide solution information, such as new product ideas. However, these users are often considered a homogeneous group of ordinary users; their individual abilities and the specific input they provide for NPD are not yet well understood. The goal of this paper is to determine whether different types of users are differently predisposed to produce ideas. We derive hypotheses regarding the possible outcome of involving different user types in idea generation tasks from the current literature on customer integration into NPD. In a quasi‐experimental setting, we test our assumptions on 93 users, who generate ideas in a smart home context. The results indicate that users’ contribution depends on their specific domain knowledge, which is broadly understood as knowledge of a specific area that influences ideation towards solutions in this domain. We distinguish between four types of users: those with high trend awareness, high technical skills, high technical innovativeness, and high ethical reflectiveness. We find that users with high technical skills are more likely to produce ideas that are technically feasible. Trend‐aware and technically innovative users produce ideas of greater originality. Ethically reflective users tend to come up with ideas that will have a positive impact on society.
25‐hydroxy vitamin D levels are associated with childhood asthma in a population‐based study in Peru
Authors: Checkley W. , Robinson C. L. , Baumann L. M. , Hansel N. N. , Romero K. M. , Pollard S. L. , Wise R. A. , Gilman R. H. , Mougey E. , Lima J. J. ,   PURA study investigators
Published: March 2014

Background

Vitamin D deficiency may be associated with an increased risk of asthma.

Objective

We studied the association between 25‐hydroxy (25‐OH) vitamin D deficiency and asthma prevalence in two Peruvian populations close to the equator but with disparate degrees of urbanization.

Methods

We conducted a population‐based study in 1441 children in two communities in Peru, of which 1134 (79%) provided a blood sample for 25‐OH vitamin D analysis.

Results

In these 1134 children, mean age was 14.8 years; 52% were boys; asthma and atopy prevalence was 12% in Lima vs. 3% in Tumbes (P < 0.001) and 59% in Lima vs. 41% in Tumbes (P < 0.001), respectively; and, mean 25‐OH vitamin D level was 20.8 ng/mL in Lima vs. 30.1 ng/mL in Tumbes (P < 0.001). Prevalence of 25‐OH vitamin D deficiency (< 20 ng/mL) was 47% in Lima vs. 7% in Tumbes (P < 0.001). In multi‐variable logistic regression, we found that lower 25‐OH vitamin D levels were associated with an increased odds of asthma (OR = 1.7 per each 10 ng/mL decrease in 25‐OH vitamin D levels, 95% CI 1.2–2.6; P < 0.01). In stratified analyses, the association between lower 25‐OH vitamin D levels and asthma was limited to children with atopy (OR = 2.2, 95% CI 1.3–3.6) and not in those without atopy (OR = 0.9, 95% CI 0.5–2.0). We did not find associations between 25‐OH vitamin D levels and other clinical biomarkers for asthma, including exhaled nitric oxide, total serum IgE and pulmonary function.

Conclusion and Clinical Relevance

Both asthma and 25‐OH vitamin D deficiency were common among children living in Lima (latitude = 12.0°S) but not among those in Tumbes (3.6°S). The relationship between 25‐OH vitamin D deficiency and asthma was similar in both sites and was limited among children with atopy. Future supplementation trials may need to consider stratification by atopy at the time of design.
Rapid-onset clinical and mechanistic effects of anti-C5aR treatment in the mouse collagen-induced arthritis model
Authors: Andersson C , Wenander C S , Usher P A , Hebsgaard J B , Sondergaard B-C , Rønø B , Mackay C , Friedrichsen B , Chang C , Tang R , Hornum L
Published: March 2014

Preclinical evidence supports targeting the C5a receptor (C5aR) in rheumatoid arthritis (RA). To support ongoing clinical development of an anti-C5aR monoclonal antibody, we have investigated for the first time the mechanism of action and the pharmacodynamics of a blocking anti-murine C5aR (anti-mC5aR) surrogate antibody in mouse collagen-induced arthritis (CIA). First, efficacy was demonstrated in a multiple-dose treatment study. Almost complete inhibition of clinical disease progression was obtained, including reduced bone and cartilage destruction in anti-mC5aR-treated mice. Then, the mechanism of action was examined by looking for early effects of anti-mC5aR treatment in single-dose treatment studies. We found that 48 h after single-dose treatment with anti-mC5aR, the neutrophil and macrophage infiltration into the paws was already reduced. In addition, several inflammatory markers, including tumour necrosis factor (TNF)-α, interleukin (IL)-6 and IL-17A were reduced locally in the paws, indicating reduction of local inflammation. Furthermore, dose-setting experiments supported a beneficial clinical effect of dosing above the C5aR saturation level. In conclusion, these preclinical data demonstrated rapid onset effects of antibody blockade of C5aR. The data have translational value in supporting the Novo Nordisk clinical trials of an anti-C5aR antibody in rheumatoid arthritis patients, by identifying potential biomarkers of treatment effects as well as by providing information on pharmacodynamics and novel insights into the mechanism of action of monoclonal antibody blockade of C5aR.
Phenotypic and molecular characteristics in eleven Chinese patients with 5α‐reductase Type 2 deficiency
Authors: Zhu Hui , Liu Wei , Han Bing , Fan Mengxia , Zhao Shuangxia , Wang Haining , Lu Yingli , Pan Chunming , Chen Fuguo , Chen Mingdao , Song Huaidong , Cheng Kaixiang , Qiao Jie
Published: March 2014

Context

Steroid 5α‐reductase type 2 deficiency (5α‐RD2) is a male‐limited, autosomal recessive inherited disease. Affected 46, XY individuals usually present with ambiguous genitalia at birth. An early and precise diagnosis is of great value to the long‐term prognosis of the disease.

Objective

To describe the clinical features and molecular determinants in 11 Chinese patients with the SRD5A2 gene mutation and to investigate the functional alteration arising from a novel splicing site mutation identified in one of the patients.

Subjects and Methods

Eleven subjects born with abnormal external genitalia from 10 unrelated families were recruited. Among them, nine patients who were reared as girls underwent virilization and gender change after puberty. Genotyping analysis of the SRD5A2 gene was performed in each of the patients. Haplotype analysis was performed in five patients with a prevalent mutation of p.G203S to illustrate the founder effect in China. Functional impairment of the new variant was explored by an in vitro splicing study and enzymatic activity assay.

Results

Nine mutations in the SRD5A2 gene were detected in the eleven patients. In addition to the previously reported p.G203S, p.R227Q, p.N193S, p.R246Q, p.Q6X, p.A228V, c.655delT and IVS1‐2 A>G, a novel splicing site mutation (IVS4 + 2 T>C) was identified. From an in vitro functional study, this mutation was found to result in a skipping of exon 4 in the course of mRNA splicing, leading to a truncated protein of 205 amino acids that lacks the catalysing activity. Two siblings with the same compound heterozygous mutation (IVS1‐2A>G/p.G203S) exhibited differing phenotypes and opposite patterns of gender rearing. A prevalent variation p.V89L combined with c.655delT was revealed to cause a mild phenotype of 5α‐RD2 with a micropenis.

Conclusion

This cohort study describes the phenotypic, biochemical and long‐term outcome in 11 Chinese patients with 5α‐RD2 deficiency and defines the genotypic spectrum of SRD5A2 mutations in China.
Reconciliation of international administrative coding systems for comparison of colorectal surgery outcome
Authors: Munasinghe A. , Chang D. , Mamidanna R. , Middleton S. , Joy M. , Penninckx F. , Darzi A. , Livingston E. , Faiz O. ,   the GI Goal Group Dr Foster Global Comparators (GC) Project, Dr Foster Intelligence in association with the Dr Foster Unit at Imperial College London
Published: March 2014

Aim

Significant variation in colorectal surgery outcomes exists between different countries. Better understanding of the sources of variable outcomes using administrative data requires alignment of differing clinical coding systems. We aimed to map similar diagnoses and procedures across administrative coding systems used in different countries.

Method

Administrative data were collected in a central database as part of the Global Comparators (GC) Project. In order to unify these data, a systematic translation of diagnostic and procedural codes was undertaken. Codes for colorectal diagnoses, resections, operative complications and reoperative interventions were mapped across the respective national healthcare administrative coding systems. Discharge data from January 2006 to June 2011 for patients who had undergone colorectal surgical resections were analysed to generate risk‐adjusted models for mortality, length of stay, readmissions and reoperations.

Results

In all, 52 544 case records were collated from 31 institutions in five countries. Mapping of all the coding systems was achieved so that diagnosis and procedures from the participant countries could be compared. Using the aligned coding systems to develop risk‐adjusted models, the 30‐day mortality rate for colorectal surgery was 3.95% (95% CI 0.86–7.54), the 30‐day readmission rate was 11.05% (5.67–17.61), the 28‐day reoperation rate was 6.13% (3.68–9.66) and the mean length of stay was 14 (7.65–46.76) days.

Conclusion

The linkage of international hospital administrative data that we developed enabled comparison of documented surgical outcomes between countries. This methodology may facilitate international benchmarking.
Biphasic modulation of cancer stem cell‐driven solid tumour dynamics in response to reactivated replicative senescence
Authors: Poleszczuk J. , Hahnfeldt P. , Enderling H.
Published: March 2014

Objectives

Cell senescence is a physiological programme of irreversible mitotic arrest that is triggered after a variety of intracellular and extracellular events. Its purpose is to protect tissue integrity by disabling mitosis in stressed or damaged cells. The senescence program serves as a tumour suppressor, and cancer cells are believed to bypass senescence to advance to malignancy. Recent studies have shown that senescence can be reactivated in cancer cells through a number of external perturbations, including oncogene activation, tumour suppressor gene withdrawal and irradiation.

Materials and methods

We have developed an agent‐based model of solid tumour growth whose input population composition is based on the cancer stem‐cell hypothesis. It is used to show how cancer stem cells can drive tumour progression, while non‐stem cancer cells (CCs) interfere with this by impeding cancer stem‐cell dynamics.

Results

Here we show that intratumoural competition between the two cell types may arise to modulate tumour progression and ultimately cancer presentation risk. Model simulations reveal that reactivation of the replicative senescence programme in CCs initially increases total tumour burden, as attrition from cell death is partially averted, but evolves to provide tumour control in the long‐term through increasing constraints on stem‐cell compartment kinetics.

Conclusions

Reactivation of replicative senescence can prolong CC competition with cancer stem cells, thereby ultimately inhibiting malignant progression regardless of tumour size.
Incidence and precipitants of hospitalization for pancreatitis in people with diabetes: the Fremantle Diabetes Study
Authors: Davis T. M. E. , Drinkwater J. , Davis W. A.
Published: March 2014

Aims

To determine the relative risk of pancreatitis in diabetes, and to establish whether diabetes‐related as well as recognized risk factors contribute.

Methods

We studied 1426 participants [mean (sd) age 62.1 (13.3) years, 49.6% male, 90.9% Type 2 diabetes, median (interquartile range) diabetes duration 4.0 (1.0–10.0) years] from the community‐based Fremantle Diabetes Study Phase I and 5663 matched residents without diabetes from the same geographical area. Pancreatitis hospitalizations between 1982 and 2010 were ascertained using validated data linkage. For Fremantle Diabetes Study Phase I participants, chart review provided data on the likely causes of pancreatitis.

Results

A total of 21 Fremantle Diabetes Study Phase I participants (1.5%) were hospitalized for pancreatitis before study entry vs 29 (0.5%) of contemporaneous residents without diabetes. During a mean (sd) of 12.1 (5.4) years of follow‐up from entry, 22 (1.6%) Fremantle Diabetes Study Phase I participants were hospitalized for a first‐ever episode of pancreatitis on 37 occasions (1.31/1000 person‐years) compared with 58 (1.0%) residents without diabetes on 81 occasions during a mean (sd) 13.6 (4.8) years (0.75/1000 person‐years). The age‐ and sex‐adjusted hazard ratio (95% CI) for first‐ever pancreatitis hospitalization in Fremantle Diabetes Study Phase I participants was 1.73 (1.06–2.83; P=0.029). Chart review of 17 of the 22 Fremantle Diabetes Study Phase I participants (77%) with incident pancreatitis and available case notes revealed that four (24%) presented without objective evidence of pancreatitis, seven (41%) presented with cholelithiasis, three (18%) with excessive alcohol consumption, two (12%) as a complication of elective endoscopic retrograde cholangiopancreatography, and one (6%) with hypertriglyceridaemia.

Conclusion

Consistent with previously published data, the risk of pancreatitis was higher in community‐dwelling Fremantle Diabetes Study Phase I participants but conventional precipitants accounted for confirmed cases. These data question whether diabetes‐specific risk factors cause or contribute to pancreatitis.
Limitations and Strengths of Doppler/Echo Pulmonary Artery Systolic Pressure–Right Heart Catheterization Correlations: A Systematic Literature Review
Authors: Finkelhor Robert S. , Lewis Steven A. , Pillai Dilip
Published: March 2014

Aims

Because many recent studies have questioned the accuracy of Doppler echocardiography (D) in determining pulmonary artery systolic pressure (PASP), we performed a detailed literature analysis attempting add clarity.

Methods and Results

Studies through 2011 comparing D and right heart catheterization (RHC) PASP, with at least 25 studied patients and reporting correlation coefficients (r) were identified. Patient demographics, study characteristics, the percent of patients studied for left or right heart pathologies, and study biases were determined. After adjusting for differing study sizes, each study's r value was used as a single datapoint and dichotomized above or below the entire cohort's mean values. From 32 studies 2604 D‐RHC parings were reported. Their overall weighted r was 0.68 ± 0.19. Poorer correlations were found for right heart pathologies compared to left heart pathologies (r = 0.58 vs. 0.84, P < 0.001) and for normal PASP patients in a study compared to abnormal PASP patients (r = 0.55 vs. 0.82, P < 0.001). Studies with predominately right heart pathology had a significantly greater D‐RHC time difference, fewer successful D determinations, a greater percentage of normal PASPs on RHC, and more between‐method differences >10 mmHg. Metaregression analyses indicated that both right heart pathology predominance and a greater percent of normal PASPs on RHC remained associated with poorer correlations.

Conclusions

D PASP‐RHC correlations were high and between‐method differences less in patients with left heart pathology but were poorer for right heart diseases and studies with proportionately more normal PASPs on RHC for which further study is needed.
Distribution and abundance of tree species in swamp forests of Amazonian Ecuador
Authors: Pitman Nigel C. A. , Andino Juan Ernesto Guevara , Aulestia Milton , Cerón Carlos E. , Neill David A. , Palacios Walter , Rivas‐Torres Gonzalo , Silman Miles R. , Terborgh John W.
Published: March 2014

Research to date on Amazonian swamps has reinforced the impression that tree communities there are dominated by a small, morphologically specialized subset of the regional flora capable of surviving physiologically challenging conditions. In this paper, using data from a large‐scale tree inventory in upland, floodplain, and mixed palm swamp forests in Amazonian Ecuador, we report that tree communities growing on well‐drained and saturated soils are more similar than previously appreciated. While our data support the traditional view of Amazonian swamp forests as low‐diversity tree communities dominated by palms, they also reveal four patterns that have not been well documented in the literature to date: 1) tree communities in these swamp forests are dominated by a phylogenetically diverse oligarchy of 30 frequent and common species; 2) swamp specialists account for < 10% of species and a minority of stems; 3) most tree species recorded in swamps (> 80%) also occur in adjacent well‐drained forest types; and 4) many tree species present in swamps are common in well‐drained forests (e.g. upland oligarchs account for 34.1% of all swamp stems). These observations imply that, as in the temperate zone, the composition and structure of Amazonian swamp vegetation are determined by a combination of local‐scale environmental filters (e.g. plant survival in permanently saturated soils) and landscape‐scale patterns and processes (e.g. the composition and structure of tree communities in adjacent non‐swamp habitats, the dispersal of propagules from those habitats to swamps). We conclude with suggestions for further research to quantify the relative contributions of these factors in structuring tree communities in Amazonian swamps.
Induction and Early‐career Support of Teachers in Europe
Authors: Valenčič Zuljan Milena , Marentič Požarnik Barica
Published: March 2014

The deep economic, social, technological and cultural changes in Europe represent a real challenge for teacher education. The teacher's role is becoming more complex and demanding, while the expectations of society are rising. Teachers are expected not only to enable optimal development of increasingly heterogeneous groups of pupils, but also to mitigate the effects of social inequality. All this requires qualitative changes in pre‐service and in‐service teacher education. In this regard, the transition from school/university to professional life — the induction period and early career years — requires special attention. In this phase, a fruitful synthesis of theory and practice can occur if novices are systematically introduced and supported by good mentoring in the transition from study to school life and culture, but a ‘practice shock’ is also possible during which many positive effects of pre‐service education are lost. Our aim is to identify some principles and optimal solutions that would foster teacher's professional development in this important phase of their career.