bluuebunny/crossref_metadata_2025 huggingface dataset:
Information technology and the quality improvement in defense industries
Authors: Haley Mary
Published: May 2014

Purpose

– Although aggressive leaps in process manipulation are the pinnacle to short-term stability and long-term growth, information technology (IT) is inherently highly variable and challenging in any continuous improvement effort. The purpose of this paper is to assess whether implementation of lean processes yielded repeatable, predictable results in IT schedule reductions. Additionally, the study determines what critical success factors (CSFs) are necessary.

Design/methodology/approach

– The research used non-experimental quantitative methods analyzing archival secondary data. The sample for this case study was compiled from a defense industry organization that implemented these techniques in development, testing and fielding.

Findings

– Based on the research, the results revealed a statistical significance whereby a difference between the PreLean schedule and PostLean schedule existed. The study also evaluated nine CSFs as quintessential to successful implementation of lean philosophies. From those nine CSFs, seven plyometric CSFs are derived as a model for implementation. These include: enterprise incorporation, team trust, transformational leadership, recursive improvement, integrated synergy, customer-centric culture and heuristic communication.

Originality/value

– Although plyometrics is a term often used in athletics (Yessis, 2009), the description of an exercised function producing power and speed to exert maximum force in minimum time is introduced. Through a combination of synergistic alignments, each plyometric CSF maximizes the effects of each single CSF to produce rapid results. The model can be applied to IT and non-IT fielding, both within the defense industry and commercial sector.
Culture-based design and implementation of business excellence
Authors: Amir Bolboli Seyed , Reiche Markus
Published: May 2014

Purpose

– The purpose of this paper is to develop an approach for implementing business excellence (BE) based on prevailing corporate culture and to propose relevant gates to monitor the corporate culture in the way to excellence.

Design/methodology/approach

– This research demonstrates a culture-based perspective of implementing BE. After an exhaustive review of literature, the relation between BE and corporate culture was clarified and a methodology was developed, which describes how BE projects can be performed successfully in the context of an existing culture instead of adapting the culture.

Findings

– The outcome of this research is the main concept for culture-based implementation of BE. Furthermore, five culture gates were designed to control the effect of BE measures on the corporate culture in long period of time. The findings indicate how BE can be implemented without considerable efforts to change the culture.

Practical implications

– The findings of this study are relevant to all different sized organizations in different sectors and industries for achieving outstanding results and maintain this capability permanently in the organization.

Originality/value

– This paper presents a unique approach for implementing BE in the light of prevailing corporate culture; such an approach has not been addressed in previous publications.
Ideological dilemmas: constructing motherhood through caring consumption in Japan
Authors: Takahashi Mayumi
Published: May 2014

Purpose

– The aim of this article is to examine the topic of mothers' consumption, particularly how mothers of young children as primary caregivers are involved in contemporary consumer culture in Japan, by using the concepts of “caring consumption” and “ideological dilemmas”.

Design/methodology/approach

– Data were gathered from in-depth semi-structured interviews with 12 mothers of young children aged between 1 and 5. Interviews were conducted either at their home or public facilities. The theoretical framework highlights a variability existing within ideology which creates a cultural space for mothering.

Findings

– Mothers' caring consumption is a key means through which motherhood is constituted and how ideologies surrounding mothering are enforced and enacted. They negotiate for certain products and services on behalf of their children, in the name of love, care and devotion, and in consideration of wider social networks. Consumption is part of maternal responsibility and task where a mother not only provides material and emotional support for her child but also becomes a facilitator to connect him/her to a wider social network through her consumption practices.

Originality/value

– This study contributes insight into how mothers of young children in Japan experience consumer culture in a specific sociocultural environment and how they construct cultural meanings of motherhood in interaction with surrounding people and a wider consumption-oriented world.
Theoretical study on multi‐level source design
Authors: Shen Honglei , Elboth Thomas , Tian Gang , Warszawski Jakub , Lilja Didrik
Published: May 2014

This paper studies aspects that influence the de‐ghosting performance of marine multi‐level sources based on a modified Johnson model. The normalized squared error between actual signature and its corresponding ghost‐free signature is introduced to evaluate the multi‐level source design. The results show that optimum depth combinations and volume combinations exist in the design. However, there is also some flexibility in the volume combination which makes it possible to optimize with respect to residual bubble oscillation. By considering both operational aspects and performance, we propose that three or four levels in a multi‐level source are reasonable. Compared to a horizontal source, a multi‐level source can be designed to reduce the notch effect, strengthen the down‐going energy and improve the energy transmission directivity. Studies of the influence of depth and firing time deviations indicate that a multi‐level source is more stable than a normal horizontal source in an operational environment.
A comparison of continuous mass‐lumped finite elements with finite differences for 3‐D wave propagation
Authors: Zhebel Elena , Minisini Sara , Kononov Alexey , Mulder Wim A.
Published: May 2014

The finite‐difference method on rectangular meshes is widely used for time‐domain modelling of the wave equation. It is relatively easy to implement high‐order spatial discretization schemes and parallelization. Also, the method is computationally efficient. However, the use of finite elements on tetrahedral unstructured meshes is more accurate in complex geometries near sharp interfaces. We compared the standard eighth‐order finite‐difference method to fourth‐order continuous mass‐lumped finite elements in terms of accuracy and computational cost. The results show that, for simple models like a cube with constant density and velocity, the finite‐difference method outperforms the finite‐element method by at least an order of magnitude. Outside the application area of rectangular meshes, i.e., for a model with interior complexity and topography well described by tetrahedra, however, finite‐element methods are about two orders of magnitude faster than finite‐difference methods, for a given accuracy.
Theory of mind and emotion recognition skills in children with specific language impairment, autism spectrum disorder and typical development: group differences and connection to knowledge of grammatical morphology, word‐finding abilities and verbal working memory
Authors: Loukusa Soile , Mäkinen Leena , Kuusikko‐Gauffin Sanna , Ebeling Hanna , Moilanen Irma
Published: May 2014

Background

Social perception skills, such as understanding the mind and emotions of others, affect children's communication abilities in real‐life situations. In addition to autism spectrum disorder (ASD), there is increasing knowledge that children with specific language impairment (SLI) also demonstrate difficulties in their social perception abilities.

Aims

To compare the performance of children with SLI, ASD and typical development (TD) in social perception tasks measuring Theory of Mind (ToM) and emotion recognition. In addition, to evaluate the association between social perception tasks and language tests measuring word‐finding abilities, knowledge of grammatical morphology and verbal working memory.

Method & Procedures

Children with SLI (n = 18), ASD (n = 14) and TD (n = 25) completed two NEPSY‐II subtests measuring social perception abilities: (1) Affect Recognition and (2) ToM (includes Verbal and non‐verbal Contextual tasks). In addition, children's word‐finding abilities were measured with the TWF‐2, grammatical morphology by using the Grammatical Closure subtest of ITPA, and verbal working memory by using subtests of Sentence Repetition or Word List Interference (chosen according the child's age) of the NEPSY‐II.

Outcomes & Results

Children with ASD scored significantly lower than children with SLI or TD on the NEPSY‐II Affect Recognition subtest. Both SLI and ASD groups scored significantly lower than TD children on Verbal tasks of the ToM subtest of NEPSY‐II. However, there were no significant group differences on non‐verbal Contextual tasks of the ToM subtest of the NEPSY‐II. Verbal tasks of the ToM subtest were correlated with the Grammatical Closure subtest and TWF‐2 in children with SLI. In children with ASD correlation between TWF‐2 and ToM: Verbal tasks was moderate, almost achieving statistical significance, but no other correlations were found.

Conclusions & Implications

Both SLI and ASD groups showed difficulties in tasks measuring verbal ToM but differences were not found in tasks measuring non‐verbal Contextual ToM. The association between Verbal ToM tasks and language tests was stronger in children with SLI than in children with ASD. There is a need for further studies in order to understand interaction between different areas of language and cognitive development.
Genome‐scale metabolic reconstruction and constraint‐based modelling of the Antarctic bacterium Pseudoalteromonas haloplanktis TAC125
Authors: Fondi Marco , Maida Isabel , Perrin Elena , Mellera Alessandra , Mocali Stefano , Parrilli Ermenegilda , Tutino Maria Luisa , Liò Pietro , Fani Renato
Published: May 2014

The Antarctic strain Pseudoalteromonas haloplanktis TAC125 is one of the model organisms of cold‐adapted bacteria and is currently exploited as a new alternative expression host for numerous biotechnological applications.

Here, we investigated several metabolic features of this strain through in silico modelling and functional integration of –omics data. A genome‐scale metabolic model of P. haloplanktis TAC125 was reconstructed, encompassing information on 721 genes, 1133 metabolites and 1322 reactions. The predictive potential of this model was validated against a set of experimentally determined growth rates and a large dataset of growth phenotypic data. Furthermore, evidence synthesis from proteomics, phenomics, physiology and metabolic modelling data revealed possible drawbacks of cold‐dependent changes in gene expression on the overall metabolic network of P. haloplanktis TAC125. These included, for example, variations in its central metabolism, amino acid degradation and fatty acid biosynthesis.

The genome‐scale metabolic model described here is the first one reconstructed so far for an Antarctic microbial strain. It allowed a system‐level investigation of variations in cellular metabolic fluxes following a temperature downshift. It represents a valuable platform for further investigations on P. haloplanktis TAC125 cellular functional states and for the design of more focused strategies for its possible biotechnological exploitation.
Novel aspinolide production by Trichoderma arundinaceum with a potential role in Botrytis cinerea antagonistic activity and plant defence priming
Authors: Malmierca Mónica G. , Barua Javier , McCormick Susan P. , Izquierdo‐Bueno Inmaculada , Cardoza Rosa E. , Alexander Nancy J. , Hermosa Rosa , Collado Isidro G. , Monte Enrique , Gutiérrez Santiago
Published: May 2014

Harzianum A (HA), a trichothecene produced by Trichoderma arundinaceum, has recently been described to have antagonistic activity against fungal plant pathogens and to induce plant defence genes. In the present work, we have shown that a tri5 gene‐disrupted mutant that lacks HA production overproduces two polyketides, aspinolides B and C, which were not detected in the wild‐type strain. Furthermore, four new aspinolides (D–G) were characterized. These compounds confirm that a terpene‐polyketide cross‐pathway exists in T. arundinaceum, and they may be responsible for the antifungal activity and the plant sensitization effect observed with the tri5‐disrupted mutant. In addition, the molecular changes involving virulence factors in the phytopathogenic fungus Botrytis cinerea 98 (Bc98) during interaction with T. arundinaceum were investigated. The expression of genes involved in the production of botrydial by Bc98 was relatively repressed by HA, whereas other virulence genes of this pathogen were induced by the presence of T. arundinaceum, for example atrB and pg1 which encode for an ABC transporter and endopolygalacturonase 1 respectively. In addition, the interaction with Bc98 significantly repressed the production of HA by T. arundinaceum, indicating that a bidirectional transcriptional regulation is established between these two antagonistic fungi.
Validation of a new catalysed reporter deposition–fluorescence in situ hybridization probe for the accurate quantification of marine Bacteroidetes populations
Authors: Acinas Silvia G. , Ferrera Isabel , Sarmento Hugo , Díez‐Vives Cristina , Forn Irene , Ruiz‐González Clara , Cornejo‐Castillo Francisco M. , Salazar Guillem , Gasol Josep M.
Published: May 2014

Catalysed reporter deposition–fluorescence in situ hybridization (CARD‐FISH) is a powerful approach to quantify bacterial taxa. In this study, we compare the performance of the widely used Bacteroidetes CF319a probe with the new CF968 probe. In silico analyses and tests with isolates demonstrate that CF319a hybridizes with non‐Bacteroidetes sequences from the Rhodobacteraceae and Alteromonadaceae families. We test the probes’ accuracy in 37 globally distributed marine samples and over two consecutive years at the Blanes Bay Microbial Observatory (NW Mediterranean). We also compared the CARD‐FISH data with the Bacteroidetes 16S rRNA gene sequences retrieved from 27 marine metagenomes from the TARA Oceans expedition. We find no significant differences in abundances between both approaches, although CF319a targeted some unspecific sequences and both probes displayed different abundances of specific Bacteroidetes phylotypes. Our results demonstrate that quantitative estimations by using both probes are significantly different in certain oceanographic regions (Mediterranean Sea, Red Sea and Arabian Sea) and that CF968 shows seasonality within marine Bacteroidetes, notably large differences between summer and winter that is overlooked by CF319a. We propose CF968 as an alternative to CF319a for targeting the whole Bacteroidetes phylum since it has better coverage, greater specificity and overall better quantifies marine Bacteroidetes.
The taste of freedom: commensality, liminality, and return amongst Afghan transnational migrants in the UK and Pakistan
Authors: Khan Nichola
Published: May 2014

This study follows UK Afghan migrants on a return visit to Northwest Pakistan. Combining theorizations of mobility, liminality, and commensality, it takes the picnic trip (chakar) as a little‐explored cultural lens through which to analyse symbolic formations of freedom, the shaping of Pakhtun transnational labour, and social hierarchies constituted through migration and return. As potent imaginary sites of remembering and forgetting, chakar map destinations left and not‐yet arrived at, routes of flight and return, and the burden of multi‐levelled constellations of political and economic insecurity on refugees living between the UK and Pakistan. The article argues that chakar are at once therapeutic and reproductive of ways in which personal and systemic realities combine features of hierarchy, exploitation, and patriarchy. They sustain participants in a tension between desires to preserve the hierarchies they conceal, and desires for more freedom. These contradictory experiences are usefully analysed through the emblematic arc of the ‘round trip’.
Ethylene signalling affects susceptibility of tomatoes to Salmonella
Authors: Marvasi Massimiliano , Noel Jason T. , George Andrée S. , Farias Marcelo A. , Jenkins Keith T. , Hochmuth George , Xu Yimin , Giovanonni Jim J. , Teplitski Max
Published: May 2014

Fresh fruits and vegetables are increasingly recognized as important reservoirs of human pathogens, and therefore, significant attention has been directed recently to understanding mechanisms of the interactions between plants and enterics, like Salmonella. A screen of tomato cultivars for their susceptibility to Salmonella revealed significant differences in the ability of this human pathogen to multiply within fruits; expression of the Salmonella genes (cysB, agfB, fadH) involved in the interactions with tomatoes depended on the tomato genotype and maturity stage. Proliferation of Salmonella was strongly reduced in the tomato mutants with defects in ethylene synthesis, perception and signal transduction. While mutation in the ripening‐related ethylene receptor Nr resulted only in a modest reduction in Salmonella numbers within tomatoes, strong inhibition of the Salmonella proliferation was observed in rin and nor tomato mutants. RIN and NOR are regulators of ethylene synthesis and ripening. A commercial tomato variety heterozygous for rin was less susceptible to Salmonella under the greenhouse conditions but not when tested in the field over three production seasons.
How do general practitioners engage with allied health practitioners to prevent falls in older people? An exploratory qualitative study
Authors: Grant Alasdair , Mackenzie Lynette , Clemson Lindy
Published: May 2014

Aim

To explore general practitioners' (GPs') perceptions about their use of Chronic Disease Management (CDM) items to access allied health interventions, in particular occupational therapy and physiotherapy, with the purpose of preventing falls, as well as to identify GP support needs with regard to development of partnerships with local allied health practitioners.

Method

A qualitative study was conducted in the Sydney metropolitan area through individual semistructured interviews with eight GPs, which were recorded, transcribed and analysed thematically.

Results

Themes included (i) difficulties and opportunities associated with multidisciplinary care; (ii) potential for CDM items to be used to support falls prevention strategies; and (iii) the user‐friendliness of the CDM items.

Conclusion

Effective coordination of multidisciplinary care between GPs and allied health professionals was desired but difficult to achieve through the CDM system, making translation of falls prevention evidence into clinical practice challenging. Further education on falls prevention and CDM item modification is needed to bridge this gap.
Cognitive impairment in coeliac disease improves on a gluten‐free diet and correlates with histological and serological indices of disease severity
Authors: Lichtwark I. T. , Newnham E. D. , Robinson S. R. , Shepherd S. J. , Hosking P. , Gibson P. R. , Yelland G. W.
Published: May 2014

Background

Mild impairments of cognition or ‘Brain fog’ are often reported by patients with coeliac disease but the nature of these impairments has not been systematically investigated.

Aim

This longitudinal pilot study investigated relationships between cognitive function and mucosal healing in people with newly diagnosed coeliac disease commencing a gluten‐free diet.

Methods

Eleven patients (8 females, 3 males), mean age 30 (range 22–39) years, were tested with a battery of cognitive tests at weeks 0, 12 and 52. Information processing efficacy, memory, visuospatial ability, motoric function and attention were tested. Small bowel biopsies were collected via routine gastroscopy at weeks 12 and 52 and were compared to baseline Marsh scores. Cognitive performance was compared to serum concentrations of tissue transglutaminase antibodies, biopsy outcomes and other biological markers.

Results

All patients had excellent adherence to the diet. Marsh scores improved significantly (P = 0.001, Friedman's test) and tissue transglutaminase antibody concentrations decreased from a mean of 58.4 at baseline to 16.8 U/mL at week 52 (P = 0.025). Four of the cognitive tests assessing verbal fluency, attention and motoric function showed significant improvement over the 12 months and strongly correlated with the Marsh scores and tissue transglutaminase antibody levels (r = 0.377–0.735; all P < 0.05). However, no meaningful patterns of correlations were found for nutritional or biochemical markers, or markers of intestinal permeability.

Conclusions

In newly diagnosed coeliac disease, cognitive performance improves with adherence to the gluten‐free diet in parallel to mucosal healing. Suboptimal levels of cognition in untreated coeliac disease may affect the performance of everyday tasks.
Suicide in bipolar disorder: characteristics and subgroups
Authors: Schaffer Ayal , Sinyor Mark , Reis Catherine , Goldstein Benjamin I , Levitt Anthony J
Published: May 2014

Objectives

The development of more sophisticated models for understanding suicide among people with bipolar disorder (BD) requires diagnosis‐specific data. The present study aimed to elucidate differences between people who die by suicide with and without BD, and to identify subgroups within those with BD.

Methods

Data on all suicide deaths in the city of Toronto from 1998 to 2010 were extracted from the Office of the Chief Coroner of Ontario, including demographics, clinical variables, recent stressors, and details of the suicide. Comparisons of person‐ and suicide‐specific variables between suicide deaths among those with BD (n = 170) and those without (n = 2,716) were conducted, and a cluster analysis was performed among the BD suicide group only.

Results

Those in the BD suicide group were more likely than those in the non‐BD suicide group to be female [odds ratio (OR) = 1.75, 95% confidence interval (CI): 1.27–2.42; p = 0.001], to have made a past suicide attempt (OR = 2.01, 95% CI: 1.45–2.80; p < 0.0001), and to have had recent contact with psychiatric or emergency services (OR = 1.59, 95% CI: 1.00–2.52; p = 0.049). Five clusters were identified within the BD group, with differences between clusters in age; sex; marital status; living circumstances; past suicide attempts; substance abuse; interpersonal, employment/financial, and legal/police stressors; and rates of death by fall/jump or self‐poisoning.

Conclusions

The present findings identified differences between BD and non‐BD suicide groups, providing support to the utilization of an illness‐specific approach to better understanding suicide in BD. Subgroups of BD suicide deaths, if replicated, should also be incorporated into the design and analysis of future studies of suicide in BD.
Hypothesis testing for an extended cox model with time‐varying coefficients
Authors: Saegusa Takumi , Di Chongzhi , Chen Ying Qing
Published: May 2014

The log‐rank test has been widely used to test treatment effects under the Cox model for censored time‐to‐event outcomes, though it may lose power substantially when the model's proportional hazards assumption does not hold. In this article, we consider an extended Cox model that uses B‐splines or smoothing splines to model a time‐varying treatment effect and propose score test statistics for the treatment effect. Our proposed new tests combine statistical evidence from both the magnitude and the shape of the time‐varying hazard ratio function, and thus are omnibus and powerful against various types of alternatives. In addition, the new testing framework is applicable to any choice of spline basis functions, including B‐splines, and smoothing splines. Simulation studies confirm that the proposed tests performed well in finite samples and were frequently more powerful than conventional tests alone in many settings. The new methods were applied to the HIVNET 012 Study, a randomized clinical trial to assess the efficacy of single‐dose Nevirapine against mother‐to‐child HIV transmission conducted by the HIV Prevention Trial Network.
The scientific basis for the use of biomaterials in stress urinary incontinence (SUI) and pelvic organ prolapse (POP)
Authors: Colaco Marc , Mettu Jayadev , Badlani Gopal
Published: May 2014

Objectives

To review the scientific and clinical literature to assess the basis for the use of biomaterials in stress urinary incontinence (SUI) and pelvic organ prolapse (POP). Pelvic floor diseases (PFDS), such as SUI and POP, are common and vexing disorders. While synthetic mesh‐based repairs have long been considered an option for PFD treatment, and their efficacy established in randomised clinical trials, safety of its use has recently been called into question.

Materials and Methods

Using the PubMed, MEDLINE and Medical Subject Headings (MeSH) databases, we performed a critical review of English‐language publications that contained the following keywords: ‘pelvic organ prolapse’, ‘stress urinary incontinence’, ‘mesh’, ‘biomaterial’, ‘collagen’, ‘elastin’ and ‘extracellular matrix’. After reviewing for relevance for mesh use in the pelvis by two independent reviewers with a third available in the case of disagreement, a total of 60 articles were included in the present review.

Results

We found that many of the potential causes of PFDs are due to altered metabolism of patient extracellular matrix (specifically collagen, elastin, and their respective enzymes) and as such, repairs using native tissue may suffer from the same abnormalities leading to a subsequent lack of repair integrity. However, mesh use is not without its unique risks. Several publications have suggested that biomaterials may undergo alteration after implantation, but these findings have not been demonstrated in the normal milieu.

Conclusion

While the decision for the use of synthetic mesh is scientifically sound, its benefits and risks must be discussed with the patient in an informed decision‐making process.
Decreased muscle mass is not an independent risk factor for metabolic syndrome in Korean population aged 70 or older
Authors: Koo Hyung Suk , Kim Moon Jong , Kim Kwang‐Min , Kim Young‐Sang
Published: May 2014

Context

The association of low muscle mass with cardiometabolic risks is still controversial.

Objective

The aim of this study was to investigate the relationship between low muscle mass and metabolic syndrome (MetS) according to the various muscle mass indices and to evaluate the influence of muscle mass on MetS independent of fat mass.

Design

Cross‐sectional study

Subjects

About 841 men and 1106 women aged 70 or older from Korea National Health and Nutrition Examination Survey 2008–2010

Measurements

We used various muscle mass indices: appendicular skeletal muscle mass (ASM) divided by height squared (ASM/Ht2), ASM divided by body weight (ASM/Wt) and ASM adjusted for height and fat mass (residual). Low muscle mass is defined as ASM/Ht2 and ASM/Wt below 2 SD of the sex‐specific mean for healthy young adults. The sex‐specific lowest quintile of the distribution of the residual was regarded as low muscle mass.

Results

The prevalence of MetS was higher in the population with low muscle mass defined by ASM/Wt, but lower in those defined by ASM/Ht2. However, after stratification according to the central obesity, low muscle mass was barely related with MetS. Meanwhile, when both ASM and fat mass were included in a logistic regression model, the odds ratios of 1 SD change of ASM for MetS were 1·07 (0·85–1·34) for men and 1·24 (1·04–1·47) for women, respectively.

Conclusions

The relationship between low muscle mass and MetS was different according to the various muscle mass indices. After controlling the influence of fat mass, decreased muscle mass was not an independent risk factor for MetS.
Effects of radioiodine treatment for differentiated thyroid cancer on testis function
Authors: Canale Domenico , Ceccarelli Claudia , Caglieresi Carolina , Moscatelli Agnese , Gavioli Silvia , Santini Pierina , Elisei Rossella , Vitti Paolo
Published: May 2014

Objective

To evaluate the effects of radioactive iodine (RAI) treatment for differentiated thyroid cancer (DTC) on testis function.

Design

A prospective longitudinal single‐centre study was performed. A comprehensive andrological evaluation including hormonal assessment, semen analysis and scrotal ultrasound was undertaken in male patients undergoing RAI treatment for DTC.

Methods

Hormonal assessment of FSH, LH, testosterone (T), sperm concentration and motility and testis volume were determined in 20 patients in basal conditions, 6 and 12 months after RAI. Results were analysed in the whole group of patients and then separately in those who received one single ablative treatment (‘Single’ group, n = 10) and those who received multiple treatments (‘Multiple’ group, n = 10).

Results

In basal conditions, 3 of 20 (15%) patients had a reduced sperm count and belonged to the ‘Multiple’ group. After RAI, an increase of FSH (8·8 ± 1·2 UI/l vs 5·2 ± 1·2, P < 0·005) and a decrease in sperm concentration (28·8 ± 7·7 millions/ml vs 54·5 ± 7·1, P < 0·005) and testis volume (15·2 ± 3·1 vs 13·7 ± 0·8 ml, P < 0·005) occurred at 6 months in the whole group. One year after RAI, seven patients had oligozoospermia (five from the ‘Multiple’ group and two from the ‘Single’ group). Permanent impairment of one or more testis function parameters was observed in patients who underwent multiple RAI treatments: 50% for sperm count, 40% for FSH levels and testis volume and, respectively, in 20 and 10% of those who received one single RAI treatment.

Conclusions

The single ablative RAI treatment in cancer patients is better tolerated respect multiple RAI treatments regard testis function. Multiple treatments for recurrent or metastatic disease may cause a permanent impairment of one or more parameters related to the reproductive potential of male patients.
Radiological and Histological Evaluation of the Effects of Cortical Perforations on Bone Healing in Mandibular Onlay Graft Procedures
Authors: Dayangac Emre , Araz Kenan , Oguz Yener , Bacanli Didem , Caylak Berrin , Uckan Sina
Published: May 2014

Background

Perforations of the cortical bone may be an advantage for the success of the autogenous bone graft procedure, but whether this perforation has a positive effect on the bone remains controversial.

Purpose

This study evaluates the effects of cortical perforation of the autogenous bone block graft radiologically and histologically.

Materials and Methods

Seven adult pigs were used for this study. On the experimental side, cortical perforation at the host site was prepared, while no perforation was done on the control side. The specimens were evaluated, and the Wilcoxon signed‐rank test was used for statistical analysis.

Results

In the radiological evaluation, the Wilcoxon signed‐rank test indicated no significant differences in densities among the grafts (p = .23) with a mean of 4.29 ± 0.951 for the unperforated graft side and 3.57 ± 0.976 for the decorticated graft side. In histological evaluation, there was a significant difference in the thickness of the grafts between the groups (experimental group 3.71 ± 1.286, control group: 4.71 ± 0.488; p = .033). However, when the remodeling and osteoblastic activity in the grafts were measured, no significant differences were observed between the groups (p = 1 and p = .133, respectively).

Conclusion

In augmentation with mandibular onlay bone grafts, cortical perforations in the recipient site make no distinct contribution to bone healing within 12 weeks.
Enhanced bone healing by improved fibrin‐clot formation via fibrinogen adsorption on biphasic calcium phosphate granules
Authors: Kim Beom‐Su , Lee Jun
Published: May 2014

Objectives

Fibrin clots play an important role in bone tissue regeneration. This study aimed at improving the fibrin‐clotting rate by coating the surface of biphasic calcium phosphate (BCP) granules with fibrinogen (FNG).

Methods and materials

FNG was coated on the BCP surface using an adsorption and freeze‐drying method. The surface morphology of FNG‐adsorbed BCP (FNG‐BCP) was characterized using scanning electron microscopy (SEM), and the stability of the adsorbed FNG evaluated by gel electrophoresis and circular dichroism (CD) analysis. The biocompatibility of FNG‐BCP was evaluated in vitro using human mesenchymal stem cells, and in vivo bone‐healing efficiency determined using a rabbit calvarial bone defect model.

Results

SEM studies showed numerous irregularly distributed FNG fractions adsorbed onto the surface of BCP granules. Gel electrophoresis, CD analysis, and in vitro coagulation results showed that the adsorbed FGN maintained its native protein structure and clotting properties. Biocompatibility experiments showed that cell proliferation and adhesion were improved in cells cultivated on the FNG‐BCP granules. After surgical implantation into the bone defects, the FNG‐BCP granules coagulated at the defect site by reacting with the blood discharged from the surgical site tissue. In addition, at 8 weeks, the volume of FNG40‐BCP (P = 0.012) was significantly higher than that of BCP alone in the newly formed bone.

Conclusions

These results indicate that self‐coagulating FNG‐CBP granules may have the potential to be used as a bone substitute for enabling effective bone repair through rapid fibrin‐clot formation.
Rückgang nicht‐melanozytärer Hauttumoren nach Umstellung der Immunsuppression auf mTOR‐Inhibitoren bei organtransplantierten Patienten
Authors: Alter Mareike , Satzger Imke , Schrem Harald , Kaltenborn Alexander , Kapp Alexander , Gutzmer Ralf
Published: May 2014

Hintergrund

Organtransplantierte Patienten entwickeln vermehrt nicht‐melanozytäre Hauttumoren. Aufgrund des multiplen Auftretens und aggressiven Wachstumsverhaltens stellt die chirurgische Therapie oftmals eine Herausforderung dar. Die Umstellung der immunsuppressiven Therapie auf einen mTOR‐Inhibitor kann eine antitumorale Wirkung haben.

Patienten und Methodik

In einer monozentrischen retrospektiven Erhebung wurden im Zeitraum von 2008 bis 2010 organtransplantierte Patienten erfasst, die sich aufgrund von nicht‐melanozytären Hauttumoren vorgestellt hatten. Erfahrungen mit Patienten, die aufgrund von nicht‐melanozytären Hauttumoren auf eine Therapie mit einem mTOR‐Inhibitor umgestellt wurden, werden detailliert dargestellt und aktuelle Studiendaten dazu zusammengefasst.

Ergebnisse

Insgesamt wurden 60 organtransplantierte Patienten mit nicht‐melanozytären Hauttumoren erfasst. Aufgrund der Entwicklung von vielen nicht‐melanozytären Hauttumoren innerhalb weniger Jahre wurde die systemische immunsuppressive Therapie bei 7 Patienten auf Everolimus und bei 5 Patienten auf Sirolimus umgestellt. Acht Patienten konnten hinsichtlich der Anzahl neu entstehender nicht‐melanozytärer Hauttumoren nach Umstellung ausgewertet werden, 4 Patienten mussten die neue immunsuppressive Therapie aufgrund verschiedener Nebenwirkungen wieder absetzen. In den 12 Monaten vor Umstellung der Immunsuppression entwickelten die 8 Patienten histologisch gesichert 16 Plattenepithelkarzinome, 3 Basalzellkarzinome und 22 Morbus Bowen. In den 12 Monaten nach Umstellung auf einen mTOR‐Inhibitor war die Zahl der Plattenepithelkarzinome (n = 2) und der Morbus Bowen (n = 3), nicht jedoch die der Basalzellkarzinome (n = 2) signifikant reduziert. Auch 5 kürzlich publizierte prospektiv‐randomisierte Studien konnten ein vermindertes Auftreten nicht‐melanozytärer Hauttumoren nach Umstellung der immunsuppressiven Therapie auf einen mTOR‐Inhibitor bei organtransplantierten Patienten zeigen.

Schlussfolgerung

Eine Umstellung der immunsuppressiven Therapie auf einen mTOR‐Inhibitor sollte bei organtransplantierten Patienten mit nicht‐melanozytären Hauttumoren diskutiert werden.
Beruflicher Hautkrebs durch UV‐Strahlung – Analyse der Verdachtsmeldungen und Anerkennungen einer „Wie‐BK“ nach § 9 Abs. 2 SGB VII der Jahre 2005 bis 2011 in Deutschland
Authors: Schmitt Jochen , Diepgen Thomas L.
Published: May 2014

Hintergrund

Durch UV‐Strahlen verursachter Hautkrebs ist bisher nicht in der Berufskrankheitenverordnung enthalten und eine Meldung und Anerkennung ist bisher nur als „Wie‐Berufskrankheit“ möglich. Ziel war es, die Verdachtsmeldungen und Anerkennungen von Hautkrebserkrankungen durch UV‐Strahlen in Deutschland in den Jahren 2005 bis 2011 zu analysieren.

Patienten und Methodik

Es wurden alle Verdachtsmeldungen von Hautkrebs durch UV‐Strahlung, die im Mai 2012 bei der Deutschen Gesetzlichen Unfallversicherung bekannt waren, ausgewertet. Die Datenanalyse erfolgte deskriptiv, stratifiziert nach Meldejahr, um zeitliche Trends darzustellen.

Ergebnisse

Die Zahl der Verdachtsmeldungen hat von 2005 bis 2011 ständig zugenommen, wobei insgesamt 548 Verdachtsmeldungen von arbeitsbedingtem Hautkrebs durch UV‐Strahlung registriert und 74 als Berufskrankheit anerkannt wurden. In 56 Fällen war das Verfahren noch nicht abgeschlossen. Am häufigsten fanden sich Plattenepithelkarzinome der Haut und Plattenepithelkarzinomata in situ (aktinische Keratosen, Morbus Bowen) bei insgesamt 333 Personen, die auch die höchste Anerkennungsrate zeigten (15,6 bzw. 24,9 %). Bei 184 Personen lagen Basalzellkarzinome vor, die Anerkennungsrate war mit 6,5 % deutlich niedriger, wobei in nur 3 Fällen die Anerkennung ausschließlich aufgrund eines Basalzellkarzinoms erfolgte. Von 50 Fällen mit Melanom wurde ein Fall anerkannt.

Schlussfolgerungen

Es zeigt sich eine gute Übereinstimmung mit der Empfehlung des Bundesarbeitsministeriums zur Aufnahme des UV‐Licht‐induzierten Hautkrebs in die Berufskrankheitenverordnung.
New and established treatment options for mycosis fungoides and Sézary syndrome – an update
Authors: Dugas‐Breit Susanne , Schulze Hans‐Joachim , Hallermann Christian
Published: May 2014

At the time of diagnosis primary cutaneous lymphomas are limited to the skin. T‐cell lymphomas represent at least two thirds of all primary cutaneous lymphomas with mycosis fungoides and Sézary syndrome being the most frequent entities. A precise staging based on clinical, histological, immunohistological and molecular biological criteria is crucial for selecting the appropriate therapy. Since curative treatment is only possible in exceptional cases, the aim of any therapy is to achieve healing of the skin lesions, minimizing relapses, preventing progression and maintaining the quality of life. While in early disease stages skin‐directed therapy is being used, in later stages systemic treatments become more important. This work aims to provide an overview of established and new therapies for the treatment of mycosis fungoides and Sézary syndrome.
Rural–Urban Migration and Gender Disparities in Child Healthcare in China and India
Authors: Goodburn Charlotte
Published: May 2014

This article assesses the impact of rural–urban migration on gender disparities in children's access to healthcare in China and India. Much research has shown widespread discrimination against girl children in both countries, including in health investments, contributing to the well‐known problem of Asia's ‘missing’ women. Much less clear is the impact of the massive rural–urban migration now occurring in China and India on discrimination against daughters. Migration is usually thought to have a positive effect on child health, because of improved access to healthcare facilities, but this is not necessarily equally beneficial for both sons and daughters. Based on fourteen months of fieldwork with rural migrant families in Shenzhen (China) and Mumbai (India), this article argues that where migration improves access to healthcare, it may increase rather than decrease the gender gap in treatment of child illness in the short term, as resources are concentrated on the treatment of sons. Furthermore, it is not the case that rural–urban migration necessarily leads to better access to healthcare even for sons: some forms of migration may actually have an overall negative effect on child health outcomes. For these two reasons, development strategies focusing on large‐scale rural–urban migration should not be seen as a short‐term solution to problems of gender inequity in child health.
Disseminated nocardiosis during systemic steroid therapy for the prevention of esophageal stricture after endoscopic submucosal dissection
Authors: Ishida Tsukasa , Morita Yoshinori , Hoshi Namiko , Yoshizaki Tetsuya , Ohara Yoshiko , Kawara Fumiaki , Tanaka Sinwa , Yamamoto Yuki , Matsuo Hiroo , Iwata Kentaro , Toyonaga Takashi , Azuma Takeshi
Published: May 2014

An 85‐year‐old man underwent endoscopic submucosal dissection for a large superficial esophageal epithelial neoplasm, which required removal of 95% of the circumference of the esophageal mucosa. Steroids were given orally to prevent esophageal stricture starting on day 3 postoperatively. In the 6th week of steroid treatment, he developed high fever without other symptoms. Chest computed tomography revealed a nodular lesion in the lung. Sputum sample showed Gram‐positive, branching, filamentous bacteria, and a diagnosis of nocardiosis was suspected. Brain magnetic resonance imaging revealed multiple focal lesions which indicated dissemination of nocardiosis. Trimethoprim‐sulfamethoxazole was immediately started, which led to the disappearance of pulmonary and cerebral nocardiosis with alleviation of fever. Recently, oral steroid treatment has been widely used for the prevention of esophageal stricture. However, the present case indicates the risk of life‐threatening infection and the importance of close monitoring of this treatment.
Efficacy and safety of endoscopic interventions using the short double‐balloon endoscope in patients after incomplete colonoscopy
Authors: Hotta Kinichi , Katsuki Shinichi , Ohata Ken , Abe Takashi , Endo Masaki , Shimatani Masaaki , Nagaya Tadanobu , Kusaka Toshihiro , Matsuda Tomoki , Uraoka Toshio , Yamaguchi Yuichiro , Murakami Yoshitaka , Saito Yutaka
Published: May 2014

Background and Aim

We have previously reported excellent cecal intubation rates using a short double‐balloon endoscope in patients with a history of incomplete colonoscopy. However, data on the endoscopic treatment of colorectal tumors using a double‐balloon endoscope are limited. The aim of the present study was to evaluate the efficacy and safety of endoscopic intervention of colorectal tumors using a short double‐balloon endoscope.

Methods

We analyzed data from a multicenter, prospective study on 110 patients (62 men, median age 66.5 years) who underwent total colonoscopy after incomplete colonoscopy to assess the characteristics of colorectal tumors, endoscopic interventions, and complications.

Results

In all, 113 colorectal tumors were detected in 55 patients; 109 of the tumors were adenomas (24 advanced adenomas) and two each were intramucosal and advanced cancers. Locations of the lesions were eight in the cecum, 30 in the ascending colon, 18 in the transverse colon, 12 in the descending colon, 34 in the sigmoid colon, five in the rectosigmoid and six in the rectum. Average tumor diameter was 6.8 ± 6.3 mm. Fifty‐nine polypectomies, 22 endoscopic mucosal resections, four hot biopsies, and six cold biopsies were done. All endoscopic interventions were successfully completed and no complications were noted. Two advanced cancers were located in the ascending colon and only a double‐balloon endoscope could reach them to take a biopsy sample.

Conclusion

Double‐balloon endoscopy is effective and safe for endoscopic intervention of colorectal tumors, irrespective of the location, in patients after incomplete colonoscopy.
Echocardiographic Evaluation in Transposition of the Great Arteries in the Adult
Authors: Thadani Samir R. , Foster Elyse
Published: May 2014

Transposition of the great arteries is marked by ventriculo–arterial discordance and occurs in 2 distinct subtypes. Echocardiography is the primary method of evaluating this condition in the adult. Key elements of the echocardiographic exam include confirming the diagnosis, evaluating ventricular size and function, assessing valvular regurgitation, identifying atrial baffle leaks or obstruction, estimating pulmonary artery pressures, and ruling out residual shunts.
Echocardiographic Evaluation of Tetralogy of Fallot
Authors: Swamy Pooja , Bharadwaj Aditya , Varadarajan Padmini , Pai Ramdas G.
Published: May 2014

Tetralogy of Fallot (TOF) is a cyanotic heart disease consisting of nonrestrictive ventricular septal defect, overriding aorta, pulmonary stenosis, and right ventricular hypertrophy. Early total correction is the treatment of choice and these patients with repaired TOF are increasingly seen in adult practice. This review addresses echocardiographic evaluation of TOF, corrected TOF, its sequelae and various complications. A working knowledge of TOF assessment is essential for all adult cardiologists and sonographers.
Exercise mitigates diclofenac‐induced liver mitochondrial dysfunction
Authors: Santos‐Alves Estela , Marques‐Aleixo Ines , Coxito Pedro , Balça Maria M. , Rizo‐Roca David , Rocha‐Rodrigues Silvia , Martins Sandra , Torrella Joan R. , Oliveira Paulo J. , Moreno Antonio J. , Magalhães José , Ascensão António
Published: May 2014

Background

Several strategies have been developed to counteract liver injury as a consequence of nonsteroid anti‐inflammatory drugs toxicity. Here, we aimed to determine whether physical exercise results in liver mitochondrial protection against in vitro diclofenac toxicity.

Material and methods

Male adult Sprague‐Dawley rats were divided into sedentary, 12‐week endurance training (ET) and voluntary activity (VPA). In vitro liver mitochondrial function as assessed by oxygen consumption, transmembrane electric potential (ΔΨ) and susceptibility to the mitochondrial permeability transition pore (MPTP) was evaluated in the absence and presence of diclofenac. Mitochondrial oxidative stress markers [MnSOD, aconitase, ‐SH and MDA, SIRT3, p66shc(Ser36)/p66shc ratio] and apoptotic signalling (caspases 3, 8 and 9, Bax, Bcl‐2 and CypD) were assessed. Content of OXPHOS components and qualitative liver morphological evaluation were assessed.

Results

Despite no effects of ET and VPA on basal liver mitochondrial oxygen consumption or ΔΨ endpoints, exercised animals showed lower susceptibility to MPTP. Diclofenac‐induced decrease in ΔΨ, increased state 4 respiration and susceptibility to MPTP opening were all prevented by exercise. Under untreated conditions, VPA group showed higher aconitase activity, while ET decreased MDA and increased Bax content. VPA decreased p66shc(Ser36), complex III and V OXPHOS subunits. Both ET and VPA increased complex IV OXPHOS subunit, and SIRT3 and Bcl‐2 content and decreased caspase 9 activity. Unexpectedly, ET and VPA decreased ANT.

Conclusions

Both chronic physical exercise models augmented the resistance to in vitro diclofenac‐induced mitochondrial alterations, including increased MPTP susceptibility, possibly by modulating oxidative stress and MPTP regulators.
POLITICAL IDEOLOGY AND ECONOMIC GROWTH: EVIDENCE FROM THE FRENCH DEMOCRACY
Authors: FACCHINI FRANÇOIS , MELKI MICKAEL
Published: May 2014

We provide a test of the impact of voters' political ideology on economic growth and of the role of preferences for government size as a transmission channel. We focus on France from the beginning of its stable democratic experience in 1871. A move of voters' ideology to the right increases economic growth over the total observation period. However, the growth effect of ideology is mediated by voters' preferences for government size only during the post‐World War II period. For reverse causality concerns, we use the political ideology of other historical democracies as an instrument variable for France's ideology. (JELE6, O43, H11)