bluuebunny/crossref_metadata_2025 huggingface dataset:
Cultural sensitivity: an antecedent of the image gap of tourist destinations
Authors: Beerli-Palacio Asunción , Martín-Santana Josefa D.
Published: May 2018

Purpose

This paper aims to analyse the influence of the cultural sensitivity of tourists on the change in image that occurs for tourist destinations prior to and after a visit; understanding cultural sensitivity as the recognition of and respect for different beliefs, values and customs.

Design/methodology/approach

A structural equations model is carried out with a representative sample of 411 tourists from Tenerife (Canary Islands).

Findings

Cultural sensitivity directly and positively influences the gap in the global image of the destination, so greater cultural sensitivity improves the post-visit image compared to the pre-visit image at a global level. Likewise, there are significant differences in cultural sensitivity according to the sociodemographic characteristics of tourists.

Research limitations

Although this study is based on a single case (Tenerife) and the generalisation of the results must be treated tentatively, the developed model could be applied in other destinations.

Practical implications

This study contributes to a better understanding of the influence of cultural sensitivity on the image gap in tourist destinations, as there is still little empirical evidence on the subject.

Originality/value

The results of this study represent an advance in the literature, as there are few studies in the tourism marketing literature that studied the effect of the cultural sensitivity on the image of a tourist destination.
The effect of online and offline experiential marketing on brand equity in the hotel sector
Authors: Castañeda García José Alberto , Del Valle Galindo Andrea , Martínez Suárez Rocío
Published: May 2018

Propose

This paper aims to measure the relationship between online experiential marketing (during the purchasing process involving information search and booking) and offline experiential marketing (during the stay) with hotel brand equity. In addition, the study attempts to determine if there is a significant link between the online hotel experience and the subsequent offline hotel stay experience.

Desing/methodology/approach

A self-report survey was conducted in a series of four-star hotels in Granada city. The questionnaire was focused on measuring online experience, offline experience and brand equity. For the analysis of the data, a structural equations model was developed.

Findings

The results suggest that the experience during the hotel stay, contrary to that of the online purchase process, has an influence on hotel brand equity. Nonetheless, the online experience has a significant impact on the hotel stay experience.

Practical implications

This study is of particular utility for hotel management given that, although it is a sector that for several years has integrated experiential marketing in its service strategy, there is little research analyzing the impact of such actions on the variables that are of interest to the hotel.

Originality/value

There are no hotel sector studies that have jointly analyzed the role of the online and offline tourist experience and its role in contributing to brand equity. Recognizing the previous notions will allow hotels to identify where to focus marketing efforts so as to increase brand equity.
Novel mutations in Chinese Han patients with tuberous sclerosis complex: Case series and review of the published work
Authors: Zheng Li‐Yun , LEE Yu‐Wei , Han Yang , Tang Li‐Li , Cheng Yu‐Yan , Dou Jin‐Fa , Zhou Fu‐Sheng , Zheng Xiao‐Dong , Wang Hong‐Yan , Wang Pei‐Guang , Gao Min
Published: May 2018

Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disease characterized by hamartomas in multiple organ systems. This study was performed in one familial and two sporadic cases with TSC. Two novel mutations (c.1884_1887delAAAG and c.5266A>G) and two previously reported mutations (c.4258_4261delTCAG and c.1960G>C) were identified by direct DNA sequencing. Of the four mutations, c.1884_1887delAAAG and c.1960G>C were found in a family and identified in the same allele by TA cloning sequencing. However, c.1960G>C was reported to be non‐pathogenic. Furthermore, correlations between genotypes and phenotypes of Chinese Han patients since 2014 were performed by paired χ2‐tests in our published work review, which has not been reported. The results showed that patients with TSC2 mutations had a higher frequency of mental retardation and there were no significant differences of seizures and skin lesions with TSC1 mutations. Genetically, they had a higher frequency of familial inheritance.
Development of a Caregiver‐Reported Experience Measure for Pediatric Hospital‐to‐Home Transitions
Authors: Desai Arti D. , Jacob‐Files Elizabeth A. , Lowry Sarah J. , Opel Douglas J. , Mangione‐Smith Rita , Britto Maria T. , Howard Waylon J.
Published: May 2018

Objective

To develop and test a caregiver‐reported experience measure for pediatric hospital‐to‐home transitions.

Data Sources/Study Setting

Primary data were collected between 07/2014 and 05/2015 from caregivers within 2–8 weeks of their child's discharge from a tertiary care children's hospital.

Study Design/Data Collection

We used a step‐wise approach to developing the measure that included drafting de novo survey items based on caregiver interviews (n = 18), pretesting items using cognitive interviews (n = 18), and pilot testing revised items among an independent sample of caregivers (n = 500). Item reduction statistics and confirmatory factor analysis (CFA) were performed on a test sample of the pilot data to refine the measure, followed by CFA on the validation sample to test the final measure model fit.

Principal Findings

Of 46 initial survey items, 19 were removed after pretesting and 19 were removed after conducting item statistics and CFA. This resulted in an eight‐item measure with two domains: transition preparation (four items) and transition support (four items). Survey items assess the quality of discharge instructions, access to needed support and resources, care coordination, and follow‐up care. Practical fit indices demonstrated an acceptable model fit: χ2 = 28.3 (df = 19); root‐mean‐square error of approximation = 0.04; comparative fit index = 0.99; and Tucker–Lewis index = 0.98.

Conclusions

An eight‐item caregiver‐reported experience measure to evaluate hospital‐to‐home transition outcomes in pediatric populations demonstrated acceptable content validity and psychometric properties.
The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Nonquantitative Treatment Limits for Specialty Behavioral Health Care
Authors: Thalmayer Amber Gayle , Harwood Jessica M. , Friedman Sarah , Azocar Francisca , Watson L. Amy , Xu Haiyong , Ettner Susan L.
Published: May 2018

Objective

To assess frequency, type, and extent of behavioral health (BH) nonquantitative treatment limits (NQTLs) before and after implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).

Data Sources

Secondary administrative data for Optum carve‐out and carve‐in plans.

Study Design

Cross‐tabulations and “two‐part” regression models were estimated to assess associations of parity period with NQTLs.

Data Collection/Extraction Methods

Optum provided four proprietary BH databases, including 2008–2013 data for 40 carve‐out and 385 carve‐in employers from Optum's claims processing databases and 2010 data from interviews conducted by Optum's parity compliance team with 49 carve‐out employers.

Principal Findings

Preparity, carve‐out plans required preauthorization for in‐network inpatient/intermediate care; otherwise coverage was denied. Postparity, 73 percent would review later by request and half charged no penalty for late authorization. Outpatient visit authorization requirements virtually disappeared. For carve‐out out‐of‐network inpatient/intermediate care, and for carve‐ins, plans changed penalties to match medical service policies, but this did not necessarily lead to fewer requirements or lower penalties.

Conclusion

After 2011, MHPAEA was associated with the transformation of BH care management, including much less restrictive preauthorization requirements, especially for in‐network care provided by carve‐out plans.
Pancreatic panniculitis: A case series from a tertiary university hospital in Spain
Authors: Fernández‐Sartorio Clara , Combalia Andrea , Ferrando Joan , Alsina Mercè , Iranzo Pilar , Estrach Teresa , Hernández‐Ruiz Eugenia , Mascaró José M
Published: May 2018

Pancreatic panniculitis is a rare type that only occurs in 2–3% of all patients with pancreatic diseases. It is usually described in association with benign pancreatic disease and less commonly in association with pancreatic carcinoma. We describe a case of pancreatic panniculitis as the first manifestation of underlying ampullary adenocarcinoma and a new case of pancreatitis, panniculitis and polyarthritis (PPP‐Syndrome). Pancreatic panniculitis may be the cutaneous manifestation of pancreatic allograft rejection after simultaneous pancreas‐kidney transplantation.
Otoplasty techniques in children: a comparative study of outcomes
Authors: Punj Puvesh , Chong Hsu Phie , Cundy Thomas P. , Lodge Michelle , Woods Roger
Published: May 2018

Background

Numerous otoplasty techniques have been described in the literature to correct prominent ears; however, few have focused on the complication rates. We reviewed our experience aiming to assess peri‐operative care requirements and complication rates.

Method

We conducted a retrospective review of 207 otoplasty procedures performed in 119 patients over a 5‐year period (2009–2014) at the Women's and Children's Hospital, Adelaide. Information pertaining to demographic details, length of stay, otoplasty technique and complications (early and late) were obtained.

Results

In the study period, 97% of the 119 patients had an overnight stay. There was an early complication of 2.2% (return to theatre for bleeding) in the modified Chongchet technique and 0.9% (wound infection) in the Mustarde technique. Late complications included suture extrusion (1.9%) with the Mustarde technique and hypertrophic scarring (2.2%) in the modified Chongchet technique. The recurrence rate requiring revision following modified Chongchet technique was 10% and Mustarde technique was 2.9%. The Mustarde otoplasty technique was associated with a slightly lower antiemetic requirement than the Chongchet technique (3.2 versus 14.3%, P = 0.032). Both techniques had comparable opioid analgesic requirement of 30–35% post‐operatively (P = 0.248).

Conclusion

Our results are comparable to the huge variation in available literature. We note the higher revision rate following modified Chongchet technique. Both techniques had a low and acceptable rate of post‐operative analgesia and antiemetic requirement. We are considering either otoplasty technique as a day surgery procedure within our unit with the provision of adequate patient support as a safe and economical advance.
Incidence, timing and impact of comorbidity on second hip fracture: a population‐based study
Authors: Harvey Lara , Toson Barbara , Mitchell Rebecca , Brodaty Henry , Draper Brian , Close Jacqueline
Published: May 2018

Background

To quantify the incidence and timing of second hip fracture, and to evaluate the relative impact of comorbidities on risk of second hip fracture.

Methods

Hospitalization records for individuals aged ≥65, admitted to a New South Wales hospital for fall‐related hip fracture between 1 January 2005 and 31 December 2009 were linked. Comorbidities were identified from the records using a 1‐year look‐back period. To calculate second hip fracture rates, individuals were followed until death, fracture or end of study period (31 December 2012). Time‐dependent competing‐risk hazards regression was used to assess the relative contribution of each comorbidity to fracture risk, adjusting for age and sex.

Results

Of the 24 500 individuals who sustained at least one hip fracture, 2.9% experienced a second within a year, 6.1% within 3 years and 9.4% within 8 years. Malnutrition/cachexia (hazard ratio (HR): 2.47; 99.9% confidence interval (CI): 1.87–3.26), dementia (HR: 2.15; 99.9% CI: 1.80–2.57), congestive heart failure (HR: 1.62; 99.9% CI: 1.30–2.04), Parkinson's disease (HR: 1.51; 99.9% CI: 1.08–2.10), cerebrovascular disease (HR: 1.41; 99.9% CI: 1.06–1.89) and osteoporosis (HR: 1.36; 99.9% CI: 1.11–1.67) were associated with increased risk of second hip fracture within 3 years. Mortality was high; with 26% of individuals dying within a year, 44.9% within 3 years and 70.2% within 8 years.

Conclusions

One in 11 older individuals with an initial hip fracture sustained a second hip fracture. While the priority is to prevent the first hip fracture, those that have sustained a hip fracture should be seen as a high risk population and be targeted for future falls and fracture prevention strategies.
Influence diagnostics for censored regression models with autoregressive errors
Authors: Schumacher Fernanda L. , Lachos Victor H. , Vilca‐Labra Filidor E. , Castro Luis M.
Published: May 2018

Observations collected over time are often autocorrelated rather than independent, and sometimes include observations below or above detection limits (i.e. censored values reported as less or more than a level of detection) and/or missing data. Practitioners commonly disregard censored data cases or replace these observations with some function of the limit of detection, which often results in biased estimates. Moreover, parameter estimation can be greatly affected by the presence of influential observations in the data. In this paper we derive local influence diagnostic measures for censored regression models with autoregressive errors of orderp(hereafter, AR(p)‐CR models) on the basis of theQ‐function under three useful perturbation schemes. In order to account for censoring in a likelihood‐based estimation procedure for AR(p)‐CR models, we used a stochastic approximation version of the expectation‐maximisation algorithm. The accuracy of the local influence diagnostic measure in detecting influential observations is explored through the analysis of empirical studies. The proposed methods are illustrated using data, from a study of total phosphorus concentration, that contain left‐censored observations. These methods are implemented in theRpackageARCensReg.
Altered exocytosis in chromaffin cells from mouse models of neurodegenerative diseases
Authors: de Diego A. M. García , García A. García
Published: May 2018

Chromaffin cells from the adrenal gland (CCs) have extensively been used to explore the molecular structure and function of the exocytotic machinery, neurotransmitter release and synaptic transmission. The CC is integrated in the sympathoadrenal axis that helps the body maintain homoeostasis during both routine life and in acute stress conditions. This function is exquisitely controlled by the cerebral cortex and the hypothalamus. We propose the hypothesis that damage undergone by the brain during neurodegenerative diseases is also affecting the neurosecretory function of adrenal medullary CCs. In this context, we review here the following themes: (i) How the discharge of catecholamines is centrally and peripherally regulated at the sympathoadrenal axis; (ii) which are the intricacies of the amperometric techniques used to study the quantal release of single‐vesicle exocytotic events; (iii) which are the alterations of the exocytotic fusion pore so far reported, in CCs of mouse models of neurodegenerative diseases; (iv) how some proteins linked to neurodegenerative pathologies affect the kinetics of exocytotic events; (v) finally, we try to integrate available data into a hypothesis to explain how the centrally originated neurodegenerative diseases may alter the kinetics of single‐vesicle exocytotic events in peripheral adrenal medullary CCs.
Gene expression profiles of CD4/CD8 double‐positive T cells in porcine peripheral blood
Authors: Okutani Mie , Tsukahara Takamitsu , Kato Yoshihiro , Fukuta Kikuto , Inoue Ryo
Published: May 2018

A characteristic subset of T cells, known as double positive T cells (DPTC) and expressing both cluster of differentiation 4 (CD4) and CD8, is observed in porcine peripheral blood. Previous studies suggested that DPTC might be memory cells. However, detailed phenotypes and functions of DPTC are yet to be fully elucidated and thus, the relatedness of DPTC with memory phenotypes remains unclear. In this study, DPTC gene expression profiles in peripheral blood were analyzed by DNA microarray in Experiment 1 and compared with those of CD4 single positive T cells (4SPTC) and CD8 single positive T cells (8SPTC). Expressions of IFNG, CCL5, NCK2, CCR2 and ITGB1 were higher than that of 4SPTC and 8SPTC. In contrast, expressions of CCR7 and SELL were lower than that of 4SPTC and 8SPTC. These results suggested that DPTC were either effector T cells or effector memory T cells (TEM). Next, to determine whether DPTC were effector T cells or TEM, differences in the response of DPTC and 8SPTC against immunized/primed antigens were compared (Experiment 2). While DPTC showed quick elevation of IL2 and CD25 gene expressions against in vitro stimulation of primed/immunized antigens, 8SPTC did not. These results suggest that at least some DPTC likely belong to TEM.
Machiavellianism, stakeholder orientation, and support for sustainability reporting
Authors: Shafer William E. , Lucianetti Lorenzo
Published: May 2018

This study investigates the relations among Machiavellianism, the stakeholder orientation, and Italian managers' support for corporate social and environmental reporting (SER). These relationships have not previously been investigated among a sample of experienced managers but have important implications. As anticipated, Machiavellianism had a strong negative association with the support for SER. Machiavellianism was also negatively related to the stakeholder orientation, which in turn was positively correlated with the support for SER. Support for the stakeholder orientation partially mediated the association between Machiavellianism and SER. The findings advance our understanding of the motivations for sustainability reporting by documenting that managers' fundamental personality traits and economic ideologies are closely associated and are important determinants of normative support for social and environmental disclosures. We further suggest that the results support the case for mandated compliance‐with‐standard sustainability reports coupled with a requirement that such reports be independently audited.
A tale of two antibodies: obinutuzumab versus rituximab
Authors: Freeman Ciara L. , Sehn Laurie H.
Published: May 2018

While rituximab has dramatically improved outcomes for patients with CD20+ malignancies for two decades, responses are not universal and resistance can develop. Obinutuzumab was developed to potentiate activity and overcome resistance. Pre‐clinical data suggests obinutuzumab is superior to rituximab at effecting B cell depletion; however recent phase III clinical trial results have been mixed. The decision of which antibody to employ will probably be further complicated by the approval of a subcutaneous preparation of rituximab and several anti‐CD20 biosimilars. Clinicians are now challenged with deciding whether to switch to obinutuzumab in approved settings, accepting the potential for increased toxicity and probable increased cost. The benefit conferred by obinutuzumab over rituximab may be context‐specific and vary based on histological subtype and immune integrity. This comprehensive review will explore the preclinical differences, investigate the proposed pathogenesis of rituximab resistance, compare the employed dosing strategies and interrogate available clinical results to help inform practice.
Management of post‐transplant lymphoproliferative disorders
Authors: DeStefano Christin B. , Desai Sanjal H. , Shenoy Aarthi G. , Catlett Joseph P.
Published: May 2018

The post‐transplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of neoplasms that are one of the most serious complications of bone marrow and solid organ transplants. Because these disorders are rare, there are no randomized trials from which to derive optimal treatment. Management can be challenging and must balance the goal of PTLD eradication with the risks of graft rejection, graft‐versus‐host disease, further delays in immune reconstitution and life‐threatening infections, among others. This paper will provide a comprehensive review of PTLD following solid organ transplant and haematopoietic stem cell transplant with a focus on management. Included is a discussion of novel agents that are being studied in clinical trials and, when combined or sequenced with conventional therapy, have the potential to improve outcomes.
Skewed megakaryopoiesis in human induced pluripotent stem cell‐derived haematopoietic progenitor cells harbouring calreticulin mutations
Authors: Takei Hiraku , Edahiro Yoko , Mano Shuichi , Masubuchi Nami , Mizukami Yoshihisa , Imai Misa , Morishita Soji , Misawa Kyohei , Ochiai Tomonori , Tsuneda Satoshi , Endo Hiroshi , Nakamura Sou , Eto Koji , Ohsaka Akimichi , Araki Marito , Komatsu Norio
Published: May 2018

Somatic mutations in the calreticulin (CALR) gene have been found in most patients with JAK2‐ and MPL‐unmutated Philadelphia chromosome‐negative myeloproliferative neoplasms (MPNs). It has recently been shown that mutant CALR constitutively activates the thrombopoietin receptor MPL and, thus, plays a causal role in the development of MPNs. However, the roles of mutant CALR in human haematopoietic cell differentiation remain predominantly elusive. To examine the impact of the 5‐base insertion mutant CALR gene (Ins5) on haematopoietic cell differentiation, we generated induced pluripotent stem cells from an essential thrombocythaemia (ET) patient harbouring a CALR‐Ins5 mutation and from a healthy individual (WT). Megakaryopoiesis was more prominent in Ins5‐haematopoietic progenitor cells (Ins5‐HPCs) than in WT‐HPCs, implying that the system recapitulates megakaryocytosis observed in the bone marrow of CALR‐mutant ET patients. Ins5‐HPCs exhibited elevated expression levels of GATA1 and GATA2, suggesting a premature commitment to megakaryocytic differentiation in progenitor cells. We also demonstrated that 3‐hydroxy anagrelide markedly perturbed megakaryopoiesis, but not erythropoiesis. Collectively, we established an in vitro model system that recapitulates megakaryopoiesis caused by mutant CALR. This system can be used to validate therapeutic compounds for MPN patients harbouring CALR mutations and in detailed studies on mutant CALR in human haematological cell differentiation.
Yanshanian deformation along the northern margin of the North China Craton: Constraints from growth strata in the Shiguai Basin, Inner Mongolia, China
Authors: Wang Yongchao , Dong Shuwen , Chen Xuanhua , Shi Wei , Wei Lijuan
Published: May 2018

The evolution of Yanshanian structures, especially the timing of onset, is a key problem in reconstructing the Late Mesozoic structural framework of the North China Craton. Growth strata and progressive unconformities, coupled with related structures, have been recognized for the first time in the Jurassic Shiguai Basin, thus allowing us to constrain the timing of Yanshanian structures with greater precision. Growth geometries and detailed structural analysis indicate that the late Middle Jurassic Changhangou Formation can be considered as the earliest sedimentary response to the onset of Yanshanian deformation during 170–160 Ma. At this time interval, shortening deformation was dominantly controlled by N–S compression driven by the closure of the Mongol‐Okhotsk Ocean, and growth structures constituted a roughly forward thrusting sequence with a slow uplift rate in the early stages and a suddenly accelerated uplift rate in the final stage. Subsequently, due to the superposition of NW–SE compression during the Late Jurassic (160–145 Ma), the initial E–W‐trending structures were converted into a stepped geometry marked by several structural reentrants developing along strike. In addition, out of sequence thrusts represented by the Beilinshan thrust and its splays began to be active in the middle portion of the previous forward thrusting sequence. Northwestward subduction of the Izanagi plate along the eastern margin of Asia is generally considered to be responsible for this phase of deformation.
Return on investment for financial assistance for living kidney donors in the United States
Authors: Mathur Amit K. , Xing Jiawei , Dickinson David M. , Warren Patricia H. , Gifford Kimberly A. , Hong Barry A. , Ojo Akinlolu , Merion Robert M.
Published: May 2018

Background

The National Living Donor Assistance Center (NLDAC) enables living donor kidney transplants through financial assistance of living donors, but its return on investment (ROI) through savings on dialysis costs remains unknown.

Methods

We retrospectively reviewed 2012‐2015 data from NLDAC, the United States Renal Data System, and the Scientific Registry of Transplant Recipients to construct 1‐, 3‐, and 5‐year ROI models based on NLDAC applications and national dialysis and transplant cost data. ROI was defined as state‐specific federal dialysis cost minus (NLDAC program costs plus state‐specific transplant cost), adjusted for median waiting time (WT).

Results

A total of 2425 NLDAC applications were approved, and NLDAC costs were USD $6.76 million. Median donor age was 41 years, 66.1% were female, and median income was $33 759; 43.6% were evaluated at centers with WT >72 months. Median dialysis cost/patient‐year was $81 485 (IQR $74 489‐$89 802). Median kidney transplant cost/patient‐year was $30 101 (IQR $26 832‐$33 916). Overall, ROI varied from 5.1‐fold (1‐year) to 28.2‐fold (5‐year), resulting in $256 million in savings. Higher ROI was significantly associated with high WT, larger dialysis and transplant costs differences, and more NLDAC applicants completing the donation process.

Conclusions

Financial support for donor out‐of‐pocket expenses produces dramatic federal savings through incremental living donor kidney transplants.
Scleroderma‐like skin changes induced by checkpoint inhibitor therapy
Authors: Tjarks B. Joel , Kerkvliet Amy M. , Jassim Ali D. , Bleeker Jonathan S.
Published: May 2018

Checkpoint inhibitors have emerged as beneficial therapies in many different types of malignancy. The most common toxicities of checkpoint inhibitors are immune‐related adverse events (irAEs). As clinical experience with these agents increases, more irAEs have been described. We report a case of scleroderma‐like skin changes induced by checkpoint inhibitor therapy. A 61‐year‐old man was treated with nivolumab for oligometastatic renal cell carcinoma. He initially tolerated the therapy well, but after 16 treatments he began experiencing skin thickening and edema of the abdominal wall, which progressed down the trunk and legs. A punch biopsy revealed epidermal attenuation overlying thickened dermal collagen with entrapment and displacement of the eccrine coils and loss of periadnexal adipose tissue. Focally increased plasma cells were present near the junction of the dermis and subcutaneous adipose tissue. Loss of CD34 staining was seen throughout the dermis. These findings were consistent with a diagnosis of scleroderma. After discontinuation of nivolumab and initiation of steroid therapy, the patient's symptoms significantly improved. This case is among the first reports of scleroderma‐like changes induced by a checkpoint inhibitor.
Association of hypoglycaemia and risk of cardiac arrhythmia in patients with diabetes mellitus: A systematic review and meta‐analysis
Authors: Fitzpatrick Claire , Chatterjee Sudesna , Seidu Samuel , Bodicoat Danielle H. , Ng G Andre , Davies Melanie J. , Khunti Kamlesh
Published: May 2018

Aims

Hypoglycaemia is associated with increased cardiovascular risk among individuals with diabetes mellitus. It has been hypothesized that hypoglycaemia may trigger autonomic changes leading to increased cardiac arrhythmia risk. We conducted a systematic review and meta‐analysis to explore this association.

Materials and methods

Ovid Medline, Embase, Scopus, Web of Science and Cochrane were searched from inception to October 10, 2017. We included studies of adults with diabetes (Type 1 or Type 2) that compared acute electrocardiogram (ECG) changes during episodes of hypoglycaemia and euglycaemia.

Results

Our search resulted in 4625 citations, among which 20 studies met the predefined inclusion criteria. Finally, 12 studies were included in the descriptive analysis and 15 in the meta‐analysis. Overall hypoglycaemia was associated with a reduction in heart rate variability and an increase in arrhythmia occurrence. QTc interval length was more significantly prolonged during hypoglycaemia compared to euglycaemia (pooled mean difference [95% confidence intervals] [0.64 (0.27‐1.01], P = ·001). Subgroup analysis based on diabetes type showed that QTc prolongation occurred in individuals with Type 1 and Type 2 diabetes; however, the change between euglycaemia reached statistical significance only among individuals with Type 1 diabetes.

Conclusion

Our findings suggest that hypoglycaemia results in ECG alterations that are associated with increased risk of cardiac arrhythmia, which is associated with increased cardiovascular events and mortality. More clinical studies are needed to determine the cardiac risks of hypoglycaemia in individuals with diabetes, especially in Type 2 diabetes.
Peripheral cannabinoid 1 receptor blockade mitigates adipose tissue inflammation via NLRP3 inflammasome in mouse models of obesity
Authors: Han Ji H. , Shin Hanho , Rho Jun G. , Kim Jung‐Eun , Son Dong H. , Yoon Juhwan , Lee Yong J. , Park Jung‐Hyuck , Song Byung J. , Choi Chang‐Sik , Yoon Seul G. , Kim Il Y. , Lee Eun K. , Seong Je K. , Kim Ki W. , Kim Wook
Published: May 2018

Aim

To analyze the metabolic parameters and adipose tissue inflammation via NLRP3 inflammasome following chronic treatment of mouse models of obesity with AJ5018 as the peripherally restricted cannabinoid 1 receptor (CB1R) antagonist.

Materials and methods

The selectivity for CB1R over CB2R, brain/plasma concentration ratio, and centrally mediated neurobehavioural effects of AJ5018, were assessed. The long‐term effects of AJ5018 and rimonabant on the metabolic parameters and adipose tissue inflammation were analyzed in diet‐induced obese (DIO) mice and diabetic db/db mice.

Results

AJ5018 had a higher degree of selectivity for CB1R over CB2R and markedly reduced brain penetrance, as reflected by the lower brain/plasma concentration ratio and the attenuated centrally mediated neurobehavioural effects, compared with its brain‐penetrant parent compound rimonabant. In DIO and db/db mice, AJ5018 exhibited comparable effects to rimonabant in improving metabolic abnormalities and suppressing macrophage infiltration into white adipose tissue, activation of the NLRP3 inflammasome, and production of proinflammatory cytokines.

Conclusions

These results suggest that peripheral CB1R blockade improves obesity‐induced insulin resistance by suppressing adipose tissue inflammation via the NLRP3 inflammasome.
Dispersion of Myzus persicae and transmission of Potato virus Y under elevated CO2 atmosphere
Authors: Bosquee Emilie , Boullis Antoine , Bertaux Morgane , Francis Frédéric , Verheggen François J.
Published: May 2018

Most phytoviruses use insect vectors to spread and infect the surrounding crop plants. Because atmospheric gas concentrations alter the physiology and metabolism of plants, we hypothesize that the concentration of carbon dioxide (CO2) affects the spread of viruses, due to modifications in the feeding behavior of the vector. Tobacco plants, Nicotiana tabacum L. (Solanaceae), and green peach aphids, Myzus persicae (Sulzer) (Hemiptera: Aphididae), were cultivated under ambient (450 p.p.m., termed aCO2) and elevated (800 p.p.m., eCO2) concentrations of CO2. For each atmospheric condition, we first evaluated the ability of the Potato virus Y to spread in a small experimental design, from a central infected tobacco plant to two surrounding circles of healthy plants in presence of aphid vectors for 7 days. The number of aphids recovered on each plant and the infection status of the plants (i.e., healthy vs. infected) were assessed at the end of the experiment. We also evaluated the ability of aphids to transmit the virus under the two experimental atmospheres, by immediately transferring a single insect from an infected plant to a healthy one. The presence of virus in healthy plants was then determined. We found that aphid dispersal, as well as the associated spread of viruses, did not differ between the two atmospheres. On the other hand, we found that aphids grown under eCO2 were more efficient in transmitting viruses to healthy plants compared to aphids reared under aCO2 conditions. The results of this experiment indicate that: (1) the ability of an aphid vector to spread a phytovirus is not affected by the level of CO2 at short time and spatial scales, but (2) the concentration of CO2 may affect plant defenses or the feeding behavior of herbivorous insects, resulting in more efficient viral transmission from the vector to the host plant.
The genetic and molecular pathogenesis of myelodysplastic syndromes
Authors: Shallis Rory M. , Ahmad Rami , Zeidan Amer M.
Published: May 2018

Myelodysplastic syndromes (MDS) comprise a diverse group of clonal and malignant myeloid disorders characterized by ineffective hematopoiesis, resultant peripheral cytopenias, and a meaningful increased risk of progression to acute myeloid leukemia. A wide array of recurring genetic mutations involved in RNA splicing, histone manipulation, DNA methylation, transcription factors, kinase signaling, DNA repair, cohesin proteins, and other signal transduction elements has been identified as important substrates for the development of MDS. Cytogenetic abnormalities, namely those characterized by loss of genetic material (including 5q‐ and 7q‐), have also been strongly implicated and may influence the clonal architecture which predicts such mutations and may provoke an inflammatory bone marrow microenvironment as the substrate for clonal expansion. Other aspects of the molecular pathogenesis of MDS continue to be further elucidated, predicated upon advances in gene expression profiling and the development of new, and improved high‐throughput techniques. More accurate understanding of the genetic and molecular basis for the development of MDS directly provides additional opportunity for treatment, which to date remains limited. In this comprehensive review, we examine the current understanding of the molecular pathogenesis and pathophysiology of MDS, as well as review future prospects which may enhance this understanding, treatment strategies, and hopefully outcomes.
Construction of land surface dynamic feedbacks for digital soil mapping with fusion of multisource remote sensing data
Authors: Zeng C. Y. , Zhu A. X. , Qi F. , Liu J. Z. , Yang L. , Liu F. , Li F. L.
Published: May 2018

The use of environmental covariates to predict soil spatial variation is a widely adopted approach to digital soil mapping. However, commonly used covariates such as topography, landform and vegetation are often ineffective for estimating soil variation in areas of low relief. Recent studies have shown the effectiveness of a new covariate called land surface dynamic feedback (LSDF) for digital soil mapping in such areas. The construction of LSDF relies on remote sensing (RS) data with high temporal resolution to record the drying process after a rain event. The trade‐off of obtaining high temporal resolution with RS data is that they are often of low spatial resolution. To overcome this limitation, our study uses the ESTARFM (enhanced spatial and temporal adaptive reflectance fusion model) algorithm to fuse MODIS and Landsat 8 data to obtain images that benefit from the high temporal resolution of MODIS and high spatial resolution of Landsat. The LSDF was then derived from the fused images to predict soil texture in a case study in north Xuancheng, Anhui Province. Compared with particle‐size fractions estimated with LSDF derived from the original MODIS data, the results were more accurate and produced more spatial detail when mapped. We conclude that the ESTARFM algorithm can improve the spatial resolution of high temporal resolution RS data and offers an effective approach to derive more accurate measures of LSDF for digital soil mapping in areas of low relief.

Highlights

We propose a new method to combine different remote sensors to predict soil properties in a low relief area.

We constructed a land surface dynamic feedback model with high spatial resolution for digital soil mapping.

The fusion process improved prediction the most in areas with complex and heterogeneous land cover.

Accuracy improved with the mapping of finer spatial detail compared to the original MODIS data.
New insights into the roles of myofibroblasts and innervation during skin healing and innovative therapies to improve scar innervation
Authors: Lebonvallet Nicolas , Laverdet Betty , Misery Laurent , Desmoulière Alexis , Girard Dorothée
Published: May 2018

During the resolution phase of normal skin wound healing, there is a considerable loss of various cell types, including myofibroblasts by apoptosis. Inappropriate delay of apoptosis, and thus increased survival of myofibroblasts, may be a factor leading to pathologies and excessive scarring. Considerable data now clearly suggest that innervation plays a major role in wound healing, including the modulation of fibroblast cellular activity. An abnormal level of neuromediators is implicated not only in the development of chronic wounds but also in excessive scar formation. Understanding interactions between neuromediators and myofibroblasts, allowing normal reinnervation and having adequate levels of neuromediators during the healing process are clearly important to avoid the appearance of pathological healing or fibrosis/scarring. The aim of this review was first to discuss the mechanisms leading to normal or excessive scarring and then to present the roles of innervation during wound healing. Finally, the latest therapeutic strategies to help wound repair and reinnervation after skin damage will be introduced. Advantages and limitations in the use of neuropeptides, growth factors and biomaterials will be discussed as well as the most recent studies on electrostimulation and the potential of targeting resident skin mesenchymal stem cells.
Red grape (Vitis vinifera L.) flavonoids down‐regulate collagen type III expression after UV‐A in primary human dermal blood endothelial cells
Authors: Di Francesco Serena , Savio Monica , Bloise Nora , Borroni Giovanni , Stivala Lucia Anna , Borroni Riccardo G.
Published: May 2018

Red grape (Vitis vinifera L.) flavonoids including flavan‐3‐ols (eg, catechin and epicatechin), flavonols (eg, quercetin) and anthocyanins (eg, malvidin) exert anti‐inflammatory and antioxidant activities. In the skin they also have a photoprotective action, and their effects have been extensively investigated in keratinocytes, melanocytes and fibroblasts. Despite their known effects also on blood vasculature, little is known on their activities on human dermal blood endothelial cells (HDBECs), which are critically involved in skin homeostasis as well as in the pathogenesis of neoplastic and inflammatory skin diseases. We sought to study the biological effects of selected red grape flavonoids in preventing the consequences of ultraviolet (UV)‐A irradiation in vitro. Our results show that red grape flavonoids prevent UV‐A‐induced sICAM‐1 release in HDBECs, suggesting that this cell type could represent an additional target of the anti‐inflammatory activity of flavonoids. In addition, flavonoids effectively inhibited UV‐A‐induced synthesis of collagen type III at both RNA and protein level, indicating that dermal blood microvasculature could be actively involved in ECM remodelling as a consequence of skin photo‐ageing, and that this can be prevented by red grape flavonoids.
Decision‐making under uncertainty through extending influence diagrams with interval‐valued parameters
Authors: Zhou Lihua , Lü Kevin , Liu Weiyi , Ren Changchun
Published: May 2018

Influence diagrams (IDs) are one of the most commonly used graphical and mathematical decision models for reasoning under uncertainty. In conventional IDs, both probabilities representing beliefs and utilities representing preferences of decision makers are precise point‐valued parameters. However, it is usually difficult or even impossible to directly provide such parameters. In this paper, we extend conventional IDs to allow IDs with interval‐valued parameters (IIDs) and develop a counterpart method of Copper's evaluation method to evaluate IIDs. IIDs avoid the difficulties attached to the specification of precise parameters and provide the capability to model decision‐making processes in a situation that the precise parameters cannot be specified. The counterpart method to Copper's evaluation method reduces the evaluation of IIDs into inference problems of Bayesian networks with interval‐valued probabilities. An algorithm based on the approximate inference of Bayesian networks with interval‐valued probabilities is proposed, and extensive experiments are conducted. The experimental results indicate that the proposed algorithm can find the optimal strategies effectively in IIDs, and the interval‐valued expected utilities obtained by proposed algorithm are contained in those obtained by exact evaluating algorithms. The newly development approach would significantly extend the range of IDs for managerial decision support applications where parameters of variables can be specifically defined by only estimated intervals.
Ratcheting progress at notch root of 1045 steel samples over asymmetric loading cycles: Experiments and analyses
Authors: Kolasangiani K. , Shariati M. , Farhangdoost K. , Varvani‐Farahani A.
Published: May 2018

The present study examines ratcheting response of steel samples with various notch diameters through conducting several cyclic tests. Ratcheting strain values were measured through strain gauges mounted at different distances from the notch root. Local ratcheting at the notch region was highly influenced by notch diameter, notch shape, distance from the notch root, and magnitude of the nominal mean/amplitude of loading cycles. Nominal force‐controlled cycles were kept below the yield point and the Neuber's rule accommodated for the maximum/minimum local stress components along those local strains measured through the strain gauges at the notch region. Plastic strains at the vicinity of notch root over loading cycles were further accumulated by means of the Chaboche hardening model. The local ratcheting strain while progressed at the notch root plastic zone over loading cycles resulted in mean stress relaxation controlled by the model.
The 2017 WHO update on mature T‐ and natural killer (NK) cell neoplasms
Authors: Matutes E.
Published: May 2018

Over the last decade, there has been a significant body of information regarding the biology of the lymphoid neoplasms. This clearly supports the need for updating the 2008 WHO (World Health Organization) classification of haematopoietic and lymphoid tumours. The 2017 WHO classification is not a new edition but an update and revision of the 4th edition. New provisional entities but not new definitive entities are included, and novel molecular data in most of the entities and changes in the nomenclature in few of them have been incorporated. In the context of the mature T‐ and NK‐cell neoplasms, the most relevant updates concern to: 1—dysregulation of the JAK/STAT pathway due to gene mutations which are common to various aggressive and indolent neoplasms; 2—incorporation of new molecular players that are relevant to the pathogenesis of these neoplasms and/or have prognostic implications; 3—inclusion of new provisional entities within the subgroups of anaplastic, primarily intestinal and cutaneous lymphomas such as breast implant‐associated anaplastic large cell lymphoma, indolent T‐cell lymphoproliferative disorder of the gastrointestinal tract and primary cutaneous acral CD8+ T‐cell lymphoma; 4—identification of poor prognostic subtypes of peripheral T‐cell lymphomas not otherwise specified (PTCL, NOS) characterized by overexpression of certain genes and of a subgroup PTCL, NOS with a T follicular phenotype that now is included together with angioimmunoblastic T‐cell lymphoma under the umbrella of lymphomas with a T follicular helper phenotype; and 5—refinement on the designation and definition of already established entities. A review of the major changes will be outlined.
Challenges to laboratory hematology practice: Egypt perspective
Authors: Rizk S.H.
Published: May 2018

Laboratory hematology is an integral part of all clinical laboratories along the extensive healthcare facilities in Egypt. The aim of this review is to portrait the laboratory hematology practice in Egypt including its unique socioeconomic background, blood disease pattern, education and training, regulatory oversight, and the related challenges. Current practice varies widely between different parts of the healthcare system in terms of the range of tests, applied techniques, workforce experience, and quality of service. The national transfusion service (NBTS) in Egypt has been recently upgraded and standardized according to the World Health Organization (WHO) guidelines. Formal postgraduate education roughly follows the British system. Laboratory hematology specialization is achieved through 2‐3 years masters' degree followed by 2‐4 years doctorate degree in clinical pathology with training and research in hematology. Improvement of laboratory hematology education is recently undergoing a reform as a part of the modernization of higher education policy and following the standards developed by the National Quality Assurance and Accreditation Agency (NQAAA). Accreditation of medical laboratories is recently progressing with the development of the “Egyptian Accreditation Council” (EGAC) as the sole accreditation body system and training of assessors. Current laboratory system has many challenges, some are related to the inadequate system performance, and others are unique to laboratory hematology issues. The rapid technological advances and therapeutic innovations in hematology practice call for an adapting laboratory system with continuous upgrading.
Evaluation of minimal residual disease in childhoodALL
Authors: Béné Marie C. , Eveillard Marion
Published: May 2018

Childhood acute lymphoblastic leukemia is one of the most frequent cancers of that age range. Tremendous progress has been achieved in the treatment of these diseases, and increasing numbers of patients are actually cured and live normal lives thereafter. The treatment however remains a complex and serious ordeal. Although statistics are more than encouraging, the specific care of any given patient must be considered with a personalized approach. Among modern tools of disease monitoring, minimal residual disease assessment has earned increasing appeal and now tends to be rather dubbed “measurable” residual disease as the major goal of therapy was the complete eradication of the pathological clone. In this review, the basic characteristics ofALLdiagnosis will be briefly recalled, before summarizing available techniques and providing some considerations on the clinical relevance and strategies of childhoodALL MRDevaluation.