bluuebunny/crossref_metadata_2025 huggingface dataset:
Digital manufacturing applicability of a laser sintered component for automotive industry: a case study
Authors: Flores Ituarte Iñigo , Chekurov Sergei , Tuomi Jukka , Mascolo Julien Etienne , Zanella Alessandro , Springer Patrick , Partanen Jouni
Published: October 2018

Purpose

Additive manufacturing requires a systemic approach to help industry on technology applicability research. Towards this end, the purpose of this research is to help manufacturing business leaders decide whether digitalised manufacturing based on additive manufacturing are suitable for engineering applications and help them plan technology transfer decisions.

Design/methodology/approach

The methodology is based on case study research and action research, involving a mix of quantitative and qualitative research methods. The empirical part involved the study of the fatigue life of industrial component manufactured by laser sintering as well as a combination of quantitative and qualitative methods to define a strategic decision-making.

Findings

Laser-sintered plastic materials are suitable in end use automotive applications, especially when there are multiple product variations. Fatigue life of the tested coupling meets the design requirements. Additionally, production of mechanical parts can be substituted by additive methods while digitalising the manufacturing process to gain productivity, especially when there is a need for mass-customisation.

Research limitations/implications

This research relies on a single case study research. The application used is unique and its technical empirical data cannot be transferred directly to other applications.

Practical implications

Industry practitioners can use this research to shed light on technology transferability challenges considering technical feasibility of additive polymer materials, economic aspects as well as strategic implications for implementing digitalised manufacturing methods based on additive manufacturing.

Originality/value

This research presents a combined study of technical and strategic factors for additive manufacturing transferability using an industrial mass-customisation case as an example. In addition, a new cost comparison model is presented including the impact of geometry variations.
Defining, evaluating, and achieving accessible library resources
Authors: Kazuye Kimura Amy
Published: October 2018

Purpose

The purpose of this paper is to review the library and information science literature related to the accessibility of digital resources by individuals with mental, physical or other impairments, to assess the state of research in the field and to explore new avenues for investigation.

Design/methodology/approach

There is an increasingly rich body of literature surrounding digital accessibility in libraries, ranging from practical guides for authors of Web content, to principles of universal design, to the ethical considerations of libraries subscribing to packages of digital content, to critical examinations of the accessibility guidelines themselves. This review is intended to be illustrative, not exhaustive; less attention is given to studies of specific tools that will become quickly outdated, and more attention is given to underlying considerations and approaches that will remain relevant even as technologies change.

Findings

Many libraries and vendors have taken steps to provide equal access to websites and electronic resources in recent years. While the literature reflects an increasing level of critical engagement with concepts around disability and diversity, it also demonstrates methodological weaknesses in assessment projects that do not lead to meaningful accessibility.

Originality/value

This review offers theoretical and practical perspectives from recent work that can assist librarians in planning and decision-making, as they deal with an increasingly complex landscape of digital resources.
An overview of biomolecules, immobilization methods and support materials of biosensors
Authors: Asal Melis , Özen Özlem , Şahinler Mert , Baysal Hasan Tahsin , Polatoğlu İlker
Published: October 2018

Purpose

Traditional analytical methods are often time-consuming and require bulky instruments, making their widespread implementation challenging. This paper aims to represent the principal concepts of biosensors as an introduction of this technology to readers and offers a comprehensive understanding of its functions.

Design/methodology/approach

The authors provide descriptions of the components, characteristics and advantages of biosensors along with the immobilization methods, followed by a brief discussion.

Findings

A biosensor is an analytical device comprising a specific biomolecule and a transducer in conjunction with an output system. The biomolecule recognizes a specific target which leads to a change in physicochemical properties of a system. This biorecognition phenomenon is later converted into a detectable signal by the transducer. Biosensors can essentially serve as rapid and cost-effective devices with excellent sensitivity and specificity for critical purposes in innumerable fields, ranging from scientific research to day-to-day applications.

Originality/value

Here, the authors explain and discuss the approaches and challenges with the aim of leading to an interest in biosensor development and improving their applications.
Factors affecting employees’ job embeddedness in the Egyptian airline industry
Authors: Shehawy Yasser Moustafa , Elbaz Ahmed , Agag Gomaa M.
Published: October 2018

Purpose

The importance of employees’ job embeddedness perception in the airline companies has not been given the required attention. To recognise the role of frontline employees’ perception regarding job embeddedness, the present research aims to develop and investigate a model that examines the determinants and consequences of employees’ job embeddedness in airline industry. The current study also aims to enrich the literature on human resources in the fields of transportation service management as the lifeblood of tourism industry as a related service industry by providing a comprehensive framework and measurement scale regarding the social exchange theory.

Design/methodology/approach

The study used a survey among a sample representative of frontline employees operating in Egyptian airline industry across Egypt. In total, 870 questionnaires were collected and analysed using structural equation modelling using WarpPLS 6.0.

Findings

The results indicate that both supervisors’ support and employees’ advocacy have a significant effect on job embeddedness. In addition, it found out that job embeddedness has a significant effect on organisational commitment and employees’ intention to leave.

Research limitations/implications

This paper is conceptual in nature regarding the social exchange theory in service related industries such as airlines and tourism.

Practical implications

The authors intend to use these considerations as a basis for future research implications for tourism small- and medium-sized enterprises in the Middle-Eastern and North-African region.

Social implications

This paper contributes to the literature on social exchange theory by measuring factors affecting employees’ job embeddedness in the Egyptian airline industry, notably its related human resources as a service industry.

Originality/value

This study developed and empirically tested a comprehensive model of job embeddedness with its drivers and evaluated its impact on both organisational commitment and intention to leave. Such findings hold important implications for tourism small- and medium-sized enterprises in the Middle-Eastern and North-African region.
Demographic and clinical features of hidradenitis suppurativa in Korea
Authors: Yang Ji Hoon , Moon Jungyoon , Kye Young Chul , Kim Kwang Joong , Kim Myeung Nam , Ro Young Suck , Park Mi Youn , Ahn Hyo Hyun , Lee Mi Woo , Lee Weon Ju , Lee Ju Hee , Lee Jee Bum , Jang Min Soo , Choi Yu Sung , Choi You Won , Suh Dae Hun ,   The Korean Society for Acne Research
Published: October 2018

Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory skin disorder. Although several epidemiological studies have been conducted in Western countries, such data regarding Asian populations are scarce. In this study, we sought to investigate the demographic and clinical features of HS in Korea. A total of 438 patients, diagnosed with HS from May 2007 to April 2017, were enrolled and the electronic medical record of each patient was reviewed. Male patients were predominant with a male : female ratio of 2.5:1. Mean age of disease onset was 23.9 years and most patients had no family history. The most frequently affected area was the buttocks, followed by axillae and groin. Acne and diabetes mellitus were the most prevalent associated diseases and no patients with inflammatory bowel diseases were observed. In the univariable analysis, male patients had severe diseases compared with females with an odds ratio (OR) of 1.790. Two or more affected body regions were associated with HS severity with an OR of 1.693. While involvement of the perineum (OR, 4.067) and buttocks (OR, 1.471) tended to be associated with increased severity of the disease, the inguinal area (OR, 0.620) showed a tendency to be inversely associated with the severity. In multivariable analysis, identified risk factors were the involvement of the perineum (OR, 3.819) and buttocks (OR, 2.288). Smoking status and high body mass index seemed to be associated with more severe diseases. Our results will provide clinical characteristics of HS patients in Asia and help to broaden understanding of HS.
Language Change And Linguistic Theory: The Case Of Archaic Indo‐European Conjunction
Authors: Goldstein D. M.
Published: October 2018

Many archaic Indo‐European languages exhibit a system of dual conjunction in which they possess both a head‐initial exponent (e.g., Latinet) and an enclitic exponent (e.g., Latin ⸗que). Mitrović () and Mitrović & Sauerland () argue that these two types of conjunctions instantiate the universal lexical categories J andμ. Several syntactic, semantic, and morphological properties are argued to result from this categorial distinction. For instance, J conjunctions are claimed to lack additive readings (i.e., ‘too, also’). Diachronically, head‐initial conjunctions are predicted to originate from combinations of J andμheads (Mitrović & Sauerland: 489). A closer look at the data reveals that neither of these predictions is borne out. The empirical motivation for the J/μdistinction is in fact paltry. I therefore offer a new history of Indo‐European conjunction, in which I demonstrate first that the earliest attested Indo‐European languages do not have this double system of conjunction. It is rather an innovation that resulted from the recruitment of new conjunctions across the family. These new conjunctions developed primarily from additive focus operators, and not from combinations of J andμheads. Empirical issues aside, the analysis of Mitrović () and Mitrović & Sauerland () raises deeper questions about the relationship between linguistic theory and language change. I argue that some of the properties of natural language that Mitrović () and Mitrović & Sauerland () assign to Universal Grammar are better analysed as epiphenomena of language change.
A Preliminary Investigation into the Accuracy of 3D Modeling and 3D Printing in Forensic Anthropology Evidence Reconstruction,
Authors: Carew Rachael M. , Morgan Ruth M. , Rando Carolyn
Published: October 2018

There is currently no published empirical evidence‐base demonstrating 3D printing to be an accurate and reliable tool in forensic anthropology, despite 3D printed replicas being exhibited as demonstrative evidence in court. In this study, human bones (n = 3) scanned using computed tomography were reconstructed as virtual 3D models (n = 6), and 3D printed using six commercially available printers, with osteometric data recorded at each stage. Virtual models and 3D prints were on average accurate to the source bones, with mean differences from −0.4 to 1.2 mm (−0.4% to 12.0%). Interobserver differences ranged from −5.1 to 0.7 mm (−5.3% to 0.7%). Reconstruction and modeling parameters influenced accuracy, and prints produced using selective laser sintering (SLS) were most consistently accurate. This preliminary investigation into virtual modeling and 3D printer capability provides a novel insight into the accuracy of 3D printing osteological samples and begins to establish an evidence‐base for validating 3D printed bones as demonstrative evidence.
An Unusually High Cocaine Blood Concentration in an Impaired Driving Investigation
Authors: Stypa Michael P. , Laythorpe Michael G.
Published: October 2018

Cocaine is an illicit drug frequently encountered by forensic practitioners in driving under the influence of drugs (DUID) casework. Whole blood collected from a suspected drugged driver was found to contain 3.000 mg/L cocaine, 1.600 mg/L benzoylecgonine, and 0.260 mg/L methamphetamine. The high concentration of cocaine, while common in overdose death investigations, is unusual for an impaired driving case. Information from the officer revealed that the motorist swallowed cocaine during the traffic stop. Although a cocaineDUIDcharge could not be pursued, the blood methamphetamine concentration exceeded the State of Nevada “per se” limit for operating a motor vehicle. The motorist was successfully prosecuted forDUIDbased on his admission of using methamphetamine prior to driving and the blood methamphetamine result. This case highlights the importance of considering case history when interpreting laboratory results and the application of jurisdictional statutes as an approach to prosecuting suspected drug‐impaired drivers.
Atypical Hemolytic‐Uremic Syndrome: An Update on Pathophysiology, Diagnosis, and Treatment
Authors: Raina Rupesh , Krishnappa Vinod , Blaha Taryn , Kann Taylor , Hein William , Burke Linda , Bagga Arvind
Published: October 2018

Atypical hemolytic uremic syndrome (aHUS), a rare variant of thrombotic microangiopathy, is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal impairment. The condition is associated with poor clinical outcomes with high morbidity and mortality. Atypical HUS predominantly affects the kidneys but has the potential to cause multi‐organ system dysfunction. This uncommon disorder is caused by a genetic abnormality in the complement alternative pathway resulting in over‐activation of the complement system and formation of microvascular thrombi. Abnormalities of the complement pathway may be in the form of mutations in key complement genes or autoantibodies against specific complement factors. We discuss the pathophysiology, clinical manifestations, diagnosis, complications, and management of aHUS. We also review the efficacy and safety of the novel therapeutic agent, eculizumab, in aHUS, pregnancy‐associated aHUS, and aHUS in renal transplant patients.
Researching Private Security in Africa: Two Theoretical Orientations, Two Tales of Security Governance
Authors: Aarstad Åsne Kalland , Martins Bruno Oliveira
Published: October 2018

The two books highlight two different views on the way that private security is governed in the African states under review.
On the Future of the Public Policy School
Authors: Anheier Helmut K.
Published: October 2018

Initially created as schools of public administration to help consolidate and advance the functioning of the expanding nation state, these institutions evolved into public policy or governance schools over time. As they evolved, they encountered many tensions inherent in a triad of “management and administration – policy analysis and academia – policy making and politics”. Each of the triad corners represents a distinct and relatively powerful constituency: academia mostly interested in analytics; public administrators eager to optimise processes; and policy makers looking for actionable answers. For the most part, schools managed to negotiate the tensions inherent in the triad, but they now face a series of new challenges that will require them to change substantially to maintain their relevance. The article discusses the evolution of public policy schools, presents the reasons behind current challenges and offers several recommendations.
Loop ileostomy reversal after laparoscopic versus open rectal resection
Authors: Sebastian Arie , Stupart Douglas , Watters David A.
Published: October 2018

Background

One of the potential advantages of laparoscopic abdominal surgery is in reducing the development of adhesions, making later surgery easier. The purpose of this study is to determine whether using the laparoscopic versus open approach for a rectal resection with a diverting ileostomy affects the speed and safety of subsequent ileostomy reversal.

Methods

This is a retrospective study using patients who underwent ileostomy reversal following a rectal cancer resection with curative intent with a diverting ileostomy at the University Hospital Geelong between January 2006 and June 2017. Demographic information, operative technique and histological staging for the initial resection were recorded. Theatre time and complication rates for the ileostomy reversal were also recorded.

Results

A total of 82 patients were included in this study (22 had laparoscopic resections as the primary operation, 50 had open resections and 10 had laparoscopic converted to open resections). The three groups were similar in age, body mass index, American Society of Anesthesiologists score and proportion undergoing chemoradiotherapy. Median (range) theatre time for ileostomy reversal was 118 (50–200) min after a laparoscopic resection, 80 (30–360) min after a laparoscopic converted to open resection and 65 (50–160) min after an open resection (P = 0.009). Complication rates after ileostomy reversal were similar between the three groups (P = 0.97).

Conclusion

Ileostomy reversal took longer to perform if the primary rectal resection was performed laparoscopically.
Systematic review with meta‐analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome
Authors: Ford Alexander C. , Harris Lucinda A. , Lacy Brian E. , Quigley Eamonn M. M. , Moayyedi Paul
Published: October 2018

Background

Irritable bowel syndrome (IBS) is a chronic functional bowel disorder. Disturbances in the gastrointestinal microbiome may be involved in its aetiology.

Aim

To perform a systematic review and meta‐analysis to examine the efficacy of prebiotics, probiotics, synbiotics and antibiotics in IBS.

Methods

MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched (up to July 2017). Randomised controlled trials (RCTs) recruiting adults with IBS, comparing prebiotics, probiotics, synbiotics or antibiotics with placebo or no therapy were eligible. Dichotomous symptom data were pooled to obtain a relative risk (RR) of remaining symptomatic after therapy, with a 95% confidence interval (CI). Continuous data were pooled using a standardised mean difference with a 95% CI.

Results

The search identified 4017 citations. Data for prebiotics and synbiotics were sparse. Fifty‐three RCTs of probiotics, involving 5545 patients, were eligible. Particular combinations of probiotics, or specific species and strains, appeared to have beneficial effects on global IBS symptoms and abdominal pain, but it was not possible to draw definitive conclusions about their efficacy. There were five trials of similar design that used rifaximin in non‐constipated IBS patients, which was more effective than placebo (RR of symptoms persisting = 0.84; 95% CI 0.79‐0.90). Adverse events were no more common with probiotics or antibiotics.

Conclusions

Which particular combination, species or strains of probiotics are effective for IBS remains, for the most part, unclear. Rifaximin has modest efficacy in improving symptoms in non‐constipated IBS.
Identification and frequency of the associated genes with virulence and antibiotic resistance of Escherichia coli isolated from cow's milk presenting mastitis pathology
Authors: Jamali Hossein , Krylova Kateryna , Aïder Mohammed
Published: October 2018

Antimicrobial resistance, genotype, and virulence gene content of Escherichia coli isolated from bovine clinical mastitis in Tehran Province, Iran, were studied. Two hundred seven (207) milk samples from individual cows presenting mastitis symptoms collected from different dairy farms were used to determine the presence of specific genes of E. coli responsible for this pathology. Multiplex PCR was used to differentiate E. coli isolates into different phylogenetic groups/subgroups and to detect their virulence and involved resistance genes. All the isolated strains were tested for the susceptibility to 21 antimicrobial agents. The results showed that E. coli was detected in 42 (20.3%) samples and 69% of them belonged to the phylogenetic groups A and B1. The phylogenetic subgroup A1 (31%) and subgroup B1 (28.6%) demonstrated the highest prevalence of virulence genes (f17c‐A, and eae (n = 6), f17b‐A, and f17d‐A (n = 5), afaD‐8, afaE‐8, aucD, and bfpA (n = 4), clpG and VT (n = 2), and LT and ST genes (n = 1)). The highest antimicrobial resistance was observed for tetracycline (45.2%) followed by streptomycin (26.2%). The antimicrobial resistance genes tetB (31%), tetA (28.6%), and aadA (26.2%) were the most prevalent. Moreover, integron class 1 and 2 were found in 24 (57.1%) and 8 (19%) of the E. coli isolates.
Increased risk of mycotic infections associated with sodium–glucose co‐transporter 2 inhibitors: a prescription sequence symmetry analysis
Authors: Adimadhyam Sruthi , Schumock Glen T. , Calip Gregory S. , Smith Marsh Daphne E. , Layden Brian T. , Lee Todd A.
Published: October 2018

Aims

To determine the risk of mycotic infections associated with the use of sodium–glucose co‐transporter 2 inhibitors (SGLT2i) in a real‐world setting.

Methods

We conducted a prescription sequence symmetry analysis using data from Truven Health MarketScan (2009–2015). We selected continuously enrolled patients newly initiating both an SGLT2i and an antifungal between 1 April 2013 and 31 December 2015 within time periods of 30, 60, 90, 180 or 365 days of each other. Adjusted sequence ratios (ASR) were calculated for each time period as the ratio of patients initiating SGLT2i first over those initiating an antifungal first adjusted for time trends in prescribing. Analyses were stratified by sex and type of SGLT2i.

Results

There were 23 276 patients who newly initiated both SGLT2i and an antifungal in our study period. These patients were further classified into those initiating the two drugs within 365 (n = 17 504), 180 (n = 11 873), 90 (n = 7697), 60 (n = 5856) or 30 (n = 3650) days of each other. Increased risks of mycotic infections were present across all time periods, with the strongest effect observed in the 90‐day interval [ASR 1.53 (confidence interval, CI 1.43–1.60)]. Findings differed by sex [90‐day ASR females: 1.65 (CI 1.56–1.74); males 1.25 (CI 1.14–1.36)] and by SGLT2i [90‐day ASR canagliflozin 1.57 (CI 1.49–1.66); non‐canagliflozin 1.42 (CI 1.31–1.55)].

Conclusion

Initiation of SGLT2i was associated with an increased risk for mycotic infections. Findings from this commercially insured population in the real world are consistent with evidence available from clinical trials.
A luminescence‐based chronology for the Harletz loess sequence, Bulgaria
Authors: Lomax Johanna , Fuchs Markus , Antoine Pierre , Rousseau Denis‐Didier , Lagroix France , Hatté Christine , Taylor Samuel N. , Till Jessica L. , Debret Maxime , Moine Olivier , Jordanova Diana
Published: October 2018

The Harletz loess‐palaeosol sequence is located in northwestern Bulgaria and represents an important link between well‐studied loess sequences in eastern Romania and further sites to the west of the Carpathians (e.g. Serbia and Hungary). The aim of this study was to establish a chronostratigraphy of the deposits, using various methods of luminescence dating, together with basic stratigraphical field observations as well as magnetic properties. Luminescence dating was carried out using the quartz fine grain fraction and a SAR protocol, and the feldspar coarse grain fraction, applying the MET‐pIRIR protocol. Due to underestimation of the quartz fine grain fraction in the lower parts of the sequence, the resulting chronology is mainly based on the feldspar ages, which are derived from the stimulation temperature at 150 °C. A comparison with nearby sequences from Serbia, Hungary and Romania, and interpretations obtained through the stratigraphical and sedimentological signature of the sequence, supports the established chronology. Our data suggest that the prominent palaeosol (soil complex) in the upper quarter of the sequence was formed during MIS 5. It would follow that large parts of the Last Glacial loess overlying this palaeosol were probably eroded, and that the thick loess accumulation underlying this soil complex can be allocated to the penultimate glacial (MIS 6). A prominent MIS 6 tephra, which has been reported from other sequences in the area, is also present at Harletz.
Instability of endogenous price dispersion equilibria: A simulation
Authors: Herrenbrueck Lucas
Published: October 2018

Models of price posting by firms and search by consumers (such as Burdett and Judd 1983), often feature equilibria with endogenous price dispersion. However, such equilibria are strategically fragile. In order to investigate how robust they are in the absence of an external coordination mechanism, I simulate various protocols firms may use to update their prices. Despite firms being myopic, some protocols yield results close to the benchmark model. If firms rush to update before observing competitors’ actions, profits are higher on average but volatile and cyclical. With cost dispersion, prices become more stable as they are more closely tied to costs. All results are robust to moderate menu costs.
A Family Focused Intervention Influences Hippocampal‐Prefrontal Connectivity Through Gains in Self‐Regulation
Authors: Hanson Jamie L. , Gillmore Alysha D. , Yu Tianyi , Holmes Christopher J. , Hallowell Emily S. , Barton Allen W. , Beach Steven R.H. , Galván Adrianna , MacKillop James , Windle Michael , Chen Edith , Miller Gregory E. , Sweet Lawrence H. , Brody Gene H.
Published: October 2018

The stressors associated with poverty increase the risks for externalizing psychopathology; however, specific patterns of neurobiology and higher self‐regulation may buffer against these effects. This study leveraged a randomized control trial, aimed at increasing self‐regulation at ~11 years of age. As adults, these same individuals completed functional MRI scanning (Mage = 24.88 years; intervention n = 44; control n = 49). Functional connectivity between the hippocampus and ventromedial prefrontal cortex was examined in relation to the intervention, gains in self‐regulation, and present‐day externalizing symptoms. Increased connectivity between these brain areas was noted in the intervention group compared to controls. Furthermore, individual gains in self‐regulation, instilled by the intervention, statistically explained this brain difference. These results begin to connect neurobiological and psychosocial markers of risk and resiliency.
Can alternative epitope mapping approaches increase the impact of B‐cell epitopes in food allergy diagnostics?
Authors: Ehlers Anna M. , Blankestijn Mark A. , Knulst Andre C. , Klinge Marco , Otten Henny G.
Published: October 2018

In vitro allergy diagnostics are currently based on the detection of specific IgE binding on intact allergens or a mixture thereof. This approach has drawbacks as it may yield false‐negative and/or false‐positive results. Thus, we reviewed the impact of known B‐cell epitopes of food allergens to predict transience or persistence, tolerance or allergy and the severity of an allergic reaction and to examine new epitope mapping strategies meant to improve serum‐based allergy diagnostics. Recent epitope mapping approaches have been worthwhile in epitope identification and may increase the specificity of allergy diagnostics by using epitopes predominately recognized by allergic patients in some cases. However, these approaches did not lead to discrimination between clinically relevant and irrelevant epitopes so far, since the polyclonal serum IgE‐binding epitope spectrum seems to be too individual, independent of the disease status of the patients. New epitope mapping strategies are necessary to overcome these obstacles. The use of patient‐derived monoclonal antibodies instead of patient sera for functional characterization of clinically relevant and irrelevant epitope combinations, distinguished by their ability to induce degranulation, might be a promising approach to gain more insight into the allergic reaction and to improve serum‐based allergy diagnostics.
A 46,XX testicular disorder of sex development caused by a Wilms' tumour Factor‐1 (WT1) pathogenic variant
Authors: Gomes Nathalia L. , de Paula Leila C.P. , Silva Juliana M. , Silva Thatiana E. , Lerário Antônio M. , Nishi Mirian Y. , Batista Rafael L. , Faria Júnior José A. D. , Moraes Daniela , Costa Elaine M.F. , Hemesath Tatiana P. , Guaragna‐Filho Guilherme , Leite Júlio C.L. , Carvalho Clarissa G. , Domenice Sorahia , Costa Eduardo C. , Mendonca Berenice B.
Published: October 2018

Molecular diagnosis is rarely established in 46,XX testicular (T) disorder of sex development (DSD) individuals with atypical genitalia. The Wilms' tumour factor‐1 (WT1) gene is involved in early gonadal development in both sexes. Classically, WT1 deleterious variants are associated with 46,XY disorders of sex development (DSD) because of gonadal dysgenesis. We report a novel frameshift WT1 variant identified in an SRY‐negative 46,XX testicular DSD girl born with atypical genitalia. Target massively parallel sequencing involving DSD‐related genes identified a novel heterozygous WT1 c.1453_1456del; p.Arg485Glyfs*14 variant located in the fourth zinc finger of the protein which is absent in the population databases. Segregation analysis and microsatellite analysis confirmed the de novo status of the variant that is predicted to be deleterious by in silico tools and to increase WT1 target activation in crystallographic model. This novel and predicted activating frameshift WT1 variant leading to the 46,XX testicular DSD phenotype includes the fourth zinc‐finger DNA‐binding domain defects in the genetic aetiology of 46,XX DSD.
Available and future treatments for atypical parkinsonism. A systematic review
Authors: Moretti Davide Vito
Published: October 2018

Aims

Success in treating patients with atypical parkinsonian syndromes, namely progressive supranuclear palsy (PSP), cortico‐basal degeneration (CBD), multiple system atrophy (MSA), Parkinson's disease with dementia (PDD), and Lewy body dementia with (LBD), remains exceedingly low. The present work overviews the most influential research literature collected on MEDLINE, ISI Web of Science, Cochrane Library, and Scopus for available treatment in atypical parkinsonisms without time restriction.

Discussion

Transdermal rotigotine, autologous mesenchymal stem cells, tideglusib, and coenzyme Q10 along with donepezil, rivastigmine, memantine, and the deep brain stimulation have shown some benefits in alleviating symptoms in APS. Moreover, many new clinical trials are ongoing testing microtubule stabilizer, antitau monoclonal antibody, tau acetylation inhibition, cell replacement, selective serotonin reuptake inhibitor, active immunization, inhibition of toxic α‐synuclein oligomers formation, and inhibition of microglia.

Conclusion

A detailed knowledge of the pathological mechanism underlying the disorders is needed, and disease‐modifying therapies are required to offer better therapeutic options to physician and caregivers of APS patients.
Bone marrow mesenchymal stem cells stimulated with low‐intensity pulsed ultrasound: Better choice of transplantation treatment for spinal cord injury
Authors: Ning Guang‐Zhi , Song Wen‐Ye , Xu Hong , Zhu Ru‐Sen , Wu Qiu‐Li , Wu Yu , Zhu Shi‐Bo , Li Ji‐Qing , Wang Man , Qu Zhi‐Gang , Feng Shi‐Qing
Published: October 2018

Stem cell transplantation, especially treatment with bone marrow mesenchymal stem cells (BMSCs), has been considered a promising therapy for the locomotor and neurological recovery of spinal cord injury (SCI) patients. However, the clinical benefits of BMSCs transplantation remain limited because of the considerably low viability and inhibitory microenvironment. In our research, low‐intensity pulsed ultrasound (LIPUS), which has been widely applied to clinical applications and fundamental research, was employed to improve the properties of BMSCs. The most suitable intensity of LIPUS stimulation was determined. Furthermore, the optimized BMSCs were transplanted into the epicenter of injured spinal cord in rats, which were randomized into four groups: (a) Sham group (n = 10), rats received laminectomy only and the spinal cord remained intact. (b) Injury group (n = 10), rats with contused spinal cord subjected to the microinjection of PBS solution. (c) BMSCs transplantation group (n = 10), rats with contused spinal cord were injected with BMSCs without any priming. (d) LIPUS‐BMSCs transplantation group (n = 10), BMSCs stimulated with LIPUS were injected at the injured epicenter after contusion. Rats were then subjected to behavioral tests, immunohistochemistry, and histological observation. It was found that BMSCs stimulated with LIPUS obtained higher cell viability, migration, and neurotrophic factors expression in vitro. The rate of apoptosis remained constant. After transplantation of BMSCs and LIPUS‐BMSCs postinjury, locomotor function was significantly improved in LIPUS‐BMSCs transplantation group with higher level of brain‐derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in the epicenter, and the expression of neurotrophic receptor was also enhanced. Histological observation demonstrated reduced cavity formation in LIPUS‐BMSCs transplantation group when comparing with other groups. The results suggested LIPUS can improve BMSCs viability and neurotrophic factors expression in vitro, and transplantation of LIPUS‐BMSCs could promote better functional recovery, indicating possible clinical application for the treatment of SCI.
Log margin‐to‐thickness ratio improves disease‐specific survival prediction in oral cancer: A single cancer centre database
Authors: Huang Chien‐Yu , Lin Yaoh‐Shiang , Kang Bor‐Hwang , Chang Kuo‐Ping , Chi Chao‐Chuan , Lin Ming‐Yee , Su Hsing‐Hao , Chang Ting‐Shou , Lee Huai‐Pao , Lee Ching‐Chih
Published: October 2018

Objective

We examined whether dynamic margin criteria margin‐to‐thickness (MTR) ratio has superior predictive value compared with the resection margin or tumour thickness alone in the survival outcome in oral squamous cell carcinoma (OSCC).

Design

This is a retrospective cohort study.

Setting

Oral squamous cell carcinoma patients treated in Kaohsiung Veterans General Hospital Cancer Center between January 2006 and December 2013.

Participants

A cohort of 302 patients with OSCC who had undergone surgical management.

Main Outcomes Measures

Log MTR was calculated for each patient, and survival data were analysed using a multivariable Cox regression model. Discriminative analysis was performed using chi‐square, Akaike information criterion (AIC) and Harrell's C tests.

Results

After assessing for discriminative ability, the linear trend of log MTR surpassed those of resection margin and tumour thickness in chi‐square, AIC and Harrell's C tests for the advanced pathologic T (pT) category. A multivariate Cox proportional hazard regression model revealed that log MTR <33% was associated with less favourable 5‐year disease‐specific survival (DSS) (P = 0.006) in the entire oral cancer study cohort. Other significant factors included perineural invasion (P = 0.021), pT category, (P = 0.005), pathologic N category (P < 0.001) and differentiation category (P = 0.022).

Conclusions

Log MTR < 33% may be a predictor of less favourable outcome in the DSS of OSCC. Log MTR outperformed both resection margin and tumour thickness alone in terms of discriminative analysis. Our study could help in presurgical planning for high‐risk patients and in aiding the decision‐making process for adjuvant treatment.
BRAF mutation in papillary thyroid cancer—Prevalence and clinical correlation in a South‐East Asian cohort
Authors: Goh Xueying , Lum Jeffery , Yang Samantha Peiling , Chionh Siok Bee , Koay Evelyn , Chiu Lily , Parameswaran Rajeev , Ngiam Kee Yuan , Loh Thomas Kwok Seng , Nga Min En , Lim Chwee Ming
Published: October 2018

Objective

BRAF mutation is the commonest mutation seen in papillary thyroid cancer (PTC), but its prevalence and clinical significance vary across countries. We aim to evaluate the prevalence and clinico‐pathological correlation of BRAF mutation in PTC patients at our centre.

Study Design

Retrospective cohort study of 75 consecutive archival thyroid specimens, whereby BRAF mutation was detected using a polymerase chain reaction (PCR) technique and correlated with clinical and pathological features and outcomes.

Setting

Tertiary university hospital in Singapore.

Participants

A total of 75 consecutive histologically proven archival thyroid specimens from patients who underwent thyroidectomy for PTC were accrued for this study.

Main outcome measures

Main outcome is to determine the prevalence of the BRAF mutation in our South‐East Asian population. Secondary aim is to correlate the mutational status with adverse pathological features like histological variants, multi‐focality, lymphovascular invasion and extra‐thyroidal extension, clinical features like demographics, TNM stage, recurrence and survival, as well as treatment details like type of surgery performed and radioiodine doses.

Results

BRAF mutation was detected in 56% (42/75) of PTC. All but one BRAF‐mutated PTC had the BRAFV600E mutation. BRAF‐mutated tumours were associated with an advanced T‐stage (P = 0.049) and were more likely to have a central neck dissection (P = 0.036). There was no significant correlation between BRAF mutation status and clinical outcomes.

Conclusion

The prevalence of BRAF mutation is 56%. BRAF mutation‐positive tumours were associated with locally advanced disease, but not poorer survival.
Coevolution of Lexical Meaning and Pragmatic Use
Authors: Brochhagen Thomas , Franke Michael , van Rooij Robert
Published: October 2018

According to standard linguistic theory, the meaning of an utterance is the product of conventional semantic meaning and general pragmatic rules on language use. We investigate how such a division of labor between semantics and pragmatics could evolve under general processes of selection and learning. We present a game‐theoretic model of the competition between types of language users, each endowed with certain lexical representations and a particular pragmatic disposition to act on them. Our model traces two evolutionary forces and their interaction: (i) pressure toward communicative efficiency and (ii) transmission perturbations during the acquisition of linguistic knowledge. We illustrate the model based on a case study on scalar implicatures, which suggests that the relationship between underspecified semantics and pragmatic inference is one of coevolution.
Eye’ll Help You Out! How the Gaze Cue Reduces the Cognitive Load Required for Reference Processing
Authors: Sekicki Mirjana , Staudte Maria
Published: October 2018

Referential gaze has been shown to benefit language processing in situated communication in terms of shifting visual attention and leading to shorter reaction times on subsequent tasks. The present study simultaneously assessed both visual attention and, importantly, the immediate cognitive load induced at different stages of sentence processing. We aimed to examine the dynamics of combining visual and linguistic information in creating anticipation for a specific object and the effect this has on language processing. We report evidence from three visual‐world eye‐tracking experiments, showing that referential gaze leads to a shift in visual attention toward the cued object, which consequently lowers the effort required for processing the linguistic reference. Importantly, perceiving and following the gaze cue did not prove costly in terms of cognitive effort, unless the cued object did not fit the verb selectional preferences.
Dealing with a first seizure: accurate diagnosis and good management
Authors: Gill Deepak
Published: October 2018

This commentary is on the original article by Sartori et al. on pages 82–90 of this issue.
Implementing personalized medicine in diabetic kidney disease: Stakeholders' perspectives
Authors: de Vries Jeroen K. , Levin Adeera , Loud Fiona , Adler Amanda , Mayer Gert , Pena Michelle J.
Published: October 2018

The promise of personalized medicine to deliver “the right treatments at the right time to the right person” is the next frontier in healthcare. However, to implement personalized medicine in chronic diseases such as diabetes mellitus and diabetic kidney disease (DKD), a number of different aspects need to be taken into account. Better risk stratification and more precise options for treatment need to be developed and included in clinical practice guidelines. A patient's unique psychological, social and environmental situation also drive disease progression and outcomes. Appraising the cost effectiveness of precision medicines is necessary, not just as the cost of new therapies, but also the cost of diagnosis with novel methodologies and averted complications. As the prevalence of DKD grows worldwide to epidemic proportions, challenges such as global disparities in resources, access to healthcare and prevalence need to be addressed. This review considers these issues to achieve the short and longer‐term goals of implementing personalized medicine in clinical practice.
Cover Image, Volume 20, Issue 11
Authors: Spiller Sandro , Blüher Matthias , Hoffmann Ralf
Published: October 2018

The cover image is based on the Original Article Plasma levels of free fatty acids correlate with type 2 diabetes mellitus by Sandro Spiller et al., 10.1111/dom.13449.

image
Three‐dimensional transesophageal echocardiography is an attractive alternative to cardiac multi‐detector computed tomography for aortic annular sizing: Systematic review and meta‐analysis
Authors: Elkaryoni Ahmed , Nanda Navin C. , Baweja Paramdeep , Arisha Mohammed J. , Zamir Harris , Elgebaly Ahmed , Altibi Ahmed MA , Sharma Rishi
Published: October 2018

Background

Cardiac imaging is the cornerstone of the pretranscatheter aortic valve replacement (TAVR) assessment. Multi‐detector computed tomography (MDCT) is considered the conventional imaging modality. However, there is still no definitive gold standard. Targeted cohort of inoperable high‐risk patients with underlying comorbidities, particularly renal impairment, makes apparent the need for MDCT alternative. We aimed to demonstrate the correlation extent between MDCT and three‐dimensional transesophageal echocardiography (3DTEE) aortic annular area measures and to answer the question: Is 3DTEE a good alternative to MDCT?

Methods

A systematic literature search and meta‐analysis were conducted to evaluate the degree of correlation and agreement between 3DTEE and MDCT aortic annular sizing. A thorough assessment of EMBASE, PubMed, and Cochrane Central Register of Controlled Trials (CENTRAL) was performed. All studies comparing 3DTEE and MDCT in relation to aortic annular sizing were included.

Results

Thirteen studies were included (N = 1228 patients). A strong linear correlation was found between 3DTEE and MDCT measurements of aortic annulus area (r = 0.84, P < 0.001), mean perimeter (r = 0. 0.85, P < 0.001), and mean diameter (r = 0.80, P < 0.001). Bland–Altman plots revealed smaller mean 3DTEE values in comparison to MDCT for aortic annular area, the mean difference being −2.22 mm2 with 95% limits of agreement −12.79 to 8.36.

Conclusion

Aortic annulus measurements obtained by 3DTEE demonstrated a high level of correlation with those evaluated by MDCT. This makes 3DTEE a feasible choice for aortic annulus assessment, with advantage of real time assessment, lack of contrast, and no radiation exposure.
The benefits of integrating dental and dental therapy and hygiene students in undergraduate curricula
Authors: Zahra Daniel , Belfield Louise , Bennett Jon , Zaric Svetislav , Mcilwaine Clare
Published: October 2018

Purpose

The purpose of the current study was to evaluate the impact of integrating the teaching of Bachelor of Dental Surgery (BDS) and Bachelor of Dental Therapy and Hygiene (BScDTH) students in enquiry‐based learning (EBL) sessions, using performance on multiple related integrated dental science (IDS) multiple‐choice question assessments.

Method

IDS assessments are sat twice in the first stages of both the BDS and BScDTH programmes. IDS scores from integrated and non‐integrated cohorts were collated and compared across test occasions (first or second assessment of the stage) and programmes (BDS and BScDTH).

Results

The results revealed that IDS scores were, overall, significantly higher for students in integrated (M = 63.46, SD = 13.06) than non‐integrated EBL groups (M = 60.75, SD = 13.67; F(1,207) = 4.277, P = 0.040,  = 0.020). Although this effect was not statistically significant when each programme was considered separately, the effect of integration on both programmes was nevertheless positive, with a more pronounced improvement for BScDTH (+7.88) than BDS (+0.63) students.

Conclusions

Integrating students from different programmes for the teaching of core dental knowledge in team environments improves student performance in subsequent dental science assessments—and more so for BScDTH than BDS students. The fact that both groups benefit from integration should go some way towards reassuring institutions that are considering integration but are cautious of threats to “established” programmes.
Divergent paths, same destiny: A Bourdieusian perspective on refugee families' negotiation of urban school transition in the US
Authors: Li Guofang
Published: October 2018

This article documents five refugee families and their children's efforts to reestablish themselves in an urban school context in the US. A thematic analysis of the families’ negotiation with the urban school system, the language programmes and their home engagement practices suggests that they were subjected to symbolic violence brought upon by the precarious context of reception, the monolingual ideologies and the hegemonic practices of the urban schools and resettlement policies and agencies. Such symbolic violence systematically fractured their language learning, educational success, and upward social mobility. Therefore, despite their divergent paths of immigration and resettlement, the children shared similar stories of system blockage, inertia, and fragmentation. These shared trajectories suggest the need for multi‐layered changes to remove blockages in the education and immigration system, transform the dispositions and practices of the key players, including policy makers, school administrators and teachers, and raise critical consciousness among the refugees.