bluuebunny/crossref_metadata_2025 huggingface dataset:
Entrepreneurship in regions: differentiated impacts of the socio cultural and gender types
Authors: Mancilla Claudio , Amorós José Ernesto
Published: February 2015

Purpose

The purpose of this paper is to study the differentiated impact of factors that influence the propensity to entrepreneur in a sample of people in Chile. A distinction is made between individuals that live in primary cities and secondary cities. The differentiating factors are socio‐cultural aspects (reference models – positive examples of entrepreneurs – and perception of social fear of failure) and the gender of the individual.

Design/methodology/approach

For the research data from the survey used in Chile by the Global Entrepreneurship Monitor for the years 2010 and 2011 were used. A logit model was used to determine the differentiated impact of the analysed factors and interactions were done using the method proposed by Corneliâen and Sonderhof (2009).

Findings

These showed that the fact that an individual lives in a secondary city decreases his entrepreneurship probability. The positive impact that the reference models have is weaker in women. Contrary to what was expected, the negative impact of the fear of failure perception is weaker in women.

Practical implications

These results have the implications to suggest focused public policies and differentiations that consider the socio‐cultural, territorial (focused in cities) and gender aspects.

Originality/value

The research contributes by giving empirical evidence of the existence of the negative impact of living in a secondary city and of differentiated effects of socio‐cultural factors from the gender perspective.
Assessing the stability of graduates’ entrepreneurial intention and exploring its predictive capacity
Authors: Liñán Francisco , Rodríguez‐Cohard Juan Carlos
Published: February 2015

Purpose

This is one of the first long‐term studies on entrepreneurial intentions (EIs) and their role in predicting start‐up. In entrepreneurship, the usefulness of intention models depends crucially on their stability over time. The purpose of this paper is to explore this issue in a cohort of university graduates.

Design/methodology/approach

Using a structural equation model (SEM), it addresses three research questions: whether EI and perceptions are stable over time; whether the pattern of relationships of the variables in the model remains stable over a three‐year period; and whether intention accurately predicts entry into self‐employment. A two‐wave study was conducted with respondents being final year students at time 1 (T1), and part of the working/active adult population at time 2 (T2).

Findings

The results suggest that construct scores and the pattern of relationships between the variables are notably stable over the three‐year period. The only partial exception is that of perceived behavioral control. Finally, EIs are found to significantly explain actual start‐up behavior. Implications are derived for future research and entrepreneurship education and policy.

Research limitations/implications

The generalizability of the results cannot be claimed until these findings are replicated by additional samples from different segments of the population and in different contexts. In particular, the number of new entrepreneurs at T2 is small and results in this respect are to be taken with caution.

Originality/value

The value of this paper resides in its clarifying the conditions under which EIs and their antecedents remain stable over time, thus enabling actual start‐up behavior.
An evaluation of citizen service web portals in Latin America
Authors: Bouzas‐Lorenzo Ramón , Mahou‐Lago Xosé María
Published: February 2015

Purpose

The purpose of this paper is to report on the level of government web portal resource development, impediments to progress in electronic government practices, and areas that require improvement in 19 Latin American countries.

Design/methodology/approach

A comparative study was carried out between March and May of 2012, based on a method combining heuristic usability analysis with an automatic web portal accessibility test.

Findings

The results suggest that Latin American government web portals do not fully meet international accessibility guidelines and that multidirectional communication and participation mechanisms lack diversity. Only functionalities related to usability presented positive scores, but with shortcomings in terms of security.

Originality/value

Extensive literature is available on the development of electronic government policies in Latin America. This study falls within that tradition but, in addition, offers a new perspective by examining the features of web portals, which ultimately aids the calibration of the results of policy implementation. The data obtained are useful for web developers, ICT policy designers and the entire community of actors involved in developing electronic government programs.
Industrial services – the solution provider’s stairway to heaven or highway to hell?
Authors: Kohtamäki Marko , Helo Petri
Published: February 2015

Purpose

– The role of industrial services has increased in importance as product manufacturing oriented companies have been moving towards industrial services and integrated solutions. While migrating towards solutions provision, manufacturing companies have been developing new Service offerings, service business models logics and methods of service delivery are developed by using new technologies for value co-production and co-creation. The purpose of this paper is to discuss the solution providers perspective by illustrating central approaches tapping into industrial services, such as environment-strategy-fit, scope of industrial service offering, industrial service business capabilities, and servitization process.

Design/methodology/approach

– The paper reviews literature related to industrial service phenomenon providing a: framework for environment-strategy-fit in the context of Industrial Services taking Fit; defining industrial service business; defining industrial service business capabilities; and a critical perspective toward industrial service business research.

Findings

– Where this paper provides a framework for environment-strategy-fit in the context of Industrial services, it also develops grounds to consider the maturity levels of servitization in a solution provider context. This paper recognizes the maturity levels of manufacturing companies providing a typology to analyze the level of servitization. Finally, this paper also serves as an introduction to an interesting special issue on industrial services.

Originality/value

– The existing industrial service theory related industrial services can be strengthened by developing frameworks and typologies to better understand the transformation from products to industrial services and integrated solutions. technology digitalization and enable operational and outsourcing services, in addition to performance services.
Service productivity in different industries – an empirical investigation
Authors: Klingner Stephan , Pravemann Stephanie , Becker Michael
Published: February 2015

Purpose

– The purpose of this paper is to quantitatively evaluate of the current status of productivity management of industrial and non-industrial service companies in Germany. Based on that knowledge, best practices and needs regarding tools and methods can be identified.

Design/methodology/approach

– In two qualitative pre-studies the theoretical foundation of service productivity was built. Using this knowledge, a quantitative empirical survey was conducted, including almost 2000 service companies. The sampling frame was based on a company database provided by Hoppenstedt. Samples were randomly selected using proportionate stratified sampling.

Findings

– The findings show the economic importance and meaningfulness of service productivity management, independently from the industry.

Research limitations/implications

– Due to the chosen population, the findings are limited to Germany. Furthermore, a more detailed comparison of service industries beyond industrial and non-industrial services was not feasible.

Practical implications

– The data contained evidence that companies conducing productivity management are more successful than those who are not. This underlines the economic importance service productivity management.

Originality/value

– The paper provides reliable, quantitative insights of the current status, demands, and benefits of service productivity management in the industrial as well as non-industrial sector.
Meteorological information service support system in wind park application
Authors: Liu Yang , Yang Wenshan
Published: February 2015

Purpose

– The purpose of this paper is to introduce a holistic decision support system based on condition-based maintenance which utilizes meteorological forecasting information to support decision-making process in services of wind power enterprises.

Design/methodology/approach

– A pilot conceptual system combining with meteorological information and operations management has been formulated in this study. The proposed system provides benchmarking to support decision making directly and indirectly basing on processing meteorological information and evaluating its impact on service operations. It collects meteorological data to predict failure probabilities in different areas which need corresponding maintenance service and schedule the optimal maintenance periods. In addition, it provides meteorological forecasting and decision support in case of extreme weather events (EWEs).

Findings

– The conceptual study shows that there is a connection between the meteorological conditions and failures, and it is feasible to make service decisions based on the predictions of weather conditions and their impacts to failures.

Research limitations/implications

– The research presented at the present phase is not much beyond a conceptual framework. The actual implementation and all possible related practical issues will be dealt with in future research.

Practical implications

– It helps decision makers to predict and identify possible categories of faults in wind turbine, make optimal service decisions to enhance the output performance of wind power generation, and take in advance emergency counteractions in case of EWEs.

Originality/value

– It presents a novel concept and provides a roadmap to achieve optimal operations in wind park application through combining meteorological information system with service decision making.
A decision support system to evaluate the business impacts of machine-to-machine system
Authors: Heikkilä Tuomo
Published: February 2015

Purpose

– The tightening competition and performance pressure in companies often leave no time or space for the assessment of business impacts of different investments and projects. In addition, in many cases the assessment may be challenging and there is no experience available to undertake it. Despite that companies often commit to different projects and investments without careful planning and vision of the costs it may cause. The purpose of this paper is to create a decision support system in order to facilitate and increase the assessment of business impacts of different investments concerning to machine-to-machine (M2M) systems.

Design/methodology/approach

– The created decision support system is composed of cost-benefit analysis including several investment decision methods. In order to deepen the understanding on it, the system was applied to two cases from the M2M business.

Findings

– During the study it was found that different financial metrics might give contradictory results when deciding whether to undertake an investment. In addition, a significant finding was how much some variables may have significance to the eligibility of an investment than others. The study also gave understanding how long payback time can be and how risky the investments might be in different M2M applications.

Originality/value

– The study describes the created decision support system and it is applied to two different M2M applications. The system provides a comprehensive combination of different financial metrics, which will help any manager make decisions whether an investment is eligible or not.
An innovative framework for performance analysis of members of supply chains
Authors: Chithambaranathan P. , Subramanian Nachiappan , Palaniappan PL.K.
Published: February 2015

Purpose

– An appropriate system for analysing performance of supply chains is an important requirement for the effective utilization of the supply chains. The purpose of this paper is to develop a conceptual model for the task of analysing the performance of members of supply chains.

Design/methodology/approach

– A thorough literature review of the methodologies proposed earlier by various authors has been made. In this paper a multi criteria decision-making (MCDM) framework comprising of two MCDM approaches is proposed for analysing performance of supply chain members.

Findings

– Performance analysis of members of supply chain and the process of decision making based on the outcome of the analysis is a MCDM process. Since human judgements are often vague, the application of fuzzy concepts is appropriate for analysing the performance of supply chains. The framework proposed in this paper was validated in a company manufacturing textiles.

Research limitations/implications

– The methodologies proposed are of great use for large- and medium-sized enterprises. However, small organizations may not be able to allot enough resources to implement the methodologies proposed.

Practical implications

– The framework developed can be applied for undertaking a comparative analysis of performance of members of supply chains. It can also be applied for the process of incorporation of new members into the supply chain.

Originality/value

– Very few methods are available for analysing the performance of supply chains and the subject remains an under researched one. The major contribution of this paper is that it proposes a new framework.
Comparing high and low performers for noise control
Authors: Bell Nikki , Lunt Jennifer , Webster Jennifer , Ward Tim
Published: February 2015

Purpose

– The purpose of this paper is to investigate the dimensions that distinguish high from low performing manufacturing companies in Great Britain with respect to controlling noise. The findings should assist regulators and industry to develop interventions that help organisations to effectively manage noise, particularly amongst the low performers.

Design/methodology/approach

– The research uses quantitative and qualitative methods. Survey data was obtained from 215 manufacturers and supplemented with 15 qualitative interviews to assess performance and individual, social, environmental and organisational influences on duty holders' decision making for controlling noise.

Findings

– Relative to low performers, decision makers from high performing companies had: greater in-depth knowledge of noise risks and controls; taken steps to promote positive health and safety attitudes and values; were large companies; and faced fewer resource barriers (time, costs, staffing). Managers in small, low performing companies sought simple interventions with a practical focus.

Research limitations/implications

– The differences reported between high and low performing companies showed a small magnitude of effect but these are considered significant in a health and safety context.

Practical implications

– Improvements in training and education, and addressing workplace health and safety culture, are recommended as offering most potential to raise the standard of noise control.

Originality/value

– To the authors’ knowledge, this is the first study to systematically assess the specific knowledge, attitudes, values and beliefs that employers hold about noise and the influence of social, environmental and organisational factors on manager’s decisions about noise controls.
Improved fitness after a workbased physical exercise program
Authors: von Thiele Schwarz Ulrica , Lindfors Petra
Published: February 2015

Purpose

– The purpose of this paper is to investigate the effects on fitness outcomes of a work-based physical exercise (PE) intervention among women working in older people’s care. In addition, effects on productivity-related outcomes including work ability and sickness absence were studied.

Design/methodology/approach

– Employees participated in a one-year intervention involving two one-hour weekly mandatory PE sessions. The intervention (n=13) was compared to referents (n=12). Fitness tests and self-reports on work ability and sickness absence were obtained before the intervention (T1), six months into the intervention and after 12 months.

Findings

– Fitness test scores (corrected for age and weight) increased significantly over time in the intervention group but not among referents. Perceived exertion decreased significantly in the intervention group and increased significantly among referents. For self-rated work ability and sickness absence, no significant time or group differences emerged.

Research limitations/implications

– Further research on larger groups of women is needed to delineate the effects of PE on self-rated productivity and performance.

Practical implications

– Work-based PE programs can improve fitness among women in older people’s care.

Social implications

– With previous research having primarily focussed on men, this study shows that women in blue-collar jobs also may benefit from taking part in work-based PE programs.

Originality/value

– This paper makes an important contribution through its focus on the effects of a work-based PE program on fitness and possible relations to productivity, among employed women.
Personality factors related to treatment discontinuation in a high secure personality disorder treatment service
Authors: Bennett Alice L.
Published: February 2015

Purpose

– The purpose of this paper is to explore the range of personality disorder diagnoses and levels of psychopathy as assessed by the Psychopathy Checklist-Revised (PCL-R) associated with treatment discontinuation in a sample of adult male prisoners.

Design/methodology/approach

– Data from 92 male offenders in a high secure prison personality disorder treatment unit was analysed. PCL-R and personality disorder diagnoses were predicted as being related to increased treatment dropout.

Findings

– Having a diagnosis of narcissistic personality disorder was related to treatment dropout, but PCL-R total scores were not. There was a trend for a diagnosis of antisocial personality disorder being associated with remaining in treatment.

Research limitations/implications

– The current study highlights that narcissistic personality disorder can be associated with treatment dropout, warranting further exploration as to why this is the case.

Practical implications

– Managing responsivity issues for those presenting with a personality disorder diagnosis could be effective in maximising treatment engagement from this specific offender group.

Originality/value

– Although treatment dropout has been explored previously, this is the first study to explore treatment dropout at a specialised unit designed specifically to provide treatment for this client group.
Exploring police-resident racial equality and violent crime
Authors: Sytsma Victoria A.
Published: February 2015

Purpose

– Residential segregation based on race/ethnicity is associated with higher crime rates. However, when there is greater diversity within a neighbourhood, there may be less clustering of crime. One sign of such diversity beyond direct measures of racial similarity may be the proportion of minority officers employed by municipal police departments. As such, the purpose of this paper is to test the effect of the proportion of minority police officers on violent crime within minority communities, controlling for residential segregation.

Design/methodology/approach

– Multi-level modelling of 91 American cities from the 2000 National Neighbourhood Crime Study was used.

Findings

– It was found that as minority populations within census tracts increase, violent crime also increases; and crime is associated with an increase in segregation. However, racial composition of police departments can moderate the impact that community racial composition has on violent crime.

Originality/value

– The current findings point to crime control strategies relevant to municipalities which focus on creating neighbourhoods of racial heterogeneity and more diverse police agencies.
Trauma Informed Additional – Programme
Authors: Worthington Rachel
Published: February 2015

Purpose

– The purpose of this paper is to explore the ways in which trauma may manifest both in terms of internalising and externalising symptoms.

Design/methodology/approach

– The paper will argue that the effects of trauma can contribute to victims engaging in problematic behaviours (such as aggression) both towards themselves and others which may require them to attend treatment programmes to target these problem behaviours. However, standard interventions designed to target these problem behaviours do not sufficiently take into account the effects of trauma in terms of attending to the therapy interfering behaviours which are brought to treatment. The paper will argue that these trauma related therapy interfering behaviours should be attended to prior to the client engaging in specific groups to target other problem behaviours (e.g. aggression).

Findings

– Clients who are referred for standard group based interventions to target problem behaviours such as aggression towards themselves or others should be offered a trauma intervention first in order to improve concentration, reduce drop-out rates and enhance feelings of safety to engage effectively in the group. Group based Eye Movement Desensitisation and Reprocessing (EMDR) should be used as a method of targeting therapy interfering behaviours associated with the effects of trauma and this should also incorporate meditation and neurobiologically informed approaches. Standard target problem behaviour groups should be adapted and modified to account for the role of trauma in information processing.

Originality/value

– The paper will introduce Trauma Informed Additional – Programme (TIA-P) which is a newly designed group designed to assist clients to tolerate and modify therapy interfering behaviours which are present as a result of trauma in order that they can then go on to attend standardised interventions. The TIA-P attends to the latest research in relation to the treatment of trauma utilising EMDR within the group to enhance safety and reduce therapy interfering behaviours.
Complementarity and selection effects in early and mid‐successional plant communities are differentially affected by plant–soil feedback
Authors: Jing Jingying , Bezemer T. Martijn , van der Putten Wim H.
Published: February 2015

Many studies that provided evidence for a positive relationship between plant diversity and productivity have proposed that this effect may be explained by complementarity among species in resources utilization, or selection of particularly productive species in high‐diversity plant communities. Recent studies have related the higher productivity in diverse plant communities to suppression of pathogenic soil biota. If soil biota plays a role in diversity–productivity relationships, the question remains about how they may influence complementarity and selection effects.

Here we examine how complementarity and selection effects may depend on soil biota using a plant–soil feedback approach. We used monocultures and mixtures of early successional plant species, which are known to have mostly negative plant–soil feedback effects, and mid‐successional plant species, which generally have neutral plant–soil feedback.

We found that plant–soil feedback effects differed between monocultures and mixed plant communities, as well as between early and mid‐successional plants. This resulted in a significant interaction effect between diversity and successional stage. In monocultures, plant–soil feedback tended to be negative for early and positive for mid‐successional plant species. Interestingly, the community feedback responses of the mixed communities were opposite, being positive for early and negative for mid‐successional community.

Plant–soil feedback differentially affected complementarity and selection effects of early and mid‐successional plant communities: it enhanced complementarity effects of early and decreased selection effects of mid‐successional species.

Synthesis. Soil biota that drive plant–soil feedback effects can influence the diversity–productivity relationship not only through decreased biomass production in monocultures compared to mixtures, but also through influencing complementarity and selection effects among species in mixed plant communities. Our results reveal that biodiversity–productivity relationships depend on plant–soil feedback interactions, which depend on the successional position of the plant. We propose that including successional position and trait‐based analyses of plant–soil feedback in diversity‐functioning studies will enhance understanding consequences of biodiversity loss for productivity and other ecosystem processes.
Banking Market Structure and Macroeconomic Stability: Are Low‐Income Countries Special?
Authors: Bremus Franziska , Buch Claudia M.
Published: February 2015

Does the structure of banking markets affect macroeconomic volatility and, if yes, is this link different in low‐income countries? In this paper, we explore the channels through which the structure of banking markets affects macroeconomic volatility. Our research has three main findings. First, we study whether idiosyncratic volatility at the bank level can impact aggregate volatility. We find weak evidence for a link between granular banking sector volatility and macroeconomic fluctuations. Second, a higher share of domestic credit to GDP coincides with higher volatility in the short run. Third, a higher level of cross‐border asset holdings increases volatility in low‐income countries.
Investing Volatile Resource Revenues in Capital‐Scarce Economies
Authors: Richmond Christine , Yackovlev Irene , Yang Shu‐Chun S.
Published: February 2015

Natural resource revenues are an important financing source for public investment in many developing economies. Investing volatile resource revenues, however, may subject an economy to macroeconomic instability. This paper studies fiscal approaches to investing resource revenues, using Angola as an example. With spend‐as‐you‐go, resource revenues are spent as received, resulting in little external saving; public investment can be interrupted, driving up the capital depreciation rate and undermining stability. Gradual scaling‐up, instead, allows countries to build up external saving to shield investment from revenue volatility. The framework adopted here can be used as a planning tool to define a medium‐term fiscal strategy.
Price Premiums for Providing Eco‐labelled Seafood: Evidence from MSC‐certified Cod in Sweden
Authors: Blomquist Johan , Bartolino Valerio , Waldo Staffan
Published: February 2015

Eco‐labelled seafood is an important tool to promote sustainable development in fisheries. A price premium on eco‐labelled seafood signals a return on investment in sustainable fishing methods, providing an incentive for fishers to adopt such methods. This paper investigates whether Swedish fishermen gained a price premium from participating in the Marine Stewardship Council (MSC)‐certified Swedish Eastern Baltic cod fishery in the period 2011–2012. Using a detailed dataset of landing tickets and log books, we apply a panel data methodology to estimate the MSC price premium. We cannot find reliable evidence that the consumer level premium for MCS cod is actually passed back to the producers in this case.
Anatomical Variations of the Blood Vascular System in Veterinary Medicine. The Internal Iliac Artery of the Dog. Part Two
Authors: Avedillo L. , Martín‐Alguacil N. , Salazar I.
Published: February 2015

The aim of this study was to investigate the variability of the internal pudendal artery. Two hundred and thirty‐two pelvic halves from 116 adult dogs were examined. Twenty‐six anatomical variations were found, thirteen occurring in more than 5% of the dogs. Anatomical variations were grouped in relation to the origin of the prostatic/vaginal arteries, middle rectal artery, urethral artery, ventral perineal and caudal rectal arteries. The chi‐squared test was used to analyse differences in sex, side of the body, profile and size, and the results were considered statistically significant whenP ≤ 0.05. An identical vascular pattern in both hemipelvises was found for most of the anatomical variations described.
Founder Haplotype Analysis of Fanconi Anemia in the Korean Population Finds Common Ancestral Haplotypes for a FANCG Variant
Authors: Park Joonhong , Kim Myungshin , Jang Woori , Chae Hyojin , Kim Yonggoo , Chung Nack‐Gyun , Lee Jae‐Wook , Cho Bin , Jeong Dae‐Chul , Park In Yang , Park Mi Sun
Published: February 2015

A common ancestral haplotype is strongly suggested in the Korean and Japanese patients with Fanconi anemia (FA), because common mutations have been frequently found: c.2546delC and c.3720_3724delAAACA of FANCA; c.307+1G>C, c.1066C>T, and c.1589_1591delATA of FANCG. Our aim in this study was to investigate the origin of these common mutations of FANCA and FANCG. We genotyped 13 FA patients consisting of five FA‐A patients and eight FA‐G patients from the Korean FA population. Microsatellite markers used for haplotype analysis included four CA repeat markers which are closely linked with FANCA and eight CA repeat markers which are contiguous with FANCG. As a result, Korean FA‐A patients carrying c.2546delC or c.3720_3724delAAACA did not share the same haplotypes. However, three unique haplotypes carrying c.307+1G>C, c.1066C > T, or c.1589_1591delATA, that consisted of eight polymorphic loci covering a flanking region were strongly associated with Korean FA‐G, consistent with founder haplotypes reported previously in the Japanese FA‐G population. Our finding confirmed the common ancestral haplotypes on the origins of the East Asian FA‐G patients, which will improve our understanding of the molecular population genetics of FA‐G. To the best of our knowledge, this is the first report on the association between disease‐linked mutations and common ancestral haplotypes in the Korean FA population.
Hydroxymethylbilane Synthase Gene Mutations and Polymorphisms in Brazilian Families with Acute Intermittent Porphyria
Authors: Gonzaga Ana Denise Gomes , de Amorim Lidia Maria da Fonte , Fonseca Ana Beatriz Monteiro , Nogueira Tatiana Lucia Santos , Pereira Olga Maria Diniz , Nagai Maria Aparecida , de Oliveira Barretto Orlando Cesar , Ribeiro Georgina Severo
Published: February 2015

Acute intermittent porphyria (AIP), an autosomal dominant disorder, is caused by a deficiency of hydroxymethylbilane synthase (HMBS). In the present study, we sought to establish a correlation between HMBS activity with the presence of mutations and polymorphisms. Enzyme activity was measured in red blood cells of four Brazilian unrelated AIP families (n = 124) and in blood donors (n = 80). The HMBS mutations in AIP family members were studied by PCR‐SSCP followed by direct sequencing. Six intragenic SNPs (1345 G>A, 1500 T>C, 2377 C>A, 2478 A>G, 3581 A>G, and 7064 C>A) were determined by PCR‐RFLP. Abnormal SSCP patterns in exons 7, 9, 12, and 15 were observed. DNA sequencing analysis revealed one nonsense mutation, R149X, two missense mutations, G111R and L338P, and one deletion, CT 730–731. All mutation carriers had lower enzyme activity. All polymorphisms, except 2377 C>A and 7064 C>A, showed no significant differences compared with previous reports. Mutation screening allowed the detection of the missense mutation, L338P, and the 730_731delCT deletion, two as yet unreported mutations in Brazilian AIP patients. Our findings also showed a high frequency of 2478 A>G and 3581 A>G polymorphism combinations suggesting that these polymorphisms contributed to enzymatic activity reduction in our study population.
Factors that predict in‐hospital mortality in eosinophilic granulomatosis with polyangiitis
Authors: Hasegawa W. , Yamauchi Y. , Yasunaga H. , Sunohara M. , Jo T. , Matsui H. , Fushimi K. , Takami K. , Nagase T.
Published: February 2015

Background

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic small‐vessel vasculitis associated with asthma, eosinophilia, and necrotizing vasculitis. EGPA is potentially life‐threatening and often involves peripheral neuropathies, peptic ulcers, cerebral vessel disease, and cardiovascular disease. However, there is limited understanding of the prognostics factors for patients with EGPA. We investigated the clinical features and factors affecting patients' in‐hospital mortality, using a national inpatient database in Japan.

Methods

We retrospectively collected data of EGPA patients who required hospitalization between July 2010 and March 2013, using the Diagnosis Procedure Combination database. We evaluated EGPA patients' characteristics and performed multivariate logistic regression analyses to assess the factors associated with in‐hospital mortality.

Results

A total of 2195 EGPA patients were identified. The mean age was 61.9 years, 42.1% (924/2195) were male, and 41.6% (914/2195) had emergent admission. In‐hospital deaths occurred in 97/2195 patients (4.4%). Higher in‐hospital mortality was associated with age older than 65 years, disturbance of consciousness on admission, unscheduled admission, respiratory disease, cardio‐cerebrovascular disease, renal disease, sepsis, and malignant disease on admission. Lower mortality was associated with female gender and peripheral neuropathies.

Conclusions

Our study revealed the clinical features of EGPA patients who required hospitalization and the factors associated with their mortality. These results may be useful for physicians when assessing disease severity or treatments for hospitalized EGPA patients.
Low testosterone is associated with poor health status in men with human immunodeficiency virus infection: a retrospective study
Authors: Rochira V. , Diazzi C. , Santi D. , Brigante G. , Ansaloni A. , Decaroli M. C. , De Vincentis S. , Stentarelli C. , Zona S. , Guaraldi G.
Published: February 2015

Men with human immunodeficiency virus (HIV) infection are often hypogonadal and develop several HIV‐associated non‐acquired immunodeficiency syndrome (AIDS) (HANA) conditions that impair overall health status. No studies explored the relationship between health status and serum testosterone (T) in HIV‐infected men. This study aims to investigate the association between total serum T and HANA, multimorbidity, and frailty in a large cohort of 1359 HIV‐infected men and to explore the relationship between patients’ overall health status and serum T. Among biochemical and hormonal measurement performed the main are serum total T, free triiodothyronine (fT3), and luteinizing hormone. Other outcome measurements include anthropometry, assessment of comorbidities and disabilities, overall health status defined as the number of HANA and by the 38‐item multimorbidity frailty index, anthropometry, and bone mineral density. The cumulative relative risk of comorbidities is increased in HIV‐infected men with hypogonadism (p < 0.001) and hypogonadism is associated with several comorbidities. The prevalence of hypogonadism increases progressively with the increase of the number of comorbidities. Frailty index is inversely related to serum total T (age‐adjusted r = 0.298, r2 = 0.089, p < 0.0001). Serum fT3 levels are significantly lower in hypogonadal than eugonadal men (p = 0.022). This suggests that low serum T could be considered a sensitive marker of frailty and poor health status and that the latter might induce hypogonadism. The more HIV‐infected men are frail the more they are hypogonadal. This suggests that hypogonadism might be a naturally occurring condition in unhealthy HIV‐infected men and raises concern about the safety of T treatment. In conclusion, low serum T is associated with multimorbidity, HANA, and frailty in HIV‐infected men and this association seems to be bidirectional. Given the wide attitude to offer T treatment to HIV‐infected men, caution is needed when prescribing T to HIV‐infected male patients, especially if the patient is unhealthy or frail.
Appropriate and timely antimicrobial therapy in cirrhotic patients with spontaneous bacterial peritonitis‐associated septic shock: a retrospective cohort study
Authors: Karvellas C. J. , Abraldes J. G. , Arabi Y. M. , Kumar A. ,   the Cooperative Antimicrobial Therapy of Septic Shock (CATSS) Database Research Group
Published: February 2015

Background

Spontaneous bacterial peritonitis (SBP)‐associated septic shock carries significant mortality in cirrhosis.

Aim

To determine whether practice‐related aspects of antimicrobial therapy contribute to high mortality.

Methods

Retrospective cohort study of all (n = 126) cirrhotics with spontaneous bacterial peritonitis (neutrophil count >250 or positive ascitic culture)‐associated septic shock (1996–2011) from an international, multicenter database. Appropriate antimicrobial therapy implied either in vitro activity against a subsequently isolated pathogen (culture positive) or empiric management consistent with broadly accepted norms (culture negative).

Results

Overall hospital mortality was 81.8%. Comparing survivors (n = 23) with non‐survivors (n = 103), survivors had lower Acute Physiology and Chronic Health Evaluation (APACHEII) (mean ± s.d.; 22 ± 7 vs. 32 ± 8) and model for end‐stage liver disease (MELD) (24 ± 9 vs. 34 ± 11) scores and serum lactate on admission (4.9 ± 3.1 vs. 8.9  ± 5.3), P < 0.001 for all. Survivors were less likely to receive inappropriate initial antimicrobial therapy (0% vs. 25%, P = 0.013) and received appropriate antimicrobial therapy earlier [median 1.8 (1.1–5.2) vs. 9.5 (3.9–14.3) h, P < 0.001]. After adjusting for covariates, APACHEII [OR, odds ratio 1.45 (1.04–2.02) per 1 unit increment, P = 0.03], lactate [OR 2.34 (1.04–5.29) per unit increment, P = 0.04] and time delay to appropriate antimicrobials [OR 1.86 (1.10–3.14) per hour increment, P = 0.02] were significantly associated with increased mortality.

Conclusions

Cirrhotic patients with septic shock secondary to spontaneous bacterial peritonitis have high mortality (>80%). Each hour of delay in appropriate antimicrobial therapy was associated with a 1.86 times increased hospital mortality. Admission APACHEII and serum lactate also significantly impacted hospital mortality. Earlier initiation of appropriate antimicrobial therapy could substantially improve outcome.
Epidermal growth factor receptor and AKT1 gene copy numbers by multi‐gene fluorescence in situ hybridization impact on prognosis in breast cancer
Authors: Li Jiao , Su Wei , Zhang Sheng , Hu Yunhui , Liu Jingjing , Zhang Xiaobei , Bai Jingchao , Yuan Weiping , Hu Linping , Cheng Tao , Zetterberg Anders , Lei Zhenmin , Zhang Jin
Published: February 2015

The epidermal growth factor receptor (EGFR)/PI3K/AKT signaling pathway aberrations play significant roles in breast cancer occurrence and development. However, the status of EGFR and AKT1 gene copy numbers remains unclear. In this study, we showed that the rates of EGFR and AKT1 gene copy number alterations were associated with the prognosis of breast cancer. Among 205 patients, high EGFR and AKT1 gene copy numbers were observed in 34.6% and 27.8% of cases by multi‐gene fluorescence in situ hybridization, respectively. Co‐heightened EGFR/AKT1 gene copy numbers were identified in 11.7% cases. No changes were found in 49.3% of patients. Although changes in EGFR and AKT1 gene copy numbers had no correlation with patients' age, tumor stage, histological grade and the expression status of other molecular makers, high EGFR (P = 0.0002) but not AKT1 (P = 0.1177) gene copy numbers correlated with poor 5‐year overall survival. The patients with co‐heightened EGFR/AKT1 gene copy numbers displayed a poorer prognosis than those with tumors with only high EGFR gene copy numbers (P = 0.0383). Both Univariate (U) and COX multivariate (C) analyses revealed that high EGFR and AKT1 gene copy numbers (P = 0.000 [U], P = 0.0001 [C]), similar to histological grade (P = 0.001 [U], P = 0.012 [C]) and lymph node metastasis (P = 0.046 [U], P = 0.158 [C]), were independent prognostic indicators of 5‐year overall survival. These results indicate that high EGFR and AKT1 gene copy numbers were relatively frequent in breast cancer. Co‐heightened EGFR/AKT1 gene copy numbers had a worse outcome than those with only high EGFR gene copy numbers, suggesting that evaluation of these two genes together may be useful for selecting patients for anti‐EGFR‐targeted therapy or anti‐EGFR/AKT1‐targeted therapy and for predicting outcomes.
Utility of next‐generation sequencing technologies for the efficient genetic resolution of haematological disorders
Authors: Zhang J. , Barbaro P. , Guo Y. , Alodaib A. , Li J. , Gold W. , Adès L. , Keating B.J. , Xu X. , Teo J. , Hakonarson H. , Christodoulou J.
Published: February 2015

Next‐generation sequencing (NGS) has now evolved to be a relatively affordable and efficient means of detecting genetic mutations. Whole genome sequencing (WGS) or whole exome sequencing (WES) offers the opportunity for rapid diagnosis in many paediatric haematological conditions, where phenotypes are variable and either a large number of genes are involved, or the genes are large making sanger sequencing expensive and labour‐intensive. NGS offers the potential for gene discovery in patients who do not have mutations in currently known genes. This report shows how WES was used in the diagnosis of six paediatric haematology cases. In four cases (Diamond–Blackfan anaemia, congenital neutropenia (n = 2), and Fanconi anaemia), the diagnosis was suspected based on classical phenotype, and NGS confirmed those suspicions. Mutations in RPS19, ELANE and FANCD2 were found. The final two cases (MYH9 associated macrothrombocytopenia associated with multiple congenital anomalies; atypical juvenile myelomonocytic leukaemia associated with a KRAS mutation) highlight the utility of NGS where the diagnosis is less certain, or where there is an unusual phenotype. We discuss the advantages and limitations of NGS in the setting of these cases, and in haematological conditions more broadly, and discuss where NGS is most efficiently used.
Extralevator abdominoperineal excision for low rectal cancer: a systematic review and meta‐analysis of the short‐term outcome
Authors: Zhou X. , Sun T. , Xie H. , Zhang Y. , Zeng H. , Fu W.
Published: February 2015

Aim

The superiority of extralevator abdominoperineal excision (ELAPE) over conventional abdominoperineal excision (APE) remains controversial, despite the publication of many studies on this issue. The aim of this meta‐analysis was to provide a clear, evidence‐based comparison of the two procedures.

Method

A systematic review and meta‐analysis was conducted through a comprehensive search of the PubMed, EMBASE/Medline and Cochrane Central Library databases for all studies comparing ELAPE with conventional APE for low rectal cancer. Pooled data on circumferential resection margin (CRM) positivity, intra‐operative bowel perforation, perineal wound complications and local recurrence were analysed.

Results

Seven studies, involving a total of 2672 patients, were included. Analysis of the pooled data did not reveal a significant difference between the two operations regarding CRM positivity [risk ratio (RR) = 0.79, 95% CI: 0.40–1.57; P = 0.50, I2 = 86%] and perineal wound complications (RR = 0.91, 95% CI: 0.71–1.16; P = 0.44, I2 = 49%), and showed a borderline reduced risk of intra‐operative bowel perforation for ELAPE, but still did not reveal a significant difference between the two groups (RR = 0.61, 95% CI: 0.37–1.00; P = 0.05, I2 = 58%).

Conclusion

The current evidence does not indicate a statistically significant superiority of ELAPE over conventional APE in terms of CRM positivity and intra‐operative bowel perforation.
Elevated tumour markers are normalized in most patients with pseudomyxoma peritonei 7 days after complete tumour removal
Authors: Di Fabio F. , Aston W. , Mohamed F. , Chandrakumaran K. , Cecil T. , Moran B.
Published: February 2015

Aim

Elevation of the preoperative tumour markers in pseudomyxoma peritonei (PMP) is common and is a risk factor for recurrence. There has, however, been no documentation of the effect of complete tumour removal on tumour markers levels after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The aim of the study was to compare the tumour markers 7 days after surgery in patients with elevated preoperative levels.

Method

This was an observational prospective study of patients with PMP of appendiceal origin treated in one of the UK National Referral Centres for this condition. Thirty patients [median age = 61 (range: 31–74) years; six men] with an elevated preoperative level of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA‐125) and/or carbohydrate antigen 19‐9 (CA19‐9) underwent repeated estimation, 7 days after CRS and HIPEC for PMP.

Results

The median preoperative CEA level of 12 μg/l fell to 0.75 μg/l postoperatively (P < 0.0001), CA‐125 fell from 45 to 31 kU/l (P = 0.183) and CA19‐9 fell from 134 to 37 kU/l (P = 0.003). The CEA was raised in 22 (73%) of 30 patients preoperatively and in two (7%) of 30 patients 7 days after surgery (P < 0.0001). The corresponding data for CA‐125 were 18 (60%) and 13 (43%) (P = 0.196) and for CA19‐9 they were 24 (80%) and 16 (53%) (P = 0.028).

Conclusion

This is the first documentation of a reduction or normalization of CEA 7 days after CRS, but not for CA19‐9 or CA‐125. This may indicate completeness of surgical resection and could aid selection for adjuvant therapy and predict prognosis. Long‐term follow‐up is, however, necessary to determine the significance of this observation.
The Achievements, Contradictions and Demise of the Rural Collectives in Songzi County, China
Authors: Xu Zhun
Published: February 2015

The literature on Chinese rural collectives offers different views on the causes of their demise in the early 1980s. Some argue it was a result of egalitarianism and inefficiency, while others emphasize the coercive nature of the decollectivization campaign. Using Songzi County as a case study, this article reviews both the achievements and the problems of the rural collectives and concludes that they can claim some remarkable achievements. It also finds that work avoidance and inefficiency were caused by stratification rather than egalitarianism. While the demise of rural collectives was mostly due to political pressure from the government, the lack of socialist political process contributed to the peasants’ passiveness in failing to resist this major institutional change.