bluuebunny/crossref_metadata_2025 huggingface dataset:
Emotional timescapes: the temporal perspective and consumption emotions in services
Authors: Maguire Louise , Geiger Susi
Published: April 2015

Purpose

– This study aims to examine how the temporal aspect of service consumption impacts the emotions that are created within consumers during service encounters.

Design/methodology/approach

– The authors adopted mobile phone or ‘SMS’ diaries to capture the emotions that participants experienced at the very moment they were being felt or ‘in-vivo’. The study included thirteen different services including both ‘brief’ and ‘extended service transactions’.

Findings

– The study suggests that the temporal perspective is a dominant cause of consumption emotions in services, influencing consumers’ emotions from before the service encounter commences to its conclusion and, in some cases, beyond the conclusion of the service event. Other antecedents of consumption emotions such as interactions with staff and the servicescape are influenced by and interwoven with this temporal aspect. By capturing emotions as they were experienced, recall difficulties that might have been encountered had the emotions been measured retrospectively were eliminated, allowing the researchers to construct a comprehensive account of the chronology and contiguity of the emotions created within consumers during service encounters.

Originality/value

– Although certain aspects of time such as the consequences of queuing and waiting have been addressed in the services marketing literature, a detailed understanding of how time impacts consumption emotions in services from the start to the conclusion of service encounters has not been undertaken to date. This research addresses that gap by examining how the temporal perspective influences not only consumption emotions in customers per se but how it also influences other causes of consumption emotions that customers encounter during service transactions.
Mass customization for financial services: an empirical study of adoption and usage behavior
Authors: Koch Stefan , Inanc Duygu
Published: April 2015

Purpose

– This paper aims to report findings from an exploratory empirical study focusing on an application of mass customization in financial services. Based on the study of configurations and usage data, the authors evaluate a series of hypotheses relating to the interplay of adoption and usage by customers.

Design/methodology/approach

– The study is based on quantitative analysis of data from a Turkish bank which offers customizable credit cards, encompassing both configurations as well as credit card usage.

Findings

– The results confirm that trial-and-error learning will not end with product definition, but will continue afterwards and lead to changes in customization. Especially active usage length shows a significant positive effect on the number of changes. The effect of base category usage could only partly be confirmed for changes, but was significant for adoption. It was also found that a series of smaller changes in a limited number of attributes has a higher likelihood than a smaller number of changes in a large number of aspects.

Research limitations/implications

– The study uses data from a single financial service provider, from a specific country. In addition, anonymized data on adoption and usage were used, thus demographic data as well as subjective measures from customers were not available.

Practical implications

– The results highlight the importance of specifying the correct solution space, as the authors could at least partially confirm the negative effect of both a large number of options, as well as basing on alternatives rather than attributes on several levels. Although overall mass customization seems less interesting than traditional credit cards, the authors discuss several positive implications for financial sector companies from offering this option.

Originality/value

– The paper extends current literature in focusing for the first time on mass customization for financial services. In addition, this is the first study using longitudinal data on adoption and modification of mass-customized solutions to analyze the long-term behavior of usage.
New regulations: challenge or opportunity for Turkish SMEs?
Authors: Bayraktar Sema
Published: April 2015

Purpose

– This study aims to analyze how recent regulation changes, namely, Basel II and the New Turkish Commercial Code, affect small and medium-sized enterprises (SMEs) and the relationship between SMEs and banks in Turkey through the eyes of SME managers. The author believes that the answers could differ for various types of SME.

Design/methodology/approach

– In-depth interviews enabled a refined analysis of the effects of regulations in the eyes of firms’ representatives. The study was conducted for SMEs in the Anatolia Organized Industrial Zone.

Findings

– One of the important conclusions of the paper is the fact that the loan approval process has been standardized and centralized. The results also show that regulations have different effects on larger and already stable firms than on smaller and/or start-up SMEs that do not have sufficient resources for the transformation required by regulations.

Originality/value

– First, this study is a qualitative study that has the advantage of reaching richer and more plausible information that cannot be obtained by analyzing the numbers. Second, this study tries to analyze the perceptions of SMEs’ financial representatives rather than the perspectives of bank representatives. Finally, to the author’s knowledge, there has been no other study that analyzed a developing country on this topic.
A borrowing cost model for effective performance of SMEs in Uganda
Authors: Tumwine Sulait , Akisimire Richard , Kamukama Nixon , Mutaremwa Gad
Published: April 2015

Purpose

– The purpose of this paper is to develop an effective cost borrowing model of qualitative factors that are relevant to micro and small enterprises (SMEs) better performance.

Design/methodology/approach

– A valid research instrument was utilized to conduct a survey on 359 SMEs (131 retail businesses, 125 service businesses, 48 farming businesses and 55 other businesses) and 897 respondents that are representative of 397 SMEs and 1,087 respondents. Correlation and regression analysis were conducted to ascertain the validity of the hypotheses.

Findings

– It was established that cost of borrowing elements (interest rate and loan processing costs) are associated with SME performance. Furthermore, cost of borrowing as a whole accounts for 31.1 percent of the variation in performance Uganda’s SMEs.

Research limitations/implications

– Only a single research methodological approach was employed, future research through interviews could be undertaken to triangulate. Multiple respondents in SMEs (owner, manager and cashier) were studied neglecting others. Furthermore, the study used the cross-sectional approach – a longitudinal approach should be employed to study the trend over years. Finally, cost of borrowing was studied and by the virtual of the results, there are other factors that contribute to SME performance that were not part of this study.

Practical implications

– There is need to intensify initiatives to encourage greater understanding and acceptance of cost of borrowing, select appropriate elements that includes interest rate and loan processing costs in order to have affordable source of financing to establish and grow SMEs, provide employment, competitive and contribute to countries GDP.

Originality/value

– This is the first paper in Sub-Saharan Africa to test empirically the relationship between cost of borrowing and performance of SMEs in the Ugandan context.
Challenges and constrains faced by small and medium enterprises (SMEs) in Al Batinah governorate of Oman
Authors: Bilal Zaroug Osman , Al Mqbali Nawal Said
Published: April 2015

Purpose

– Although many studies have been conducted in this area in many countries, there is still, a few studies on these enterprises have been done in Oman concerning the obstacles and constrains. The paper aims to discuss this issue.

Design/methodology/approach

– The main purpose of this paper is to throw light on the challenges and constraints faced by small and medium enterprise (SMEs) in Al Batinah Governorate of Oman and try to give some suggestions to solve problems.

Findings

– The data have been gathered through questionnaires from SMEs in Al Batinah Governorate in Oman. The descriptive analysis has been used to analyze the data, nonparametric testing and analysis of variance.

Originality/value

– After the data have been analyzed, the results show that obstacles and constrains facing SMEs in Al Batinah Governorate accordance to their importance are as follows: the investment environment come fist obstacles, capabilities of business owners come second, followed by the marketing obstacles, finance obstacles, while the legislations and regulations obstacles came last. Some of the recommendations have been presented which call for more attention and concentration on solving the obstacles facing SMES in Oman.
What is the animal doing? Tools for exploring behavioural structure in animal movements
Authors: Gurarie Eliezer , Bracis Chloe , Delgado Maria , Meckley Trevor D. , Kojola Ilpo , Wagner C. Michael
Published: April 2015

Movement data provide a window – often our only window – into the cognitive, social and biological processes that underlie the behavioural ecology of animals in the wild. Robust methods for identifying and interpreting distinct modes of movement behaviour are of great importance, but complicated by the fact that movement data are complex, multivariate and dependent. Many different approaches to exploratory analysis of movement have been developed to answer similar questions, and practitioners are often at a loss for how to choose an appropriate tool for a specific question.

We apply and compare four methodological approaches: first passage time (FPT), Bayesian partitioning of Markov models (BPMM), behavioural change point analysis (BCPA) and a fitted multistate random walk (MRW) to three simulated tracks and two animal trajectories – a sea lamprey (Petromyzon marinus) tracked for 12 h and a wolf (Canis lupus) tracked for 1 year.

The simulations – in which, respectively, velocity, tortuosity and spatial bias change – highlight the sensitivity of all methods to model misspecification. Methods that do not account for autocorrelation in the movement variables lead to spurious change points, while methods that do not account for spatial bias completely miss changes in orientation.

When applied to the animal data, the methods broadly agree on the structure of the movement behaviours. Important discrepancies, however, reflect differences in the assumptions and nature of the outputs. Important trade‐offs are between the strength of the a priori assumptions (low in BCPA, high in MRW), complexity of output (high in the BCPA, low in the BPMM and MRW) and explanatory potential (highest in the MRW).

The animal track analysis suggests some general principles for the exploratory analysis of movement data, including ways to exploit the strengths of the various methods. We argue for close and detailed exploratory analysis of movement before fitting complex movement models.
Social information from immigrants: multiple immigrant‐based sources of information for dispersal decisions in a ciliate
Authors: Jacob Staffan , Chaine Alexis S. , Schtickzelle Nicolas , Huet Michèle , Clobert Jean
Published: April 2015

Dispersal is increasingly recognized as being an informed process, based on information organisms obtain about the landscape. While local conditions are often found to drive dispersal decisions, local context is not always a reliable predictor of conditions in neighbouring patches, making the use of local information potentially useless or even maladaptive. In this case, using social information gathered by immigrants might allow adjusting dispersal decisions without paying the costs of prospecting. However, this hypothesis has been largely neglected despite its major importance for ecological and evolutionary processes.

We investigated three fundamental questions about immigrant‐informed dispersal: Do immigrants convey information that influences dispersal, do organisms use multiple cues from immigrants, and is immigrant‐informed dispersal genotype dependent?

Using Tetrahymena thermophila ciliates in microcosms, we manipulated the number of immigrants arriving, the density of congeners, the resource quality in neighbouring patches, matrix characteristics and the level of cooperation of individuals in the neighbouring populations.

We provide the first experimental evidence that immigrants convey a number of different cues about neighbouring patches and matrix (patch quality, matrix characteristics and cooperation in neighbouring populations) in this relatively simple organism. Furthermore, we demonstrate genotype‐dependent immigrant‐informed dispersal decisions about patch quality and matrix characteristics.

Multiple cues from immigrants and genotype‐dependent use of cues have major implications for theoretical metapopulation dynamics and the potential for local adaptation.
Combined effects of retention forestry and prescribed burning on polypore fungi
Authors: Suominen Mai , Junninen Kaisa , Heikkala Osmo , Kouki Jari
Published: April 2015

Retention forestry and prescribed burning aim to alleviate the negative effects of forestry on biodiversity by maintaining the structural elements of natural forests in managed forests. We present the long‐term effects of these methods on polypore fungi, a taxonomic group that has been severely affected by forestry.

Using a 10‐year, large‐scale field experiment, we studied how prescribed burning and two different tree retention levels (10 and 50 m3 ha−1) affect polypore fungi. We monitored polypore sporocarps on 2767 individually marked trees four times over the study period: in the first autumn after the treatments, and again 2, 4 and 10 years after the treatments.

The number of polypore species and records initially increased rather slowly but showed a marked increasing trend towards the end of the 10‐year monitoring period. After 2 years, the higher retention sites had an average 8·5 species and the low retention sites 4·5 species per site. After 4 years, the difference was 14 vs. 9 species and after 10 years 26 vs. 19 species. Red‐listed species were not found often on the trunks earlier than 10 years after the treatments.

Prescribed burning increased the number of polypore species and records along with time. Furthermore, 13 species favoured burned sites, while only six species favoured unburned sites, and the differences in the composition of species assemblages between burned and unburned sites were evident 10 years after the treatments.

Synthesis and applications. We show, for the first time, that retention trees can host rich polypore assemblages, and even some red‐listed species, and, thus, be useful in conservation of forest biodiversity outside protected areas. Higher retention levels maintain more diverse polypore assemblages. Prescribed burning increases the positive effects of retention forestry by creating substrates that are typical in the early‐successional natural forests.
Feeding evolution of a herbivore influences an arthropod community through plants: implications for plant‐mediated eco‐evolutionary feedback loop
Authors: Utsumi Shunsuke
Published: April 2015

Genetic variation in individual species can have important ecological consequences, and sometimes, these interactions are mediated through another species. For example, genetic variation in an herbivore could alter plant responses that then influence other plant‐associated arthropods. However, few systems have experimentally tested the ecological consequences of genetic variation as mediated through other species, especially within the same trophic community context.

I studied how evolution of feeding preference in the willow leaf beetle (Plagiodera versicolora), which occurs under selection in a herbivore community context, feeds back to an arthropod community through plant‐mediated indirect interactions. Previous studies show beetle populations locally adapt distinct preferences ranging from the gourmet‐type, which feeds exclusively on new leaves of willows, to the no‐preference (no‐pref) type, which displays non‐preferential feeding on leaves of different ages.

I conducted field experiments at two sites that mimicked evolutionary changes in the feeding preference of the leaf beetle. I manipulated the composition of leaf beetle feeding types for 6 days in spring and then investigated subsequent development of arthropod communities. I found that initial herbivory by a higher proportion of gourmet‐type beetles led to lower subsequent abundance of conspecific beetle larvae. In contrast, a higher proportion of gourmet‐type beetles resulted in higher abundance of aphids. Aphid‐tending ants also increased with the increasing abundance of aphids. As a result, species diversity of arthropod communities decreased with the proportion of gourmet‐type beetles in the initial beetle treatment.

Community assembly dynamics were significantly influenced by interactive effects between the initial beetle treatment and subsequent colonizer species identities. Thus, beetle genetic variation had long‐lasting effects through a temporal chain of indirect interactions likely mediated through induced plant responses and the abundance of aphids.

Synthesis. Evolutionary changes in feeding traits within an herbivore species had profound but predictable impact on local arthropod communities. Because the feeding evolution of herbivores nearly always occurs in a community context, plant‐mediated feedback loops between the evolution and ecological community of arthropods may be widespread in nature.
Vitamin D3 potentiates the growth inhibitory effects of metformin in DU145 human prostate cancer cells mediated by AMPK/mTOR signalling pathway
Authors: Li Hong‐Xia , Gao Jing‐Miao , Liang Jia‐Qi , Xi Jun‐Min , Fu Meng , Wu Yong‐Jie
Published: April 2015

Metformin and vitamin D3 both exhibit a strong antiproliferative action in numerous cancer cell lines, including in human prostate cancer cells. Here we showed that the combination of the two drugs had a much stronger effect on DU145 human prostate cancer cell growth than either drug alone. In this research, cell proliferation was measured by methylthiazol tetrazolium (MTT) assay. Cell apoptosis was determined with Hoechst 33342 staining. Western blotting and cell cycle analyses were used to elucidate potential mechanisms of interaction between the drugs. It is shown that in cultured DU145 cells, vitamin D3 combined with metformin exhibits synergistic effects on cell proliferation and apoptosis. The underlying antitumor mechanisms may involve altered cycle distribution with a G1/S cell cycle arrest, activation of phospho‐AMPK with subsequent inhibition of downstream mTOR signalling pathway, down‐regulate c‐Myc expression, and reducing the level of anti‐apoptotic protein p‐Bcl‐2. In conclusion, metformin and vitamin D3 synergistically inhibit DU145 cell growth, indicating a promising clinical therapeutic strategy for the treatment of androgen‐independent prostate cancer.
A Rickettsiales symbiont of amoebae with ancient features
Authors: Schulz Frederik , Martijn Joran , Wascher Florian , Lagkouvardos Ilias , Kostanjšek Rok , Ettema Thijs J. G. , Horn Matthias
Published: April 2015

The Rickettsiae comprise intracellular bacterial symbionts and pathogens infecting diverse eukaryotes. Here, we provide a detailed characterization of ‘Candidatus Jidaibacter acanthamoeba’, a rickettsial symbiont of Acanthamoeba. The bacterium establishes the infection in its amoeba host within 2 h where it replicates within vacuoles. Higher bacterial loads and accelerated spread of infection at elevated temperatures were observed. The infection had a negative impact on host growth rate, although no increased levels of host cell lysis were seen. Phylogenomic analysis identified this bacterium as member of the Midichloriaceae. Its 2.4 Mb genome represents the largest among Rickettsiales and is characterized by a moderate degree of pseudogenization and a high coding density. We found an unusually large number of genes encoding proteins with eukaryotic‐like domains such as ankyrins, leucine‐rich repeats and tetratricopeptide repeats, which likely function in host interaction. There are a total of three divergent, independently acquired type IV secretion systems, and 35 flagellar genes representing the most complete set found in an obligate intracellular Alphaproteobacterium. The deeply branching phylogenetic position of ‘Candidatus Jidaibacter acanthamoeba’ together with its ancient features place it closely to the rickettsial ancestor and helps to better understand the transition from a free‐living to an intracellular lifestyle.
Social acceptance and the choosing of favourite classmates: a comparison between students with special educational needs and typically developing students in a context of full inclusion
Authors: Nepi L. D. , Fioravanti J. , Nannini P. , Peru A.
Published: April 2015

Empirical data on the effects of inclusion regarding the social participation of typically developing students and those with special educational needs are still controversial. While some studies suggest that the more extensive the inclusion, the higher the social position of students with special educational needs, evidence from other studies indicates that the full inclusion of students with special educational needs into ordinary schools is not sufficient, per se, to increase their social participation. In this study, we set out to investigate the social position of students with special educational needs and typically developing students studying in regular classroom environments in Italian primary and secondary schools. Given that being accepted is far from the same as being chosen, besides examining rates of acceptance and rejection, we also considered the choices made by students regarding their favourite classmates. The results demonstrated that students with special educational needs are significantly less accepted and are very rarely chosen as favoured classmates by their typically developing counterparts. The theoretical and practical implications of these results are discussed.
Fiscal Transparency, Fiscal Performance and Credit Ratings
Authors: Arbatli Elif , Escolano Julio
Published: April 2015

Fiscal transparency can provide policymakers with incentives to adopt better policies by enhancing the public debate on the design and sustainability of fiscal policy and establishing accountability for their implementation. Fiscal transparency can also reduce uncertainty about fiscal policy and fiscal outturns by providing more information on the underlying fiscal position and fiscal risks. Both effects suggest that countries should benefit from adopting transparency enhancing policies through better market assessments of their sovereign risk. In this paper, we investigate whether fiscal transparency has an effect on market perceptions of sovereign risk, as measured by sovereign credit ratings, and if so, through which channels. We find that fiscal transparency has a positive and significant effect on ratings – one standard deviation increase in fiscal transparency increases credit ratings by 0.7 and 1 notches (or steps in the credit rating scale) in advanced and developing economies, respectively – but its effect works through different channels in advanced and developing economies. In advanced economies, fiscal transparency is associated with better fiscal outcomes, leading indirectly to higher credit ratings. In developing economies, the direct uncertainty‐reducing effect of fiscal transparency seems to be more important. Indeed, the effect of fiscal transparency on fiscal performance is found to increase with the level of institutional development.
How voters' perceptions of junior coalition partners depend on the prime minister's position
Authors: Fortunato David , Adams James
Published: April 2015

Recent studies document that voters infer parties' left‐right policy agreement based on governing coalition arrangements. This article extends this research to present theoretical and empirical evidence that European citizens update their perceptions of junior coalition partners' left‐right policies to reflect the policies of the prime minister's party, but that citizens do not reciprocally project junior coalition partners' policies onto the prime minister's party. These findings illuminate the simple rules that citizens employ to infer parties' policy positions, broaden understanding of how citizens perceive coalition governance and imply that ‘niche’ parties, whose electoral appeal depends upon maintaining a distinctive policy profile, assume electoral risks when they enter government.
Prostatosymphyseal fistula and osteomyelitis pubis following transurethral resection of the prostate: CT and MRI findings
Authors: Plateau Benjamin , Ruivard Marc , Montoriol Pierre‐François
Published: April 2015

We present a very rare case of osteomyelitis pubis in a 75‐year‐old male patient due to a prostatosymphyseal fistula, which constituted a few weeks after trans‐urethral resection of the prostate. The patient had a previous history of prostatic carcinoma treated by radiotherapy, which may have played a role in the development of the fistula. Computed tomography with excretory phase and magnetic resonance imaging were performed and enabled to make the final diagnosis.
Nefopam as an adjunct to intravenous patient‐controlled analgesia after renal transplantation: a randomised trial
Authors: Kim S. Y. , Huh K. H. , Roh Y. H. , Oh Y. J. , Park J. , Choi Y. S.
Published: April 2015

Background

Nefopam has been used as an adjuvant to opioid analgesia after operation. We investigated the efficacy of nefopam as an adjunct to fentanyl‐based intravenous patient‐controlled analgesia (IV PCA) on post‐operative pain relief in patients undergoing renal transplantation.

Methods

Ninety‐eight patients undergoing elective renal transplantation were randomised into two groups: nefopam or control groups. The former received nefopam (160 mg in 200 ml at a rate of 4 ml/h) whereas the latter received normal saline during the first 48 h after reperfusion of grafted kidney. Pain intensity scores, cumulative dose of fentanyl, and the incidence of adverse events were assessed at 1, 6, 12, 24, and 48 h post‐operatively. Serum creatinine and estimated glomerular filtration rate were evaluated on post‐operative days 1, 2, 4, and 7.

Results

The cumulative fentanyl consumption during the first 48 h after operation was 19% less in the nefopam group than that in the control group (1005 ± 344 μg vs. 1246 ± 486 μg, mean ± SD; P = 0.006). Pain intensity scores at rest and on coughing were significantly lower in the nefopam group throughout the first 12 and 48 h after operation, respectively. Adverse events and early graft function were comparable between the groups, except a significantly lower incidence of drowsiness observed in the nefopam group (4% vs. 21%, P = 0.027).

Conclusion

In combination with fentanyl PCA, nefopam reduced post‐operative fentanyl consumption with superior analgesia after renal transplantation.
Prevalence and predictors of persistent post‐surgical pain 12 months after thoracotomy
Authors: Hetmann F. , Kongsgaard U. E. , Sandvik L. , Schou‐Bredal I.
Published: April 2015

Background

Persistent post‐surgical pain is recognised as a major problem. Prevalence after different surgical procedures has been reported to range from 5% up to 85%. Limb amputation and thoracotomy have the highest reported prevalence. Prediction of persistent post‐surgical pain has over the last decade caught attention. Several factors have been investigated, but in‐depth knowledge is still scarce. The purpose of this study was to investigate the prevalence of persistent post‐surgical pain, and predictive factors for persistent post‐surgical pain 12 months after thoracotomy.

Methods

A prospective longitudinal study was conducted. One‐hundred and seventy patients were recruited before scheduled thoracotomy, and asked to answer a questionnaire. One‐hundred and six patients completed the same questionnaire at 12‐month follow‐up. Regression analysis was performed to explore variables assumed predictive of persistent post‐surgical pain.

Results

One‐hundred and six patients (62%) filled out the questionnaire at both time points. Preoperative, 34% reported muscle‐skeletal related chronic pain. At 12‐month follow‐up, 50% of the patients reported persistent post‐surgical pain. Of the variables explored in the logistic regression model, only preoperative pain (P < 0.001) and dispositional optimism (P = 0.04) were statistically significant. In this study, preoperative pain was a predominant predictor for persistent postoperative pain (OR 6.97, CI 2.40–20.21), while dispositional optimism (OR 0.36, CI 0.14–0.96) seem to have protective properties.

Conclusion

Our results show that preoperative pain is a predominant predictor of future pain. This implies that patients presenting with a chronic pain condition prior to surgery should be assessed thoroughly preoperatively and have an individually tailored analgesic regimen.
Ethical Issues in the Response to Ebola Virus Disease in United States Emergency Departments: A Position Paper of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine
Authors: Venkat Arvind , Asher Shellie L. , Wolf Lisa , Geiderman Joel M. , Marco Catherine A. , McGreevy Jolion , Derse Arthur R. , Otten Edward J. , Jesus John E. , Kreitzer Natalie P. , Escalante Monica , Levine Adam C. ,   the American College of Emergency Physicians,   the Emergency Nurses Association,   the Society for Academic Emergency Medicine
Published: April 2015

The 2014 outbreak of Ebola virus disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments (EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians (EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD.
Learning Curves in Emergency Ultrasound Education
Authors: Blehar David J. , Barton Bruce , Gaspari Romolo J.
Published: April 2015

Objectives

Proficiency in the use of bedside ultrasound (US) has become standard in emergency medicine residency training. While milestones have been established for this training, supporting data for minimum standard experience are lacking. The objective of this study was to characterize US learning curves to identify performance plateaus for both image acquisition and interpretation, as well as compare performance characteristics of learners to those of expert sonographers.

Methods

A retrospective review of an US database was conducted at a single academic institution. Each examination was scored for agreement between the learner and expert reviewer interpretation and given a score for image quality. A locally weighted scatterplot smoothing method was used to generate a model of predicted performance for each individual examination type. Performance characteristics for expert sonographers at the site were also tracked and used in addition to performance plateaus as benchmarks for learning curve analysis.

Results

There were 52,408 US examinations performed between May 2007 and January 2013 and included for analysis. Performance plateaus occurred at different points for different US protocols, from 18 examinations for soft tissue image quality to 90 examinations for right upper quadrant image interpretation. For the majority of examination types, a range of 50 to 75 examinations resulted in both excellent interpretation (sensitivity > 84% and specificity > 90%) and good image quality (90% the image quality benchmark of expert sonographers).

Conclusions

Educational performance benchmarks occur at variable points for image interpretation and image quality for different examination types. These data should be considered when developing training standards for US education as well as experience requirements for US credentialing.
Laboratory Alcohol Self‐Administration Experiments Do Not Increase Subsequent Real‐Life Drinking in Young Adult Social Drinkers
Authors: Sommer Christian , Seipt Christian , Spreer Maik , Blümke Toni , Markovic Alexandra , Jünger Elisabeth , Plawecki Martin H. , Zimmermann Ulrich S.
Published: April 2015

Background

While the utility of experimental free‐access alcohol self‐administration paradigms is well established, little data exist addressing the question of whether study participation influences subsequent natural alcohol consumption. We here present drinking reports of young adults before and after participation in intravenous alcohol self‐administration studies.

Methods

Timeline Follow‐back drinking reports for the 6 weeks immediately preceding the first, and the 6 weeks after the last experimental alcohol challenge were examined from subjects completing 1 of 2 similar alcohol self‐administration paradigms. In study 1, 18 social drinkers (9 females, mean age 24.1 years) participated in 3 alcohol self‐infusion sessions up to a maximum blood alcohol concentration (BAC) of 160 mg%. Study 2 involved 60 participants (30 females, mean age 18.3 years) of the Dresden Longitudinal Study on Alcohol Use in Young Adults (D‐LAYA), who participated in 2 sessions of alcohol self‐infusion up to a maximum BAC of 120 mg%, and a nonexposed age‐matched control group of 42 (28 females, mean age 18.4 years) subjects.

Results

In study 1, participants reported (3.7%) fewer heavy drinking days as well as a decrease of 2.5 drinks per drinking day after study participation compared to prestudy levels (p < 0.05, respectively). In study 2, alcohol‐exposed participants reported 7.1% and non‐alcohol‐exposed controls 6.5% fewer drinking days at poststudy measurement (p < 0.001), while percent heavy drinking days and drinks per drinking day did not differ.

Conclusions

These data suggest that participation in intravenous alcohol self‐administration experiments does not increase subsequent real‐life drinking of young adults.
Effects of Acamprosate on Attentional Set‐Shifting and Cellular Function in the Prefrontal Cortex of Chronic Alcohol‐Exposed Mice
Authors: Hu Wei , Morris Brett , Carrasco Angelique , Kroener Sven
Published: April 2015

Background

The medial prefrontal cortex (mPFC) inhibits impulsive and compulsive behaviors that characterize drug abuse and dependence. Acamprosate is the leading medication approved for the maintenance of abstinence, shown to reduce craving and relapse in animal models and human alcoholics. Whether acamprosate can modulate executive functions that are impaired by chronic ethanol (EtOH) exposure is unknown. Here we explored the effects of acamprosate on an attentional set‐shifting task and tested whether these behavioral effects are correlated with modulation of glutamatergic synaptic transmission and intrinsic excitability of mPFC neurons.

Methods

We induced alcohol dependence in mice via chronic intermittent EtOH (CIE) exposure in vapor chambers and measured changes in alcohol consumption in a limited access 2‐bottle choice paradigm. Impairments of executive function were assessed in an attentional set‐shifting task. Acamprosate was applied subchronically for 2 days during withdrawal before the final behavioral test. Alcohol‐induced changes in cellular function of layer 5/6 pyramidal neurons, and the potential modulation of these changes by acamprosate, were measured using patch clamp recordings in brain slices.

Results

Chronic EtOH exposure impaired cognitive flexibility in the attentional set‐shifting task. Acamprosate improved overall performance and reduced perseveration. Recordings of mPFC neurons showed that chronic EtOH exposure increased use‐dependent presynaptic transmitter release and enhanced postsynaptic N‐methyl‐d‐aspartate receptor function. Moreover, CIE treatment lowered input resistance, and decreased the threshold and the after hyperpolarization of action potentials, suggesting chronic EtOH exposure also impacted membrane excitability of mPFC neurons. However, acamprosate treatment did not reverse these EtOH‐induced changes cellular function.

Conclusions

Acamprosate improved attentional control of EtOH exposed animals, but did not alter the concurrent changes in synaptic transmission or membrane excitability of mPFC neurons, indicating that these changes are not the pharmacological targets of acamprosate in the recovery of mPFC functions affected by chronic EtOH exposure.
Mechanoreceptors in the Anterior Horn of the Equine Medial Meniscus: an Immunohistochemical Approach
Authors: Nemery E. , Gabriel A. , Grulke S. , Piret J. , Toppets V. , Antoine N.
Published: April 2015

Lameness due to stifle and especially meniscal lesions is frequent in equine species. In humans, mechanoreceptors involved in proprioceptive function are well studied. Given the high incidence of meniscal injuries in horses, and the lack of information concerning them in equine menisci, our objective was to study these corpuscles in six healthy anterior horns of the equine medial meniscus, which is the most common localisation reported for equine meniscal injuries. Immunohistochemical stainings were performed using antibodies against high molecular weight neurofilaments and glial fibrillary acidic proteins. From a purely fundamental point of view, our work highlights for the first time the presence of Ruffini, Pacini and Golgi corpuscles in equine meniscus. They were found, isolated or in clusters and always located at the vicinity of blood vessels, at the level of the anterior horn of the equine medial meniscus. This morphological approach could serve as a basis for clinical studies, to evaluate the impact of these corpuscles on the poor sportive prognosis in equine meniscal tears.
A New Correction for Multiple Testing in Gene–Gene Interaction Studies
Authors: Babron Marie‐Claude , Etcheto Adrien , Dizier Marie‐Helene
Published: April 2015

A major problem in gene–gene interaction studies in large marker panels is how to correct for multiple testing while accounting for the dependence between marker pairs due to the presence of linkage disequilibrium. The “gold standard” approach is to perform permutations of case/control labels. However, this is often not feasible in practice, due to computational demands. Here, we propose a correction based on the effective number of independent tests of interaction between marker pairs. This number depends on the effective number of independent single‐marker tests. We tested its validity using simulated samples, as well as that of another correction of marker pair tests. We showed that our approach was valid while the other correction strongly underestimated the effective number of independent tests. Our method provides estimates of the effective number of independent tests close to those reported in the literature for a Genome‐Wide Interaction Study on a 550K chip. Our correction method is quick and simple, and can be applied whatever the marker panel and the underlying linkage disequilibrium pattern.
Joint Effect of Unlinked Genotypes: Application to Type 2 Diabetes in the EPIC‐Potsdam Case‐Cohort Study
Authors: Knüppel Sven , Meidtner Karina , Arregui Maria , Holzhütter Hermann‐Georg , Boeing Heiner
Published: April 2015

Analyzing multiple single nucleotide polymorphisms (SNPs) is a promising approach to finding genetic effects beyond single‐locus associations. We proposed the use of multilocus stepwise regression (MSR) to screen for allele combinations as a method to model joint effects, and compared the results with the often used genetic risk score (GRS), conventional stepwise selection, and the shrinkage method LASSO. In contrast to MSR, the GRS, conventional stepwise selection, and LASSO model each genotype by the risk allele doses. We reanalyzed 20 unlinked SNPs related to type 2 diabetes (T2D) in the EPIC‐Potsdam case‐cohort study (760 cases, 2193 noncases). No SNP–SNP interactions and no nonlinear effects were found. Two SNP combinations selected by MSR (Nagelkerke's R² = 0.050 and 0.048) included eight SNPs with mean allele combination frequency of 2%. GRS and stepwise selection selected nearly the same SNP combinations consisting of 12 and 13 SNPs (Nagelkerke's R² ranged from 0.020 to 0.029). LASSO showed similar results. The MSR method showed the best model fit measured by Nagelkerke's R² suggesting that further improvement may render this method a useful tool in genetic research. However, our comparison suggests that the GRS is a simple way to model genetic effects since it does not consider linkage, SNP–SNP interactions, and no non‐linear effects.
Predictors of depression outcomes among abstinent methamphetamine‐dependent individuals exposed to an exercise intervention
Authors: Haglund Margaret , Ang Alfonso , Mooney Larissa , Gonzales Rachel , Chudzynski Joy , Cooper Christopher B. , Dolezal Brett A. , Gitlin Michael , Rawson Richard A.
Published: April 2015

Background and Objectives

This paper expands on a study investigating depression outcomes in response to an 8‐week exercise intervention among methamphetamine (MA) dependent individuals in early recovery.

Methods

A total of 135 MA‐dependent individuals enrolled in residential treatment were randomly assigned to either a structured exercise intervention or a structured health education control group. Both groups were similar in format: 60‐minute sessions, offered three times a week over an 8‐week study period.

Results

Results showed that at the 8‐week trial endpoint, participants randomized to the exercise intervention showed significantly greater reduction in depression symptom scores than participants randomized to the health education group, and that participants who attended the greatest number of exercise sessions derived the greatest benefit. This paper further analyzes study data to uncover individual predictors of depression response to exercise and finds that among participants randomized to exercise treatment, individuals with the most severe medical, psychiatric, and addiction disease burden at baseline showed the most significant improvement in depressive symptoms by study endpoint.

Conclusions

Our findings suggest that exercise in moderate dose is effective at treating depressive symptoms in individuals in early recovery from addiction, and furthermore, that treatment with exercise appears to be particularly beneficial to individuals who suffer from severe medical, psychiatric, and addictive disorders. (Am J Addict 2015;24:246–251)
Baseline characteristics of patients predicting suitability for rapid naltrexone induction
Authors: Mogali Shanthi , Khan Nabil A. , Drill Esther S. , Pavlicova Martina , Sullivan Maria A. , Nunes Edward , Bisaga Adam
Published: April 2015

Background and Objectives

Extended‐release (XR) injection naltrexone has proved promising in the treatment of opioid dependence. Induction onto naltrexone is often accomplished with a procedure known as rapid naltrexone induction. The purpose of this study was to evaluate pre‐treatment patient characteristics as predictors of successful completion of a rapid naltrexone induction procedure prior to XR naltrexone treatment.

Methods

A chart review of 150 consecutive research participants (N = 84 completers and N = 66 non‐completers) undergoing a rapid naltrexone induction with the buprenorphone‐clonidine procedure were compared on a number of baseline demographic, clinical and psychosocial factors. Logistic regression was used to identify client characteristics that may predict successful initiation of naltrexone after a rapid induction‐detoxification.

Results

Patients who failed to successfully initiate naltrexone were younger (AOR: 1.040, CI: 1.006, 1.075), and using 10 or more bags of heroin (or equivalent) per day (AOR: 0.881, CI: 0.820, 0.946). Drug use other than opioids was also predictive of failure to initiate naltrexone in simple bivariate analyses, but was no longer significant when controlling for age and opioid use level.

Conclusions

Younger age, and indicators of greater substance dependence severity (more current opioid use, other substance use) predict difficulty completing a rapid naltrexone induction procedure. Such patients might require a longer period of stabilization and/or more gradual detoxification prior to initiating naltrexone.

Scientific Significance

Our study findings identify specific characteristics of patients who responded positively to rapid naltrexone induction. (Am J Addict 2015;24:258–264)
Neurotoxicity of intrathecal 6% hydroxyethyl starch 130/0.4 injection in a rat model
Authors: Vassal O. , Del Carmine P. , Beuriat P.‐A. , Desgranges F.‐P. , Gadot N. , Allaouchiche B. , Timour‐Chah Q. , Stewart A. , Chassard D.
Published: April 2015

Epidural blood patch is the gold standard treatment for post‐dural puncture headache, although hydroxyethyl starch may be a useful alternative to blood if the latter is contraindicated. The aim of this experimental study was to assess whether hydroxyethyl starch given via an indwelling intrathecal catheter resulted in clinical or histopathological changes suggestive of neurotoxicity. The study was conducted in rats that were randomly allocated to receive three 10‐μl injections on consecutive days of either saline or hydroxyethyl starch administered via the intrathecal catheter. Eight rats were given injections of saline 0.9% and 11 were given 6% hydroxyethyl starch 130/0.4 derived from thin boiling waxy corn starch in 0.9% sodium chloride (Voluven®). Daily clinical evaluation, activity measured by actimetry and neuropathological analysis of the spinal cord were subsequently performed to assess for signs of neurotoxicity. No clinical or actimetric changes were observed in either group following intrathecal saline or hydroxyethyl starch administration. Histopathological examination showed non‐specific changes with no differences between the two groups. This experimental study in the rat suggests that repeated intrathecal injection of hydroxyethyl starch is not associated with neurotoxicity.