bluuebunny/crossref_metadata_2025 huggingface dataset:
Customer acquisition at Abhyudaya Co-operative Bank Ltd
Authors: Bapat Dhananjay
Published: October 2014

Subject area

Marketing, Banking.

Study level/applicability

Post Graduate Programme, MBA, BBA.

Case overview

On 27 June 2011, Abhyudaya Bank, a leading urban cooperative bank, opened its 101 new branch at Diva, which is on the outskirts of Mumbai city in India. Diva area is populated but has less number of bank branches. The bank planned to surpass its earlier record of customer acquisition in branches which were newly opened at Marve Link Road and Jogeshwari in Mumbai. According to Mr Morye, Managing Director, Abhyudaya Bank, “With the expanding horizons, continuous developments and competition, the bank proposes to become full-fledged financial service provider, fulfilling requirements of customers and other stakeholders by providing all allied services, as permitted by the regulatory authorities. The Bank has adopted advanced technology for providing faster and convenient services to clients. These major long term proposals will enable the bank to increase its market share and better fulfillment of expectations of all the stakeholders.” The case introduces the structure of urban cooperative banks of which Abhyudaya Cooperative Bank is a part. The case provides the key highlights of the bank and discusses the catalyst role of planning and marketing department for branches to achieve its target and how the bank implemented unique and differentiated strategy involving employees of the banks. Employees form an important asset for banks, and banks need to utilize their potential in creating long-term and sustainable relationships with customers. The case examines how the branch can benefit from detail area-wise planning capturing the potential. Branch area planning is a unique exercise covering the branch potential analysis and a new branch manager must utilize it for acquiring higher number of customers. Regardless of the branching, a bank seeking to expand its branch operations faces a number of important decisions. As the area develops, a bank branch decides to take up appropriate strategy with an objective to move its base of operations to attract new customers in a new area and thereafter maintain its existing ones.

Expected learning outcomes

The case is suitable for students pursuing a post-graduate course in bank marketing, banking postgraduate and MBA course in strategic management and marketing management. The case presents an opportunity to assess the strategy adopted by the bank for new branch launch and evolving role by a marketing function in a bank.

Supplementary materials

Teaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes.
Workforce management for worldwide workers
Authors: Borkin David
Published: October 2014

Purpose

– The purpose of this article is to highlight the need for human resources (HR) specialists to ensure that there is one record of each employee that integrates information on his or her history, past training and future needs in an easy-to-view system.

Design/methodology/approach

– Underlines the advantages that such a record can bring.

Findings

– Argues that global businesses need tools to help them to overcome the complexity of communicating with, and efficiently deploying, managing and developing, a dispersed workforce without compromising operational efficiency. Tracking and catering for the needs of field-based or shift employees can be particularly challenging. There are also important compliance issues.

Practical implications

– Demonstrates that having the ability to quickly and easily view and analyze employee and workforce data around training, learning and compliance means that management and HR teams can make strategic decisions around regulation, compliance and training needs based on relevant and up-to-date information.

Social implications

– Highlights how the training requests of employees themselves can also be more easily handled by having a central information repository.

Originality/value

– Reveals that by creating a logical connection between the processes involved in workforce management, managers will streamline their work, avoid duplication and make decisions based on real-time information.
Dell’s technical-support staff have the power to do more
Authors: Bagga Teena , Khanna Geetanjali
Published: October 2014

Purpose

– This paper aims to describe how computer giant Dell recruits and trains its technical-support staff.

Design/methodology/approach

– The paper reveals the competencies the company seeks in its recruits and how the recruits are developed.

Findings

– It highlights the importance of being tech-savvy, patient and adaptable and having a positive attitude, good communication skills, empathy with customers and loyalty to the organization.

Practical implications

– It explains that the company’s competency-based interview questions are designed to elicit details about the work the candidate has done, the way he or she has completed that work and the environment in which he or she worked.

Originality/value

– It provides a good insight into the recruitment and training of technical-support staff at a major international organization.
Ethan learns to be a learning organization
Authors: Rana Geeta , Goel Alok
Published: October 2014

Purpose

– This paper aims to describe the main human resource management policies at Ethan Power Private Ltd, an Indian design, sales and manufacturing company, and the specific circumstances that led it to become a learning organization.

Design/methodology/approach

– This paper outlines the company’s origins and growth and its policies in such areas as recruitment, induction, training, remuneration, performance management and industrial relations.

Findings

– This paper reveals that learning organization concepts have stimulated debate in the business, and there is growing acceptance of self-managed development, empowerment and creativity.

Practical implications

– This paper explains that there is much more evidence in the company of effective teamwork and the principles of total quality management, while HR specialists are encouraging the processes of reflection and self-improvement that lie at the heart of organizational improvement.

Social implications

– This paper reveals that, in general, and while fully complying with industrial-relations legislation, the company prefers to employ people who are not members of a trade union.

Originality/value

– This paper details the factors that led an Indian organization to change its organizational culture and how this change was achieved.
Building a culture of creativity at Moving Pixels Company
Authors: Batra Safal , Pollitt David
Published: October 2014

Purpose

– The paper aims to describe the key role of creativity at Moving Pixels, a small Indian media company.

Design/methodology/approach

– It charts the rise of the company and its organizational culture. It also emphasizes the importance of informality, openness and respect.

Findings

– It reveals that each member of the five-strong team is prepared to work long hours in exchange for feeling to be a part of the business and respected by its owner.

Practical implications

– It highlights the hands-on approach of the company owner and how closely he works with employees on individual projects.

Social implications

– It concedes that the culture of long working hours can take its toll on employees’ personal lives.

Originality/value

– It considers the workings of a small Indian media company.
Guanxi, a two-edged sword! How Australian accounting professionals view the process within a moral framework
Authors: Han Fan Ying , Woodbine Gordon , Scully Glennda
Published: October 2014

Purpose

– The purpose of this study is to determine how Western business practitioners, specifically Australian accounting professionals, identify with the Chinese value concept ofguanxiand the impact of their perceptions ofguanxion their ethical decision-making. This objective is predicated by a belief that aspects ofguanxiare similar to the Western concepts of social networking and would be identified by practitioners as an organizational process providing positive benefits to those associated with its application. Further, it is anticipated that concepts ofguanxiinfluence the way Australian accountants form ethical judgements and intentions, precursors to acceptable moral behaviour.

Design/methodology/approach

– A cross-sectional questionnaire based on a survey of 111 usable Australian accounting professionals was completed during 2012. A confirmatory factor analysis was used to validate each construct ofguanxibefore a path analysis was performed.

Findings

– Australian accounting professionals associate well with the favour-seeking aspects ofguanxi, suggesting an affiliation with Western concepts of social networking. Both groups (i.e. public accountants and private accountants) reject rent-seekingguanxias clearly unethical. Rent-seekingguanxiis seen to directly influence ethical judgement and intention; however, their favour-seekingguanxiattitudes do not influence ethical judgement or intention, regardless of employment type. Public and private accountants applyguanxiin a differential manner when determining moral intention. Public accountants are viewed as acting spontaneously without adequately considering the consequences (via the judgement phase), which appears to be a function of the nature of their personal association with the case study applied in this research.

Originality/value

– The research provides evidence that Australian accounting professionals relate to favour-seekingguanxias representative of a broader notion of social networking. In this context, theguanxiinstrument appears to be amenable to cross-cultural evaluations of group behaviour. Significant differences of opinion exist compared to the prior Chinese studies when unethical practices are considered. Theguanxiinstrument proves to be a useful tool when examining the group interactions involving Western professionals and also helps establish differences in moral constructions based on employment types.
Linking HRM competency to firm performance: an empirical investigation of Chinese firms
Authors: Ngo Hang-yue , Jiang Chun-Yan , Loi Raymond
Published: October 2014

Purpose

– The purpose of this paper is to attempt to investigate the relationship between human resource management (HRM) competency and firm performance. Drawn upon the resource-based view and alignment theory, HRM competency is expected to be related to the adoption of high performance work systems (HPWS) and the achievement of external fit in HRM, which in turn contribute to firm performance.

Design/methodology/approach

– The data for this study were collected via a survey of in 157 Chinese enterprises located in the high technology development zone of three large cities. Two different respondents from each firm provided information about organizational characteristics, HRM policy and practices, and firm performance. Multiple regressions were used to test the hypotheses.

Findings

– Results indicate that HRM competency has a significant and positive effect on firm performance. Such an effect is found to be mediated by the achievement of external fit, but not the adoption of HPWS.

Research limitations/implications

– Limitations of the study include cross-sectional data, perceptual measure of firm performance, omission of external variables, and restricted sample. This study highlights the importance of HRM competency in strategic HRM, and provides evidence about how this construct is linked to firm performance.

Originality/value

– This is the first study that explores the effect of HRM competency on the adoption of HPWS and the achievement of external fit. It further reveals that the achievement of external fit mediates the relationship between HRM competency and firm performance, and hence contributes to the HRM literature.
Academic background and credibility in executive coaching effectiveness
Authors: Bozer Gil , C. Sarros James , C. Santora Joseph
Published: October 2014

Purpose

– Little empirical research has examined the role of coach characteristics in coaching success. The purpose of this paper is to address this gap in the literature by identifying and testing the relationships between a coach's academic background in psychology and credibility with executive coaching effectiveness as reflected in greater levels of individual outcomes.

Design/methodology/approach

– These factors were examined through a quasi-experimental pretest-posttest design. Participants were drawn from the client bases of four Israeli executive coaching agencies.

Findings

– A coach's academic background in psychology was positively related to executive coaching effectiveness as reflected in greater improvement in coachee self-awareness and job performance as reported by the direct supervisor. Further, coach credibility was positively related to executive coaching effectiveness as reflected in higher mean scores in coachee self-reported job performance.

Originality/value

– Findings should assist businesses and educators in improving the formal preparation of coaches and in better identifying and selecting competent coaches. This may lead to better executive coaching design, implementation, and outcomes. Recommendations for future research are provided.
Alopecia areata. How not to miss Satoyoshi syndrome?
Authors: Rudnicka Lidia , Kwiatkowska Małgorzata , Rakowska Adriana , Czuwara Joanna , Olszewska Małgorzata
Published: October 2014

Satoyoshi syndrome is a multisystem disorder of suspected autoimmune etiology, characterized predominantly by alopecia, muscle spasms and diarrhea. Antinuclear antibodies are present in 60% of patients. The syndrome primarily affects girls and young women. Trichoscopy shows regularly distributed yellow dots, indistinguishable from typical alopecia areata. The condition may be easily misdiagnosed and treated as alopecia areata. On the basis of an in‐depth analysis of all published cases we developed diagnostic criteria for Satoyoshi syndrome. We also suggest that two subtypes of the disorder should be distinguished, the ANA‐positive Satoyoshi syndrome with generally good response to systemic glucocorticosteroid therapy and the ANA‐negative Satoyoshi with less favorable prognosis. In our opinion all patients will alopecia areata (in particular alopecia totalis) should be inquired about muscle spasms and diarrhea and tested for antinuclear antibodies to decrease the risk of missing Satoyoshi syndrome.
The consequences of demand‐driven seed provisioning for sexual differences in reproductive investment inThalictrum occidentale(Ranunculaceae)
Authors: Ida Takashi Y. , Harder Lawrence D. , Kudo Gaku
Published: October 2014

Many iteroparous angiosperms may benefit from flexible annual resource allocation in response to variable reproductive opportunities induced by external conditions. If maximal reproductive investment is fixed, lack of reproductive sinks would cause resource redistribution to other sinks. Alternatively, reproductive investment may vary depending on the demand of reproductive sinks, changing source–sink relations. In particular, differential responses by males and females to the demands of flower and seed production may cause sexual dimorphism.

We assess the occurrence of demand‐driven seed allocation by females and its implications for sexual differences in reproductive investment, including the dynamics of mass and carbon allocation and the physiological cost of reproduction, for a dioecious, perennial herb,Thalictrum occidentale. We specifically quantified allocation responses to partial defoliation, which reduced current resource supply, and partial flower/fruit removal, which reduced the aggregate demand of reproductive sinks.

During flowering, males preferentially invested carbon and mass in flowers at the expense of vegetative organs, whereas females allocated less mass to flowers and invested more in new rhizome production for future performance than males. In contrast, during early fruiting, both sexes had new rhizomes of similar size and a doubling of reproductive mass by females after flowering resulted in similar total reproductive investment for both sexes. Manipulation of the source–sink balance did not influence carbon allocation, except that partial fruit removal increased new rhizome mass compared with intact plants.

Females with many fertilized ovules invested proportionally more in seed number and mass per seed than females with few fertilized ovules, indicating both demand‐driven seed maturation and its elimination of seed size‐number trade‐off. Furthermore, males consistently exhibited size‐dependent flower production, whereas females exhibited size‐dependent flower production only if they had not reproduced during the previous year.

Synthesis. This study demonstrates that sexual differences in policies of reproductive investment and the timing of the physiological costs of reproduction impose contrasting allocation schedules. Males invested in reproduction proportionally with their size, whereas females invested flexibly in seeds in response to the demand of developing embryos. Thus, the contrasting certainty and timing of reproductive resource requirements between the sexes contribute to sexual dimorphism.
A Receiver‐Based Approach to Effective Instructional Crisis Communication
Authors: Sellnow Deanna D. , Lane Derek , Littlefield Robert S. , Sellnow Timothy L. , Wilson Bethney , Beauchamp Kimberly , Venette Steven
Published: October 2014

Much research has informed the development of a valuable series of sender‐focused best practices for effective crisis communication. Relatively little crisis communication research, however, focuses on receiver‐focused best practices as related to eliciting appropriate actions before, during and after crisis events. Because effective instructional communication is measured by learner (i.e., receiver) outcome achievement of affective (perceived value), cognitive (comprehension) and behavioural (performance) variables, this study examined perceived message effectiveness and behavioural intention using the IDEA model of instructional risk and crisis communication. Results of this comparative quasi‐experimental study revealed that messages integrating all elements of the IDEA model were more effective than status quo messages and point to the need for continued research on effective instructional crisis communication message design.
Health‐related quality of life and depression in a sample of Latin American adults with rheumatoid arthritis
Authors: Senra Hugo , Rogers Heather , Leibach Gillian , Altamar Marvín L. P. , Plaza Silvia L. O. , Perrin Paul , Durán Maria A. S.
Published: October 2014

Objective

To compare the health related quality of life (HRQoL) and depression of individuals with rheumatoid arthritis (RA) to healthy controls in Colombia, as well as to examine the connections between these two variables in individuals with RA.

Method

One hundred and three individuals with RA were recruited from ambulatory centers in Colombia. Seventy‐three control participants were recruited from the local community. Both groups differed with respect to age, gender and marital status (P < 0.001), while education and socio‐economic levels were similar. HRQoL was assessed using the Short Form‐36 (SF‐36) and depressive symptoms were assessed using the Patient Health Questionnaire‐9 (PHQ‐9).

Results

A multivariate analysis of covariance found that RA patients reported substantially higher depressive symptoms and lower HRQoL than healthy controls (P < 0.01 and P < 0.05, respectively). The effect sizes of the differences between patients and controls in HRQoL and depressive symptoms were all large. All SF‐36 HRQoL variables were significantly correlated with depressive symptoms in patients and controls (P < 0.05). Social functioning and vitality were uniquely associated with depressive symptoms in the RA group (P < 0.01 and P < 0.05, respectively), whereas education and social functioning were uniquely associated with depressive symptoms in controls (P < 0.05 and P < 0.005, respectively).

Conclusions

Research indicates that individuals with RA have deteriorated HRQoL, and this study extends these findings to a Colombian sample and highlights the importance of the independent relationship between depressive symptoms and vitality in this group of Colombians with RA.
Amelioration of oxidative stress in the joint tissue may be the basis for the antiarthritic activity of Terminalia arjuna bark extract
Authors: Tyagi Pravesh , Khan Haider A.
Published: October 2014

Aim

In this study we have evaluated the antioxidant and antiarthritic activity of Terminalia arjuna bark extract (TABE) in collagen‐induced arthritis (CIA) in rats.

Methods

Arthritis was induced in rats by intradermal injection of the collagen‐complete Freund's adjuvant emulsion. Right hind paw thickness was measured as a primary marker for severity of arthritis. Biochemical parameters such as tissue levels of superoxide dismutase (SOD), catalase, reduced glutathione (GSH), nitrites and thiobarbituric acid reactive substances (TBARS) were measured to determine the effect of treatment on antioxidant defenses. Articular elastase (ELA) level in the arthritic tissue was measured as a marker for neutrophil infiltration.

Result

Terminalia arjuna bark extract administration significantly inhibited the increase in paw thickness induced by immunization with collagen as compared to CIA‐control animals. Further, it attenuated the fall in tissue SOD and GSH levels and mitigated the increase in tissue nitrites and TBARS levels as compared to CIA‐control animals. Tissue ELA levels, which were significantly increased in the CIA‐control animals as compared to normal animals were also significantly reduced by TABE administration.

Conclusion

Results of our study demonstrate the antioxidant and antiarthritic activity of TABE in CIA in rats. We believe that TABE could find clinical application in the management of rheumatoid arthritis and associated disorders.
Peripheral immature B cells: modulators of autoimmunity
Authors: Lee Jisoo , Sim Ji‐Hyun , Kim In‐Je
Published: October 2014

B cells play an essential role in humoral immunity by producing antigen‐specific antibodies. However, B cells also participate in cellular immune responses by presenting antigens, providing costimulation, and producing cytokines to activate and expand effectors and memory T cell populations. Recent identification of antibody‐independent functions of B cells has reawakened interest in the many roles of B cells in normal immune responses as well as in autoimmune diseases. B cells interact with other immunocompetent cells during a tightly regulated immune activation process, acting as both effector and regulator. If this balance between effector and regulatory B cell functions is disrupted, harmful effects of immune activation such as autoimmunity can occur. In this review, we will discuss the role of human peripheral immature B cells in normal immune responses as a modulator of autoimmunity. We will also discuss abnormalities of these cells in pathogenesis of systemic autoimmunity with particular focus on systemic lupus erythematosus pathogenesis.
Baseline serum level of matrix metalloproteinase‐3 as a biomarker of progressive joint damage in rheumatoid arthritis patients
Authors: Galil Sahar Mahfouz Abdel , El‐Shafey Abeer Mohamed , Hagrass Hoda A. , Fawzy Faten , Sammak Ahmed El
Published: October 2014

Aim

Matrix metalloproteinase‐3 (MMP‐3) plays a pivotal role in the destruction of bone and degradation of cartilage components in rheumatoid arthritis (RA). We aimed in this study to analyze the relation between baseline levels of MMP‐3 and the progression of joint damage in RA.

Methods

Eighty‐one untreated RA patients with joint symptoms for <1 year were evaluated at baseline and after 12 months as regards erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP), rheumatoid factor (RF), anti‐cyclic citrullinated peptide (anti‐CCP) and plain X‐ray of both hands and wrists. Baseline levels of MMP‐3 were measured by enzyme‐linked immunosorbent assay and magnetic resonance imaging (MRI) of hands/wrists was performed. Disease Activity Score (DAS28) and Health Assessment Questionnaire (HAQ) were performed at baseline evaluation and after 12 months.

Results

The baseline MMP‐3 levels were significantly higher in the high‐progression group compared with the low‐progression one (95.75 ± 42.84 vs. 50.45 ± 12.83, P < 0.001). There was a positive correlation between baseline levels of MMP‐3 and MRI erosion score and other baseline clinical parameters, except for HAQ and the van der Heijde modification of the Sharp scoring system (SvdH) scores, while after 12 months, there were high positive correlations between MMP‐3 and SvdH score, as well as all parameters except for ESR.

Conclusion

Serum baseline levels of MMP‐3 are strong prognostic markers of disease activity, and act well as an early predictor of progressive joint damage in recent‐onset RA disease.
Tolerance to anthropogenic disturbance by a large carnivore: the case of Eurasian lynx in south‐eastern Norway
Authors: Bouyer Y. , Gervasi V. , Poncin P. , Beudels‐Jamar R. C. , Odden J. , Linnell J. D. C.
Published: October 2014

The relative merits of land sparing versus land sharing are being debated within conservation biology. While the debate is multifaceted, a central issue concerns the ability of biodiversity to actually persist in ‘shared’ human‐dominated landscapes. There is a widespread perception that large predators are synonymous with wilderness and have a low tolerance for human‐modified landscapes. However, there is an increasing body of evidence that is questioning this paradigm. In order to explore the tolerance levels of Eurasian lynx to human activity, we have analysed data on 49 lynx home ranges in south‐eastern Norway occupying a gradient of landscapes from near wilderness to the urban–forest interface. Our results indicate that lynx have the ability to tolerate relatively high levels of human presence both within their home ranges and within the immediate surroundings of their home ranges. Home‐range orientations reflect preference for areas associated with low levels of human‐induced habitat modification, and avoidance of the more heavily disturbed areas. The results show that lynx have a large potential to exist in shared landscapes if their presence is tolerated by people.
Carrion ecology modelling for vulture conservation: are vulture restaurants needed to sustain the densest breeding population of theAfrican white‐backed vulture?
Authors: Kane A. , Jackson A. L. , Monadjem A. , Colomer M. A. , Margalida A.
Published: October 2014

As obligate scavengers, vultures are entirely dependent on carrion resources. In this study, we model the carrion ecology of an ecosystem inSwaziland which is home to the densest breeding population of theAfrican white‐backed vultureGyps africanus. We collected data on life‐history parameters of the avian scavenging guild of the area as well as the potential food available from the ungulate fauna. Using novelPopulationDynamicsP‐Systems, we show that carrion provided by wild ungulates biomass is currently enough to sustain this vulture species. However, in light of the forecasted population increases, food will become a limiting factor. We discuss the significance of mass closure of supplementary feeding stations inSwaziland which now forces these birds to forage farther afield endangering them to poisoning events. We put these results in the context of biomass management and suggest conservation actions to secure the viability of vulture populations and the important ecosystem services they provide.
Consequences of a screening programme on the prevalence of congenital hereditary sensorineural deafness in the Australian Cattle Dog
Authors: Sommerlad S. F. , Morton J. M. , Johnstone I. , O'Leary C. A. , Seddon J. M.
Published: October 2014

Genetic disease testing programmes are used in domestic animal breeds to guide selective breeding with the aim of reducing disease prevalence. We assessed the change in the prevalence of canine congenital hereditary sensorineural deafness (CHSD) in litters of Australian Cattle Dogs following the introduction of a brainstem auditory evoked response (BAER) testing programme. We studied 608 pups from 122 litters from 10 breeding kennels. Despite 10 years of testing (1998–2008), no substantial reduction in prevalence of CHSD was evident in these 10 breeding kennels. Even for the subset of litters in which both parents were BAER tested as normal hearing (305 pups from 58 litters), there was no evidence of substantial reduction in prevalence. Odds ratios for CHSD in pups for each extra year since testing in the kennel commenced were 1.01 (95% CI, 0.88–1.17) and 1.03 (95% CI, 0.82–1.30) respectively for these populations. Amongst 284 dogs from 54 litters with extended pedigrees and both parents BAER‐tested normal hearing, observed prevalences of CHSD were highest in pups with no BAER‐tested normal grandparents (17% or 5/29) and lowest in pups with all four grandparents tested normal (0% or 0/9). In pups for which one, two and three grandparents tested negative, prevalences of CHSD were 12% (9/74), 9% (9/101) and 8% (6/71) respectively. Hence, testing programmes based on phenotypic screening may not lead to a substantial reduction in recessive genetic disease prevalence over the medium term, even when only tested normal parents are used. Exclusive breeding of litters in which both parents and all four grandparents are BAER‐tested normal is expected to reduce CHSD prevalence in pups to the greatest extent over the long term.
Catheter‐related upper limb venous thrombosis in a tertiary hospital setting
Authors: Ye Xuan , Wong Shing W. , Zhang John , Moo Ing‐How , Lee Chern Chuen
Published: October 2014

Background

To determine the relative likelihood of upper limb venous thrombosis (ULVT) in patients with peripherally inserted central catheter (PICC) versus central venous catheter (CVC), compared with patients without a catheter, in a tertiary hospital setting.

Methods

Retrospective review of all upper limb venous duplex ultrasounds performed for the investigation of venous thrombosis from the Prince of Wales Hospital Vascular Diagnostic Laboratory between July 2009 and October 2012 was conducted. Multivariate logistic regression analysis was used to determine the association between risk factors and the presence of ULVT. The total number of lines inserted was determined from medical, electronic and departmental records.

Results

Eight hundred and seventy‐six US scans in 637 patients were identified yielding 213 cases of ULVT. ULVT was found in 38/85 scans in patients with PICC, 36/103 scans in patients with CVC and 139/688 scans in patients without a catheter in situ. Compared with patients without catheters, the odds ratio (OR) for developing ULVT was 3.5 (P < 0.001) for PICC and 2.1 (P = 0.002) for CVC. Previous deep venous thrombosis (OR = 11.60; P < 0.001) and malignancy (OR = 2.10; P < 0.02) were additional risk factors. Median time from catheter insertion to diagnosis was 10 days for PICC and 19 days for CVC. The incidence of pulmonary embolism (PE) was 1.8%. The overall 6‐month mortality for patients with PICC was 5.9% and CVC was 17.7%. A total of 1855 PICC and 2435 CVC were inserted. The incidence of ULVT was 2.05% per PICC and 1.48% per CVC inserted (P = 0.08).

Conclusion

Catheters predispose to the formation of ULVT. PICCs are more likely to be associated with ULVT than CVC and have shorter time to symptomatic clot. PE from ULVT is uncommon.
Endoscopic self‐expandable metallic stenting for palliation of malignant gastric outlet obstruction in Southeast Asia
Authors: Lye Tiffany Jian Ying , Goh Yaw Chong , Eng Alvin Kim Hock , Ong Hock Soo , Wong Wai Keong , Chan Weng Hoong
Published: October 2014

Background

Malignant gastric outlet obstruction (GOO) is a pre‐terminal event in the natural history of gastric and pancreaticobiliary cancers. The use of endoscopic placement of self‐expandable metallic stents (SEMS) is a less invasive alternative palliative option for these patients. This is the first study in Southeast Asia to evaluate the clinical efficacy and safety of endoscopic SEMS placement in patients with malignant GOO.

Methods

A retrospective review of our department's database in endoscopic SEMS placement for the treatment of malignant GOO was performed. Twenty‐four patients with advanced or metastatic malignancy that underwent placement of SEMS for treatment of malignant GOO between January 2003 and July 2013 were analysed. The GOO severity score was used as an objective means of assessing patients' oral intake.

Results

Technical success rate was 100%. All patients resumed oral intake of liquids within the same day of stent placement. Clinical success was achieved in 21 patients (87.5%). There was a significant improvement of GOO severity score from 0.62 ± 1.0 (mean ± standard deviation) before stent placement to 2.04 ± 0.86 after stent placement (P < 0.001). Complication rate was 12.5%. Stent‐related complications observed include stent migration (two patients) and tumour ingrowth (one patient). Serious complications such as gastrointestinal haemorrhage or perforation did not occur in any patients. The median survival after stent placement was 57 days (95% confidence interval, 12.2–101.8 days). None of the patients died from stent‐related complications.

Conclusion

Endoscopic SEMS placement is a minimally invasive, safe and effective option for the palliation of malignant GOO.
Two‐year serum metal ion levels in minimally invasive total conservative hip resurfacing: preliminary results of a prospective study
Authors: Tai Stephen M. , Millard Natascha , Munir Selin , Jenabzadeh Amir R. , Walter Leonard R. , Walter William L.
Published: October 2014

Background

Metal‐on‐metal (MoM) hip resurfacings have been associated with the potential development of metallic debris and its associated pathology. Serum cobalt and chromium levels are a reliable surrogate marker of wear rates in MoM bearings. The aim of the study was to examine the trend in serum metal ion levels in the initial 2‐year post‐operative period following implantation of the minimally invasive total conservative hip MoM hip resurfacing and to determine whether head size, acetabular component orientation, clinical outcome scores or post‐operative range of movement would affect these levels.

Methods

In this prospective cohort study, serum cobalt and chromium ion levels were measured pre‐ and post‐operatively in 25 patients who underwent minimally invasive total conservative hip MoM hip resurfacing. The results were correlated with acetabular component orientation, head size, outcome scores and post‐operative range of movement.

Results

The mean serum cobalt and chromium levels at 2 years were 1.2 ppb (0.4–4.4 ppb) and 2.1 ppb (0.7–5.7 ppb). The mean cup inclination was 43° (30°–60°) and anteversion was 18° (1°–47°). There was no clear relationship between serum ions and acetabular component orientation, outcome scores or range of movement. Patients with a head size ≤52 mm had significantly higher metal ion levels (cobalt P = 0.02, chromium P = 0.045).

Conclusion

Our preliminary results show all patients had cobalt and chromium levels below those indicating a high‐risk implant, suggesting successful early outcome from minimally invasive total conservative hip resurfacing surgery.
Improving care for patients with oesophageal and gastric cancer: impact of a statewide multidisciplinary team
Authors: Wilson Eleanor E. , Thompson Sarah K. , Bull Jeff , Jones Bronwyn , Price Timothy , Devitt Peter G. , Watson David I. , Bright Tim
Published: October 2014

Background

To standardize management of upper gastrointestinal (GI) cancer in South Australia, a statewide video linked multidisciplinary team (MDT) meeting was established in late 2009. Although cancer MDTs are recognized as a standard of care, it is important to audit their impact.

Methods

A retrospective audit of MDT outcomes and recommendations for patients reviewed by the upper GI MDT between 1 January 2010 and 31 December 2011 was undertaken. The proportion of patients with new upper GI malignancies reviewed and the proportion reviewed within 2 weeks of diagnosis were determined. Recommendations from the MDT meetings regarding treatment intent, management, investigations and trial participation were audited.

Results

From 2010 to 2011, the proportion of newly diagnosed upper GI malignancies in South Australia reviewed by the MDT increased from 43.2% to 54.3%. More oesophageal than gastric cancer cases were reviewed by the MDT. The proportion of patients reviewed within 2 weeks of diagnosis increased from 20% to 50%. The proportion of patients referred for neoadjuvant or definitive chemoradiotherapy increased from 2010 to 2011. Fifty per cent of all patients reviewed were recommended to have further investigations. Recommendations for clinical trial participation increased from 0% in 2010 to 11% in 2011.

Conclusion

A statewide upper GI cancer MDT is feasible. Implementation of the MDT was followed by an increase in the number of patients reviewed and the proportion reviewed within 2 weeks of diagnosis. Greater awareness of the MDT and access to it may be required to continue to increase the proportion of cancers reviewed.
The efficacy of moderate‐to‐vigorous resistance exercise during pregnancy: a randomized controlled trial
Authors: Petrov Fieril Karolina , Glantz Anna , Fagevik Olsen Monika
Published: October 2014

Objectives

To assess the effect and safety of moderate‐to‐vigorous resistance exercise during pregnancy.

Design

Randomized controlled study.

Setting

Two antenatal clinics in Gothenburg, Sweden.

Population

Ninety‐two healthy pregnant women.

Methods

The intervention was administered during gestational weeks 14–25. The intervention group received supervised resistance exercise twice a week, performed at an activity level equivalent to within moderate‐to‐vigorous (n = 51). The control group received generalized exercise recommendation, a home‐based training program and a telephone follow up (n = 41).

Main outcome measures

Health‐related quality of life, physical strength, pain, weight, blood pressure, functional status, activity level, and perinatal data.

Results

Functional status deteriorated during the intervention in both groups and pain increased. Significant differences between the groups were obtained only for birthweight. Newborns delivered by women who underwent resistance exercise during pregnancy were significantly heavier than those born to control women; 3561 (±452) g vs. 3251 (±437) g (p = 0.02), a difference that disappeared when adjustment was made for gestational age (p = 0.059). Both groups showed normal health‐related quality of life, blood pressure, and perinatal data.

Conclusions

These findings indicate that supervised, moderate‐to‐vigorous resistance exercise does not jeopardize the health status of healthy pregnant women or the fetus during pregnancy, but instead appears to be an appropriate form of exercise in healthy pregnancy.
Lactation studies of anticonvulsants: a quality review
Authors: van der Meer Douwe H. , Wieringa Andre , Wegner Ilse , Wilffert Bob , ter Horst Peter G. J.
Published: October 2014

Aim

The aim of this review was to investigate the quality of the current literature on the transfer of anticonvulsants to breast milk to provide an overview of which anticonvulsants are in need of further research.

Methods

We reviewed the quality of the available lactation studies for 19 anticonvulsants against the guidelines of the Food and Drug Administration (FDA) and the International Lactation Consultant Association (ILCA).

Results

Except for one study on lamotrigine and one case report on gabapentin, no study on anticonvulsants had both the absolute infant dose (AID) and milk to plasma ratio (M : P) correctly assessed. Only one study on carbamazepine, phenytoin and vigabatrin was found that correctly assessed the AID. The main cause for this low number is the lack of essential details in published studies, since 25 of 62 studies were case reports, letters or abstracts. Other major shortcomings were the lack of information on sampling methods, the number of samples in a particular dose interval as well as the low number of study participants.

Conclusion

The quality of the current literature on the transfer of anticonvulsants to breast milk is low, except for lamotrigine, which makes it hard to draw conclusions about the safety of the use of anticonvulsants during the lactation period. Therefore, further research is needed.
Short‐term pretreatment with a dual 5α‐reductase inhibitor before bipolar transurethral resection of the prostate (B‐TURP): evaluation of prostate vascularity and decreased surgical blood loss in large prostates
Authors: Busetto Gian Maria , Giovannone Riccardo , Antonini Gabriele , Rossi Antonella , Del Giudice Francesco , Tricarico Stefano , Ragonesi Giulia , Gentile Vincenzo , De Berardinis Ettore
Published: October 2014

Objective

To investigate if short‐term treatment with dutasteride (8 weeks) before bipolar transurethral resection of the prostate (B‐TURP) can reduce intraoperative bleeding, as dutasteride a dual 5α‐reductase inhibitor (5‐ARI) blocks the conversion of testosterone into its active form dihydrotestosterone (DHT), and reduces prostate volume and prostate‐specific antigen (PSA) levels, while increasing urinary flow rate.

Patients and Methods

In all, 259 patients were enrolled and randomised to two groups: Group A, receiving placebo and Group B, receiving dutasteride (0.5 mg daily for 8 weeks). Blood samples were taken before and after B‐TURP for serum chemistry evaluation. In particular we evaluated blood parameters associated with blood loss [haemoglobin (Hb) and haematocrit (Ht)] and prostate vascularity [vascular endothelial growth factor (VEGF) immunoreactivity and microvessel density (MVD) using cluster of differentiation 34 (CD34) immunoreactivity].

Results

Total testosterone, DHT, PSA level and prostate volume were evaluated and with the exception of DHT and PSA level there was no statistically significant differences between the groups. When comparing changes in Hb and Ht between Group A and Group B before and after B‐TURP, there was a statistically significant difference only in patients with large prostates of ≥50 mL (ΔHb 3.86 vs 2.05 g/dL and ΔHt 4.98 vs 2.64%, in Groups A and B, respectively). There was no significant difference in MVD and VEGF index in prostates of <50 mL, conversely in large prostates the difference become statistically significant.

Conclusions

Dutasteride was able to reduce operative and perioperative bleeding only in patients with large prostates (≥50 mL) that underwent B‐TURP. Our findings are confirmed by Hb and Ht values reported before and after the B‐TURP and reductions in the molecular markers for VEGF and CD34 in the dutasteride‐treated specimens.
Impact of alcohol consumption on survival in patients with esophageal carcinoma: A large cohort with long‐term follow‐up
Authors: Huang Qingyuan , Luo Kongjia , Yang Hong , Wen Jing , Zhang Shuishen , Li Jinhui , Ela Bella Amos , Liu Qianwen , Yang Fu , Zheng Yuzhen , Hu Ronggui , Chen Junying , Fu Jianhua
Published: October 2014

Alcohol is a well‐established cause of esophageal carcinoma, but its effect on survival is little known and contradictory. To clarify whether drinking is an independent predictor of survival in esophageal carcinoma, 2151 Chinese patients, receiving surgical resection from January 1997 to December 2008, were followed until March 2014. Cox proportional hazards analysis was applied to evaluate the prognostic effect of alcohol consumption. The median follow‐up was 64 months. The median overall survival (OS; 42 months) and disease‐free survival (DFS; 33 months) for never‐drinkers were significantly higher than ever‐drinkers (27 and 22 months, respectively). In the multivariate Cox model that was adjusted for age, weight loss, stage according to criteria set by the American Joint Committee on Cancer, radicality of surgery, adjuvant treatment, smoking status, and gender, the hazard ratios of ever‐drinking were 1.22 (1.06–1.41, P = 0.005) on OS, and 1.16 (1.01–1.34, P = 0.037) on DFS. The hazardous effect on OS and DFS of drinking grew statistically significantly in a dose‐dependent manner with increasing amount of alcohol consumption per day (both P‐value for trend < 0.05). The predictive effect of drinking on OS (P = 0.596) or DFS (P = 0.207) was not significant in the subgroup with esophageal adenocarcinoma (n = 195). The current study revealed that the survival is shortened, of those patients who consume alcohol before diagnosis of esophageal squamous cell carcinoma, which are not attributable to differences in stage, smoking status, and gender. Alcohol control should be emphasized to reduce mortality of esophageal carcinoma, and further outcome studies should include alcohol as a potential prognosticator.
Real‐Time Isosurface Extraction With View‐Dependent Level of Detail and Applications
Authors: Scholz Manuel , Bender Jan , Dachsbacher Carsten
Published: October 2014

Volumetric scalar data sets are common in many scientific, engineering and medical applications where they originate from measurements or simulations. Furthermore, they can represent geometric scene content, e.g. as distance or density fields. Often isosurfaces are extracted, either for indirect volume visualization in the former category, or to simply obtain a polygonal representation in case of the latter. However, even moderately sized volume data sets can result in complex isosurfaces which are challenging to recompute in real time, e.g. when the user modifies the isovalue or when the data itself are dynamic. In this paper, we present a GPU‐friendly algorithm for the extraction of isosurfaces, which provides adaptive level of detail rendering with view‐dependent tessellation. It is based on a longest edge bisection scheme where the resulting tetrahedral cells are subdivided into four hexahedra, which then form the domain for the subsequent isosurface extraction step. Our algorithm generates meshes with good triangle quality even for highly non‐linear scalar data. In contrast to previous methods, it does not require any stitching between regions of different levels of detail. As all computation is performed at run time and no pre‐processing is required, the algorithm naturally supports dynamic data and allows us to change isovalues at any time.
Prick testing with chemicals in the diagnosis of occupational contact urticaria and respiratory diseases
Authors: Helaskoski Eva , Suojalehto Hille , Kuuliala Outi , Aalto‐Korte Kristiina
Published: October 2014

Background

Little is known about the use of prick tests with chemicals in diagnosing occupational diseases.

Objective

To evaluate the use of prick tests in the diagnosis of occupational contact urticaria, asthma and rhinitis caused by chemicals (undertaken at theFinnishInstitute ofOccupationalHealth).

Material and methods

We retrospectively reviewed the patient and test files for the period 1January 1991 to 31May 2011. Prick tests were performed with chemical solutions and human serum albumin (HSA)–chemical conjugates.

Results

Positive prick test reactions to isocyanate–HSAconjugates were associated with isocyanate‐specificIgEin all 20 patients, and 17 patients had a relevant occupational disease. Positive reactions to chloramine‐T–HSAconjugates in 10 patients also indicated the presence of specificIgE, although occupational diseases were not always diagnosed. Eleven of 17 patients with positive reactions to persulfate solutions were diagnosed with an occupational disease. Methacrylates, colophonium‐related substances, amine hardeners, ethanolamines, glutaraldehyde, glyoxal, pyrocatechol and ammonium thioglycolate did not elicit any relevant prick test reactions. No generalized reactions were detected.

Conclusion

Prick tests can be safely used for diagnosing contact urticaria, asthma and rhinitis caused by isocyanates, chloramine‐T, persulfates, and chlorhexidine, but the results should be carefully interpreted and related to clinical symptoms and other diagnostic tests.