bluuebunny/crossref_metadata_2025 huggingface dataset:
Transungual Excision of Glomus Tumors: A Treatment and Quality of Life Study
Authors: Reinders Edouard F.H. , Klaassen Karlijn M.G. , Pasch Marcel C.
Published: October 2019

BACKGROUND

Glomus tumors are rare benign painful tumors, frequently found in the subungual region. Complete surgical excision is essential for relief of symptoms. The main postoperative complications are tumor recurrence and nail dystrophy.

OBJECTIVE

To evaluate the long-term outcome and the impact on quality of life (QoL) of glomus tumors after a transungual approach.

MATERIALS AND METHODS

A retrospective cohort study was conducted. Twenty-six patients underwent transungual excision of subungual glomus tumors. A self-administered questionnaire was sent to evaluate the postoperative outcome. Glomus tumor-related QoL was investigated using modified nail psoriasis (NPQ10) and onychomycosis questionnaires.

RESULTS

A response rate of 85% was achieved. After a mean follow-up of 63 months after transungual excision of the tumor, the mean Numeric Pain Rating Score had improved from 7.9 (±SD 1.8) preoperatively, to 0.8 (±SD 1.9) (p < .000). Quality of life improved significantly: the mean NPQ10-score improved from 5.5 (±SD 3.4) to 0.64 (±SD 2.1) (p < .000). Nail-related sequelae were not reported in any of the patients.

CONCLUSION

Our study showed that glomus tumors cause impairment on QoL, mostly due to severe pain. Surgical excision with the transungual approach is an effective treatment, without permanent damage to the nail unit that gives relief of pain and improves QoL.
Intrasubunit V-Y Muscle Sling Myocutaneous Island Advancement Flap for Small Defects Isolated to the Nasal Ala
Authors: Guzman Anthony K. , Bhatt Mehul D. , Sobanko Joseph F. , Etzkorn Jeremy R. , Shin Thuzar M. , Cosulich Michael T. , Miller Christopher J.
Published: October 2019

BACKGROUND

The V-Y island advancement flap is a useful reconstruction technique for nasal alar defects, but flap mobility is limited by the insertion of the muscles of facial expression into the dermis of the alae.

OBJECTIVE

To describe a V-Y muscle sling myocutaneous island advancement flap (SMIAF) for improved mobility and intrasubunit reconstruction of alar defects.

MATERIALS AND METHODS

A retrospective review of patient records and preoperative and postoperative photographs was performed on all patients with alar defects repaired with the SMIAF between April 2008 and October 2017. Patients and physicians rated aesthetic outcomes with the Patient and Observer Scar Assessment Scale (POSAS).

RESULTS

A total of 18 nasal alar defects were repaired with the SMIAF after Mohs micrographic surgery. All defects were located on the anterior two-thirds of the alar lobule and had a mean surface area of 0.42 ± 0.19 cm2. No patients experienced flap necrosis. Patients and 3 independent dermatologic surgeons rated favorable aesthetic outcomes.

CONCLUSION

The SMIAF is a reliable reconstruction option with good aesthetic outcomes for small defects on the anterior two-thirds of the nasal ala.
Successful Treatment of Multiple Common Warts With Intralesional Ozone
Authors: Ibrahim Alshimaa M. , Elkot Reham A. , Khashaba Shrook A.
Published: October 2019

BACKGROUND

Although there are multiple treatments for warts, wart management remains a challenge. Ozone therapy is an emerging treatment for infectious and noninfectious dermatological diseases.

OBJECTIVE

To assess intralesional ozone gas safety and efficacy in multiple warts management.

MATERIALS AND METHODS

Seventy-four adult patients with multiple common warts were included in this study. They were randomly assigned into 2 groups: first group comprised 44 patients treated with intralesional ozone gas, and the second group comprised 30 patients who received intralesional saline injection. In both groups, warts in all patients were directly injected weekly until complete clearance occurred or for a maximum of 10 treatment sessions. The subjects were followed for 6 months to record any recurrences.

RESULTS

In the ozone group, 25 patients (56.8%) had a complete response with an excellent cosmetic outcome, 15 patients (34.1%) showed a partial response, and 4 patients (9.1%) had no response. More subjects responded to ozone than to saline (p < .001). Ozone therapy was associated with mild side effects, including pain at time of injection, numbness, and fatigue.

CONCLUSION

Intralesional ozone is effective and safe for the treatment of multiple warts.
Interrelation between midwall mechanics and longitudinal strain in newly diagnosed and never-treated hypertensive patients without clinically defined hypertrophy
Authors: Lembo Maria , Santoro Ciro , Sorrentino Regina , Canonico Mario E. , Fazio Valeria , Trimarco Bruno , Tadic Marijana , Galderisi Maurizio , Esposito Roberta
Published: October 2019

Background:

In hypertensive patients, an impairment of midwall myocardial mechanics was described in presence of left ventricular (LV) concentric geometry. Under these circumstances, also LV longitudinal dysfunction was found.

Purpose:

Our aim was to evaluate longitudinal and circumferential systolic function and correlations between these two functional components in newly diagnosed hypertensive patients without clinically defined LV hypertrophy (LVH). One hundred and thirty-eight newly diagnosed, never-treated hypertensive patients without LVH and a control group of 105 healthy normotensive individuals underwent two-dimensional and speckle tracking echocardiography. Global longitudinal strain (GLS) was derived (in absolute value) and midwall fractional shortening (MFS) computed. In addition, the hypertensive population was divided into two groups according to GLS: normal GLS (≥20%, n = 94) and reduced GLS (<20%, n = 44).

Results:

Hypertensive patients had lower MFS (P < 0.001) and GLS (P < 0.0001) than healthy controls. By dividing hypertensive patients according to GLS thresholds of normalcy, MFS was lower in patients with GLS less than 20% (P < 0.0001) while no significant difference was found in LV geometry, ejection fraction and diastolic parameters in comparison with patients with GLS at least 20%. In the pooled hypertensive population, GLS resulted positively related to MFS (r = 0.33, P < 0.0001). By a multiple linear regression analysis, after adjusting for female sex, age, BMI, circumferential end-systolic stress, average e′, ejection fraction and relative wall thickness, MFS remained independently associated with GLS (β = 0.222, P < 0.005).

Conclusion:

In newly diagnosed and never-treated hypertensive patients without LVH, an early LV systolic dysfunction is testified by the reduction of both MFS and GLS. These two parameters resulted independently associated after adjusting for several confounders.
Biological convergence of three human and animal model quantitative trait loci for blood pressure
Authors: Deng Alan Y. , Ménard Annie
Published: October 2019

Objectives:

Blood pressure (BP) is comparable among different mammalian orders, despite their evolution divergence. Because of it, fundamental mechanisms should connect humans and rodents by their shared BP physiology. We hypothesized that similar quantitative trait loci (QTLs) function in both humans and rodents in controlling BP.

Methods:

We utilized inbred hypertensive Dahl salt-sensitive rats (DSS) as a functional proxy to evaluate the relevance of human genome-wide association studies (GWAS) genes in BP regulation.

Results:

First, three DSS BP QTLs functionally captured three specific human GWAS genes. Each QTL has a major biological impact, not a miniscule effect, on BP, in causation by function. Second, noncoding single-nucleotide polymorphisms (SNPs) found in GWAS are by products of primate evolution, instead of mechanistic drivers in regulating BP, because their absence did not impact on BP of mammals. Third, a missense mutation, rather than a noncoding GWAS SNP marking it nearby, is the priority functional basis for a given QTL. Depleting such a noncoding GWAS SNP had no impact, whereas eliminating the muscarinic cholinergic receptor 3 (M3R) signaling decreased BP. Finally, epistatic modularity biologically organizes multiple QTLs with redundant functions, and is the genetic mechanism that modulates the BP homeostasis when QTLs function collectively.

Conclusions:

Two pathogenic pathways of hypertension biologically unify mechanisms of BP regulations for humans and their functional surrogates. The mechanism-based biology for the M3R-mediated pathway in raising BP has established M3R as a novel pathogenesis-driven target for antihypertension therapies.
Phenotypes of masked hypertension: Isolated ambulatory, isolated home and dual masked hypertension
Authors: Stergiou George S. , Kyriakoulis Konstantinos G. , McManus Richard J. , Andreadis Emmanuel A. , Jula Antti , Kollias Anastasios , Lindroos Annika , Ntineri Angeliki , Schwartz Claire , Niiranen Teemu J.
Published: October 2019

Objectives:

Masked hypertension (MH) is defined as normal office blood pressure (OBP) and elevated ambulatory (ABP) or home blood pressure (HBP). This study assessed MH identified by each of these two methods.

Methods:

A retrospective analysis of cross-sectional data in treated and untreated adults from Greece, Finland and UK who had OBP, HBP and 24-h ABP measurements was performed. Dual MH was defined as normal OBP and elevated HBP and ABP, isolated ambulatory MH as normal OBP and HBP and elevated ABP and isolated home MH as normal OBP and ABP and elevated HBP.

Results:

Of 1971 participants analyzed, 445 (23%) had MH on ABP and/or HBP (age 57.1 ± 10.8 years, men 55%, treated 49%). Among participants with any MH, 215 had dual MH (48%), 132 isolated ambulatory MH (30%) and 98 isolated home MH (22%). Moreover, 55% had high-normal, 35% normal and 10% optimal OBP. In logistic regression analysis isolated ambulatory MH was predicted by younger age (OR 0.35, P < 0.01 per 10 years increase), whereas isolated home MH was predicted by older age (OR 2.05, P < 0.01 per 10 years increase).

Conclusion:

Masked hypertension diagnosed by ABP and not HBP monitoring or the reverse is not uncommon. Age appears to be the most important determinant of isolated ambulatory or home MH, with the former being more common in younger participants and the latter in older ones. Only half of participants with MH have high-normal OBP, whereas the rest have lower levels.
AN ATYPICAL CASE OF OPTIC DISK PSEUDO-DUPLICATION WITH PROLIFERATIVE DIABETIC RETINOPATHY
Authors: Bloom Steven M. , Adeniran Janelle F. , Mandava Anupa , Singal Inder P.
Published: October 2019

Purpose:

To present a unique case of optic disk pseudo-duplication with proliferative diabetic retinopathy.

Methods:

Case report.

Results:

A 63-year-old white diabetic man presented with an apparent duplicated optic disk in the superonasal midperiphery of his left eye. A large flat frond of neovascularization fanned out from this structure. Optical coherence tomography scanning showed a noncolobomatous scar with a large plume of blood vessels sprouting from the choroid, thru the retina and branching out into the vitreous. Magnetic resonance imaging scanning revealed a normal left globe and orbit with a single optic nerve. The neovascularization regressed after panretinal photocoagulation and anti–vascular endothelial growth factor therapy.

Conclusion:

We describe a unique case of proliferative diabetic retinopathy associated with pseudo-duplication of the optic disk. This case is unique in the peripheral location of the pseudo-duplication, the presence of spontaneous choroidovitreal neovascularization in proliferative diabetic retinopathy, and the appearance of neovascularization elsewhere mimicking neovascularization of the duplicated disk.
Health Insurance Coverage of Gender-Affirming Top Surgery in the United States
Authors: Ngaage Ledibabari M. , Knighton Brooks J. , McGlone Katie L. , Benzel Caroline A. , Rada Erin M. , Bluebond-Langner Rachel , Rasko Yvonne M.
Published: October 2019

Background:

Despite the medical necessity, legislative mandates, and economic benefits of gender-affirming surgery, access to treatment remains limited. The World Professional Association for Transgender Health (WPATH) has proposed guidelines for transition-related surgery in conjunction with criteria to delineate medical necessity. The authors assessed insurance coverage of “top” gender-affirming surgery and evaluated the differences between insurance policy criteria and WPATH recommendations.

Methods:

The authors conducted a cross-sectional analysis of insurance policies for coverage of top gender-affirming surgery. Insurance companies were selected based on their state enrollment data and market share. A Web-based search and individual telephone interviews were conducted to identify the policy. Medical necessity criteria were abstracted from publicly available policies.

Results:

Of the 57 insurers evaluated, bilateral mastectomy (transmasculine) was covered by significantly more insurers than breast augmentation (transfeminine) (96 percent versus 68 percent; p < 0.0001). Only 4 percent of companies used WPATH-consistent criteria. No criterion was universally required by insurers. Additional prerequisites for coverage that extended beyond WPATH guidelines for top surgery were continuous living in congruent gender role, two referring mental health professionals, and hormone therapy before surgery. Hormone therapy was required in a significantly higher proportion of transfeminine policies compared with transmasculine policies (90 percent versus 21 percent; p < 0.0001).

Conclusions:

In addition to the marked intercompany variation in criteria for insurance coverage that often deviated from WPATH recommendations, there are health care insurers who categorically deny access to top gender-affirming surgery. A greater evidence base is needed to provide further support for the medical necessity criteria in current use.
Nationwide Cost Variation for Thumb Replantation: A Population Study
Authors: Billig Jessica I. , Zhong Lin , Chung Kevin C.
Published: October 2019

Background:

Health care reforms aimed at bundling payments attempt to contain costs. Uncovering variation in spending provides one strategy for decreasing expenditure. This study aims to investigate interhospital cost variation for thumb replantation.

Methods:

A retrospective cross-sectional analysis of patients undergoing thumb replantation using data from the Healthcare Cost and Utilization Project National Inpatient Sample database from 2001 to 2011 was performed. Univariate and multivariable logistic regression models were used to investigate associations between patient-level and hospital-level characteristics and cost.

Results:

A total of 778 patients were included in the study, with a mean cost for thumb replantation of $20,965. Thumb replantations performed at high-volume hospitals were significantly more expensive than those performed at low-volume hospitals (median cost, $20,395 versus $13,463; p < 0.001), with longer lengths of stay (5 days versus 4 days), despite having similar surgical complication rates (p = 0.07). Thumb replantations performed in the West were significantly more expensive than those performed in the South (median cost, $22,579 in the West versus $14,823 in the South; p < 0.001), with longer lengths of stay (5 days versus 4 days; p = 0.005) and similar surgical complications (p = 0.239). In multivariable logistic regression, hospital volume (p < 0.001), hospital region (p < 0.001), and increased length of stay (p < 0.001) were predictive of higher cost.

Conclusions:

High-volume hospitals and hospitals in the West are more expensive, with longer lengths of stay, despite having similar complications. Expedited discharge may be one avenue for decreasing expenditure without compromising care.
Early Postoperative Application of Botulinum Toxin Type A Prevents Hypertrophic Scarring after Epicanthoplasty: A Split-Face, Double-Blind, Randomized Trial
Authors: Huang Ru-Lin , Ho Chia-Kang , Tremp Mathias , Xie Yun , Li Qingfeng , Zan Tao
Published: October 2019

Background:

Postoperative hypertrophic scarring of the medial canthal area is a common phenomenon and deterrent for patients considering epicanthoplasty. Botulinum toxin type A has been reported for hypertrophic scar and keloid treatment. However, there is a lack of high-level evidence regarding the effects of botulinum toxin type A in the medial canthal area.

Methods:

In this split-face, double-blind, randomized trial, 43 consecutive consenting patients undergoing Park Z-epicanthoplasty were randomized to receive 5 U of botulinum toxin type A or the same volume of saline injections at days 6 to 7 postoperatively. Scars were assessed independently using the Vancouver Scar Scale, the visual analogue scale, and patient satisfaction rating at the 1-, 3-, and 6-month follow-ups.

Results:

Overall, 30 patients completed this trial. The botulinum toxin type A–treated side achieved significantly improved Vancouver Scar Scale scores. The most obvious improvements were observed at the 3-month follow-up visit. Among the four subscores of the Vancouver Scar Scale, the most significantly improved subscores were the height and pliability. The visual analogue scale scores also decreased significantly on the botulinum toxin type A–treated side at all three follow-up visits. Approximately 86.7 percent of the patients were satisfied with the scar and epicanthoplasty outcomes. No severe complications were reported.

Conclusions:

Early postoperative botulinum toxin type A injection in the medial canthal region efficiently reduces hypertrophic scarring and improves the outcome of epicanthoplasty. Therefore, botulinum toxin type A injection can be used as a routine method to prevent hypertrophic scarring and improve the outcome of epicanthoplasty.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, II.
Sequelae of Facial Palsy: A Comprehensive Treatment
Authors: Guerreschi Pierre , Labbé Daniel
Published: October 2019

Learning Objectives:

After studying this article, the participant should be able to: 1. Identify the different types of facial paralysis sequelae and define the several medical and surgical techniques commonly available today. 2. Develop a surgical plan to restore symmetry of the face at rest and in dynamic expressions and manage the patient during smile rehabilitation after dynamic smile reanimation with regional or free muscle transfer. 3. Understand the different types of facial paralysis sequelae and know the several medical and surgical techniques commonly available today. 4. Establish a comprehensive treatment plan to restore symmetry of the face at rest and in dynamic expressions and support the patient during smile rehabilitation after dynamic smile reanimation with regional or free muscle transfer.

Sequelae of facial palsy have a negative impact on the cosmetic aspect and functions of the face. They bear severe consequences for patients with regard to their body image and social relationships. There are numerous medical and surgical treatments that should be proposed to patients to achieve comprehensive facial symmetry. The key to an adapted therapeutic choice, to achieve the best outcomes for patients, is to perform a comprehensive evaluation of the paralyzed face and have broad knowledge of the several techniques described over time in the literature. The patient should be informed of the different therapeutic alternatives, their implications, and their limits. With this article, readers will be able to accurately diagnose the different types of facial paralysis sequelae to develop a surgical plan adapted to each case to restore symmetry at rest and in motion.
18F-FDG PET/CT Findings of Ovarian Mesothelioma
Authors: Sun Rui , Chen Yue , Huang Zhanwen
Published: October 2019

Ovarian mesothelioma is a rare and aggressive tumor. Early diagnosis of the disease is difficult, delaying effective treatment. Here we report a 50-year-old woman who was referred for an 18F-FDG PET/CT imaging to assess her newly detected left ovarian mass. The images not only demonstrated a hypermetabolic mass in the left ovary, but also several hepatic low densities with increased FDG uptake, which suggested ovarian malignancy with hepatic metastases. Mesothelioma was diagnosed histopathologically following the biopsy. Our case demonstrates PET/CT findings observed in ovarian mesothelioma.
Veau III and Veau IV Cleft Palate: Do Peri-Operative Complications Differ?
Authors: Chouairi Fouad , Mets Elbert J. , Gabrick Kyle S. , Alperovich Michael
Published: October 2019

Objective:

The Veau classification represents the most commonly used system for characterizing cleft palate severity. Conflicting evidence exists as to how increasing Veau classification affects outcomes. This study compared perioperative outcomes between Veau III and IV cleft palate repairs.

Methods:

The National Surgical Quality Improvement Program Pediatric (NSQIP-P) database was used to identify cleft palate repairs between 2012 and 2016 using CPT codes. Patients with alveolar bone grafts were excluded. Veau III (unilateral) and Veau IV (bilateral) cleft palate repairs were identified using International Classification of Disease code 9 and 10 (ICD-9 and -10 codes. Patient demographics, comorbidities, and adverse events were compared between the cohorts.

Results:

A total of 5026 patients underwent cleft palate repair between 2012 and 2016. Of the 2114 patients with identifiable Veau classification, 1302 had Veau III cleft palates and 812 had Veau IV cleft palates.

The Veau IV cleft palate patient population was older (377.8 versus 354.1 days, P < 0.001) and had significantly more comorbidities including a higher incidence of chronic lung disease (P = 0.014), airway abnormalities (P = 0.001), developmental delay (P = 0.018), structural central nervous system deformities (P < 0.001), and nutritional support (P < 0.001). Veau IV cleft palate repairs also had longer operative times (153.2 versus 140.2 minutes, P < 0.001). Despite significant differences in comorbidities and perioperative factors, there were no differences in 30-day complications, readmissions, or reoperation rates between Veau III and IV cleft palate repairs.

Conclusions:

Patients undergoing Veau IV cleft palate repair have a significantly greater number of comorbidities than Veau III cleft palate repairs. Despite differences in patient populations, 30-day surgical outcomes are comparable between the cohorts.
Lupus auto-antibodies act as positive allosteric modulators at NMDA receptors and induce spatial memory deficits
Authors: Chan Kelvin , Nestor Jacquelyn , Huerta Tomás S. , Certain Noele , Moody Gabrielle , Kowal Czeslawa , Huerta Patricio T. , Volpe Bruce T. , Diamond Betty , Wollmuth Lonnie P.
Published: October 2019

Patients with Systemic lupus erythematosus (SLE) experience various peripheral and central nervous system manifestations including spatial memory impairment. A subset of auto-antibodies (DNRAbs) cross-react with the GluN2A and GluN2B subunits of the NMDA receptor (NMDAR). We find that these DNRAbs act as positive allosteric modulators on NMDARs with GluN2A-containing NMDARs, even those containing a single GluN2A subunit, exhibiting a much greater sensitivity to DNRAbs than those with exclusively GluN2B. Accordingly, GluN2A-specific antagonists provide greater protection from DNRAb-mediated neuronal cell death than GluN2B antagonists. Using transgenic mice to perturb expression of either GluN2A or GluN2B in vivo, we find that DNRAb-mediated disruption of spatial memory characterized by early neuronal cell death and subsequent microglia-dependent pathologies requires GluN2A-containing NMDARs. Our results indicate that GluN2A-specific antagonists or negative allosteric modulators are strong candidates to treat SLE patients with nervous system dysfunction.
Automated analysis of sleep in adultC. eleganswith closed-loop assessment of state-dependent neural activity
Authors: Lawler Daniel E. , Chew Yee Lian , Hawk Josh D. , Aljobeh Ahmad , Schafer William R. , Albrecht Dirk R.
Published: October 2019

Sleep, a state of quiescence associated with growth and restorative processes, is conserved across species. Invertebrates including the nematodeCaenorhabditis elegansexhibit sleep-like states during development and periods of satiety and stress. Here we describe two methods to study behavior and associated neural activity during sleep and awake states in adultC. elegans. A large microfluidic device facilitates population-wide assessment of long-term sleep behavior over 12 h, including effects of fluid flow, oxygen, feeding, odors, and genetic perturbations. Smaller devices allow simultaneous recording of sleep behavior and neuronal activity, and a closed-loop sleep detection system delivers chemical stimuli to individual animals to assess sleep-dependent changes to neural responses. Sleep increased the arousal threshold to aversive chemical stimulation, yet sensory neuron (ASH) and first-layer interneuron (AIB) responses were unchanged. This localizes adult sleep-dependent neuromodulation within interneurons presynaptic to the AVA premotor interneurons, rather than afferent sensory circuits.
Determinism and stochasticity in seed dispersal-successional feedbacks
Authors: Nuñez Nohemi Huanca , Chazdon Robin L. , Russo Sabrina E.
Published: October 2019

Regeneration of tropical secondary forests depends critically on seed input, and yet successional dynamics of seed dispersal remain poorly understood. We investigated the role of stochastic vs. deterministic processes in structuring seed rain in successional forests using four years of seed rain data collected at two time periods in four tropical secondary forest fragments representing a chronosequence and in mature forest. Determinism in successional trajectories is defined as predictable, directional, and orderly changes in community structure through time, resulting in convergence toward a climax community. We found that with increasing successional age, the community assembly of the seed rain in secondary forests became more deterministic, and community structure converged to that in the mature forest, both in terms of taxonomic and functional composition. Taxonomic similarity of the seed rain in successional forest to that of the mature forest increased with successional age, as did species co-occurrence and the percentage of shared species between the seed rain of successional and mature forests. The proportions of large, shade-tolerant species in the seed rain increased with successional age, although the proportion of animal-dispersed species increased only modestly. Analyses of the spatial variation in community structure in the seed rain among sites within each secondary forest showed evidence that assembly processes transitioned from being deterministic and convergent early on, to purely stochastic, and then to deterministic and divergent later in succession. Moreover, with increasing successional age, the composition of the seed rain became more similar to that of the mature woody stems in the forest, which could be an important deterministic driver of successional change, that, along with among site variation in landscape context and environment, could also generate idiosyncratic successional patterns among secondary forest fragments Our results suggest that the dominant processes influencing seed dispersal and assembly of the seed rain change during succession and point to successional feedbacks influencing the seed rain that are likely to shape regeneration trajectories.
3D-Cardiomics: A spatial transcriptional atlas of the mammalian heart
Authors: Mohenska Monika , Tan Nathalia M. , Tokolyi Alex , Furtado Milena B. , Costa Mauro W. , Perry Andrew J. , Hatwell-Humble Jessica , van Duijvenboden Karel , Nim Hieu T. , Nilsson Susan K. , Powell David R. , Rosenthal Nadia A. , Rossello Fernando J. , Ramialison Mirana , Polo Jose M.
Published: October 2019

Understanding spatial gene expression and regulation is key to uncovering developmental and physiological processes, during homeostasis and disease. Numerous techniques exist to gain gene expression and regulation information, but very few utilise intuitive true-to-life three-dimensional representations to analyze and visualize results. Here we combined spatial transcriptomics with 3D modelling to represent and interrogate, transcriptome-wide, three-dimensional gene expression and location in the mouse adult heart. Our study has unveiled specific subsets of genes that display complex spatial expression in organ sub-compartments. Also, we created a web-based user interface for spatial transcriptome analysis and visualization. The application may be accessed fromhttp://3d-cardiomics.erc.monash.edu/.
Development of a lipid-based delivery system for the chemotherapeutic compound SN-38
Authors: Cantón Alicia Soler , van den Broek Niels , Danelon Christophe
Published: October 2019

SN-38 is a chemotherapeutic compound with potent antitumor effects. However, its clinical application is currently limited due to its poor solubility and low stability at physiological pH. Liposomes and cyclodextrins have been long studied for the solubilization and delivery of hydrophobic compounds. Aiming to combine the advantages from both systems, we attempted to develop an SN-38-in-cyclodextrin-in-liposome formulation. We found that the encapsulation of SN-38-SBE-β-CD inclusion complexes in the lumen of liposomes was not possible, owing to the disassembly of liposomes and the formation of lipid nanoparticles, as revealed by size exclusion chromatography and single nanoparticle fluorescence microscopy. Interestingly, the retention time of SN-38 inside SN-38-SBE-β-CD-lipid nanoparticles is higher than in liposomes, whereby SN-38 was directly loaded into the lipid film. The toxicity of purified SN-38-SBE-β-CD- lipid nanoparticles was assayed in cultured cancer cells, showing no therapeutic advantage compared to bulk SN-38-SBE-β-CD complexes. Further formulation optimization, in particular an increased concentration of the nanoparticles, will be necessary to obtain cytotoxicity effects. Moreover, the results highlight the value of fluorescence imaging of single, surface-immobilized nanoparticles, in the development of liposomal delivery systems such as drug-in-cyclodextrin- in-liposomes.
Dual-targeted transcription factors are required for optimal photosynthesis and stress responses in Arabidopsis thaliana
Authors: Gawroński Piotr , Burdiak Paweł , Scharff Lars B. , Mielecki Jakub , Zaborowska Magdalena , Waszczak Cezary , Karpiński Stanisław
Published: October 2019

Chloroplast to nucleus retrograde signaling is essential for cell function, acclimation to fluctuating environmental conditions, plant growth and development. The vast majority of chloroplast proteins are nuclear-encoded and must be imported into the organelle after synthesis in the cytoplasm. This import is essential for the development of fully functional chloroplasts. On the other hand, functional chloroplasts act as sensors of environmental changes and can trigger acclimatory responses that influence nuclear gene expression. Signaling via mobile transcription factors (TFs) has been recently recognized as a way of communication between organelles and the nucleus. In this study, we performed a targeted reverse genetic screen to identify novel dual-localized TFs involved in chloroplast retrograde signaling during stress responses. We found that CHLOROPLAST IMPORT APPARATUS 2 (CIA2), a TF with putative plastid transit peptide can be detected in chloroplasts and the nucleus. Further, we found that CIA2, along with its homolog CIA2-like (CIL) act in an unequally redundant manner and are involved in the regulation of Arabidopsis responses to UV-AB, high light, and heat shock. Finally, our results suggest that both CIA2 and CIL are crucial for chloroplast translation. Our results contribute to a deeper understanding of signaling events in the chloroplast-nucleus cross-talk.

Significance

We found that a transcription factor CIA2 can be located in chloroplasts and nucleus. CIA2 and is close homolog CIL are involved in protein translation and abiotic stress responses, and we suggest that they play an essential role in retrograde signaling between these organelles.
A cyanide-bridged FeIII–MnII heterobimetallic one-dimensional coordination polymer: synthesis, crystal structure, experimental and theoretical magnetism investigation
Authors: Lan Wenlong , Zhou Zhen , Li Jie , Dou Yong , Hao Xiaoyun , Yang Lu , Liu Hui , Li Dacheng , Liu Qingyun , Zhang Daopeng
Published: October 2019

A new cyanide-bridged FeIII–MnII heterobimetallic coordination polymer (CP), namely catena-poly[[[N,N′-(1,2-phenylene)bis(pyridine-2-carboxamidato)-κ4
N,N′,N′′,N′′′]iron(III)]-μ-cyanido-κ2
C:N-[bis(4,4′-bipyridine-κN)bis(methanol-κO)manganese(II)]-μ-cyanido-κ2
N:C], {[FeMn(C18H12N4O2)(CN)2(C10H8N2)2(CH3OH)2]ClO4}
n
, (1), was prepared by the self-assembly of the trans-dicyanidoiron(III)-containing building block [Fe(bpb)(CN)2]− [bpb2− = N,N′-(1,2-phenylene)bis(pyridine-2-carboxamidate)], [Mn(ClO4)2]·6H2O and 4,4′-bipyridine, and was structurally characterized by elemental analysis, IR spectroscopy, single-crystal X-ray crystallography and powder X-ray diffraction (PXRD). Single-crystal X-ray diffraction analysis shows that CP 1 possesses a cationic linear chain structure consisting of alternating cyanide-bridged Fe–Mn units, with free perchlorate as the charge-balancing anion, which can be further extended into a two-dimensional supramolecular sheet structure via inter-chain π–π interactions between the 4,4′-bipyridine ligands. Within the chain, each MnII ion is six-coordinated by an N6 unit and is involved in a slightly distorted octahedral coordination geometry. Investigation of the magnetic properties of 1 reveals an antiferromagnetic coupling between the cyanide-bridged FeIII and MnII ions. A best fit of the magnetic susceptibility based on the one-dimensional alternating chain model leads to the magnetic coupling constants J
1 = −1.35 and J
2 = −1.05 cm−1, and the antiferromagnetic coupling was further confirmed by spin Hamiltonian-based density functional theoretical (DFT) calculations.
K&T Proyectos SAC: when ethics are more important than business
Authors: Meier Antonio Eduardo
Published: October 2019

Learning outcomes

The learning outcomes are as follows: The importance of doing business ethically; how to build trust relationships; how to develop a market; and how to react to a change in business and trust conditions.

Case overview/synopsis

The case is about the importance of doing business in an ethical manner. In how you can build trust relationships between supplier companies and buyers, and how that strong relationship can be destroyed by short-term interest, affecting the viability of business.

Complexity academic level

The case could be taught to undergraduate students who are studying Business Administration. The case could also be applied in MBA programs.

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.

Subject code

CSS 5: International Business
Psycho-attitudinal features: a study of female entrepreneurs in Saudi Arabia
Authors: Sabri Maram Saeed , Thomas Keith
Published: October 2019

Purpose

This paper aims to investigate psycho-attitudinal features in female entrepreneurs participating in micro, small and medium-sized enterprises in Saudi Arabia, using the Big Five model of personality traits and risk propensity. These attitudes, further grouped into three broad categories, namely, fixed, moderate and growth-oriented mindsets, are used to illustrate the collective impact of attitude over the entrepreneurial process.

Design/methodology/approach

The study is a quantitative study, using a survey to registered business owners and entrepreneurs operating in micro, small and medium businesses in Riyadh, Makkah and Eastern Province, three major administration areas of Saudi Arabia. Survey distribution was through the Chamber of Commerce located in each city. In total, 701 questionnaires were collected with 232 completed responses suitable for use in the study’s empirical findings. The overall response rate was 33 per cent.

Findings

The paper provides practical insights into gender-specific attitudes, including reported variance over the entrepreneurial process. It shows that attitude is an equally predominant feature for both genders through all business stages, with female entrepreneurs reporting a slightly higher growth-oriented attitude relative to their male counterparts. Overall, significant differences were noted between gender and business stages for five of the six-attitudinal growth subscales. From a policy perspective, noting the country’s plan for economic reform and desire for greater participation by women, there are important questions that arise concerning the impact of incentive devices and policy measures.

Research limitations/implications

The main limitation of this study is in the number of women participants, which was small. As participation rates for women rise, there is a good opportunity for future analysis to extend this current study’s findings.

Practical implications

The research uses the Big Five model and risk propensity to explore the important role of attitude in female entrepreneurs. Noting the moderating influence of factors in the macro-environment and the pervasive impact of social norms on women, this study flags some implications for government and policymakers in formulating supportive policies to enable greater uptake by women entrepreneurs with growth-oriented mindsets.

Originality/value

This paper contributes to the literature on the role of gender-specific attitudes through the business stages. This paper presents original research on the attitudes of women in the context of Arabic society.
Announcements effect of corporate bond issuance on share price returns
Authors: M’ng Jacinta Chan Phooi , Rahman Mahfuzur , Kit Goh Kok
Published: October 2019

Purpose

The purpose of this paper is to investigate the effect of bond issuance announcements on share price returns in three emerging markets and examine the characteristics of bond issues that affect the abnormal share price returns of the company.

Design/methodology/approach

This study employs event study, correlation and multiple regression techniques to attain the research objectives. The authors test hypotheses on 105 public listed companies from Malaysia, Singapore and Thailand, during the period of 2008–2014.

Findings

The findings show positive cumulative average abnormal returns resulting from the announcement of corporate bond issuance for Malaysia, Singapore and Thailand. The results reveal that there is a significant effect of bond issuance announcements on share price returns. The results also disclose that the market is not efficient at its semi-strong form as proposed by the market efficiency hypothesis.

Originality/value

The results provide better references for fund managers and investors in capital markets to take advantage of the abnormal returns resulting from bond issuance announcements.
A systematic literature review of healthcare supply chain and implications of future research
Authors: Dixit Anuj , Routroy Srikanta , Dubey Sunil Kumar
Published: October 2019

Purpose

This paper aims to review the healthcare supply chain (HSC) literature along various areas and to find out the gap in it.

Design/methodology/approach

In total, 143 research papers were reviewed during 1996-2017. A critical review was carried out in various dimensions such as research methodologies/data collection method (empirical, case study and literature review) and inquiry mode of research methodology (qualitative, quantitative and mixed), country-specific, targeted area, research aim and year of publication.

Findings

Supply chain (SC) operations, performance measurement, inventory management, lean and agile operation, and use of information technology were well studied and analyzed, however, employee and customer training, tracking and visibility of medicines, cold chain management, human resource practices, risk management and waste management are felt to be important areas but not much attention were made in this direction.

Research limitations/implications

Mainly drug and vaccine SC were considered in current study of HSC while SC along healthcare equipment and machine, hospitality and drug manufacturing related papers were excluded in this study.

Practical implications

This literature review has recognized and analyzed various issues relevant to HSC and shows the direction for future research to develop an efficient and effective HSC.

Originality/value

The insight of various aspects of HSC was explored in general for better and deeper understanding of it for designing of an efficient and competent HSC. The outcomes of the study may form a basis to decide direction of future research.
Integrating sustainability in higher planning education through international cooperation
Authors: Fokdal Josefine , Čolić Ratka , Milovanović Rodić Danijela
Published: October 2019

Purpose

This paper aims to supplement existing research on a joint approach to integrate sustainability into higher planning education (HPE) by facilitating an international transformative learning process. It looks at three different urban master’s programs in Serbia (Belgrade) and Germany (Berlin and Stuttgart).

Design/methodology/approach

In this paper, students' assessments of the pedagogical model, individual learning outcomes and the long-term value of the pedagogical model in respect of key competences for sustainability are presented and discussed. Basic assumptions of the study include that assessment from the students' perspective can provide feedback on the transformational learning experience with the aim of improving the experience and thus learning outcomes; help identify limitations and target specific areas for improvement in the pedagogical model; and improve the evaluation of effectiveness in developing knowledge and skills for sustainability in HPE.

Findings

The paper provides evidence that a learner-centered and action-oriented approach, as well as a global dialogue among peers from different backgrounds and nationalities, is an effective way to educate future generations of urban planners to become “change agents” for societal transformation toward a more sustainable future within their respective contexts.

Originality/value

The paper is a supplement to the existing research on educational initiatives that attempts to integrate sustainability into the curricula, especially of urban-related programs; showcases outcomes of the pedagogical model(s) for sustainable development applied, especially when addressing the competences of students working in developing, transitional and developed countries or different geographic contexts; and shows long-term learning outcomes after the students move into work practice.
The effects of leaders’ behaviors on employees’ resilience
Authors: Salehzadeh Reza
Published: October 2019

Purpose

The purpose of this paper is to propose a new typology for classifying the leaders’ behaviors and investigate the effects of leaders’ behaviors on employees’ resilience.

Design/methodology/approach

This paper used a mixed method research (i.e. interview and questionnaire). First, through the interviews with employees, the leaders’ behaviors were identified. Next, based on the identified behaviors and Kano model the type of each behavior was classified. Finally, according to this classification, the impact of leaders’ behaviors on employees’ resilience was investigated.

Findings

Based on the results of the interviews, 46 leaders’ behaviors which influence employees’ satisfaction/dissatisfaction were identified out of which 10 behaviors were must-be; 5 behaviors were one-dimensional, 18 behaviors were attractive and 13 behaviors were reverse type. Also, the results of hypotheses testing showed that attractive behaviors have a stronger relationship to employees’ resilience than one-dimensional and must-be behaviors; one-dimensional behaviors have a stronger relationship to employees’ resilience than must-be behaviors; and reverse behaviors have an indirect effect on employees’ resilience.

Originality/value

This research proposes a new typology for classifying the leaders’ behaviors into the five categories and the approach and findings of this research contribute to the literature of Kano model and leadership theory.
The evolution of “entrepreneurial policing”: a review of the literature
Authors: Smith Robert
Published: October 2019

Purpose

In the past decade, the concept and theory of “Entrepreneurial Policing” has emerged in academic and policing circles, particularly in a UK context. The purpose of this paper is to collect salient articles from extant but diverse literatures such as policing and criminology to synthesise a literature on it, focussing upon conceptual, theoretical and practical elements.

Design/methodology/approach

The approach is based on synthesising a literature using an in-depth review methodology and on analysing it to develop new insights into theoretical elements.

Findings

The findings are that the literature base is diverse and comes from a variety of policing, criminology, entrepreneurship, management, leadership and policy journals. There is a protean literature but at present little conceptual or theoretical clarity.

Research limitations/implications

There is a need for further empirical research in the form of qualitative face-to-face interviews to be conducted to develop typologies, taxonomies and topographies of entrepreneurial policing (EP). Developing illustrative case studies and teaching cases will educate new generations of police officers into the power and potential of EP as a change agent. This necessitates a change of policing structures, philosophies, processes and practices. From such theoretical groundwork, it is possible at a universal theory of what constitutes EP can be developed and tested. There is a need for commissioned research into the potentially revolutionary phenomenon; a text book and for training courses and seminars on the topic.

Practical implications

There are a number of practical implications for policing and policy practitioners and for its application in the future. From a policing perspective, an increased awareness of EP and criminal entrepreneurship can have positive outcomes in terms of new policing structures, philosophies, methodologies, practices and processes. From a criminal perspective, it heralds a better understanding of entrepreneurial crime, entrepreneurial criminals and organised crime groups. This could result in entrepreneurship educational programmes for police officers, senior officers and other law enforcement personnel and entrepreneurship awareness training for prisoners and ex-offenders and new avenues for utilising entrepreneurship as a diversion out of crime.

Social implications

There are also a number of social implications including the need for policy makers and politicians to be aware of the policing–entrepreneurship nexus and to award financial grants to encourage enterprising behaviour across the criminal justice system; encourage entrepreneurs to give back to their local communities; and increase the number of social enterprises in under-privileged communities.

Originality/value

This review is the first of its kind to deal specifically with EP and its evolution.