bluuebunny/crossref_metadata_2025 huggingface dataset:
Hybrid lesson study: extending lesson study on-line
Authors: D. Nickerson Susan , Fredenberg Michael , Kinsella Druken Bridget
Published: May 2014

Purpose

– Lesson study in the USA provides a space for teachers to discuss classroom teaching with a goal of improving student learning. In general, US teachers’ professional lives are constrained by a lack of time for planning and observation. Within a lesson study context, we designed and utilized a web site to support and extend collaboration among teachers of mathematics at 26 school sites across two school districts. The purpose of this paper is to describe the lesson study context and share results of the investigation and affordances of the web site.

Design/methodology/approach

– Through the use of a survey, discourse analysis, and grounded theory, we examined how teachers used the web site and how best to foster regular and inclusive participation.

Findings

– The results reveal the web site spans time and distance. A significant percentage of the teachers used the web site for accessing resources, while a smaller fraction of teachers used the web site to discuss pedagogy and students’ mathematical thinking.

Originality/value

– The work expands the descriptive knowledge base of lesson study efforts in the US with the hybrid lesson study model that addresses the time constraints of US teachers. Also, the work addresses the challenge of geographical distance associated with facilitating communication among teachers from multiple sites.
Learning to learn from teaching: a first-hand account of lesson study in Japan
Authors: A. Ermeling Bradley , Graff-Ermeling Genevieve
Published: May 2014

Purpose

– Over the last 15 years, Japanese lesson study has attracted growing interest as an alternative to conventional teacher professional development. Despite its popularity and results, the descriptive knowledge base of authentic lesson study in Japan is still limited to a few cases from elementary math and science teachers. The purpose of this paper is to contribute to the expansion of the lesson study descriptive knowledge base by offering a first-hand account of two American educators’ experience with lesson study at the secondary level while working as licensed teachers in a Japanese school.

Design/methodology/approach

– Using an autoethnographic case study methodology, the authors document their personal experience working through a complete lesson study cycle with a ninth grade English course in Japan, systematically reconstructed from field texts and deliberate co-construction techniques.

Findings

– The paper describes significant cognitive and socio-cultural adjustments that were required to participate in the process, and highlights essential skills and mindsets for lesson study: fashioning a coherent lesson storyline, articulating and testing working hypotheses, relying on evidence to guide planning and reflection, embracing collective ownership of improvement, and persisting with problems over time.

Originality/value

– This first-hand account provides a distinctive inside look at lesson study from an American perspective and offers a rare description of Japan-based lesson study at the secondary level. The detailed records and insights contribute to researchers and practitioners emerging understanding of prerequisite skills for lesson study.
It pays to be happy (if you are a man)
Authors: Mishra Vinod , Smyth Russell
Published: May 2014

Purpose

– The purpose of this paper is to use cross-sectional data collected from six cities in China to examine the relationship between subjective wellbeing and male and female earnings and also to consider the contribution of differences in subjective wellbeing to explaining the gender wage gap.

Design/methodology/approach

– The paper uses survey data for 3,390 respondents working in a variety of blue collar and white collar jobs across a range of sectors including government, heavy and light manufacturing, mining and services in six Chinese cities: Chengdu, Dalian, Fushun, Fuxin, Fuzhou and Wuhan. The authors employ the ordinary least squares, Lewbel instrumental variable and Blinder-Oaxaca decomposition to econometrically analyze the relationship between subjective wellbeing and gender wage gap.

Findings

– The paper finds that the relationship between subjective wellbeing and wages is stronger for males than females. The authors note that 0.2 percent of the observed gender wage gap can be attributed to differences in mean subjective wellbeing in favor of females, while 53.5 percent can be ascribed to gender differences in returns to subjective wellbeing in favor of males. The paper also finds evidence that the relationship between subjective wellbeing and income is non-linear and that income peaks at higher levels of subjective wellbeing for men than women.

Originality/value

– The paper extends the existing literature in three important ways. First, the authors use a novel identification strategy, proposed by Lewbel (2012); second it uses a better measure for subjective wellbeing and third, it examine the role of differences in subjective wellbeing in explaining the gender wage gap.
National culture and inter-tier price competition
Authors: Sivakumar K.
Published: May 2014

Purpose

– This research aims to examine the role of national culture dimensions in the nature of tier competition between high-tier brands and low-tier brands.

Design/methodology/approach

– It starts with a conceptual framework based on prospect theory to explain the asymmetric inter-tier competition. It then describes how the national culture dimensions influence the implications of prospect theory and as a result, the nature of inter-tier competition. The paper uses Hofstede's framework to operationalize national culture and derives a number of research propositions that explicate the role of national culture in inter-tier price competition.

Findings

– The study finds that the extent of asymmetry favouring high-tier brands over low-tier brands depends on the national culture dimensions. Whereas high levels of individualism, power distance, uncertainty avoidance, and masculinity increase the asymmetry favouring high-tier brands, higher long-term orientation decreases asymmetric price competition favouring high-tier brands.

Practical implications

– The findings offer important guidelines for understanding the nature of inter-tier price competition as a function of national culture.

Originality/value

– This is the first study to extend inter-tier price competition in the global setting and also the first study that links national culture with prospect theory to examine the boundary conditions of inter-tier price competition.
Ethical consumers' brand avoidance
Authors: Rindell Anne , Strandvik Tore , Wilén Kristoffer
Published: May 2014

Purpose

– The purpose of this paper is to explore ethical consumers' brand avoidance. The study contributes to brand-avoidance research by exploring what role consumers' ethical concerns play in their brand avoidance.

Design/methodology/approach

– A qualitative approach is adopted by interviewing 15 active members of organizations that represent ethical concerns for the well-being of animals, the environment and humans.

Findings

– The study indicates that consumers with a strong value-based perspective on consumption (such as ethical consumers) may reject brands in two different but interrelated ways. In essence, the study reveals characteristics of brand avoidance that have not been discussed in earlier research, in terms of two dimensions: persistency (persistent vs temporary) and explicitness (explicit vs latent).

Practical implications

– The study shows the importance of considering the phenomenon of brand avoidance, as it may reveal fundamental challenges in the market. These challenges may relate to consumer values that have not been regarded as important or that have been thought of as relating only to a specific group of consumers.

Originality/value

– The ethical consumers' views represent new insights into understanding brand avoidance.
Young people as company stakeholders? Moving beyond CSR…
Authors: de La Ville Valérie-Inés
Published: May 2014

Purpose

– The case of corporations establishing a relationship with young people – because of the moral responsibility involved – allows us to illustrate the complexities of trying to decide what is morally correct to collectively ensure children's well-being. This paper aims to discuss these issues.

Design/methodology/approach

– Applying the “stakeholder theory” to child industries – under which term this paper includes all business activities that establish a commercial relationship involving children, either as the recipient or user of the final product or beneficiary of a specific service, or as a co-decision-maker for purchases within his/her family or social circles – reveals a series of conceptual challenges...

Findings

– The limited understanding of stakeholder theory within the CSR managerial perspective leads companies to overlook some important moral issues about children's well-being, and exposes them to particularly hard criticisms of their actions and marketing policies.

Research limitations/implications

– If children have been overlooked by the stakeholder theory, how may the interests of youth be represented in a stakeholder perspective?

Practical implications

– To deal with some of the dilemmas entailed by considering children's representatives as legitimate spokespersons, the paper suggests drawing on the ethics of care to attempt delineating a corporate social responsibility towards young people.

Originality/value

– This paper emphasises a number of issues relevant to young consumers, including the absence of children in stakeholder theory and how that absence speaks to the presumed extent and boundaries of corporate social responsibility.
Routine labour epidural analgesia versus labour analgesia on request: a randomised non‐inferiority trial
Authors: Wassen MMLH , Smits LJM , Scheepers HCJ , Marcus MAE , Van Neer J , Nijhuis JG , Roumen FJME
Published: May 2014

Objective

To assess the effect on mode of delivery of the routine use of labour epidural analgesia (EA) compared with analgesia on request.

Design

Randomised non‐inferiority trial.

Setting

One university and one non‐university teaching hospital in The Netherlands.

Population

Women with a singleton pregnancy in cephalic presentation beyond 36 + 0 weeks' gestation.

Methods

Participants were randomly allocated to receive either routine EA or analgesia on request. Intention‐to‐treat (ITT) and per‐protocol (PP) analyses were performed, with confidence intervals (CI) calculated for the differences in percentages or means.

Main outcome measures

Rate of operative delivery (instrumental vaginal or caesarean), labour characteristics, and adverse labour and neonatal outcomes.

Results

A total of 488 women were randomly allocated to the routine EA (n = 233) or analgesia on request group (n = 255). In the routine EA group, 89.3% (208/233) received EA. According to ITT analysis, 34.8% (81/233) women in the routine EA group had an operative delivery, compared with 26.7% (68/255) in the analgesia on request group (difference 8.1%, 95% CI −0.1 to 16.3). The difference in rate of operative deliveries according to the PP analysis was statistically significant (difference 8.9%, 95% CI 0.4 to 17.4). Inferiority of EA could not be rejected, as in both analyses the upper bound of the confidence interval exceeded the pre‐specified inferiority criterion of +10%. Women in the routine EA group had more adverse effects, including hypotension (difference 9.5%, 95% CI 4.2 to 14.9), and motor blockade (difference 6.8%, 95% CI 1.1 to 12.5).

Conclusion

Non‐inferiority of routine EA could not be demonstrated in this trial. Routine EA use is likely to lead to more operative deliveries and more maternal adverse effects. The results of our study do not justify routine use of EA.
Touching from a Distance: The Younger Generation of One Nation Conservatives and Thatcherism
Authors: Evans Stephen
Published: May 2014

It is argued here that the younger generation of One Nation Conservatives made a concerted effort to conform to the requirements of the free market agenda of the Thatcher governments during the 1980s. This served to distinguish them from the older generation of wets who had preceded them in the cabinet and who had been more inclined to engage in coded criticism of that agenda. The younger One Nation Conservatives knew that they had to conform if they wanted to hold office and the problems which Britain faced gave them a structural, as well as a personal, motive for conformity. Their willingness to conform made them important members of the second and third Thatcher governments. They provided a renewed radical impetus to government policy in the mid and late 1980s, which culminated in the introduction of the community charge or poll tax, and they possessed the communication skills needed to promote those policies in public. The efforts which the younger generation of One Nation Conservatives made to conform in the sphere of domestic economic policy were undone, after Thatcher had been replaced by Major in November 1990, by the issue on which they retained their distinctiveness: Europe. Their continued expression of pro‐European views became a problem for them after Thatcher had recoiled from the prospect of economic and monetary union in the late 1980s, because it proved to those on the right of the Conservative Party that they were not really ‘one of us’ at all.
The effect of intra‐operative passive movement therapy on non‐surgical site pain after breast reconstructive surgery: a preliminary study
Authors: Bidd H. , Dulai R. , Edelman N. , Giles J. , Patel C.
Published: May 2014

Pain distant to an operative site is under‐reported but sometimes more severe than pain from the surgical site. Intra‐operative passive movement could possibly reduce this pain. This preliminary study was designed to assess the practicalities of conducting a randomised controlled trial of this therapy in anaesthetised patients. The study design was pragmatic. Forty‐two patients undergoing breast reconstruction were randomly assigned to receive either intra‐operative passive movement or standard care. Twenty‐four hours after surgery, median (IQR [range]) morphine consumption was 33 (11–42 [0–176]) mg in the passive movement group compared with 74 (15–118 [0–238]) mg with standard care (p = 0.126), while participants reported median (IQR [range]) visual analogue scores in areas distant from the surgical site of 0 (0–4 [0–34]) mm in the passive movement group compared with 10 (2–30 [0–57]) mm in those receiving standard care (p = 0.002). A full trial of intra‐operative passive movement therapy to reduce postoperative is feasible and warranted.
Environmental and genetic risk factors for retinal angiomatous proliferation
Authors: Caramoy Albert , Ristau Tina , Lechanteur Yara T. , Ersoy Lebriz , Müller Sebastian , Gelisken Faik , Hoyng Carel B. , Kirchhof Bernd , den Hollander Anneke I. , Fauser Sascha
Published: May 2014

Purpose

To identify genetic and environmental risk factors in patients with retinal angiomatous proliferation (RAP), a clinical subtype of age‐related macular degeneration (AMD).

Methods

In this case–control study, 108 AMD cases with RAP, 258 AMD patients with choroidal neovascularization (CNV) without RAP and 443 healthy controls were evaluated. Single nucleotide polymorphisms in age‐related maculopathy susceptibility 2 (ARMS2) and complement factor H (CFH) and various environmental risk factors were analysed. Statistical analysis was performed by univariate and multivariate regression analysis.

Results

High age, female sex and genetic variants in CFH and ARMS2 were identified as risk factors for developing any CNV. In RAP patients, arterial hypertension was also identified as a risk factor (OR 2.39; p = 0.0005). Compared with the ‘non‐RAP’ CNV group, the association with high age (OR 1.05; p = 0.008) and arterial hypertension (OR 1.82; p = 0.02) was significantly higher in RAP patients, while the association with CFH risk alleles (homozygous OR 0.40; p = 0.003) was significantly lower, which was confirmed in a multivariate analysis (OR 0.41; p = 0.03 for the heterozygous risk allele and OR 0.38; p = 0.03 for the homozygous risk allele).

Conclusion

The association with the CFH Y402 risk allele was less pronounced in RAP patients than in ‘non‐RAP’ CNV patients, while the association with high age and arterial hypertension appeared to be stronger. These findings stress the importance of detailed phenotyping in AMD to identify homogeneous AMD subtypes and their different risk factors and disease mechanisms.
Systematic review with meta‐analysis: the effects of rifaximin in hepatic encephalopathy
Authors: Kimer N. , Krag A. , Møller S. , Bendtsen F. , Gluud L. L.
Published: May 2014

Background

Rifaximin is recommended for prevention of hepatic encephalopathy (HE). The effects of rifaximin on overt and minimal HE are debated.

Aim

To perform a systematic review and meta‐analysis of randomised controlled trials (RCTs) on rifaximin for HE.

Methods

We performed electronic and manual searches, gathered information from the U.S. Food and Drug Administration Home Page, and obtained unpublished information on trial design and outcome measures from authors and pharmaceutical companies. Meta‐analyses were performed and results presented as risk ratios (RR) with 95% confidence intervals (CI) and the number needed to treat. Subgroup, sensitivity, regression and sequential analyses were performed to evaluate the risk of bias and sources of heterogeneity.

Results

We included 19 RCTs with 1370 patients. Outcomes were recalculated based on unpublished information of 11 trials. Overall, rifaximin had a beneficial effect on secondary prevention of HE (RR: 1.32; 95% CI 1.06–1.65), but not in a sensitivity analysis on rifaximin after TIPSS (RR: 1.27; 95% CI 1.00–1.53). Rifaximin increased the proportion of patients who recovered from HE (RR: 0.59; 95% CI: 0.46–0.76) and reduced mortality (RR: 0.68, 95% CI 0.48–0.97). The results were robust to adjustments for bias control. No small study effects were identified. The sequential analyses only confirmed the results of the analysis on HE recovery.

Conclusions

Rifaximin has a beneficial effect on hepatic encephalopathy and may reduce mortality. The combined evidence suggests that rifaximin may be considered in the evidence‐based management of hepatic encephalopathy.
The Role of Dedicated Innovation Functions for Innovation Process Control and Performance – An Empirical Study among Hospitals
Authors: Labitzke Giso , Svoboda Sven , Schultz Carsten
Published: May 2014

As health care systems evolve, innovation is becoming a key driver of performance in the hospital sector. However, innovation management has been adopted only sporadically in hospitals, and dedicated innovation functions remain in the developmental stage. Using control theory, this study develops a theoretical framework that links control mechanisms (proactiveness, innovation process formalization) and a dedicated innovation function to innovation activity and innovation performance. For the empirical analysis, data were collected from a survey of 158 German hospitals, with information provided by general hospital management. We apply a structural equation model and control for hospital characteristics such as hospital size and ownership (public/non‐profit/private). The empirical results show positive effects of formal and informal control mechanisms on innovation performance and a positive effect of informal controls on innovation activity. Moreover, a dedicated innovation function is found to positively affect innovation activity and both formal and informal control mechanisms. Based on our findings, we argue that hospital management might devote greater attention to control mechanisms to increase innovation activity and performance. Furthermore, hospital management might consider the creation and empowerment of a dedicated innovation function to take advantage of the positive effects of such a function on informal and formal controls as well as on innovation activity.
Innovations in Practice: DISCOVER CBT workshops for 16–18‐year‐olds: development of an open‐access intervention for anxiety and depression in inner‐city youth
Authors: Sclare Irene , Michelson Daniel , Malpass Liz , Coster Fay , Brown June
Published: May 2014

Background

Anxiety and depression are common in adolescence but access to effective intervention is limited.

Method

Open‐access CBT workshops were developed in consultation with 16–18‐year‐olds. Rates of uptake, pre‐post outcomes and acceptability of workshops were assessed in an uncontrolled study.

Results

Participants (N = 31) were predominantly from black and minority ethnic groups and three quarters had not previously sought psychological support. Improvements were observed in self‐reported anxiety, depression and self‐esteem at 12‐week follow‐up. High levels of satisfaction were reported along with suggestions for further programme development.

Conclusions

Community‐based CBT workshops show promise in terms of accessibility and acceptability for older adolescents who may not otherwise engage in mental health services.
Isothiazolinones in commercial products at Danish workplaces
Authors: Friis Ulrik Fischer , Menné Torkil , Flyvholm Mari‐Ann , Bonde Jens Peter Ellekilde , Lepoittevin Jean‐Pierre , Le Coz Christophe J. , Johansen Jeanne Duus
Published: May 2014

Background

In recent years, a steep increase in the frequency of occupational contact allergy to isothiazolinones has been reported from several European countries.

Objective

To examine the extent and occurrence of isothiazolinones in different types of product at Danish workplaces.

Methods

Seven different isothiazolinones were identified in the Dictionary of Contact Allergens: Chemical Structures, Sources, and References from Kanerva's Occupational Dermatitis. By use of the chemical names and Chemical Abstracts Service numbers for these chemicals, information on products registered in the Danish Product Register Database (PROBAS) was obtained.

Results

All seven isothiazolinones were registered in PROBAS. The top three isothiazolinones registered were: benzisothiazolinone (BIT), registered in 985 products, methylisothiazolinone (MI), registered in 884 products, and methylchloroisothiazolinone (MCI)/MI, registered in 611 products. The concentration ranges were 0.01 ppm to 45% for BIT, 0.01 ppm to 10% for MI, and 0.01 ppm to 14.1% for MCI/MI. The most common product type was ‘paint and varnish’; five of the seven isothiazolinones were registered in this type of product.

Conclusion

Isothiazolinones are present in multiple products registered for use at workplaces, and may occur in high concentrations.
Palladium‐based dental alloys are associated with oral disease and palladium‐induced immune responses
Authors: Muris Joris , Scheper Rik J. , Kleverlaan Cornelis J. , Rustemeyer Thomas , van Hoogstraten Ingrid M. W. , von Blomberg Mary E. , Feilzer Albert J.
Published: May 2014

Background

Palladium (Pd) and gold (Au) based dental alloys have been associated with oral disease.

Objectives

This study was designed to explore possible associations between the presence of Au‐based and Pd‐based dental alloys, and oral lesions, systemic complaints, and specific in vivo and in vitro immune responses.

Methods

The investigated population consisted of three groups: 26 non‐metal‐allergic volunteers, 25 metal‐allergic patients, and 20 oral disease patients. Medical histories were taken, oral examinations were carried out, and compositions of all dental alloys were determined. Then, Au and Pd patch tests and in vitro assays were performed, revealing cytokine production by peripheral blood mononuclear cells [T helper (Th)1, interferon‐γ; Th2, interleukin (IL)‐5 and IL‐13] and lymphocyte proliferation (LTT‐MELISA®).

Results

Non‐plaque‐related gingivitis was associated with the presence of Pd‐based dental alloys, and Pd‐positive patch tests and in vitro assays. Collectively, participants with Pd‐based dental alloys showed increased Pd patch test reactivity (p < 0.05) and lymphoproliferation (p < 0.05). In contrast, oral lichenoid lesions were associated with Au‐based alloys (p < 0.05), but this was not reflected by Au‐specific immunoreactivity.

Conclusions

Oral lesions and Pd‐induced immune responses are associated with the presence of dental alloys. However, most oral disease patients did not show positive patch test results or in vitro signs of specific immunoreactivity, suggesting local toxic reactions or the involvement of innate immune responses.
Idiopathic intracranial hypertension in childhood: pitfalls in diagnosis
Authors: Krishnakumar Deepa , Pickard John D , Czosnyka Zofia , Allen Louise , Parker Alasdair
Published: May 2014

Aim

Idiopathic intracranial hypertension (IIH) is prone to misdiagnosis. Our aim was to identify the reasons for this in children in our region referred for suspected IIH.

Method

We reviewed the records of all children referred with symptoms and/or signs consistent with raised intracranial pressure (ICP) and normal magnetic resonance imaging of the brain to our tertiary neurology unit over 4 years. IIH was confirmed after expert ophthalmology including ultrasound/tomography and advanced cerebrospinal fluid (CSF) pressure studies.

Results

Of 15 children (six males, nine females; median age 12y, range 3–15y), six (five females, one male) were confirmed to have IIH. All weighed above the 91st centile and were over 10 years old. Four of the six had raised ICP secondary to other causes. Four had been misdiagnosed locally with papilloedema, three had drusen, and one had ‘crowded discs’. Two had raised CSF pressures on standard lumbar puncture, but 20‐minute steady state and infusion studies were normal, with symptoms settling after therapy was withdrawn.

Interpretation

Misdiagnosis of IIH was frequent, but could be reduced by (1) expert ophthalmological fundoscopy, orbital ultrasound, and optical coherence tomography; (2) expert neuroradiology; and (3) assessment of steady state CSF pressure rather than standard opening pressure in centimetres of water.
The Symbol Digit Modalities Test as sentinel test for cognitive impairment in multiple sclerosis
Authors: Van Schependom J. , D'hooghe M. B. , Cleynhens K. , D'hooge M. , Haelewyck M.C. , De Keyser J. , Nagels G.
Published: May 2014

Background and purpose

Cognitive impairment (CI) is found in about half of the multiple sclerosis (MS) population and is an important contributor to employment status and social functioning. CI is encountered in all disease stages and correlates only moderately with disease duration or Expanded Disability Status Scale scores. Most present neuropsychological test batteries are time‐demanding and expensive. The Symbol Digit Modalities Test (SDMT) has been suggested as a screening tool for CI in MS. In this paper, we aim to assess the performance of the SDMT in predicting the outcome of an extensive battery.

Methods

Neuropsychological test results from 359 patients were assessed in a multidisciplinary MS center (National MS Center Melsbroek, Belgium). Using receiver operating characteristic curves, the performance of the SDMT in predicting the general cognitive outcome of the extensive Neuropsychological Screening Battery for MS (NSBMS) could be assessed. The performance of the SDMT was assessed for different levels of CI and compared with other cognitive tests. Finally, useful covariates were included in a logistic regression model.

Results

At a specificity of 0.60 a high sensitivity (0.91) was obtained indicating the potential of the SDMT as a sentinel test for CI in MS. The SDMT outperformed the individual tests included in the NSBMS, used as benchmark. As the logistic regression model did not result in a relevant improvement, it is concluded that most clinical variables influence both the SDMT and the NSBMS in a similar way. Excluding patients with possible practice effects, an optimal cutoff of 40 was found for the SDMT.

Conclusion

As the SDMT is an easy, low‐cost and fast test, this result may help to detect CI in everyday clinical practice.
Revisiting the spectrum of lower motor neuron diseases with snake eyes appearance on magnetic resonance imaging
Authors: Lebouteux M.‐V. , Franques J. , Guillevin R. , Delmont E. , Lenglet T. , Bede P. , Desnuelle C. , Pouget J. , Pascal‐Mousselard H. , Pradat P.‐F.
Published: May 2014

Background and purpose

The ‘snake eyes’ sign refers to bilateral hyperintensities of the anterior horns on axial spinal cord imaging. Based on sporadic reports, it has been associated with a range of lower motor neuron (LMN) syndromes, such as spondylotic amyotrophy and Hirayama disease, as well as spinal cord infarction. The objective of our study was to comprehensively characterize the full diagnostic spectrum of LMN syndromes with this radiological clue and discuss potential aetiological factors.

Methods

A large patient cohort with snake eyes sign and upper limb LMN degeneration was recruited from three French neuromuscular units. Patients underwent detailed electrophysiological, radiological, clinical and anamnestic profiling.

Results

Twenty‐nine patients were ascertained and followed up for 9.5 ± 8.6 years. The majority of the patients were male (86.2%) with a mean age of 37.3 ± 14.4 years. Symptoms were bilateral in most cases (86.2%). Patients with predominantly proximal and distal deficits were equally represented (44.8% and 55.2%, respectively). A history of preceding trauma or intense physical activity was confirmed in 58.6% of the cases; 27.6% of the patients were given an initial clinical diagnosis of amyotrophic lateral sclerosis (ALS), and 51.7% were originally suspected to have multifocal motor neuropathy. None of the patients developed ALS on longitudinal follow‐up.

Conclusion

The snake eyes sign on magnetic resonance imaging is associated with a wide spectrum of neurological conditions and is more common in young men with a history of strenuous activity or antecedent trauma. The recognition of this syndrome is crucial as many of these patients are initially misdiagnosed with ALS.
The case for medical marijuana in epilepsy
Authors: Maa Edward , Figi Paige
Published: May 2014

Charlotte, a little girl with SCN1A‐confirmed Dravet syndrome, was recently featured in a special that aired on CNN. Through exhaustive personal research and assistance from a Colorado‐based medical marijuana group (Realm of Caring), Charlotte's mother started adjunctive therapy with a high concentration cannabidiol/Δ9‐tetrahydrocannabinol (CBD:THC) strain of cannabis, now known as Charlotte's Web. This extract, slowly titrated over weeks and given in conjunction with her existing antiepileptic drug regimen, reduced Charlotte's seizure frequency from nearly 50 convulsive seizures per day to now 2–3 nocturnal convulsions per month. This effect has persisted for the last 20 months, and Charlotte has been successfully weaned from her other antiepileptic drugs. We briefly review some of the history, preclinical and clinical data, and controversies surrounding the use of medical marijuana for the treatment of epilepsy, and make a case that the desire to isolate and treat with pharmaceutical grade compounds from cannabis (specifically CBD) may be inferior to therapy with whole plant extracts. Much more needs to be learned about the mechanisms of antiepileptic activity of the phytocannabinoids and other constituents of Cannabis sativa.
Cannabidiol: Pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders
Authors: Devinsky Orrin , Cilio Maria Roberta , Cross Helen , Fernandez‐Ruiz Javier , French Jacqueline , Hill Charlotte , Katz Russell , Di Marzo Vincenzo , Jutras‐Aswad Didier , Notcutt William George , Martinez‐Orgado Jose , Robson Philip J. , Rohrback Brian G. , Thiele Elizabeth , Whalley Benjamin , Friedman Daniel
Published: May 2014

To present a summary of current scientific evidence about the cannabinoid, cannabidiol (CBD) with regard to its relevance to epilepsy and other selected neuropsychiatric disorders. We summarize the presentations from a conference in which invited participants reviewed relevant aspects of the physiology, mechanisms of action, pharmacology, and data from studies with animal models and human subjects. Cannabis has been used to treat disease since ancient times. Δ9‐Tetrahydrocannabinol (Δ9‐THC) is the major psychoactive ingredient and CBD is the major nonpsychoactive ingredient in cannabis. Cannabis and Δ9‐THC are anticonvulsant in most animal models but can be proconvulsant in some healthy animals. The psychotropic effects of Δ9‐THC limit tolerability. CBD is anticonvulsant in many acute animal models, but there are limited data in chronic models. The antiepileptic mechanisms of CBD are not known, but may include effects on the equilibrative nucleoside transporter; the orphan G‐protein‐coupled receptor GPR55; the transient receptor potential of vanilloid type‐1 channel; the 5‐HT1a receptor; and the α3 and α1 glycine receptors. CBD has neuroprotective and antiinflammatory effects, and it appears to be well tolerated in humans, but small and methodologically limited studies of CBD in human epilepsy have been inconclusive. More recent anecdotal reports of high‐ratio CBD:Δ9‐THC medical marijuana have claimed efficacy, but studies were not controlled. CBD bears investigation in epilepsy and other neuropsychiatric disorders, including anxiety, schizophrenia, addiction, and neonatal hypoxic‐ischemic encephalopathy. However, we lack data from well‐powered double‐blind randomized, controlled studies on the efficacy of pure CBD for any disorder. Initial dose‐tolerability and double‐blind randomized, controlled studies focusing on target intractable epilepsy populations such as patients with Dravet and Lennox‐Gastaut syndromes are being planned. Trials in other treatment‐resistant epilepsies may also be warranted.

A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.
A hypothetical, aetiological relationship between the horse's bit, nasopharyngeal asphyxia and negative pressure pulmonary oedema
Authors: Cook W. R.
Published: May 2014

Tentative explanations for the aetiology of soft palate instability and dorsal displacement at exercise are based on the proposition that it is caused by one or more, as yet unidentified, neuromuscular or inflammatory diseases. As judged by reviews, none of the treatments based on these assumptions are entirely satisfactory. Most researchers agree that their cause is unknown. In 1999, Cook proposed that they were caused by the bit breaking what should be an airtight lip seal. The present article describes a development of this hypothesis – loss of oral compartment subatmospheric pressure. The feral horse is an obligate nose‐breather and runs with a closed mouth and no air in the oral cavity and oropharynx. Evacuation of air from these compartments is proposed as the primary mechanism, strengthened by the cohesive force of surface tension, whereby the soft palate resists the elevating force of negative pressure on inspiration. It is suggested that subatmospheric pressure in the oral compartment is generated by a single swallow before running. Poll extension supplements the rigidity of the nasopharyngeal tube and reinforces the ostium intrapharyngium seal. In the domesticated horse, the lip seal is broken by a bit and bit‐induced poll flexion, jaw and tongue movement often breaks the ostium seal. Oral atmospheric pressure is proposed as the mechanism for nasopharyngeal asphyxia. It is considered that negative pressure pulmonary oedema – currently known as exercise‐induced pulmonary haemorrhage and conventionally thought to be a separate problem – is one of its clinical signs. It is suggested that the bit is the most common cause of nasopharyngeal asphyxia and that this, in turn, results in a cascade of dynamic obstructions in the larynx and cervical trachea, leading ultimately to pulmonary oedema and ‘bleeding.’ It is concluded that these are sequelae to rules in many disciplines that mandate bit usage.
Right‐to‐Work Laws and Financial Leverage
Authors: Marciukaityte Dalia
Published: May 2014

High leverage can be used to improve a firm's bargaining position with unions. I find that this use of leverage in the United States is concentrated in states without right‐to‐work (RTW) laws. The use of high leverage by unionized firms in these states is associated with high market‐to‐book ratios and is more likely when shareholder and manager interests are aligned through compensation contracts. I confirm these findings by examining the adoption of RTW laws in Oklahoma, as well as presidential and congressional elections. Moreover, I confirm the importance of RTW laws using cash balances instead of leverage.
Multiple genome modifications by the CRISPR/Cas9 system in zebrafish
Authors: Ota Satoshi , Hisano Yu , Ikawa Yoshiya , Kawahara Atsuo
Published: May 2014

The type II clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR‐associated (Cas) system, which is an adaptive immune system of bacteria, has become a powerful tool for genome editing in various model organisms. Here, we demonstrate multiple genome modifications mediated by CRISPR/Cas9 in zebrafish (Danio rerio). Multiple genes including golden/gol and tyrosinase/tyr, which are involved in pigment formation, and s1pr2 and spns2, which are involved in cardiac development, were disrupted with insertion and/or deletion (indel) mutations introduced by the co‐injection of multiple guide RNAs (gRNAs) and the nuclease Cas9 mRNA. We simultaneously observed two distinct phenotypes, such as, the two hearts phenotype and the hypopigmentation of skin melanophores and the retinal pigment epithelium, in the injected F0 embryos. Additionally, we detected the targeted deletion and inversion genes as a 7.1‐kb fragment between the two distinct spns2 targeted sites together with indel mutations. Conversely, chromosomal translocations among five target loci were not detected. Therefore, we confirmed that the CRISPR/Cas9‐induced indel mutations and a locus‐specific deletion were heritable in F1 embryos. To screen founders, we improved heteroduplex mobility assay (HMA) for simultaneously detecting indel mutations in different target loci. The results suggest that the multi‐locus HMA is a powerful tool for identification of multiple genome modifications mediated by the CRISPR/Cas9 system.
Development of a Watershed‐Based Geospatial Groundwater Specific Vulnerability Assessment Tool
Authors: Baloch Mansoor A. , Sahar Liora
Published: May 2014

This study assesses and characterizes the vulnerability of unregulated groundwater systems to microbial contamination in 18 counties in the state of Georgia using a contamination risk screening strategy based on watershed characteristics and elements of the Safe Drinking Water Act's Wellhead Protection program. Environmental data sources analyzed include septic systems, elevation, land use and land cover data, soil, vegetation coverage, demographics, and livestock. A geospatial overlay/index modeling approach was developed to identify areas of higher vulnerability for groundwater pollution by taking into consideration watershed land use, hydrology, and topography (LHT). Sensitivity analysis was used to evaluate the effectiveness of model variables. The results of the model were validated by using field data and output from U.S. EPA's DRASTIC model, a widely used intrinsic vulnerability assessment tool. The validation showed a higher risk of microbial contamination for wells located in a high to medium LHT vulnerability zones. LHT provided a clear distribution of satisfactory and unsatisfactory wells in the three vulnerability zones; however, the majority of wells (>75%), with both satisfactory and unsatisfactory test results, are located in medium DRASTIC vulnerability zone. This difference between LHT and DRASTIC can be attributed to the microbial contamination specific factors incorporated into LHT index. It is concluded that although inclusion of potential contamination sources on adjacent land uses in the vulnerability assessment framework adds to the complexity of the processes involved in a vulnerability assessment, such inclusion provides a meaningful perspective to groundwater protection efforts as an effective screening tool.
Tetracycline‐ and Furazolidone‐containing Quadruple Regimen as Rescue Treatment for Helicobacter pylori Infection: A Single Center Retrospective Study
Authors: Zhang Yuemiao , Gao Wen , Cheng Hong , Zhang Xuezhi , Hu Fulian
Published: May 2014

Background and Objective

Eradication rate of Helicobacter pylori decreases worldwide, while antibiotics resistance rates of H. pylori increase rapidly in recent years. In most cases, H. pylori would be resistant to clarithromycin, metronidazole, and quinolone if these antibiotics had been used as component of eradication regimen. H. pylori strains resistant to both tetracycline and furazolidone are rare. The aim of our study was to evaluate efficacy and side effects of tetracycline‐ and furazolidone‐containing quadruple regimen as rescue treatment.

Methods

Patients with H. pylori infection given RTFB (rabeprazole 20 mg b.i.d. + tetracycline 750 mg b.i.d. +furazolidone 100 mg b.i.d. + colloidal bismuth subcitrate 200 mg b.i.d.) regimen for 14 days as rescue treatment were enrolled in this retrospective study. Eradication status was evaluated by 13C‐urea breath test, and side effects were collected.

Results

One hundred and nine patients were enrolled. The intention‐to‐treat eradication rate was 91.74% (100 of 109) and 95.24% (100 of 105) per protocol analysis. Side effects including fever, palpitation, and skin rash occurred in 35 patients.

Conclusions

The 14‐day tetracycline‐ and furazolidone‐containing quadruple regimen can achieve a relatively high eradication rate as rescue treatment. Some side effects including fever may occur during the treatment.
Factors associated with sustained virological response in 24‐week telaprevir‐based triple therapy for chronic hepatitis C genotype 1b patients with the IL28B minor genotype
Authors: Abe Hiroshi , Tsubota Akihito , Shimada Noritomo , Atsukawa Masanori , Kato Keizo , Takaguchi Koichi , Asano Toru , Chuganji Yoshimichi , Sakamoto Choitsu , Toyoda Hidenori , Kumada Takashi , Ide Tatsuya , Sata Michio , Aizawa Yoshio
Published: May 2014

Aim

Single nucleotide polymorphisms (SNP) near the interleukin‐28B (IL28B) gene affect the outcome of 24‐week telaprevir‐based triple therapy with telaprevir, pegylated interferon‐α and ribavirin for chronic hepatitis C virus (HCV) genotype 1b patients. We aimed to identify factors associated with treatment outcomes in patients with the unfavorable minor IL28B SNP genotype, who have poor response to combination therapy.

Methods

Pretreatment and on‐treatment factors associated with sustained virological response (SVR) for 24‐week telaprevir‐based triple therapy were analyzed using multiple logistic regression analysis in 106 HCV genotype 1b patients with the minor IL28B SNP rs8099917 genotype (non‐TT).

Results

Of the 106 non‐TT patients, 62 (58.5%) achieved SVR. Of the 44 remaining patients, 22 experienced relapse, 13 experienced viral breakthrough and nine were non‐responders. Pretreatment factors such as treatment‐naïve/prior treatment response (P = 0.0041), high fasting serum low‐density lipoprotein cholesterol (LDL‐C) concentration (P = 0.0068) and low serum HCV RNA levels (P = 0.0088) were significantly and independently associated with SVR. On‐treatment factors such as achievement of rapid virological response (RVR) were significantly and independently associated with SVR (P = 0.0001). For both pre‐ and on‐treatment factors, treatment‐naïve/prior treatment response (P = 0.0018), low pretreatment serum fasting LDL‐C (P = 0.0062) and achieving RVR (P = 0.0021) were significantly and independently associated with SVR.

Conclusion

In HCV genotype 1b patients with the minor IL28B SNP rs8099917 genotype, evaluating prior treatment response and achieving RVR and pretreatment serum fasting LDL‐C concentrations were useful for predicting SVR achievement after 24‐week telaprevir‐based triple therapy.
Intrahepatic triglyceride measurement and estimation of viability in rat fatty livers by near‐infrared spectroscopy
Authors: Fudaba Yasuhiro , Oshita Akihiko , Tashiro Hirotaka , Ohdan Hideki
Published: May 2014

Aim

This study investigated the features of fatty livers using near‐infrared (NIR) spectroscopy and validated the usefulness of NIR spectroscopy for the measurement of intrahepatic triglyceride (TG) contents and evaluation of viability in fatty livers.

Methods

In vitro, we examined specific spectra for each purified TG fraction by NIR. In vivo, the differences between the spectra obtained from normal and fatty livers before warm ischemia and the differences between the spectra obtained from each rat liver before and after warm ischemia were subjected to multicomponent analysis.

Results

In vitro experiments revealed a specific peak at 925 nm in major TG fractions, and NIR spectroscopy precisely detected changes in TG volume. In vivo experiments revealed that NIR spectroscopy detected TG content changes in rat fatty livers induced by a choline‐deficient diet following the addition of purified TG spectrum for NIR spectroscopic analysis in least square curve fitting. The TG level in the fatty livers measured by NIR spectroscopy significantly correlated with the morphometric measurement of lipid content in the livers. NIR spectroscopy also revealed decreased levels of total hemoglobin (Hb) and oxidized Hb and maintenance of homeostasis in cytochrome redox states in fatty livers under normal condition. However, NIR spectroscopy showed irreversible deterioration of hepatic microcirculation, Hb oxygenation and homeostasis of the cytochrome redox states in fatty livers after 60‐min warm ischemia reperfusion.

Conclusion

These studies demonstrated that NIR spectroscopy can quantitatively measure the intrahepatic TG content in addition to simultaneously evaluating microcirculation and Hb oxygenation.
Geochemistry and petrogenesis of the Cretaceous A‐type granites in the Laoshan granitic complex, eastern China
Authors: Yan Quanshu , Shi Xuefa
Published: May 2014

Major element and trace element compositions, and Sr, Nd and Pb isotopic compositions for postcollisional granites from the Laoshan granitic complex, in the eastern side of the Triassic suture between the South China and North China tectonic blocks were determined. The granites are alkaline, A‐type and can be further classified as A1 granites. The trace element composition of these granites is transitional between those of oceanic island basalt and enriched mid‐oceanic ridge basalt, with depletions in Ba, Sr, P, and Ti that can be ascribed to mineral fractionation and enrichments in Cs, Rb, Th and U possibly resulted from the involvement of slab fluids. The isotopic signature of Laoshan granites represent a mixture between an enriched mantle type 1 (EMI)‐like end‐member and lower continental crust (LCC). We propose that the magmas that formed the Laoshan A1 granites are a mixture between those derived from the EMI‐like delaminated eclogitic rocks (subsequently enriched by fluids released from Mesozoic Pacific subducted slab) and those derived from the LCC, which consists of granulites or metamorphic residues from the prior generation of I‐type granites in the region. The mixed magmas then experienced a strongly alkali feldspar‐dominated fractionation prior to their emplacements as A‐type granites in the Laoshan granitic complex.