bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting the progress trends of science and technology in Iran through a system dynamics approach
Authors: Dabestani Reza , Nahavandi Nasim , Saljoughian Mohammad
Published: March 2016

Purpose

– The purpose of this study is an attempt to identify the most crucial factors and their influence on one another, which can result in predicting the country’s next phase of progress based on these factors’ variation patterns.

Design/methodology/approach

– The authors proposed a model based on the existing literature and then ran a system dynamics analysis on the data obtained from the World Bank official Web site. The factors including “Research and development expenditure (% of GDP)”, “Scientific and technical journal articles”, “Patent applications”, “Trademark applications”, “Industry value added”, “Researchers in R
&
D (per million people)” and “High technology export” were considered as the related factors with science and technology.

Findings

– The findings can also reveal what aspects require more attention and investment if the government demands to facilitate and accelerate the development process. The results show that the most intense increase refers to the number of patent applications and trademark applications, and the lowest increase is related to research and development expenditure and researchers in R
&
D.

Practical implications

– The authors hope that tracking the changes of those factors leads practitioners and scholars to have a better understanding of the trends of science and technology development in a country, which in turn leads them to foresee the country’s upcoming opportunities as well as challenges.

Originality/value

– Proposing a system dynamic model for predicting science and technology trend in a country is relatively novel.
Importance of CEM in CRM-CL framework
Authors: Singh Jagwinder , Saini Shivani
Published: March 2016

Purpose

– The purpose of this paper is to propose a model to understand the role of customer relationship management efforts in building, sustaining and enhancing customer loyalty (CL).

Design/methodology/approach

– This paper reviews extant literature in customer relationship management (CRM), customer experience management (CEM) and CL, with a particular emphasis on exploring the relationships between these proposed domains.

Findings

– The CRM efforts, customer acquisition, retention and experience, are suggested to have positive influence on attitudinal and behavioural loyalty. A model for testing the associations of customer relationship efforts to various forms of CL, including the satisfaction, trust and commitment as mediators in CRM-CL link are proposed.

Research limitations/implications

– This paper represents a first attempt to build and propose a conceptual framework of CRM–CL. This is an indicative research than a conclusive one. Therefore, research implications are to perform the empirical testing of model in different business environments.

Practical implications

– This application of proposed model in a business environment will be helpful for the marketing practitioners to well understand the customers’ changing expectations as well as to prioritize the marketing functions. The emphasis and right calculation about the acquisition, retention and experience decisions would be helpful to marketers to know the expected profitability of customers.

Originality/value

– This is the first paper to provide a comprehensive integrated model of CRM and CL to understand the effects of CRM efforts on various forms of CL.
Graphical interpretation of outranking principles
Authors: Costa Helder Gomes
Published: March 2016

Purpose

– This study aims to use a graphical approach to highlight the differences between outranking and preference relationships. The outranking principle is based on a structure of non-dominance, which differs from the usual structures of preferences.

Design/methodology/approach

– To reach the objective, the paper makes a deep analysis of outranking and preference relationships and uses graphical representation to highlight the differences between these two concepts. Graphical interpretation is also used to support the results form ELECTRE I and to highlight misinterpretation of results, such as rank reversal in ELECTRE I.

Findings

– The results show that the assumption of rank reversal while using ELECTRE I is a mistake.

Originality/value

– It was not found in literature a previous work paper that demonstrates a result like this one.
The impact of national culture and knowledge management on governmental intelligence
Authors: De Angelis Cristiano Trindade
Published: March 2016

Purpose

– The purpose of this paper is to demonstrate that the integration of intelligences plays a great role in changing the organisational and national culture and, in consequence, in changing governmental intelligence (GI). This paper investigates the impact of national culture (NC) and knowledge management (KM) on GI.

Design/methodology/approach

– This paper explores the development of a culture knowledge intelligence model (CKI) to test a number of propositions through web-based survey methodology administered to 101 civil servants of two national public administrations, Brazil’s Planning Ministry and Germany’s Bundesanstalt. The data were analysed quantitatively through SPSS and SmartPLS (CFA and SEM). In this paper, the relationships between the variables (hypotheses) were empirically tested using structure equation modelling (SEM).

Findings

– The high correlation between organisational/national culture on GI raises the discussion of these relationships in the academic community. The impact of organisational/national culture on GI is much higher in Brazil than in Germany. In opposition to Germany, in Brazil, the GI is more influenced by culture than by knowledge. This is related to the fact that German culture, in opposition to Brazil, is future- and performance-orientated, getting information from facts, books and statistics, instead of being people-oriented, getting the first-hand (oral) information. The major practical implication is to demonstrate the importance of integration of intelligences to improve GI.

Originality/value

– The influence of NC on decisions of governments is paramount to understand failures in government decisions, mainly because of the difficulty of public leaders to learn by comparison and collaboration from a global, participative and integrative vision and action. Despite the importance of the relationship between NC and GI, this intuitive juxtaposition has not received attention in the literature.
The use of social media among business-to-business sales professionals in China
Authors: Niedermeier Keith E. , Wang Emily , Zhang Xiaohan
Published: March 2016

Purpose

– The purpose of this study is to explore the role of social media usage among business-to-business sales professionals in China. Specifically, the authors seek to define and explore the unique ways in which Chinese salespeople use social media, with a special emphasis on the role ofguanxi.Guanxiis a complex cultural construct that revolves around the exchange of favors to build trust and connection for business purposes.

Design/methodology/approach

– Three in-depth interviews of sales managers from two industries along with survey data from 42 pharmaceutical sales representatives were collected to gain an understanding of the general usage and attitudes toward social media in the sales process in China.

Findings

– Results indicated that virtually all the salespeople in the sample were highly familiar with social media and integrated it into the sales process. Furthermore, all participants indicated that their companies were highly supportive of the use of social media with their customers. More importantly, salespeople in China view social media as a critical tool in buildingguanxiwith their customers. Findings from this exploratory study are used to create a conceptual framework for understanding the important role of social media in buildingguanxiin China.

Research limitations/implications

– While the sample is limited to three managerial interviews and 42 survey responses, the data indicated a near universal acceptance and use of social media among Chinese salespeople. Most importantly, social media appears to be the modern gateway to the ancient and culturally unique construct ofguanxithat is absolutely indispensable to successful business-to-business sales performance in China.

Practical implications

– The structural challenges within China make trust and emotional connection essential to any potential business relationship. Trust is at the core ofguanxi. Any firm hoping to succeed in China must understandguanxiand the use of Chinese social media to help build it. This study adds to the knowledge and understanding ofguanxiand begins to elucidate the uses of social media as a tool to build and maintain it.

Social implications

– Social media appears to be the modern gateway to the ancient and culturally unique construct ofguanxithat is absolutely indispensable to successful business-to-business sales performance in China. This study deepens our understanding of not onlyguanxibut also how the modern phenomenon of social media is affecting it.

Originality/value

– This is one of very few studies to investigate the use of social media among salesforces in China. More importantly, the authors know of no other study linking social media withguanxi.
Bull's eye dermatoscopy pattern at bacillus Calmette–Guérin inoculation site correlates with systemic involvements in patients with Kawasaki disease
Authors: Tseng Han‐Chi , Ho Ji‐Chen , Guo Mindy Ming‐Huey , Lo Mao‐Hung , Hsieh Kai‐Sheng , Tsai Wen‐Chien , Kuo Ho‐Chang , Lee Chih‐Hung
Published: March 2016

For the past decades, although the rash at the bacillus Calmette–Guérin (BCG) inoculation site has been recognized as a diagnostic clue in Kawasaki disease, the present study is the first known one attempting to characterize BCG inoculation by dermatoscopy in Kawasaki disease and correlate the grade of BCG reaction with systemic involvement. Thirty‐four patients diagnosed with Kawasaki disease by pediatric specialists were enrolled. We performed detailed history taking, laboratory examination, physical examination and dermatoscopy examinations. Based on the BCG reaction pattern by dermatoscopy, we were able to characterize three patterns: (A) Bull's eye pattern in 18 patients; (B) faint homogenous erythema in nine; and (C) central white patch in seven. Patients from group A exhibited the highest elevation of blood aspartate aminotransferase levels (P < 0.05). Notably, three patients from group A had a significantly dilated coronary artery despite i.v. immunoglobulin injection. We concluded that the bull's eye dermatoscopy sign is not only a useful diagnostic clue but also a severity biomarker in patients with Kawasaki disease.
Species‐specific differences in the ability of feline lentiviral Vif to degrade feline APOBEC3 proteins
Authors: Yoshikawa Rokusuke , Nakano Yusuke , Yamada Eri , Izumi Taisuke , Misawa Naoko , Koyanagi Yoshio , Sato Kei
Published: March 2016

How host–virus co‐evolutionary relationships manifest is one of the most intriguing issues in virology. To address this topic, the mammal–lentivirus relationship can be considered as an interplay of cellular and viral proteins, particularly apolipoprotein B mRNA editing enzyme catalytic polypeptide‐like 3 (APOBEC3) and viral infectivity factor (Vif). APOBEC3s enzymatically restrict lentivirus replication, whereas Vif antagonizes the host anti‐viral action mediated by APOBEC3. In this study, the focus was on the interplay between feline APOBEC3 proteins and two feline immunodeficiency viruses in cats and pumas. To our knowledge, this study provides the first evidence of non‐primate lentiviral Vif being incapable of counteracting a natural host's anti‐viral activity mediated via APOBEC3 protein.
The case for an ultrasound mandate
Authors: Bomann J Scott
Published: March 2016

Emergency Medicine pioneered the use of ultrasound at the bedside. All of the Colleges of Emergency Medicine in the Anglo‐American system have incorporated Emergency Ultrasound into their training curriculum, and all but ACEM have made training and proficiency mandatory. Emergency Ultrasound has not taken hold in Australasia the way it has in other parts of the world. It is a unique procedure that requires a College mandate to overcome the political and financial arguments that have kept it from flourishing in our hospitals. ACEM needs to instate such a mandate.
Influence of copper on expression of nirS, norB and nosZ and the transcription and activity of NIR, NOR and N2OR in the denitrifying soil bacteria Pseudomonas stutzeri
Authors: Black Amanda , Hsu Pei‐Chun L. , Hamonts Kelly E. , Clough Tim J. , Condron Leo M.
Published: March 2016

Reduction of the potent greenhouse gas nitrous oxide (N2O) occurs in soil environments by the action of denitrifying bacteria possessing nitrous oxide reductase (N2OR), a dimeric copper (Cu)‐dependent enzyme producing environmentally benign dinitrogen (N2). We examined the effects of increasing Cu concentrations on the transcription and activity of nitrite reductase (NIR), nitric oxide reductase (NOR) and N2OR in Pseudomonas stutzeri grown anaerobically in solution over a 10‐day period. Gas samples were taken on a daily basis and after 6 days, bacterial RNA was recovered to determine the expression of nirS, norB and nosZ encoding NIR, NOR and N2OR respectively. Results revealed that 0.05 mM Cu caused maximum conversion of N2O to N2 via bacterial reduction of N2O. As soluble Cu generally makes up less than 0.001% of total soil Cu, extrapolation of 0.05 mg l−l soluble Cu would require soils to have a total concentration of Cu in the range of, 150–200 μg g−1 to maximize the proportion of N2O reduced to N2. Given that many intensively farmed agricultural soils are deficient in Cu in terms of plant nutrition, providing a sufficient concentration of biologically accessible Cu could provide a potentially useful microbial‐based strategy of reducing agricultural N2O emissions.
Neoadjuvant chemoradiation (modified Eilber protocol) versus adjuvant radiotherapy in the treatment of extremity soft tissue sarcoma
Authors: Lehane Chris , Ho Frederick , Thompson Stephen R , Links David , Lewis Craig , Smee Robert , Parasyn Andrew , Friedlander Michael , Williams Janet , Crowe Phil
Published: March 2016

Background

Local control for extremity soft tissue sarcomas (STS) requires surgery combined with radiotherapy, usually given pre‐operatively or post‐operatively. The modified Eilber protocol, a neoadjuvant chemoradiation regimen, has been reported with excellent local control rates. This retrospective single‐centre study compared outcomes for patients treated with the modified Eilber protocol with those treated with standard adjuvant radiotherapy.

Methods

Patients with a diagnosis of extremity STS were retrospectively reviewed from the Prince of Wales Hospital Sarcoma Database from 1995 to 2012. Sixty‐three patients underwent curative surgery with either neoadjuvant Eilber chemoradiotherapy (Eilber) or adjuvant radiotherapy (Adjuvant).

Results

Twenty‐nine patients were treated with modified Eilber protocol. Thirty‐four patients received adjuvant radiotherapy. Three patients (10%) in the Eilber group and five patients (15%) in the Adjuvant group developed local recurrence (P = 0.87). Major acute wound complications were noted in four patients in each group (P = 0.55). One patient (3.4%) in the Eilber group developed Grade 3 or 4 late toxicities after 1 year compared with nine patients (27%) in the Adjuvant group (P = 0.02).

Conclusion

Neoadjuvant chemoradiation (Eilber protocol) provided similar rates of local control when compared with adjuvant radiotherapy. Acute wound complication rates were similar but there was less severe late toxicity in the Eilber group.
Biofumigant effect of new defatted seed meals against the southern root‐knot nematode, Meloidogyne incognita
Authors: Curto G. , Dallavalle E. , Matteo R. , Lazzeri L.
Published: March 2016

In recent years, Brassica carinata defatted seed meals (DSMs) have been successfully applied as an amendment in the control of pests and soil pathogens in several countries with clear advantages for the environment and soil fertility. The effectiveness of this product is clearly linked to the release of bioactive compounds by the well‐known glucosinolate (GL)–myrosinase (MYR) system. Until now, this commercial know‐how has been limited to allyl‐isothiocyanate, the breakdown product of hydrolysis catalysed by MYR of the GL sinigrin. Brassicaceae germplasm is an extremely wide‐ranging family, considering that more than 3500 species have been classified in this family in nature, which contains around 200 different GLs. Therefore, there is a great potential for the availability of new still unexplored bioactive compounds. This study evaluated, in controlled glasshouse conditions, the effect of biofumigation on the nematode Meloidogyne incognita and that of biostimulation on tomato plants of 13 DSMs obtained from different Brassicaceae species at different levels of soil inoculation. Among the tested DSMs, the best results for all inoculations were achieved by Eruca sativa (rocket), Barbarea verna (land cress) and Brassica nigra (black mustard), whereas the other species gave either alternate results or results not different from untreated or sunflower DSM controls. All the DSMs, including sunflower, determined a clear positive effect on plant vigour. These first results open new perspectives for the application of biofumigation in plant protection and management.
Estimated economic impact of pre‐filled ephedrine syringes in the operating room
Authors: Armoiry X. , Carry P.‐Y. , Lehot J.‐J. , Michel C. , Aulagner G. , Piriou V.
Published: March 2016

Background

Syringes of ephedrine are usually prepared ahead of time in order to reduce the time to injection. Commercial pre‐filled syringes of ephedrine have been introduced to minimize the amount of waste. Our primary objective was to determine the economic impact of commercial syringes. We hypothesized that costs could be reduced compared to standard syringes.

Methods

Using data extracted from our medical records system, we retrospectively measured the total dose of ephedrine received per patient in 2013 to estimate the number of administered standard syringes. The proportion of administered standard syringes was calculated as the total number of administered standard syringes divided by the number of delivered ampoules in 2013. Thereafter, we calculated the annual cost difference as the difference between the cost for commercial syringes and the cost for standard syringes. Endpoints were calculated overall and for each operating room.

Results

At least one dose of ephedrine was given in 19,422 patients (44,943 administrations). The overall proportion of administered standard syringes was estimated to 52.8%. The threshold proportion of administered standard syringes for which commercial syringes would add no extra cost was 20.4%. In 30/32 operating rooms, the proportion of administered standard syringes was higher than 20.4%. The overall cost increase with commercial syringes was estimated to 51,567 €. Among operating rooms, incremental costs varied between −703 and 5086 €.

Conclusion

Based on our findings, pre‐filled ephedrine commercial syringes do not appear to reduce costs.
Shark conservation and management policy: a review and primer for non‐specialists
Authors: Shiffman D. S. , Hammerschlag N.
Published: March 2016

There is increasing concern for the conservation of sharks among scientists, environmental conservation advocates, and the interested public, but misunderstanding among policy non‐specialists about which conservation and management policies are available, and which might work best for certain situations, persists. Here we present a review of fisheries management and conservation literature relating to sharks. Policies are broadly divided into target‐based policies that aim for sustainable fisheries exploitation (e.g. fisheries quotas) and limit‐based policies that aim to prevent all fisheries exploitation of entire taxa (e.g. marine reserves). A list of the pros and cons of each policy is included, as is a decision tree to aid in selection of the most appropriate policy. Our goal is that this paper will allow policy non‐specialists, including scientists without policy training, environmental activists, and concerned citizens, to make informed decisions when advocating for shark conservation.
Inhibiting subthalamic nucleus decreases cocaine demand and relapse: therapeutic potential
Authors: Bentzley Brandon S. , Aston‐Jones Gary
Published: March 2016

Preclinical evidence indicates that inactivation of subthalamic nucleus (STN) may be effective for treating cocaine addiction, and therapies that target STN, e.g. deep brain stimulation, are available indicating that this may have clinical promise. Here, we assessed the therapeutic potential of STN inactivation using a translationally relevant economic approach that quantitatively describes drug‐taking behavior, and tested these results with drug‐seeking tasks. Economic demand for cocaine was assessed in rats (n = 11) using a within‐session threshold procedure in which cocaine price (responses/mg cocaine) was sequentially increased throughout the session. Cocaine demand was assessed in this manner immediately after bilateral microinfusions into STN of either vehicle (artificial cerebrospinal fluid) or the GABAA receptor agonist muscimol. A separate group of animals (n = 8) was tested for changes in cocaine seeking either during extinction or in response to cocaine‐associated cues. Muscimol‐induced inhibition of STN significantly attenuated cocaine consumption at high prices, drug seeking during extinction and cued reinstatement of cocaine seeking. In contrast, STN inhibition did not reduce cocaine consumption at low prices or locomotor activity. Thus, STN inactivation reduced economic demand for cocaine and multiple measures of drug seeking during extinction. In view of the association between economic demand and addiction severity in both rat and human, these results indicate that STN inactivation has substantial clinical potential for treatment of cocaine addiction.
Sex differences in impulsive and compulsive behaviors: a focus on drug addiction
Authors: Fattore Liana , Melis Miriam
Published: March 2016

Sex differences in inhibition and self‐regulation at a behavioral level have been widely described. From an evolutionary point of view, the different selection pressures placed on male and female hominids led them to differ in their behavioral strategies that allowed our species to survive during natural selection processes. These differences reflect changes in neural and structural plasticity that might be the core of sex differences, and of the susceptibility towards one psychiatric condition rather than another. The goal of the present review is to summarize current evidence for such a dichotomy in impulsive and compulsive behavior with a focus on drug addiction. Sex‐dependent differences in drug abuse and dependence will be examined in the context of pathophysiological regulation of impulse and motivation by neuromodulators (i.e. gonadal hormones) and neurotransmitters (i.e. dopamine). Advances in the understanding of the sex differences in the capability to control impulses and motivational states is key for the determination of efficacious biologically based intervention and prevention strategies for several neuropsychiatric disorders where loss of impulse control and compulsivity are the core symptoms.
Compulsive sexual behaviour as a behavioural addiction: the impact of the internet and other issues
Authors: Griffiths Mark D.
Published: March 2016

Commentary to: Should compulsive sexual behavior be considered an addiction?
Radiotherapy for brainstem gliomas in children and adults: A single‐institution experience and literature review
Authors: Yoshida Kenji , Sulaiman Nor Shazrina , Miyawaki Daisuke , Ejima Yasuo , Nishimura Hideki , Ishihara Takeaki , Matsuo Yoshiro , Nishikawa Ryo , Sasayama Takashi , Hayakawa Akira , Kohmura Eiji , Sasaki Ryohei
Published: March 2016

Aim

To evaluate the treatment results of radiotherapy (RT) in children and adults with brainstem gliomas (BSGs) and review the previous literature.

Methods

Thirty patients (14 children, 16 adults) with BSG treated using RT were retrospectively evaluated. The median ages of the children and adults were 8 years (range: 2–16 years) and 49 years (range: 19–75 years), respectively. A histological diagnosis was obtained in 11 patients. The median total radiation dose was 56 Gy (range: 50–70 Gy) with a single fraction size of 1.8–2.0 Gy. Temozolomide was administered concurrently with RT in 14 patients.

Results

Tumor progression after RT occurred in 26 patients (14 children and 12 adults). Four adults survived without tumor progression. The median survival times for children and adults were 8.5 and 39 months, respectively. The 1‐, 2‐ and 3‐year overall survival rates for children/adults were 29%/75%, 14%/68% and 0%/53%, respectively (P = 0.001), and the 1‐, 2‐ and 3‐year progression‐free survival rates for children/adults were 14%/69%, 0%/49% and 0%/35%, respectively (P < 0.001). Grade 3 or higher acute and late toxicities did not occur.

Conclusion

In this study, the prognosis of children with BSGs was considerably poorer than that of adults, and our results are consistent with those of previous studies. Efforts should be made to improve the survival outcomes of patients with BSGs, especially children.
The reduction of temporal optic nerve head microcirculation in autosomal dominant optic atrophy
Authors: Inoue Maki , Himori Noriko , Kunikata Hiroshi , Takeshita Takayuki , Aizawa Naoko , Shiga Yukihiro , Omodaka Kazuko , Nishiguchi Koji M , Takahashi Hidetoshi , Nakazawa Toru
Published: March 2016

Purpose

To evaluate the optic nerve head (ONH) microcirculation in autosomal dominant optic atrophy (ADOA) patients.

Methods

This study comprised 22 eyes of 12 ADOA patients, diagnosed according to clinical findings including family history and the presence of mutations in the OPA1 gene. Twenty‐four normal eyes of 24 age‐matched subjects, with either the right or left eye randomly selected for use, served as controls. Circumpapillary retinal nerve fibre layer thickness (cpRNFLT) and mean blur rate (MBR) in the ONH were determined with optical coherence tomography (OCT) and laser speckle flowgraphy (LSFG), respectively. For each ONH quadrant (superior, temporal, inferior and nasal), the MBR and cpRNFLT ratio was also calculated by dividing tissue MBR in that quadrant by tissue MBR in the entire ONH and by dividing cpRNFLT in that quadrant by cpRNFLT in the entire ONH respectively.

Results

Mean blur rate (MBR) in all quadrants was significantly lower in the ADOA patients than in the controls (p < 0.001 in each). The MBR ratio was significantly lower in the ADOA patients only in the temporal quadrant (p < 0.001). Similarly, cpRNFLT was lower in the ADOA patients in all quadrants (p < 0.001 in each), and the cpRNFLT ratio was lower in the temporal quadrant (p < 0.001).

Conclusion

Reduced blood flow in the temporal optic disc in ADOA patients is associated with reduced temporal cpRNFLT, suggesting that both are caused by damage to the papillomacular bundle. The anatomical characteristics of the papillomacular bundle may make it especially susceptible to mitochondrial dysfunction‐induced damage, which occurs in ADOA.
Interferon‐gamma release assays can effectively screen migrants for the tuberculosis infection, but urgent, active cases need clinical recognition
Authors: Nejat Sahar , Bennet Rutger
Published: March 2016

Aim

Increasing numbers of migrants to Sweden are screened for tuberculosis (TB), and a rational approach to screening is required. We evaluated positive tuberculin skin tests (TSTs) and interferon‐gamma release assays (IGRAs) on paediatric migrants in relation to the TB incidence in the corresponding foreign‐born populations in Stockholm.

Methods

This study examined the characteristics of migrants under the age of 18 who were referred to a paediatric TB clinic at Karolinska University Hospital from 2008 to 2014 by primary care centres in Stockholm County.

Results

We saw 943 TST‐positive children with a median age of 14 years at the TB clinic and performed IGRAs on 557. IGRA positivity ranged from 64% in migrants from Somalia to 20% in those from the former Soviet Union and eastern Europe, with an estimated population level prevalence of 18.8% and 4.2%, respectively. These were significantly correlated to TB incidence in foreign‐born Stockholm children. We diagnosed active TB in 20 screened migrants, and advanced, symptomatic TB was diagnosed in 10 recently arrived migrants without screening.

Conclusion

IGRAs showed higher specificity than TST in identifying tuberculosis. TB screening should focus on migrants from high‐incidence countries, but this may be inadequate to detect advanced TB cases.
Early intervention leads to long‐term developmental improvements in very preterm infants, especially infants with bronchopulmonary dysplasia
Authors: Van Hus JWP , Jeukens‐Visser M , Koldewijn K , Holman R , Kok JH , Nollet F , Van Wassenaer‐Leemhuis AG
Published: March 2016

Aim

Various early intervention programmes have been developed in response to the high rate of neurodevelopmental problems in very preterm infants. We investigated longitudinal effects of the Infant Behavioral Assessment and Intervention Program on cognitive and motor development of very preterm infants at the corrected ages of six months to five and a half years.

Methods

This randomised controlled trial divided 176 infants with a gestational age <32 weeks or birthweight <1500 g into intervention (n = 86) and control (n = 90) groups. Cognitive development and motor development were assessed with the Bayley Scales of Infant Development at the CAs of six, 12 and 24 months and at five and a half years with the Wechsler Preschool and Primary Scale of Intelligence and the Movement Assessment Battery for Children.

Results

We found significant longitudinal intervention effects (0.4 SD, p = 0.006) on motor development, but no significant impact on cognitive development (p = 0.063). Infants with bronchopulmonary dysplasia showed significant longitudinal intervention effects for cognitive (0.7 SD; p = 0.019) and motor (0.9 SD; p = 0.026) outcomes. Maternal education had little effect on intervention effects over time.

Conclusion

The Infant Behavioral Assessment and Intervention Program led to long‐term developmental improvements in the intervention group, especially in infants with BPD.
Overexpression of vascular adhesion protein‐1 is associated with poor prognosis of astrocytomas
Authors: Kostoro Joanna , Chang Shu‐Jyuan , Clark Lai Yen‐Chang , Wu Chun‐Chieh , Chai Chee‐Yin , Kwan Aij‐Lie
Published: March 2016

Vascular adhesion protein‐1 (VAP‐1) is one of the endothelial adhesion molecules that is believed to play a role in tumor progression and metastasis, supporting cancer cell extravasation. Very few studies have been performed on analyzing the contribution of VAP‐1 in brain tumor. Astrocytomas are the most common type of brain tumors, which are classified by World Health Organization (WHO) into four grades according to the degree of malignancy. This study was designed to investigate VAP‐1 expression level in different astrocytoma grades and its correlation with clinicopathological features as well as prognosis of astrocytoma patients. Eighty‐seven patients with different grades of astrocytoma (WHO Grade I–Grade IV) were enrolled in this study. The expression of VAP‐1 was assayed by immunohistochemistry. The correlation between VAP‐1 expression and clinicopathological features was evaluated by Chi‐square test, and overall survival was analyzed by Kaplan–Meier method. Cox regression analysis was applied to analyze the independent influence of each parameter on overall survival. The expression level of VAP‐1 was significantly higher in diffuse astrocytoma than those of pilocytic astrocytoma (p < 0.0001). In the subgroup analysis, upregulated VAP‐1 expression was frequently found in older age patients (≥50 years). The VAP‐1 expression was found to be significantly correlated with the overall survival (p = 0.0002). There was a statistical correlation between VAP‐1high tumors in diffuse astrocytoma and VAP‐1low tumors in pilocytic astrocytoma (p < 0.0001). Multivariate Cox analysis indicated VAP‐1 was an independent predictive marker for poorer prognosis (p = 0.0036). Therefore, VAP‐1 could be a promising prognostic biomarker in astrocytoma.
Validation of a classification protocol: meeting the prospect requirement and ensuring distinctiveness when assigning forest development phases
Authors: Zenner Eric K. , Peck JeriLynn E. , Hobi Martina L. , Commarmot Brigitte
Published: March 2016

Aims

Evaluation and modification of a classification protocol for delineating development phases of the beech forest life cycle (Tabaku, Struktur von Buchen‐Urwäldern in Albanien im Vergleich mit deutschen Buchen‐Naturwaldreservaten und‐Wirtschaftswäldern, 2000).

Location

The Uholka‐Shyrokyi Luh primeval beech forest, Carpathian Biosphere Reserve in the Ukrainian Carpathian Mountains.

Methods

The classification protocol was evaluated by examining the requirements for each type based on the literature and empirically assessing the suitability of the typology resulting from applying it to non‐overlapping 156.25 m2 grid cells superimposed on a 10‐ha stem‐mapped old‐growth European beech stand. Modifications were proposed and the modified protocol applied to the 10‐ha old‐growth stand and evaluated using permutation tests to assess the distinctiveness of primary attributes among types in the resulting typology.

Results

We found a consistent bias in the classification protocol resulting from a failure of the prospect requirement: the compound classification rule rendered it virtually impossible for grid cells to be assigned to the Late Optimum phase. The proposed modified protocol alleviates this problem and was found to result in distinct types with statistically significantly different mean values for many primary attributes.

Conclusions

Interpretations of a purported ‘signature texture’ for old‐growth beech forests dependent on the absence of the Late Optimum phase when using the original classification protocol require reconsideration. The proposed modified protocol would be less susceptible to this bias, but caution is still advised, given the inherent constraints of the classification protocol at small scales.
Complications and quality of life in elderly patients with several comorbidities undergoing cutaneous ureterostomy with single stoma or ileal conduit after radical cystectomy
Authors: Longo Nicola , Imbimbo Ciro , Fusco Ferdinando , Ficarra Vincenzo , Mangiapia Francesco , Di Lorenzo Giuseppe , Creta Massimiliano , Imperatore Vittorio , Mirone Vincenzo
Published: March 2016

Objectives

To compare peri‐operative outcomes and quality of life (QoL) in a series of elderly patients with high comorbidity status who underwent single stoma cutaneous ureterostomy (CU) or ileal conduit (IC) after radical cystectomy (RC).

Patients and Methods

The clinical records of patients aged >75 years with an American Society of Anesthesiologists (ASA) score >2 who underwent RC at a single institution between March 2009 and March 2014 were retrospectively analysed. After RC, all patients included in the study received an IC urinary diversion or a CU with single stoma urinary diversion. Preoperative clinical characteristics as well as intra‐ and postoperative outcomes were evaluated and compared between the two groups. In addition, the Bladder Cancer Index (BCI) was used to assess QoL.

Results

A total of 70 patients were included in the final comparative analyses. Of these, 35 underwent IC diversion and 35 CU single stoma diversion. The two groups were similar with regard to age, gender, ASA score, type of indication and pathological features. Operating times (P < 0.001), estimated blood loss (P < 0.001), need for intensive care unit stay (P = 0.01), time to drain removal (P < 0.001) and length of hospital stay (P < 0.001) were significantly higher in patients undergoing IC diversion. The number of patients with intra‐ (P = 0.04) and early postoperative (P = 0.02) complications was also significantly higher among those undergoing IC diversion. Interestingly, the mean BCI scores were overlapping in the two groups.

Conclusions

The present results show that CU with a single stoma can represent a valid alternative to IC in elderly patients with relevant comorbidities, reducing peri‐operative complications without a significant impairment of QoL.
The safety of robot‐assisted cystectomy in patients with previous history of pelvic irradiation
Authors: Al Hussein Al Awamlh Bashir , Nguyen Daniel P. , Otto Brandon , O'Malley Padraic , Khan Farehin , Brooks Savanah , Scherr Douglas S.
Published: March 2016

Objective

To determine the safety of robot‐assisted cystectomy (RAC) in patients with an irradiated pelvis, by comparing perioperative complication outcomes after RAC in patients with and without a history of pelvic irradiation.

Patients and Methods

In all, 252 consecutive patients underwent RAC at a tertiary referral centre from 2002 to 2013. Of all patients, 46 (18%) had a history of pelvic irradiation. Complications occurring at ≤30 days and ≤90 days of RAC were graded using the modified Clavien–Dindo classification system and additionally categorised by organ system. Baseline variables and outcomes of irradiated and non‐irradiated patients were compared using descriptive statistics. Multivariable logistic regression models were generated to test the effect of previous pelvic irradiation on complications.

Results

The indications for RAC in patients with a history of pelvic irradiation were: bladder cancer (30 patients, 65%), prostate cancer (two, 4%), fistulae (five, 11%), and intractable symptoms from radiation cystitis (nine, 20%). In all, 25 (54%) irradiated and 112 (54%) non‐irradiated patients had complications at ≤90 days (P > 0.9), of which 11 (24%) and 43 (21%) respectively had major complications (P = 0.7). One (2%) patient with and two (1%) patients without a history of irradiation died from surgical complications (P = 0.5). Infectious, bleeding, and gastrointestinal complications were the most common events in both groups. In multivariable analyses, a history of pelvic irradiation was not associated with a higher risk of complications.

Conclusion

RAC performed by an experienced surgeon is a reasonable option in selected patients with a history of pelvic irradiation, as complication rates do not significantly differ compared with non‐irradiated patients.
Combination of prostate imaging reporting and data system (PI‐RADS) score and prostate‐specific antigen (PSA) density predicts biopsy outcome in prostate biopsy naïve patients
Authors: Washino Satoshi , Okochi Tomohisa , Saito Kimitoshi , Konishi Tsuzumi , Hirai Masaru , Kobayashi Yutaka , Miyagawa Tomoaki
Published: March 2016

Objective

To assess the value of the Prostate Imaging Reporting and Data System (PI‐RADS) scoring system, for prostate multi‐parametric magnetic resonance imaging (mpMRI) to detect prostate cancer, and classical parameters, such as prostate‐specific antigen (PSA) level, prostate volume and PSA density, for predicting biopsy outcome in biopsy naïve patients who have suspected prostate cancer.

Patients and methods

Patients who underwent mpMRI at our hospital, and who had their first prostate biopsy between July 2010 and April 2014, were analysed retrospectively. The prostate biopsies were taken transperineally under transrectal ultrasonography guidance. In all, 14 cores were biopsied as a systematic biopsy in all patients. Two cognitive fusion‐targeted biopsy cores were added for each lesion in patients who had suspicious or equivocal lesions on mpMRI. The PI‐RADS scoring system version 2.0 (PI‐RADS v2) was used to describe the MRI findings. Univariate and multivariate analyses were performed to determine significant predictors of prostate cancer and clinically significant prostate cancer.

Results

In all, 288 patients were analysed. The median patient age, PSA level, prostate volume and PSA density were 69 years, 7.5 ng/mL, 28.7 mL, and 0.26 ng/mL/mL, respectively. The biopsy results were benign, clinically insignificant, and clinically significant prostate cancer in 129 (45%), 18 (6%) and 141 (49%) patients, respectively. The multivariate analysis revealed that PI‐RADS v2 score and PSA density were independent predictors for prostate cancer and clinically significant prostate cancer. When PI‐RADS v2 score and PSA density were combined, a PI‐RADS v2 score of ≥4 and PSA density ≥0.15 ng/mL/mL, or PI‐RADS v2 score of 3 and PSA density of ≥0.30 ng/mL/mL, was associated with the highest clinically significant prostate cancer detection rates (76–97%) on the first biopsy. Of the patients in this group with negative biopsy results, 22% were subsequently diagnosed as prostate cancer. In contrast, a PI‐RADS v2 score of ≤3 and PSA density of <0.15 ng/mL/mL yielded no clinically significant prostate cancer and no additional detection of prostate cancer on further biopsies.

Conclusions

A combination of PI‐RADS v2 score and PSA density can help in the decision‐making process before prostate biopsy and in the follow‐up strategy in biopsy naïve patients. Patients with a PI‐RADS v2 score of ≤3 and PSA density of <0.15 ng/mL/mL may avoid unnecessary biopsies.
MODELLING THE TRANSITION TOWARDS THE RENMINBI'S FULL CONVERTIBILITY: IMPLICATIONS FOR CHINA'S GROWTH
Authors: Bonatti Luigi , Fracasso Andrea
Published: March 2016

There is a widespread consensus that China needs to rebalance its export‐driven growth paradigm towards a more consumption‐based one and that such process is to be accompanied by the transition towards the renminbi's full convertibility. However, the Chinese authorities have so far acted with great caution because this transition cannot but accelerate the slowdown of China's growth which will likely occur because of other structural factors. We address these issues by means of a two‐country two‐stage (before and after the renminbi's full convertibility) model, which reproduces some qualitative features of China's growth pattern and its relationship with the United States. We analyse the extent to which altering the Chinese exchange rate regime, as well as other policies affecting sensitive social and economic issues, may impact on the short‐, medium‐ and long‐term evolution of the Chinese economy. The paper shows that by lifting the controls on the capital account and letting the currency float, the Chinese authorities will renounce those policy instruments for controlling the allocation of the national resources and the dynamics of China's economy.
Synthesis and Biological Evaluation of 3, 8‐dimethyl‐5‐isopropylazulene Derivatives as Anti‐gastric Ulcer Agent
Authors: Cao Tingting , Li Yong , Yang Ziyao , Yuan Mingxing , Li Ying , Yang Hongjun , Feng Yuchuan , Yin Shufan
Published: March 2016

Recent studies showed that Guaiazulene (GA) and Sodium guaiazulene sulfonate (GAS‐Na) have good anti‐gastric ulcer effect. Here, two series of GA derivatives were synthesized and evaluated for their anti‐gastric ulcer activity. The data obtained from in vivo testing of these compounds in a rodent ethanol‐induced stomach injury model are discussed. Among the tested compounds, A1, A4, and A9 (ulcer index: 1.125 ± 1.246**, 1.714 ± 0.756*, 1.875 ± 1.126*) exhibited better anti‐gastric ulcer activity than the positive control Omeprazole (2.005 ± 1.011*). The information got from these studies and the results of 3D‐SAR investigation may be useful in the design of novel anti‐gastric ulcer agents.
Hormonal evaluation in relation to phenotype and genotype in 286 patients with a disorder of sex development from Indonesia
Authors: Juniarto A. Zulfa , van der Zwan Yvonne G. , Santosa Ardy , Ariani Mahayu Dewi , Eggers Stefanie , Hersmus Remko , Themmen Axel P.N. , Bruggenwirth Hennie T. , Wolffenbuttel Katja P. , Sinclair Andrew , White Stefan J. , Looijenga Leendert H.J. , de Jong Frank H. , Faradz Sultana M.H. , Drop Stenvert L.S.
Published: March 2016

Objective

The objective of this study was to determine the aetiological spectrum of disorders of sex development (DSD) in a large cohort of underprivileged and undiagnosed patients from Indonesia.

Methods

A total of 286 patients with atypical external and/or internal genitalia were evaluated using clinical, hormonal, molecular genetic and histological parameters.

Results

The age (years) at presentation was 0–0·5 in 41 (14·3%), >0·5–12 in 181 (63·3%) and >12 in 64 cases (22·4%). 46,XY DSD was most common (68·2%, n = 195), 46,XX DSD was found in 23·4% (n = 67) and sex chromosomal DSD in 8·4% (n = 24). In 61·2% of 46,XX DSD patients, 17·9% of 46,XY DSD patients and all sex chromosome DSD patients (29·4% in total), a final diagnosis was reached based on genetic or histological gonadal tissue evaluation. 17‐hydroxyprogesterone and androstenedione levels were the most distinctive parameters in 46,XX DSD patients. In 46,XY DSD, diagnostic groups were identified based on the external masculinization score: androgen action disorder (AAD), unknown male undermasculinization (UMU), and gonadal dysgenesis (GD). LH, FSH and testosterone levels were most informative especially in the older age group. HCG tests were of no additional value as no patients with androgen synthesis disorders were found. Hormonal profiles of patients with sex chromosome DSD and a Y‐chromosome sequence containing karyotype showed high levels of LH and FSH, and low levels of AMH, inhibin B and testosterone compared with the normal male range. Gene mutations were found in all patients with CAH, but in only 24·5% and 1·8% of patients with AAD and UMU. In 32% of 46,XY GD patients, copy number variants of different genes were found.

Conclusion

A stepwise diagnostic approach led to a molecularly or histologically proven final diagnosis in 29·4% of the patients. The most informative parameters were serum levels of 17‐hydroxyprogesterone and androstenedione in 46,XX DSD patients, and serum LH, FSH and testosterone levels in 46,XY DSD patients.