bluuebunny/crossref_metadata_2025 huggingface dataset:
From technical to non-technical skills among information systems suppliers
Authors: Branchet Bénédicte , Sanseau Pierre-Yves
Published: February 2017

Purpose

Existing research infers that in the information systems (IS) and information technology (IT) fields, a shift may occur between technical and non-technical skills. However, relatively little research has focused on going changes in terms of key skills in the IS suppliers sector. The purpose of this paper is to address this gap by investigating these skills evolution in the IS suppliers domain and discusses their impacts on IS and IT curricula.

Design/methodology/approach

This paper uses a qualitative method based on 15 semi-structured face-to-face interviews, with highly dedicated operational managers in senior positions in the field.

Findings

This study identifies, for the IS suppliers, the critical skills, which are basically non-technical, and peripheral skills, which are primarily technical. It then considers the consequences of this change and the necessary adaptations it requires for businesses and training for this field.

Practical implications

The findings suggest the need to redesign the educational curricula for future managers, and the adaptations required to the work organization, human resource management and business models of firms in the field.

Originality/value

The paper’s value is twofold. First, it focuses on IS service suppliers, an understudied area (most research examines IS outsourcing from the customer’s standpoint); second, it reveals the shift away from technical toward non-technical skills in a field that is intrinsically technical – a change that may occur more slowly than in other less technical sectors – and the consequences of this change for firms, education and society.
A meta-analysis of e-health applications acceptance
Authors: Chauhan Sumedha , Jaiswal Mahadeo
Published: February 2017

Purpose

The increasing importance of electronic health (e-health) has raised the significance of exploring the factors influencing the users’ acceptance of e-health applications. There has been an extensive usage of the technology acceptance model (TAM) in e-health applications acceptance research. However, not all TAM relationships are borne out in all the studies. There is a variation in predicted effects in several studies with different user type and application type. The purpose of this paper is to bridge a research gap by providing a holistic view of the e-health applications acceptance research by integrating the findings of existing relevant literature.

Design/methodology/approach

A statistical meta-analysis of the effect size of causal relationships between common TAM constructs was conducted on 111 peer-reviewed academic studies published in various journals.

Findings

The results confirm the validity and robustness of the TAM in e-health applications acceptance research. Further, a moderator analysis based on user type and e-health application type demonstrated that the effect size of causal relationships between TAM constructs majorly depends on the user type, but not on e-health application type.

Research limitations/implications

This research provides a ready reference of the existing studies on e-health applications acceptance to the researchers. Further, if researchers or practitioners want to learn more about the particular user or application type, they may find the results valuable.

Practical implications

This research suggests that the general public can be used as the surrogates for patients in e-health applications acceptance research. The implementation strategy found successful for medical staff may not work for general public and patients. This research also suggests ways to enhance acceptance of e-health applications among different user groups.

Originality/value

The research is original and is based on the existing literature and its interpretation.
Green IT/IS investments evaluation within the aviation industry
Authors: Jongsaguan Salakjit , Ghoneim Ahmad
Published: February 2017

Purpose

The purpose of this paper is to utilize the existing theories and knowledge surrounding information systems (IS) evaluation and Green information technology (IT)/IS investments to develop a conceptual model for helping decision makers to overcome and reduce the impacts from Green IT/IS investment related to cost overruns or under-optimized budgets.

Design/methodology/approach

The paper is discursive, based on the analysis and synthesis of literature pertaining to IS evaluation, Green IT/IS adoption and Sustainable/Green/CSR within an aviation context. Gaps in the preceding research have been identified, and a conceptual model is proposed. Additionally, further research and a methodology are suggested.

Findings

The paper proposes a conceptual model that can identify factors including external factors derived from institutional theory, internal organizational factors, and a list of indirect costs associated with Green IT/IS investments for an aviation organization.

Research limitations/implications

As a conceptual paper, the study is limited to literature, identifying gaps, and proposing a model. The paper recommends further empirical validation of the proposed conceptual model.

Practical implications

The conceptual model is helpful for decision makers within the aviation industry to enhance their understanding of the identification and management of indirect costs within the aviation context, which results in effective management of Green IT/IS indirect costs.

Originality/value

The paper fills gaps in the knowledge of IS evaluation, Green IT/IS adoption/evaluation within aviation context through helping decision makers to understand, identify, and manage the associated indirect costs.
What’s so funny about marketing? Twentieth-century cartoonist portrayals of US marketing
Authors: Jorgensen Brian K.
Published: February 2017

Purpose

This purpose of this paper is to present an investigation into changes in portrayals of marketing by individuals outside of the industry during the important time frame between 1930 and 1999. The twentieth century was a period of significant development in how scholars and practitioners viewed the theory and activities of marketing.

Design/methodology/approach

The study consisted of a content analysis of 1,400 randomly selected marketing-related cartoons published in The New Yorker magazine from 1930 through 1999.

Findings

The aspects of marketing portrayed by individuals outside of the discipline, specifically cartoonists, shifted over the early/mid to later parts of the twentieth century. In particular, earlier portrayals focused primarily on retail store transactions, while later portrayals depicted an increased incidence of marketing communications taking place outside the store setting. Eventually, more portrayals also addressed the adoption of marketing ideas and vocabulary into non-marketers’ everyday lives. Overall, the proportion of portrayals that showed marketing in a negative light was low.

Originality/value

This study investigates changes in portrayals of marketing by non-marketers over a seven-decade period of significant development of marketing thought. Both the relatively long period and the outsiders’ perspective provide meaningful contributions. Also, findings do not support the perception that marketing and marketers are commonly viewed by those outside of marketing as unethical or likely to be in conflict with customers.
Immune priming specificity within and across generations reveals the range of pathogens affecting evolution of immunity in an insect
Authors: Dhinaut Julien , Chogne Manon , Moret Yannick
Published: February 2017

Many organisms can improve their immune response as a function of their immunological experience or that of their parents. This phenomenon, called immune priming, has likely evolved from repetitive challenges by the same pathogens during the host lifetime or across generation.

All pathogens may not expose host to the same probability of re‐infection, and immune priming is expected to evolve from pathogens exposing the host to the greatest probability of re‐infection. Under this hypothesis, the priming response to these pathogens should be specifically more efficient and less costly than to others.

We examined the specificity of immune priming within and across generations in the mealworm beetle, Tenebrio molitor, by comparing survival of individuals to infection with bacteria according to their own immunological experience or that of their mother with these bacteria.

We found that insects primed with Gram‐positive bacteria became highly protected against both Gram‐positive and Gram‐negative bacterial infections, mainly due to an induced persistent antibacterial response, which did not exist in insects primed with Gram‐negative bacteria. Insects primed with Gram‐positive bacteria also exhibited enhanced concentration of haemocytes, but their implication in acquired resistance was not conclusive because of the persistent antibacterial activity in the haemolymph. Offspring maternally primed with Gram‐positive and Gram‐negative bacteria exhibited similarly improved immunity, whatever the bacteria used for the infection. Such maternal protection was costly in the larval development of offspring, but this cost was lower for offspring maternally primed with Gram‐positive bacteria.

While T. molitor can develop some levels of primed response to Gram‐negative bacteria, the priming response to Gram‐positive bacteria was more efficient and less costly. We concluded that Gram‐positive bacterial pathogens were of paramount importance in the evolution of immune priming in this insect species.
Depletion of heterogeneous source species pools predicts future invasion rates
Authors: Liebhold Andrew M. , Brockerhoff Eckehard G. , Kimberley Mark
Published: February 2017

Predicting how increasing rates of global trade will result in new establishments of potentially damaging invasive species is a question of critical importance to the development of national and international policies aimed at minimizing future invasions. Centuries of historical movement and establishment of invading species may have depleted the supply of species available for future invasions, and it has been suggested that the problem of invasions will diminish as a result of this. However, the extent to which source pool depletion affects future invasions remains unclear.

Here we describe a mechanistic model that captures the simultaneous effects of depletion of source species pools along with increases in pathway rates (e.g. imports) to predict future numbers of new invasions. We assume that the distribution of species abundance within invasion pathways is positively skewed, which is modelled using a log‐normal distribution. Given their high propagule pressure, the most abundant species are likely to invade first, while the many rare species are likely to invade only under high pathway volumes. We apply this model to the case study of bark beetle, Scolytinae, invasions in the USA.

Source species pools in Europe and Asia (225 and 655 species of Scolytinae, respectively) are much larger than numbers that have historically established (16 and 32). Parameterization of the model indicates a highly skewed species abundance distribution in the pathway and this is confirmed by species frequencies in port inspection records, thus explaining why only a small fraction of species has historically invaded.

Forecasts from the model indicate that with increasing rates of imports, more species from these regions are likely to invade in the future despite the depletion of the most abundant species from source species pools. Previous statistical models tend to underestimate future establishments in the presence of increasing import rates due to their failure to account for key underlying mechanisms.

Policy implications. The mechanistic model developed here is widely applicable for predicting future invasions of all taxa and provides insights into how increases in rates of imports counteract the species pool depletion effect, resulting in the continued establishment of new species.
A New Input‐Oriented Plant Capacity Notion: Definition and Empirical Comparison
Authors: Cesaroni Giovanni , Kerstens Kristiaan , Van de Woestyne Ignace
Published: February 2017

Starting from the existing output‐oriented plant capacity measure, this paper proposes a new input‐oriented plant capacity measure. Furthermore, we empirically illustrate both input‐oriented and output‐oriented decompositions of technical efficiency integrating these technical concepts of capacity utilization. In particular, we pay attention to the impact of convexity of the technology on both input‐oriented and output‐oriented plant capacity measures.
Preparation of Chitosan‐Coated Nanostructured Lipid Carriers (CH‐NLCs) to Control Iron Delivery and Their Potential Application to Food Beverage System
Authors: Lee Sun Ah , Joung Hee Joung , Park Hyun Jin , Shin Gye Hwa
Published: February 2017

Nanostructured lipid carriers (NLCs) and chitosan‐coated NLCs (CH‐NLCs) were prepared by a combined double emulsion and melt dispersion method. The physicochemical properties of them were investigated to determine the optimum conditions. At 3% emulsifier concentration, the NLCs showed about 191.0 ± 4.1 nm mean particle size and low polydispersity index value compared to those observed under other conditions. The encapsulation efficiency of CH‐NLCs was 83.9% which was about 10% higher than that of NLCs. In vitro release test showed that low release amount of iron from the NLCs (11%) and CH‐NLCs (5%) in simulated gastric condition within 3 h, whereas the iron release amounts of the NLCs and CH‐NLCs were high (over 77%) in simulated intestinal condition because both NLCs and CH‐NLCs were totally destructed in the intestinal condition after 3 h. In the thiobarbituric acid test, the absorbance of milk‐fortified NLC and CH‐NLCs was lower than that of original milk. Based on these results, CH‐NLCs showed great potential for iron fortification in milk.
Differential sex effects of systolic blood pressure and low‐density lipoprotein cholesterol on type 2 diabetes: Life course data from the Bogalusa Heart Study
Authors: Pollock Benjamin D. , Chen Wei , Harville Emily W. , Shu Tian , Fonseca Vivian , Mauvais‐Jarvis Franck , Kelly Tanika N. , Bazzano Lydia A.
Published: February 2017

Background

There may be sex‐specific cardiometabolic mechanisms early in life that affect the development of type 2 diabetes mellitus (T2DM) through mid‐adulthood. However, few studies have examined whether early life course interactions between cardiometabolic risk factors and sex are associated with incident T2DM.

Methods

This study followed 7725 children (3834 [49.6%] females, 3891 [50.4%] males) from the Bogalusa Heart Study through mid‐adulthood to examine whether low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C), body mass index (BMI), or systolic blood pressure (SBP) differentially affect the risk of T2DM for females versus males. Potential sex interactions were tested after adjusting for age, race, triglycerides, smoking, follow‐up time, puberty stage, use of birth control, and enrollment year.

Results

Mean (± SD) age at baseline was 9.4 ± 3.5 years. There were 176 cases of T2DM (cumulative incidence = 2.3%) during a median follow‐up of 9.1 years. In females versus males, LDL‐C and SBP were differentially associated with T2DM (P ≤ 0.001 and P = 0.017, respectively). The relationships of BMI and HDL‐C with T2DM were non‐differential between females and males (P = 0.79 and P = 0.27, respectively).

Conclusions

This study is the first to show evidence of sex‐specific differential effects of LDL‐C and SBP on the risk of T2DM from childhood to adulthood. Greater LDL‐C places girls at disproportionally higher risk of T2DM as women, whereas greater SBP differentially exposes boys to a greater risk of T2DM as men. Additional studies within existing child cohorts are needed to confirm and investigate the mechanisms underlying these differential effects.
Acne necrotica (necrotizing lymphocytic folliculitis): An enigmatic and under‐recognised dermatosis
Authors: Pitney Lucy K , O'Brien Blake , Pitney Michael J
Published: February 2017

Acne necrotica is a disorder of adults of obscure aetiology, featuring repeated cropping of inflammatory papulonodules which rapidly necrotise, leaving varying degrees of superficial scarring with pathological features in early lesions of a necrotising lymphocytic folliculitis. A perceived diminishing interest in this entity in recent years prompted a prospective study of patients presenting to a dermatology practice over a 3‐year period to reassess the prevalence of this disorder in general dermatological patients, leading to the identification of 47 patients (35 female) with features of acne necrotica, with histopathology undertaken in atypical cases. We identified the importance of the recognition of primary lesions (1–2 mm umbilicated erythematous papules), often difficult to find in excoriated areas, as being paramount in the diagnosis both clinically and histologically in our study, which reveals a significantly more prevalent and clinically diverse disorder than featured in previous textbook and academic journal descriptions.
The CCL17‐CCR4 axis between endometrial stromal cells and macrophages contributes to the high levels of IL‐6 in ectopic milieu
Authors: Zhou Wen‐Jie , Hou Xin‐Xin , Wang Xiao‐Qiu , Li Da‐Jin
Published: February 2017

Endometriosis is a chronic inflammatory disease characterized by the elevation of proinflammatory cytokines, such as IL‐6, in the peritoneal fluid. However, the precise mechanism of the highly elevated IL‐6 levels in ectopic milieu remains unclear. The aim of this study was to investigate whether the cross talk between endometrial stromal cells (ESCs) and macrophages contributes to the elevated IL‐6 production. Samples of endometrium and ectopic tissues were obtained from patients with or without endometriosis. The peripheral blood samples were collected from healthy volunteers. Enzyme‐linked immunosorbent assay (ELISA) was for IL‐6 levels in peritoneal fluid and cell culture supernatant. In‐Cell Western assay was used for protein expression of CCL17 and phosphorylation levels of ERK, JNK, and P38. Immunohistochemistry was performed on normal, eutopic endometrium and ectopic tissues to analyze CCL17 expression. Flow cytometry was applied to detect the expression of CCR4, IL‐6, and the phosphorylation levels of NF‐κB. Patients with endometriosis have higher levels of IL‐6 in peritoneal fluid compared to the control. The co‐culture of ESCs and macrophages produce more IL‐6 than cultured alone, respectively. The eutopic endometrium had significantly higher expression of CCL17 compared to normal endometrium, and the ectopic tissues had the highest expression. IL‐6 induced CCL17 secretion in ESCs via activating JNK signaling pathway, CCL17 upregulated the expression of its receptor CCR4 on macrophages. Furthermore, CCL17‐CCR4 axis subsequently led to excessive IL‐6 production in macrophages by activating NF‐κB. These findings suggest that the cross talk between ESCs and macrophages promotes the expression of CCL17 in ESCs and CCR4 on macrophages, which contributes to the high levels of IL‐6 in ectopic milieu.
Oxidative stress, placental ageing‐related pathologies and adverse pregnancy outcomes
Authors: Sultana Zakia , Maiti Kaushik , Aitken John , Morris Jonathan , Dedman Lee , Smith Roger
Published: February 2017

Oxidative stress (OS), an imbalance between free radical generation and antioxidant defence, is recognized as a key factor in the pathogenesis of adverse pregnancy outcomes. Although OS is a common future of normal pregnancy, persistent, overwhelming OS leads to consumption and decline of antioxidants, affecting placental antioxidant capacity and reducing systems. The accumulation of OS causes damage to lipids, proteins and DNA in the placental tissue that induces a form of accelerated ageing. Premature ageing of the placenta is associated with placental insufficiency that prevents the organ meeting the needs of the foetus, and as a consequence, the viability of the foetus is compromised. This review summarizes the literature regarding the role of OS and premature placental ageing in the pathophysiology of pregnancy complications.
Sex steroid hormones in relation to Barrett's esophagus: an analysis of theFINBARStudy
Authors: Cook M. B. , Wood S. , Hyland P. L. , Caron P. , Drahos J. , Falk R. T. , Pfeiffer R. M. , Dawsey S. M. , Abnet C. C. , Taylor P. R. , Guillemette C. , Murray L. J. , Anderson L. A.
Published: February 2017

Previously, we observed strong positive associations between circulating concentrations of free testosterone and free dihydrotestosterone (DHT) in relation to Barrett's esophagus in aUSmale military population. To replicate these findings, we conducted a second study of sex steroid hormones and Barrett's esophagus in the Factors Influencing the Barrett/Adenocarcinoma Relationship (FINBAR) Study based in Northern Ireland and Ireland. We used mass spectrometry to quantitateEDTAplasma concentrations of nine sex steroid hormones andELISAto quantitate sex hormone‐binding globulin in 177 male Barrett's esophagus cases and 185 male general population controls within theFINBARStudy. Free testosterone, freeDHT, and free estradiol were estimated using standard formulas. Multivariable logistic regression estimated odds ratios (OR) and 95% confidence intervals (95%CI) of associations between exposures and Barrett's esophagus. While plasma hormone and sex hormone‐binding globulin concentrations were not associated with all cases of Barrett's esophagus, we did observe positive associations with estrogens in younger men (e.g. estrone + estradiolORcontinuous per ½IQR = 2.92, 95%CI:1.08, 7.89), and free androgens in men with higher waist‐to‐hip ratios (e.g. free testosteroneORcontinuous per ½IQR = 2.71, 95%CI:1.06, 6.92). Stratification by body mass index, antireflux medications, and geographic location did not materially affect the results. This study found evidence for associations between circulating sex steroid hormones and Barrett's esophagus in younger men and men with higher waist‐to‐hip ratios. Further studies are necessary to elucidate whether sex steroid hormones are consistently associated with esophageal adenocarcinogenesis.
AdVance male urethral sling: medium‐term results in an Australian cohort
Authors: Papachristos Alexander , Mann Sarah , Talbot Kay , Moon Daniel
Published: February 2017

Background

Since 2008, the AdVance male urethral sling has emerged as a minimally invasive option for stress urinary incontinence. We aimed to evaluate the success of the AdVance sling using validated continence outcome measures.

Methods

A total of 72 patients treated with the AdVance sling completed validated questionnaires reporting on quality of life and functional outcomes. Incontinence was assessed according to pad weight, pad usage per day (PPD), International Consultation on Incontinence Questionnaire scores and Patient Global Impression of Improvement scores.

Results

At a median 52‐month follow‐up, 37 (51%) patients were pad free or used a security pad; 18 (25%) used ≥50% fewer PPDs; and the remaining 17 (24%) patients were classified as ‘failed’. According to pad weights, 27 (38%) patients were dry; 32 (44%) had mild incontinence (<100 mL/day); and 13 (18%) had moderate (100–400 mL/day) or severe (>400 mL/day) incontinence. Patient satisfaction was high, with 57 (79%) very much or much better, six (8%) somewhat better and only nine (13%) unchanged or worse. There was a trend of declining continence over time, although the majority remained improved. Patients with severe preoperative incontinence performed significantly worse postoperatively (P = 0.02), as did those who had had prior pelvic radiotherapy (P = 0.02).

Conclusions

The AdVance sling offers a high rate of success for the treatment of mild to moderate post‐prostatectomy incontinence according to PPD; however, when using objective measures of continence, the success rates are lower. The improvement in urinary control is largely durable over the medium term; however, they may decline beyond 4 years. Reduced efficacy is seen in those with a history of radiotherapy and severe incontinence, although the majority of these men are still improved with surgery.
Pancreatoduodenectomy and the risk of complications from perioperative fluid administration
Authors: Gill Preetjote , Chua Terence C. , Huang Yeqian , Mehta Shreya , Mittal Anubhav , Gill Anthony J. , Samra Jaswinder S.
Published: February 2017

Background

The dogma of administering sufficient intravenous fluids aggressively to avoid under‐resuscitation has recently been challenged. Evidence suggests that excessive perioperative fluid administration may be associated with negative clinical outcomes in gastrointestinal surgery. This study examines the impact of fluid administration on perioperative outcomes in patients undergoing pancreatoduodenectomy (PD).

Methods

A retrospective analysis of 202 patients undergoing PD between January 2004 and August 2015 was performed. A cut‐off value of 10 mL/kg/h was applied (low fluid group: <10 mL/kg/h versus high fluid group: ≥10 mL/kg/h).

Results

There were 76 patients in the low fluid group and 126 patients in the high fluid group. Both groups had comparable age, American Society of Anesthesiologists score and preoperative morbidity rates. Patients in the high fluid group received significantly more total fluids, crystalloids and colloids intraoperatively (P < 0.0001, P < 0.0001 and P = 0.013, respectively) without a significant difference in estimated blood loss (P = 0.586). The net fluid balance on post‐operative day 0 was also significantly higher in the high fluid group (P < 0.0001). The mortality rate was 0% in the cohort. Major morbidity rate was 46.1% and 44.4% in low and high fluid groups, respectively (P = 0.836). Reoperation rate was 5.3% for the low fluid group and 1.6% for the high fluid group (P = 0.136). There were no significant differences between the groups for any of the individual complications.

Conclusion

This study did not identify a difference in post‐operative outcomes between the low and high fluid regime in patients undergoing PD.
Term twin birth – impact of mode of delivery on outcome
Authors: Ylilehto Elina , Palomäki Outi , Huhtala Heini , Uotila Jukka
Published: February 2017

Introduction

The main aims of this study were to compare maternal and neonatal outcomes in term twin birth according to the planned mode of delivery and to study the effects of chorionicity and inter‐twin delivery time on neonatal outcome.

Material and methods

A single‐center cohort study of 495 women with twin deliveries at ≥37+0 weeks of gestation. Term twin deliveries were divided into a trial of labor group (TOL, 69.3%) and a planned cesarean section (CS) group (30.7%). The primary outcomes were maternal and neonatal morbidity.

Results

80.8% of women attempting TOL achieved vaginal birth. In the TOL group, mothers had less bleeding [median 500 mL (range 150–2700 mL) vs. 950 mL (range 150–3500 mL), p < 0.001) and fewer surgical complications (3.2% vs. 8.6%, p = 0.011), whereas second twins more often had five‐minute Apgar scores of <7 (5.0% vs. 0%, p = 0.002) or umbilical artery pH < 7.05 (5.7% vs. 0%, p = 0.003), compared with the planned CS group. There was a slight, non‐significant tendency for more NICU admissions in the TOL group, yet the need for NICU treatment was infrequent in the whole study material. Outcomes among dichorionic (DC) second twins were similar to those in the whole material, but among monochorionic (MC) second twins there were no differences between the TOL and planned CS groups. In secondary analysis, a five‐minute Apgar score <7 occurred significantly more often in the DC group among second twins if the inter‐twin delivery time exceeded 30 min.

Conclusions

TOL is a good option for women with twin pregnancy at term, regardless of chorionicity. Active management of labor for the second twin is important, also in DC births. Maternal outcomes were more favorable with TOL and although low Apgar scores and low umbilical blood pH may be more frequent after TOL – especially with the second twin – serious neonatal morbidity is rare and does not differ from that after planned CS.
Efficacy of a morantel–abamectin combination for the treatment of resistant ascarids in foals
Authors: Wilkes EJA , McConaghy FF , Thompson RL , Dawson K , Sangster NC , Hughes KJ
Published: February 2017

Background

This study was performed to investigate the efficacy of a morantel–abamectin combination for the treatment of macrocyclic lactone (ML)‐resistant Parascaris spp. infections in foals.

Methods

Foals on five properties with a Parascaris faecal egg count (FEC) > 50 eggs per gram were used to estimate the FEC reduction (FECR) and efficacy of the anthelmintic combination.

Results & Conclusion

On all properties, resistance to ivermectin and abamectin was present and the Parascaris FECR in foals administered the morantel–abamectin combination was > 99%, indicating that this combination effectively controlled ML‐resistant parasites.
Early signal of diverted use of tropicamide eye drops in France
Authors: Ponté Camille , Pi Christian , Palmaro Aurore , Jouanjus Emilie , Lapeyre‐Mestre Maryse ,   on behalf of the French Addictovigilance Network
Published: February 2017

Aims

Tropicamide is a mydriatic drug used as eye‐drops for diagnostic or therapeutic purposes. From 2013, a diverted use by intravenous route has been suspected in Eastern Europe in opioids users. To date, no signal of misuse has been identified in France. The aims of this study were to investigate any early signals of a diverted use of tropicamide eye drops and to collect information regarding motives for the misuse and tropicamide‐induced effects.

Methods

Information was obtained at three levels: (1) at regional level (Midi‐Pyrénées area), from reimbursement data and pharmacists’ reports on suspicious requests; (2) at national level: from reimbursement data and prescriptions suggesting possible abuse from the OSIAP (Ordonnances Suspectes, Indicateur d'Abus Possible) survey; and (3) at international level: from VigiBase® reports and Web sources. Beta‐blocker eye‐drops were used as comparators.

Results

In France, in 2014–2015, 17 (0.91%, 95% CI [0.53–1.46%]) falsified prescriptions involving tropicamide were identified in the OSIAP survey (compared with 0%, 95% CI [0–0.19%] for beta‐blockers). Moreover, 37 other suspicious prescriptions were presented in 2015 (notified in 2016). In Midi‐Pyrénées, seven patients aged 35–49 were reimbursed for 19–45 vials of 10 ml, in a year. Since September 2014, the regional Addictovigilance Centre has received 91 notifications of suspicious requests to obtain tropicamide. In VigiBase®, two cases were identified but none in France. An increased interest in tropicamide‐related Internet searches was observed from Russia and Ukraine.

Conclusions

These results represent the first early warnings of a tropicamide diverted use in France. Tropicamide abusers would seek euphoria or hallucinations. The high doses involved in intravenous administration could lead to serious complications.
Prognostic significance of flow‐cytometry evaluation of minimal residual disease in children with acute myeloid leukaemia treated according to the AIEOP‐AML 2002/01 study protocol
Authors: Buldini Barbara , Rizzati Frida , Masetti Riccardo , Fagioli Franca , Menna Giuseppe , Micalizzi Concetta , Putti Maria Caterina , Rizzari Carmelo , Santoro Nicola , Zecca Marco , Disarò Silvia , Rondelli Roberto , Merli Pietro , Pigazzi Martina , Pession Andrea , Locatelli Franco , Basso Giuseppe
Published: February 2017

In children with acute myeloid leukaemia (AML), assessment of initial treatment response is an essential prognostic factor; methods more sensitive than morphology are still under evaluation. We report on the measurement of minimal residual disease (MRD), by multicolour flow‐cytometry in one centralized laboratory, in 142 children with newly diagnosed AML enrolled in the Associazione Italiana di EmatoOncologia Pediatrica‐AML 2002/01 trial. At the end of the first induction course, MRD was <0·1% in 69, 0·1–1% in 16 and >1% in 51 patients. The 8‐year disease‐free survival (DFS) of 125 children in morphological complete remission and with MRD <0·1%, 0·1–1% and ≥1% was 73·1 ± 5·6%, 37·8 ± 12·1% and 34·1 ± 8·8%, respectively (P < 0·01). MRD was also available after the second induction course in 92/142 patients. MRD was ≥0·1% at the end of the first induction course in 36 patients; 13 reached an MRD <0·1% after the second one and their DFS was 45·4 ± 16·7% vs. 22·8 ± 8·9% in patients with persisting MRD ≥0·1% (P = 0·037). Multivariate analysis demonstrated that MRD ≥0·1% after first induction course was, together with a monosomal karyotype, an independent adverse prognostic factor for DFS. Our results show that MRD detected by flow‐cytometry after induction therapy predicts outcome in patients with childhood AML and can help stratifying post‐remission treatment.
‘Appeals to nature’ in marriage equality debates: A content analysis of newspaper and social media discourse
Authors: O'Connor Cliodhna
Published: February 2017

In May 2015, Ireland held a referendum to legalize same‐sex marriage, which passed with 62% of the vote. This study explores the role played by ‘appeals to nature’ in the referendum debate. Little research has investigated how biological attributions are spontaneously generated in real‐world discourse regarding sexual rights. Through content analysis of newspaper and Twitter discussion of the referendum, this study aims to (1) establish the frequency of appeals to nature and their distribution across the various ‘sides’ of the debate and (2) analyse the forms these natural claims took and the rhetorical functions they fulfilled. Appeals to nature occurred in a minority of media discussion of the referendum (13.6% of newspaper articles and .3% of tweets). They were more prominent in material produced by anti‐marriage equality commentators. Biological attributions predominantly occurred in relation to parenthood, traditional marriage, gender, and homosexuality. The article analyses the rhetorical dynamics of these natural claims and considers the implications for marriage equality research and activism. The analysis suggests appeals to nature allow anti‐marriage equality discourse adapt to a cultural context that proscribes outright disapproval of same‐sex relationships. However, it also queries whether previous research has overemphasized the significance of biological attributions in discourse about groups’ rights.
Transient Receptor Potential Cation Channel Subfamily M Member 8 channels mediate the anti‐inflammatory effects of eucalyptol
Authors: Caceres Ana I , Liu Boyi , Jabba Sairam V , Achanta Satyanarayana , Morris John B , Jordt Sven‐Eric
Published: February 2017

Background and Purpose

Eucalyptol (1,8‐cineol), the major ingredient in the essential oil of eucalyptus leaves and other medicinal plants, has long been known for its anti‐inflammatory properties. Eucalyptol interacts with the TRP cation channels among other targets, but it is unclear which of these mediates its anti‐inflammatory effects.

Experimental Approach

Effects of eucalyptol were compared in wild‐type and TRPM8 channel‐deficient mice in two different models: footpad inflammation elicited by complete Freund's adjuvant (CFA) and pulmonary inflammation following administration of LPS. Oedema formation, behavioural inflammatory pain responses, leukocyte infiltration, enzyme activities and cytokine and chemokine levels were measured.

Key Results

In the CFA model, eucalyptol strongly attenuated oedema and mechanical allodynia and reduced levels of inflammatory cytokines (IL‐1β, TNF‐α and IL‐6), effects comparable with those of ibuprofen. In the LPS model of pulmonary inflammation, eucalyptol treatment diminished leukocyte infiltration, myeloperoxidase activity and production of TNF‐α, IL‐1β, IFN‐γ and IL‐6. Genetic deletion of TRPM8 channels abolished the anti‐inflammatory effects of eucalyptol in both models. Eucalyptol was at least sixfold more potent on human, than on mouse TRPM8 channels. A metabolite of eucalyptol, 2‐hydroxy‐1,8‐cineol, also activated human TRPM8 channels.

Conclusion and Implications

Among the pharmacological targets of eucalyptol, TRPM8 channels were essential for its anti‐inflammatory effects in mice. Human TRPM8 channels are more sensitive to eucalyptol than rodent TRPM8 channels explaining the higher potency of eucalyptol in humans. Metabolites of eucalyptol could contribute to its anti‐inflammatory effects. The development of more potent and selective TRPM8 agonists may yield novel anti‐inflammatory agents.
The technical efficiency of oral healthcare provision: Evaluating role substitution in National Health Service dental practices in England
Authors: Hill Harry , Birch Stephen , Tickle Martin , McDonald Ruth , Brocklehurst Paul
Published: February 2017

Objectives

In many countries increasing use is being made of dental care professionals (DCPs) to provide aspects of clinical activity previously undertaken by dentists. This study evaluates the differences in practice efficiency associated with the utilisation of DCPs in the provision of General Dental Services in the National Health Service (NHS) in England.

Methods

One hundred twenty‐one NHS practices completed a questionnaire and shared practice information held at the NHS Business Services Authority. Practice efficiency was estimated using data envelopment analysis with the robustness of the findings checked using Stochastic Frontier Model estimation.

Results

Dental practices operated at an estimated mean level of technical efficiency of 64%. Variations among practices in the use of DCPs were not associated with variations in practice efficiency after controlling for other staffing levels, patient population characteristics and practice variables.

Conclusions

The current NHS dental contract limits the potential for efficiency improvements by setting annual practice activity targets that produce little incentive for role substitution. Whilst DCPs may by practising efficiently, this is not reflected in practice‐level efficiency, possibly because of dentists using the time released for other non‐NHS activity.
Using environmental heterogeneity to plan for sea‐level rise
Authors: Hunter Elizabeth A. , Nibbelink Nathan P.
Published: February 2017

Environmental heterogeneity is increasingly being used to select conservation areas that will provide for future biodiversity under a variety of climate scenarios. This approach, termed conserving nature's stage (CNS), assumes environmental features respond to climate change more slowly than biological communities, but will CNS be effective if the stage were to change as rapidly as the climate? We tested the effectiveness of using CNS to select sites in salt marshes for conservation in coastal Georgia (U.S.A.), where environmental features will change rapidly as sea level rises. We calculated species diversity based on distributions of 7 bird species with a variety of niches in Georgia salt marshes. Environmental heterogeneity was assessed across six landscape gradients (e.g., elevation, salinity, and patch area). We used 2 approaches to select sites with high environmental heterogeneity: site complementarity (environmental diversity [ED]) and local environmental heterogeneity (environmental richness [ER]). Sites selected based on ER predicted present‐day species diversity better than randomly selected sites (up to an 8.1% improvement), were resilient to areal loss from SLR (1.0% average areal loss by 2050 compared with 0.9% loss of randomly selected sites), and provided habitat to a threatened species (0.63 average occupancy compared with 0.6 average occupancy of randomly selected sites). Sites selected based on ED predicted species diversity no better or worse than random and were not resilient to SLR (2.9% average areal loss by 2050). Despite the discrepancy between the 2 approaches, CNS is a viable strategy for conservation site selection in salt marshes because the ER approach was successful. It has potential for application in other coastal areas where SLR will affect environmental features, but its performance may depend on the magnitude of geological changes caused by SLR. Our results indicate that conservation planners that had heretofore excluded low‐lying coasts from CNS planning could include coastal ecosystems in regional conservation strategies.
Underrecognized clinical features of folliculotropic mycosis fungoides: a large clinical series
Authors: Baykal Can , Atci Tugba , Ozturk Sari Sule , Polat Ekinci Algun , Buyukbabani Nesimi
Published: February 2017

Background and Objective

A rare variant of mycosis fungoides (MF), folliculotropic MF (FMF) is characterized by a broad clinical spectrum that primarily includes follicle‐based lesions but also many atypical clinical manifestations. The objective of the present study was to conduct a clinical analysis of patients with FMF, with a particular focus on highlighting underrecognized dermatological features.

Patients and Methods

Overall, 27 FMF patients enrolled in our department';s MF registry, which includes 572 patients, were retrospectively reevaluated with regard to demographics, clinical features, treatment modalities, follow‐up, and outcomes.

Results

Besides the well‐known clinical features of FMF, we found lichen spinulosus‐like lesions in association with hypopigmentation (n = 3) and alopecia (n = 2), infiltrated/elevated erythematous facial plaques initially considered to be lupus tumidus (n = 2), pseudotumoral lesions clinically mimicking tumor‐stage MF (n = 1), persistent excoriations (n = 1) and erythematous facial papules mimicking rosacea (n = 1), as well as white dome‐shaped asymptomatic papules/nodules filled with mucin (on histology) (n = 2) that overlay other disease‐related lesions. Various therapeutic methods were used with variable results. Eight (29.6 %) patients had late‐stage disease.

Conclusions

Awareness of underrecognized clinical manifestations may be key to reducing delayed diagnosis of this aggressive MF variant.
Etanercept, adalimumab, and ustekinumab in psoriasis: analysis of 209 treatment series in Austria
Authors: Richter Leo , Vujic Igor , Sesti Alma , Monshi Babak , Sanlorenzo Martina , Posch Christian , Rappersberger Klemens
Published: February 2017

Background and objectives

Widely used in the treatment of psoriasis, biologics have been tested in numerous clinical trials. However, drug efficacies and adverse events (AEs) may differ in ‘real‐world’ patients as they do not undergo as rigorous selection and monitoring. Our objective was to examine drug survival, efficacy, and AEs (quality, time of onset) in ‘real‐world’ psoriasis patients treated with etanercept, adalimumab, and ustekinumab.

Patients and methods

Retrospective data analysis (Jan 1, 2004 to Jun 30, 2015) of patients treated at a psoriasis clinic in an Austrian hospital. All patients who had received at least one dose of etanercept, adalimumab, or ustekinumab were included in the analysis. We analyzed: demographics, drug survival, Psoriasis Area and Severity Index (PASI), as well as quality and time of onset of AEs.

Results

In 209 treatment series, the estimated median drug survival varied among the various treatments: 21 months (SE: 6.9) for etanercept, 61 months (SE: 9.4) for adalimumab, and 65 months (SE 1.4) for ustekinumab. Male gender and pretreatment with a biologic were positive predictors of longer drug survival in adalimumab. We found no significant difference in drug efficacy as determined by PASI.

Conclusions

Most AEs occur during the first year of treatment. Adalimumab and ustekinumab are marked by longer drug survival compared to etanercept.
Sodium‐glucose co‐transporter‐2 inhibitors and risk of adverse renal outcomes among patients with type 2 diabetes: A network and cumulative meta‐analysis of randomized controlled trials
Authors: Tang Huilin , Li Dandan , Zhang Jingjing , Li Yufeng , Wang Tiansheng , Zhai Suodi , Song Yiqing
Published: February 2017

Aim

To compare the associations of individual sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors with adverse renal outcomes in patients with type 2 diabetes mellitus (T2DM).

Methods

PubMed, EMBASE, CENTRAL and ClinicalTrials.gov were searched for studies published up to May 24, 2016, without language or date restrictions. Randomized trials that reported at least 1 renal‐related adverse outcome in patients with T2DM treated with SGLT2 inhibitors were included. Pairwise and network meta‐analyses were carried out to calculate the odds ratios (ORs) with 95% confidence intervals (CIs), and a cumulative meta‐analysis was performed to assess the robustness of evidence.

Results

In total, we extracted 1334 composite renal events among 39 741 patients from 58 trials, and 511 acute renal impairment/failure events among 36 716 patients from 53 trials. Dapagliflozin was significantly associated with a greater risk of composite renal events than placebo (OR 1.64, 95% CI 1.26‐2.13). Empagliflozin seemed to confer a lower risk than placebo (OR 0.63, 95% CI 0.54‐0.72), canagliflozin (OR 0.48, 95% CI 0.29‐0.82) and dapagliflozin (OR 0.38, 95% CI 0.28‐0.51). With regard to acute renal impairment/failure, only empagliflozin was significantly associated with a lower risk than placebo (OR 0.72, 95% CI 0.60‐0.86). The cumulative meta‐analysis indicated the robustness of our significant findings.

Conclusions

The present meta‐analysis indicated that dapagliflozin may increase the risk of adverse renal events, while empagliflozin may have a protective effect among patients with T2DM. Further data from large well‐conducted randomized controlled trials and a real‐world setting are warranted.
Targeted deletion of GD3 synthase protects against MPTP‐induced neurodegeneration
Authors: Akkhawattanangkul Y. , Maiti P. , Xue Y. , Aryal D. , Wetsel W. C. , Hamilton D. , Fowler S. C. , McDonald M. P.
Published: February 2017

Parkinson's disease is a debilitating neurodegenerative condition for which there is no cure. Converging evidence implicates gangliosides in the pathogenesis of several neurodegenerative diseases, suggesting a potential new class of therapeutic targets. We have shown that interventions that simultaneously increase the neuroprotective GM1 ganglioside and decrease the pro‐apoptotic GD3 ganglioside – such as inhibition of GD3 synthase (GD3S) or administration of sialidase – are neuroprotective in vitro and in a number of preclinical models. In this study, we investigated the effects of GD3S deletion on parkinsonism induced by 1‐methyl‐4phenyl‐1,2,3,6‐tetrahydropyridine (MPTP). MPTP was administered to GD3S−/− mice or controls using a subchronic regimen consisting of three series of low‐dose injections (11 mg/kg/day × 5 days each, 3 weeks apart), and motor function was assessed after each. The typical battery of tests used to assess parkinsonism failed to detect deficits in MPTP‐treated mice. More sensitive measures – such as the force‐plate actimeter and treadmill gait parameters – detected subtle effects of MPTP, some of which were absent in mice lacking GD3S. In wild‐type mice, MPTP destroyed 53% of the tyrosine‐hydroxylase (TH)‐positive neurons in the substantia nigra pars compacta (SNc) and reduced striatal dopamine 60.7%. In contrast, lesion size was only 22.5% in GD3S−/− mice and striatal dopamine was reduced by 37.2%. Stereological counts of Nissl‐positive SNc neurons that did not express TH suggest that neuroprotection was complete but TH expression was suppressed in some cells. These results show that inhibition of GD3S has neuroprotective properties in the MPTP model and may warrant further investigation as a therapeutic target.