bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring consumers’ attitude towards relationship marketing
Authors: Jones Michael A , Reynolds Kristy E , Arnold Mark J , Gabler Colin B , Gillison Stephanie T , Landers Vincent Myles
Published: April 2015

Purpose

– The purpose of this study is to explore consumers’ overall attitude toward relationship marketing and to determine the influence of consumers’ overall attitude on consumers’ intentions and behaviors. Many services companies practice relationship marketing and customer relationship management. Although the benefits and drawbacks of relationship marketing for consumers have been established, little is known about whether consumers have a relatively positive or negative attitude toward relationship marketing practices.

Design/methodology/approach

– This research investigates consumers’ attitudes toward relationship marketing using a national survey of 245 consumers and a survey of 417 consumers living in the southern region of the USA.

Findings

– Although approximately 70 per cent of our national consumer sample had a somewhat positive attitude toward relationship marketing, about 30 per cent had a somewhat negative or neutral attitude. Furthermore, approximately 39 per cent of consumers in the study would choose a company that does not engage in relationship marketing over a company that does. The results also indicate that consumers’ overall attitude toward relationship marketing impacts their likelihood to respond favorably to specific relationship marketing tactics.

Research limitations/implications

– Some limitations should be noted. First and not uncommon to most survey research in marketing, the relationships between constructs in this study may be inflated because of common methods bias. Second, this research reports the results from two studies. Although one of the studies represents a national sample, additional research using the scales developed in this research is needed.

Practical implications

– This research indicates that consumers’ attitudes toward relationship marketing impacts their willingness to engage in relationships with service companies and their response to specific relationship marketing tactics. Because consumer attitudes toward relationship marketing vary, companies should consider segmenting their customer base using this information.

Originality/value

– This study extends previous research by using quantitative techniques to measure consumers’ overall attitudes toward relationship marketing and assessing the influence of those attitudes on intentions and behaviors.
Measuring client-based corporate reputation in B2B professional services: scale development and validation
Authors: Walsh Gianfranco , Beatty Sharon E , Holloway Betsy Bugg
Published: April 2015

Purpose

– The purpose of this paper is to develop and validate a client-based reputation of business-to-business professional services firms scale (PSF-Rep) which measures clients’ perceptions of the reputation of professional service provider firms. So far, no multidimensional scale exists in the literature to measure the reputation of professional service firms, although the reputation dimensions of importance are likely to be very different from other settings.

Design/methodology/approach

– From an initial pool of fieldwork-based items, an 18-item PSF-Rep scale is developed, which is validated using several samples – corporate financial decision-makers’ views of their accounting firms in a US national sample and organizational clients of one large legal firm with national presence.

Findings

– The four-dimensional PSF-Rep scale meets all established reliability and validity criteria. Further, reputation and its dimensions (using PSF-Rep) are positively associated with important marketing outcomes, including word of mouth, loyalty intentions, trust and share of wallet.

Originality/value

– As professional service markets become more competitive, firms recognize the importance of a good reputation in attracting customers. This research is the first to propose a psychometrically robust measure to capture client-based reputation of business-to-business professional services firms.
Shari’ah supervision in the Yemeni Islamic banks: a qualitative survey
Authors: Ayedh Abdullah Mohammed , Echchabi Abdelghani
Published: April 2015

Purpose

– The purpose of this study is mainly to comprehensively investigate the current practices of Islamic banks’ Shari’ah supervisory boards in the specific context of Yemen.

Design/methodology/approach

– The study uses a qualitative approach in the form of in-depth interviews of a number of Shari’ah scholars active within the Yemeni Islamic banks.

Findings

– The findings support the notion that Islamic banking still lacks regulations and standards, as the Yemeni Islamic banks are still following the minimum requirements and only apply the compulsory standards. Another key finding is that Islamic banks in Yemen apply similar principles in Fatwa issuance and Shari’ah compliance assurance, especially in referring to the different Madzhabs’ and scholars’ opinions because of the sensitivity of Yemeni community with regards to the Shari’ah compliance aspect. Finally, the procedure of Shari’ah review of the Islamic banks’ operations varied from the typical set of procedures to the loose ones in terms of the number of staff in the Shari’ah audit department and the application of a comprehensive survey or sampling to review the banks’ transactions.

Originality/value

– This study provides some valuable recommendations to further enhance the Shari’ah supervisory practices not only in Yemen but also in similar settings.
Compliance with AAOIFI guidelines in general presentation and disclosure by Libyan Islamic banks
Authors: Ahmad Nassr Saleh Mohamad , Daw Abdu Samia Daw Ben
Published: April 2015

Purpose

– The purpose of this paper is to reveal the level of compliance with Accounting and Auditing Organisation for Islamic Financial Institutions (AAOIFI) guidelines in general presentation and disclosure in the financial statements of Fashlowm Islamic branch of the Gumhouria Bank as the biggest bank in Libya.

Design/methodology/approach

– The study used two-dimensional analysis, which combines a questionnaire with content analysis. It allowed a better understanding of the picture than would have been provided by the questionnaire alone.

Findings

– The results of this study indicate that the level of compliance with AAOIFI guidelines regarding general presentation and disclosure in the financial statements is low. Many reasons were identified as being behind such a low level. The lack of training programmes on AAOIFI standards was at the forefront of these reasons.

Research limitations/implications

– The sample is limited to the Fashlowm Islamic branch of Gumhouria Bank. This is may not be true for other branches and banks. Further research is needed in this area.

Originality/value

– The AAOIFI has existed for over 20 years, but little empirical research has been conducted into compliance with the standards developed by this body in the Libyan context. This paper helps to address this gap and provide a foundation for future research and development in this area. Moreover, the findings of this study may be useful to policy makers and legislators.
Driving local community transformation through participatory rural entrepreneurship development
Authors: Kolawole Oluwatoyin Dare , Ajila Kehinde
Published: April 2015

Purpose

– Rural entrepreneurship development and employment generation are fundamental to enhancing local-level progress and transformation. Achieving gainful employment in rural communities contributes immensely to the realisation of the potential of people living in remote communities. The purpose of this paper is to present a ten-stage practical approach for enhancing rural entrepreneurship development as a major driver of local community transformation and development.

Design/methodology/approach

– The action research was preceded by a preliminary study, which identified some crucial factors associated with the success of rural entrepreneurial activities in rural Lagos, Nigeria. The research, which is an offshoot of the earlier field survey, was designed to engage viable community-based organisations (CBOs) in Ikorodu, Epe, Badagry and Lekki communities for the implementation of context-specific rural entrepreneurship development projects through the provision of “non-serviceable” revolving loans.

Findings

– Successful funded rural entrepreneurs and CBOs served as veritable models for driving entrepreneurship development and employment promotion in rural Lagos, Nigeria. Projects funded included artisanal fisheries, barbering salons, piggeries and snail production.

Practical implications

– The projects which generated employment opportunities for rural youths and other able-bodied community members serve as a strategy for lifting people out of poverty. The action research was designed to inform rural development policy in Nigeria and other similar economies in the south.

Originality/value

– The study outlines a step-by-step process of entrepreneurship development project implementation.
Herbivore cross‐scale redundancy supports response diversity and promotes coral reef resilience
Authors: Nash Kirsty L. , Graham Nicholas A. J. , Jennings Simon , Wilson Shaun K. , Bellwood David R.
Published: April 2015

Functional redundancy contributes to resilience if different species in the same functional group respond to disturbance in different ways (response diversity). If species in a functional group perform their functional role at different spatial scales (cross‐scale redundancy), they are expected to respond differently to scale‐specific disturbance. Consequently, variance in the spatial scales over which species perform their functional role may provide a proxy for resilience.

Coral reefs are diverse systems that provide key ecosystem services and are subject to increasing anthropogenic disturbances. Algal grazing by herbivorous fish contributes to the maintenance of coral‐dominated reefs. To date, there has been little evaluation of the traits driving response diversity among herbivorous fish and how this relates to coral recovery following acute disturbances.

Using body size as a proxy for the spatial scale at which fish function, we tested whether cross‐scale redundancy in herbivores was an effective indicator of response diversity and coral recovery on 21 reefs monitored through a climate‐induced disturbance that caused coral bleaching and widespread coral mortality.

When herbivorous fish assemblages that operated over a broader range of spatial scales were present on reefs prior to disturbance, the reefs were more likely to recover to coral‐dominated states after the disturbance. After the temperature‐induced disturbance, the loss of small herbivores was compensated for through increases in large herbivores. This was indicative of high response diversity and drove the overall increase in herbivore biomass at recovering sites. These compensatory mechanisms were not found at sites where herbivores operated over a narrower range of spatial scales.

Synthesis and applications. Cross‐scale redundancy provides managers with an indicator of coral reef resilience, although the contribution of cross‐scale redundancy to resilience will vary among sites. Maintaining high cross‐scale redundancy at a given site requires that no size classes of reef herbivores are disproportionately depleted by fishing. Balanced harvesting, where species are all fished in proportion to their potential production, would help achieve this.
Fuels and fires influence vegetation via above‐ and belowground pathways in a high‐diversity plant community
Authors: Gagnon Paul R. , Passmore Heather A. , Slocum Matthew , Myers Jonathan A. , Harms Kyle E. , Platt William J. , Paine C. E. Timothy
Published: April 2015

Fire strongly influences plant populations and communities around the world, making it an important agent of plant evolution. Fire influences vegetation through multiple pathways, both above‐ and belowground. Few studies have yet attempted to tie these pathways together in a mechanistic way through soil heating even though the importance of soil heating for plants in fire‐prone ecosystems is increasingly recognized.

Here we combine an experimental approach with structural equation modelling (SEM) to simultaneously examine multiple pathways through which fire might influence herbaceous vegetation. In a high‐diversity longleaf pine groundcover community inLouisiana,USA, we manipulated fine‐fuel biomass and monitored the resulting fires with high‐resolution thermocouples placed in vertical profile above‐ and belowground.

We predicted that vegetation response to burning would be inversely related to fuel load owing to relationships among fuels, fire temperature, duration and soil heating.

We found that fuel manipulations altered fire properties and vegetation responses, of which soil heating proved to be a highly accurate predictor. Fire duration acting through soil heating was important for vegetation response in ourSEMs, whereas fire temperature was not.

Our results indicate that in this herbaceous plant community, fire duration is a good predictor of soil heating and therefore of vegetation response to fire. Soil heating may be the key determinant of vegetation response to fire in ecosystems wherein plants persist by resprouting or reseeding from soil‐stored propagules.

Synthesis. OurSEMs demonstrate how the complex pathways through which fires influence plant community structure and dynamics can be examined simultaneously. Comparative studies of these pathways across different communities will provide important insights into the ecology, evolution and conservation of fire‐prone ecosystems.
Selective blockade of mGlu5 metabotropic glutamate receptors is protective against hepatic mitochondrial dysfunction in 6‐OHDA lesioned Parkinsonian rats
Authors: Ferrigno Andrea , Vairetti Mariapia , Ambrosi Giulia , Rizzo Vittoria , Richelmi Plinio , Blandini Fabio , Fuzzati‐Armentero Marie‐Therese
Published: April 2015

Non‐motor symptoms including those involving the splanchnic district are present in Parkinson's disease (PD). The authors previously reported that PD‐like rats, bearing a lesion of the nigrostriatal pathway induced by the injection of 6‐hydroxydopamine (6‐OHDA), have impaired hepatic mitochondrial function. Glutamate intervenes at multiple levels in PD and liver pathophysiologies. The metabotropic glutamate receptor 5 (mGluR5) is abundantly expressed in brain and liver and may represent a pharmacological target for PD therapy. This study investigated whether and how chronic treatment with 2‐methyl‐6‐(phenylethynyl)‐pyridine (MPEP), a well‐characterized mGluR5 antagonist, may influence hepatic function with regard to neuronal cell loss in PD‐like rats. Chronic treatment with MPEP was started immediately (Early) or 4 weeks after (Delayed) intrastriatal injection of 6‐OHDA and lasted 4 weeks. Early MPEP treatment significantly prevented the decrease in adenosine triphosphate (ATP) production/content and counteracted increased reactive oxygen species (ROS) formation in isolated hepatic mitochondria of PD‐like animals. Early MPEP administration also reduced the toxin‐induced neurodegenerative process; improved survival of nigral dopaminergic neurons correlated with enhanced mitochondrial ATP content and production. ATP content/production, in turn, negatively correlated with ROS formation suggesting that the MPEP‐dependent improvement in hepatic function positively influenced neuronal cell survival. Delayed MPEP treatment had no effect on hepatic mitochondrial function and neuronal cell loss. Antagonizing mGluR5 may synergistically act against neuronal cell loss and PD‐related hepatic mitochondrial alterations and may represent an interesting alternative to non‐dopaminergic therapeutic strategies for the treatment of PD.
Pubertal administration of antiserum against nerve growth factor regresses renal vascular remodeling in spontaneously hypertensive rats
Authors: Ohara Maiko , Tomoda Fumihiro , Koike Tsutomu , Liu Hexing , Uno Kyosuke , Nitta Atsumi , Inoue Hiroshi
Published: April 2015

To investigate the role of nerve growth factor (NGF) in the development of hypertensive renal vascular remodeling, antiserum against NGF (anti‐NGF) or vehicle was injected at 3 weeks of age in spontaneously hypertensive rats (SHR) and Wistar–Kyoto (WKY) rats (n = 9 for each treatment in each strain). Flow‐pressure (F‐P) and pressure‐glomerular filtration rate (P‐GFR) relationships at vasodilated perfused kidneys were determined at 10 weeks of age. In the vehicle rats, blood pressure, renal noradrenaline content, the gradient of F‐P (minimal vascular resistance at pre‐ and post‐glomerular vasculature) and the X‐intercept of P‐GFR (preglomerular : postglomerular vascular resistance ratio) were greater in SHR than in WKY rats, although the gradient of P‐GFR (glomerular filtration capacity) did not differ significantly between the strains. Blood pressure and renal noradrenaline content were lower in SHR receiving anti‐NGF than in SHR receiving vehicle, although such difference was not observed in WKY rats. The gradient of F‐P was less but the gradient of P‐GFR was greater in SHR receiving anti‐NGF compared with SHR receiving vehicle, although the similar differences did not occur in WKY rats. Blood pressure and renal noradrenaline content remained greater in SHR treated with anti‐NGF compared with WKY rats treated with vehicle; however, the gradient of F‐P did not differ significantly between them. Contrary, anti‐NGF did not affect the X‐intercept of P‐GFR in either strain. In conclusion, NGF could contribute to the genesis of renal vascular remodeling, at least in part, through modification of renal sympathetic activity and blood pressure in SHR.
Decomposing Inequality Changes: Allowing for Leisure in the Evaluation of Tax and Transfer Policy Effects
Authors: Creedy John , Hérault Nicolas
Published: April 2015

In this paper, we present two alternative methods of accounting for changes in leisure time in decomposing the inequality effects of tax and transfer policy changes. Three components are identified: tax policy, labour supply responses to tax policy changes and other population effects. The methods are used to decompose inequality changes in Australia between 2001 and 2006. Inequality is first defined in non‐welfarist terms as a function of disposable income: the independent judge places no value on leisure. Then, this is modified to allow for evaluations using a weighted geometric mean of disposable income and leisure. This is seen to modify the evaluation of changes in important ways. The results are found to differ from those obtained using a ‘welfarist’ evaluation in terms of money metric utility, where separate labour supply effects cannot be isolated.
Egg clutch patterning in Lestes virens (Odonata, Lestidae) with evolutionary emphasis on endophytic oviposition in lestid dragonflies
Authors: Matushkina Natalia A. , Buy Denis , Lambret Philippe
Published: April 2015

Egg deposition within plants is one of the most widely distributed and ancient behaviors in Odonata. The resulting clutch consists of eggs placed in peculiar pattern that can be a characteristic for certain groups of Odonata. Despite their importance for paleontological and evolutionary research, data on egg‐clutch positioning are missing or insufficient for most species. Here, patterning of egg clutches in Lestes virens was measured and described in detail for the first time. The female usually produces a linear row of single eggs directed at an angle rightward or leftward to the longitudinal axis of plant substrate. Less often eggs are arranged in egg‐sets consisting of up to 4 eggs. Apparently, the female insect follows the rigid behavior stereotypes during oviposition and is unable to easily switch to the alternate stereotypical behavior of single egg deposition or production of multiegg sets. Based on a literature review and original data, egg clutch patterning of European Lestidae is overlaid on preexisting phylogenies. The resulting evolutionary scenario of egg‐clutch patterning can be considered in the framework of egg‐laying behavior in Lestidae.
Differential kinetics of response and toxicity using stereotactic radiation and interventional radiological coiling for pulmonary arterio‐venous shunting from metastatic leiomyosarcoma
Authors: Wong Annie Ngai Man , Siva Shankar , Manser Renee , Dowling Richard , Antippa Phillip , Chin Kwang , Mileshkin Linda Rose
Published: April 2015

Case report demonstrating the differential kinetics of response and toxicity using stereotactic radiation and interventional radiological coiling for pulmonary arterio‐venous shunting from leiomyosarcoma pulmonary metastases.
Interpreting the flock algorithm from a statistical perspective
Authors: Anderson Eric C. , Barry Patrick D.
Published: April 2015

We show that the algorithm in the program flock (Duchesne & Turgeon 2009) can be interpreted as an estimation procedure based on a model essentially identical to the structure (Pritchard et al. 2000) model with no admixture and without correlated allele frequency priors. Rather than using MCMC, the flock algorithm searches for the maximum a posteriori estimate of this structure model via a simulated annealing algorithm with a rapid cooling schedule (namely, the exponent on the objective function →∞). We demonstrate the similarities between the two programs in a two‐step approach. First, to enable rapid batch processing of many simulated data sets, we modified the source code of structure to use the flock algorithm, producing the program flockture. With simulated data, we confirmed that results obtained with flock and flockture are very similar (though flockture is some 200 times faster). Second, we simulated multiple large data sets under varying levels of population differentiation for both microsatellite and SNP genotypes. We analysed them with flockture and structure and assessed each program on its ability to cluster individuals to their correct subpopulation. We show that flockture yields results similar to structure albeit with greater variability from run to run. flockture did perform better than structure when genotypes were composed of SNPs and differentiation was moderate ( 0.022–0.032). When differentiation was low, structure outperformed flockture for both marker types. On large data sets like those we simulated, it appears that flock's reliance on inference rules regarding its ‘plateau record’ is not helpful. Interpreting flock's algorithm as a special case of the model in structure should aid in understanding the program's output and behaviour.
Downregulation of miR‐21 is Involved in Direct Actions of Ursolic Acid on the Heart: Implications for Cardiac Fibrosis and Hypertrophy
Authors: Dong Xingli , Liu Shangkun , Zhang Lingling , Yu Siming , Huo Linman , Qile Muge , Liu Lu , Yang Baofeng , Yu Jinling
Published: April 2015

Purpose

Myocardial fibrosis contributes to cardiac remodeling and loss of cardiac function in myocardial infarction and heart failure. This study used in vitro and in vivo models to examine the effects of ursolic acid (UA) on myocardial fibrosis and to explore its potential mechanism.

Methods

Transverse aortic constriction (TAC) surgery was performed in mice to induce cardiac hypertrophy and fibrosis. UA was orally administered 1 week prior to TAC. Two weeks after TAC, myocardial pathology was detected using Masson's trichrome staining and transmission electron microscopy, and heart‐to‐body weight ratio was measured. For in vitro studies, cultured cardiac fibroblasts were treated with serum in the presence or absence of UA. The relative levels of miR‐21 and p‐ERK/ERK, collagen content and cell viability were measured.

Results

Ursolic acid attenuated pathological cardiac hypertrophy and myocardial fibrosis in vivo induced by TAC. Downregulation of miR‐21 and p‐ERK/ERK were observed in myocardial fibroblasts treated with UA in a dose‐dependent manner compared with the control group both in vitro and in vivo.

Conclusions

Our study demonstrates that UA can inhibit myocardial fibrosis both in vitro and in vivo, and the effects of UA on myocardial fibrosis may be due to the inhibition of miR‐21/ERK signaling pathways.
Modulation of Adhesion Molecules by Cholesterol‐Lowering Therapy in Mononuclear Cells from Hypercholesterolemic Patients
Authors: Cerda Alvaro , Rodrigues Alice Cristina , Alves Camila , Genvigir Fabiana Dalla Vecchia , Fajardo Cristina Moreno , Dorea Egidio Lima , Gusukuma Maria Cecilia , Pinto Gelba Almeida , Hirata Mario Hiroyuki , Hirata Rosario Dominguez Crespo
Published: April 2015

Introduction

Cholesterol‐lowering therapy has been related with several pleiotropic effects including anti‐inflammatory action in vascular endothelium; however, their influence on monocyte adhesion molecules is poorly described.

Aims

To investigate the effect of inhibitors of synthesis (statins) and absorption (ezetimibe) of cholesterol on expression of adhesion molecules L‐selectin, PSGL‐1, VLA‐4, LFA‐1, and Mac‐1 in mononuclear cells in vivo and in vitro using THP‐1 cells.

Methods

The influence of simvastatin (10 mg/day), ezetimibe (10 mg/day), and their combination (10 mg each/day) on mRNA expression of adhesion molecules was analyzed in peripheral blood mononuclear cells (PBMC) from hypercholesterolemics. The effects of atorvastatin, simvastatin, and ezetimibe on mRNA and protein expression of adhesion molecules were also evaluated in THP‐1 cells.

Results

Simvastatin/ezetimibe combination, but not the monotherapies, reduced the mRNA expression of the PSGL‐1, LFA‐1, and Mac‐1 genes in PBMC from hypercholesterolemics. Total and LDL cholesterol in serum correlated with PSGL‐1 mRNA expression, whereas HDL cholesterol negatively correlated with mRNA levels of L‐selectin and VLA‐4 genes (P < 0.05). Plasma hsCRP was also correlated with mRNA levels of VLA‐4, LFA‐1, and Mac‐1 (P < 0.05). Atorvastatin and simvastatin at 10 μM reduced mRNA and protein expression of L‐selectin, PSGL‐1, and VLA‐4 in THP‐1 cells (P < 0.05).

Conclusion

Cholesterol‐lowering therapy modulates gene expression of adhesion molecules in PBMC from hypercholesterolemics and THP‐1 cells. Simvastatin/ezetimibe combination gives more benefits by reducing to a larger extent the expression of adhesion molecules in mononuclear cells.
Implementation by Gradual Revelation
Authors: Celik Gorkem
Published: April 2015

We investigate the feasibility of implementing an allocation rule with a gradual‐revelation mechanism in which agents reveal their private information over time (rather than all at once). With independently distributed types, private values, and transferable utilities satisfying a single‐crossing property, an ex‐post monotonicity condition is sufficient for budget‐balanced implementation of any incentive‐compatible allocation rule with any gradual‐revelation scheme. When we extend the single‐crossing property over the set of randomized allocations, a weaker monotonicity condition is necessary and sufficient for budget‐balanced implementation by gradual revelation.
Clinical experiences with molecular targeted therapy in lung cancer in China
Authors: Wang Yan , Sun Yan
Published: April 2015

In the past decade, a dramatic shift has been witnessed in cancer therapy in China. Although traditional cytotoxic chemotherapy still remains the treatment of choice for many malignancies, targeted therapies are now a component of treatment for many types of cancer, including lung cancer. As molecular target agents are widely used in clinical practice and relevant studies have been conducted, we have accumulated valuable experience in the treatment strategy for advanced non‐small cell lung cancer. On this basis we have successfully developed our Class‐I new drug through independent research, which significantly accelerates the clinical development of targeted therapy for lung cancer. This article summarizes the clinical practice and relevant studies of current targeted therapies for lung cancer in China.
Intraarrest Rhythms and Rhythm Conversion in Asphyxial Cardiac Arrest
Authors: Varvarousi Giolanda , Chalkias Athanasios , Stefaniotou Antonia , Pliatsika Paraskevi , Varvarousis Dimitrios , Koutsovasilis Anastasios , Xanthos Theodoros
Published: April 2015

Objectives

The objective was to analyze the cardiac arrest rhythms presenting during asphyxial cardiac arrest (ACA).

Methods

Asphyxial cardiac arrest was induced in 30 Landrace large white piglets, aged 12 to 15 weeks and with a mean (±SD) weight of 20 (±2) kg. After the onset of cardiac arrest, the animals were left untreated for 4 minutes, after which cardiopulmonary resuscitation was commenced. Heart rhythms were monitored from the onset of asphyxia until return of spontaneous circulation or death.

Results

After endotracheal tube clamping and prior to cardiac arrest, normal sinus rhythm was noted in 14 animals, atrial fibrillation in two animals, Mobitz II atrioventricular block in 10 animals, and third‐degree atrioventricular block in four animals. At the onset of cardiac arrest, seven animals had ventricular fibrillation (VF), two had asystole, and 21 had pulseless electrical activity (PEA). During the 4‐minute period of untreated arrest, however, significant changes in the monitored rhythm were noted; at the end of the fourth minute, 19 animals had VF, two animals had asystole, and nine animals had PEA.

Conclusions

The most common rhythm after 4 minutes of untreated ACA was VF, while in 57% of animals, PEA was spontaneously converted to VF during the cardiac arrest interval.
Radiographic Evaluation of Carotid Artery Compression in Patients With Extraglottic Airway Devices in Place
Authors: White Jenna M. B. , Braude Darren A. , Lorenzo Gamaliel , Hart Blaine L.
Published: April 2015

Objectives

Extraglottic airway devices (EADs) are now commonly placed for airway management of critically ill or injured patients, particularly by emergency medical services providers in the out‐of‐hospital setting. Recent literature has suggested that EADs may cause decreased cerebral blood flow due to compression of the arteries of the neck by the devices’ inflated cuffs.

Methods

The authors identified a cohort of 17 patients presumed to be hemodynamically stable with EADs in place who underwent radiographic imaging of the neck. These studies were reviewed by a neuroradiologist to determine if mechanical compression of the carotid arteries was present.

Results

None of the 17 cases reviewed had radiographically evident mechanical compression of the carotid artery.

Conclusions

Until further studies are performed in which cerebral perfusion is evaluated prospectively in both hemodynamically stable and unstable human subjects, there is insufficicent evidence to recommend against the use of extraglottic airways in the emergency setting on the basis of carotid artery compression.
The “5Es” of Emergency Physician–performed Focused Cardiac Ultrasound: A Protocol for Rapid Identification of Effusion, Ejection, Equality, Exit, and Entrance
Authors: Kennedy Hall M. , Coffey E. C. , Herbst Meghan , Liu Rachel , Pare Joseph R. , Andrew Taylor R. , Thomas Sheeja , Moore Chris L.
Published: April 2015

Emergency physician (EP)‐performed focused cardiac ultrasound (EP FOCUS) has been increasingly recognized as a crucial tool to help clinicians diagnose and treat potentially life‐threatening conditions. The existing literature demonstrates a variety of EP FOCUS applications and protocols; however, EP FOCUS is not taught, practiced, or interpreted consistently between institutions. Drawing on over 12 years of experience in a large‐volume, high‐acuity academic emergency department, we have developed a protocol for teaching and performing EP FOCUS known as “The 5Es,” where each E represents a specific assessment for immediately relevant clinical information. These include pericardial effusion, qualitative left ventricular ejection, ventricular equality, exit (aortic root diameter), and entrance (inferior vena cava diameter and respirophasic variation). Each of these assessments has been well described in the emergency medicine literature and is within the scope of EP‐performed echocardiography. This approach provides a reliable and easily recalled framework for assessing, teaching, and communicating EP FOCUS findings that are essential in caring for the patient in the emergency setting.
Clinical Risk Factors for In‐hospital Adverse Cardiovascular Events After Acute Drug Overdose
Authors: Manini Alex F. , Hoffman Robert S. , Stimmel Barry , Vlahov David
Published: April 2015

Objectives

It was recently demonstrated that adverse cardiovascular events (ACVE) complicate a high proportion of hospitalizations for patients with acute drug overdoses. The aim of this study was to derive independent clinical risk factors for ACVE in patients with acute drug overdoses.

Methods

This prospective cohort study was conducted over 3 years at two urban university hospitals. Patients were adults with acute drug overdoses enrolled from the ED. In‐hospital ACVE was defined as any of myocardial injury, shock, ventricular dysrhythmia, or cardiac arrest.

Results

There were 1,562 patients meeting inclusion/exclusion criteria (mean age, 41.8 years; female, 46%; suicidal, 38%). ACVE occurred in 82 (5.7%) patients (myocardial injury, 61; shock, 37; dysrhythmia, 23; cardiac arrests, 22) and there were 18 (1.2%) deaths. On univariate analysis, ACVE risk increased with age, lower serum bicarbonate, prolonged QTc interval, prior cardiac disease, and altered mental status. In a multivariable model adjusting for these factors as well as patient sex and hospital site, independent predictors were: QTc > 500 msec (3.8% prevalence, odds ratio [OR] = 27.6), bicarbonate < 20 mEq/L (5.4% prevalence, OR = 4.4), and prior cardiac disease (7.1% prevalence, OR = 9.5). The derived prediction rule had 51.6% sensitivity, 93.7% specificity, and 97.1% negative predictive value, while presence of two or more risk factors had 90.9% positive predictive value.

Conclusions

The authors derived independent clinical risk factors for ACVE in patients with acute drug overdose, which should be validated in future studies as a prediction rule in distinct patient populations and clinical settings.
Chronic Ethanol‐Induced Impairment of Wnt/β‐Catenin Signaling is Attenuated by PPAR‐δ Agonist
Authors: Xu Chelsea Q. , de la Monte Suzanne M. , Tong Ming , Huang Chiung‐Kuei , Kim Miran
Published: April 2015

Background

The Wnt/β‐catenin pathway regulates liver growth, repair, and regeneration. Chronic ethanol (EtOH) exposure blunts normal liver regenerative responses, in part by inhibiting insulin/IGF signaling, and correspondingly, previous studies showed that EtOH‐impaired liver regeneration could be restored by insulin sensitizer (proliferator‐activated receptor [PPAR]‐δ agonist) treatment. As Wnt/β‐catenin functions overlap and cross talk with insulin/IGF pathways, we investigated the effects of EtOH exposure and PPAR‐δ agonist treatment on Wnt pathway gene expression in relation to liver regeneration.

Methods

Adult male Long Evans rats were fed with isocaloric liquid diets containing 0 or 37% EtOH for 8 weeks and also treated with vehicle or a PPAR‐δ agonist during the last 3 weeks of the feeding regimen. The rats were then subjected to 70% partial hepatectomy (PH) and livers harvested at various post‐PH time points were used to quantitate expression of 19 Wnt pathway genes using Quantigene 2.0 Multiplex Assay.

Results

EtOH broadly inhibited expression of Wnt/β‐catenin signaling‐related genes, including down‐regulation of Wnt1, Fzd3, Lef1, and Bcl9 throughout the post‐PH time course (0 to 72 hours), and suppression of Wnt7a, Ccnd1, Fgf4, Wif1, Sfrp2, and Sfrp5 at 18‐ and 24‐hour post‐PH time points. PPAR‐δ agonist treatments rescued the EtOH‐induced suppression of Wnt1, Wnt7a, Fzd3, Lef1, Bcl9, Ccnd1, and Sfrp2 gene expression in liver, corresponding with the improvements in DNA synthesis and restoration of hepatic architecture.

Conclusions

Chronic high‐dose EtOH exposures inhibit Wnt signaling, which likely contributes to the impairments in liver regeneration. Therapeutic effects of PPAR‐δ agonists extend beyond restoration of insulin/IGF signaling mechanisms and are mediated in part by enhancement of Wnt pathway signaling. Future studies will determine the degree to which targeted restoration of Wnt signaling is sufficient to improve liver regeneration and remodeling in the context of chronic EtOH exposure.
Analysis of Human Triallelic SNPs by Next‐Generation Sequencing
Authors: Cao Min , Shi Juan , Wang Jiqiu , Hong Jie , Cui Bin , Ning Guang
Published: April 2015

Although single‐nucleotide polymorphisms (SNPs) have become extremely useful in the study of geneticvariation, triallelic SNPs are still not fully understood. Next‐generation sequencing (NGS) is a promising approach to identify triallelic sites in large populations. In this study, we explored exome sequencing data from 221 Chinese individuals, with an average depth of 70‐fold. We identified 382,901 SNPs in the study samples, including 2,002 (0.52%) triallelic sites. Among the triallelic SNPs, 17.3% were coding SNPs (cSNPs) and 78.3% were novel. Comparison and analysis revealed that the variant alleles were more likely to result in nonsynonymous variation at triallelic sites. In addition, natural selection seemed to influence triallelic SNPs. However, with the limited sample size assessed, more studies will be required in order to fully characterize the features of triallelic SNPs.
Lipid transfer protein sensitization: reactivity profiles and clinical risk assessment in an Italian cohort
Authors: Scala E. , Till S. J. , Asero R. , Abeni D. , Guerra E. C. , Pirrotta L. , Paganelli R. , Pomponi D. , Giani M. , De Pità O. , Cecchi L.
Published: April 2015

Background

Nonspecific lipid transfer proteins (nsLTPs) represent a major cause of systemic food allergic reactions in the Mediterranean area. This study investigate hierarchical patterns and cluster relationships of IgE sensitization to different nsLTPs, and the relationship to clinical allergy in a large Italian cohort.

Methods

A total of 568 nsLTP‐positive subjects after IgE ImmunoCAP‐ISAC microarray analysis with Ara h 9, Art v 3, Cor a 8, Jug r 3, Pla a 3, Pru p 3 and Tri a 14 allergens were studied. IgE inhibition experiments were carried out with mugwort and plane tree pollen extracts.

Results

Eighty‐two per cent of nsLTP‐positive participants (94% if <6 years old) were Pru p 3pos, and 71% were Jug r 3pos. Participants who reacted to >5 nsLTPs reported a higher incidence of food‐induced systemic reactions. Only Art v 3 and Pla a 3 (mugwort and plane tree nsLTPs, respectively) were associated with respiratory symptoms, and a correlation was observed between sensitization to pollen and plant food nsLTPs, particularly between Pla a 3 and tree nut/peanut nsLTPs. Co‐sensitization to Par j 2 and PR‐10 or profilin pan‐allergens was associated with a lower prior prevalence of severe food‐induced reactions. In inhibition assays, plane and mugwort pollen extracts inhibited 50–100% of IgE binding to food nsLTPs in microarrays.

Conclusions

Testing IgE reactivity to a panel of nsLTP allergens unveils important associations between nsLTP sensitization profiles and clinical presentation and allows the identification of novel cluster patterns indicating likely cross‐reactivities and highlighting potential allergens for nsLTP immunotherapy.
Malignant glomus tumor with oncocytic features: an unusual presentation of dysphagia
Authors: Ugras Nesrin , Yercİ Ömer , Yalçınkaya Ulviye , Gülcü Barış , Öztürk Ersin , Yıldırım Çınar , Çavuşoğlu İlkin
Published: April 2015

Glomus tumors in the gastrointestinal tract are unusual, as the previous series in the literature have been mainly limited to the stomach. Less than 10 cases of esophageal glomus tumors have been described in the literature. Oncocytic glomus tumors are a recently identified, rare variant of the glomus tumor. We report a 47‐year‐old female who presented with an approximately 3‐month history of dysphagia and weight loss. Upper gastrointestinal endoscopy showed a black‐purple, hypervascular, protruding lesion measuring approximately 65 mm at the 37th cm of the esophagus. The patient underwent an Ivor Lewis operation via open thoracotomy. The resected specimen had a protuberant, ulcerated mass measuring 80 × 35 mm in the posterior wall of the esophagus. Based on the histopathological, immunohistochemical and electron microscope findings, the final diagnosis was a malignant glomus tumor with oncocytic features. To our knowledge, this is the first report of a malignant glomus tumor with oncocytic features in an esophageal location.
Systematic review and meta‐analysis: opportunistic infections and malignancies during treatment with anti‐integrin antibodies in inflammatory bowel disease
Authors: Luthra P. , Peyrin‐Biroulet L. , Ford A. C.
Published: April 2015

Background

Anti‐integrin antibodies are effective therapies for Crohn's disease (CD) and ulcerative colitis (UC). However, these drugs carry theoretical risks of opportunistic infection and malignancy.

Aim

To pool data from all placebo‐controlled studies, to estimate risk of opportunistic infection or malignancy with anti‐integrin antibodies.

Methods

MEDLINE, EMBASE and the Cochrane central register of controlled trials were searched (up to December 2014). Randomised placebo‐controlled trials of anti‐integrin antibodies in adults with active or quiescent CD or UC were eligible. Dichotomous data were pooled to obtain a relative risk (RR) of opportunistic infection or malignancy, with 95% confidence intervals (CIs).

Results

The search strategy identified 1579 citations, 12 of which were eligible (four trials of natalizumab, six of vedolizumab and two of etrolizumab). The RR of developing an opportunistic infection was not significantly higher with non‐gut specific (2.34; 95% CI 0.05–108.72) or gut specific anti‐integrin antibodies (1.55; 95% CI 0.16–14.83). The RR was generally higher in trials of non‐gut specific anti‐integrin antibodies with duration of therapy ≥52 weeks (RR = 15.00; 95% CI 0.86–261), but remained non‐significant. The RR of malignancy was not elevated with non‐gut specific (1.57; 95% CI 0.19–12.74) or gut specific anti‐integrin antibodies (0.78; 95% CI 0.15–4.02).

Conclusions

Absolute numbers of opportunistic infections were higher with anti‐integrin antibodies, but this difference is not statistically significant. There was no increased risk of malignancy detected. Long‐term data in large prospective cohorts are needed to further assess this issue.
Freedom of Choice About Incidental Findings Can Frustrate Participants' True Preferences
Authors: Viberg Jennifer , Segerdahl Pär , Langenskiöld Sophie , Hansson Mats G.
Published: April 2015

Ethicists, regulators and researchers have struggled with the question of whether incidental findings in genomics studies should be disclosed to participants. In the ethical debate, a general consensus is that disclosed information should benefit participants. However, there is no agreement that genetic information will benefit participants, rather it may cause problems such as anxiety. One could get past this disagreement about disclosure of incidental findings by letting participants express their preferences in the consent form. We argue that this freedom of choice is problematic.

In transferring the decision to participants, it is assumed that participants will understand what they decide about and that they will express what they truly want. However, psychological findings about people's reaction to probabilities and risk have been shown to involve both cognitive and emotional challenges. People change their attitude to risk depending on what is at stake. Their mood affects judgments and choices, and they over‐ and underestimate probabilities depending on whether they are low or high. Moreover, different framing of the options can steer people to a specific choice.

Although it seems attractive to let participants express their preferences to incidental findings in the consent form, it is uncertain if this choice enables people to express what they truly prefer. In order to better understand the participants' preferences, we argue that future empirical work needs to confront the participant with the complexity of the uncertainty and the trade‐offs that are connected with the uncertain predictive value of genetic risk information.
Establishing a Clinically Relevant Large Animal Model Platform for TBI Therapy Development: Using Cyclosporin A as a Case Study
Authors: Margulies Susan S. , Kilbaugh Todd , Sullivan Sarah , Smith Colin , Propert Kathleen , Byro Melissa , Saliga Kristen , Costine Beth A. , Duhaime Ann‐Christine
Published: April 2015

We have developed the first immature large animal translational treatment trial of a pharmacologic intervention for traumatic brain injury (TBI) in children. The preclinical trial design includes multiple doses of the intervention in two different injury types (focal and diffuse) to bracket the range seen in clinical injury and uses two post‐TBI delays to drug administration. Cyclosporin A (CsA) was used as a case study in our first implementation of the platform because of its success in multiple preclinical adult rodent TBI models and its current use in children for other indications. Tier 1 of the therapy development platform assessed the short‐term treatment efficacy after 24 h of agent administration. Positive responses to treatment were compared with injured controls using an objective effect threshold established prior to the study. Effective CsA doses were identified to study in Tier 2. In the Tier 2 paradigm, agent is administered in a porcine intensive care unit utilizing neurological monitoring and clinically relevant management strategies, and intervention efficacy is defined as improvement in longer term behavioral endpoints above untreated injured animals. In summary, this innovative large animal preclinical study design can be applied to future evaluations of other agents that promote recovery or repair after TBI.
Lack of weight gain after angiotensin AT1 receptor blockade in diet‐induced obesity is partly mediated by an angiotensin‐(1–7)/Mas‐dependent pathway
Authors: Schuchard Johanna , Winkler Martina , Stölting Ines , Schuster Franziska , Vogt Florian M , Barkhausen Jörg , Thorns Christoph , Santos Robson A , Bader Michael , Raasch Walter
Published: April 2015

Background and Purpose

Angiotensin AT1 receptor antagonists induce weight loss; however, the mechanism underlying this phenomenon is unknown. The Mas receptor agonist angiotensin‐(1‐7) is a metabolite of angiotensin I and of angiotensin II . As an agonist of Mas receptors, angiotensin‐(1‐7) has beneficial cardiovascular and metabolic effects.

Experimental Approach

We investigated the anti‐obesity effects of transgenically overexpressed angiotensin‐(1‐7) in rats. We secondly examined whether weight loss due to telmisartan (8 mg·kg−1·d−1) in diet‐induced obese Sprague Dawley (SD) rats can be blocked when the animals were co‐treated with the Mas receptor antagonist A779 (24 or 72 μg·kg−1·d−1).

Key Results

In contrast to wild‐type controls, transgenic rats overexpressing angiotensin‐(1‐7) had 1.) diminished body weight when they were regularly fed with chow; 2.) were protected from developing obesity although they were fed with cafeteria diet (CD); 3.) showed a reduced energy intake that was mainly related to a lower CD intake; 5.) remained responsive to leptin despite chronic CD feeding; 6.) had a higher, strain‐dependent energy expenditure, and 7.) were protected from developing insulin resistance despite CD feeding. Telmisartan‐induced weight loss in SD rats was partially antagonized after a high, but not a low dose of A779.

Conclusions and Implications

Angiotensin‐(1‐7) regulated food intake and body weight and contributed to the weight loss after AT1 receptor blockade. Angiotensin‐(1‐7)‐like agonists may be drug candidates for treating obesity.