bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in quality characteristic of immature flat persimmon (Diospyros kaki Thunb) during heat treatment aging
Authors: Sim Hye-Jin , Kang Jae-Ran , Kang Min-Jung , Choi Myoung-Hyo , Suh Hwa-Jin , Shin Jung-Hye
Published: September 2016

The objective of this study was to investigate physicochemical and antioxidant characteristics of immature flat persimmon during 7 heat treatment aging steps. The pH decreased, and hence, acidity increased with aging. Hunter L value decreased with aging. The a value rapidly increased until step 3, whereas the b value decreased. Fructose content decreased while glucose contents slightly increased during aging. Hardness, chewiness and gumminess rapidly decreased, indicating softening in texture, but it was negligible after aging step 3. Phenolic compounds including gallic acid and homogentisic acid were detected at step 3 and then gradually increased with aging. However, contents of flavonoid and tannin were much higher in step 1 sample than others. The antioxidant activities observed by DPPH, ABTS, and FRAP assay were the highest at step 1 possibly due to the higher levels of flavonoids and tannin acid in the step 1 sample.
Characterization and optimization for beverage manufacture using Korean red ginseng extract
Authors: Choi Ji-Won , Oh Mi-Jin , Ha Sang Keun , Park Yongkon , Park Ho-Young
Published: September 2016

This study was designed to develop a manufacturing process for ginseng concentrate with reduced unpleasant aroma and bitter taste. Two types of ginseng, white and red, were extracted under six different conditions (the 1st to the 6th step) of temperature (65~95℃) and ethanol concentration (0~70%). Six extracts of each ginseng were evaluated by a sensory test, and assayed for crude saponin, ginsenosides, and acidic polysaccharides. The content of crude saponin in the extracts decreased with extraction time. There was no significant difference in the crude saponin content between white and red ginseng extracts. The yield of red ginseng extract was higher (45%) than that of white ginseng. No significant difference was observed in the acidic polysaccharide content between red and white ginseng extracts. Rg3, a specific ginsenoside in red ginseng, was detected in the 1st to 6th extracts of red ginseng. Bitterness, astringency, and sourness of ginseng extracts decreased as the extraction steps proceeded. The composite of the 1st, 2nd, and 6th step extracts decreased bitterness and astringency, and the highest overall acceptance. Compared with commercial beverages, the composition of the three extracts is the desirable method to decrease the bitter and astringent tastes, and the overall unpleasant flavor of ginseng.
Quality characteristics of detoxified Rhus verniciflua vinegar fermented using different acetic acid bacteria
Authors: Baek Seong Yeol , Kim Ji-Seon , Mun Ji-Young , Lee Choong Hwan , Park Yoo Kyoung , Yeo Soo-Hwan
Published: September 2016

To investigate the effect of different acetic acid bacteria on qualities of detoxified Rhus verniciflua vinegar (DRV), different DRVs were produced by using three acetic acid bacterial strains including Acetobacter pasteurianus KACC16934 (AP), Acetobacter malorum V5-7 (AM), and Gluconoacetobacter entanii RDAF-S (GE). Little difference in pH (2.87~2.90) or titratable acidity (5.33~5.68%) was observed among different DRVs. Acetic acid yields of the AP, AM, and GE strains were 78.6%, 85.3%, and 85.9%, respectively. Organic acid content in different DRVs was in the range of 69.84~73.83 mg/mL. Oxalic acid, malic acid, succinic acid, acetic acid, and fumaric acid were detected in all DRVs. And glutamic acid, alanine, valine, leucine, tyrosine, lysine, anserine, and arginine were detected in all DRVs. Arginine and alanine were the predominant amino acids in all DRVs. PCA plots of electronic nose analysis data showed a significant differentiation of DRVs from different acetic acid bacterial strains. A sensory evaluation of all DRVs indicated that DRV fermented using AM was superior in the aspect of flavor, tasted and overall preference.
Biological activities of Aster scaber extracts
Authors: Lee Eun-Ho , Park Hye-Jin , Kim Na-Hyun , Hong Eun-Jin , Park Mi-Jung , Lee Seon-Ho , Kim Myung-Uk , An Bong-Jeun , Cho Young-Je
Published: September 2016

The phenolic compounds extracted from Aster scaber were examined for their biological activities owing to their potential use in health and beauty food products. The phenolic content in water and 60% ethanol extracts were 11.1±0.11 and 4.18±0.05 mg/g, respectively. The DPPH radical scavenging activities of the water and ethanol extracts were 87% and 91% at 50 μg phenolics/mL, respectively. At the same phenolics concentration, the respective extracts showed 84% and 95% for ABTS radical decolorization activities and 95% and 97% for TBARs. The antioxidant protection factors for the water and ethanol extracts at 200 μg phenolics/mL were 1.87 and 2.22 PF, respectively. Enzyme inhibitory activities of the water and ethanol extracts (50 μg phenolics/mL) were 50.8% and 69.4% on angiotensin converting enzyme, 91% and 80% on xanthine oxidase, and 24% and 89% on α-amylase, respectively. The tyrosinase inhibitory activities indicating skin-whitening were 47% and 25% for the water and ethanol extracts, respectively. Anti-wrinkle effect of the water extract was relatively higher than that of the ethanol extract. These results suggest that the water and ethanol extracts of Aster scaber can be used as an ingredient in health and beauty food products.
Changes in physicochemical characteristics of porcine blood under various conditions of enzyme hydrolysis
Authors: Park Joo Young , Kim Mi-Yeon , Jeong Yong-Jin
Published: September 2016

The aim of this study was to investigate physicochemical properties of porcine blood hydrolyzed by proteases under various conditions for utilization as a food source. Five kinds of proteases (Alcalase, Neutrase, Protex-40L, PTPF-1430, and KMFP-15) were tested at different concentrations (0.1, 0.2, and 0.3%, w/v) during hydrolysis at 55 for 4 hr. Hydrolysis with ℃ KMFP-15 showed the lowest pH by 7.3. The highest soluble solid (24.3 °Brix) and free amino acid (4,944 mg%) contents were obtained by hydrolysis with KMFP-15 (w/v) at 0.2% addition level, which was not significantly different from the sample hydrolyzed at 0.3% level. Under the optimal condition of KMFP-15 at 0.2%, porcine blood was hydrolyzed at 60 up to 8 hr. The ℃ free amino acid content reached the highest at 4 hr, and then decreased with longer hydrolysis time. Under the optimal hydrolysis conditions, porcine blood hydrolysis powder had plenty of crude proteins, amino acids, and minerals, including iron, potassium, and zinc. The results showed that porcine blood could be utilized as an useful source of food supplement. The optimum conditions of hydrolyzing porcine blood, using 0.2 KMFP at 60℃ for 4 hr, can be used in the commercial production of protein supplements, amino acid sources, and iron fortifying agents
Spatial patterning of P granules by RNA-induced phase separation of the intrinsically-disordered protein MEG-3
Authors: Smith Jarrett , Calidas Deepika , Schmidt Helen , Lu Tu , Rasoloson Dominique , Seydoux Geraldine
Published: September 2016

RNA granules are non-membrane bound cellular compartments that contain RNA and RNA binding proteins. The molecular mechanisms that regulate the spatial distribution of RNA granules in cells are poorly understood. During polarization of theC. eleganszygote, germline RNA granules, called P granules, assemble preferentially in the posterior cytoplasm. We present evidence that P granule asymmetry depends on RNA-induced phase separation of the granule scaffold MEG-3. MEG-3 is an intrinsically disordered protein that binds and phase separates with RNAin vitro.In vivo, MEG-3 forms a posterior-rich concentration gradient that is anti-correlated with a gradient in the RNA-binding protein MEX-5. MEX-5 is necessary and sufficient to suppress MEG-3 granule formationin vivo, and suppresses RNA-induced MEG-3 phase separationin vitro. Our findings support a model whereby MEX-5 functions as an mRNA sink to locally suppress MEG-3 phase separation and drive P granule asymmetry.

HIGHLIGHTS

- The intrinsically-disordered protein MEG-3 is essential for localized assembly of P granules inC. eleganszygotes.

- MEG-3 binds RNA and RNA stimulates MEG-3 phase separation.

- The RNA-binding protein MEX-5 inhibits MEG-3 granule assembly in the anterior cytoplasm by sequestering RNA.
Arabidopsis STAY-GREEN, Mendel's Green Cotyledon Gene, Encodes Magnesium-Dechelatase
Authors: Shimoda Yousuke , Ito Hisashi , Tanaka Ayumi
Published: September 2016

Pheophytin a is an essential component of oxygenic photosynthetic organisms because the primary charge separation between chlorophyll a and pheophytin a is the first step in the conversion of light energy. In addition, conversion of chlorophyll a to pheophytin a is the first step of chlorophyll degradation. Pheophytin is synthesized by extracting magnesium (Mg) from chlorophyll; the enzyme Mg-dechelatase catalyzes this reaction. In this study, we report that Mendel's green cotyledon gene, STAY-GREEN (SGR), encodes Mg-dechelatase. The Arabidopsis thaliana genome has three SGR genes, SGR1, SGR2, and STAY-GREEN LIKE (SGRL). Recombinant SGR1/2 extracted Mg from chlorophyll a but had very low or no activity against chlorophyllide a; by contrast, SGRL had higher dechelating activity against chlorophyllide a compared with chlorophyll a. All SGRs could not extract Mg from chlorophyll b. Enzymatic experiments using the photosystem and light-harvesting complexes showed that SGR extracts Mg not only from free chlorophyll but also from chlorophyll in the chlorophyll-protein complexes. Furthermore, most of the chlorophyll and chlorophyll binding proteins disappeared when SGR was transiently expressed by a chemical induction system. Thus, SGR is not only involved in chlorophyll degradation but also contributes to photosystem degradation.
Role of social media in information-seeking behaviour of international students
Authors: Hamid Suraya , Bukhari Sarah , Ravana Sri Devi , Norman Azah Anir , Ijab Mohamad Taha
Published: September 2016

Purpose

The purpose of this paper is to investigate the information-seeking behaviour of international students in terms of their information needs and to highlight the role of social media.

Design/methodology/approach

In this paper, a systematic literature survey was conducted in order to investigate information-seeking trends among international students while using social media. As a result, an exhaustive systematic literature review (SLR) was carried out in order to investigate social media as a source for the observation of the behaviours of international students. For this purpose, 71 articles were selected from various well-known sources after an intensive SLR process of searching, filtering and enforcing the inclusion and exclusion criteria.

Findings

As an outcome of this study, the information-seeking behaviour of international students was highlighted with respect to social media as a source of information. In addition, this research identifies the information needs of the international students and categorizes them by the roles played by the social media in fulfilling the information needs.

Practical implications

A comparative study that highlighted the dearth of studies which merge the social media and information-seeking behaviour of international students as well as identify the future direction for the researchers and for benefits of international students.

Originality/value

A detail SLR which highlights the need of shifting the information seeking behaviour from libraries to social media in regard to the new environment for international students.
How to overcome the digital divide? An empirical study of Taiwan’s DOCs
Authors: Chao Cheng-Min , Yu Tai-Kuei
Published: September 2016

Purpose

The digital divide is a concern, as the inequality of information access might have significant influences on social development and quality of life. The purpose of this paper is to examine the perceived benefit of Digital Opportunity Centers (DOCs) programs on remote area participants from the perspective of computer anxiety and personal information ability.

Design/methodology/approach

The Taiwanese Government has built DOCs in remote areas to provide information technology (IT) training and learning programs to citizens residing in these areas. DOC program participants in Taiwan voluntarily completed a self-report questionnaire; the authors received 2,105 completed questionnaires, with a response rate of 84.2 percent. This research used partial least-squares (PLS) to empirical the research model.

Findings

Using PLS, the results show that information and communication technology ability influences the perceived benefit of DOC programs; computer anxiety has significantly negative effects on package software use, internet use, and IT usefulness; and internet use and IT usefulness have positive effects on perceived benefits.

Originality/value

IT is continuously advancing, but digital resources are still lacking within remote areas. DOCs provide citizens different types of learning experiences related to economic, social, and educational development. DOC programs provide participants with opportunities to obtain and improve basic IT knowledge and abilities and decreasing the digital divide.
Value based e-health care – a case study of Tata Memorial Centre
Authors: Krishnamoorthy Bala , Narayan H.K.V.
Published: September 2016

Subject area

The subject areas are strategy, general management, health-care management, change management and inclusive growth model and application of technology to manage health care.

Study level/applicability

The case can be used to teach challenges in managing change in a health-care facility.

Case overview

Tata Memorial Centre (TMC) is dedicated to provide best health-care services in the field of cancer cure. TMC established its credentials for service, education and research, which contributed to it being rated among the ten best hospitals year on year. Starting from humble moorings, TMC has grown to an institution of high repute from an 80-bed hospital to a 700-bed hospital. TMC held a number of pioneering efforts, which included bone marrow transplantation, external beam radiotherapy (linear accelerator), tumor tissue bank and bio-imaging to name a few. The management team of TMC had ensured that the growth had been orderly and appropriate to the changing needs of the community. Managing a hospital with disparate skill sets in the face of ever-increasing demand for services had always been a challenge in itself. As a government-run facility and well funded by the trust, TMC offered excellent services and post-operative care to the patients. So, it became imperative for the hospital to adopt technology to improve its hospital services and maintain transparency. Patients came to the hospital from different states in India and across the globe. TMC registered international and national patients online. Online medical reports were checked before the patients visited the hospital. TMC has developed an e-system that will allow patients around the world to send their tissue samples that are suspected to be cancerous for medical advice to the hospital. This case study is developed to provide insights into the transformation of TMC into an e-health-care service and explains the process of change management.

Expected learning outcomes

They are to provide insights into the challenges in health-care management, to illustrate the challenges faced by organization in implementing information and communication technology- managing change and to bring about best practices in the case organization and find solutions to the following questions: What are challenges faced by health-care officials in providing health care using new technological innovations? How can hospitals equip themselves with new technology? With the advent of improved and modern communication methods, medical practices and cases are more easily shared. Cases are discussed, recorded and, in many cases, put up for general public viewing through the electronic media. How can hospitals manage change? How can hospital administrators manage speed of delivery, quality healthcare, innovation and brand image?

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:11 Strategy.
Dissuasion: the Elaboration Likelihood Model and young children
Authors: McAlister Anna R. , Bargh Danielle
Published: September 2016

Purpose

The Elaboration Likelihood Model (ELM) proposes two routes to persuasion – the central route (persuasion occurs via information) and the peripheral route (persuasion occurs via visual cues, attractive actors and other source characteristics). The central route is typically used for high-involvement decisions and the peripheral route is used in low involvement situations. The ELM has received extensive support when tested with adults; however, its ability to explain young children’s responses to persuasive communications has not been fully tested. Hence, the purpose of this research is to assess whether the standard tenets of the ELM apply to children’s processing of persuasive messages.

Design/methodology/approach

This study involved 84 preschool children, ages three to six. It used a 2 (involvement) × 2 (argument strength) × 2 (source attractiveness) design to test children’s responsiveness to advertisements for a novel breakfast cereal.

Findings

The findings suggest that children are naturally inclined to be persuaded by advertising messages, regardless of their level of involvement. It is the weak arguments and weak peripheral cues that dissuade children who are highly involved with a message.

Originality/value

This research makes an original contribution to the existing literature by testing the extent to which the ELM applies to children’s processing of persuasive advertisements. The finding that weak peripherals dissuade children from believing an ad’s message has strong implications for advertising practitioners.
Up, close and intimate: qualitative inquiry into brand proximity amongst young adult consumers in emerging market
Authors: Gahlot Sarkar Juhi , Sarkar Abhigyan
Published: September 2016

Purpose

The purpose of this study was to explore possible types of brand proximity based on respective psychological causal antecedents, and also to uncover possible marking outcomes of brand proximity.

Design/methodology/approach

Data were collected from young adult respondents through semi-structured depth interviewing. The data were coded using a grounded theory method to interpret causal relationships between concepts.

Findings

Data coding resulted in a causal process model showing various psychological factors that would predict various brand proximity types, and also various attitudinal outcomes of brand proximity. Important emerging market context-specific findings are that the majority of Asian consumers feel emotionally close to developed foreign country originated brands, and that they use brands as a means to escape from various stress factors present in their daily lives.

Originality/value

A value of the study lies in exploring the contemporary types of psychological brand proximity and associated factors in the domain of consumer-brand relationship for the first time among Asian young adults.
Ungual hyalohyphomycosis caused by Fusarium proliferatum in an immunocompetent patient
Authors: Noguchi Hiromitsu , Hiruma Masataro , Matsumoto Tadahiko , Kano Rui , Ihn Hironobu
Published: September 2016

The patient was a 73‐year‐old healthy female farmer who had been treated with terbinafine for 25.5 months by a primary physician. She exhibited a discoloration and thickening of the right big toenail. She had no concomitant paronychia. Direct microscopy revealed chlamydoconidia and hyphae, and periodic acid‐Schiff stained nail specimen showed septate hyphae. On the basis of these morphological features and gene analysis, the final diagnosis was ungual hyalohyphomycosis caused by Fusarium proliferatum. Topical application of 10% efinaconazole solution cured the disease in 10 months.
Effects of landscape configuration and composition on phylogenetic diversity of trees in a highly fragmented tropical forest
Authors: Matos Fabio Antonio R. , Magnago Luiz Fernando S. , Gastauer Markus , Carreiras João M. B. , Simonelli Marcelo , Meira‐Neto João Augusto A. , Edwards David P.
Published: September 2016

Fragmentation of tropical forests is a major driver of the global extinction crisis. A key question is understanding how fragmentation impacts phylogenetic diversity, which summarizes the total evolutionary history shared across species within a community. Conserving phylogenetic diversity decreases the potential of losing unique ecological and phenotypic traits and plays important roles in maintaining ecosystem function and stability.

Our study was conducted in landscapes within the highly fragmented Brazilian Atlantic forest. We sampled living trees with d.b.h. ≥ 4.8 cm in 0.1 ha plots within 28 fragment interiors and 12 fragment edges to evaluate the impacts of landscape configuration, composition and patch size, as well as edge effects, on phylogenetic diversity indices (PD, a measure of phylogenetic richness; MPD, phylogenetic distance between individuals in a community in deep evolutionary time; and MNTD, phylogenetic distance between each individual and its nearest phylogenetic neighbour).

We found that PD and MPD were correlated with species richness, while MNTD was not. Best models suggest that MPD was positively related to edge density and negatively related to the number of forest patches, but that there was no effect of landscape configuration and composition metrics on PD or MNTD, or on standardized values of phylogenetic structure (sesPD, sesMPD and sesMNTD), which control for species richness. Considering all selected models for phylogenetic diversity and structure, edge density and number of forest patches were most frequently selected.

With increasing patch size, we found lower PD in interiors but no change at edges and lower sesMNTD regardless of habitat type. Additionally, PD and sesMNTD were higher in interiors than at edges.

Synthesis. Changes in MPD and sesMNTD suggest that extirpation of species at edges or in highly fragmented landscapes increases the dominance of species within a subset of clades (phylogenetic clustering), likely those adapted to disturbance. Smaller patch sizes are phylogenetically diverse and overdispersed, probably due to an invasion of edge‐adapted species. Conservation must enhance patch area and connectivity via forest restoration; pivotally, even small forest patches are important reservoirs of phylogenetic diversity in the highly threatened Brazilian Atlantic forest.
Arbitrage, uncertainty and the new ethos of capitalism
Authors: Mellor Philip A , Shilling Chris
Published: September 2016

This paper examines the arbitrageur as a figure who both embodies the new ethos of uncertainty central to ‘financialized’ capitalism, and exemplifies the issues of ethics and innovation raised by those who now personify what Weber called the ‘devotion to the calling of making money’. We begin by providing a brief background to financial ‘abstraction’ in the economy, and the issues of dissimulation with which this has been associated, before suggesting that engaging creatively with Weber’s writings can help us identify uncertainty as key to the character of contemporary financial decision-making. It is against this background that we analyse the arbitrageur as an ideal-type personality who embodies a newly abstract approach to capitalism. This approach is frequently portrayed as unethical, but we suggest it can be associated with an ethics of managing the unknown through an innovative commitment to overcoming limits that has consequences for human life in general.
Slow‐growth high‐mortality: A meta‐analysis for insects
Authors: Chen Ke‐Wei , Chen Yigen
Published: September 2016

The slow growth‐high mortality hypothesis (SG‐HG) predicts that slower growing herbivores suffer greater mortality due to a prolonged window of vulnerability. Given diverse plant–herbivore–natural enemy systems resulting from different feeding ecologies of herbivores and natural enemies, this hypothesis might not always be applicable to all systems. This is evidenced by mixed support from empirical data. In this study, a meta‐analysis of the SG‐HM hypothesis for insects was conducted, aiming to find conditions that favor or reject SG‐HM. The analysis revealed significant within‐ and between‐group heterogeneity for almost all explanatory variables and overall did not support SG‐HM. In this analysis, SG‐HM was supported when any of the following 5 conditions was met: (1) host food consisted of artificial diet; (2) herbivore growth was measured as larval mass; (3) herbivores were generalists; (4) no or multiple species of natural enemies were involved in the study; and (5) parasitoids (i.e., parasitic insects) involved in the study were gregarious. SG‐HM was rejected when any of the following 5 conditions was met: (1) herbivores were from the order Hymentoptera; (2) parasitoids from more than 1 order caused herbivore mortality; (2) parasitoids were specialists; (3) parasitoids were solitary; (4) parasitoids were idiobionts or koinobionts; and (5) single species of natural enemy caused mortality of specialist herbivores. All known studies investigated herbivore mortality for a short period of their life cycle. Researchers are encouraged to monitor herbivore mortality during the entire window of susceptibility or life cycle using life tables. Studies involving multiple mortality factors (i.e., both biotic and abiotic) or multiple natural enemy species are also encouraged since herbivores in nature face a multitude of risks during the entire life cycle. More comprehensive studies may increase our understanding of factors influencing the relationships between herbivore growth and mortality.
Barriers to insulin treatment among Australian Torres Strait Islanders with poorly controlled diabetes
Authors: Taylor Sean , Thompson Fintan , McDermott Robyn
Published: September 2016

Objective

To explore self reported knowledge and attitudes to insulin treatment among a group of adults with poorly controlled diabetes in the Torres Strait islands.

Design

Cross‐sectional survey in 2014, interviews with 29 adults with HbA1c ≥ 8.5% (69 mmol mol−1) and not taking insulin, using Insulin Treatment Appraisal Scale (ITAS) and Barriers to Insulin Treatment Questionnaire (BITQ) scores.

Setting

Five remote Torres Strait Island communities in the Torres Strait region.

Participants

Poorly controlled insulin‐naïve type 2 diabetics.

Main outcome measures

BITQ and ITAS scores on items related to knowledge and attitudes to insulin treatment, clinical and demographic measures.

Results

Overall, 34% of the cohort had poor glycaemic control. Compared to those with HbA1c ≥ 8.5% and taking insulin (n = 37), the 29 insulin‐naïve participants were more obese, more likely to smoke and drink alcohol, have lower mean HbA1c and fewer years with diabetes. Among the insulin‐naïve group, those reporting higher ‘barriers’ (BITQ scores) were older and with lower formal education than those reporting fewer barriers. Torres participants consistently scored low on ‘knowledge’ items in the ITAS, especially those which would guide insulin initiation (insulin improves glucose control and prevents complications).

Conclusion

Compared to other published studies, the Torres participants had higher scores for BITQ ‘barrier’ items and lower ‘knowledge’ scores. This suggests better education around glycaemic control with medication and discussion of perceptions and exchange of experiences with peers who are taking insulin might improve the uptake of insulin in this high‐risk group.
Dignity, Wisdom, and Tomorrow's Ethical Business Leader
Authors: Hicks Donna , Waddock Sandra
Published: September 2016

This article examines the role wisdom and dignity play in developing ethical business leaders, or what we call shamanic leaders, for the twenty‐first century. We define wisdom as the integration of moral imagination (the good), systems understanding (the true), and aesthetic sensibility (the beautiful) into decisions, actions, and practices in the service of a better world. Dignity is our inherent value, worth, and vulnerability, a core aspect of humanity that each of us is born with. The challenges of developing shamanic leaders, i.e., individuals who evidence the shamanic attributes of healing, connecting, and sensemaking, are discussed, including how to think about and embody wisdom, and the learning that is required to understand and lead with dignity. We argue that dignity and wisdom can be learned and provide the reader with insights into what is required to promote an inclusive and integrated culture where human flourishing and well‐being are at the core of ethical leadership.
A rapid, inexpensive and disposable point‐of‐care blood test for sickle cell disease using novel, highly specific monoclonal antibodies
Authors: Quinn Charles T. , Paniagua Mary C. , DiNello Robert K. , Panchal Anand , Geisberg Mark
Published: September 2016

Sickle cell disease (SCD) is a significant healthcare burden worldwide, but most affected individuals reside in low‐resource areas where access to diagnostic testing may be limited. We developed and validated a rapid, inexpensive, disposable diagnostic test, the HemoTypeSC™, based on novel monoclonal antibodies (MAbs) that differentiate normal adult haemoglobin (Hb A), sickle haemoglobin (Hb S) and haemoglobin C (Hb C). In competitive enzyme‐linked immunosorbent assays, each MAb bound only its target with <0·1% cross‐reactivity. With the HemoTypeSC™ test procedure, the sensitivity for each variant was <5·0 g/l. The accuracy of HemoTypeSC™ was evaluated on 100 whole blood samples from individuals with common relevant haemoglobin phenotypes, including normal (Hb AA, N = 20), carrier or trait (Hb AS, N = 22; Hb AC, N = 20), SCD (Hb SS, N = 22; Hb SC, N = 13), and Hb C disease (Hb CC, N = 3). The correct haemoglobin phenotype was identified in 100% of these samples. The accuracy of the test was not affected by Hb F (0–94·8% of total Hb) or Hb A2 (0–5·6% of total Hb). HemoTypeSC™ requires <1 μl of whole blood and no instruments or power sources. The total time‐to‐result is <20 min. HemoTypeSC™ may be a practical solution for point‐of‐care testing for SCD and carrier status in low‐resource settings.
Autologous stem cell‐based therapy for sickle cell leg ulcer: a pilot study
Authors: Meneses José Válber L. , Fortuna Vitor , de Souza Eliane Silva , Daltro Gildasio Cerqueira , Meyer Roberto , Minniti Caterina P. , Borojevic Radovan
Published: September 2016

Recurrent chronic leg ulcers are among the most severe vasculopathic complications of sickle cell disease (SCD). Their treatment remains a challenge. Stem cell therapy with bone marrow mononuclear cells (BMMC) is a promising new therapeutic option for other forms of chronic ulcers. This prospective pilot study was performed to evaluate safety and feasibility of BMMC implantation in patients with SCD and chronic leg ulcers (SCLU). Ulcer closure, recurrence and local pain were evaluated. BMMC were successfully administered to 23 SCLU patients and no serious adverse events occurred. During the 6‐month follow‐up period, 91·3% of patients had improved ulcer pain compared with baseline and 29·2% of the treated ulcers achieved total healing. The frequency of progenitor stem cells (CD34CD45low and fibroblast colony‐forming units) in BMMC was found to be significantly reduced in SCLU patients and compared to SCD patients without ulcers (P < 0·004 and P < 0·01, respectively). No relationship was observed between treatment outcome and the number of implanted BM progenitor stem cells. In conclusion, BMMC implantation is a feasible and safe procedure, showing favourable outcomes for the treatment of SCLU, and encouraging further controlled clinical trials.
Conservation implications of anthropogenic impacts on visual communication and camouflage
Authors: Delhey Kaspar , Peters Anne
Published: September 2016

Anthropogenic environmental impacts can disrupt the sensory environment of animals and affect important processes from mate choice to predator avoidance. Currently, these effects are best understood for auditory and chemosensory modalities, and recent reviews highlight their importance for conservation. We examined how anthropogenic changes to the visual environment (ambient light, transmission, and backgrounds) affect visual communication and camouflage and considered the implications of these effects for conservation. Human changes to the visual environment can increase predation risk by affecting camouflage effectiveness, lead to maladaptive patterns of mate choice, and disrupt mutualistic interactions between pollinators and plants. Implications for conservation are particularly evident for disrupted camouflage due to its tight links with survival. The conservation importance of impaired visual communication is less documented. The effects of anthropogenic changes on visual communication and camouflage may be severe when they affect critical processes such as pollination or species recognition. However, when impaired mate choice does not lead to hybridization, the conservation consequences are less clear. We suggest that the demographic effects of human impacts on visual communication and camouflage will be particularly strong when human‐induced modifications to the visual environment are evolutionarily novel (i.e., very different from natural variation); affected species and populations have low levels of intraspecific (genotypic and phenotypic) variation and behavioral, sensory, or physiological plasticity; and the processes affected are directly related to survival (camouflage), species recognition, or number of offspring produced, rather than offspring quality or attractiveness. Our findings suggest that anthropogenic effects on the visual environment may be of similar importance relative to conservation as anthropogenic effects on other sensory modalities.
The accuracy of preoperative imaging in measuring the length of the ileocolic segment affected by Crohn's disease: a prospective cohort study
Authors: Brouquet A. , Rangheard A.‐S. , Ifergan J. , Lazure T. , Carbonnel F. , Penna C. , Benoist S.
Published: September 2016

Aim

The study aimed to evaluate the accuracy of imaging for measurement of the length of the ileocolic segment affected by Crohn's disease.

Method

Fifty‐four consecutive patients who underwent resection between 2011 and 2014 for ileocolic Crohn's disease were prospectively studied. All had preoperative MR or CT enterography. Two independent radiologists measured the length of the diseased intestinal segment. The measurements were compared with the length of disease assessed on pathology of the non‐fixed surgical specimen.

Results

The median preoperative length of the Crohn's disease segment on imaging was 20.5 (2–73) cm and 20 (3–90) cm, as measured by the two radiologists. Interobserver agreement was substantial (κ = 0.69) with a correlation coefficient (r) of 0.82 (P < 0.001). The median length of the Crohn's disease segment on pathological examination was 16.5 (2–75) cm and was closely correlated with the radiological measurement (r = 0.76, P < 0.001). The length of the Crohn's disease segment on imaging was correct to within 5 cm of the value on pathology. It was correct in 30 (55%) patients and was underestimated and overestimated in 6 (11.1%) and 18 (33.3%). A length of disease of less than 20 cm found on imaging in 26 patients was confirmed in 25 (96%) on pathology, whereas a length of more than 20 cm found on imaging in 28 patients was confirmed in 18 (64%) on pathology. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of imaging for predicting a length of less than 20 cm were 71%, 95%, 96%, 64% and 79%.

Conclusion

Imaging accurately identifies the length of the ileocolic segment of Crohn's disease when it is 20 cm or less on pathological examination. In patients with more extensive disease, imaging tends to overestimate the length and should be interpreted with caution.
Acute pulmonary thromboembolism in emergency room: gray‐scale versus color doppler ultrasound evaluation
Authors: Ghanem Maha Kamel , Makhlouf Hoda Ahmed , Hasan Ali Abdel‐Azeem , Alkarn Ahmed Atef
Published: September 2016

Background

Pulmonary thromboembolism (PTE) remains under‐diagnosed fatal disease at emergency units suggesting the need for alternative, easy, and noninvasive bedside diagnostic approaches.

Objectives

To determine the diagnostic role of gray‐scale and color Doppler transthoracic ultrasonography (TUS) in patients with PTE.

Patients and Methods

Blinded to 64 multi‐detectors CT pulmonary angiography (MDCTPA) examination as a gold standard, 60 patients with clinically suspected PTE underwent gray‐scale and then color Doppler TUS examination. Results were compared and diagnostic accuracy of TUS was assessed.

Results

Forty patients proved to have PTE by MDCTPA. TUS showed typical lesions in 33 patients with the mean of 2 lesions per patient. Most lesions were hypoechoic, wedge‐ shaped, and pleural‐ based and the majority (80%) was located in the lower lobes. Consolidation with little perfusion was detected by Color Doppler ultrasound in 97% of lesions. Isolated central PTE was significantly higher in TUS negative patients. For gray –scale TUS, sensitivity, specificity, positive and negative predictive values and accuracy were 82%, 90%, 94%, 72%, and 85%. Meanwhile the sensitivity, specificity, positive and negative predictive values and accuracy of color Doppler TUS were 80%, 95%, 97%, 70% and 87%, respectively.

Conclusion

TUS is a reliable diagnostic bedside test for PTE in critically ill and immobile patients. Adding color Doppler to gray–scale TUS increases the specificity and accuracy and consequently the confidence in the diagnosis of peripheral pulmonary infarctions and differentiates them from other pulmonary lesions that allow initiation of anticoagulants.
Study on small airway function in asthmatics with fractional exhaled nitric oxide and impulse oscillometry
Authors: Liu Lin , Liu Wen , Liu Chunhong , Wang Dexiang , Zhao Jiping , Wang Junfei , Wu Jinxiang , Liu Tian , Zhang Yuanyuan , Liu Yahui , Cao Liuzhao , Dong Liang
Published: September 2016

Objectives

The invasive techniques can be direct and objective to assess small airway function, but they have significant risks and inconveniences for patients and cannot be repeated often. Some sophisticated techniques such as fractional exhaled nitric oxide (FeNO) and impulse oscillometry (IOS) may surmount such restrictions. Therefore, we investigated the relation among FeNO, IOS, and small airway function in asthmatic patients.

Methods

We recruited 140 asthmatic patients including 69 patients with small airway normal function and 71 patients with small airway dysfunction. FeNO, eosinophil（EOS）count and total immunoglobulin E (IgE) in peripheral blood, pulmonary function, as well as IOS were measured.

Results

The levels of FeNO, the reactance area (AX), the resonant frequency Fres and EOS were significantly increased in small airway dysfunction group compared with small airway normal function group (P < 0.01 respectively). A multiple regression model showed that FeNO, AX and Fres were correlative factors of mid forced expiratory flow of percentages of predicted values [FEF25–75 (%pred)] (P < 0.01, respectively). A receiver operating characteristic (ROC) analysis showed that the combination of FeNO, AX and Fres had a greater area under the ROC curve (AUC) than each of them (AUC: 0.881, P < .001, 95％CI: 0.815‐0.929).

Conclusion

FeNO and IOS are helpful in diagnosis of small airway dysfunction with high sensitivity and specificity, and FeNO combined with IOS can better evaluate the small airway function in asthmatic patients.
Erhöhtes Lungenkrebs‐Risiko bei Ekzempatienten: eine landesweite Kohortenstudie in Taiwan
Authors: Juan Chao‐Kuei , Shen Jui‐Lung , Lin Cheng‐Li , Kim Karen Wang , Chen Wen‐Chi
Published: September 2016

Hintergrund

Der Zusammenhang zwischen Lungenkrebs und Ekzemen bleibt umstritten. Frühere Studien haben zu widersprüchlichen Ergebnissen geführt. Diese retrospektive populationsbasierte Kohortenstudie zielt darauf ab, das Risiko von Lungenkrebs im Zusammenhang mit Ekzemen abzuklären.

Patienten und Methoden

In der Forschungsdatenbank der taiwanesischen nationalen Krankenversicherung identifizierten wir 43719 Patienten, bei denen in den Jahren 2000 bis 2010 ein Ekzem neu diagnostiziert wurde. Die Vergleichskohorte bildeten 87438 zufällig ausgewählte, altersangepasste Patienten ohne Ekzem. Die Fälle aus diesen beiden Kohorten wurden bis 2011 verfolgt. Zur Kalkulation des Lungenkrebsrisikos bei Ekzempatienten wurde die Cox‐Regression verwendet. Die Datenbank enthielt keine Informationen über Raucherstatus, Alkoholkonsum, sozioökonomischen Status oder Familienanamnese.

Ergebnisse

Nach der Bereinigung um Alter und Komorbidität hatte die Population mit Ekzemen ein um 2,80 erhöhtes Risiko für die Entwicklung von Lungenkrebs gegenüber der Vergleichskohorte (bereinigte Hazard‐Ratio 2,80, 95 % Konfidenzinterval 2,59–3,03). Ekzempatienten mit Begleiterkrankungen, darunter Asthma, chronisch obstruktive Lungenerkrankungen, alkoholbedingten Leberschäden oder Diabetes, hatten ein höheres Lungenkrebsrisiko als Patienten ohne Ekzeme oder Komorbidität.

Schlussfolgerungen

Ekzeme gehen mit einem höheren Risiko für die Entwicklung von Lungenkrebs einher. Weitere Studien mit umfassenderen Informationen über weitere potentielle Einflussfaktoren sind sinnvoll.
Mitotic rate in primary melanoma: interobserver and intraobserver reliability, analyzed using H&E sections and immunohistochemistry
Authors: Garbe Claus , Eigentler Thomas K. , Bauer Jürgen , Blödorn‐Schlicht Norbert , Cerroni Lorenzo , Fend Falko , Hantschke Markus , Kurschat Peter , Kutzner Heinz , Metze Dieter , Mielke Volker , Preßler Harald , Reusch Michael , Reusch Ursula , Stadler Rudolf , Tronnier Michael , Yazdi Amir , Metzler Gisela
Published: September 2016

Background

In 2009, the AJCC issued a revised melanoma staging system. In addition to tumor thickness and ulceration, the mitotic rate was introduced as the third major prognostic parameter for the classification of primary cutaneous melanoma. Given that, according to the 2009 AJCC classification, the detection of one or more dermal tumor mitoses leads to an upstaging – from stage Ia to Ib – of melanomas with a tumor thickness of ≤ 1.0 mm, we set out to investigate the reproducibility of this new parameter.

Methods

In order to assess interobserver reliability, 17 dermatopathologists und pathologists – all well versed in the diagnosis of cutaneous melanoma – analyzed the mitotic rate in 15 thin primary cutaneous melanomas (mean tumor thickness 0.91 mm) using identical slides. Mitotic rates were determined on H&E and phosphohistone H3 (Ser10)‐stained samples. Without knowledge of their previous assessment, five of the aforementioned examiners reevaluated the samples after more than one year in order to ascertain intraobserver reliability.

Results

Interobserver reliability of the mitotic rate in thin primary melanomas is disappointing and independent of whether H&E or immunohistochemically stained samples are used (kappa value: 0.088 [H&E], 0.154 [IH], respectively). Kappa values improved to 0.345 (H&E) and 0.403 (IH) when using a cutoff of 0/1 vs. 2+ mitoses. Similarly unsatisfactory, kappa values for intraobserver reliability ranged from 0.18 and 0.348, depending on the individual examiner.

Discussion

Given the unsatisfactory reproducibility and large variations in assessing the mitotic rate, it remains a matter of debate whether this diagnostic parameter should play a role in therapeutic decisions.
Therapeutic management of cutaneous and genital warts
Authors: Ockenfels Hans Michael
Published: September 2016

During their lifetime, at least 10 % of the population will be infected by human papillomaviruses (HPV), clinically characterized by the formation of cutaneous or genital warts. Although warts are ubiquitous, there are no defined treatments. Especially in the first six months, warts frequently resolve without therapeutic intervention. This complicates the interpretation of study data, given that many studies do not differentiate between newly infected patients and those with infections that have persisted for a long time. Similarly, most studies do not take location, size, and thickness of lesions into account, either. The objective of the present review article is to analyze the study data currently available, taking into consideration both subtypes and locations – factors exceedingly crucial in clinical practice. In particular, the distinction between new‐onset and chronic recalcitrant warts is reflected in a therapeutic algorithm. In the case of genital warts, the algorithm is more clearly determined by the extent of the area affected rather than the longevity of lesions. In immunocompetent individuals, any therapeutic intervention must be aimed at achieving complete resolution.
Therapeutisches Management kutaner und genitaler Warzen
Authors: Ockenfels Hans Michael
Published: September 2016

Mindestens 10 % der Bevölkerung erkranken während ihres Lebens an einer Infektion mit humanen Papillomaviren (HPV), welche sich klinisch anhand der Ausbildung kutaner oder genitaler Warzen manifestiert. Obwohl Warzen ubiquitär sind, existieren keine definierten Behandlungen. Warzen zeigen, insbesondere in den ersten sechs Monaten, eine erhöhte Selbstheilungsrate. Dieser Umstand erschwert die Interpretation von Studien, da häufig Patienten mit Neuinfektionen zusammen mit Patienten mit Altinfektionen behandelt werden. Lokalisationen, Größe und Dicke der Warzen sind ebenfalls in den meisten Fällen nicht berücksichtigt. Ziel dieses Übersichtsartikels ist eine Analyse des vorliegenden Studienmaterials, unter der für den klinischen Alltag so wichtigen Berücksichtigung von Subtypen und Lokalisationen. Insbesondere die Abgrenzung zwischen frischen und chronisch‐therapieresistenten Verrucae vulgares spiegelt sich in einem Therapiealgorithmus wider. Bei genitalen Warzen wird der Therapiealgorithmus deutlicher durch das Ausmaß der infizierten Fläche als durch das Alter der Warzen bestimmt. Bei immunkompetenten Personen muss es mit den hier aufgezeigten therapeutischen Methoden immer das Ziel sein, eine komplette Abheilung zu erzielen.