bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a Delayed Start to Oral Feeding on Feeding Performance and Physiological Responses in Preterm Infants: A Randomized Clinical Trial
Authors: WANG Yu-Wen , HUNG Hsiao-Ying , LIN Chyi-Her , WANG Chi-Jane , LIN Yuh-Jyh , CHANG Ying-Ju
Published: February 2018

Background:

The efficient and safe oral feeding of preterm infants, an essential criterion for hospital discharge, is affected by neurodevelopmental maturation. However, the timing of initiating oral feeding and its relation to maturation, feeding performance, and physiological responses are unclear.

Purpose:

The aim of this study was to determine the effect of a 1-week delay in the initiation of oral feeding on feeding performance, transition time, weight gain, and cardiorespiratory responses in preterm infants.

Methods:

In this randomized controlled trial, 40 infants with a gestational age at birth of less than 32 weeks were recruited. The control group (n = 18) began oral feeding when the infants were physiologically stable, whereas the experimental group (n = 22) began oral feeding 1 week later. Infant feeding performance, heart rate, and oxygen saturation were measured before, during, and after feeding on the first day of oral feeding and 3 days later. Daily weight gain was calculated by measuring body weight every morning, and transition time was calculated by counting the number of days from the initiation of oral feeding to the termination of tube feeding.

Results:

There were no significant differences between the two groups in terms of feeding performance, weight gain, or postmenstrual age at the completion of full oral feeding. The transition time was significantly shorter in the experimental group than in the control group. More infants in the control group experienced episodes of oxygen desaturation during feeding than in the experimental group.

Conclusions/Implications for Practice:

For infants with a postmenstrual age of greater than 32 weeks who are ready to initiate oral feeding, postponing oral bottle feeding for 1 week may be considered as an intervention to reduce physiological distress.
Basal Subnuclear Vacuolization, Armanni-Ebstein Lesions, Wischnewsky Lesions, and Elevated Vitreous Glucose and β-Hydroxybuyrate
Authors: Tse Rexson , Garland Jack , Kesha Kilak , Triggs Yvonne , Yap Zhi , Stables Simon
Published: February 2018

Hypothermia and diabetic ketoacidosis are both potentially fatal conditions, which have historically been considered to have associated pathognomonic pathologies. Hypothermia and diabetic ketoacidosis share similar pathological mechanisms, which result in metabolic derangement, with increased post mortem vitreous glucose and β-hydroxybuyrate, and are able to exacerbate and precipitate one another. Although Wischnewsky lesions are associated with hypothermia, and Armanni-Ebstein lesions and basal subnuclear vacuolization are associated with diabetic ketoacidosis, recent studies have demonstrated that there is a significant overlap between the pathological findings of these 2 conditions. We report a case of a 50-year-old woman with type 1 diabetes who was found deceased in the middle of winter. Autopsy showed Wischnewsky lesions, Armanni-Ebstein lesions, and basal subnuclear vacuolization, together with elevated vitreous glucose and β-hydroxybuyrate. The cause of death was the combined effects of hypothermia and diabetic ketoacidosis. This case highlights the overlapping clinical presentation, pathophysiology, and pathology of these 2 conditions.
Functional Stroke Mimics: Incidence and Characteristics at a Primary Stroke Center in the Middle East
Authors: Wilkins Stacy Schantz , Bourke Paula , Salam Abdul , Akhtar Naveed , D'Souza Atlantic , Kamran Saadat , Bhutta Zain , Shuaib Ashfaq
Published: February 2018

Objective

Approximately 30% of individuals who initially present with stroke are found to be stroke mimics (SM), with functional/psychological SM (FSM) accounting for up to 6.4% of all stroke presentations. Middle Eastern countries may have higher rates of somatization of emotional distress. The aim of this study was to evaluate the incidence and characteristics of FSM at a large general hospital in the Middle East.

Methods

All patients presenting with an initial diagnosis of stroke from June 2015 to September 2016 were eligible for this study. Clinical and sociodemographic data were obtained from the hospital's stroke database. All SM and strokes were diagnosed by Joint Commission International–certified stroke program neurologists. SM was defined as any discharge diagnosis (other than acute stroke) for symptoms that prompted initial admission for suspected stroke. FSM were compared with medical stroke mimics (MSM) and strokes (ischemic, hemorrhagic, and transient ischemic attacks).

Results

A total of 1961 patients were identified; 161 FSM (8.2%), 390 MSM (19.9%), and 1410 strokes (71.9%) (985 ischemic strokes, 196 transient ischemic attacks, 229 intracerebral hemorrhages). Admission with FSM was related to patients' nationality, with the highest frequency in Arabic (15.6%) and African (16.8%) patients. FSM patients were younger, more often female, and had fewer cardiovascular risk factors except for smoking compared with the strokes. FSM patients presented with more left-sided weakness and had more magnetic resonance imagings than the stroke and MSM groups. A total of 9.9% of FSM patients received thrombolysis versus only 0.5% of the MSM and 16.4% of ischemic strokes.

Conclusions

FSM frequencies varied by nationality, with Arab and African nationals being twice as prevalent. Stress, vulnerable status as expats, sociopolitical instability, and exposure to trauma are proposed as potential factors contributing to FSM.
Exploring and Evaluating Patient Safety Culture in a Community-Based Primary Care Setting
Authors: Desmedt Melissa , Bergs Jochen , Willaert Benjamin , Schrooten Ward , Vlayen Annemie , Hellings Johan , Claes Neree , Vandijck Dominique
Published: February 2018

Objectives

The primary aim was to measure patient safety culture in two home care services in Belgium (Flanders). In addition, variability based on respondents’ profession was examined.

Methods

A cross-sectional study was conducted by administering the SCOPE–Primary Care questionnaire in two home care service organizations.

Results

In total, 1875 valid questionnaires were returned from 2930 employees, representing a response rate of 64%. The highest mean patient safety culture score was found for “organizational learning” (mean [SD] = 3.81 [0.53]), followed by “support and fellowship” (mean [SD] = 3.76 [0.61]), “open communication and learning from error” (mean [SD] = 3.73 [0.64]), and “patient safety management” (mean [SD] = 3.71 [0.60]). The lowest mean scores were found for “handover and teamwork” (mean [SD] = 3.28 [0.58]) and “adequate procedures and working conditions” (mean [SD] = 3.30 [0.56]). Moreover, managers/supervisors scored significantly higher on the dimensions “open communication and learning from error,” “adequate procedures and working conditions,” “patient safety management,” “support and fellowship,” and “organizational learning” than clinical and nonclinical staff.

Conclusions

In conclusion, organizational learning is perceived as most positive. However, large gaps remain in the continuity of care as “handover and teamwork” is perceived as the most negative safety culture dimension. With knowledge of the current patient safety culture, organizations can redesign processes or implement improvement strategies to avoid patient safety incidents and patient harm in the future.
Thrombopoietin signaling to chromatin elicits rapid and pervasive epigenome remodeling within poised chromatin architectures
Authors: Comoglio Federico , Park Hyun Jung , Schoenfelder Stefan , Barozzi Iros , Bode Daniel , Fraser Peter , Green Anthony R.
Published: February 2018

Thrombopoietin (TPO) is a critical cytokine regulating hematopoietic stem cell maintenance and differentiation into the megakaryocytic lineage. However, the transcriptional and chromatin dynamics elicited by TPO signaling are poorly understood. Here, we study the immediate early transcriptional andcis-regulatory responses to TPO in hematopoietic stem/progenitor cells (HSPCs) and use this paradigm of cytokine signaling to chromatin to dissect the relationship betweencis-regulatory activity and chromatin architecture. We show that TPO profoundly alters the transcriptome of HSPCs, with key hematopoietic regulators being transcriptionally repressed within 30 min of TPO. By examiningcis-regulatory dynamics and chromatin architectures, we demonstrate that these changes are accompanied by rapid and extensive epigenome remodeling ofcis-regulatory landscapes that is spatially coordinated within topologically associating domains (TADs). Moreover, TPO-responsive enhancers are spatially clustered and engage in preferential homotypic intra- and inter-TAD interactions that are largely refractory to TPO signaling. By further examining the link betweencis-regulatory dynamics and chromatin looping, we show that rapid modulation ofcis-regulatory activity is largely independent of chromatin looping dynamics. Finally, we show that, although activated and repressedcis-regulatory elements share remarkably similar DNA sequence compositions, transcription factor binding patterns accurately predict rapidcis-regulatory responses to TPO.
A synthetic indicator of corruption for Latin America: a global vision
Authors: Cardenas Cardenas Gilberto , García Gamez Sofía , Salas Suarez Alvaro
Published: February 2018

Purpose

The purpose of this paper is to develop an overview of the phenomenon of corruption in Latin America and to propose a synthetic aggregate indicator to compress most of the statistical information available on corruption for Latin American countries.

Design/methodology/approach

The indicator of corruption has been obtained through factor analysis by applying the principal component methodology.

Findings

The authors have managed to obtain a single component that reproduces and synthesizes 86 per cent of all the information about corruption in Latin America gathered by prestigious institutions.

Research limitations/implications

The authors are aware that their study is not free from limitations. The first limitation is associated with the impossibility of incorporating information related to the phenomenon of corruption from the indicator called Latinobarómetro, as the economies of Cuba and Haiti (included in this research) are not part of the sample analyzed by that indicator. Second, this study reproduces and synthesizes 86 per cent of all available information by prestigious institutions about corruption in Latin America, and although this percentage is significant, it does not constitute 100 per cent.

Originality/value

This study has created a new indicator that gathers methodologies to measure corruption in Latin American countries.
Regional patent activity in Russia: does level of risks make a difference?
Authors: Ermasova Natalia , Ijose Olumide , Ermasov Sergey
Published: February 2018

Purpose

The purpose of this paper is to explore empirically the linkages among level of economic, managerial, financial, criminal risks and patent activity in Russia. This paper examines the relationship between the economic, managerial, financial and criminal regional risks ratings, on the one hand, and patent activity, as measured by regional patent applications for inventions, on the other.

Design/methodology/approach

A random effect model was performed for a data sample of 83 regions, covering the period 2006-2010 in Russia.

Findings

The empirical results show that increased levels of regional economic risks are significantly associated with decrease in patent activity in Russia.

Originality/value

This study fills a gap within the literature and offers a unique analysis of regional risks and their impact on patent activity. The empirical results showed that economic risk ratings have had considerable negative impact on the patent activities on regional level in Russia.
Thermal stability analysis of passive components embedded into printed circuit boards
Authors: Stęplewski Wojciech , Dziedzic Andrzej , Janeczek Kamil , Araźna Aneta , Lipiec Krzysztof , Borecki Janusz , Serzysko Tomasz
Published: February 2018

Purpose

The purpose of this paper is to investigate the behavior of embedded passives under changing temperature conditions. Influence of different temperature changes on the basic properties of embedded passives was analyzed. The main reason for these investigations was to determine functionality of passives for space application.

Design/methodology/approach

The investigations were based on the thin-film resistors made of Ni-P alloy, thick-film resistors made of carbon or carbon-silver inks, embedded capacitors made of FaradFlex materials and embedded inductor made in various configurations. Prepared samples were examined under the influence of a constant elevated temperature (100, 130 or 160°C) in a long period of time (minimum of 30 h), thermal cycles (from −40 to +85°C) or thermal shocks (from −40 to +105°C or from −40 to +125°C).

Findings

The achieved results revealed that resistance drift became bigger when the samples were treated at a higher constant temperature. At the same time, no significant difference in change in electrical properties for 50 and 100 Ω resistors was noticed. For all the tests, resistance change was below 2 per cent regardless of a value of the tested resistors. Conducted thermal shock studies indicate that thin-film resistors, coils and some thick-film resistors are characterized by minor variations in basic parameters. Some of the inks may show considerable resistance variations with temperature changes. Significant changes were also exhibited by embedded capacitors.

Originality/value

The knowledge about the behavior of the operating parameters of embedded components considering environmental conditions allow for development of more complex systems with integrated printed circuit boards.
Figuratively speaking: of metaphor, simile and metonymy in marketing thought
Authors: Brown Stephen , Wijland Roel
Published: February 2018

Purpose

Much has been written about metaphor in marketing. Much less has been written about simile and metonymy. It is widely assumed that they are types of metaphor. Some literary theorists see them as significantly different things. If this is the case, then there are implications for marketing theory and thought.

Design/methodology/approach

In keeping with literary tradition, this paper comprises a wide-ranging reflective essay, not a tightly focussed empirical investigation. A combination of literature review and conceptual contemplation, it challenges convention by “reading against the grain”.

Findings

The essay reveals that, far from being part of metaphor’s supporting cast, simile and metonymy are stars in themselves. With the aid of three concise cases-in-point – relationship marketing (RM), the consumer odyssey (CO) and Kotler’s generic concept (GC) – the authors present an alternative interpretation of their conceptual contribution and continuing importance.

Practical implications

Marketing management is replete with metaphorical speculation (positioning, warfare, myopia and more). The shortcomings of such figures of speech are rarely spelled out, much less foregrounded. By raising figurative consciousness, marketing practice is furthered.

Originality/value

As similes and metonymies are rarely spoken about in marketing scholarship, the study starts a much-needed conversation. It raises the issue of marketing’s figurative foundations and, in so doing, offers further scope for future debate.
Understanding ethical consumers: willingness-to-pay by moral cause
Authors: Park Kendall Cox
Published: February 2018

Purpose

Moral issues such as environmental degradation and workers’ rights are no longer relegated to the political realm; today, they permeate the marketing of consumer products. Some consumer studies focus on organics, others on green goods and still others on fair trade products, but none include the full range of ethical consumption. This study, aims to investigate consumer willingness to pay for five distinct ethical narratives.

Design/methodology/approach

Using original data from a national sample, this paper parses out five types of ethical narratives: fair trade, sustainable/green, American-made and two types of charitable partnerships. Using random assignment and an experimental design allows in isolating the effects of gender, age, education, income, political orientation and political involvement on how much consumers are willing to pay for each type of ethical product.

Findings

This survey experiment demonstrates that the fair trade narrative is the most valuable to consumers, followed by the charitable narratives. The two charitable narratives are universally appealing, whereas fair trade, green and American-made products appeal to three distinct groups of consumers. This paper demonstrates that there is not one sort of ethical shopper, but many.

Practical/implications

This study examines what sorts of stories appeal to particular demographics. It will help socially and environmentally responsible companies better understand their target demographic and how to motivate their target audience.

Originality/value

Previous research yields conflicting findings about who values ethical products because each study focuses on a different form of ethical consumption. This study uses original data to investigate consumers’ valuations of five different types of ethical narratives. The results help in making sense of divergent findings in the literature and expand understanding of socially conscious shoppers.
Does impact of price endings differ for the non-green and green products? Role of product categories and price levels
Authors: Tripathi Avinash , Pandey Neeraj
Published: February 2018

Purpose

The discount image associated with odd-ending prices has led to its extensive use by retailers. The purpose of this study is to assess the impacts and applications of nine-ending vs round-ending prices on the purchase of green and non-green products at different price levels and under different purchase motivations.

Design/methodology/approach

Three experiments are conducted. The first experiment is a 2 (price ending: nine-ending vs round-ending) × 2 (product appeal: green vs non-green) between-subjects study; the second experiment is a 2 (price ending: nine-ending vs round-ending) × 2 (price level: low price vs high price) × 2 (product appeal: green vs non-green) between-subjects study; and the third experiment examined buyers’ preferences of price endings regarding the purchase of green products having either utility (utilitarian) or pleasure (hedonic) motivation.

Findings

This research highlights that consumers prefer zero-ending prices for green products and pleasure motivation products, but they prefer odd endings for low-priced and utilitarian products. These results support the increased reception of round-ending prices. Accordingly, this study contributes to the literature by providing a boundary condition for odd-ending prices. Specifically, the study finds that the effect of nine-ending prices becomes weaker as the price of the product increases.

Practical implications

The findings of this study have practical implications for managers, as the results indicate that pricing green products and high-quality perception products using round digits and pricing low-priced and utility perception products using odd digits will increase consumers’ purchase intentions. Moreover, pricing the products using round-ending prices will reduce the perception of low quality and deter brand loyalty emanating from a low-priced/discount image of a product.

Originality/value

This research contributes to theoretical and practical aspects of behavioural pricing literature. This research uncovers the buyers’ distinct preferences for zero-ending prices and odd-ending prices when purchasing different products based on different motivations and varied price levels. This is the first research of its kind to explore and compare the impact of psychological pricing on green products. The study also resolves a contradiction in past literature regarding the use of nine-ending prices by providing boundary conditions.
Children and their brands: how young consumers relate to brands
Authors: Lopez Alberto , Rodriguez Rachel
Published: February 2018

Purpose

The purpose of this study is to understand and explain the process by which child consumers form relationships with brands. Specifically, the authors attempt to understand how child consumers conceptualize brands, why and how they decide to engage in relationships with brands and why they decide to breakup with brands though sometimes reconcile with them.

Design/methodology/approach

A mixed methodology was followed in this research. On the basis of an ethnographic approach, ten in-depth interviews were conducted among 8-12-year-old girls. Subsequently, a survey was completed by 122 children (boys and girls) to quantitatively examine the hypotheses formulated after the qualitative phase.

Findings

Findings from both the qualitative and quantitative studies highlight and confirm that children conceptualize brands according to visual branding components, signs and promotional activities. Furthermore, children make moral evaluations of brand behaviors and judge them as “good” or “bad”. More importantly, the authors propose two typologies: one for the reasons children decide to engage in a positive relationship and another for why children engage in a negative relationship with a brand. Additionally, the authors found that children report having an active or passive relationship role according to the characteristics of the brand relationship. Moreover, despite their young age, children report having broken up relationships with several brands; the reasons are categorized into positive and negative breakups. Finally, the authors found that positive breakups lead to more probable brand relationship reconciliation than negative breakups.

Originality/value

Despite a vast body of literature in the child consumer behavior field, there is scarce research regarding brand relationship phenomena. To the best of the authors’ knowledge, this is the first empirical research conducted with child consumers, addressing brand relationship formation, dissolution and reconciliation.
Facing contradictory emotions in event marketing: leveraging on surprise
Authors: Addis Michela , Miniero Giulia , Soscia Isabella
Published: February 2018

Purpose

This paper aims to explore the role of surprise in reducing the negative impact of an undesired emotion, such as embarrassment, on the attitudes and behavioral intentions of consumers taking part in an event.

Design/methodology/approach

In total, 220 consumers took part in a pre-test/post-test quasi-experimental within-subject design. Data were analyzed using structural equation modeling.

Findings

Findings show that an in-store social event designed to elicit young customers’ surprise and feelings of romantic love might also give rise to a relevant negative emotion such as embarrassment, and that surprise can act as a powerful managerial tool in limiting the negative effects of this negative emotion. Moreover, brand attitude and purchase intention are outcomes of positive emotions elicited by the event.

Practical implications

The study shows that event marketing is an appealing but risky strategy. Evoking surprise is an effective way to manage negative emotions such as embarrassment that can arise unintentionally during an event.

Originality/value

The research contributes to the understanding of the role of contradictory emotions in a specific social experience, namely, the event, and focuses on unplanned and undesired the affective contributions of customers.
Customizing persuasive messages; the value of operative measures
Authors: Kaptein Maurits
Published: February 2018

Purpose

This paper aims to examine whether estimates of psychological traits obtained using meta-judgmental measures (as commonly present in customer relationship management database systems) or operative measures are most useful in predicting customer behavior.

Design/methodology/approach

Using an online experiment (N = 283), the study collects meta-judgmental and operative measures of customers. Subsequently, it compares the out-of-sample prediction error of responses to persuasive messages.

Findings

The study shows that operative measures – derived directly from measures of customer behavior – are more informative than meta-judgmental measures.

Practical implications

Using interactive media, it is possible to actively elicit operative measures. This study shows that practitioners seeking to customize their marketing communication should focus on obtaining such psychographic observations.

Originality/value

While currently both meta-judgmental measures and operative measures are used for customization in interactive marketing, this study directly compares their utility for the prediction of future responses to persuasive messages.
Integrating antecedents of workplace deviance: utilizing AHP approach
Authors: Malik Pooja , Lenka Usha
Published: February 2018

Purpose

This paper aims to propose an integrated conceptual framework depicting the antecedents of workplace deviance. This framework demonstrates three broad categories of antecedents of workplace deviance incorporating individual, interpersonal and organizational antecedents. The identified antecedents were later ranked in the order of their impact on workplace deviance.

Design/methodology/approach

PRISMA diagram was used to conduct the systematic literature review and identify the antecedents of workplace deviance. The identified antecedents were later ranked using analytic hierarchy process (AHP). For AHP, data were collected from 20 HR managers and academicians employed in various Indian organizations and institutes.

Findings

This study identified three categories of antecedents of workplace deviance, namely, organizational, interpersonal and individual antecedents. Results of AHP indicated that organizational antecedents have the most significant role in overcoming workplace deviance (18.92 per cent), which was followed by individual (1.47 per cent) and interpersonal level antecedents (1.28 per cent).

Practical implications

This study posits that organizations should avoid unfavorable exchange with its employees by providing suitable organizational and interpersonal practices and by conducting ethical programs and workshops to discourage deviant practices. Moreover, organizations should conduct integrity tests, personality assessment tests to avoid individuals with negative personality characteristics.

Originality/value

This study adds to the literature on workplace deviance by identifying and classifying all the proposed antecedents of literature in an integrated framework. Moreover, this study used techniques of PRISMA and AHP, which represents novelty in the literature of workplace deviance.
Proposing a sequential operationalization of absorptive capacity
Authors: Chaudhary Sanjay , Batra Safal
Published: February 2018

Purpose

This paper makes an attempt to demonstrate the importance of breaking absorptive capacity (AC) into two sequential components, to effectively measure and utilize the construct.

Design/methodology/approach

Data on potential AC, realized AC and firm performance were collected utilizing survey questionnaire administered to 284 Indian SMEs operating in the automotive service segment.

Findings

To test the proposed hypotheses, the authors broke AC into its two sequential components – potential AC and realized AC, and tested their linkages with firm performance. The authors not only found the sequential components to be more reliable, but also found better explanation of firm performance.

Research limitations/implications

The findings in this paper have crucial implications for researchers working in the domain of AC and knowledge management. By demonstrating the operationalization of AC as two sequential components, the authors make a case for more effective utilization of the construct in future studies.

Originality/value

This study is among the few research attempts that have tried to create a sequential operationalization of AC. The findings clearly reveal that potential AC is an enabler of the realized AC, which in turn enhances firm performance.
Ozone effects on European forest growth—Towards an integrative approach
Authors: Cailleret Maxime , Ferretti Marco , Gessler Arthur , Rigling Andreas , Schaub Marcus
Published: February 2018

The phytotoxic impacts of tropospheric ozone on cellular and molecular processes are increasingly understood and quantified. They generally lead to a decrease in plant carbon uptake that is mainly detectable at leaf scale. At larger scales, most of the empirical and modelling studies reported negative ozone effects on productivity, but the latest empirical studies and model developments temper these observations and simulations.

Ozone impacts on European forest growth are controversial and seem negligible because of (1) differences among tree sizes and species, sites, data sources and methodological approaches, (2) the moderate link between adult tree growth and carbon uptake, (3) the presence of several confounding factors such as drought or nitrogen fertilization, and of legacy effects of past land use and management on stand development, and (4) the presence of compensatory processes such as tree acclimation, population adaptation and changes in competition intensity and species composition.

We provide a comprehensive review of the empirical and modelling approaches available for ozone risk assessment by detailing their respective main outputs, advantages and limits, and examine research gaps.

Synthesis. To disentangle between the forcing factors and to better understand ozone impacts at each ecosystem level and feedbacks across levels, and to reinforce the strength of ozone impact predictions, we recommend to combine ozone‐controlled experiments and long‐term monitoring data with physiological and forest succession process‐based models.
Effects of an Information Sharing System on Employee Creativity, Engagement, and Performance
Authors: LI SHELLEY XIN , SANDINO TATIANA
Published: February 2018

Many service organizations rely on information sharing systems to boost employee creativity to meet customer needs. We conducted a field experiment in a retail chain, based on a registered report accepted by JAR, to test whether an information sharing system recording employees’ creative work affected the quality of creative work, job engagement, and financial performance. We found that, on average, this system did not have a significant effect on any of these outcomes. However, it significantly improved the quality of creative work in stores that had accessed the system more frequently and in stores with fewer same‐company nearby stores. It also improved creative work and job engagement in stores in divergent markets, where customers needed more customization. We found weak evidence of better financial results where salespeople had lower creative talent before the system was introduced. Our findings shed light on those conditions in which information sharing systems affect employees’ creative work.
Stem cell transplant in systemic sclerosis: An Indian experience
Authors: Nair Velu , Vasdev Vivek , Kumar Abhishek , Shankar Subramanian , Nair Vivek , Sharma Ajay
Published: February 2018

Aim

To prospectively evaluate long term outcomes in a cohort of patients with Systemic sclerosis treated with Hematopoietic stem cell transplant (HSCT).

Method

This is a prospective observational study of four SSc patients who underwent HSCT at a tertiary care center in India between 2008–2012. The selection criteria included young individuals with rapidly progressive disease and at least one major organ involvement. We used granulocyte colony‐stimulating factor for peripheral blood stem cell mobilization, pre‐transplant conditioning with fludarabine, cyclophosphamide and rabbit anti‐thymocyte globulin followed by re‐infusion of autologous stem cells as per standard institute protocol.

Results

A total of four patients (one male and three females) underwent autologous HSCT for SSc. Patients had heterogeneous disease manifestations including severe Raynaud's phenomenon with vasculopathic ulcers, gastrointestinal problems and mild interstitial lung disease (ILD). Patients were followed up for a mean duration of 7 years. There was significant sustained improvement in skin score, vasculopathy and gastrointestinal manifestations. Interstitial lung disease did not show any deterioration. The quality of life indices showed remarkable improvement in all subjects. No complications related to transplant were noted.

Conclusion

In absence of an effective pharmacotherapy for SSc, autologous HSCT has a huge potential in management of cutaneous and internal organ manifestations.
Entrepreneurship and Legal Uncertainty: Unexpected Federal Trademark Registrations for Marijuana Derivatives
Authors: Schuster W. Michael , Wroldsen Jack
Published: February 2018

Though several states have legalized marijuana use, the drug remains illegal under federal law. Not surprisingly, the United States Patent and Trademark Office (USPTO) refuses to register trademarks related to marijuana because of the federal prohibition. What is surprising, though, is the willingness to grant trademarks for cannabidiol (CBD), a marijuana derivative that is likewise expressly illegal under federal drug laws. This article explains why the USPTO's divergent treatment of trademark applications for CBD and marijuana products is legally incoherent. Additionally, when viewed from an entrepreneurial perspective, this phenomenon exemplifies how legal uncertainty breeds entrepreneurial opportunity. Specifically, the article argues that the evolving regulatory landscape for CBD and marijuana products has been and continues to be ripe for legal strategists and innovative entrepreneurs to combine forces to create competitive advantage in the emerging marijuana industry.
Twenty‐year analysis of implant treatment in an Australian public dental clinic
Authors: Duong A , Dudley J
Published: February 2018

Background

This retrospective cohort study reviewed dental implant treatment completed at the Adelaide Dental Hospital over a 20‐year period.

Methods

The database of implant treatment completed between 1996 and 2015 was analysed for patient, implant, prosthesis and operator specifics together with known implant status.

Results

Three hundred and twenty patients (mean age, 51.50 years) were treated with 527 implants. One hundred and eighty‐four female patients received 296 implants and 136 males received 231 implants. Three hundred implants were restored with single crowns, 147 implants were restored with 63 mandibular implant overdentures, five implants were restored with two maxillary implant overdentures and 67 implants were restored with 20 full‐arch fixed prostheses. The overall known implant survival rate was 87.67%. Mandibular implant overdentures had a risk of implant failure four times that of single implant‐retained crowns that was statistically significant (P = 0.0100).

Conclusions

Implant treatment completed in this public sector clinic using finite resources and a defined system of patient and restorative selection criteria demonstrated a high known implant survival rate. Utilizing a structured and maintained patient recall protocol, it would be ideal to investigate further parameters of interest, particularly those that could improve treatment delivery and longevity.
Evidence for species‐specific plant responses to soil microbial communities from remnant and degraded land provides promise for restoration
Authors: Smith Monique E. , Delean Steven , Cavagnaro Timothy R. , Facelli José M.
Published: February 2018

Below‐ground interactions between soil microbial communities and plants play important roles in shaping plant community structure, but are currently poorly understood. Understanding these processes has important practical implications, including for restoration. In this study, we investigated whether soil microbes from remnant areas can aid the restoration of old‐fields, and whether soil microbes from an old‐field encourages further invasive establishment. In a glasshouse experiment, we measured growth and survival of two native grasses (Austrostipa nodosa and Rytidosperma auriculatum) and an invasive grass (Lolium rigidum) grown in sterile soil inoculated with whole soil from three locations: an old‐field, a remnant grassland, and a seed orchard planted with native grasses 7 years ago. Plants grown in sterile, non‐inoculated soil acted as controls. The orchard inoculant was included to test whether soil microbes from an area cultivated with native grasses induced plant responses similar to remnant areas. The remnant treatment resulted in the highest biomass and no mortality for R. auriculatum. All inoculant types increased the biomass of the invasive species equally. The native grass, A. nodosa, was the most sensitive to the addition of inoculum, whereas the invasive L. rigidum suffered very low mortality across all treatments. Overall, mortality was highest in the old‐field treatment at 42.9%. These results give insights into how soil microbes can affect community structure and dynamics, e.g. the high mortality of natives with old‐field inoculant may be one mechanism that allows invasive species to dominate. Poorer performance of native species with the orchard inoculant suggests it would not make a suitable replacement for remnant soil; therefore, more work is needed to understand the requirements of target species and their interactions before this technique can be exploited to maximum benefit.
Can pelvic floor trauma be predicted antenatally?
Authors: Caudwell‐Hall Jessica , Kamisan Atan Ixora , Brown Chris , Guzman Rojas Rodrigo , Langer Susanne , Shek Ka L. , Dietz Hans P.
Published: February 2018

Introduction

Levator trauma is a risk factor for the development of pelvic organ prolapse. We aimed to identify antenatal predictors for significant damage to the levator ani muscle during a first vaginal delivery.

Material and methods

A retrospective observational study utilizing data from two studies with identical inclusion criteria and assessment protocols between 2005 and 2014. A total of 1148 primiparae with an uncomplicated singleton pregnancy were recruited and assessed with translabial ultrasound at 36 weeks antepartum and 871 (76%) returned for reassessment 3–6 months postpartum. The ultrasound data of vaginally parous women were analyzed for levator avulsion and microtrauma. The former was diagnosed if the muscle insertion at the inferior pubic ramus in the plane of minimal hiatal dimensions and within 5 mm above were abnormal on tomographic ultrasound imaging. Microtrauma was diagnosed in women with an intact levator and if there was a postpartum increase in hiatal area on Valsalva by >20% with the resultant area ≥25 cm2.

Results

The complete datasets of 844 women were analyzed. Among them, 609 delivered vaginally: by normal vaginal delivery in 452 (54%), a vacuum birth in 102 (12%) and a forceps delivery in 55 (6%). Levator avulsion was diagnosed in 98 and microtrauma in 97. On multivariate analysis, increasing maternal age, lower body mass index and lower bladder neck descent were associated with avulsion. Increased bladder neck descent and a family history of cesarean section (CS) were associcated with microtrauma.

Conclusions

Maternal age, body mass index, bladder neck descent and family history of CS are antenatal predictors for levator trauma.
The Griffiths Development Scales‐Chinese (GDS‐C): A cross‐cultural comparison of developmental trajectories between Chinese and British children
Authors: Tso W. W. Y. , Wong V. C. N. , Xia X. , Faragher B. , Li M. , Xu X. , Ao L. , Zhang X. , Jiao F.‐Y. , Du K. , Shang X. , Wong P. T. Y. , Challis D.
Published: February 2018

Background

The Griffiths Mental Development Scales (GMDS) are used in many countries to assess the development of children from birth to 8 years. There is a need for accurate and culturally appropriate developmental assessment tools for Chinese children. Here, we adapted the GMDS for use in Chinese children and compare the developmental trajectories between Chinese and British children.

Methods

Children with typical development were recruited from 7 urban cities in China between 2009 and 2013. The Griffiths Mental Development Scales‐Chinese (GDS‐C) were adapted and used to assess the development of urban Chinese children. Developmental curves were computed for 6 subscales using learning management system methods and compare against the British curves from the Griffiths Mental Development Scales‐Extended Revised (GMDS‐ER).

Results

The GDS‐C were used to assess the developmental status of 815 Chinese children. Plots of the 1st, 5th, 10th, 25th, 50th, 75th, 90th, 95th, and 99th percentiles, and full percentile tables were obtained, which showed similar trends to data from the British GMDS‐ER.

Conclusions

The Chinese developmental curves obtained from the GDS‐C showed similarities and differences to the developmental curves from the British GMDS‐ER. The development of urban Chinese children should be assessed with the culturally appropriate GDS‐C.
International survey on high‐ and low‐dose synacthen test and assessment of accuracy in preparing low‐dose synacthen
Authors: Cross Alexandra S. , Helen Kemp E. , White Anne , Walker Leanne , Meredith Suzanne , Sachdev Pooja , Krone Nils P. , Ross Richard J. , Wright Neil P. , Elder Charlotte J.
Published: February 2018

Objective

The short synacthen test (SST) is widely used to assess patients for adrenal insufficiency, but the frequency and protocols used across different centres for the low‐dose test (LDT) are unknown. This study aimed to survey centres and test the accuracy of ten different synacthen preparation strategies used for the LDT.

Methods

Members of 6 international endocrine societies were surveyed regarding diagnostic tests used for adrenal insufficiency, and in particular the SST. Synacthen was diluted for the LDT and concentrations measured using a synacthen ELISA.

Results

Survey responses were received from 766 individuals across 60 countries (52% adult, 45% paediatric endocrinologists). The SST is used by 98% of centres: 92% using high‐dose (250 μg), 43% low‐dose and 37% both. Ten low‐dose dilution methods were assessed and variation in synacthen concentration was demonstrated with intramethod coefficients of variation (CV) ranging from 2.1% to 109%. The method using 5% dextrose as a diluent was the least variable (CV of 2.1%). The variation in dilution methods means that the dose of synacthen administered in a LDT may vary between 0.16 and 0.81 μg.

Conclusions

The high‐dose SST is the most popular diagnostic test of adrenal insufficiency, but up to 72% of paediatric endocrinologists use a LDT. There is considerable variation observed both within and between low‐dose synacthen dilution methods creating considerable risk of inaccurate dosing and thereby invalid results.
Genetics in multiple sclerosis: Updates in the era of big data
Authors: Isobe Noriko
Published: February 2018

Multiple sclerosis is a complex disease where both genetics and environmental factors play critical roles in its susceptibility. The contribution of genetics has been proven by familial studies, but there still exists missing heritability. Big data science has been a novel approach in research, including multiple sclerosis genetics, and multiple tools to handle those big data have been developed for researchers in different fields: from tools with a user‐friendly graphical user interface to more professional tools with a text user interface. In this era of big data, it is important to accelerate collaborative studies with researchers of distinct professions, such as bioinformaticians, statisticians, geneticists and computational biologists.
Metastasis to the extraocular muscles: a case report, literature review and pooled data analysis
Authors: Leung Vannessa , Wei Michael , Roberts Timothy V
Published: February 2018

Metastasis to the extraocular muscles (EOM) is rare. The existing literature comprises only of isolated case reports therefore a summative description of these lesions is lacking. This study presents a case of bilateral rectus muscle metastasis from malignant melanoma. Furthermore a literature review and pooled data analysis is undertaken with 43 articles encompassing 77 patients and 101 eyes. Mean age was 53 years, 54% were male, 66% had unilateral involvement and 34% had bilateral involvement. The primary malignancies were melanoma (n = 17, 22%), breast (n = 15, 15%) and carcinoid (n = 11, 14%). A single muscle was involved in 56 eyes (67%) and multiple muscles in 27 eyes (33%). Lateral rectus was most commonly affected (n = 44, 53%). Presenting symptoms included restricted eye movements (n = 48, 62%), proptosis (n = 45, 58%), diplopia (n = 27, 35%) and pain (n = 18, 23%). Scattered case reports have previously made it difficult to characterise this phenomenon thus a pooled data analysis is presented.
Lack of clear and univocal genotype‐phenotype correlation in familial Mediterranean fever patients: A systematic review
Authors: Gangemi S. , Manti S. , Procopio V. , Casciaro M. , Di Salvo E. , Cutrupi M. , Ganci G. , Salpietro C. , Chimenz R. , Cuppari C.
Published: February 2018

Familial Mediterranean fever (FMF) is the most common autosomal recessive autoinflammatory disease. To date, following the isolation of more than 280 MEFV sequence variants, the genotype‐phenotype correlation in FMF patients has been intensively investigated; however, an univocal and clear consensus has not been yet reached. Thus, the aim of this systematic review was to analyze the available literature findings in order to provide to scientific community an indirect estimation of the impact of genetic factors on the phenotypic variability of FMF. This systematic review has been conducted according to the Preferred Reporting Items for Systematic reviews and Meta‐Analysis (PRISMA) guidelines. The p.M694V mutation was reported to have a relatively severe clinical course, similarly, patients homozygous for M694I and M680I, or carrying a combination of both at codons 694 and 680, have a severe disease. Also, patients homozygous for M694V and V726A variants experienced more severe clinical picture. Conversely, heterozygous p.V726A and p.E148Q genotypes have been correlated with a milder disease course. At present, doubts remain on the potential pathogenic role of E148Q variant. The heterogenity in clinical FMF manifestations reflects the changes occuring in repertoire of mutations. We believe that clinical criteria and gene tests, enhancing each other, could better support the diagnosis of FMF.