bluuebunny/crossref_metadata_2025 huggingface dataset:
Technologies to support cultural tourism for Latin Latium
Authors: Bordoni Luciana
Published: August 2011

Purpose

The purpose of this paper is to show the validity of the advanced technologies of computer science and propose the outline of a technological infrastructure to promote, develop, and exploit cultural tourism, taking the territory of Latin Latium as a local system.

Design/methodology/approach

Semantic web technologies offering intelligent integration of information about the region and heritage of Latin Latium are used. The information includes all kinds of cultural heritage, from bibliographic items to industrial assets, or prehistoric excavations in this region. A cultural heritage ontology has to be designed, constructed, fed, and exploited in order to achieve this aim. A methodology for the ontology population and exploitation for other regions of Italy or even outside Italy is proposed. The network of skills and knowledge thus created, provides features of interest for other types of users, such as experts, scholars, and students, in addition to acting on the cultural tourism market.

Findings

Currently in the prototype phase, the information technology infrastructure is an added value for cultural tourism information, since it has an ontology on resources pertaining to cultural assets. This makes it possible to develop applications with specific functions for the tourist, such as the construction of “cultural paths” and the production of cultural information in addition to the global positioning system path points. The application integrated within a web site (www.laziolatino.it/) will also be used with mobile devices as 3G cell phones and handsets.

Research limitations/implications

This is a research in progress and the intention is to validate this idea in the near future through rigorous research initiatives.

Originality/value

The proposed outline of the infrastructure is a first step towards developing platforms and products whose spread will make it possible to turn to account and promote those territorial areas that, although at the margins of tourism circuits, have a strong cultural identity.
Technological aspects of public tourism communication in Italy
Authors: Baggio Rodolfo , Mottironi Cristina , Antonioli Corigliano Magda
Published: August 2011

Purpose

The purpose of this paper is to evaluate the online presence of Italian destination management organizations (DMOs) by assessing the quality of their web sites through a demand‐side heuristic approach. Moreover, given the importance of a clear strategic vision for an efficient and effective use of online media, the paper examines the alignment between tourism development plans and practical implementation of information and communication technologies (ICT). Finally, the possible impact of the adoption of a strategic approach on the overall quality of the web sites under investigation is explored.

Design/methodology/approach

A double analysis was conducted. An assessment of the main quality features of the official tourism web sites and an evaluation of the statements of public authorities concerning strategic intentions and guidelines for developing ICT instruments. The two evaluations are compared in order to examine their relationships. A strategic matrix of the technological performance and attitude of Italian regional authorities is proposed.

Findings

The quality of the Italian DMOs' web sites is satisfactory, on average. Weaknesses are found in the offer of interactive services and Web 2.0 functions. Moreover, an improvement in the user evaluations with respect to the past demonstrates the attention given to ICTs by the DMOs. As a matter of fact, the strategic plans examined deal, in general, relatively well with ICT issues, while it is also shown that poor strategic vision, as expressed in the promotional plans, is related to poor performance of some web sites.

Originality/value

The paper assesses the quality of Italian DMOs' web sites quality as perceived by visitors and, for the first time, relates the evaluations to how ICT strategic plans deal with the issue.
The indicators of intention to adopt mobile electronic tourist guides
Authors: Peres Rita , Correia Antónia , Moital Miguel
Published: August 2011

Purpose

The purpose of this paper is to understand tourists' acceptance of innovative information technologies by examining the factors influencing the intention to use mobile electronic tourist guides (METG).

Design/methodology/approach

This paper developed and tested a model for examining tourists' acceptance of METG based upon Davis' technology acceptance model (TAM). The model considered three antecedents of intention: knowledge, usefulness and attitude. The relationships between them and between these and intention were explored using structural equation modeling.

Findings

The findings revealed that tourists' behavioural intentions towards using METG could be raised through attitude by ensuring greater levels of perceived usefulness. Usefulness, in turn, is highly influenced by the tourists' level of knowledge regarding METG. In addition, there was also a direct significant path between knowledge and behavioural intention, suggesting that good levels of knowledge of the technology are a pre‐condition for greater usage of METG.

Research limitations/implications

This paper suggests that the predictive ability of the TAM in the context of innovations at their early stages of diffusion, that is, when potential adopters know little about them, can be enhanced by incorporating knowledge as an explanatory variable. Future studies could use the full version of the TAM by including other measures of knowledge beyond awareness knowledge, such as how‐to knowledge, as suggested by Rogers.

Originality/value

This paper adapts the TAM to study the acceptance of technology‐based information technologies at their early stages of development. The findings of this study contribute to enhancing our understanding of what influences tourists' acceptance of METG. They can be used to inform local and national strategies aimed at developing Portugal's (and other countries') credentials as digital destinations.
Information technology applications and competitive advantage in hotel companies
Authors: Bilgihan Anil , Okumus Fevzi , “Khal” Nusair Khaldoon , Joon‐Wuk Kwun David
Published: August 2011

Purpose

This paper aims to propose a conceptual framework that illustrates how information technology (IT) applications may lead to competitive advantage in hotel companies.

Design/methodology/approach

The paper is written based on a synthesis of previous literature in this area.

Findings

Multiple areas need to be carefully evaluated in developing and implementing IT projects so that they can lead to competitive advantage in hotel companies. There are four closely related areas when analyzing IT decisions in hotels, which include coherence between the business strategy and IT decision, types of IT applications, intended benefits of IT decisions, and decision‐making style. Technology sophistication, management skills, and integration of resources are key issues when implementing IT decisions. Investments into IT applications in hotel companies can lead to superior IT competencies and IT capabilities, which can subsequently result in lower cost, agility, innovation, added value for customers, and better customer service. However, not all IT investments may result in positive outcomes or their sustainability may be short lived. In addition, there can be a lag time between making IT investment decisions and seeing their intended outcomes.

Practical implications

There are multiple areas and issues that need to be considered in making and implementing IT investment decisions if they are to contribute to the company's competitive advantage. Hotel companies need to be selective in their IT investment decisions and look at each IT investment from the strategic management perspective.

Originality/value

This is one of the first articles in the hospitality field that offers a theoretical framework on how IT applications can lead to competitive advantage in hotels. It also offers numerous theoretical and practical implications. Therefore, this paper should help hotel executives and researchers in evaluating IT projects in hotel companies.
How SOEs succeed in privatization: net political benefits and learning in networks
Authors: Gao Zhaojun
Published: August 2011

Purpose

Drawing on population ecology and net political theory, the purpose of this paper is to examine the influence of representative institutions (net political benefits (NPB)) on the success rates of privatization adopted by state‐owned enterprises (SOEs) and their learning curve during the process.

Design/methodology/approach

The author focuses on the privatization of SOEs listed in China and employs the social network with event‐history analysis (survival analysis).

Findings

The results demonstrate that the determinants of NPB increase the success rates of privatization, while SOEs learn from two perspectives: private firms and other privatizing SOEs within the same population. In particular, I suggest that the outdegree market location network centrality before privatization, as well as the indegree centrality after privatization, both positively moderate the relationship between learning processes and the success rate of SOEs' privatization.

Practical implications

More precisely, institutions are factors that not only determine the choice of SOEs to privatization, but also the success of this strategy. The finding will encourage government administrations, both central and local, to promote the development of institutions in order to facilitate market transactions. Implications for firms might be the learning mechanisms discovered in this research. When firms adopted the strategy of privatization, they could choose two sources of learning: private firms within the same industry and others who were implementing the same strategy.

Originality/value

The contribution of the paper is, its synthesis of institutional and ecological perspectives and research on privatization in emerging markets and organization learning in networking. Theoretically, the author extends the privatization literature into a worldly context with a combination of institution and organization learning theory. Empirically, with the application of network perspective and survival analysis, the author uncovered and carefully examined the learning mechanism in the process of privatization.
Cross listing, corporate governance and corporate performance
Authors: Jian Zhou , Tingting Zhang , Shengchao Cui
Published: August 2011

Purpose

The purpose of this paper is to explore whether corporate governance is the intermediary between the cross listing strategy and corporate performance.

Design/methodology/approach

The paper first reviews the studies on cross listing and corporate governance, and then constructs the theoretical model to express the relationship between cross listing, corporate governance, and corporate performance. Then, the paper takes the regression test and mediating effects test with the companies listed in Hong Kong as the sample.

Findings

Empirical studies found that corporate governance is the intermediary between the cross listing strategy and corporate performance. Meanwhile, the study verified that cross listing strategy does enhance corporate performance.

Originality/value

The finding will help Chinese corporations choose another way to be international and practise the strategy of cross listing.
Deal of the day at Cherry.ee
Authors: Kerem Katri , Sternad Dietmar
Published: August 2011

Subject area

Marketing, branding, strategic management, online retailing, and entrepreneurship.

Study level/applicability

Postgraduate courses in: strategic management; marketing management (branding); and entrepreneurship.

Case overview

The case describes the founding and the first year of an Estonian internet start-up, the “deal-of-the-day” web site Cherry.ee. The focal topic of the case is the analysis of alternative scenarios for the further development of the company after the first year in business: selling the company, entering into a merger with similar businesses, or continuing to develop the brand independently. The case gives an example of creating a new market, introducing a new business model and launching a brand with substantial use of social media marketing. The successful business model was quickly copied by a lot of followers creating a fierce competitive environment and raising a question of sustainability of the competitive advantage. The case provides an opportunity to discuss how to strategically handle the development of a growing start-up company in an increasingly competitive market environment.

Expected learning outcomes

Understanding the critical success factors and potential pitfalls for an internet start-up; developing skills to critically analyze the concept of sustainable competitive advantage; comprehension of the main factors influencing the strategic decision on whether to follow a growth, cooperation, or exit strategy; and awareness of the relative advantages of online and offline marketing and understanding how social media strategies can be used to build a brand.

Supplementary materials

Teaching note.
TGF‐β1 content in atherosclerotic plaques, TGF‐β1 serum concentrations and incident coronary events
Authors: Herder Christian , Peeters Wouter , Zierer Astrid , de Kleijn Dominique P. V. , Moll Frans L. , Karakas Mahir , Roden Michael , Meisinger Christa , Thorand Barbara , Pasterkamp Gerard , Koenig Wolfgang
Published: August 2011

Eur J Clin Invest 2012; 42 (3): 329–337

Background  We tested the hypothesis that high TGF‐β1 content in atherosclerotic plaques and high TGF‐β1 serum levels are associated with lower risk of coronary events in two independent prospective studies.

Materials and methods  In the prospective Athero‐Express biobank study, total TGF‐β1 plaque levels were measured in 632 atherosclerotic lesions from patients who underwent carotid endarterectomy. In a population‐based case‐cohort study within the Monitoring of trends and determinants in cardiovascular disease (MONICA)/Cooperative Health Research in the Region of Augsburg (KORA) Augsburg studies, baseline total TGF‐β1 serum levels were measured in 333 individuals with and 1728 without incident coronary events.

Results  Patients with TGF‐β1 content in their plaques above the study median did not have a lower risk of coronary events than patients with lower TGF‐β1 levels [adjusted HR (95% CI) 1·46 (0·83–2·53); P = 0·16; mean follow‐up 2·6 ± 0·7 years] in the Athero‐Express biobank study. Cox proportional hazard models adjusting for age, sex, body mass index, metabolic factors, lifestyle factors and survey did not reveal a significant association between TGF‐β1 serum levels and incident coronary events [HR (95% CI) for increasing TGF‐β1 tertiles 1·0, 1·22 (0·88–1·68), 1·13 (0·82–1·57); P = 0·47; mean follow‐up: 10·8 ± 4·6 years] in the MONICA/KORA Augsburg studies.

Conclusion  Our results indicate that high TGF‐β1 content in human atherosclerotic plaques and high serum levels of TGF‐β1 are not associated with reduced risk of coronary events.
Homogenous phenomenon of graft liver CYP2C19 genotypes after living donor liver transplantation
Authors: Chiu King‐Wah , Nakano Toshiaki , Hu Tsung‐Hui , Tseng Hui‐Peng , Cheng Yu‐Fan , Jawan Bruno , Eng Hock‐Liew , Goto Shigeru , Chen Chao‐Long
Published: August 2011

Eur J Clin Invest 2012; 42 (4): 352–356

Background  The donor liver grafts with different allelic patterns do not affect CYP2C19 genotypes in the peripheral blood of living donor liver transplantation (LDLT) recipients.

Aim  This study investigated the influence of graft liver CYP2C19 genotypes on recipients who received the same or different CYP2C19 genotypes from donors after LDLT.

Methods  There were 30 donors and 30 recipients with the same CYP2C19 genotypes and 47 donors and 47 recipients with different CYP2C19 genotypes. Genomic DNA was isolated from the liver tissue of recipients. The CYP2C19 haplotypes were determined by polymerase chain reaction.

Results  A homogenous phenomenon in the sequences of graft liver CYP2C19 genotypes was indicated because the recipients showed mixed patterns that were similar to that of the original donor after LDLT. A significant decrease in homozygous extensive metabolizer (HomEM) and an increase in poor metabolizer (PM) distribution were observed in recipients with different CYP2C19 genotypes from their donors compared with recipients with the same CYP2C19 genotype as their donors (P < 0·05).

Conclusions  Homogenous phenomenon of sequence changes in graft liver CYP2C19 from the different genotypes between the donors and the recipients may play a role in graft stability by causing decreased HomEM and increased PM after LDLT.
Contemporary changes in dissolved organic carbon (DOC) in human‐dominated rivers: is there a role for DOC management?
Authors: STANLEY EMILY H. , POWERS STEPHEN M. , LOTTIG NOAH R. , BUFFAM ISHI , CRAWFORD JOHN T.
Published: August 2011

1. Dissolved organic carbon (DOC) plays a central role in the dynamics of stream and river ecosystems, affecting processes such as metabolism, the balance between autotrophy and heterotrophy, acidity, nutrient uptake and bioavailability of toxic compounds. However, despite its importance to stream processes, restoration and management activities rarely incorporate DOC as a major management criterion.

2. Lotic DOC pools reflect terrestrial organic carbon accumulation, transfer to the river channel and aquatic processing. In pristine landscapes, characteristics such as topography, climate, and landscape composition are strong predictors of terrestrial accumulation and transfer. Within aquatic systems, the quantity and form of DOC are altered by a variety of processes including primary production, microbial breakdown, sorption to particles and photodegradation.

3. Terrestrial accumulation, transfer and aquatic processing of DOC in agricultural and other human‐dominated landscapes are all subject to substantial change. Consequently, DOC pools in agricultural streams likely differ from historic conditions and now include more labile material and low concentrations of a variety of ubiquitous synthetic organic compounds (e.g. pesticides, antibiotics).

4. Although DOC change in agricultural streams and associated ecological consequences are expected to be widespread, current understanding and relevant data needed to manage affected systems are surprisingly scarce.

5. Wetland and riparian restoration projects have variable effects on fluvial DOC regimes, but management at this intermediate scale is a realistic compromise between the small extent of most restoration projects and the large spatial scale over which organic carbon impairment occurs.
Landscape controls on the timing of spring, autumn, and growing season length in mid‐Atlantic forests
Authors: Elmore Andrew J. , Guinn Steven M. , Minsley Burke J. , Richardson Andrew D.
Published: August 2011

The timing of spring leaf development, trajectories of summer leaf area, and the timing of autumn senescence have profound impacts to the water, carbon, and energy balance of ecosystems, and are likely influenced by global climate change. Limited field‐based and remote‐sensing observations have suggested complex spatial patterns related to geographic features that influence climate. However, much of this variability occurs at spatial scales that inhibit a detailed understanding of even the dominant drivers. Recognizing these limitations, we used nonlinear inverse modeling of medium‐resolution remote sensing data, organized by day of year, to explore the influence of climate‐related landscape factors on the timing of spring and autumn leaf‐area trajectories in mid‐Atlantic, USA forests. We also examined the extent to which declining summer greenness (greendown) degrades the precision and accuracy of observations of autumn offset of greenness. Of the dominant drivers of landscape phenology, elevation was the strongest, explaining up to 70% of the spatial variation in the onset of greenness. Urban land cover was second in importance, influencing spring onset and autumn offset to a distance of 32 km from large cities. Distance to tidal water also influenced phenological timing, but only within ~5 km of shorelines. Additionally, we observed that (i) growing season length unexpectedly increases with increasing elevation at elevations below 275 m; (ii) along gradients in urban land cover, timing of autumn offset has a stronger effect on growing season length than does timing of spring onset; and (iii) summer greendown introduces bias and uncertainty into observations of the autumn offset of greenness. These results demonstrate the power of medium grain analyses of landscape‐scale phenology for understanding environmental controls on growing season length, and predicting how these might be affected by climate change.
Implications of reef ecosystem change for the stability and maintenance of coral reef islands
Authors: Perry Chris T. , Kench Paul S. , Smithers Scott G. , Riegl Bernhard , Yamano Hiroya , O'Leary Michael J.
Published: August 2011

Coral reef islands are among the most vulnerable environments on Earth to climate change because they are low lying and largely constructed from unconsolidated sediments that can be readily reworked by waves and currents. These sediments derive entirely from surrounding coral reef and reef flat environments and are thus highly sensitive to ecological transitions that may modify reef community composition and productivity. How such modifications – driven by anthropogenic disturbances and on‐going and projected climatic and environmental change – will impact reef island sediment supply and geomorphic stability remains a critical but poorly resolved question. Here, we review the unique ecological–geomorphological linkages that underpin this question and, using different scenarios of environmental change for which reef sediment production responses can be projected, explore the likely resilience of different island types. In general, sand‐dominated islands are likely to be less resilient than those dominated by rubble grade material. However, because different islands typically have different dominant sediment constituents (usually either coral, benthic foraminifera or Halimeda) and because these respond differently to individual ecological disturbances, island resilience is likely to be highly variable. Islands composed of coral sands are likely to undergo major morphological change under most near‐future ecological change scenarios, while those dominated by Halimeda may be more resilient. Islands composed predominantly of benthic foraminifera (a common state through the Pacific region) are likely to exhibit varying degrees of resilience depending upon the precise combination of ecological disturbances faced. The study demonstrates the critical need for further research bridging the ecological–geomorphological divide to understand: (1) sediment production responses to different ecological and environmental change scenarios; and (2) dependant landform vulnerability.
Timing of dressing removal in the healing of surgical wounds by primary intention: quantitative systematic review protocol
Authors: Berg Almuth , Fleischer Steffen , Kuss Oliver , Unverzagt Susanne , Langer Gero
Published: August 2011

Berg A., Fleischer S., Kuss O., Unverzagt S. & Langer G. (2012) Timing of dressing removal in the healing of surgical wounds by primary intention: quantitative systematic review protocol. Journal of Advanced Nursing 68(2), 264–270.

Aim.  The purpose of this systematic review is to evaluate the efficacy of different lengths of time of postoperative dressing removal in the healing of surgical wounds by primary intention.

Background.  It is generally practiced and recommended in clinical guidelines to cover surgical incisions which are healing by primary intention postprocedure. However, the timing of dressing removal in relation to the prevention of surgical site infections has not yet been sufficiently examined.

Methods.  The systematic review and meta‐analyses will be performed according to the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Randomized controlled trials will be included. Comparisons will be made between different durations of leaving dressings in place, including not dressing the surgical site at all, and covering wounds until suture removal. Primary outcome measure is the rate of surgical site infections. Funding of the review was confirmed in March 2010.

Discussion.  The results of the review can put the timing of dressing removal for wounds which are healing by primary intention into perspective. Because of the widespread use of surgical dressings, clinical practice could be changed in various settings.
A cross‐cultural study of the concept of caring through behaviours: patients’ and nurses’ perspectives in six different EU countries
Authors: Papastavrou Evridiki , Efstathiou Georgios , Tsangari Haritini , Suhonen Riitta , Leino‐Kilpi Helena , Patiraki Elisabeth , Karlou Chryssoula , Balogh Zoltan , Palese Alvisa , Tomietto Marco , Jarosova Darja , Merkouris Anastasios
Published: August 2011

papastavrou e., efstathiou g., tsangari h., suhonen r., leino‐kilpi h., patiraki e., karlou c., balogh z., palese a., tomietto m., jarosova d. & merkouris a. (2011) A cross‐cultural study of the concept of caring through behaviours: patients’ and nurses’ perspectives in six different EU countries. Journal of Advanced Nursing 68(5), 1026–1037.

Aim.  This paper is a report of an international study of patients’ and nurses’ perceptions of nurse caring behaviours.

Background.  Current economic constraints on healthcare systems, demand to increase the quality of care and the incorporation of the consumers’ perspective into care, have created a need to develop a clear understanding of nursing behaviours which convey caring. Patients in different areas of the world report different expectations of nurses’ caring actions when compared to nurses’ views.

Method.  A descriptive comparative survey design was used to analyse a sample of surgical patients (n = 1659) and their nurses (n = 1195) in 88 wards of 34 hospitals in Cyprus, the Czech Republic, Finland, Greece, Hungary and Italy. Data were collected in autumn 2009 using the Caring Behaviours Inventory‐24. Nurses’ and patients’ responses were compared using both inferential and descriptive statistics.

Results.  Independent samples t‐tests showed important differences between nurses’ and patients’ views. Although both groups perceived knowledge and skill as being the most important sub‐scale, the nurses’ responses were higher compared to patients (P < 0·05) with important differences in the ‘assurance of human presence’ (P < 0·001) and the ‘respectful deference to others’ (P < 0·001) sub‐scales. Cross‐country comparisons showed important differences between the nurses’ (F = 24·199, P < 0·001) and patients’ views on caring (F = 26·945, P < 0·001).

Conclusions.  Important differences were observed between patient–nurse perceptions in the participating countries. The results form a foundation for future research into the development of a common international perspective about caring behaviours between patients and their nurses.
Considering virtue: public health and clinical ethics
Authors: Meagher Karen M.
Published: August 2011

As bioethicists increasingly turn their attention to the profession of public health, many candidate frameworks have been proposed, often with an eye toward articulating the values and foundational concepts that distinguish this practice from curative clinical medicine. First, I will argue that while these suggestions for a distinct ethics of public health are promising, they arise from problems within contemporary bioethics that must be taken into account. Without such cognizance of the impetus for public health ethics, we risk developing a set of ethical resources meant exclusively for public health professionals, thereby neglecting implications for curative medical ethics and the practice of bioethics more broadly. Second, I will present reasons for thinking some of the critiques of dominant contemporary bioethics can be met by a virtue ethics approach. I present a virtue ethics response to criticisms that concern (1) increased rigor in bioethics discourse; (2) the ability of normative theory to accommodate context; and (3) explicit attention to the nature of ethical conflict. I conclude that a virtue ethics approach is a viable avenue for further inquiry, one that leads us away from developing ethics of public health in a vacuum and has the potential for overcoming certain pitfalls of contemporary bioethics discourse.
TaMYB13 is a transcriptional activator of fructosyltransferase genes involved in β‐2,6‐linked fructan synthesis in wheat
Authors: Xue Gang‐Ping , Kooiker Maarten , Drenth Janneke , McIntyre C. Lynne
Published: August 2011

Fructans are soluble fructosyl‐oligosaccharides deposited in many cool‐season grass species as a carbon reserve; they are synthesised by fructosyltransferases. In wheat and barley fructans can accumulate in mature stems at a very high level and serve as an important carbon source for grain filling. Fructan synthesis in temperate cereals is regulated by sucrose level and developmental signals, and functions as a metabolic adjustment for carbon balance between carbon supply and sink demand. In this study the expression levels of a highly homologous group of Triticum aestivumMYB genes (TaMYB13‐1, TaMYB13‐2 and TaMYB13‐3) were found to be positively correlated with the mRNA levels of sucrose:sucrose 1‐fructosyltransferase (1‐SST) and sucrose:fructan 6‐fructosyltransferase (6‐SFT) in wheat stems among recombinant inbred lines with a wide range of fructan concentrations through Affymetrix array expression analysis. This expression correction extended to expression profiles during stem development. TaMYB13 contains an R2R3‐type MYB domain. In vitro random DNA‐binding site selection followed by base substitution mutagenesis revealed that TaMYB13 bound to a (A/G/T)TT(A/T/C)GGT core sequence, which was present in the promoters of wheat Ta1‐SST and Ta6‐SFT genes as well as a barley Hv6‐SFT gene. Transactivation analysis showed that TaMYB13 was a transcriptional activator and could markedly enhance the expression of 1‐SST and 6‐SFT promoter‐driven reporter genes in wheat. Elimination of TaMYB13‐binding sites in Ta6‐SFT and Ta1‐SST promoters markedly reduced TaMYB13‐mediated reporter gene transactivation. These data suggest that TaMYB13 and its orthologues are positive regulators for controlling the expression of major fructosyltransferases involved in the fructan synthetic pathway in temperate cereals.
A member of the mitogen‐activated protein 3‐kinase family is involved in the regulation of plant vacuolar glucose uptake
Authors: Wingenter Karina , Trentmann Oliver , Winschuh Irina , Hörmiller Imke I. , Heyer Arnd G. , Reinders Jörg , Schulz Alexander , Geiger Dietmar , Hedrich Rainer , Neuhaus H. Ekkehard
Published: August 2011

Vacuolar solute accumulation is an important process during plant development, growth and stress responses. Although several vacuolar carriers have been identified recently, knowledge regarding the regulation of transport is still limited. Solute accumulation may be controlled by various factors, such as alterations in carrier abundance or activity. Phosphorylation via kinases is a well‐known principle for activation or deactivation of proteins. Several phosphorylated proteins have been identified in the tonoplast proteome; however, kinases that catalyse the phosphorylation of tonoplast proteins are currently unknown. The tonoplast monosaccaride transporter from Arabidopsis (AtTMT1) and its homologue from barley have multiple phosphorylation sites in their extremely large loops. Here we demonstrate that the loop of AtTMT1 interacts with a mitogen‐activated triple kinase‐like protein kinase (VIK), that an aspartate‐rich loop domain is required for effective interaction, and that the presence of VIK stimulates glucose import into isolated vacuoles. Furthermore, the phenotype of VIK loss‐of‐function plants strikingly resembles that of plants lacking AtTMT1/2. These data suggest that VIK‐mediated phosphorylation of the AtTMT1 loop enhances carrier activity and consequently vacuolar sugar accumulation. As many phosphorylated proteins have been identified in the tonoplast, differential phosphorylation may be a general mechanism regulating vacuolar solute import.
Accuracy of immunological criteria for identifying virological failure in children on antiretroviral therapy – The IeDEA Southern Africa Collaboration
Authors: Davies Mary‐Ann , Boulle Andrew , Eley Brian , Moultrie Harry , Technau Karl , Rabie Helena , van Cutsem Gilles , Giddy Janet , Wood Robin , Egger Matthias , Keiser Olivia ,   for the International epidemiologic Databases to Evaluate AIDS Southern Africa (IeDEA‐SA) Collaboration
Published: August 2011

Objectives  To determine the diagnostic accuracy of World Health Organization (WHO) 2010 and 2006 as well as United States Department of Health and Human Services (DHHS) 2008 definitions of immunological failure for identifying virological failure (VF) in children on antiretroviral therapy (ART).

Methods  Analysis of data from children (<16 years at ART initiation) at South African ART sites at which CD4 count/per cent and HIV‐RNA monitoring are performed 6‐monthly. Incomplete virological suppression (IVS) was defined as failure to achieve ≥1 HIV‐RNA ≤400 copies/ml between 6 and 15 months on ART and viral rebound (VR) as confirmed HIV‐RNA ≥5000 copies/ml in a child on ART for ≥18 months who had achieved suppression during the first year on treatment.

Results  Among 3115 children [median (interquartile range) age 48 (20–84) months at ART initiation] on treatment for ≥1 year, sensitivity of immunological criteria for IVS was 10%, 6% and 26% for WHO 2006, WHO 2010 and DHHS 2008 criteria, respectively. The corresponding positive predictive values (PPV) were 31%, 20% and 20%. Diagnostic accuracy for VR was determined in 2513 children with ≥18 months of follow‐up and virological suppression during the first year on ART with sensitivity of 5% (WHO 2006/2010) and 27% (DHHS 2008). PPV results were 42% (WHO 2010), 43% (WHO 2006) and 20% (DHHS 2008).

Conclusion  Current immunological criteria are unable to correctly identify children failing ART virologically. Improved access to viral load testing is needed to reliably identify VF in children.
Prioritizing research needs based on a systematic evidence review: a pilot process for engaging stakeholders
Authors: Gold Rachel , Whitlock Evelyn P. , Patnode Carrie D. , McGinnis Paul S. , Buckley David I. , Morris Cynthia
Published: August 2011

Background/context  Systematic evidence reviews (SERs) identify knowledge gaps in the literature, a logical starting place for prioritizing future research. Varied methods have been used to elicit diverse stakeholders’ input in such prioritization.

Objective  To pilot a simple, easily replicable process for simultaneously soliciting consumer, clinician and researcher input in the identification of research priorities, based on the results of the 2009 SER on screening adults for depression in primary care.

Methods  We recruited 20 clinicians, clinic staff, researchers and patient advocates to participate in a half‐day event in October 2009. We presented SER research methods and the results of the 2009 SER. Participants took part in focus groups, organized by profession; broad themes from these groups were then prioritized in a formal exercise. The focus group content was also subsequently analysed for specific themes.

Results  Focus group themes generally reacted to the evidence presented; few were articulated as research questions. Themes included the need for resources to respond to positive depression screens, the impact of depression screening on delivery systems, concerns that screening tools do not address comorbid or situational causes of depression and a perceived ‘disconnect’ between screening and treatment. The two highest‐priority themes were the system effects of screening for depression and whether depression screening effectively leads to improved treatment.

Conclusion  We successfully piloted a simple, half‐day, easily replicable multi‐stakeholder engagement process based on the results of a recent SER. We recommend a number of potential improvements in future endeavours to replicate this process.
Successful cord blood transplantation with reduced‐intensity conditioning for childhood cerebral X‐linked adrenoleukodystrophy at advanced and early stages
Authors: Niizuma Hidetaka , Uematsu Mitsugu , Sakamoto Osamu , Uchiyama Toru , Horino Satoshi , Onuma Masaei , Matsuhashi Tetsuro , Rikiishi Takeshi , Sasahara Yoji , Minegishi Masayoshi , Tsuchiya Shigeru
Published: August 2011

Niizuma H, Uematsu M, Sakamoto O, Uchiyama T, Horino S, Onuma M, Matsuhashi T, Rikiishi T, Sasahara Y, Minegishi M, Tsuchiya S. Successful cord blood transplantation with reduced‐intensity conditioning for childhood cerebral X‐linked adrenoleukodystrophy at advanced and early stages.  Pediatr Transplantation 2012: 16: E63–E67. © 2011 John Wiley & Sons A/S.

Abstract:  Childhood cerebral ALD is a rapidly progressive and neurodegenerative disorder for which HSCT is the curative therapy if carried out at early stages. We successfully treated two patients of childhood cerebral ALD by CBT with RIC. The proband was a seven‐yr‐old boy whose brain MRI severity score (Loes score) was 14.5. Unrelated CBT was performed in five wk. To minimize conditioning regimen‐related neurotoxicity, the combination of fludarabine (125 mg/m2), melphalan (140 mg/m2), and 4 Gy of brain‐sparing TBI was used. The second patient was a six‐yr‐old brother of the proband. Four wk after the detection of a single small lesion (Loes score 1), he received unrelated CBT with the same RIC as the proband. In both patients, the engraftment was fast and stable, and severe complications were not observed. Furthermore, gadolinium‐enhanced inflammation on brain MRI rapidly disappeared after CBT. Now, 20 and 13 months have passed after CBT, respectively, and both patients are neurologically stable. The RIC we used was sufficient for stable engraftment of cord blood and also tolerable even to the patient with advanced ALD. RIC‐CBT should be considered for the patients with cerebral ALD at advanced stages, as well as those at early stages.
Unusual shunt for symptomatic portal vein thrombosis after liver transplantation – Clatworthy revisited
Authors: Mali V. P. , Robless P. A. , Aw M. , Loh D. L. , Quak S. H. , Prabhakaran K.
Published: August 2011

Mali VP, Robless PA, Aw M, Loh DL, Quak SH, Prabhakaran K. Unusual shunt for symptomatic portal vein thrombosis after liver transplantation – Clatworthy revisited.

Abstract:  PV thrombosis is not an uncommon occurrence following pediatric LT. Symptomatic PHT following PV thrombosis is treated medically, surgical portosystemic shunting (mesorex, splenorenal, and mesocaval) being reserved for refractory cases. A 10‐yr‐old boy suffered recurrent malena and hemorrhagic shock because of chronic PV thrombosis following LT nine yr ago (1999). Extensive work‐up failed to localize the bleeding source. The liver function remained normal. Initial attempts at surgical shunts failed owing to thrombosis (mesocaval 2001, splenorenal, inferior mesenteric‐left renal vein, splenic‐left external iliac vein 2008). In this situation, we performed a Clatworthy shunt by anastomosing the divided lower end of the LCIV to the side of SMV. There was a single, large caliber anastomosis. Post‐operatively, the malena stopped completely, and clinically, there was no lower limb edema or encephalopathy. Doppler USG revealed persistence of hepatopetal flow within the portal collaterals. Follow‐up at two yr reveals stable hepatic function with a patent shunt. To the best of our knowledge, we are not aware of a Clatworthy shunt being performed in a transplant setting. We reviewed the literature pertaining to this shunt in non‐transplant patients with PHT.
The purine‐rich DNA‐binding protein OsPurα participates in the regulation of the rice sucrose synthase 1 gene expression
Authors: Chang Jui‐Che , Liao Yi‐Chun , Yang Chien‐Chih , Wang Ai‐Yu
Published: August 2011

The rice sucrose synthase 1 (RSus1) gene is transcriptionally induced by sucrose, and a region within its promoter, at −1117 to −958 upstream of the transcription initiation site, was found to be essential for enhancing the sucrose‐induced expression. Further dissection of this region revealed that a group of nuclear proteins interact with a 39‐bp fragment named A‐3‐2 (−1045 to −1007). A protein that specifically and directly interacted with A‐3‐2 was isolated from the suspension‐cultured cells of rice and was subsequently identified as a purine‐rich DNA‐binding protein. The amino acid sequence of this protein, OsPurα, exhibited 73% identity with the Arabidopsis Purα‐1 protein, and its modeled structure resembled the structure of Pur‐α in Drosophila. Recombinant OsPurα expressed and purified from Escherichia coli was demonstrated to have DNA‐binding activity and to interact with A‐3‐2 specifically. Moreover, OsPurα was able to enhance sucrose‐induced expression of the β‐glucuronidase (GUS) reporter gene, which was transcriptionally fused to two copies of a DNA fragment containing A‐3‐2 and the cauliflower mosaic virus 35S minimal promoter, in vivo. The level of OsPurα bound to A‐3‐2 was higher in cells cultured in the presence of sucrose; however, the level of OsPurα mRNA in cells was not affected by sucrose. The results of this study demonstrate that OsPurα participates in the regulation of RSus1 expression in response to sucrose; nevertheless, it may require other partner proteins for full function.
Recent issues in contrast‐induced nephropathy
Authors: Kitajima Kazuhiro , Maeda Tetsuo , Watanabe Sanae , Sugimura Kazuro
Published: August 2011

Contrast‐induced nephropathy (CIN) is a serious complication resulting from the use of iodinated contrast medium (CM) with potentially high morbidity and mortality. Patients with pre‐existing renal insufficiency appear to be at higher risk of CIN. To prevent CIN among patients undergoing contrast‐enhanced computed tomography, every effort is required, including routine identification of at‐risk patients, the use of appropriate hydration regimens, withdrawal of nephrotoxic drugs, selection of low‐osmolality CM or iso‐osmolar CM, and using the minimum volume of CM possible.
Ureterosciatic hernia successfully treated by ureteral stent placement
Authors: Sugimoto Masaaki , Iwai Hidenori , Kobayashi Takeshi , Morokuma Futoshi , Kanou Takehiro , Tokuda Noriaki
Published: August 2011

A 76‐year‐old woman with history of cholecystectomy, hysterectomy, and vesicourethral suspension presented with acute lumbar backache and discomfort in the lower abdomen and severe nausea, with frequent vomiting, but without any associated fever. Physical examination revealed knocking tenderness at the left costal–vertebral angle. The patient's serum white blood cell count was 14 900 /mm3 and the results of other laboratory tests, including urinalysis, were normal. Non‐enhanced computed tomography revealed left hydroureteronephrosis and obstruction of the distal left ureter with herniation into the sciatic foramen. A left ureteral stent was inserted with a double‐J stent. The stent was removed after 2 months and thereafter the patient did not experience any recurrence.
The economic and clinical benefits of adequate insulin initiation and intensification in people with type 2 diabetes mellitus
Authors: Asche C. V. , Bode B. , Busk A. K. , Nair S. R.
Published: August 2011

Aim: To study the clinical and economic benefits associated with adequate and early initiation and intensification of insulin in people with type 2 diabetes mellitus (T2DM).

Methods: A systematic review was performed using published articles from January 2000 to August 2010 that linked intervention, disease, study design and outcomes. Studies were further classified as initiation and intensification based on predefined criteria. Individual studies in systematic reviews and meta‐analysis were searched and included if relevant.

Results: A total of 2690 articles were screened with 76 (40 initiation and 36 intensification) studies included. Most initiation studies had mean baseline HbA1c values of >8.5%. The endpoint HbA1c values were reduced with insulin treatment in these studies, with endpoint values ranging from 6.6 to 9.8%. Similar results were seen with the intensification studies (endpoint HbA1c: 6.4–9.6%). Addition of insulin to oral antidiabetics (OADs) resulted in better glycaemic control in most studies. Blood glucose levels reduced substantially with OADs + insulin compared with OADs alone. Quality of life outcomes and treatment satisfaction were reported in six studies and not significantly different for insulin vs. OADs. Hypoglycaemic events were manageable with insulin initiation. However, all insulin types were associated with weight gain although the comparison with OADs elicited varying results.

Conclusions: Proactive management with early insulin initiation and intensification should be considered in people with T2DM in inadequate glycaemic control. The economic benefits with early initiation and intensification have to be fully explored.
Oestrogen alters adipocyte biology and protects female mice from adipocyte inflammation and insulin resistance
Authors: Stubbins R. E. , Najjar K. , Holcomb V. B. , Hong J. , Núñez N. P.
Published: August 2011

Aims: Obesity is associated with insulin resistance, liver steatosis and low‐grade inflammation. The role of oestrogen in sex differences in the above co‐morbidities is not fully understood. Our aim was to assess the role oestrogen has in modulating adipocyte size, adipose tissue oxidative stress, inflammation, insulin resistance and liver steatosis.

Methods: To determine the role oestrogen has in the above co‐morbidities related to obesity, we randomized C57BL/6J mice into four groups (15 mice per group): (i) male, (ii) non‐ovariectomized female (novx), (iii) ovariectomized female (ovx) and (iv) ovariectomized female mice supplemented with 17β estradiol (ovx‐E). Mice received either a low‐fat (LF) or a high‐fat (HF) diet for 10 weeks. Outcomes measured were bodyweight, body fat, adipocyte diameter, adipose tissue lipolysis markers, adipose tissue oxidative stress, inflammation, insulin resistance and liver steatosis.

Results: Male and ovx‐female mice consuming the HF diet had a higher propensity of gaining weight, specifically in the form of body fat. Oestrogen protected female mice from adipocyte hypertrophy and from developing adipose tissue oxidative stress and inflammation. Moreover, novx‐female and ovx‐female+E mice had higher phosphorylated levels of protein kinase A and hormone sensitive lipase, markers associated with lipolysis. Additionally, male and ovx female mice had a higher propensity of developing liver steatosis and insulin resistance. In contrast, oestrogen protected female mice from developing liver steatosis and from becoming insulin resistant.

Conclusion: We show that oestrogen protects female mice from adipocyte hypertrophy and adipose tissue oxidative stress and inflammation. Furthermore, oestrogen prevented female mice from developing liver steatosis and from becoming insulin resistant.