bluuebunny/crossref_metadata_2025 huggingface dataset:
Improved Long-Term Volume Retention of Stromal Vascular Fraction Gel Grafting with Enhanced Angiogenesis and Adipogenesis
Authors: Zhang Yuteng , Cai Junrong , Zhou Tao , Yao Yao , Dong Ziqing , Lu Feng
Published: January 2018

Background:

The apoptosis of mature adipocytes after fat grafting can result in chronic inflammation, absorption, and fibrosis, leading to unpredictable outcomes. Selective elimination of mature adipocytes may result in better outcomes and a different underlying retention mode. The authors previously developed a mature adipocyte–free product, stromal vascular fraction gel, derived from lipoaspirate, which eliminates adipocytes and preserves the stromal vascular fraction. This study investigated the retention and regeneration mode of stromal vascular fraction gel grafting.

Methods:

Nude mice were grafted with human-derived stromal vascular fraction gel or Coleman fat. Detailed cellular events over 3 months were investigated histologically and immunohistochemically.

Results:

The retention rate 90 days after grafting was significantly higher for stromal vascular fraction gel grafts than for standard Coleman fat (82 ± 15 percent versus 42 ± 9 percent; p < 0.05). Histologic analysis suggested that, unlike Coleman fat grafts, stromal vascular fraction gel grafts did not include significant necrotic areas. Moreover, although adipose tissue regeneration was found in grafts of both groups, rapid angiogenesis and macrophage infiltration were observed at a very early stage after stromal vascular fraction gel grafting. The presence of small preadipocytes with multiple intracellular lipid droplets in stromal vascular fraction gel grafts on day 3 also suggested very early adipogenesis. Although some of the cells in the stromal vascular fraction survived in stromal vascular fraction gel grafts, most of the newly formed adipose tissue was host-derived.

Conclusion:

Stromal vascular fraction gel has a high long-term retention rate and a unique adipose regeneration mode, involving prompt inflammation and infiltration of immune cells, stimulating rapid angiogenesis and inducing host cell–mediated adipogenesis.
Sex Differences in Faculty Rank Among Academic Surgeons in the United States in 2014
Authors: Blumenthal Daniel M. , Bergmark Regan W. , Raol Nikhila , Bohnen Jordan D. , Eloy Jean Anderson , Gray Stacey T.
Published: January 2018

Objective:

The aim of this study was to evaluate sex differences in full professorship among a comprehensive, contemporary cohort of US academic surgeons.

Summary of Background Data:

Previous work demonstrates that women are less likely than men to be full professors in academic medicine, and in certain surgical subspecialties. Whether sex differences in academic rank exist across all surgical fields, and after adjustment for confounders, is not known.

Methods:

A comprehensive list of surgeons with faculty appointments at US medical schools in 2014 was obtained from Association of American Medical Colleges (AAMC) faculty roster and linked to a comprehensive physician database from Doximity, an online physician networking website, which contained the following data for all physicians: sex, age, years since residency, publication number (total and first/last author), clinical trials participation, National Institutes of Health grants, and surgical subspecialty. A 20% sample of 2013 Medicare payments for care was added to this dataset. Multivariable regression models were used to estimate sex differences in full professorship, adjusting for these variables and medical school-specific fixed effects.

Results:

Among 11,549 surgeon faculty at US medical schools in 2014, 1692 (14.7%) were women. Women comprised 19.4% of assistant professors (1072/5538), 13.8% of associate professors (404/2931), and 7.0% of full professors (216/3080). After multivariable analysis, women were less likely to be full professors than men (adjusted odds ratio: 0.76, 95% confidence interval: 0.6–0.9).

Conclusion:

Among surgical faculty at US medical schools in 2014, women were less likely than men to be full professors after adjustment for multiple factors known to impact faculty rank.
Multi-institutional Analysis of Recurrence and Survival After Neoadjuvant Chemoradiotherapy of Esophageal Cancer
Authors: Xi Mian , Yang Yadi , Zhang Li , Yang Hong , Merrell Kenneth W. , Hallemeier Christopher L. , Shen Robert K. , Haddock Michael G. , Hofstetter Wayne L. , Maru Dipen M. , Ho Linus , Wu Carol C. , Liu Mengzhong , Lin Steven H.
Published: January 2018

Objective:

To determine the impact of histology on pathologic response, survival outcomes, and recurrence patterns in patients with esophageal cancer (EC) who received neoadjuvant chemoradiotherapy (CRT).

Summary of Background Data:

There is a paucity of data regarding comparative outcomes after neoadjuvant CRT between esophageal squamous cell carcinoma (SCC) and adenocarcinoma.

Methods:

Between 2002 and 2015, 895 EC patients who underwent neoadjuvant CRT followed by esophagectomy at 3 academic institutions were retrospectively reviewed, including 207 patients with SCC (23.1%) and 688 patients with adenocarcinoma (76.9%). Pathologic response, survival, recurrence pattern, and potential prognostic factors were compared.

Results:

Pathologic complete response (pCR) rate was significantly higher for SCC compared with adenocarcinoma (44.9% vs 25.9%, P < 0.001). After a median follow-up of 52.9 months, 71 patients (34.3%) with SCC versus 297 patients (43.2%) with adenocarcinoma had recurrent disease (P = 0.023). For patients who achieved a pCR, no significant differences were found in recurrence pattern, sites, or survival end-points between the 2 histology groups. For non-pCR patients, the SCC group demonstrated significantly higher regional and supraclavicular recurrence rates but a lower hematogenous metastasis rate than adenocarcinoma patients, whereas the adenocarcinoma patients had a more favorable locoregional failure-free survival (P = 0.005) and worse distant metastasis-free survival (P = 0.024). No differences were found in overall survival (P = 0.772) or recurrence-free survival (P = 0.696) between groups.

Conclusions:

SCC was associated with a significantly higher pCR rate than adenocarcinoma. Recurrence pattern and survival outcomes were significantly different between the 2 histology subtypes in non-pCR patients.
Is a Pathological Complete Response Following Neoadjuvant Chemoradiation Associated With Prolonged Survival in Patients With Pancreatic Cancer?
Authors: He Jin , Blair Alex B. , Groot Vincent P. , Javed Ammar A. , Burkhart Richard A. , Gemenetzis Georgios , Hruban Ralph H. , Waters Kevin M. , Poling Justin , Zheng Lei , Laheru Daniel , Herman Joseph M. , Makary Martin A. , Weiss Matthew J. , Cameron John L. , Wolfgang Christopher L.
Published: January 2018

Objectives:

To describe the survival outcome of patients with borderline resectable or locally advanced pancreatic ductal adenocarcinoma (BR/LA-PDAC) who have a pathologic complete response (pCR) following neoadjuvant chemoradiation.

Background:

Patients with BR/LA-PDAC are often treated with neoadjuvant chemoradiation in an attempt to downstage the tumor. Uncommonly, a pCR may result.

Methods:

A retrospective review of a prospectively maintained database was performed at a single institution. pCR was defined as no viable tumor identified in the pancreas or lymph nodes by pathology. A near complete response (nCR) was defined as a primary tumor less than 1 cm, without nodal metastasis. Overall survival (OS) and disease-free survival (DFS) were reported.

Results:

One hundred eighty-six patients with BR/LA-PDAC underwent neoadjuvant chemoradiation and subsequent pancreatectomy. Nineteen patients (10%) had a pCR, 29 (16%) had an nCR, and the remaining 138 (74%) had a limited response. Median DFS was 26 months in patients with pCR, which was superior to nCR (12 months, P = 0.019) and limited response (12 months, P < 0.001). The median OS of nCR (27 months, P = 0.003) or limited response (26 months, P = 0.001) was less than that of pCR (more than 60 months). In multivariable analyses pCR was an independent prognostic factor for DFS (HR = 0.45; 0.22–0.93, P = 0.030) and OS (HR=0.41; 0.17–0.97, P = 0.044). Neoadjuvant FOLFIRINOX (HR=0.47; 0.26–0.87, P = 0.015) and negative lymph node status (HR=0.57; 0.36–0.90, P = 0.018) were also associated with improved survival.

Conclusions:

Patients with BR/LA-PDAC who had a pCR after neoadjuvant chemoradiation had a significantly prolonged survival compared with those who had nCR or a limited response.
Decoding Grade B Pancreatic Fistula
Authors: Maggino Laura , Malleo Giuseppe , Bassi Claudio , Allegrini Valentina , McMillan Matthew T. , Borin Alex , Chen Bofeng , Drebin Jeffrey A. , Ecker Brett L. , Fraker Douglas L. , Lee Major K. , Paiella Salvatore , Roses Robert E. , Salvia Roberto , Vollmer Charles M.
Published: January 2018

Objective:

The aim of this study was to describe characteristics and management approaches for grade B pancreatic fistula (B-POPF) and investigate whether it segregates into distinct subclasses.

Background:

The 2016 ISGPS refined definition of B-POPF is predicated on various postoperative management approaches, ranging from prolonged drainage to interventional procedures, but the spectrum of clinical severity within this entity is yet undefined.

Methods:

Pancreatectomies performed at 2 institutions from 2007 to 2016 were reviewed to identify B-POPFs and their treatment strategies. Subclassification of B-POPFs into 3 classes was modeled after the Fistula Accordion Severity Grading System (B1: prolonged drainage only; B2: pharmacologic management; B3: interventional procedures). Clinical and economic outcomes, unique from the ISGPS definition qualifiers, were analyzed across subclasses.

Results:

B-POPF developed in 320 of 1949 patients (16.4%), and commonly required antibiotics (70.3%), prolonged drainage (67.8%), and enteral/parenteral nutrition (54.7%). Percutaneous drainage occurred in 79 patients (24.7%), always in combination with other strategies. Management of B-POPFs was widely heterogeneous with a median of 2 approaches/patient (range 1 to 6) and 38 various strategy combinations used. Subclasses B1–3 comprised 19.1%, 52.2%, and 28.8% of B-POPFs, respectively, and were associated with progressively worse clinical and economic outcomes. These results were confirmed by multivariable analysis adjusted for clinical and operative factors. Notably, distribution of the B-POPF subclasses was influenced by institution and type of resection (P < 0.001), while clinical/demographic predictors proved elusive.

Conclusion:

B-POPF is a heterogeneous entity, where 3 distinct subclasses with increasing clinical and economic burden can be identified. This classification framework has potential implications for accurate reporting, comparative research, and performance evaluation.
The effect of prehospital transport time, injury severity, and blood transfusion on survival of US military casualties in Iraq
Authors: Kotwal Russ S. , Scott Laura L.F. , Janak Jud C. , Tarpey Bruce W. , Howard Jeffrey T. , Mazuchowski Edward L. , Butler Frank K. , Shackelford Stacy A. , Gurney Jennifer M. , Stockinger Zsolt T.
Published: January 2018

BACKGROUND

Reducing time from injury to care can optimize trauma patient outcomes. A previous study of prehospital transport of US military casualties during the Afghanistan conflict demonstrated the importance of time and treatment capability for combat casualty survival.

METHODS

A retrospective descriptive analysis was conducted to analyze battlefield data collected on US military combat casualties during the Iraq conflict from March 19, 2003, to August 31, 2010. All casualties were analyzed by mortality outcome (killed in action, died of wounds, case fatality rate) and compared with Afghanistan conflict. Detailed data for those who underwent prehospital transport were analyzed for effects of transport time, injury severity, and blood transfusion on survival.

RESULTS

For the total population, percent killed in action (16.6% vs. 11.1%), percent died of wounds (5.9% vs. 4.3%), and case fatality rate (10.0 vs. 8.6) were higher for Iraq versus Afghanistan (p < 0.001). Among 1,692 casualties (mean New Injury Severity Score, 22.5; mortality, 17.6%) with detailed data, the injury mechanism included 77.7% from explosions and 22.1% from gunshot wounds. For prehospital transport, 67.6% of casualties were transported within 60 minutes, and 32.4% of casualties were transported in greater than 60 minutes. Although 97.0% of deaths occurred in critical casualties (New Injury Severity Score, 25–75), 52.7% of critical casualties survived. Critical casualties were transported more rapidly (p < 0.01) and more frequently within 60 minutes (p < 0.01) than other casualties. Critical casualties had lower mortality when blood was received (p < 0.01). Among critical casualties, blood transfusion was associated with survival irrespective of transport time within or greater than 60 minutes (p < 0.01).

CONCLUSION

Although data were limited, early blood transfusion was associated with battlefield survival in Iraq as it was in Afghanistan.

LEVEL OF EVIDENCE

Performance improvement and epidemiological, level IV.
Pediatric vascular trauma practice patterns and resource availability: A survey of American College of Surgeon–designated pediatric trauma centers
Authors: Bonasso Patrick C. , Gurien Lori A. , Smith Samuel D. , Gowen Marie E. , Dassinger M Sidney
Published: January 2018

BACKGROUND

Variation exists in pediatric vascular trauma management. We aim to determine practice patterns for vascular trauma management at American College of Surgeons verified pediatric trauma centers and evaluate the resources available for management of vascular trauma at both freestanding children’s hospitals (FSCH) and pediatric hospitals within general adult hospitals.

METHODS

Pediatric surgeons and trauma medical directors at American College of Surgeons designated pediatric surgery trauma centers completed a survey designed to evaluate anticipated management of traumatic arterial injuries and resource availability. Hospital setting comparisons were made using Fisher exact tests and t tests. Binomial tests were used to compare pediatric and vascular surgeons’ responses to clinical vignettes. p Values of 0.05 or less were significant.

RESULTS

One hundred seventy-six (42%) of 414 pediatric surgeons participated. Vascular surgeons are more likely to operatively manage vascular trauma at all anatomic sites except subclavian artery when compared to pediatric surgeons, regardless of hospital setting (p <0.001). Forty-eight percent of the pediatric trauma medical directors completed their portion of the survey. At FSCHs, 36% did not have a fellowship-trained vascular surgeon on-call schedule, 27% did not have endovascular capabilities, and 18% did not have a radiology technologist always available.

CONCLUSION

Vascular surgeons are more likely to manage pediatric vascular trauma regardless of hospital setting. However, FSCH have fewer resources available to provide optimal care.

LEVEL OF EVIDENCE

Care management, level IV.
Classification of Single Particles from Human Cell Extract Reveals Distinct Structures
Authors: Verbeke Eric J. , Mallam Anna L. , Drew Kevin , Marcotte Edward M. , Taylor David W.
Published: January 2018

Multi-protein complexes are necessary for nearly all cellular processes, and understanding their structure is required for elucidating their function. Current high-resolution strategies in structural biology are effective, but lag behind other fields (e.g. genomics and proteomics) due to their reliance on purified samples rather than characterizing heterogeneous mixtures. Here, we present a method combining single particle analysis by electron microscopy with protein identification by mass spectrometry to structurally characterize macromolecular complexes from extracts of human cells. We obtain three-dimensional structures of native proteasomes directly from ab initio classification of a heterogeneous mixture of protein complexes. In addition, we find an ~1 MDa size structure of unknown composition and reference our proteomics data to suggest possible identities. Our study shows the power of using a shotgun approach to electron microscopy (shotgun EM) when coupled with mass spectrometry as a tool to uncover the structures of macromolecular machines in parallel.
An aggregated and dynamic analysis of innovations in campus sustainability
Authors: Washington-Ottombre Camille , Bigalke Siiri
Published: January 2018

Purpose

This paper aims to compose a systematic understanding of campus sustainability innovations and unpack the complex drivers behind the elaboration of specific innovations. More precisely, the authors ask two fundamental questions: What are the topics and modes of implementation of campus sustainability innovations? What are the external and internal factors that drive the development of specific innovations?

Design/methodology/approach

The authors code and analyze 454 innovations reported within the Sustainability Tracking Assessment and Rating System (STARS), the campus sustainability assessment tool of the Association for the Advancement of Sustainability in Higher Education. Using descriptive statistics and illustrations, the paper assesses the state of environmental innovations (EIs) within STARS. Then, to evaluate the role of internal and external drivers in shaping EIs, the authors have produced classification and regression tree models.

Findings

The authors’ analysis shows that external and internal factors provide incentives and a favorable context for the implementation of given EIs. External drivers such as climatic zones, local income and poverty rate drive the development of several EIs. Internal drivers beyond the role of the agent of change, often primarily emphasized by past literature, significantly impact the implementation of given EIs. The authors’ work also reveals that EIs often move beyond traditional mitigation approaches and the boundaries of campus. EIs create new dynamics of innovation that echo and reinforce the culture of a higher education institution.

Originality/value

This work provides the first aggregated picture of EIs in the USA and Canada. It produces a new and integrated understanding of the dynamics of campus sustainability that complexifies narratives and contextualizes the role of change agents.
Estimating the crisis information coverage model in the internet communities
Authors: Lu Liangdong , Xu Jia , Lu Zhenggang , Wei Jiuchang
Published: January 2018

Purpose

In this study, the process of crisis information communication is viewed as a systems-based concept. An integrated and systematic three-phase model has been constructed to describe the process of crisis information coverage on the internet. By analyzing factors in the three stages that affect the coverage ratio and speed, this study aims to explore the law of information communication in this process and provide useful evidence for crisis managers to make informed decisions.

Design/methodology/approach

A complete information communication model has been constructed including the following three stages: crisis information release, crisis information diffusion and crisis information reception. The effects of important factors and variables in the model have been studied, including the crisis information release quantity, crisis information release mode, crisis information diffusion speed and crisis information obsolescence speed.

Findings

The quantitative analysis shows that crisis information release quantity and diffusion speed are positively correlated with coverage ratio; crisis information obsolescence speed is negatively correlated with coverage ratio; and crisis information release mode affects the speed of coverage but does not affect the final coverage ratio.

Originality/value

Theoretical value: from the perspective of systems thinking, a detailed, systematic and coupled information coverage model has been constructed. Application value: this study finds the most efficient methods to regulate coverage speed and final rate, knowledge of which may play an important role in guiding the practice of crisis communication management.
Tourist’s preferences in selection of local food: perception and behavior embedded model
Authors: Rahman Muhammad Sabbir , Zaman Mahmud Habib , Hassan Hasliza , Wei Chong Chin
Published: January 2018

Purpose

Locally derived foods from the lens of restaurant settings play an important source of tourist attraction. Surprisingly, research into this sector is quite scarce. The aim of the paper is to develop and empirically examine a conceptual framework on tourist’s preferences in selecting local foods. The framework includes tourists’ satisfaction, quality of food, tourist’s perception, purchase intention and purchase behavior among tourist’s selection for local foods.

Design/methodology/approach

The research is designed as quantitative in nature. A sum of 280 usable questionnaires was used from 300 distributed instruments by using convenient sampling techniques.

Findings

The results show that the relationship of tourist satisfaction and behavior is mediated by purchase intention, whereas tourist’s satisfaction and perception have a positive and significant impact on the intention of purchasing local foods. There is also a significant relationship between tourist’s satisfaction and perceived quality toward the tourist’s perception of local foods. Moreover, a significant relationship exists between tourist’s intentions and tourist’s purchase behavior.

Research limitations/implications

The study derived the purchase behavior dimensions of local foods by the tourists through literature and verified the conceptual model through empirical testing. Based on these findings, managers of local food restaurants require maximizing the purchase behavior of the visitors by considering satisfaction and perceived quality. In summation, they also should consider perception and behavioral intention of tourists. The limitation of this research relates to the sample, where data were collected from the major city of a tourist-friendly country. Future research could investigate the perceived value and gender variance as moderating variables in and between purchase intention and purchase behavior.

Practical implications

Managers and policymakers may use the outcome of this research as a guideline to understand the depth of tourist’s behavior. By identifying the antecedents of the behavioral factors may assist the managers to strengthen the restaurant’s competitive position within the industry. Finally, policymakers may use the research to assess tourists’ perceptions of local foods acceptability in promoting the nation’s culture to other parts of the world.

Originality/value

This work adds to tourism behavior research by exploring the effect of satisfaction, perceived quality, perception and intention on behaviors associated with local foods purchase behavior. In particular, the study highlights the relationships between tourist’s perception, perceived quality of local foods and satisfaction of local foods to measure tourist’s behavior through purchase intention for local foods from the perspective of restaurant settings, which have received less research attention.
Investigating the information security management role in smart city organisations
Authors: Hasbini Mohamad Amin , Eldabi Tillal , Aldallal Ammar
Published: January 2018

Purpose

Information security management (ISM) is proving to be an important topic in the modern world; in environments that will rely a great deal on digital technologies, such as smart cities, ISM research is of high importance and needs to be well analysed. The paper aims to discuss these issues.

Design/methodology/approach

This paper indicates the criticality of ISM for smart cities through the literature, then focusses on top organisational factors influencing ISM in smart city organisations, which are embraced and justified from the literature.

Findings

This paper highlights the need for more research around ISM in the context of smart city organisations, also ISM-related organisational factors that are expected to most influence smart city organisational performance.

Research limitations/implications

This paper is proposed to influence more research in the area of ISM for smart cities among the research community. Additional research is also expected to further validate and examine the selected organisational factors.

Originality/value

This paper presents new information on ISM in smart city organisations, the lack of research in this area, and the criticality of the highlighted issues, creates high value for the conclusions and findings of this research. The paper also highlights top organisational factors that are expected to influence ISM in smart city organisations.
Geostatistical models using remotely‐sensed data predict savanna tsetse decline across the interface between protected and unprotected areas in Serengeti, Tanzania
Authors: Lord Jennifer S. , Torr Stephen J. , Auty Harriet K. , Brock Paddy M. , Byamungu Mechtilda , Hargrove John W. , Morrison Liam J. , Mramba Furaha , Vale Glyn A. , Stanton Michelle C.
Published: January 2018

Monitoring abundance is essential for vector management, but it is often only possible in a fraction of managed areas. For vector control programmes, sampling to estimate abundance is usually carried out at a local‐scale (10s km2), while interventions often extend across 100s km2. Geostatistical models have been used to interpolate between points where data are available, but this still requires costly sampling across the entire area of interest. Instead, we used geostatistical models to predict local‐scale spatial variation in the abundance of tsetse—vectors of human and animal African trypanosomes—beyond the spatial extent of data to which models were fitted, in Serengeti, Tanzania.

We sampled Glossina swynnertoni and Glossina pallidipes >10 km inside the Serengeti National Park (SNP) and along four transects extending into areas where humans and livestock live. We fitted geostatistical models to data >10 km inside the SNP to produce maps of abundance for the entire region, including unprotected areas.

Inside the SNP, the mean number of G. pallidipes caught per trap per day in dense woodland was 166 (± 24 SE), compared to 3 (±1) in grassland. Glossina swynnertoni was more homogenous with respective means of 15 (±3) and 15 (±8). In general, models predicted a decline in abundance from protected to unprotected areas, related to anthropogenic changes to vegetation, which was confirmed during field survey.

Synthesis and applications. Our approach allows vector control managers to identify sites predicted to have relatively high tsetse abundance, and therefore to design and implement improved surveillance strategies. In East and Southern Africa, trypanosomiasis is associated with wilderness areas. Our study identified pockets of vegetation which could sustain tsetse populations in farming areas outside the Serengeti National Park. Our method will assist countries in identifying, monitoring and, if necessary, controlling tsetse in trypanosomiasis foci. This has specific application to tsetse, but the approach could also be developed for vectors of other pathogens.
Trait‐based selection of nurse plants to restore ecosystem functions in mine tailings
Authors: Navarro‐Cano Jose Antonio , Verdú Miguel , Goberna Marta
Published: January 2018

Metal mining in drylands generates waste tailings with high toxicity, physical instability, as well as water and thermal stresses that hamper their biological colonization. This limits the restoration of ecosystem functions that are essential to re‐integrate these artificial micro‐deserts within the landscape matrix.

We assessed the functional role of local nurse plant species and their traits to restore ecosystem functions related to soil fertility, soil microbial productivity and the reduction of abiotic stress. We sampled 30 metalliferous tailings in a mining district from semi‐arid Spain to detect nurse plant species and quantify their ability to promote essential functions from their establishment on the barren substrate up to the adult stage.

We found 11 plant species acting as nurses out of 102 species able to colonize barren soils. Ten nurses further triggered a cascade of effects increasing soil fertility and microbial productivity and/or lowering soil abiotic stress.

Plant species with larger life‐forms and longer periods of establishment since tailing abandonment contributed the most to the promotion of ecosystem functions. C4 plant species developing root systems with lower intensivity and depth:laterality ratios, as well as leaves with lower carbon:nitrogen ratios (C:N) induced a faster recovery of ecosystem functions.

Synthesis and applications. We propose a protocol for selecting key species to be used in restoration programmes based on their ability to restore ecosystem functions under extremely stressful conditions. We encourage combination of multiple target species with complementary traits in order to reinforce the rehabilitation of ecosystem functions.
More of the Same? A Dual Case Study Approach to Examining Change Momentum in the Public Sector
Authors: Barker Laura , McKeown Tui , Wolfram Cox Julie , Bryant Melanie
Published: January 2018

Despite the significant amount of change experienced by the public sector, there has been relatively limited empirical examination of how change agendas affect public sector employees in Australia. This article presents a comparative analysis of two Australian public sector organisations that implemented the same positive work change agenda, but experienced very different outcomes. Using a critical realist approach, we draw on a mix of qualitative techniques to suggest that textbook notions of ‘successful change’, which are often derived from large private sector expectations, may fail to capture the complex nature of how public sector change initiatives may unfold. In particular, we demonstrate how political, temporal, contextual, and process factors interact to shift change momentum. Illustrative examples are provided throughout and the findings are discussed in terms of their implications for theory building, for change facilitation, and for future research.
Myotropic activity and immunolocalization of selected neuropeptides of the burying beetle Nicrophorus vespilloides (Coleoptera: Silphidae)
Authors: Urbański Arkadiusz , Lubawy Jan , Marciniak Paweł , Rosiński Grzegorz
Published: January 2018

Burying beetles (Nicrophorus sp.) are necrophagous insects with developed parental care. Genome of Nicrophorus vespilloides has been recently sequenced, which makes them interesting model organism in behavioral ecology. However, we know very little about their physiology, including the functioning of their neuroendocrine system. In this study, one of the physiological activities of proctolin, myosuppressin (Nicve‐MS), myoinhibitory peptide (Trica‐MIP‐5) and the short neuropeptide F (Nicve‐sNPF) in N. vespilloides have been investigated. The tested neuropeptides were myoactive on N. vespilloides hindgut. After application of the proctolin increased hindgut contraction frequency was observed (EC50 value was 5.47 × 10−8 mol/L). The other tested neuropeptides led to inhibition of N. vespilloides hindgut contractions (Nicve‐MS: IC50 = 5.20 × 10−5 mol/L; Trica‐MIP‐5: IC50 = 5.95 × 10−6 mol/L; Nicve‐sNPF: IC50 = 4.08 × 10−5 mol/L). Moreover, the tested neuropeptides were immunolocalized in the nervous system of N. vespilloides. Neurons containing sNPF and MIP in brain and ventral nerve cord (VNC) were identified. Proctolin‐immunolabeled neurons only in VNC were observed. Moreover, MIP‐immunolabeled varicosities and fibers in retrocerebral complex were observed. In addition, our results have been supplemented with alignments of amino acid sequences of these neuropeptides in beetle species. This alignment analysis clearly showed amino acid sequence similarities between neuropeptides. Moreover, this allowed to deduce amino acid sequence of N. vespilloides proctolin (RYLPTa), Nicve‐MS (QDVDHVFLRFa) and six isoforms of Nicve‐MIP (Nicve‐MIP‐1—DWNRNLHSWa; Nicve‐MIP‐2—AWQNLQGGWa; Nicve‐MIP‐3—AWQNLQGGWa; Nicve‐MIP‐4—AWKNLNNAGWa; Nicve‐MIP‐5—SEWGNFRGSWa; Nicve‐MIP‐6— DPAWTNLKGIWa; and Nicve‐sNPF—SGRSPSLRLRFa).
Acts of Negotiation: Governmentality and Medium of Instruction in an Eastern Ukrainian University
Authors: Goodman Bridget
Published: January 2018

This study investigates language policy and language choices at a university in Ukraine, a country of evolving national governance and shifting language policy. Ethnographic data interpreted through the lenses of governmentality, language planning and policy, and conversation analysis show that (1) the institution rather than the national government is at the center of language planning and policy and (2) language choices are negotiations of alignment between a collective Ukrainian identity and individual preferences or abilities.
Runs of homozygosity reveal genome‐wide autozygosity in Italian sheep breeds
Authors: Mastrangelo S. , Ciani E. , Sardina M. T. , Sottile G. , Pilla F. , Portolano B. ,   the Bi.Ov. Ita Consortium
Published: January 2018

The availability of dense single nucleotide polymorphism (SNP) assays allows for the determination of autozygous segments based on runs of consecutive homozygous genotypes (ROH). The aim of the present study was to investigate the occurrence and distribution of ROH in 21 Italian sheep breeds using medium‐density SNP genotypes in order to characterize autozygosity and identify genomic regions that frequently appeared in ROH within individuals, namely ROH islands. After filtering, the final number of animals and SNPs retained for analyses were 502 and 46 277 respectively. A total of 12 302 ROH were identified. The mean number of ROH per breed ranged from 10.58 (Comisana) to 44.54 (Valle del Belice). The average length of ROH across breeds was 4.55 Mb and ranged from 3.85 Mb (Biellese) to 5.51 Mb (Leccese). Valle del Belice showed the highest value of inbreeding on the basis of ROH (FROH = 0.099), whereas Comisana showed the lowest (FROH = 0.016), and high standard deviation values revealed high variability in autozygosity levels within each breed. Differences also existed in the length of ROH. Analysis of the distribution of ROH according to their size showed that, for all breeds, the majority of the detected ROH were <10 Mb in length, with a few long ROH >25 Mb. The levels of ROH that we estimated here reflect the inbreeding history of the investigated sheep breeds. These results also highlight that ancient and recent inbreeding have had an impact on the genome of the Italian sheep breeds and suggest that several animals have experienced recent autozygosity events. Comisana and Bergamasca appeared as the less consanguineous breeds, whereas Barbaresca, Leccese and Valle del Belice showed ROH patterns typically produced by recent inbreeding. Moreover, within the genomic regions most commonly associated with ROH, several candidate genes were detected.
Understanding Australian medical student attitudes towards older people
Authors: Wilson Mark AG , Kurrle Susan E , Wilson Ian
Published: January 2018

Objective

The aim of this article was to review the literature around Australian medical student attitudes towards older people.

Methods

An Ovid cross‐search and SCOPUS search were performed using keywords such as ‘Attitude’, ‘Medical Student’ and ‘Aged or Older or Elderly’.

Results

Several recent studies have investigated the attitudes of Australian medical students towards older people. Baseline attitudes at two medical schools were positive. Three studies quantified attitude improvement after curriculum intervention. All the studies used US‐developed instruments, which have not been validated in Australia. Qualitative studies have described mixed attitudes towards older people: negative themes included nihilism, paternalism, communication issues, greater morbidity and reduced quality of life. Positively, students placed value on clinical decision‐making and critical reflection during residential aged care placements.

Conclusion

Australian medical students’ attitudes towards older people are mixed and not well understood based on quantitative measures developed for use in the US and on qualitative evidence. Future research in this area requires a reliable and locally‐validated instrument.
MAML1 and TWIST1 co‐overexpression promote invasion of head and neck squamous cell carcinoma
Authors: Ardalan Khales Sima , Ebrahimi Ehsan , Jahanzad Eisa , Ardalan Khales Sahar , Forghanifard Mohammad Mahdi
Published: January 2018

Aims

Head and neck squamous cell carcinoma (HNSCC) is the seventh most common cancer worldwide with considerable morbidity and mortality. Invasion and metastasis of HNSCC is a complex process involving multiple molecules and signaling pathways. Twist Family BHLH Transcription Factor 1 (TWIST1) and Mastermind‐like 1 (MAML1) are essential in induction of epithelial–mesenchymal transition through direct regulation of implicated molecules in cellular adhesion, migration and invasion. Our aim in this study was to assess the clinical significance of MAML1 and TWIST1 expression in HNSCC, and elucidate the probable correlation between these genes to exhibit their possible associations with progression and metastasis of the disease.

Methods

The gene expression profile of MAML1 and TWIST1 was assessed in fresh tumoral compared to distant tumor‐free tissues of 55 HNSCC patients using quantitative real‐time Polymerase chain reaction (PCR).

Results

Significant overexpression of MAML1 and TWIST1 mRNA was observed in 49.1% and 38.2% (P ˂ 0.05) of tumor specimens, respectively. Overexpression of MAML1 was associated with vascular invasion (P = 0.048). Concomitant overexpression of MAML1 and TWIST1 was significantly correlated to each other (P = 0.004). Co‐overexpression of the genes was significantly correlated to the various clinicopathological indices of poor prognosis including depth of tumor invasion (P < 0.01), lymphatic invasion and grade of tumor cell differentiation (P < 0.05).

Conclusions

Significant correlation between MAML1 and TWIST1 in HNSCC was revealed. This study was the first report elucidating MAML1 clinical relevance in HNSCC. These new findings suggest an oncogenic role for concomitant expression of MAML1 and TWIST1 genes in HNSCC invasion and metastasis.
Clinical and metabolic effects associated with weight changes and obeticholic acid in non‐alcoholic steatohepatitis
Authors: Hameed B. , Terrault N. A. , Gill R. M. , Loomba R. , Chalasani N. , Hoofnagle J. H. , Van Natta M. L. ,   for the NASH CRN
Published: January 2018

Background

In a 72‐week, randomised controlled trial of obeticholic acid (OCA) in non‐alcoholic steatohepatitis (NASH), OCA was superior to placebo in improving serum ALT levels and liver histology. OCA therapy also reduced weight.

Aims

Because weight loss by itself can improve histology, to perform a post hoc analysis of the effects of weight loss and OCA treatment in improving clinical and metabolic features of NASH.

Methods

The analysis was limited to the 200 patients with baseline and end‐of‐treatment liver biopsies. Weight loss was defined as a relative decline from baseline of 2% or more at treatment end.

Results

Weight loss occurred in 44% (45/102) of OCA and 32% (31/98) of placebo‐treated patients (P = 0.08). The NAFLD Activity score (NAS) improved more in those with than without weight loss in both the OCA‐ (−2.4 vs −1.2, P<0.001) and placebo‐treated patients (−1.2 vs −0.5, P = 0.03). ALT levels also improved in those with vs without weight loss in OCA‐ (−43 vs −34 U/L, P = 0.12) and placebo‐treated patients (−29 vs −10 U/L, P = 0.02). However, among those who lost weight, OCA was associated with opposite effects from placebo on changes in alkaline phosphatase (+21 vs −12 U/L, P<0.001), total (+13 vs −14 mg/dL, P = 0.02) and LDL cholesterol (+18 vs −12 mg/dL, P = 0.01), and HbA1c (+0.1 vs −0.4%, P = 0.01).

Conclusions

OCA leads to weight loss in up to 44% of patients with NASH, and OCA therapy and weight loss have additive benefits on serum aminotransferases and histology. However, favourable effects of weight loss on alkaline phosphatase, lipids and blood glucose seen in placebo‐treated patients were absent or reversed on OCA treatment. These findings stress the importance of assessing concomitant metabolic effects of new therapies of NASH. Clinical trial number: NCT01265498.
Clinical features and treatment of nonalcoholic fatty liver disease across the Asia Pacific region—the GO ASIA initiative
Authors: Chan W.‐K. , Treeprasertsuk S. , Imajo K. , Nakajima A. , Seki Y. , Kasama K. , Kakizaki S. , Fan J.‐G. , Song M. J. , Yoon S. K. , Dan Y.‐Y. , Lesmana L. , Ho K.‐Y. , Goh K.‐L. , Wong V. W.‐S.
Published: January 2018

Background

The Gut and Obesity Asia (GO ASIA) workgroup was formed to study the relationships between obesity and gastrointestinal diseases in the Asia Pacific region.

Aim

To study factors associated with nonalcoholic steatohepatitis (NASH) and advanced fibrosis, and medical treatment of biopsy‐proven nonalcoholic fatty liver disease (NAFLD) patients.

Methods

Retrospective study of biopsy‐proven NAFLD patients from centres in the GO ASIA Workgroup. Independent factors associated with NASH and with advanced fibrosis on binary logistic regression analyses in a training cohort were used for the development of their corresponding risk score, which were validated in a validation cohort.

Results

We included 1008 patients from nine centres across eight countries (NASH 62.9%, advanced fibrosis 17.2%). Independent predictors of NASH were body mass index ≥30 kg/m2, diabetes mellitus, dyslipidaemia, alanine aminotransferase ≥88 U/L and aspartate aminotransferase ≥38 U/L, constituting the Asia Pacific NASH risk score. A high score has a positive predictive value of 80%‐83% for NASH. Independent predictors of advanced fibrosis were age ≥55 years, diabetes mellitus and platelet count <150 × 109/L, constituting the Asia‐Pacific NAFLD advanced fibrosis risk score. A low score has a negative predictive value of 95%‐96% for advanced fibrosis. Only 1.7% of patients were referred for structured lifestyle program, 4.2% were on vitamin E, and 2.4% were on pioglitazone.

Conclusions

More severe liver disease can be suspected or ruled out based on factors identified in this study. Utilisation of structured lifestyle program, vitamin E and pioglitazone was limited despite this being a cohort of biopsy‐proven NAFLD patients with majority of patients having NASH.
Dasatinib‐induced pulmonary arterial hypertension
Authors: Özgür Yurttaş Nurgül , Eşkazan Ahmet Emre
Published: January 2018

Drug‐induced (group 1) pulmonary hypertension (PH) is an important subgroup of PH involving dasatinib as a likely related agent, which is a second‐generation tyrosine kinase inhibitor (TKI) used in the treatment of chronic myeloid leukaemia (CML). The mechanism of dasatinib‐induced pulmonary arterial hypertension (PAH) is unclear. However, the occurrence of PAH with late onset in CML patients suggests a chronic pathological mechanism with an insidious onset rather than an acute inflammatory or cardiac aetiology. Dasatinib has a broader effect than other TKIs; the major known difference between dasatinib and other TKIs is the additional inhibition of Src family kinases. Therefore, Src inhibition was thought to play a role in the development of dasatinib‐induced PAH. However, recently, it was also speculated that chronic dasatinib therapy may cause pulmonary endothelial damage, attenuate hypoxic pulmonary vasoconstriction responses and increase susceptibility to PAH independently of the Src family kinase‐induced mechanism. Dasatinib‐induced PAH usually seems to be reversible with the cessation of the drug, and sometimes with PAH‐specific treatment strategies. Transthoracic echocardiography can be recommended as a routine screening prior to dasatinib initiation, and this non‐invasive procedure can be utilized in patients having signs and symptoms attributable to PAH during dasatinib treatment.
Children's Perceptions of Economic Groups in a Context of Limited Access to Opportunities
Authors: Elenbaas Laura , Killen Melanie
Published: January 2018

Children (N = 267, ages 8–14 years,M = 11.61 years, middle to upper‐middle income) made predictions regarding groups of same‐aged peers from high‐wealth and low‐wealth backgrounds. The context involved granting access to a special opportunity. From middle childhood to early adolescence children increasingly expected both high‐ and low‐wealth groups to want access to opportunities for their own group. However, children viewed high‐wealth groups as motivated in part by selfishness and low‐wealth groups as concerned in part with broader economic inequality. Finally, the higher children's family income, the more they expected group‐serving tendencies. These findings revealed children's perceptions of exclusive preferences between economic groups, negative stereotypes about high‐wealth children, and awareness of some of the constraints faced by low‐wealth children.
Chronic inflammatory demyelinating polyneuropathy: The spectrum and immunopathogenesis deciphered by electrophysiology and neuroimaging
Authors: Kuwabara Satoshi , Misawa Sonoko , Mori Masahiro
Published: January 2018

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a heterogeneous disorder having a wide range of clinical phenotypes, and is currently classified into “typical CIDP” and variants, such as multifocal acquired demyelinating sensory and motor neuropathy. Typical CIDP is clinically characterized by symmetric polyneuropathy involving proximal as well as distal muscle weakness, whereas electrophysiology shows evidence of demyelination predominant in the distal nerve terminals, and magnetic resonance neurography frequently shows prominent hypertrophy of the nerve roots. The pattern of demyelination distribution strongly suggests primary involvement of the nerve terminals and roots, where the blood–nerve barrier is anatomically deficient, and the importance of an antibody‐mediated mechanism. In contrast, multifocal acquired demyelinating sensory and motor neuropathy is multiple mononeuropathy or asymmetric polyneuropathy with multifocal conduction blocks and focal nerve enlargement in the intermediate nerve trunks at the site of conduction block; such distribution of lesions is reasonably explained by breakdown of the blood–nerve barrier by activated lymphocytes, suggesting a multiple sclerosis‐like cellular mechanism. Clinical features are likely to be determined by the immunopathogenesis, and therefore different immunological treatment would be required for each CIDP subtype. The present review focuses on current concepts of the disease spectrum of “CIDP syndrome” deciphered by electrophysiology and neuroimaging.
Complex interplay among adiposity, insulin resistance and bone health
Authors: Ma C. , Tonks K. T. , Center J. R. , Samocha‐Bonet D. , Greenfield J. R.
Published: January 2018

Obesity and osteoporosis are common public health problems. Paradoxically, while obesity is associated with higher bone density, type 2 diabetic obese individuals have an increased fracture risk. Although obesity and insulin resistance co‐exist, some obese individuals remain insulin‐sensitive. We suggest that the apparent paradox relating obesity, bone density and fracture risk in type 2 diabetes may be at least partly influenced by differences in bone strength and quality between insulin‐resistant and insulin‐sensitive obese individuals. In this review, we focus on the complex interplay between, adiposity, insulin resistance and osteoporotic fracture risk and suggest that this is an important area of study that has implications for individually tailored and targeted treatment to prevent osteoporotic fracture in obese type 2 diabetic individuals.