bluuebunny/crossref_metadata_2025 huggingface dataset:
Using an iPad for Basic Communication Between Spanish-Speaking Families and Nurses in Pediatric Acute Care
Authors: Jackson Kylie H. , Mixer Sandra J.
Published: April 2017

The growing number of Spanish speakers in the United States poses communication challenges for healthcare providers. Language barriers in pediatric acute care have been associated with an increased risk for adverse events, longer hospital stays, and decreased quality of care. In addition, clinicians’ usage of interpreter services is inconsistent. In fact, nurses often lack interpreter support during daily bedside care. Nursing staff at a pediatric children’s hospital in the southeastern United States identified bedside communication with Spanish-speaking patients and families as a clinical challenge. To address this challenge, a basic communication interface, UTalk version 1.0 (the author is the owner and proprietor), supported by an Apple iPad, was developed by the researcher with input from nursing staff, a certified medical interpreter, and Spanish-speaking community members. A feasibility pilot study of the interface’s usability and engagement was conducted on the hospital’s pediatric medical-surgical unit through qualitative interviews with nurse-family dyads. Three themes emerged from the data: UTalk-facilitated communication, UTalk needs improvement, and interpreter miscommunication. These findings indicate that a mobile digital device interface is a feasible method for augmenting bedside communication with Spanish-speaking patients and families. These results also may serve as a reference for the development of similar mobile device interfaces. Further research with a larger sample size is needed.
Successful Treatment of Stable Vitiligo by Low-Density Cultured Autologous Melanocyte Transplantation Combined With Narrowband Ultraviolet B Therapy
Authors: Yao Lei , Liu Yuanyuan , Song Yang , Zhong Shuxia , Li Shanshan
Published: April 2017

BACKGROUND

Cultured autologous melanocyte transplantation (CMT) is an effective treatment for stable vitiligo, but the current method is time consuming and expensive because of the requirement of a large number of melanocytes.

OBJECTIVE

To assess the clinical effect of low-density CMT combined with narrowband ultraviolet B (NB-UVB) in treating stable vitiligo.

MATERIALS AND METHODS

The authors treated 8 patients with CMT at a low cell density (less than 2.5 × 104 cells/cm2). Among them, 6 patients underwent NB-UVB therapy after CMT.

RESULTS

All the 6 patients treated with low-density CMT combined with NB-UVB obtained more than 90% repigmentation at the 1-year follow-up.

CONCLUSION

The authors' data suggest that low-density CMT combined with NB-UVB can be an effective form of surgical treatment for stable vitiligo.
Effect of Electroacupuncture at The Zusanli Point (Stomach-36) on Dorsal Random Pattern Skin Flap Survival in a Rat Model
Authors: Wang Li-Ren , Cai Le-Yi , Lin Ding-Sheng , Cao Bin , Li Zhi-Jie
Published: April 2017

BACKGROUND

Random skin flaps are commonly used for wound repair and reconstruction. Electroacupuncture at The Zusanli point could enhance microcirculation and blood perfusion in random skin flaps.

OBJECTIVE

To determine whether electroacupuncture at The Zusanli point can improve the survival of random skin flaps in a rat model.

MATERIALS AND METHODS

Thirty-six male Sprague Dawley rats were randomly divided into 3 groups: control group (no electroacupuncture), Group A (electroacupuncture at a nonacupoint near The Zusanli point), and Group B (electroacupuncture at The Zusanli point). McFarlane flaps were established. On postoperative Day 2, malondialdehyde (MDA) and superoxide dismutase were detected. The flap survival rate was evaluated, inflammation was examined in hematoxylin and eosin–stained slices, and the expression of vascular endothelial growth factor (VEGF) was measured immunohistochemically on Day 7.

RESULTS

The mean survival area of the flaps in Group B was significantly larger than that in the control group and Group A. Superoxide dismutase activity and VEGF expression level were significantly higher in Group B than those in the control group and Group A, whereas MDA and inflammation levels in Group B were significantly lower than those in the other 2 groups.

CONCLUSION

Electroacupuncture at The Zusanli point can effectively improve the random flap survival.
The Nasal Tip Rotation Flap for Reconstruction of the Lateral Nasal Tip, Anterior Ala, and Soft Triangle: The Authors' Experience With 55 Patients
Authors: Benoit Anastasia , Hollmig S. Tyler , Leach Brian C.
Published: April 2017

BACKGROUND

Defects of the lateral nasal tip, anterior ala, and soft triangle subunits lack reconstructive options that are consistently satisfactory. For such defects, the novel anterior-based nasal tip rotation flap provides functional and aesthetic results in a single operative session.

OBJECTIVE

To describe the authors' experience with the nasal tip rotation flap, including patient selection and design modifications to enhance aesthetic success.

METHODS

An IRB-approved retrospective database review of nasal tip rotation flap repairs was performed at the Medical University of South Carolina and Stanford University Medical Center. The design and surgical technique of this flap are described and illustrated, emphasizing factors such as nasal shape and defect location in modifying flap design.

RESULTS

The nasal tip rotation is a single-stage, local flap that provides optimal tissue match with recapitulation of the native topography of the nasal tip and incision lines that are well hidden at the junction of cosmetic subunits. The mechanics of the flap distribute closure tension widely across the alar rim without focal notching or airway compromise.

CONCLUSION

The nasal tip rotation flap is a reliable, cosmetically elegant repair that fills a gap in the reconstructive options for anterior ala and soft triangle defects on the nose.
Nurse practitioner–physician comanagement of primary care patients: The promise of a new delivery care model to improve quality of care
Authors: Norful Allison Andreno , Swords Kyleen , Marichal Mickaela , Cho Hwayoung , Poghosyan Lusine
Published: April 2017

Background:

The U.S. primary care system is under tremendous strain to deliver care to an increased volume of patients with a concurrent primary care physician shortage. Nurse practitioner (NP)–physician comanagement of primary care patients has been proposed by some policy makers to help alleviate this strain. To date, no collective evidence demonstrates the effects of NP–physician comanagement in primary care.

Purpose:

This is the first review to synthesize all available studies that compare the effects of NP–physician comanagement to an individual physician managing primary care.

Methods:

The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) framework guided the conduct of this systematic review. Five electronic databases were searched. Titles, abstracts, and full texts were reviewed, and inclusion/exclusion criteria were applied to narrow search results to eligible studies. Quality appraisal was performed using Downs and Black’s quality checklist for randomized and nonrandomized studies.

Results:

Six studies were identified for synthesis. Three outcome categories emerged: (a) primary care provider adherence to recommended care guidelines, (b) empirical changes in clinical patient outcomes, and (c) patient/caregiver quality of life. Significantly more recommended care guidelines were completed with NP–physician comanagement. There was variability of clinical patient outcomes with some findings favoring the comanagement model. Limited differences in patient quality of life were found. Across all studies, the NP–physician comanagementcare delivery model was determined to produce no detrimental effect on measured outcomes and, in some cases, was more beneficial in reaching practice and clinical targets.

Practice Implications:

The use of NP–physician comanagement of primary care patients is a promising delivery care model to improve the quality of care delivery and alleviate organizational strain given the current demands of increased patient panel sizes and primary care physician shortages. Future research should focus on NP–physician interactions and processes to isolate the attributes of a successful NP–physician comanagement model.
Doing well by doing good: Evaluating the influence of patient safety performance on hospital financial outcomes
Authors: Beauvais Brad , Richter Jason P. , Kim Forest S.
Published: April 2017

Background:

As financial pressures on hospitals increase because of changing reimbursement structures and heightened focus on quality and value, the association between patient safety performance and financial outcomes remains unclear.

Purpose:

The purpose of this study is to investigate if hospitals with higher patient safety performance are associated with higher levels of profitability than those with lower safety performance.

Methodology/Approach:

Using multinomial logistic regression, we analyzed data from the spring 2014 Leapfrog Hospital Safety Score and the 2014 American Hospital Association to determine the association between Leapfrog Hospital Safety Score performance and three dimensions of organizational profitability: operating margin, net patient revenue, and operating income.

Results:

Our findings suggest that improved hospital safety scores are associated with a relative risk of being in the top versus bottom quartile of financial performance: 5.41 times greater (p < .001) for operating margin, 10.98 times greater (p < .001) for net patient revenue, and 4.03 times greater (p < .001) for operating income.

Practice Implications:

Our findings suggest that improved patient safety performance, as evaluated within the Leapfrog Hospital Safety Score, is associated with improved financial performance at the hospital level. Targeted focus on patient safety may allow hospitals to improve financial performance, maximize scarce resources, and generate additional capital to continue to positively evolve care.
Safety of the Inactivated Japanese Encephalitis Virus Vaccine IXIARO in Children
Authors: Dubischar Katrin L. , Kadlecek Vera , Sablan Benjamin , Borja-Tabora Charissa Fay , Gatchalian Salvacion , Eder-Lingelbach Susanne , Mueller Zsuzsanna , Westritschnig Kerstin
Published: April 2017

Background:

Japanese encephalitis remains a serious health concern in Asian countries and has sporadically affected pediatric travelers. In the present study, we monitored the safety profile of the Japanese encephalitis virus vaccine IXIARO (Valneva Austria GmbH, Vienna, Austria) in a pediatric population.

Methods:

We randomized 1869 children between 2 months and 17 years of age in an age-stratified manner to vaccination with IXIARO or one of the control vaccines, Prevnar (formerly Wyeth Pharmaceuticals Inc., now Pfizer Inc., Kent, United Kingdom) and HAVRIX 720 (GlaxoSmithKline Biologicals, Rixensart, Belgium). Adverse events (AEs) (unsolicited and solicited local and systemic AEs), serious AEs and medically attended AEs were assessed up to day 56 and month 7 after the first dose.

Results:

Incidences of AEs, serious AEs or medically attended AEs did not differ significantly between the groups in any age stratum. AEs were most frequent in children <1 year of age and decreased with age. AEs of special interest, predefined as AEs associated with potential hypersensitivity/allergy or neurologic disorders up to day 56, were reported in 4.6% (IXIARO) versus 6.3% (Prevnar) in the ≥2 months to <1 year age group and 3.4% (IXIARO) versus 3.3% (HAVRIX) in the ≥1 to <18 years age group. Fever, the most frequent systemic reaction in 23.7% of infants to 3.8% of adolescents, decreased with age and did not differ between groups.

Conclusions:

The safety profile of IXIARO was comparable to the control vaccines in terms of overall AE rates, serious AEs and medically attended AEs.
Lesion on the Ankle
Authors: Jacob Sharon E. , Zumwalt Jonathan
Published: April 2017

Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. This is a teledermatology case of multiple pustules presenting on the foot.
Evidence-Based Practice and U.S. Healthcare Outcomes
Authors: Harper Mary G. , Gallagher-Ford Lynn , Warren Joan I. , Troseth Michelle , Sinnott Loraine T. , Thomas Bindu Koshy
Published: April 2017

Nursing professional development (NPD) practitioners are integral to implementing evidence-based practice (EBP). Research was conducted to describe NPD practitioners’ EBP beliefs and competencies, frequency of implementing EBP, and perceptions of organizational culture and readiness for EBP. Relationships among NPD practitioner characteristics and organization outcomes were explored. Findings indicate that NPD practitioners must develop personal competence in EBP, become engaged in shared governance, collaborate with others, and use quality metrics to demonstrate the effectiveness and value of NPD activities.
Identifying Undiagnosed Pediatric Mental Illness in the Emergency Department
Authors: Downey La Vonne A. , Zun Leslie S.
Published: April 2017

Background

It is well known that pediatric psychiatric patients frequent emergency department (ED), but the number of patients with undiagnosed psychiatric illness presenting to an ED is not well known. Identification and referral of these patients may provide an opportunity for improved patient care. The primary study objective was to identify a tool that can screen for unsuspected psychiatric illness in pediatric patients who present to the ED with non–psychiatric-related complaints.

Methods

The MINI International Neuropsychiatric Interview for Children and Adolescents screening tool was administered to 200 pediatric consenting patients and guardians. The inclusion criteria were English-speaking patients who presented in the ED with a nonpsychiatric complaint who were stable and able to communicate. The study was conducted in a level 1 trauma center ED of an inner-city hospital that serves a predominantly African American and Hispanic population. This study was institutional review board approved.

Results

The study populations consisted of 53% African American (107), 45% Hispanic (90), 1% white (2), and 0.5% Asian (1). Their age range was divided, with 49% between 12 and 14 years (98) and 51% between 15 and 17 years (102). The sex was evenly split, with 50% male (100) and 50% female (100). The 41% who did screen positive for an undiagnosed mental illness had a range of diagnoses. The top modules with positive results were oppositional defiant (13.5%, 27), attention-deficit/hyperactivity disorder (13%, 25), depression (10%, 11), conduct disorder (9%, 19), and anxiety (5%, 11).

Conclusions

The pediatric Mini International Neuropsychiatric Interview was effective in screening for undiagnosed mental illness in pediatric patients who presented to the ED with no psychiatric-related illness. The screening tool indicated that 41% of pediatric patients screened positive for an undiagnosed mental illness, with attention deficit–related disorders being the most widely seen. Further study should be conducted to test the tools used in a range of ED settings.
Minimally Invasive, Organ-preserving Surgery for Large Submucosal Tumors in the Abdominal Esophagus
Authors: Kanehira Eiji , Tanida Takashi , Kamei Aya , Takahashi Kodai
Published: April 2017

Background:

Surgical resection of submucosal tumors (SMTs) in the abdominal esophagus is not standardized. Enucleation may be a minimally invasive option, whereas its oncological validity is not very clear. Moreover, how to treat the esophageal wall defect after enucleation and necessity of additional antireflux procedure are also undetermined.

Methods:

In 13 patients with a SMT originating the abdominal esophagus laparoscopic enucleation was performed with preserving the integrity of submucosa. When the muscular layer defect was <4 cm it was directly closed by suturing, whereas it was left open in case the defect was larger. Fundoplication was added when the esophagus was dissected posteriorly or the myotomy was not closed.

Results:

Tumors were resected en-bloc without rupture in all cases. In 5 patients myotomy was closed, whereas in the remaining 8 it was left open. In 11 patients fundoplication was added (Toupet in 5 and Dor in 6). The patients developed neither regurgitation nor stenosis postoperatively. The histopathologic findings revealed leiomyoma in 9 patients, whereas the other 4 were miscellaneous. The average tumor size was 5.5 cm (range, 2.8 to 8.8). Microscopically surgical margin was negative in all cases.

Conclusions:

Laparoscopic enucleation of SMTs in the abdominal esophagus seems to be safe, reproducible operation enabling preservation of function of the lower esophagus and esophagogastric junction. Even when the muscular defect is not approximated additional fundoplication can minimize the risk of postoperative reflux disease.
Technical and Survival Risks Associated With Esophagojejunostomy by Laparoscopic Total Gastrectomy for Gastric Carcinoma
Authors: Yamamoto Manabu , Kawano Hiroyuki , Yamaguchi Shohei , Egashira Akinori , Minami Kazuhito , Morita Masaru , Sakaguchi Yoshihisa , Toh Yasushi
Published: April 2017

Background:

We performed esophagojejunostomy after totally laparoscopic total gastrectomy (TLTG) using functional end-to-end anastomosis (FEEA) as the first choice and laparoscopic-assisted total gastrectomy (LATG) using a circular stapler with a transorally inserted anvil as the second choice.

Patients and Methods:

We examined 109 patients with gastric cancer who underwent TLTG and LATG. Among these, 100 patients underwent TLTG and the rest underwent LATG.

Results:

The length of resected esophageal segment in LATG patients was significantly longer than that in TLTG patients (P<0.001). The length of the resected esophagus segment was inversely correlated with body mass index in cases of esophagojejunostomy by FEEA (P<0.05). Multivariate analysis revealed that T factor, N factor, and severe complications were the independent factors for survival.

Conclusions:

Esophagojejunostomy using FEEA or a circular stapler with a transorally inserted anvil should be selected according to the length of the resected esophageal segment and/or body mass index.
Symptomatic Epidermoid Cyst Presenting as a Paravaginal Mass
Authors: Davenport Abigail P. , Zimmerman Carl W. , Hill Bryan J. , Davis Jeffrey
Published: April 2017

Background

Ischioanal fossa epidermoid cysts are uncommon masses of epithelial origin and are believed to be either congenital or the result of trauma. Surgical excision is preferred as opposed to incision and drainage because these masses may enlarge, recur, become infected, or undergo malignant transformation.

Case

This report describes a case of a 62-year-old woman who presented for evaluation of vaginal and perineal discomfort and fullness. Physical examination and computed tomography scan revealed a 7.1-cm cystic mass in the left ischioanal space. Transgluteal surgical excision was performed and pathology revealed an epidermoid cyst. The patient recovered with symptomatic improvement.

Conclusions

This report demonstrates a rare case of ischioanal fossa epidermoid cyst. In cases of rectal masses, cystic lesions should be considered. Thorough physical examination, imaging studies, and proper surgical management of these masses can improve patient symptomatology, prevent recurrence, and also decrease the risk of malignant transformation.
The Association of Judgment and Related Factors That Affect Fall Risk in Older Adults
Authors: Bright Beth , Boerger Erica , Grillot Lindsay , Knous Katie , Lee Megan , Selking Chelsea , Umeno Risa
Published: April 2017

The purpose of this study was to develop a standardized assessment (LDUKES) that measures an individual's reported use of judgment in relation to fall risk. Fifty-three participants from 7 different senior care facilities completed an assessment that was created by researchers. Researchers found that participants' responses indicated a statistically significant inverse correlation (P < .05) between whether the participant had fallen and his or her perceived risk of falling. This relationship indicates that those who reported falling thought that they were at a lower risk of falling in the future. In addition, when comparing fall history (A3) with physical characteristics (section C) using an independent-samples t test, a significance was found between individuals who reported falls or stumbles and individuals who did not report falls (P < .05). Further research using the LDUKES assessment is recommended to identify the ability to effectively assess judgment related to fall risk.
Use of the Sharpened Romberg as a Screening for Fall Risk
Authors: Gras Laura Z. , Pohl Patricia S. , Epidy John , Godin Brittany , Hoessle Naida
Published: April 2017

A quick screening test to determine older adults' fall risk would be beneficial given that the physical therapist has limited time to complete an initial examination. The purpose of this study was to determine whether performance on the sharpened Romberg is associated with fall risk, mobility, and gait measures. Results of data from 34 adults at least 60 years of age revealed that the ability to attain and hold the tandem stance position for the sharpened Romberg is associated with low fall risk. The sharpened Romberg can serve as a quick balance screen that requires minimal space and equipment.
Differences in Fall Risk Factors Between Adults With Diabetes and Those Without Who Are Homebound
Authors: Migliarese Sara James
Published: April 2017

Background and Purpose:

Adults with type II diabetes are at higher risk for falls than their nondiabetic peers. The purpose of this study was to identify the differences in factors that influence fall risk between adults who are homebound and are diabetic (DM) and adults who are nondiabetic and homebound (NDM) in a population identified at high risk for falls.

Methods:

Five factors were collected that impact fall risk for 279 homebound adults during an initial physical therapy evaluation. Participants were identified as having high fall risk by a physician referring them for home health physical therapy.

The sample was subdivided into those with diabetes (73 type II diabetic [DM] adults) and those without diabetes (206 nondiabetic [NDM] adults). Factors previously identified as influential for fall risk included sensation on the soles of the feet, lower extremity neuropathic pain, sensory integration scores on the modified Clinical Test of Sensory Interaction and Balance (mCTSIB), dynamic balance measured by the Dynamic Gait Index, and balance confidence as measured by the Modified Falls Efficacy Scale. Data were compared between diabetic and nondiabetic groups, between 5 age categories, and between blended diagnostic cohorts with and without protective foot sensation. All cohorts were divided into age categories of 47 to 54, 55 to 64, 65 to 74, 75 to 84, and 85 to 98 years of age.

Results and Discussion:

A significant difference was found between DM and NDM cohorts in monofilament scores for foot sensation (P = .003, DM mean = 5.9, NDM mean = 7.4, mean difference =−1.47, standard error = 0.48). All other risk factors for falling trended toward increased severity in the diabetic group but were not statistically significant. Significant differences were noted between participants with protective foot sensation and those without it for scores in all 4 positions of the mCTSIB (position 1, P = .011; position 2, P = .001; position 3, P = .02; and position 4, P = .029), total mCTSIB score (P = .001), the Dynamic Gait Index score (P = .002), and neuropathic pain (P = .001) but not for the Modified Falls Efficacy Scale score.

Conclusions:

Sensation on the soles of the feet represented the best differentiator between fall risk factors when comparing homebound adults with diabetes with those without diabetes. Clinicians performing a fall risk assessment on homebound adults should recognize the variability in fall risk and perform thorough multifactorial evaluations regardless of the absence or presence of the diagnosis of diabetes, including a minimum of sensory testing and the mCTSIB that were sensitive to variations in age and protective sensation.
Impact of Sodium Status on Growth in Premature Infants
Authors: Fisher Kelly , Parker Anna , Zelig Rena
Published: April 2017

Sodium plays a role in DNA synthesis, cell proliferation, and absorption of nutrients, and may have an underappreciated role in the growth of infants. Serum sodium is the most common measure of sodium status, but urinary sodium better reflects total body sodium status because it accounts for renal conservation of sodium, an extracellular electrolyte. This article discusses the relationship between inadequate sodium status and growth in premature infants. Implications of prematurity on the gastrointestinal (GI) tract and kidney function and GI losses, because of GI disease on sodium status and growth, and the effects of sodium supplementation are also described.
Interacting effects of land use and climate on rodent-borne pathogens in central Kenya
Authors: Young Hillary S. , McCauley Douglas J. , Dirzo Rodolfo , Nunn Charles L. , Campana Michael G. , Agwanda Bernard , Otarola-Castillo Erik R. , Castillo Eric R. , Pringle Robert M. , Veblen Kari E. , Salkeld Daniel J. , Stewardson Kristin , Fleischer Robert , Lambin Eric F. , Palmer Todd M. , Helgen Kristofer M.
Published: April 2017

Understanding the effects of anthropogenic disturbance on zoonotic disease risk is both a critical conservation objective and a public health priority. Here, we evaluate the effects of multiple forms of anthropogenic disturbance across a precipitation gradient on the abundance of pathogen-infected small mammal hosts in a multi-host, multi-pathogen system in central Kenya. Our results suggest that conversion to cropland and wildlife loss alone drive systematic increases in rodent-borne pathogen prevalence, but that pastoral conversion has no such systematic effects. The effects are most likely explained both by changes in total small mammal abundance, and by changes in relative abundance of a few high-competence species, although changes in vector assemblages may also be involved. Several pathogens responded to interactions between disturbance type and climatic conditions, suggesting the potential for synergistic effects of anthropogenic disturbance and climate change on the distribution of disease risk. Overall, these results indicate that conservation can be an effective tool for reducing abundance of rodent-borne pathogens in some contexts (e.g. wildlife loss alone); however, given the strong variation in effects across disturbance types, pathogen taxa and environmental conditions, the use of conservation as public health interventions will need to be carefully tailored to specific pathogens and human contexts.

This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications’.
Conservation of biodiversity as a strategy for improving human health and well-being
Authors: Kilpatrick A. Marm , Salkeld Daniel J. , Titcomb Georgia , Hahn Micah B.
Published: April 2017

The Earth's ecosystems have been altered by anthropogenic processes, including land use, harvesting populations, species introductions and climate change. These anthropogenic processes greatly alter plant and animal communities, thereby changing transmission of the zoonotic pathogens they carry. Biodiversity conservation may be a potential win–win strategy for maintaining ecosystem health and protecting public health, yet the causal evidence to support this strategy is limited. Evaluating conservation as a viable public health intervention requires answering four questions: (i) Is there a general and causal relationship between biodiversity and pathogen transmission, and if so, which direction is it in? (ii) Does increased pathogen diversity with increased host biodiversity result in an increase in total disease burden? (iii) Do the net benefits of biodiversity conservation to human well-being outweigh the benefits that biodiversity-degrading activities, such as agriculture and resource utilization, provide? (iv) Are biodiversity conservation interventions cost-effective when compared to other options employed in standard public health approaches? Here, we summarize current knowledge on biodiversity–zoonotic disease relationships and outline a research plan to address the gaps in our understanding for each of these four questions. Developing practical and self-sustaining biodiversity conservation interventions will require significant investment in disease ecology research to determine when and where they will be effective.

This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications’.
Dopaminergic modulation of hemodynamic signal variability and the functional connectome during cognitive performance
Authors: Alavash Mohsen , Lim Sung-Joo , Thiel Christiane , Sehm Bernhard , Deserno Lorenz , Obleser Jonas
Published: April 2017

Dopamine underlies important aspects of cognition, and has been suggested to boost cognitive performance. However, how dopamine modulates the large-scale cortical dynamics during cognitive performance has remained elusive. Using functional MRI during a working memory task in healthy young human listeners (N=22), we investigated the effect of levodopa (L-dopa) on two aspects of cortical dynamics, blood oxygen-level-dependent (BOLD) signal variability and the functional connectome of large-scale cortical networks. We here show that enhanced dopaminergic signaling modulates the two potentially interrelated aspects of large-scale cortical dynamics during cognitive performance, and the degree of these modulations is able to explain inter-individual differences in L-dopa-induced behavioral benefits. Relative to placebo, L-dopa increased BOLD signal variability in task-relevant temporal, inferior frontal, parietal and cingulate regions. On the connectome level, however, L-dopa diminished functional integration across temporal and cingulo-opercular regions. This hypo-integration was expressed as a reduction in network efficiency and modularity in more than two thirds of the participants and to different degrees. Hypo-integration co-occurred with relative hyper-connectivity in paracentral lobule and precuneus, as well as posterior putamen. Both, L-dopa-induced BOLD signal variability modulation and functional connectome modulations proved predictive of an individual’s L-dopa-induced gain in behavioral performance, namely response speed and perceptual sensitivity. Lastly, L-dopa-induced modulations of BOLD signal variability were correlated with L-dopa-induced modulation of nodal connectivity and network efficiency. Our findings underline the role of dopamine in maintaining the dynamic range of, and communication between, cortical systems, and their explanatory power for inter-individual differences in benefits from dopamine during cognitive performance.
High-resolution mapping of heteroduplex DNA formed during UV-induced and spontaneous mitotic recombination events in yeast
Authors: Yin Yi , Dominska Margaret , Yim Eunice , Petes Thomas D.
Published: April 2017

In yeast, DNA breaks are usually repaired by homologous recombination (HR). An early step for HR pathways is formation of a heteroduplex, in which a single-strand from the broken DNA molecule pairs with a strand derived from an intact DNA molecule. If the two strands of DNA are not identical, there will be mismatches within the heteroduplex DNA (hetDNA). In wild-type strains, these mismatches are repaired by the mismatch repair (MMR) system, producing a gene conversion event. In strains lacking MMR, the mismatches persist. Most previous studies involving hetDNA formed during mitotic recombination were restricted to one locus. Below, we present a global mapping of hetDNA formed in the MMR-defectivemlh1strain. We find that many recombination events are associated with repair of double-stranded DNA gaps and/or involve Mlh1-independent mismatch repair. Many of our events are not explicable by the simplest form of the double-strand break repair model of recombination.
Transcriptional decomposition reveals active chromatin architectures and cell specific regulatory interactions
Authors: Rennie Sarah , Dalby Maria , van Duin Lucas , Andersson Robin
Published: April 2017

Transcriptional regulation is tightly coupled with chromosomal positioning and three-dimensional chromatin architecture. However, it is unclear what proportion of transcriptional activity is reflecting such organisation, how much can be informed by RNA expression alone, and how this impacts disease. Here, we develop a transcriptional decomposition approach separating the proportion of expression associated with genome organisation from independent effects not directly related to genomic positioning.

We show that positionally attributable expression accounts for a considerable proportion of total levels and is highly informative of topological associating domain activities and organisation, revealing boundaries and chromatin compartments. Furthermore, expression data alone accurately predicts individual enhancer-promoter interactions, drawing features from expression strength, stabilities, insulation and distance. We further characterise commonalities and differences across predictions in 76 human cell types, observing extensive sharing of domains, yet highly cell-type specific enhancer-promoter interactions and strong enrichments in relevant trait-associated variants. Our work demonstrates a close relationship between transcription and chromatin architecture, presenting a novel strategy and an unprecedented resource for investigating regulatory organisations and interpretations of disease associated genetic variants across cell types.
Recombineering inVibrio natriegens
Authors: Lee Henry H. , Ostrov Nili , Gold Michaela A. , Church George M.
Published: April 2017

Here, we show that λ-Red homologs found in theVibrio-associated SXT mobile element potentiate allelic exchange inV. natriegensby ~10,000-fold. Specifically, we show SXT-Beta (s065), SXT-Exo (s066), and λ-Gam proteins are sufficient to enable recombination of single- and double-stranded DNA with episomal and genomic loci. We characterize and optimize episomal oligonucleotide-mediated recombineering and demonstrate recombineering at genomic loci. We further show targeted genomic deletion of the extracellular nuclease genednsusing a double-stranded DNA cassette. Continued development of this recombination technology will advance high-throughput and large-scale genetic engineering efforts to domesticateV. natriegensand to investigate its rapid growth rate.
Genome-wide meta-analyses of stratified depression in Generation Scotland and UK Biobank
Authors: Hall Lynsey S. , Adams Mark J. , Arnau-Soler Aleix , Clarke Toni-Kim , Howard David M. , Zeng Yanni , Davies Gail , Hagenaars Saskia P. , Fernandez-Pujals Ana Maria , Gibson Jude , Wigmore Eleanor M. , Boutin Thibaud S. , Hayward Caroline , Scotland Generation ,   Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium, Porteous David J. , Deary Ian J. , Thomson Pippa A. , Haley Chris S. , McIntosh Andrew M.
Published: April 2017

Few replicable genetic associations for Major Depressive Disorder (MDD) have been identified. However recent studies of depression have identified common risk variants by using either a broader phenotype definition in very large samples, or by reducing the phenotypic and ancestral heterogeneity of MDD cases. Here, a range of genetic analyses were applied to data from two large British cohorts, Generation Scotland and UK Biobank, to ascertain whether it is more informative to maximize the sample size by using data from all available cases and controls, or to use a refined subset of the data - stratifying by MDD recurrence or sex. Meta-analysis of GWAS data in males from these two studies yielded one genome-wide significant locus on 3p22.3. Three associated genes within this region (CRTAP, GLB1, andTMPPE) were significantly associated in subsequent gene-based tests. Meta-analyzed MDD, recurrent MDD and female MDD were each genetically correlated with 6 of 200 health-correlated traits, namely neuroticism, depressive symptoms, subjective well-being, MDD, a cross-disorder phenotype and Bipolar Disorder. Meta-analyzed male MDD showed no statistically significant correlations with these traits after correction for multiple testing. Whilst stratified GWAS analysis revealed a genome-wide significant locus for male MDD, the lack of independent replication, the equivalent SNP-based heritability estimates and the consistent pattern of genetic correlation with other health-related traits suggests that phenotypic stratification in currently available sample sizes is currently weakly justified. Based upon existing studies and our findings, the strategy of maximizing sample sizes is likely to provide the greater gain.
A practical guide to CRISPR/Cas9 genome editing in Lepidoptera
Authors: Zhang Linlin , Reed Robert D.
Published: April 2017

CRISPR/Cas9 genome editing has revolutionized functional genetic work in many organisms and is having an especially strong impact in emerging model systems. Here we summarize recent advances in applying CRISPR/Cas9 methods in Lepidoptera, with a focus on providing practical advice on the entire process of genome editing from experimental design through to genotyping. We also describe successful targeted GFP knockins that we have achieved in butterflies. Finally, we provide a complete, detailed protocol for producing targeted long deletions in butterflies.
Loss of MECP2 leads to activation of p53 and neuronal senescence
Authors: Ohashi M. , Allen D. , Lee P. , Korsakova E. , Fu K. , Vargas B. , Cinkornpumin J. , Salas C. , Park J. , Germanguz I. , Chronis K. , Kuoy E. , Tran S. , Xiao G. , Pellegrini M. , Plath K. , Lowry WE.
Published: April 2017

To determine the role for mutations of MECP2 in Rett Syndrome, we generated isogenic lines of human iPSCs (hiPSCs), neural progenitor cells (NPCs), and neurons from patient fibroblasts with and without MECP2 expression in an attempt to recapitulate disease phenotypesin vitro. Molecular profiling uncovered neuronal specific gene expression changes including induction of a Senescence Associated Secretory Phenotype (SASP) program. Patient derived Neurons made without MECP2 show signs of stress, including induction of p53, and senescence. The induction of p53 appeared to affect dendritic branching in Rett neurons, as p53 inhibition restored dendritic complexity. These disease-in-a-dish data suggest that loss of MECP2 can lead to dendritic defects due to an increase in aspects of neuronal aging.
Mio Amore: surviving brand change in transition economy
Authors: Jammulamadaka Nimruji , Mishra Prashant , Saha Biswatosh
Published: April 2017

Subject area

This case is about a food brand with franchisee stores which has implemented a brand change initiative in the Indian emerging market.

Study level/applicability

This case is suitable for MBA level students in courses like strategic brand management, marketing in emerging markets and retail management. Issues relate to brand name change management, building and securing channel cooperation in brand change, channel peculiarities in emerging markets and franchisee institutional support systems in emerging markets like India.

Case overview

The case documents the process followed by Switz Foods Private Limited (SFPL) in planning for and implementing a “brand-name” change across its 150-plus stores retailing fresh bakery products. The switch away from a 20-year-old food brand that had carved out a place in the popular culture of the community in Kolkata was risky. While opinion inside the organization was divided on whether to use mass media to communicate the brand-name change to its customers, the company finally decided to rely only on in-store signage and product packaging. SFPL took into confidence the franchisee retail store owners, a key stakeholder group with whom it enjoyed a long-term trusted business relation, and relied on their support to implement a smooth transition. It shows how in the context of the bazaars in transition economies, trust-based business relations and word-of-mouth reputation can often provide frugal managerial alternatives.

Expected learning outcomes

The three main learning objectives are: planning for a brand name transition, which includes three parts: generating consumer insights and using the data to aid decision-making in choosing a brand name and developing a brand campaign; overcoming network or business partner resistance/uncertainties associated with a brand name transition; managing customer perceptions before and after brand-name transition. Second learning objective included understanding risks in a franchisor–franchisee relationship. Third included appreciating the significance of trust-based relationships in managing transition economies.

Subject code

CSS 8: Marketing.
Disaster preparedness of private social services: case Finland
Authors: Rapeli Merja , Mussalo-Rauhamaa Helena
Published: April 2017

Purpose

The purpose of this paper is to explore the level of disaster preparedness of institutional care and sheltered housing services provided by the private sector in Finland.

Design/methodology/approach

A web-based questionnaire was completed by businesses producing institutional care and sheltered housing services in Finland. They answered questions on disaster preparedness, impacts of recent hazards, measures taken during the hazards and connections to disaster risk management actors and relatives of their residents during the hazards.

Findings

The study showed that only 19 percent of the private service providers had a disaster preparedness plan, and only 11 percent reported that it was a requirement agreed on with the service purchaser. The size of the unit predicted only partly the differences in the level of preparedness. The major impacts of storms were on energy supply, leading to disruptions in the daily activities of the services.

Practical implications

The most vulnerable to disasters are people dependent on others, which include those receiving social services. Consequently, this study recommends that preparedness planning should be legally mandated requirement for all social service providers. In addition, the local governments’ service purchasers should include private services in their disaster preparedness activities.

Originality/value

Private businesses are increasingly involved in producing social services in Finland; hence, their preparedness to face hazards and connection with disaster risk management partners is vital. This study increases knowledge of private institutional care and sheltered housing services’ disaster preparedness, which has seldom been the focus of studies.
Sustaining innovation of information technology service providers
Authors: Presbitero Alfred , Roxas Banjo , Chadee Doren
Published: April 2017

Purpose

How do knowledge-intensive technology-based offshore information technology service providers (ITSPs) in developing countries sustain their innovation and remain competitive? The purpose of this paper is to answer this question by drawing from the knowledge-based view of firm innovation to argue that organisational collectivism (COLL) plays a crucial role in influencing the effects of knowledge-based capabilities on innovation of ITSPs.

Design/methodology/approach

The study develops a model which shows that learning mediates the effects of knowledge sharing on innovation and that COLL moderates the effects of knowledge sharing on both innovation and learning. A moderated-mediation model is tested using structural equation modelling techniques and data (n=388) from a survey of ITSPs in the Philippines.

Findings

The results show that knowledge sharing capability is positively related to innovation and that organisational learning capability fully mediates the effects of knowledge sharing on innovation. Moreover, COLL is found to significantly and positively moderate the effects of knowledge sharing on both organisational learning and innovation. The results indicate that organisational learning serves as the mechanism that transforms knowledge into innovation, but this effect is contingent on COLL of ITSPs.

Practical implications

The findings suggest that ITSPs from developing countries can look beyond costly investments in research and development activities to invigorate their innovative capabilities. ITSPs can focus on the development of their intangible assets such as COLL to enhance the effects of knowledge-based resources on innovation for sustaining their competitiveness.

Originality/value

The moderated-mediation analytical approach to assessing the joint effects of knowledge sharing, organisational learning and collectivism on innovation is novel. The significant effects of the moderator suggest that the mediation mechanisms might differ depending on the levels of development of COLL in the organisation.
Understanding the decision to offshore human resource activities: a coevolutionary perspective
Authors: Paz-Aparicio Carmen , Ricart Joan E. , Bonache Jaime
Published: April 2017

Purpose

Offshoring has been studied widely in the literature on strategic management and international business. However, apart from its consideration as an administrative activity, scant attention has been paid to the offshoring of the human resource (HR) function. Research in this regard has instead focussed on outsourcing (Reichel and Lazarova, 2013). The purpose of this paper is to achieve a better understanding of companies’ decisions to offshore HR activities. It adapts the outsourcing model of Baron and Kreps (1999) by including the HR offshoring phenomenon and a dynamic perspective.

Design/methodology/approach

While the analysis is mostly conceptual, the authors ground the author’s arguments in offshoring data from the Offshoring Research Network, to explore whether the drivers for offshoring HR differ from the drivers for offshoring other administrative activities. The idiosyncrasy of the HR function is supported by the authors’ exploratory analysis and also by the descriptive case of a multinational and its experience with offshoring.

Findings

A coevolutionary model is proposed for understanding the behaviour of companies offshoring their HR activities. This study contends that companies should address their decision to offshore HR activities from a dynamic perspective, being aware of three processes that are in constant change: the evolution of the HR function, the evolution of service providers, and the evolution of offshoring decisions.

Originality/value

This study seeks to make a threefold contribution to the international business, strategy, and HR management disciplines.
Global offshoring portfolio diversity and performance implications
Authors: Lin Nidthida , Tan Hao , Chen Stephen
Published: April 2017

Purpose

The purpose of this paper is to examine how three key dimensions of a firm’s offshoring portfolio – location diversity, functional diversity and governance mode – affect the financial and innovation outcomes of offshoring.

Design/methodology/approach

The authors investigate the relationships between the diversity of a firm’s offshoring portfolio and its offshoring outcomes using a sample of US, European and Asia Pacific firms engaging in offshoring activities.

Findings

The authors found that: location diversity shows a significant “flipped S-shape” relationship with innovation outcomes, but has a negative impact on financial outcomes, functional diversity has a significant and positive effect on innovation outcome and the use of an outsourcing governance mode significantly moderates these relationships, such that the degree of offshore outsourcing weakens some of these effects.

Originality/value

The authors conclude that firms which strategically coordinate all three dimensions of their offshoring portfolio are more likely to achieve better innovation or financial outcomes from their use of offshoring in global supply chain and sourcing.