bluuebunny/crossref_metadata_2025 huggingface dataset:
Consumer preferences and policy implications for the green car market
Authors: Chowdhury Mahzabin , Salam Khan , Tay Richard
Published: September 2016

Purpose

The purpose of this paper is to understand consumer preferences for green vehicles with low fuel consumption and emission. It will examine six important vehicle attributes, including fuel efficiency and CO2emissions, and determine the impacts of increasing demand for green attributes on the domestic car industry in Sweden.

Design/methodology/approach

Responses to an adaptive choice-based conjoint experiment from a sample of 100 residents in Northern Sweden were analyzed using monotone regression and market simulation.

Findings

The authors found that consumer preferences were sensitive to changes in fuel efficiency and emission levels. However, engine power was the most important attribute for existing owners whereas price was the most important one for potential customers, while both market segments valued emission more than fuel efficiency. Also, the domestic producer will benefit from both an increase in market size and market share if all new vehicles have higher fuel efficiency but its market share will decrease if all new vehicles have lower CO2emissions.

Social implications

Although promoting green vehicle purchase is beneficial for the environment, policy makers also need to balance this benefit against any potential adverse effect on the domestic industry and the economy. This study will provide evidence-based recommendations to increase the share of green cars in new vehicle purchase, and thus contribute to improving the environment. Moreover, it will also predict the changes in the market shares of different vehicles, and the potential impact on the domestic automobile manufacturing sector and the economy.

Originality/value

This study will contribute significantly to the understanding of consumer preferences by exploring the preferences of a sample of consumers from a country with a well-established alternative fuel and green car market but has adverse weather and driving conditions and a domestic automobile manufacturing industry. It will also examine the differences in preference between existing owners and potential green car buyers. Finally, it will simulate the effects of changing fuel efficiency and emission levels on consumer utility and preference shares to predict changes in market share of different vehicles, and thus the potential impact on the domestic automobile manufacturing sector and the economy.
Message involvement and attitude towards green advertisements
Authors: Fernando Angeline Gautami , Sivakumaran Bharadhwaj , Suganthi L.
Published: September 2016

Purpose

Previous green research shows conflicting results regarding the relationship between environmental concern and persuasion. It has also largely overlooked the role of situational involvement. The purpose of this paper is to aim to show that message involvement influences attitude towards green advertisements.

Design/methodology/approach

To test the proposed model, an experimental study based on a sample of young adults in an emerging economy was used to investigate if situational involvement can produce favourable attitudes towards green advertisements.

Findings

Using PLS, it was found that fear and response efficacy increased message involvement which in turn was a significant predictor of attitude towards the advertisement. The findings show that advertisers can use these variables to increase message involvement.

Originality/value

This research extends previous studies on message involvement and expands current knowledge by showing that situational involvement predicts attitude towards green advertising.
Strategic performance through inter-firm networks
Authors: Yousaf Zahid , Majid Abdul
Published: September 2016

Purpose

The purpose of this paper is to examine and develop a strategic performance model for small and medium enterprises linking with inter-firm networks, strategic alignment and environmental dynamism.

Design/methodology/approach

Drawing on the live experiences of 757 respondents, including managing directors/owners and CEOs of different SMEs, the authors proposed a theoretical model representing how firms could attain strategic performance through inter-firm networks with a mediating role of strategic alignment.

Findings

The current study demonstrated that SMEs with strong inter-firm networks have the ability to align business activities with strategies and get earlier strategic performance. Strategic performance looks skeptical to ever gain acceptance until strategic alignment is adopted by small and medium enterprises. The findings of this study indicated that environmental dynamism strengthens the relationship between strategic alignment and strategic performance.

Originality/value

This research extended the understanding about the inter-firm networks, strategic alignment and environmental dynamism surrounding strategic performance. This study identified and empirically tested how the inter-firm networks impact on strategic performance through the mediating effect of strategic alignment.
Divided by the Market, Divided by the State: Distribution, Redistribution and Welfare Attitudes in 47 Countries
Authors: Wulfgramm Melike , Starke Peter
Published: September 2016

This article examines the impact of income inequality and welfare state context on the extent to which the rich and poor share similar attitudes towards redistribution. It asks whether and how differences in attitudes, particularly those between income groups, are shaped by inequality and redistributive efforts. Based on a multi‐level analysis of individual survey data across 47 countries at three points in time, the article shows that such an interaction of individual characteristics and the macro‐context indeed matters considerably. While material self‐interest, unsurprisingly, explains part of the individual differences, the analysis also shows, for the first time, that both high inequality and strongly redistributive policies divide public opinion along the lines of socioeconomic position. Put differently, while market inequality may be associated with less cohesive attitudes, a highly redistributive welfare state does not seem to foster agreement among the public, either. These findings have important policy implications for advanced welfare states, including a renewed emphasis on ‘predistribution’ (i.e., policies that influence the primary distribution of income) in order to avoid the scenario of intensified redistributive conflicts.
Welcome to ‘Pikettyville’? Mapping London’s alpha territories
Authors: Burrows Roger , Webber Richard , Atkinson Rowland
Published: September 2016

This paper considers the influence of the burgeoning global ‘super-rich’ on contemporary socio-spatialization processes in London in the light of a contemporary re-reading of Pahl’s classic volume, Whose City? It explores if a turn to ‘big data’ – in the form of commercial geodemographic classifications – can offer any additional insights to a sociological approach to the study of the ‘super-rich’ that extends the ‘spatialization of class’ thesis further ‘up’ the class structure.
Whose city now? Urban managerialism reconsidered (again)
Authors: Forrest Ray , Wissink Bart
Published: September 2016

This introductory essay reflects on the continuing relevance of Ray Pahl’s Whose City? It reassesses the original urban managerialist perspective, developed in the Europe of the late 1960s and early 1970s. When large-scale public institutions dominated access to scarce urban resources, Pahl argued that urban managers played a crucial role in the shaping of life chances. But with the emergence of Marxist perspectives on the city under capitalism, urban managers receded from view as minor players within overarching structures of exploitation and inequality. This was only reinforced by the neoliberal transformations that started to take hold after the late 1970s. We are now living in a very different world of global financialized capitalism in which the relevance of various radical theorists is being reassessed. Have new urban managers emerged? Who are they and what do they do? Should we modify the urban managerialist perspective for the post-privatized city, the city of ‘governance’, the city of choice in which interests and responsibilities appear to have become more fragmented and less transparent? The essay concludes with a discussion of the other papers in this special section and their contribution to a reassessment of Ray Pahl’s urban managerialism.
Monarchs in decline: a collateral landscape‐level effect of modern agriculture
Authors: Stenoien Carl , Nail Kelly R. , Zalucki Jacinta M. , Parry Hazel , Oberhauser Karen S. , Zalucki Myron P.
Published: September 2016

We review the postulated threatening processes that may have affected the decline in the eastern population of the monarch butterfly, Danaus plexippus L. (Lepidoptera: Nymphalidae), in North America. Although there are likely multiple contributing factors, such as climate and resource‐related effects on breeding, migrating, and overwintering populations, the key landscape‐level change appears to be associated with the widespread use of genetically modified herbicide resistant crops that have rapidly come to dominate the extensive core summer breeding range. We dismiss misinterpretations of the apparent lack of population change in summer adult count data as logically flawed. Glyphosate‐tolerant soybean and maize have enabled the extensive use of this herbicide, generating widespread losses of milkweed (Asclepias spp.), the only host plants for monarch larvae. Modeling studies that simulate lifetime realized fecundity at a landscape scale, direct counts of milkweeds, and extensive citizen science data across the breeding range suggest that a herbicide‐induced, landscape‐level reduction in milkweed has precipitated the decline in monarchs. A recovery will likely require a monumental effort for the re‐establishment of milkweed resources at a commensurate landscape scale.
Standard‐dose versus low‐dose azathioprine in the treatment of Crohn's disease: A prospective randomized study
Authors: Zhang Yu , Xia Jing Jing , Xiao Peng , Zhao Yuan , Ye Ling Na , Li Xiao Lin , Lin Zi Wen , Xu Zhen Jie , Huang Yi Biao , Wang Meng Yu , Qian Jia Ming , Hu Pin Jin , Cao Qian
Published: September 2016

Objective

Azathioprine (AZA) is widely used to treat Crohn's disease (CD) with a recommended dose of 2–2.5 mg/kg per day for Westerners. Asian patients are suggested to take a lower dose. However, many clinicians reported poor efficacy with a reduced dose. This study aimed to explore a efficient and safe dose of AZA providing the best efficacy for Chinese CD patients.

Methods

Fifty patients with active CD were enrolled and randomized into two groups (n = 25 each). All other treatments were the same except that group A received 1 mg/kg per day and group B took 2 mg/kg per day of AZA. Complete remission (CR) rate and response rate at weeks 12, 24 and 48 were assessed by using intent‐to‐treat (ITT) and per‐protocol (PP) analyses. Adverse events and recurrence rate were also evaluated.

Results

At week 48, CR rate and response rate in group B (ITT: 50.0% and 59.1%; PP: 57.9% and 68.4%) were significantly higher than those in group A (ITT: 13.0% and 17.4%; PP: 16.7% and 22.2%) (P < 0.05). Nine adverse events occurred, including pancreatitis (n = 1), arthritis (n = 2) and myelosuppression (n = 6). There was no significant difference in adverse events between the two groups. However, recurrence rate was significantly higher in group A than in group B (P = 0.042).

Conclusion

AZA 2 mg/kg per day is more appropriate than 1 mg/kg per day for Chinese CD patients with a high efficacy, a low recurrence rate and not increased adverse events.
Impact of the Innate Immune Response in the Actions of Ethanol on the Central Nervous System
Authors: Montesinos Jorge , Alfonso‐Loeches Silvia , Guerri Consuelo
Published: September 2016

The innate immune response in the central nervous system (CNS) participates in both synaptic plasticity and neural damage. Emerging evidence from human and animal studies supports the role of the neuroimmune system response in many actions of ethanol (EtOH) on the CNS. Research studies have shown that alcohol stimulates brain immune cells, microglia, and astrocytes, by activating innate immune receptors Toll‐like receptors (TLRs) and NOD‐like receptors (inflammasome NLRs) triggering signaling pathways, which culminate in the production of pro‐inflammatory cytokines and chemokines that lead to neuroinflammation. This review focuses on evidence that indicates the participation of TLRs and the inflammasome NLRs signaling response in many effects of EtOH on the CNS, such as neuroinflammation associated with brain damage, cognitive and behavioral dysfunction, and adolescent brain development alterations. It also reviews findings that indicate the role of TLR4‐dependent signaling immune molecules in alcohol consumption, reward, and addiction. The research data suggest that overactivation of TLR4 or NLRs increases pro‐inflammatory cytokines and mediators to cause neural damage in the cerebral cortex and hippocampus, while modest TLR4 activation, along with the generation of certain cytokines and chemokines in specific brain areas (e.g., amygdala, ventral tegmental area), modulate neurotransmission, alcohol drinking, and alcohol rewards. Elimination of TLR4 and NLRP3 abolishes many neuroimmune effects of EtOH. Despite much progress being made in this area, there are some research gaps and unanswered questions that this review discusses. Finally, potential therapies that target neuroimmune pathways to treat neuropathological and behavioral consequences of alcohol abuse are also evaluated.
Cardiac Orienting Responses Differentiate the Impact of Prenatal Alcohol Exposure in Ukrainian Toddlers
Authors: Kable Julie A. , Coles Claire D. , Jones Kenneth L. , Yevtushok Lyubov , Kulikovsky Yaroslav , Wertelecki Wladimir , Chambers Christina D. ,   the CIFASD
Published: September 2016

Background

Prenatal alcohol exposure (PAE) has been found to impact neurophysiological encoding of environmental events negatively in the first year of life but has not been evaluated in older infants or toddlers. Cardiac orienting responses (ORs) collected during a habituation/dishabituation learning paradigm were obtained from 12‐ to 18‐month‐olds to assess the impact of PAE beyond the first year of life.

Methods

Participants included women and their toddlers who differed in PAE histories and enrolled in a randomized clinical trial of multivitamin/mineral usage during pregnancy. Those who were randomly assigned to the no intervention group were used for this analysis. The habituation/dishabituation paradigm consisted of 10 habituation and 5 dishabituation trials. Baseline heart rate (HR) was collected for 30 seconds prior to stimulus onset, and responses to the stimuli were assessed by sampling HR for 12 seconds poststimulus onset.

Results

The speed of the OR in response to auditory stimuli in the dishabituation condition was found to be altered as a function of maternal alcohol use around conception. For visual stimuli, positive histories of PAE were predictive of the magnitude but not the speed of the response on habituation and dishabituation trials. A history of binge drinking was associated with reduced magnitude of the OR response on visual encoding trials, and level of alcohol exposure at the time of conception was predictive of the magnitude of the response on visual dishabituation trials.

Conclusions

Cardiac ORs collected in the toddler period were sensitive to the effects of PAE. The magnitude of the OR was more sensitive to the impact of PAE than in previous research with younger infants, and this may be a function of brain maturation. Additional research assessing the predictive utility of using ORs in making decisions about individual risk was recommended.
On bias in alcohol epidemiology and the search for the perfect study
Authors: Roerecke Michael
Published: September 2016

Commentary to: Selection biases in observational studies affect associations between ‘moderate’ alcohol consumption and mortality
Substrate controls growth rates of the woody pioneer Leptospermum lanigerum colonizing montane grasslands in northern Tasmania
Authors: Wood Sam W. , Ward Carly , Bowman David M. J. S.
Published: September 2016

Woody encroachment into grasslands is occurring across the world and is of concern to land managers. Studies of forest–grassland boundaries have informed models describing factors that govern tree establishment and the maintenance and origin of grassland ecosystems. Central to these models is the role of fire relative to ‘bottom up’ resources such as soil and the geological substrate in determining the extent of grassland and forest in the landscape. The view that human lit fires have shaped vegetation across the Australian continent has been bolstered by early 19th century observations of Aboriginal‐set fires in Tasmanian montane grasslands and the documented encroachment of trees into these grasslands in the 20th century. We examined the pattern of lateral encroachment of woolly tea‐tree (Leptospermum lanigerum (Sol. ex Aiton) Sm.) into these grasslands and used tree ring chronologies to investigate (i) past fire activity and (ii) how the geological substrate mediates growth rates of L. lanigerum. Changes in fire regimes inferred from L. lanigerum recruitment were corroborated by historical records. Encroachment (and increases in woody cover) of trees into grasslands was highest on granitic substances, although L. lanigerum growth rates were highest on basalt substrates, followed by conglomerate, granite and Mathinna sediments. Frequent burning up to the 1980s may have stymied the encroachment of trees in grasslands underlain by basalt. Growth rates decreased with increasing distance from the forest edge. This may be due to incremental changes in soil resources, grass competition and/or microclimate. The dynamics between grasslands and forests in montane Tasmania are consistent with tree growth–fire interaction models that highlight the interplay of edaphic factors, growth rates and fire history. Such complexity cautions against generalizations concerning the direct effects of landscape fire in shaping vegetation distribution across Australia.
Clostridium difficile infection diagnostics – evaluation of the C. DIFF Quik Chek Complete assay, a rapid enzyme immunoassay for detection of toxigenic C. difficile in clinical stool samples
Authors: Johansson Karin , Karlsson Hanna , Norén Torbjörn
Published: September 2016

Diagnostic testing for Clostridium difficile infection (CDI) has, in recent years, seen the introduction of rapid dual‐EIA (enzyme immunoassay) tests combining species‐specific glutamate dehydrogenase (GDH) with toxin A/B. In a prospective study, we compared the C. DIFF Quik Chek Complete test to a combination of selective culture (SC) and loop‐mediated isothermal amplification (LAMP) of the toxin A gene. Of 419 specimens, 68 were positive in SC including 62 positive in LAMP (14.7%). The combined EIA yielded 82 GDH positives of which 47 were confirmed toxin A/B positive (11%) corresponding to a sensitivity and specificity of 94% for GDH EIA compared to SC and for toxin A/B EIA a sensitivity of 71% and a specificity of 99% compared to LAMP. Twenty different PCR ribotypes were evenly distributed except for UK 081 where only 25% were toxin A/B positive compared to LAMP. We propose a primary use of a combined GDH toxin A/B EIA permitting a sensitive 1‐h result of 379 of 419 (90%, all negatives plus GDH and toxin EIA positives) referred specimens. The remaining 10% being GDH positive should be tested for toxin A/B gene on the same day and positive results left to a final decision by the physician.
Population pharmacokinetics of exenatide
Authors: Cirincione Brenda , Mager Donald E.
Published: September 2016

Aim

The aim of the present analysis was to develop a core population pharmacokinetic model for the pharmacokinetic properties of immediate‐release (IR) exenatide, which can be used in subsequent analyses of novel sustained‐release formulations.

Methods

Data from eight clinical trials, evaluating a wide range of doses and different administration routes, were available for analysis. All modelling and simulations were conducted using the nonlinear mixed‐effect modelling program NONMEM. External model validation was performed using data from the phase III clinical trials programme through standard visual predictive checks.

Results

The pharmacokinetics of IR exenatide was described by a two‐compartment model, and the absorption of subcutaneous exenatide was described with a sequential zero‐order rate constant followed by a saturable nonlinear absorption process. Drug elimination was characterized by two parallel routes (linear and nonlinear), with significant relationships between renal function and the linear elimination route, and between body weight and volume of distribution. For a subject with normal renal function, the linear clearance was estimated to be 5.06 l hr−1. The nonlinear elimination was quantified with a Michaelis–Menten constant (Km) of 567 pg ml−1 and a maximum rate of metabolism (Vmax) of 1.6 μg h−1. For subcutaneous administration, 37% of the subcutaneous dose is absorbed via the zero‐order process, and the remaining 63% via the nonlinear pathway.

Conclusions

The present analysis provides a comprehensive population pharmacokinetic model for exenatide, expanding the elimination process to include both linear and nonlinear components, providing a suitable platform for a broad range of concentrations and patient conditions that can be leveraged in future modelling efforts of sustained‐release exenatide formulations.
The effect of renal dysfunction and haemodialysis on circulating liver specific miR‐122
Authors: Rivoli Laura , Vliegenthart A. D. Bastiaan , de Potter Carmelita M. J. , van Bragt Job J. M. H. , Tzoumas Nikolaos , Gallacher Peter , Farrah Tariq E. , Dhaun Neeraj , Dear James W.
Published: September 2016

Aims

microRNA‐122 (miR‐122) is a hepatotoxicity biomarker with utility in the management of paracetamol overdose and in drug development. Renal dysfunction and haemodialysis have been associated with a reduction in circulating microRNA. The objective of this study was to determine their effect on miR‐122.

Methods

Blood samples were collected from 17 patients with end‐stage renal disease (ESRD) on haemodialysis, 22 healthy controls, 30 patients with chronic kidney disease (CKD) and 15 patients post‐kidney transplantation. All had normal standard liver function tests. Samples from ESRD patients were collected immediately pre‐ and post‐haemodialysis. Serum alanine transaminase activity (ALT), miR‐122 and miR‐885 (liver enriched) were compared.

Results

Circulating miR‐122 was substantially reduced in ESRD patients pre‐haemodialysis compared with the other groups (19.0‐fold lower than healthy controls; 21.7‐fold lower than CKD). Haemodialysis increased miR‐122 from a median value of 6.7 × 103 (2.3 × 103–1.4 × 104) to 1.6 × 104 (5.4 × 103–3.2 × 104) copies ml−1. The increase in miR‐122 did not correlate with dialysis adequacy. miR‐122 was reduced in the argonaute 2 bound fraction pre‐haemodialysis; this fraction was increased post‐dialysis. There was no change in miR‐122 associated with extracellular vesicles. miR‐885 was also reduced in ESRD patients (4‐fold compared to healthy subjects) and increased by haemodialysis.

Conclusion

miR‐122 is substantially lower in ESRD compared to healthy controls, patients with CKD and transplanted patients. Haemodialysis increases the concentration of miR‐122. These data need to be considered when interpreting liver injury using miR‐122 in patients with ESRD on dialysis, and specific reference ranges that define normal in this setting may need to be developed.
Anabolic Effect of Insulin Therapy on the Bone: Osteoprotegerin and Osteocalcin Up‐Regulation in Streptozotocin‐Induced Diabetic Rats
Authors: Bortolin Raul Hernandes , Freire Neto Francisco Paulo , Arcaro Carlos Alberto , Bezerra João Felipe , da Silva Flávio Santos , Ururahy Marcela Abbott Galvão , Souza Karla Simone da Costa , Lima Valeria Morgiana Gualberto Duarte Moreira , Luchessi André Ducati , Lima Francisco Pignataro , Lia Fook Marcus Vinicius , da Silva Bartolomeu Jorge , Almeida Maria das Graças , Abreu Bento João , de Rezende Luciana Augusto , de Rezende Adriana Augusto
Published: September 2016

Type 1 diabetes mellitus (T1DM) is associated with several skeletal alterations, particularly in conditions of poor glycaemic control. Insulin therapy is the major conservative treatment for T1DM; however, the effects of this hormone on bone markers of T1DM rats are limited, and the regulatory mechanisms remain elusive. Therefore, the evaluation of molecular and non‐molecular parameters in a chronic animal model of T1DM‐induced bone loss, treated with and without insulin, may help in elucidating the insulin mechanisms. Male Wistar rats were assigned into three groups: control, T1DM (T1DM rats induced with streptozotocin [STZ] at 40 mg/kg intravenously) and T1DM plus insulin therapy (T1DMI). After 8 weeks, we evaluated the serum biochemical, tibia histomorphometric and biomechanical parameters, as well as the gene expression of the receptor activator of nuclear factor kappa‐B ligand (RANKL), osteoprotegerin (OPG) and osteocalcin (OC) of femur mRNA. Compared with T1DM, the T1DMI group showed less bone loss, which was revealed by the increased trabecular width (TbWi, p < 0.001) and trabecular bone area (BAr, p < 0.01), reduced trabecular separation (TbSp, p < 0.01) and increased Young's modulus (p < 0.05). Moreover, molecular analyses indicated that the expression of OPG and OC was up‐regulated (p < 0.001 and p < 0.05, respectively). In summary, the up‐regulation of OPG and OC in the T1DMI group supports an anabolic effect of insulin, which was demonstrated by the maintenance of bone architecture and flexibility. These results suggest that insulin therapy may prevent T1DM‐induced bone loss via the effects on the bone formation.
The effects of cigarette smoking behavior and psychosis history on general and social cognition in bipolar disorder
Authors: Ospina Luz H , Russo Manuela , Nitzburg George M , Cuesta‐Diaz Armando , Shanahan Megan , Perez‐Rodriguez Mercedes M , Mcgrath Meaghan , Levine Hannah , Mulaimovic Sandra , Burdick Katherine E
Published: September 2016

Objectives

Several studies have documented the prevalence and effects of cigarette smoking on cognition in psychotic disorders; fewer have focused on bipolar disorder (BD). Cognitive and social dysfunction are common in BD, and the severity of these deficits may be related both to illness features (e.g., current symptoms, psychosis history) and health‐related behaviors (e.g., smoking, alcohol use). The current study assessed the influence of cigarette smoking on general and social cognition in a BD cohort, accounting for illness features with a focus on psychosis history.

Methods

We assessed smoking status in 105 euthymic patients with BD, who completed a comprehensive battery including social (facial affect recognition, emotional problem‐solving, and theory of mind) and general (the MATRICS Consensus Cognitive Battery and executive functioning) cognitive measures. We compared smokers vs nonsmokers on cognitive performance and tested for the effects of psychosis history, premorbid intellectual functioning, substance use, and current affective symptoms.

Results

Within the nonpsychotic subgroup with BD (n=45), smokers generally outperformed nonsmokers; by contrast, for subjects with BD with a history of psychosis (n=41), nonsmokers outperformed smokers. This pattern was noted more globally using a general composite cognitive score and on social/affective measures assessing patients’ ability to identify emotions of facial stimuli and solve emotional problems.

Conclusions

Cigarette smoking differentially affects performance on both general and social cognition in patients with BD as a function of psychosis history. These results suggest that there may be at least partially divergent underlying neurobiological causes for cognitive dysfunction in patients with BD with and without psychosis.
Comparative clinical effectiveness of azacitidine versus decitabine in older patients with myelodysplastic syndromes
Authors: Zeidan Amer M. , Davidoff Amy J. , Long Jessica B. , Hu Xin , Wang Rong , Ma Xiaomei , Gross Cary P. , Abel Gregory A. , Huntington Scott F. , Podoltsev Nikolai A. , Hajime Uno , Prebet Thomas , Gore Steven D.
Published: September 2016

The hypomethylating agents (HMAs) azacitidine and decitabine are both approved for treatment of myelodysplastic syndromes (MDS) in the USA. In Europe, decitabine is not approved due to lack of survival advantage in randomized trials. The two drugs have not been compared in clinical trials. We identified patients diagnosed with MDS between 2004 and 2011 from the Surveillance, Epidemiology, and End Results (SEER)‐Medicare linked database in the USA who received ≥ 10 doses of either HMA. We estimated survival from HMA initiation with Kaplan–Meier methods and used multivariate Cox proportional hazards models to adjust for covariates. Analyses controlled for histological subtype and we conducted a subset analysis limited to patients with refractory anaemia with excess blasts (RAEB). In 2025 HMA‐treated patients, median survival was 15 months with no difference in survival based on the HMA received in adjusted analysis (decitabine versus azacitidine, hazard ratio = 1·06, 95% confidence interval: 0·94–1·19, P = 0·37). For RAEB patients (n = 523), median survival was 12 months, with no significant difference based on HMA received. No significant survival difference was found between azacitidine and decitabine in patients with MDS, including RAEB. Importantly, population‐based survival of azacitidine‐treated RAEB patients was substantially shorter than in the AZA‐001 clinical trial (11 versus 24·5 months).
Decreased WNT3 expression in chronic lymphocytic leukaemia is a hallmark of disease progression and identifies patients with worse prognosis in the subgroup with mutated IGHV
Authors: Poppova Lucie , Janovska Pavlina , Plevova Karla , Radova Lenka , Plesingerova Hana , Borsky Marek , Kotaskova Jana , Kantorova Barbara , Hlozkova Michaela , Figulova Jana , Brychtova Yvona , Machalova Michaela , Urik Milan , Doubek Michael , Kozubik Alois , Pospisilova Sarka , Pavlova Sarka , Bryja Vitezslav
Published: September 2016

The canonical Wnt pathway, dependent on β‐catenin‐controlled transcription, is the most explored Wnt pathway, known to drive the malignant transformation of multiple cell types. Several reports have suggested that this pathway also participates in chronic lymphocytic leukaemia (CLL) pathogenesis. To get a better insight into the role of the Wnt/β‐catenin pathway in CLL we analysed in detail the expression of the most overexpressed Wnt ligand, encoded by the WNT3 gene, in a well‐defined cohort of 137 CLL patients. Our analysis demonstrated that (i) untreated patients with more aggressive disease (with a notable exception of patients with 11q deletion) express less WNT3, (ii) WNT3 declines with disease progression in a significant proportion of patients and (iii) low WNT3 was identified as a strong independent marker indicating shorter treatment‐free survival in CLL patients with IGHV mutation. Interestingly, CLL‐related lymphoid cell lines, but not stromal cells, failed to respond to the ligand‐induced activation of the Wnt/β‐catenin pathway. This opens the possibility that CLL cells use Wnt‐3 to communicate with the cells in the microenvironment. We thus propose that the Wnt/β‐catenin pathway plays a more complex role in CLL pathogenesis than previously anticipated.
Rates and risk factors of hypertension in adolescents and adults with sickle cell anaemia in Tanzania: 10 years’ experience
Authors: Makubi Abel , Mmbando Bruno P. , Novelli Enrico M. , Lwakatare Johnson , Soka Deogratius , Marik Harvest , Tibarazwa Kemi , Ngaeje Mariam , Newton Charles R. , Gladwin Mark T. , Makani Julie
Published: September 2016

Data on the magnitude and risk factors for hypertension in sickle cell anaemia (SCA) are limited. A retrospective analysis of individuals with SCA aged ≥15 years enrolled from 2004–2014 at Muhimbili National Hospital, Tanzania was conducted to determine the prevalence, incidence and risk factors for hypertension. A total of 1013 individuals with SCA were analysed, of whom 571(56%) were females. The median age [interquartile range] was 17 [15–22] years. Four hundred and forty‐one (44%) of the patients had relative hypertension [systolic blood pressure (SBP) 120–139 mmHg or diastolic blood pressure (DBP) 70–89 mmHg], and 79 (8%) had hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg). The incidence of hypertension was 64/1000 person years of observation and the 5‐year survival rate was 0·71 [95% confidence interval (CI): 0·67–0·75]. In multivariate analysis, age>18 years, Hazard ratio (HR) 1·50 (95% CI: 1·03–2·18); pulse pressure, HR 0·64 (95% CI: 0·42 to 0·98); pulse rate, 1·02 (95% CI: 1·01–1·03); body mass index (BMI), HR 1·08 (95% CI: 1·03–1·13); blood transfusion, HR 2·50 (95% CI: 1·01–6·21) and haemoglobin, HR 1·12 (95% CI: 1·05–1·33) were independently associated with hypertension. In conclusion, despite the younger age, hypertension in this population was higher than that reported in others studies. Age, BMI, pulse pressure and haemoglobin were independently associated with hypertension in SCA.
99mTc‐anti‐epidermal growth factor receptor nanobody for tumor imaging
Authors: Piramoon Majid , Hosseinimehr Seyed Jalal , Omidfar Kobra , Noaparast Zohreh , Abedi Seyed Mohammad
Published: September 2016

Nanobodies are important biomolecules for tumor targeting. In this study, we synthesized and labeled anti‐epidermal growth factor receptor (EGFR) nanobody OA‐cb6 with 99mTc(CO)3+ and evaluated its characteristics for targeting the EGFR in the A431 human epidermal carcinoma cell line. Nanobody radiolabeling was achieved with high yield and radiochemical purity, and the radioconjugate was stable. Biodistribution results in nude mice exhibited a favorable tumor‐to‐muscle ratio at 4‐hr postinjection, and tumor location was visualized at 4 hr after injection of radiolabeled nanobody. Our result showed that the OA‐cb6‐99mTc‐tricarbonyl radiolabeled nanobody is a promising radiolabeled biomolecule for tumor imaging in cancers with high EGFR overexpression.
The impact of smoking on marginal bone loss in a 10‐year prospective longitudinal study
Authors: Bahrami Golnosh , Væth Michael , Kirkevang Lise‐Lotte , Wenzel Ann , Isidor Flemming
Published: September 2016

Objectives

The aim of this epidemiologic study was to determine the impact of smoking on marginal bone loss in a subsample derived from an original randomly selected adult sample, after adjusting for oral and general factors.

Methods

The number of participants at baseline in this 10‐year longitudinal study was 616 (mean age: 42 years, range 21–63 years). The participants underwent a full‐mouth radiographic survey. After recall in 2003, 473 (77%) of the participants accepted and completed an identical survey. In 2008, the survey was repeated, and 301 (48.9%) individuals were included in this study. The marginal bone level of each tooth was measured in mm. Age, gender, smoking habits, number of teeth, apical periodontitis, crowns and initial marginal bone level were also recorded for each individual. Only individuals who did not report a change in smoking habits during the 10‐year period were included in the study. Multiple regression analyses were used to evaluate crude and adjusted associations between smoking and marginal bone loss.

Results

At the first, radiographic survey smokers had a statistically significantly more reduced marginal bone level (in average 0.9 mm) than nonsmokers. After 10 years, a progression of a mean marginal bone loss of > 2 mm was statistically significantly more common in smokers than in nonsmokers (7.1% and 0%, respectively). Furthermore, a marginal bone loss of 1–2 mm was observed in 29% of the smokers and 19% of the nonsmokers, and ≤ 1 mm marginal bone loss was found in 69% of smokers and 81% of nonsmokers. Even after adjusting for initial marginal bone level, gender, age, and also presence of apical periodontitis and crowns, the difference in progression of marginal bone loss was still statistically higher in smokers (on average 0.36 mm).

Conclusions

The smokers started out with a more reduced marginal bone level than nonsmokers. However, even after adjusting for the initial marginal bone level, the progression of marginal bone loss in smokers was more pronounced than in nonsmokers. This shows that smoking is a factor with significant impact on the marginal bone level and can be assumed to be a true risk factor for marginal bone loss.
Total thyroidectomy: a clue to understanding the metabolic changes induced by subclinical hyperthyroidism?
Authors: Bel Lassen Pierre , Kyrilli Aglaia , Lytrivi Maria , Ruiz Patino Maria , Corvilain Bernard
Published: September 2016

Objective

The effects of endogenous subclinical hyperthyroidism (eSCH) on heart and bone have been well documented. There are only limited data available regarding the impact of eSCH on weight regulation and lipid metabolism. Our aim was to evaluate the changes in body weight and metabolic parameters after total thyroidectomy in patients with pre‐operative eSCH compared with pre‐operative patients with euthyroid (EUT).

Design

A retrospective study of 505 patients who underwent total thyroidectomy for benign multinodular goitre in an academic hospital in Brussels (Belgium) was performed.

Patient's Measurements

Two hundred and 25 patients were included (eSCH group: n = 74; EUT group: n = 151). The mean follow‐up time was 26·1 ± 0·8 months and was similar in both groups.

Results

Absolute BMI gain was significantly greater in the eSCH group than in the EUT group (1·11 ± 0·17 vs 0·33 ± 0·13 kg/m2; P = 0·003). A significant increase in LDL cholesterol was observed in the eSCH group (16·1 ± 3·8 mg/dl; P < 0·001) but not in the EUT group (0·0 ± 3·0 mg/dl; P = 0·88). In a multivariate model, pre‐operative TSH levels were the main factor significantly associated with increases in BMI or LDL cholesterol. Post‐operative median TSH levels and L‐thyroxine substitution were similar in both groups.

Conclusion

After total thyroidectomy, increases in weight and serum cholesterol were observed in the eSCH group. Given that post‐operative TSH levels were similar in the two groups, these observations are probably due to the correction of eSCH, suggesting a direct effect of eSCH on body weight regulation and lipid metabolism.
Effect of sham feeding with gum chewing on postoperative ileus after liver transplantation—a randomized controlled trial
Authors: Lee Hannah , Cho Chan Woo , Yoon Susie , Suh Kyung‐Suk , Ryu Ho Geol
Published: September 2016

Postoperative ileus (POI) is a common complication after major abdominal surgery. Gum chewing has been shown to stimulate bowel motility and decrease duration of POI after abdominal surgery. We evaluated the effect of gum chewing in reducing the time to first flatus and on oral calorie intake in patients undergoing living or deceased donor liver transplantation. Patients were randomized into the sham feeding group or the control group. The sham feeding group chewed two pieces of xylitol flavored gum for 15 minutes, three times a day after extubation until oral nutrition was tolerated. The control group received the same routine care except for the gum chewing. Fifty‐nine patients were randomized into the sham feeding group (n=30) or the control group (n=29). There was no difference in the time to first flatus (72 [66.1‐82.9] hours vs 69.0 [57.6‐77.2] hours, P=.422). Cumulative energy intake (2.8 [5.8‐23.2] % vs 10.0 [8.5‐15.9] %, P=.695) and length of intensive care unit stay (4.2 [3.9‐5.3] days vs 4.0 [6.7‐4.5] days, P=.077) were also similar. In conclusion, sham feeding with gum chewing did not shorten the duration of POI nor facilitate oral intake after liver transplantation. (Clinicaltrials.gov number: NCT 01956643).
Digital pathology and its role in cytology education
Authors: Wilbur D. C.
Published: September 2016

Digital methods have the potential to greatly expand content availability, accessibility, and quality for pathology education. Use of this technology allows for anywhere/anytime interactions and delivery in a variety of methods to accommodate any learning style. This review introduces basic digital technology, its uses for education, and prospects for the future.
Education and training in cytology in Europe
Authors: Tötsch M.
Published: September 2016

Education and training in cytology in Europe is hampered by the fact that there is no homogenous programme across Europe. This can be observed for (Cyto)Pathologists and Cytotechnologists. However, lack of workforce and lack of a pan‐European Cytology diploma are decreasing motivation among junior staff to dedicate their professional interests to cytology. Cytology and histology are complementary approaches for the diagnosis or exclusion of disease in patients and there are many individual efforts of National Societies to maintain competencies in cytology by workshops, seminars, tutorials and congresses. Furthermore, professional organizations such as the European Federation of Cytology Societies (EFCS), the European Society of Pathology (ESP) and Union of European Medical Specialists (UEMS) – Section Pathology are working together in order to develop a pan‐European Cytology diploma. The EFCS is part supported by EU funding in this endeavour. Activities are ongoing in the fields of training (Eurocytology) and examination (QUATE Aptitude Test ‐ Quality Assurance, Training and Examination) or both (Cy‐Test). Modern techniques such as Webatlas with teaching modules in cytology and Tele(cyto)pathology are more and more integrated in daily teaching activities resulting in standardization of cytology in Europe.
Cytology training in the UK: a training centre prospective
Authors: Dudding N.
Published: September 2016

Training in both cervical and non‐gynaecological cytology in the UK has never faced a more challenging environment. A national reconfiguration of cervical cytology services has focussed resources on large centres and damaged the traditional links and overlapping roles within non‐gynaecological cytology. The UK is now at significant risk of falling behind most European countries in the use of non‐gynaecological cytology. The UK currently has five training centres which are approved by the NHS Screening programme for training in cervical cytology; the planned introduction of HPV primary screening and the subsequent dramatic reduction in cervical cytology workload will increase pressure on the remaining training schools. Funding is variable across the country as is the degree of diversification that training schools have undertaken to try to ensure a viable future. It is vital for the future of cytology in the UK that the strong network of training schools remain to ensure the quality of the laboratory service as the UK moves towards HrHPV primary screening. There is no doubt that the training school roles will change and new technology embraced to deliver training fit for the changing role of cytology in healthcare but this will require funding and recognition of the vital role the training centres play in the delivery of high quality training in both cervical and non‐gynaecological cytology.
Stages of Supply Chain Disruption Response: Direct, Constraining, and Mediating Factors for Impact Mitigation
Authors: Bode Christoph , Macdonald John R.
Published: September 2016

It is well established that supply chain disruptions can have a severe negative impact on firms and general wisdom suggests that this impact can be mitigated by quick responses. Aside from a few anecdotes, however, little is known about the decision‐making process that leads to speedy responses and about its impeding and supporting antecedents. Using the organizational information‐processing perspective, this empirical study unravels the disruption management process along a sequence of four stages—disruption recognition, disruption diagnosis, response development, and response implementation—and hypothesizes constraining and mediating effects of these stages. The findings contribute to an improved understanding of the role that the decision stages play in mitigating supply chain disruptions, and confirm the prediction that the speed with which information is processed and the stages are worked through positively affects supply chain performance. In addition, the findings suggest that one of the stages, diagnosis, acts as a constraining factor to the other stages. The stages also play a mediating role between the impact that the disruption has and a firm's readiness (prior to a disruption), dependence on a key supplier, and supply chain complexity. This provides guidance to decision makers in the application of resources both prior to a negative event and during a disruption recovery.
Identifying spinal cord compression in achondroplasia – the role of somatosensory evoked potentials and the need for screening
Authors: Thompson Dominic
Published: September 2016

This commentary is on the original article by Fornarino et al. on pages 192–198 of this issue.
Alterations in foraging behavior of Coccinella septempunctata and Propylea japonica mediated by a novel defended prey affect their predatory potential
Authors: Barry Adema , Ohno Kazuro
Published: September 2016

Generalist aphidophagous coccinellids have to cope with novel prey aphids in environments that are changing rapidly because of anthropogenic activity. The goldenrod aphid, Uroleucon nigrotuberculatum (Olive) (Hemiptera: Aphididae), is a noxious prey, which was recently introduced into Japan. It is a major prey for the native Japanese predators Coccinella septempunctata bruckii Mulsant and Propylea japonica (Thunberg) (both Coleoptera: Coccinellidae) in early summer on patches of solidago, Solidago altissima L. (Asteraceae). Prey preference of these coccinellids between this aphid and a native suitable prey aphid, Megoura crassicauda Mordvilko (Hemiptera: Aphididae), as well as their foraging behavior were studied for a better understanding of the negative impacts of the noxious novel aphid. Coccinella septempunctata initially preferred the novel prey, but later switched to the native prey, M. crassicauda; P. japonica had no preference for either prey. Feeding time of the first instars of C. septempunctata on U. nigrotuberculatum was significantly longer than that of P. japonica. The foraging bouts of fourth instars of C. septempunctata were significantly longer on U. nigrotuberculatum than on M. crassicauda, whereas only the feeding time of fourth instars of P. japonica on U. nigrotuberculatum was significantly longer than on M. crassicauda. Both coccinellids consumed less of U. nigrotuberculatum than of M. crassicauda. Thus, solidago patches infested by U. nigrotuberculatum may present an ecological trap, especially for C. septempunctata.