bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender in top management research
Authors: Mensi-Klarbach Heike
Published: April 2014

Purpose

– The purpose of this article is to offer a multi-layered approach to gender topics in top management team research.

Design/methodology/approach

– Recent empirical work on the role of gender diversity in top management teams will be reviewed and contrasted with gender and diversity theory.

Findings

– The results show that gender diversity has often been operationalized and defined in a highly stereotypical fashion, strongly rooted in assumed biological traits (in particular male/female skills and aptitudes). This very simplistic assumption that men and women behave differently does not take into account gender and diversity theories, but simply reproduces gender stereotypes. As a result, a framework is presented that takes societal, organizational, group and individual variables into account to understand the impact of gender in top management positions.

Research limitations/implications

– The paper is a conceptual paper aiming at enriching scholarly work on gender and top management teams by considering several potentially gendered processes on different layers: society, organizations, groups and individuals.

Originality/value

– This concept is the first to offer a fresh perspective on the intensively researched topic of gender and performance in top management. By overcoming the stereotypical view that the contributions of female and male managers are inherently different, the paper aims to enrich the scholarly debate on relevant top management characteristics, and furthermore ensure that discriminatory ascriptions to female and male managers are not reproduced through academic work.
Using a network modularity analysis to inform management of a rare endemic plant in the northern Great Plains, USA
Authors: Larson Diane L. , Droege Sam , Rabie Paul A. , Larson Jennifer L. , Devalez Jelle , Haar Milton , McDermott‐Kubeczko Margaret
Published: April 2014

Analyses of flower‐visitor interaction networks allow application of community‐level information to conservation problems, but management recommendations that ensue from such analyses are not well characterized. Results of modularity analyses, which detect groups of species (modules) that interact more with each other than with species outside their module, may be particularly applicable to management concerns.

We conducted modularity analyses of networks surrounding a rare endemic annual plant, Eriogonum visheri, at Badlands National Park, USA, in 2010 and 2011. Plant species visited were determined by pollen on insect bodies and by flower species upon which insects were captured. Roles within modules (network hub, module hub, connector and peripheral, in decreasing order of network structural importance) were determined for each species.

Relationships demonstrated by the modularity analysis, in concert with knowledge of pollen species carried by insects, allowed us to infer effects of two invasive species on E. visheri. Sharing a module increased risk of interspecific pollen transfer to E. visheri. Control of invasive Salsola tragus, which shared a module with E. visheri, is therefore a prudent management objective, but lack of control of invasive Melilotus officinalis, which occupied a different module, is unlikely to negatively affect pollination of E. visheri. Eriogonum pauciflorum may occupy a key position in this network, supporting insects from the E. visheri module when E. visheri is less abundant.

Year‐to‐year variation in species' roles suggests management decisions must be based on observations over several years. Information on pollen deposition on stigmas would greatly strengthen inferences made from the modularity analysis.

Synthesis and applications: Assessing the consequences of pollination, whether at the community or individual level, is inherently time‐consuming. A trade‐off exists: rather than an estimate of fitness effects, the network approach provides a broad understanding of the relationships among insect visitors and other plant species that may affect the focal rare plant. Knowledge of such relationships allows managers to detect, target and prioritize control of only the important subset of invasive species present and identify other species that may augment a rare species' population stability, such as E. pauciflorum in our study.
Assessment of various second‐line medications in addition to inhaled corticosteroid in asthma patients: a randomized controlled trial
Authors: Rajanandh Muhasaparur Ganesan , Nageswari Arcot Deenadayalu , Ilango Kaliappan
Published: April 2014

Many patients with persistent asthma cannot achieve the treatment goal for asthma with a single controller medication. The aim of the present study was to assess lung function and rescue medication use in asthma patients receiving four different categories of drugs in combination with an inhaled corticosteroid. Patients recruited to the study were randomized into four groups to receive budesonide with either formoterol, doxofylline, montelukast or tiotropium for a period of 3 months. Lung function (i.e. forced expiratory volume in 1 s (FEV1)) and rescue medication use were determined at baseline and on Day 15, 30, 45, 60 and 90 of treatment. A total of 297 patients completed the study. At baseline, no significant differences (P > 0.05) were observed in any of the outcome measures. Significant within‐group improvement in FEV1 was observed in all groups. On Day 90, between‐group differences showed that the improvement in FEV1 was significantly (P < 0.05) higher for patients receiving budesonide + formoterol, followed by budesonide + montelukast and budesonide + doxofylline, and least for those receiving budesonide + tiotropium. Similarly, within‐ and between‐group comparisons showed significant (P < 0.05) reductions in rescue medication use in all groups. However, the magnitude of the decrease was greater in the budesonide + formoterol group, followed by the budesonide + montelukast, budesonide + doxofylline and budesonide + tiotropium groups. Based on our findings, among the second‐line treatment regimens, budesonide with either montelukast or doxofylline was found to be better than budesonide + tiotropium in patients with mild‐to‐moderate persistent asthma. Further studies with a longer duration are likely to be useful.
Diversity and genomic insights into the uncultured Chloroflexi from the human microbiota
Authors: Campbell Alisha G. , Schwientek Patrick , Vishnivetskaya Tatiana , Woyke Tanja , Levy Shawn , Beall Clifford J. , Griffen Ann , Leys Eugene , Podar Mircea
Published: April 2014

Many microbial phyla that are widely distributed in open environments have few or no representatives within animal‐associated microbiota. Among them, the Chloroflexi comprises taxonomically and physiologically diverse lineages adapted to a wide range of aquatic and terrestrial habitats. A distinct group of uncultured chloroflexi related to free‐living anaerobic Anaerolineae inhabits the mammalian gastrointestinal tract and includes low‐abundance human oral bacteria that appear to proliferate in periodontitis. Using a single‐cell genomics approach, we obtained the first draft genomic reconstruction for these organisms and compared their inferred metabolic potential with free‐living chloroflexi. Genomic data suggest that oral chloroflexi are anaerobic heterotrophs, encoding abundant carbohydrate transport and metabolism functionalities, similar to those seen in environmental Anaerolineae isolates. The presence of genes for a unique phosphotransferase system and N‐acetylglucosamine metabolism suggests an important ecological niche for oral chloroflexi in scavenging material from lysed bacterial cells and the human tissue. The inferred ability to produce sialic acid for cell membrane decoration may enable them to evade the host defence system and colonize the subgingival space. As with other low abundance but persistent members of the microbiota, discerning community and host factors that influence the proliferation of oral chloroflexi may help understand the emergence of oral pathogens and the microbiota dynamics in health and disease states.
CPSU Legacies and Regional Democracy in Contemporary Russia
Authors: Libman Alexander , Obydenkova Anastassia V.
Published: April 2014

This article investigates the impact of Communist historical legacies on the variation of sub-national regimes in a federal state. It focuses on the Russian Federation and studies the role of sub-national variations of membership rates in the Communist Party of the Soviet Union (CPSU) during the 1970s and 1980s as a predictor of regional democracy in Russia in the 2000s. Using a unique dataset collected by the authors, the article shows that past CPSU membership rates continue to have a significant and negative impact on democracy at the sub-national level. The article also investigates possible mechanisms of this effect and links them to the persistence of Soviet bureaucracies and their role in exercising control over regional economies. These findings contribute to understanding the complex nexus of federalism and sub-national democracy and to the study of the role of communist legacies in democratisation.
Impact of introducing Practical Obstetric Multi‐Professional Training (PROMPT) into maternity units in Victoria, Australia
Authors: Shoushtarian M , Barnett M , McMahon F , Ferris J
Published: April 2014

Objective

To assess the introduction of Practical Obstetric Multi‐professional Training (PROMPT) into maternity units and evaluate effects on organisational culture and perinatal outcomes.

Design

A retrospective cohort study.

Setting

Maternity units in eight public hospitals in metropolitan and regional Victoria, Australia.

Population

Staff in eight maternity units and a total of 43 408 babies born between July 2008 and December 2011.

Methods

Representatives from eight Victorian hospitals underwent a single day of training (Train the Trainer), to conduct PROMPT. Organisational culture was compared before and after PROMPT. Clinical outcomes were evaluated before, during and after PROMPT.

Main outcome measures

The number of courses run and the proportion of staff trained were determined. Organisational culture was measured using the Safety Attitude Questionnaire. Clinical measures included Apgar scores at 1 and 5 minutes (Apgar 1 and Apgar 5), cord lactate, blood loss and length of baby's stay in hospital.

Results

Seven of the eight hospitals conducted PROMPT. Overall about 50% of staff were trained in each year of the study. Significant increases were found in Safety Attitude Questionnaire scores representing domains of teamwork (Hedges’ g 0.27, 95% confidence interval [95% CI] 0.13–0.41), safety (Hedges’ g 0.28, 95% CI 0.15–0.42) and perception of management (Hedges’ g 0.17, 95% CI 0.04–0.31). There were significant improvements in Apgar 1 (OR 0.84, 95% CI 0.77–0.91), cord lactates (odds ratio 0.92, 95% CI 0.85–0.99) and average length of baby's stay in hospital (Hedges’ g 0.03, 95% CI 0.01–0.05) during or after training, but no change in Apgar 5 scores or proportion of cases with high blood loss.

Conclusion

PROMPT can be introduced using the Train the Trainer model. Improvements in organisational culture and some clinical measures were observed following PROMPT.
Differential Impacts of Foreign Capital and Remittance Inflows on Domestic Savings in Developing Countries: A Dynamic Heterogeneous Panel Analysis
Authors: Hossain Delwar
Published: April 2014

The study examines the role of foreign capital and remittance inflows in the domestic savings of 63 developing countries for 1971–2010, paying attention to likely differential effects of FDI, portfolio investment, foreign aid and remittances. The conventional homogeneous panel estimates suggest that foreign aid and remittance flows have a significant negative impact on domestic savings. However, these techniques ignore cross‐section dependence and parameter heterogeneity properties and hence yield biased and inconsistent estimates. When we allow for parameter heterogeneity and cross‐sectional dependence by employing Pesaran's () Common Correlated Effects Mean Group estimator technique, only remittances crowd out savings.
Effectiveness of peroral endoscopic myotomy in the treatment of achalasia: A pilot trial in Chinese Han population with a minimum of one‐year follow‐up
Authors: Ling Ting Sheng , Guo Hui Min , Yang Tian , Peng Chun Yan , Zou Xiao Ping , Shi Rui Hua
Published: April 2014

Objective

To investigate the outcomes of Chinese Han patients who underwent peroral endoscopic myotomy (POEM) for achalasia.

Methods

Patients undergoing POEM for achalasia at the Affiliated Drum Tower Hospital of Nanjing University Medical School were prospectively enrolled in this study, with a follow‐up duration of at least one year. Their outcomes were evaluated by analyzing esophageal manometry, timed barium esophagogram and 36‐Item Short Form Health Survey (SF‐36), which were performed before surgery, 5 days after surgery and at the last follow‐up. Patients' symptom relief was considered the primary outcome. Secondary outcomes included lower esophageal sphincter (LES) pressure, esophageal emptying, patients' quality of life (QoL) and procedure‐related complications.

Results

Eighty‐seven patients were included in the study. Eckardt score after POEM was remarkably lower than the preoperative score (0.4 ± 0.7 vs 7.1 ± 2.1, P = 0.001). The preoperative LES pressure was 32.4 ± 15.3 mmHg, which was decreased to 3.8 ± 3.9 mmHg immediately after surgery. The height of the barium column at 1 min after barium swallow was significantly reduced after treatment (11.7 ± 1.2 cm vs 3.2 ± 1.6 cm, P < 0.001). The patients' QoL was also improved, as indicated by obviously increased physical and mental component summary (PCS and MCS) scores of the SF‐36. Complications occurred during POEM included cutaneous emphysema, mucosal injury and pneumothorax.

Conclusion

POEM is an effective approach for treating achalasia, which can relieve the symptoms of achalasia by improving esophageal emptying and lowering LES pressure.
How does four‐dimensional computed tomography spare normal tissues in non‐small cell lung cancer radiotherapy by defining internal target volume?
Authors: Bai Tong , Zhu Jian , Yin Yong , Lu Jie , Shu Huazhong , Wang Lin , Yang Bo
Published: April 2014

Background

To investigate how the four‐dimensional computed tomography (4DCT) technique spares normal tissues in non‐small cell lung cancer (NSCLC) radiotherapy by defining individualized internal target volume (ITV).

Materials and Methods

Gross tumor volume (GTV) and clinical target volume (CTV) were contoured on all 10 respiratory phases of 4DCT scans in 10 patients with peripheral NSCLC. Both 3D and 4D treatment plans were performed for each patient using planning target volume (PTV)3D (derived from a single CTV plus conventional margins) and PTV4D (derived from 4D internal target volume, which included all 10 CTVs plus setup margins). Dose volume histogram and normal tissue complication probability (NTCP) values were compared for the lung, heart, and spinal cord between 3D and 4D treatment plans.

Results

The average PTV of the 4D (127.56 ± 70.79) was less than the 3D plans (147.65 ± 76.89). The 4D spared more surrounding normal tissues than the 3D plans, especially in the lung. Compared with 3D plans, V5, V10, V20 and V30 of the total lung decreased from 41.25%, 37.75%, 24.25%, 17.00% to 38.13%, 33.00%, 21.25%, 15.13%, respectively. Without increasing the NTCP of the lung significantly, the 4D plans allowed us to increase the average prescription dose from 60 Gy to 66.00 ± 4.62 Gy.

Conclusions

4DCT based plans can reduce the target volumes, spare more normal tissues, and allow dose escalation compared with 3D plans in NSCLC radiotherapy.
Continuous positive airway pressure/pressure support pre‐oxygenation of morbidly obese patients
Authors: HARBUT P. , GOZDZIK W. , STJERNFÄLT E. , MARSK R. , HESSELVIK J. F.
Published: April 2014

Background

Morbidly obese patients are more prone to desaturation of arterial blood during apnea with induction of anesthesia than are non‐obese. This study aimed to assess the effect of low‐pressure continuous positive airway pressure (CPAP) with pressure support ventilation (PSV) during pre‐oxygenation on partial oxygen pressure in arterial blood (PaO2) immediately after tracheal intubation (post‐intubation PaO2).

Methods

Forty‐four adult patients scheduled for laparoscopic gastric bypass surgery were pre‐oxygenated with 80% O2 for 2 min, randomized either to CPAP 5 cm H2O + PSV 5 cm H2O (CPAP/PSV, n = 22) or neutral‐pressure breathing without CPAP/PSV (control, n = 22). Anesthesia was induced in a rapid‐sequence protocol and the trachea was intubated without prior mask ventilation. Arterial blood gases were measured before pre‐oxygenation, before induction of anesthesia, and immediately following intubation, before the first positive pressure breath.

Results

After pre‐oxygenation, partial carbondioxide pressure was significantly lower in the CPAP/PSV group (4.9 ± 0.5 kPa), (mean ± standard deviation) than in the control group (5.2 ± 0.7 kPa) (P = 0.025). Post‐preoxygenation PaO2 did not differ between the groups, but post‐intubation PaO2 was significantly higher in the CPAP/PSV group (32.2 ± 4.1 kPa) than in the control group (23.8 ± 8.8 kPa) (P < 0.001). In the control group, nadir oxygen saturation was lower (median 98%, range 83–99%) than in the CPAP/PSV group (median 99%, range 97–99%, P = 0.011).

Conclusions

In morbidly obese patients, low‐pressure CPAP combined with low‐pressure PSV during pre‐oxygenation resulted in better oxygenation, compared with neutral‐pressure breathing, and prevented desaturation episodes.
Influence of Botrytis cinerea (Helotiales: Sclerotiniaceae) infected leaves of Vitis vinifera (Vitales: Vitaceae) on the preference of Epiphyas postvittana (Lepidoptera: Tortricidae)
Authors: Rizvi Syed Z M , Raman Anantanarayanan , Wheatley Warwick , Cook Geoffrey , Nicol Helen
Published: April 2014

Herbivorous insects use sensory cues to choose their host plants for feeding and/or oviposition by assessing host quality. Olfactory, contact and visual cues of the host mediate such choices. The right‐host choice for oviposition by a lepidopteran is essential for the performance of its progeny. In natural conditions, plants are often and concurrently attacked by both herbivorous insects and pathogenic fungi. In such a three‐way relationship, the interaction between the plant and insect is usually influenced by the fungal population, and such an influence can be either mutualistic or antagonistic. In the present study, we tested the three‐way relationship using the system, Epiphyas postvittana–Vitis vinifera–Botrytis cinerea. We sought answers to the questions: (1) whether the females of E. postvittana prefer to oviposit on V. vinifera leaves infected by B. cinerea; and (2) whether the larvae of E. postvittana prefer to feed on V. vinifera leaves infected by B. cinerea. We found that the host‐seeking gravid females of E. postvittana ‘tested’ the infection status of the host plant using olfactory, visual, and tactile cues; in consequence, they laid significantly fewer eggs on the moderately (30–60%) and intensely (90–100%) infected leaves of V. vinifera. The neonate larvae preferred to feed on mildly (5–10%) and moderately (30–60%) infected leaves, as against the uninfected (control) leaves, and showed no preference for intensely (90–100%) infected leaves. External and internal examination of the larvae established that the larvae fed on B. cinerea‐infected leaf because viable conidia of B. cinerea occurred on the body surface and within the gut of the neonate larvae.
The dynamics of herpesvirus reactivations during and after severe drug eruptions: their relation to the clinical phenotype and therapeutic outcome
Authors: Ishida T. , Kano Y. , Mizukawa Y. , Shiohara T.
Published: April 2014

Background

Drug‐induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms (DIHS/DRESS) and Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) represent contrasting poles of severe drug eruptions, and sequential reactivations of several herpesviruses have exclusively been demonstrated in the former. No previous studies, however, were extended beyond the acute stage. We sought to investigate whether herpesvirus reactivations could also be observed in SJS/TEN and beyond the acute stage of both diseases.

Methods

Patients with SJS (n = 16), SJS/TEN overlap (n = 2), TEN (n = 10), and DIHS/DRESS (n = 34) were enrolled. We performed a retrospective analysis of Epstein–Barr virus (EBV), human herpesvirus 6 (HHV‐6), and cytomegalovirus (CMV) DNA loads sequentially determined by real‐time polymerase chain reaction during a 2‐year period after onset.

Results

Persistently increased EBV loads were detected in SJS during the acute stage and long after resolution, but not in others. In contrast, high HHV‐6 loads were exclusively detected in DIHS/DRESS during the acute stage. The dynamics of herpesvirus reactivation varied in DIHS/DRESS according to the use of systemic corticosteroids: While EBV loads were higher in patients not receiving systemic corticosteroids, CMV and HHV‐6 loads were higher in those receiving them.

Conclusions

Distinct patterns of herpesvirus reactivation according to the pathological phenotype and to the use of systemic corticosteroids were observed during the acute stage and follow‐up period, which may contribute, at least in part, to the difference in the clinical manifestations and long‐term outcomes. Systemic corticosteroids during the acute stage may improve the outcomes in DIHS/DRESS.
Cardiovascular autonomic function testing under non‐standardised and standardised conditions in cardiovascular patients with type‐2 diabetes mellitus
Authors: Keet S. W. M. , Bulte C. S. E. , Sivanathan A. , Verhees L. , Allaart C. P. , Boer C. , Bouwman R. A.
Published: April 2014

Autonomic function tests require standardised test conditions. We compared testing under non‐standardised and standardised conditions and investigated the agreement between heart and pulse rate variability in 30 subjects with diabetes mellitus. Deep breathing, Valsalva manoeuvre and quick standing tests showed non‐standardised reproducibility intraclass correlations (95% CI) of 0.96 (0.82–0.99), 0.96 (0.81–0.99) and 0.75 (−0.98 to 0.94), respectively. Intraclass correlations for sustained handgrip and quick standing were poor. Heart and pulse rate variability showed high‐frequency band intraclass correlations (95% CI) of 0.65 (−0.07 to 0.89) and 0.47 (−0.88 to 0.85) for the very low‐frequency band, respectively, 0.68 (0.00−0.90) and 0.70 (−0.09 to 0.91) for the low‐frequency band, and 0.86 (0.57−0.95) and 0.82 (0.39−0.95) for the high‐frequency band. Reproducibility under standardised conditions was comparable. The mean difference (95% limits of agreement) between heart and pulse rate variability was 0.99 (0.80−1.22) for very low frequency, 1.03 (0.88−1.21) for low frequency and 1.35 (0.84−2.16) for high frequency, with a Spearman's correlation coefficient of 1.00, 0.99 and 0.98, respectively. We demonstrated a high agreement between heart and pulse rate variability and acceptable reproducibility with most autonomic function tests, heart and pulse rate variability.
Evaluation of a large‐scale donation of Lifebox pulse oximeters to non‐physician anaesthetists in Uganda
Authors: Finch L. C. , Kim R. Y. , Ttendo S. , Kiwanuka J. K. , Walker I. A. , Wilson I. H. , Weiser T. G. , Berry W. R. , Gawande A. A.
Published: April 2014

Pulse oximetry is widely accepted as essential monitoring for safe anaesthesia, yet is frequently unavailable in resource‐limited settings. The Lifebox pulse oximeter, and associated management training programme, was delivered to 79 non‐physician anaesthetists attending the 2011 Uganda Society of Anaesthesia Annual Conference. Using a standardised assessment, recipients were tested for their knowledge of oximetry use and hypoxia management before, immediately following and 3–5 months after the training. Before the course, the median (IQR [range]) test score for the anaesthetists was 36 (34–39 [26–44]) out of a maximum of 50 points. Immediately following the course, the test score increased to 41 (38–43 [25–47]); p < 0.0001 and at the follow‐up visit at 3–5 months it was 41 (39–44 [33–49]); p = 0.001 compared with immediate post‐training test scores, and 75/79 (95%) oximeters were in routine clinical use. This method of introduction resulted in a high rate of uptake of oximeters into clinical practice and a demonstrable retention of knowledge in a resource‐limited setting.
Hypoxic conditions stimulate the release of B‐type natriuretic peptide from human retinal pigment epithelium cell culture
Authors: Aaltonen Vesa , Kinnunen Kati , Jouhilahti Eeva‐Mari , Peltonen Juha , Nikinmaa Mikko , Kaarniranta Kai , Arjamaa Olli
Published: April 2014

Purpose

A‐type peptide, a natriuretic peptide belonging to the natriuretic peptide family, has been shown to be increased in the vitreous of patients suffering from diabetic retinopathy and that human retina has a well‐developed natriuretic peptide system. The stimulus to which the synthesis of natriuretic peptides responded in these patients has, however, remained unknown. As the natriuretic peptides have recently been shown to respond to hypoxic conditions, the genes of both A‐type and B‐type have a hypoxia‐response element (HRE) in their promoter sequence, we therefore hypothesized that hypoxia in the human retinal pigment epithelium will increase the secretion of NT‐proBNP, the most common natriuretic peptide monitored in clinical medicine.

Methods

We used cultured human retinal pigment epithelium cell line (ARPE‐19) which was exposed either to normoxia or to hypoxia for 2 hr, 4 hr, 6 hr and 24 hr. NT‐proBNP was measured with enzyme immunoassay, VEGF with ELISA and HIF‐1α with Western blotting.

Results

Hypoxia induced VEGF 165 release in culture medium and HIF‐1α expression in cultured ARPE‐19 cells. Time‐dependent NT‐proBNP release was detected when the ARPE‐19 cells were cultured under normoxia. When hypoxia was induced, a statistically significant increase in NT‐proBNP release was demonstrated in the culture medium.

Conclusions

Hypoxic conditions increase the release of a natriuretic peptide from retinal pigment epithelium (RPE) cells. The secretion of VEGF was also enhanced. The responses were associated with the up‐regulation of the HIF‐1α transcription factor. These results explain the previous findings from patients with diabetes, which also suggest that hypoxia is a ubiquitous stimulus for the secretion of natriuretic peptides in human body.
Idarubicin‐loaded beads for chemoembolisation of hepatocellular carcinoma: results of the IDASPHERE phase I trial
Authors: Boulin M. , Hillon P. , Cercueil J. P. , Bonnetain F. , Dabakuyo S. , Minello A. , Jouve J. L. , Lepage C. , Bardou M. , Wendremaire M. , Guerard P. , Denys A. , Grandvuillemin A. , Chauffert B. , Bedenne L. , Guiu B.
Published: April 2014

Background

A phase I dose‐escalation trial of transarterial chemoembolisation (TACE) with idarubicin‐loaded beads was performed in cirrhotic patients with hepatocellular carcinoma (HCC).

Aim

To estimate the maximum‐tolerated dose (MTD) and to assess safety, efficacy, pharmacokinetics and quality of life.

Methods

Patients received a single TACE session with injection of 2 mL drug‐eluting beads (DEBs; DC Bead 300–500 μm) loaded with idarubicin. The idarubicin dose was escalated according to a modified continuous reassessment method. MTD was defined as the dose level closest to that causing dose‐limiting toxicity (DLT) in 20% of patients.

Results

Twenty‐one patients were enrolled, including nine patients at 5 mg, six patients at 10 mg, and six patients at 15 mg. One patient at each dose level experienced DLT (acute myocardial infarction, hyperbilirubinaemia and elevated aspartate aminotransferase (AST) at 5‐, 10‐ and 15‐mg, respectively). The calculated MTD of idarubicin was 10 mg. The most frequent grade ≥3 adverse events were pain, elevated AST, elevated γ‐glutamyltranspeptidase and thrombocytopenia. At 2 months, the objective response rate was 52% (complete response, 28%, and partial response, 24%) by modified Response Evaluation Criteria in Solid Tumours. The median time to progression was 12.1 months (95% CI 7.4 months – not reached); the median overall survival was 24.5 months (95% CI 14.7 months – not reached). Pharmacokinetic analysis demonstrated the ability of DEBs to release idarubicin slowly.

Conclusions

Using drug‐eluting beads, the maximum‐tolerated dose of idarubicin was 10 mg per TACE session. Encouraging responses and median time to progression were observed. Further clinical investigations are warranted (NCT01040559).
Systematic review: the safety and efficacy of hyperbaric oxygen therapy for inflammatory bowel disease
Authors: Dulai P. S. , Gleeson M. W. , Taylor D. , Holubar S. D. , Buckey J. C. , Siegel C. A.
Published: April 2014

Background

Hyperbaric oxygen therapy (HBOT) provides 100% oxygen under pressure, which increases tissue oxygen levels, relieves hypoxia and alters inflammatory pathways. Although there is experience using HBOT in Crohn's disease and ulcerative colitis, the safety and overall efficacy of HBOT in inflammatory bowel disease (IBD) is unknown.

Aim

To quantify the safety and efficacy of HBOT for Crohn's disease (CD) and ulcerative colitis (UC). The rate of adverse events with HBOT for IBD was compared to the expected rate of adverse events with HBOT.

Methods

MEDLINE, EMBASE, Cochrane Collaboration and Web of Knowledge were systematically searched using the PRISMA standards for systematic reviews. Seventeen studies involving 613 patients (286 CD, 327 UC) were included.

Results

The overall response rate was 86% (85% CD, 88% UC). The overall response rate for perineal CD was 88% (18/40 complete healing, 17/40 partial healing). Of the 40 UC patients with endoscopic follow‐up reported, the overall response rate to HBOT was 100%. During the 8924 treatments, there were a total of nine adverse events, six of which were serious. The rate of adverse events with HBOT in IBD is lower than that seen when utilising HBOT for other indications (P < 0.01). The risk of bias across studies was high.

Conclusions

Hyperbaric oxygen therapy is a relatively safe and potentially efficacious treatment option for IBD patients. To understand the true benefit of HBOT in IBD, well‐controlled, blinded, randomised trials are needed for both Crohn's disease and ulcerative colitis.
‘Dangerous Minds’? Deconstructing Counter‐Terrorism Discourse, Radicalisation and the ‘Psychological Vulnerability’ of Muslim Children and Young People in Britain
Authors: Coppock Vicki , McGovern Mark
Published: April 2014

Current British Government strategies to counter terrorism (exemplified in the Prevent policy and Channel programme) are based upon a problematic fusion of certain dominant explanatory models of the ‘causes of terrorism’ (specifically, ‘psychological vulnerability’ to ‘radicalisation’) with discourses of ‘child protection/safeguarding’. Derived from particular mainstream traditions of social scientific epistemology and inquiry, these knowledge paradigms ‘legitimise’ a pre‐emptive, interventionist and securitising approach that affects the lives of young British Muslims. The aim of this article is to challenge some of the assumptions that underpin the understanding of ‘radicalisation’, ‘psychological vulnerability’ and ‘child protection’ evidenced in these state practices and policies.
Children and ADHD: seeking control within the constraints of diagnosis
Authors: Brady Geraldine
Published: April 2014

The views of children diagnosed with ADHD have, until recently, largely been neglected in research, policy and practice. This article focuses on qualitative research which explored children's lived experience, drawing attention to the ways that they actively ‘take’ responsibility for managing their physical, psychological and emotional well‐being within the constraints of a medical diagnosis. The neglect of a tradition which asks children about their own experiences of ADHD is crucially bound up with children's low social and political status in UK society and notions of competency and responsibility in relation to ADHD.
The Utmost Discretion: How Presumed Prudence Leaves Children Susceptible to Electroshock
Authors: van Daalen‐Smith Cheryl , Adam Simon , Breggin Peter , LeFrançois Brenda A.
Published: April 2014

This article examines the controversial and largely publicly undocumented practice of administering electroconvulsive therapy (ECT or electroshock) to children who are undergoing psychiatric treatment. Conventional psychiatric beliefs and practices are challenged, along with a presentation of the history of scientific research which questions electroshock's ‘effectiveness’ and outlines its brain‐damaging and incapacitating effects. As such, we provide counterarguments regarding the legitimacy of ECT as a treatment option, deconstructing the principle of presumed prudence in its use. Our analysis leads us to conclude that the ‘principle of presumed prudence’ should be eschewed in favour of the ‘precautionary principle’, in order to underscore and uphold the medical ethos ‘to do no harm’ and to ensure the application of children's rights within the psychiatric system.
Current status of endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy in Japan: Questionnaire survey and important discussion points at Endoscopic Forum Japan 2013
Authors: Katanuma Akio , Isayama Hiroyuki
Published: April 2014

Background and Aim

Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is still challenging. We aimed to clarify the current status of ERCP in Japan in patients with surgically altered anatomy.

Methods

Questionnaire survey was conducted in 2012 at 11 participating facilities regarding ERCP in patients with surgically altered anatomy.

Results

A total of 490 ERCP procedures were carried out in 273 patients with surgically altered anatomy. The breakdown of surgical procedures was as follows: Roux‐en‐Y (R‐Y) reconstruction (n = 154 [31.4%]), pancreaticoduodenectomy (PD) (n = 136 [27.8%]), hepaticojejunostomy (n = 103 [21.0%]), liver transplantation (n = 20 [4.1%]), Billroth II reconstruction (n = 69 [14.1%]), and interposition after total gastrectomy (n = 8 [1.6%]). The overall success rate of reaching the target site was 91.8% (450 of 490 ERCP procedures). According to reconstructive surgical procedures, the target site was reached in 138 of 154 procedures (89.6%) for R‐Y reconstruction, 129 of 136 procedures (94.8%) for PD, 89 of 103 procedures (86.4%) for hepaticojejunostomy, 18 of 20 procedures (90.0%) for liver transplantation, 68 of 69 procedures (98.6%) for Billroth II reconstruction, and eight of eight procedures (100%) for interposition after total gastrectomy.

Conclusions

The success rate of reaching the target site was high in patients with Billroth II reconstruction and low in patients with hepaticojejunostomy. Although the success rate of endoscopic insertion for ERCP in patients with surgically altered anatomy was high, there are still cases in which it is difficult to achieve technical success.
Ampullary intervention for bile duct stones in patients with surgically altered anatomy
Authors: Ito Kei , Masu Kaori , Kanno Yoshihide , Ohira Tetsuya , Noda Yutaka
Published: April 2014

Transpapillary endoscopic treatment is a standard technique for the treatment of bile duct stones. This technique includes biliary cannulation, ampullary interventions such as endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilation (EPBD), and stone removal. In patients with Roux‐en‐Y anastomosis, the transpapillary approach using an ordinary scope has been challenging. A recently developed single‐/double‐balloon enteroscope enables therapeutic endoscopic retrograde cholangiopancreatography to be carried out in such cases. EST using a balloon enteroscope is often difficult to carry out as a result of restriction of scope maneuverability or inadequate direction of the accessory. Although EPBD is easy to carry out for any anatomy, large or multiple stones are difficult to remove by EPBD only because of insufficient opening of Vater's papilla. Endoscopic papillary large‐balloon dilation following EST is reported to be useful for the treatment of large and/or multiple stones. This technique is also useful for the treatment of bile duct stones in patients with Roux‐en‐Y anastomosis.
Cold polypectomy techniques for diminutive polyps in the colorectum
Authors: Uraoka Toshio , Ramberan Hemchand , Matsuda Takahisa , Fujii Takahiro , Yahagi Naohisa
Published: April 2014

Adequate colonoscopic polypectomy is a very important intervention for the prevention of colorectal cancer progression during screening and surveillance colonoscopy. Whereas various techniques are used for the removal of diminutive polyps, including cold biopsy forceps, hot biopsy forceps, hot snare, and cold snare, hot polypectomy techniques with electrocautery have been associated with an increased risk of electrocautery‐related complications, including immediate and/or delayed bleeding or perforation. In contrast, recent studies have found a polypectomy technique without electrocautery, so‐called cold polypectomy, to be a safer and more efficacious technique. The present article discusses the use of cold polypectomy techniques and describes how cold biopsy forceps polypectomy using jumbo biopsy forceps designed with a greater capacity for removing larger tissue samples, and cold snare polypectomy, are adequate for removing diminutive polyps completely and safely and shorten withdrawal time of the colonoscopy procedure.
Endoscopic diagnosis of superficial non‐ampullary duodenal epithelial tumors in Japan: Multicenter case series
Authors: Goda Kenichi , Kikuchi Daisuke , Yamamoto Yorimasa , Takimoto Kengo , Kakushima Naomi , Morita Yoshinori , Doyama Hisashi , Gotoda Takuji , Maehata Yuji , Abe Noritsugu
Published: April 2014

Background and Aim

To verify the current status in Japan on endoscopic diagnosis of superficial non‐ampullary duodenal epithelial tumors (SNADET) by a multicenter case series through a questionnaire survey.

Methods

Nine endoscopists and a surgeon responded to a questionnaire on endoscopic diagnosis of SNADET. The subjects of this survey were histologically confirmed SNADET that were endoscopically or surgically resected from 2007 to 2012. This survey collected data of 364 patients with 396 SNADET.

Results

Of the 396 SNADET, 121 were histologically diagnosed as low‐grade dysplasia (LGD), 112 as high‐grade dysplasia (HGD), and 163 as superficial adenocarcinoma (SAC) including 153 mucosal carcinomas and 10 submucosal carcinomas. Total number of SNADET increased from 125 in the first half to 271 in the second half of the survey period. Compared to LGD, a significantly greater number of HGD or SAC was found in the tumors having a diameter >5 mm as well as solitary or predominantly red color. Preoperative endoscopic diagnosis indicated significantly higher sensitivity and accuracy and significantly lower specificity for HGD or SAC of final histology than preoperative biopsy. Ten submucosal carcinomas had 0‐I or 0‐IIa+IIc macroscopic‐type tumors with red color.

Conclusions

This multicenter case series study suggested that the number of resected SNADET is dramatically increasing in Japan. Tumor diameter >5 mm and red color seemed to be signs for tumors of HGD or SAC. Preoperative endoscopy may provide a more reliable diagnosis of final histology of HGD or SAC than preoperative biopsy. Further studies are warranted for establishing endoscopic features of submucosal carcinoma.
Seasonal cycles of diversity and similarity in a Central American rainforest butterfly community
Authors: Grøtan V. , Lande R. , Chacon I. A. , DeVries P. J.
Published: April 2014

Despite the importance of understanding the effects of tropical seasonality on ecological diversity, few studies have investigated the influence of environmental factors on seasonal community composition, and even fewer use standardized sampling and robust analytical methods that are directly comparable. Our 104 months of sampling in Costa Rican lowland rainforest yielded 12 757 individuals of 106 fruit‐feeding butterfly species demonstrated biannual cycles in species diversity, but community similarity showed an annual cycle that peaked in the driest months. We found that community diversity and similarity did not decline with increasing time lag, which we attribute to lack of long‐term changes in species abundances. Our findings differ from a similar study in Ecuador, where cycles in weather and community diversity were annual. Long‐term intensive monitoring and robust statistical analysis of changes in community composition in relation to environmental factors can help to elucidate the dynamics of communities, and their response to climate change.
Early intervention for first‐episode psychosis: broadening the scope of economic estimates
Authors: Park A‐La , McCrone Paul , Knapp Martin
Published: April 2014

Aim

To explore the economic impacts of early intervention in England on outcomes and costs for people with first‐episode psychosis.

Methods

Three decision analytical models were constructed to compare treatment by early intervention for first‐episode psychosis with standard care in relation to employment, education, homicide and suicide. Data on effectiveness and costs were taken from previous studies and expert opinion. Sensitivity analyses tested the robustness of assumptions.

Results

Our models indicate that early intervention demonstrates savings of £2087 per person over 3 years from improved employment and education outcomes. In addition, the annual costs over 10 years related to homicide after early intervention were £80 lower than for standard care. There were also annual savings of £957 per person for early intervention over 4 years compared to standard care as a result of suicides averted.

Conclusions

Not only can investment in early intervention help reduce some of the long‐term costs and consequences of mental disorders to the health‐care system. In addition, there are broader economic benefits that strengthen the potential cost savings to society.
Characterisation of the inflammatory cytokine response to anthelmintic treatment in ponies
Authors: Betancourt A. , Lyons E. T. , Horohov D. W.
Published: April 2014

Reasons for performing study

Anthelmintic treatments have been associated with local inflammatory reactions. Since each class of anthelmintic has unique mechanisms of action affecting different subpopulations of parasites, we hypothesised that they will also induce characteristic proinflammatory responses.

Objectives

To determine the effect of anthelmintic class on the proinflammatory response post treatment.

Study design

Ponies naturally infected with cyathostomins and other parasites after pasture grazing were left untreated or treated with representatives of 3 different classes of anthelmintics: fenbendazole (benzimidazole); pyrantel tartrate (pyrimidine); and moxidectin (macrocyclic lactone). All were monitored for the expression of proinflammatory genes in the peripheral blood using real‐time PCR.

Methods

The ponies were divided into 4 treatment groups: Group 1 (n = 4) were untreated controls; Group 2 (n = 5) received 5 daily doses of fenbendazole (10 mg/kg bwt); Group 3 (n = 4) received daily treatment of pyrantel tartrate 2× (2.65 mg/kg bwt); and Group 4 (n = 5) received a single dose of moxidectin (400 μg/kg bwt). Blood samples were collected daily for 2 weeks to determine the effect of deworming on proinflammatory gene expression. Faecal egg counts were used to evaluate the efficacy of each drug.

Results

While treatment with the benzimidazole significantly reduced egg counts up to 14 days post treatment, it also stimulated proinflammatory gene expression. Treatment with pyrantel salt also reduced faecal egg counts with less of a proinflammatory response. Treatment with the macrocyclic lactone was the most successful in reducing faecal egg counts and produced no signs of increased proinflammatory cytokine expression.

Conclusions

This study revealed pronounced differences in the cytokine responses to anthelmintic treatment. This inflammatory reaction may play a role in the development of parasitic disease post anthelmintic treatment.
Allosteric regulation of phosphofructokinase controls the emergence of glycolytic oscillations in isolated yeast cells
Authors: Gustavsson Anna‐Karin , van Niekerk David D. , Adiels Caroline B. , Kooi Bob , Goksör Mattias , Snoep Jacky L.
Published: April 2014

Oscillations are widely distributed in nature and synchronization of oscillators has been described at the cellular level (e.g. heart cells) and at the population level (e.g. fireflies). Yeast glycolysis is the best known oscillatory system, although it has been studied almost exclusively at the population level (i.e. limited to observations of average behaviour in synchronized cultures). We studied individual yeast cells that were positioned with optical tweezers in a microfluidic chamber to determine the precise conditions for autonomous glycolytic oscillations. Hopf bifurcation points were determined experimentally in individual cells as a function of glucose and cyanide concentrations. The experiments were analyzed in a detailed mathematical model and could be interpreted in terms of an oscillatory manifold in a three‐dimensional state‐space; crossing the boundaries of the manifold coincides with the onset of oscillations and positioning along the longitudinal axis of the volume sets the period. The oscillatory manifold could be approximated by allosteric control values of phosphofructokinase for ATP and AMP.

Database

The mathematical models described here have been submitted to the JWS Online Cellular Systems Modelling Database and can be accessed at http://jjj.mib.ac.uk/webMathematica/UItester.jsp?modelName=gustavsson5.

[Database section added 14 May 2014 after original online publication]
ILEI: a novel marker for epithelial–mesenchymal transition and poor prognosis in colorectal cancer
Authors: Gao Zhao‐Hua , Lu Chong , Wang Zhen‐Ning , Song Yong‐Xi , Zhu Jin‐Liang , Gao Peng , Sun Jing‐Xu , Chen Xiao‐Wan , Wang Mei‐Xian , Dong Yu‐Lan , Xu Hui‐Mian
Published: April 2014

Aims

Accumulating evidence over the past decade has shown that abnormal activation of epithelial to mesenchymal transition (EMT) contributes to tumour progression and metastasis in colorectal cancer (CRC). In this study, we investigated the expression of interleukin‐like EMT inducer (ILEI) and EMT‐associated markers (E‐cadherin, vimentin) in CRC tissues and determined the correlations between ILEI expression and clinicopathological characteristics, prognosis and EMT in CRC.

Methods and results

In total, 194 patients diagnosed with CRC based on histopathological evaluation and those subjected to surgical resection at the First Hospital of China Medical University between 2003 and 2005 were examined. Immunohistochemical staining for ILEI, vimentin and E‐cadherin was performed for each specimen. Cytoplasmic overexpression of ILEI usually accompanied down‐regulation of E‐cadherin and positive expression of vimentin. Conversely, ILEI was simultaneously down‐regulated with overexpression of E‐cadherin and negative expression of vimentin. ILEI overexpression was associated significantly with T‐stage, N‐stage, TNM stage and EMT phenotype (P = 0.024, <0.001, <0.001 and <0.001, respectively). Multivariate analysis revealed that ILEI expression was an independent prognostic factor for patient survival.

Conclusions

Our findings indicate that cytoplasmic ILEI expression is a potential marker of EMT and tumour progression in CRC. ILEI is an independent predictive factor associated with poor prognosis in CRC.