bluuebunny/crossref_metadata_2025 huggingface dataset:
A native-visitor in Western Australia: an account of an insider-outsider
Authors: Holmes Kirsten , Rowley Steven
Published: October 2015

Purpose

– This study aims to apply confirmatory personal introspection (CPI) to illuminate the experiences of the authors as partial native-visitors to Western Australia. The native-visitor is the tourist who is able to see beyond Urry’s shallow conception of the Tourist Gaze through their lengthy immersion as “insiders” in the destination’s culture. In this paper, the experiences of two immigrants, the authors, to Western Australia illustrate the different perspectives of the Tourist Gaze 4.0.

Design/methodology/approach

– The paper uses CPI, as this is a more reliable method of uncovering a traveler’s experiences than subjective personal introspection because CPI uses additional data sources such as written historical records and photographs for confirming the researcher’s accounts. In this study, accounts of both authors alongside photographs are used to both confirm and contrast their individual experiences.

Findings

– The paper demonstrates the varied forms of the tourist gaze, with an emphasis on that of the native visitor. The findings illustrate how individuals’ both maintain aspects of their original cultural identity and adopt those of the new country after an extended time living in that country. This enables individuals to see attractions and destinations from an insider perspective.

Practical implications

– This study shows how even after an extended period of time living in a new country, visitors may not have the cultural confidence to behave as local residents at tourist attractions and destinations, which could limit their engagement and enjoyment of these experiences. Marketers should take this into account in designing and promoting tourist experiences to visitors.

Originality/value

– CPI provides a valuable means for illustrating the range of perspectives within the Tourist Gaze 4.0. The method enables individuals’ rich experiences to be uncovered but at the same time uses multiple data sources to provide additional rigour.
My traditional Japanese wedding?
Authors: Martin Drew
Published: October 2015

Purpose

– This paper aims to demonstrate deep gaze using a Japanese Shinto wedding ceremony as an example. Some long-term tourists develop an intimate understanding of the host country’s culture by gaining access to authentic experiences typically limited to the locals. These native visitors experience a deep gaze.

Design/methodology/approach

– Combing subjective personal introspection (SPI) and confirmatory personal introspection (CPI), the author’s 76 wedding photographs are examined critically.

Findings

– Results demonstrate how a native visitor uses SPI and CPI analyses of native gaze. While the Shinto wedding ceremony’s authenticity mixes traditional and evolutionary elements, the ceremony is best viewed as a Gestalt experience. The evidence suggests authenticity need not have deep roots in the culture.

Research limitations/implications

– The findings serve as only one configuration of many possible gazes. Tourist Gaze 4.0 is a set of complex antecedent conditions and multiple configurations.

Originality/value

– Using photographs taken by native family members, this paper demonstrates how SPI and CPI identify deep gaze through a different lens.
Patient satisfaction constructs
Authors: Rahman Muhammad Sabbir , Osmangani Aahad M
Published: October 2015

Purpose

– The purpose of this paper is to examine the five-factor structure of patients’ satisfaction constructs toward private healthcare service providers.

Design/methodology/approach

– This research is a cross-sectional study. A questionnaire-based survey was conducted with previous and current Bangladeshi patients. Exploratory factor analysis was employed to extract the underlying constructs.

Findings

– Five underlying dimensions that play a significant role in structuring the satisfaction perceived by Bangladeshi private healthcare patients are identified in this study.

Practical implications

– The main contribution of this study is identifying the dimensions of satisfaction perceived by Bangladeshi patients regarding private healthcare service providers.

Originality/value

– Healthcare managers adopt the five identified underlying construct items in their business practices to improve their respective healthcare efficiency while ensuring overall customer satisfaction.
Lean Six Sigma implementation and organizational culture
Authors: Knapp Susan
Published: October 2015

Purpose

– The purpose of this paper is to examine the relationship between four organizational cultural types defined by the Competing Values Framework and three Lean Six Sigma implementation components – management involvement, use of Lean Six Sigma methods and Lean Six Sigma infrastructure.

Design/methodology/approach

– The study involved surveying 446 human resource and quality managers from 223 hospitals located in Maine, New Hampshire, Vermont, Massachusetts and Rhode Island using the Organizational Culture Assessment Instrument.

Findings

– In total, 104 completed responses were received and analyzed using multivariate analysis of variance. Follow-up analysis of variances showed management support was significant, F(3, 100)=4.89, p
<
0.01, η2=1.28; infrastructure was not significant, F(3, 100)=1.55, p=0.21, η2=0.05; and using Lean Six Sigma methods was also not significant, F(3, 100)=1.34, p=0.26, η2=0.04. Post hoc analysis identified group and development cultures having significant interactions with management support.

Practical implications

– The relationship between organizational culture and Lean Six Sigma in hospitals provides information on how specific cultural characteristics impact the Lean Six Sigma initiative key components. This information assists hospital staff who are considering implementing quality initiatives by providing an understanding of what cultural values correspond to effective Lean Six Sigma implementation.

Originality/value

– Managers understanding the quality initiative cultural underpinnings, are attentive to the culture-shared values and norm’s influence can utilize strategies to better implement Lean Six Sigma.
Early warning scores: unravelling detection and escalation
Authors: Smith Gary B , Prytherch David R , Meredith Paul , Schmidt Paul E
Published: October 2015

Purpose

– The purpose of this paper is to increase understanding of how patient deterioration is detected and how clinical care escalates when early warning score (EWS) systems are used.

Design/methodology/approach

– The authors critically review a recent National Early Warning Score paper published in IJHCQA using personal experience and EWS-related publications, and debate the difference between detection and escalation.

Findings

– Incorrect EWS choice or poorly understood EWS escalation may result in unnecessary workloads forward and responding staff.

Practical implications

– EWS system implementers may need to revisit their guidance materials; medical and nurse educators may need to expand the curriculum to improve EWS system understanding and use.

Originality/value

– The paper raises the EWS debate and alerts EWS users that scrutiny is required.
Addressing child labour: reflections on the WTO’s role
Authors: Williams Jessica
Published: October 2015

Purpose

– This paper aims to analyse whether the World Trade Organisation (WTO) covered agreements ought to be interpreted in a manner that enables an importing country to restrict or prohibit import of goods manufactured using child labour. This question is pertinent, given the WTO-covered agreements do not explicitly mention child labour, yet there is increasing international concern for the phenomenon of child labour, evidenced through international human rights law and international labour law treaties and a push by some developed countries’ WTO Members for inclusion of a “social clause” governing child labour under the covered agreements.

Design/methodology/approach

– This paper examines the WTO-covered agreements, current trends in interpretation of the covered agreements by panels and the Appellate Body (AB) and scholarly debate regarding connecting trade with labour standards and human rights.

Findings

– This paper argues: that although inclusion of a social clause in the covered agreements is unlikely, Article XX(a) GATT, Article XX(b) GATT and Article 2.1 TBT can in certain circumstances be interpreted as to allow such restrictions on the import of goods; that no clear academic argument logically precludes connecting trade with labour standards and human rights; and that to legitimate both the WTO and the international legal system as a whole, the covered agreements, as the basis of international trade law, ought to be interpreted in a manner consistent with international labour law and international human rights law.

Originality/value

– This paper draws upon the recent AB decision in European Commission – Seal Products, examining the AB’s interpretation of the Article XX(a) GATT “public morals” exception. This paper further seeks to provide a succinct overview of the argument surrounding WTO involvement in the issue of child labour.
Histamine H4 receptor knockout mice display reduced inflammation in a chronic model of atopic dermatitis
Authors: Rossbach K. , Schaper K. , Kloth Ch. , Gutzmer R. , Werfel T. , Kietzmann M. , Bäumer W.
Published: October 2015

Background

The histamine H4 receptor (H4R) was brought into focus as a new therapeutic target for the treatment of allergic disorders such as atopic dermatitis (AD). H4R antagonists have already been tested in several animal models of AD, but these studies have yielded conflicting results.

Material and methods

The development of ovalbumin‐induced AD‐like skin lesions was analysed in H4R−/− mice and in H4R antagonist (JNJ28307474)‐treated mice.

Results

H4R−/− mice showed a clear amelioration of the skin lesions, with a diminished influx of inflammatory cells and a reduced epidermal hyperproliferation at lesional skin sites. H4R−/− mice had a reduced amount of ovalbumin‐specific IgE, a reduced number of splenocytes and lymph node cells with a decreased number of CD4+ T cells. The H4R modulated the cytokine secretion of CD4+ T cells and splenocytes and altered the cellular profile in the lymph nodes. The anti‐inflammatory effect could only partially be mimicked by JNJ28307474 and only when the H4R antagonist was given during sensitization and challenge and not when JNJ28307474 was only given during the provocation phase of the allergic reaction.

Conclusion

The H4R modulates inflammation in a chronic allergic dermatitis setting. However, results of this study indicate that it is necessary to block the H4R during ontogeny and development of the allergic inflammation.
Experiencing Functional Electrical Stimulation Roots on Education, and Clinical Developments in Paraplegia and Tetraplegia With Technological Innovation
Authors: Varoto Renato , Cliquet Alberto
Published: October 2015

Cybernetics‐based concepts can allow for complete independence for paralyzed individuals, including sensory motor recovery. Spinal cord injuries are responsible for a huge stress on health and a financial burden to society. This article focuses on novel procedures such as functional diagnosis for paraplegics and tetraplegics, cybertherapies toward lessening comorbidities such as cardiovascular diseases, osteoporosis, etc., and the production of new technology for upper and lower limb control. Functional electrical stimulation reflects a unique opportunity for bipedal gait to be achieved by paraplegics and tetraplegics. Education and training of undergraduates and postgraduates in engineering and life sciences have also been a major aim of this work.
To build a home: the material cultural practices of Karen refugees across borders
Authors: Smith Ei Phyu
Published: October 2015

Civil strife between the central military government and dissident groups in Burma has caused the displacement of Karen refugees since the late 1950s. Fleeing the practices of armed groups that include the confiscation of farmland, forced labour and gendered violence, Karen refugees seek refuge along the Thai–Burma border where they are not recognised as ‘legal persons’ and therefore forced to remain in camps established from the late 1980s. This long‐standing conflict has resulted in one of the most protracted refugee situations in the world. Since 2006, the Canadian government has been re‐settling Karen refugees from this border region. Situated within this context, in this paper I explore Karen refugees' creation of ‘home’ through an examination of their material cultures. I argue that while the notion of home becomes destabilised at different junctures of displacement, phases of mobility and immobility nurture the creation of home. Through their material engagements with dwellings at the Thai–Burma border and in Canada, Karen refugees' everyday practices reinforce the specialised role of place within flows of movement. The bordering projects at the Thai–Burma boundary are reinforced and troubled by both the presence of these shelters, which serve as physical reminders of the ongoing conflict, and the mobility and immobility of bodies.
A novel approach for estimating ingested dose associated with paracetamol overdose
Authors: Zurlinden Todd J. , Heard Kennon , Reisfeld Brad
Published: October 2015

Aim

In cases of paracetamol (acetaminophen, APAP) overdose, an accurate estimate of tissue‐specific paracetamol pharmacokinetics (PK) and ingested dose can offer health care providers important information for the individualized treatment and follow‐up of affected patients. Here a novel methodology is presented to make such estimates using a standard serum paracetamol measurement and a computational framework.

Methods

The core component of the computational framework was a physiologically‐based pharmacokinetic (PBPK) model developed and evaluated using an extensive set of human PK data. Bayesian inference was used for parameter and dose estimation, allowing the incorporation of inter‐study variability, and facilitating the calculation of uncertainty in model outputs.

Results

Simulations of paracetamol time course concentrations in the blood were in close agreement with experimental data under a wide range of dosing conditions. Also, predictions of administered dose showed good agreement with a large collection of clinical and emergency setting PK data over a broad dose range. In addition to dose estimation, the platform was applied for the determination of optimal blood sampling times for dose reconstruction and quantitation of the potential role of paracetamol conjugate measurement on dose estimation.

Conclusions

Current therapies for paracetamol overdose rely on a generic methodology involving the use of a clinical nomogram. By using the computational framework developed in this study, serum sample data, and the individual patient's anthropometric and physiological information, personalized serum and liver pharmacokinetic profiles and dose estimate could be generated to help inform an individualized overdose treatment and follow‐up plan.
Efficiency of a New Mesh‐Type Nebulizer (NE‐SM1 NEPLUS) for Intrapulmonary Delivery of Ipratropium Bromide in Surgical Patients
Authors: Lee Yong‐Hun , Kwon Gu‐Youn , Park Do‐Yang , Bang Ji‐Yeon , Jang Dong‐Min , Lee Soo‐Han , Lee Eun‐Kyung , Choi Byung‐Moon , Noh Gyu‐Jeong
Published: October 2015

This study was aimed to evaluate the efficiency of a new mesh‐type nebulizer for the intrapulmonary delivery of ipratropium bromide in surgical patients under mechanical ventilation. A total of 20 patients were randomly allocated to receive 0.5 mg ipratropium bromide using either a control (Pariboy SX, Pari, Co., Starnberg, Germany, n = 10) or test (NE‐SM1 NEPLUS, KTMED INC., Seoul, Korea, n = 10) nebulizer during general anaesthesia. Ipratropium bromide was nebulized continuously for 20 min. in each group. Plasma concentrations of ipratropium bromide were obtained from blood samples at preset intervals. Non‐compartmental analysis of ipratropium bromide was performed to compare the efficiency of pulmonary drug delivery in both nebulizers. Population pharmacokinetic analysis of ipratropium bromide was performed. Additionally, the noise level during the nebulizer operation and the aerosol particle size for each device were measured. The dose‐normalized AUClast was 0.10 min/L for both nebulizers. The pharmacokinetics of nebulized ipratropium bromide can be described best by a one‐compartment model with first‐order absorption. The apparent volume of distribution and metabolic clearance were 1340 L and 6.78 L/min, respectively. Type of nebulizer was a significant covariate for absorption rate constant. The equivalent sound level and median aerosol particle diameter were 35.0 dB and 4.52 μm for the test nebulizer, and 60.2 dB and 3.85 μm for the control nebulizer, respectively. From the standpoint of the dose‐normalized AUClast, a new vibrating mesh‐type nebulizer shows similar performance in the intrapulmonary delivery of ipratropium bromide to that of a jet‐type nebulizer in surgical patients.
Sequential therapy with cyclophosphamide and mycophenolic acid in patients with progressive immunoglobulin A nephropathy: a long-term follow-up
Authors: Rasche F M , Keller F , Rasche W G , Schiekofer S , Kahn T , Fahnert J
Published: October 2015

In progressive immunoglobulin (Ig)A nephropathy (IgAN), cyclophosphamide pulse therapy (CyP), high-dose intravenous immunoglobulins (IVIg) and mycophenolic acid (MPA) have been used to stop progressive loss of renal function, but disease progression may occur after the end of the initial treatment. Here, we report the long-term follow-up of patients with progressive IgAN with MPA as maintenance therapy after CyP (CyP-MPA). In a median observation time of 6·2 years, we analysed the slopes of the loss of renal function of 47 patients with biopsy-proven IgAN and treated with CyP. Thirty-one patients with further progression were treated with MPA maintenance for a median time of 5·2 years. Follow-up was compared with symptomatic therapy and IVIg as historically matched control groups. Median loss of renal function was reduced significantly from 0·9 ml/min to 0·1 ml/min per month with CyP (P < 0·05), and with MPA in patients with a relapse from −0·4 ml/min to −0·1 ml/min per month (P < 0·05) until the end of the study. Proteinuria decreased significantly from 1·6 g/l to 1·0 g/l after CyP, and during MPA treatment to 0·6 g/l (P = 0·001 Friedman test). Median renal survival time was in patients with CyP 10·5 years (range = 3·2–17·8), with CyP-MPA 10·7 years (range = 8·3–13·1), with IVIg 4·7 years (range = 2·6–6·6), and in untreated patients 1·2 years (range = 0·8–1·6; log-rank test P < 0·01). In patients with progressive IgAN, our long-term follow-up observation indicates that sequential CyP-MPA therapy maintains renal survival significantly.
Insulin‐like growth factor I and risk of incident cancer in elderly men – results from MrOS (Osteoporotic Fractures in Men) in Sweden
Authors: Carlzon Daniel , Svensson Johan , Petzold Max , Karlsson Magnus K. , Ljunggren Östen , Haghsheno Mohammad‐Ali , Damber Jan‐Erik , Mellström Dan , Ohlsson Claes
Published: October 2015

Objective

Studies of the association between circulating IGF‐I and cancer risk have shown conflicting results. We have previously observed a U‐shaped association between IGF‐I and cancer mortality. This study test the hypotheses of a U‐shaped association between IGF‐I and incident cancer.

Design

Elderly men (2368), randomly recruited from the general community.

Methods

IGF‐I was measured in a cohort of elderly men. Complete data for incident cancer were obtained from the Swedish Cancer Registry. Statistical analyses included Cox proportional hazards regressions with or without a spline approach.

Results

Three hundred and sixty‐nine participants had incident cancer after baseline. Prostate cancer was most frequent (n = 140). There was no association between serum IGF‐I and all cancer or prostate cancer incidence. However, there was a nonlinear association between IGF‐I and nonprostate cancer incidence (P = <0·05). Exploratory analyses were performed for low and high serum IGF‐I (quintiles 1 and 5) vs intermediate (quintiles 2–4, referent). There was a tendency of increased nonprostate cancer risk in men with high IGF‐I (HR = 1·26, 95% confidence interval (CI): 0·92–1·71, P = 0·15). After excluding participants with follow‐up of less than 2·6 years (half median follow‐up time), to control for potential diagnostic delay, the association was statistically significant (HR = 1·55, CI: 1·03–2·35).

Conclusion

There was a significant nonlinear association between IGF‐I and nonprostate cancer. No association between IGF‐I and prostate cancer was observed. Future studies are warranted to further investigate this nonlinear association, including whether IGF‐I concentration is a reproducible, and useful, risk marker of nonprostate cancer.
Prospective case‐controlled sound localisation study after cochlear implantation in adults with single‐sided deafness and ipsilateral tinnitus
Authors: Mertens G. , Desmet J. , De Bodt M. , Van de Heyning P.
Published: October 2015

Objectives

To analyse the sound localisation skills of subjects with profound single‐sided deafness (SSD) and accompanied ipsilateral tinnitus who are using a cochlear implant (CI) for between 4 and 11 years.

Design

Sound localisation skills were tested using nine loudspeakers in a frontal semicircle ranging from −90° to +90°. Subjects were tested in the CION and the CIOFF conditions via 3 localisation stimuli: broadband noise (BB), low‐pass noise (LP) and high‐pass noise (HP).

Participants

The test group consisted of 10 adult subjects with profound sensorineural SSD, ipsilateral tinnitus and a CI. Normative data of a control group of 30 normal hearing subjects were used for comparison.

Main outcome measures

Sound location accuracy was analysed via the root‐mean‐square error (RMSE), the mean absolute error (MAE), the localisation bias (‘b’) and the bias‐adjusted deviation (‘db’). Subjective dynamic aspects of hearing were assessed via a reduced version of the Speech, Spatial and Qualities of Hearing Scale (SSQ5).

Results

For all 3 stimuli, the RMSE improved significantly in SSD subjects in the CION condition compared to the CIOFF condition. The localisation accuracy of subjects with SSD improved significantly for BB and HP stimuli. A significant bias‐adjusted deviation ‘db’ was found for the BB and HP stimuli. Subjects’ mean SSQ5 scores were significantly higher in the CION condition at test date than in the CIOFF condition preoperatively.

Conclusions

Subjects can better locate sound in the CION condition than in the CIOFF condition.
Palliative surgical intervention in metastatic colorectal carcinoma: a prospective analysis of quality of life
Authors: Tan W. J. , Chew M. H. , Tan I. B. H. , Law J. H. , Zhao R. , Acharyya S. , Mao Y. L. , Fernandez L. G. , Loi C. T. , Tang C. L.
Published: October 2015

Aim

Quality of life (QOL) was assessed after palliative surgery for incurable metastatic colorectal cancer (CRC).

Method

Newly diagnosed patients with incurable metastatic CRC who were offered elective palliative surgical intervention were included. The European Organization for Research and Treatment of Cancer QLQ‐C30 and QLQ‐CR29 questionnaire was used for the assessment of QOL at baseline and at 3 and 6 months after surgery. Generalized estimating equations were used to estimate the mean change in the QOL score from baseline.

Results

Twenty‐four patients formed the study group. Sixteen underwent resection of the primary tumour and eight had a proximal diversion or bypass. The Global Health (GH) score and Social Functioning (SF) score improved at 3 and 6 months after intervention respectively (GH +11, P = 0.021; SF +15, P = 0.005). Mean anxiety scores were markedly improved from the baseline of 51 to 71 (P = 0.004, 3 months) and 76 (P = 0.002, 6 months). Weight concerns also improved significantly when compared with baseline (3 months, +20, P < 0.001; 6 months, +14, P = 0.012). Symptoms of diarrhoea (3 months, −‒17, P = 0.007; 6 months,‒−16, P = 0.008) and nausea (−‒8, P = 0.032) improved.

Conclusion

In patients with incurable metastatic CRC, surgery improved QOL.
A three‐dimensional skin equivalent reflecting some aspects of in vivo aged skin
Authors: Diekmann Johanna , Alili Lirija , Scholz Okka , Giesen Melanie , Holtkötter Olaf , Brenneisen Peter
Published: October 2015

Human skin undergoes morphological, biochemical and functional modifications during the ageing process. This study was designed to produce a 3‐dimensional (3D) skin equivalent in vitro reflecting some aspects of in vivo aged skin. Reconstructed skin was generated by co‐culturing skin fibroblasts and keratinocytes on a collagen–glycosaminoglycan–chitosan scaffold, and ageing was induced by the exposition of fibroblasts to Mitomycin‐C (MMC). Recently published data showed that MMC treatment resulted in a drug‐induced accelerated senescence (DIAS) in human dermal fibroblast cultures. Next to established ageing markers, histological changes were analysed in comparison with in vivo aged skin. In aged epidermis, the filaggrin expression is reduced in vivo and in vitro. Furthermore, in dermal tissue, the amount of elastin and collagen is lowered in aged skin in vivo as well as after the treatment of 3D skin equivalents with MMC in vitro. Our results show histological signs and some aspects of ageing in a 3D skin equivalent in vitro, which mimics aged skin in vivo.
Histology‐guided protein digestion/extraction from formalin‐fixed and paraffin‐embedded pressure ulcer biopsies
Authors: Taverna Domenico , Pollins Alonda C. , Nanney Lillian B. , Sindona Giovanni , Caprioli Richard M.
Published: October 2015

Herein we present a simple, reproducible and versatile approach for in situ protein digestion and identification on formalin‐fixed and paraffin‐embedded (FFPE) tissues. This adaptation is based on the use of an enzyme delivery platform (hydrogel discs) that can be positioned on the surface of a tissue section. By simultaneous deposition of multiple hydrogels over select regions of interest within the same tissue section, multiple peptide extracts can be obtained from discrete histological areas. After enzymatic digestion, the hydrogel extracts are submitted for LC‐MS/MS analysis followed by database inquiry for protein identification. Further, imaging mass spectrometry (IMS) is used to reveal the spatial distribution of the identified peptides within a serial tissue section. Optimization was achieved using cutaneous tissue from surgically excised pressure ulcers that were subdivided into two prime regions of interest: the wound bed and the adjacent dermal area. The robust display of tryptic peptides within these spectral analyses of histologically defined tissue regions suggests that LC‐MS/MS in combination with IMS can serve as useful exploratory tools.
Phenotypic and functional changes in dermal primary fibroblasts isolated from intrinsically aged human skin
Authors: Brun Cécilia , Jean‐Louis Francette , Oddos Thierry , Bagot Martine , Bensussan Armand , Michel Laurence
Published: October 2015

Dermal fibroblasts play a key role in maintaining skin homoeostasis by synthesizing and degrading extracellular matrix components. During ageing, they are subjected to changes, such as the loss of type I collagen expression and an increased synthesis of metalloproteinase I, leading to fragmentation of collagen fibrils with consequent reduction of the mechanical tension and defects of skin wound healing. Most information about fibroblast ageing was obtained from experiments performed on replicative‐senescent dermal fibroblasts in vitro. However, the senescence status of fibroblasts isolated from intrinsically aged skins and its consequences on functionality need to be deeper investigated. Herein, we studied age‐related phenotypic and functional alteration of fibroblasts from ‘young’ (<35 years) and ‘old’ (>50 years) donors. Our results brought evidence of the senescent status of ‘old’ fibroblasts by senescence associated β‐galactosidase (SA‐βgal) positive staining and p16 expression. A PCR array focusing on senescence highlighted a subset of downregulated genes including cell cycle progression and ECM genes in ‘old’ fibroblasts as well as a subset of upregulated genes involved in senescence features. In ‘old’ fibroblasts, we measured a downregulation of proliferative and contractile capacities of migratory potential under PDGF stimulation and activation into myofibroblasts under TGFβ. Old fibroblasts were also more sensitive to oxidative stress than ‘young’ ones. Of interest, downregulation of p16 expression partially reversed the senescent phenotype of ‘old’ fibroblasts but failed to restore their functional properties. In conclusion, our data brought evidence of phenotypic and functional differences between fibroblasts from young and intrinsically aged skin that may contribute to the alterations observed with ageing.
Three patients treated with daclatasvir and asunaprevir for recurrent hepatitis C after liver transplantation: Case report
Authors: Kawaoka Tomokazu , Imamura Michio , Morio Kei , Nakamura Yuki , Tsuge Masataka , Nelson Hayes C. , Kawakami Yoshiiku , Aikata Hiroshi , Ochi Hidenori , Ishiyama Kouhei , Ide Kentaro , Tashiro Hirotaka , Ohdan Hideki , Chayama Kazuaki
Published: October 2015

We previously reported our data on telaprevir or simeprevir used in combination with pegylated interferon (PEG IFN) and ribavirin (RBV) for the treatment of recurrent hepatitis C virus (HCV) genotype 1 infection after liver transplantation (LT). Here, we report three patients who achieved viral responses with no effect on the blood concentrations of immunosuppressive agents following daclatasvir and asunaprevir treatment. The first patient was a 57‐year‐old man with HCV‐related liver cirrhosis who failed to respond to PEG IFN/RBV after living donor LT. He had been treated with 1 mg/day of tacrolimus. The second was a 63‐year‐old man with HCV‐related liver cirrhosis and hepatocellular carcinoma who failed to respond to PEG IFN/RBV after living donor LT. He had been treated with 1 mg/day of tacrolimus. The third was a 61‐year‐old man with HCV‐related liver cirrhosis. He had been treated with mycophenolate mofetil (MMF). Serum HCV RNA became undetectable by TaqMan polymerase chain reaction test after 4 weeks of daclatasvir and asunaprevir treatment in all patients, and no remarkable fluctuations in blood concentration were observed either in tacrolimus or in MMF during 24 weeks of therapy. No adverse events were observed, and all patients received the full dose of daclatasvir and asunaprevir over 24 weeks. Serum HCV RNA remained negative at 12 weeks after the end of treatment in all patients. The daclatasvir and asunaprevir treatment showed a remarkable viral response with little effect on blood levels of immunosuppressive agents for recurrent HCV genotype 1 infection after LT.
Female Empowerment in Iran: The Voice of Iranian University Students
Authors: Fereidouni Somayeh , Mehran Golmar , Mansourian Yasdan
Published: October 2015

In line with global trends, the rate of Iranian female students' enrolment in higher education has increased. However, some policy makers have been concerned about this and without considering the female voice, they have implemented strategies to balance the labour market, which has led to a decrease in female students in certain majors. The results of an empirical study showed that going to university is the primary route to empowerment for girls in Iran. The study into the meaning of empowerment adopted a qualitative approach using unstructured in‐depth interviews with 80 Iranian female university students from seven provinces of Iran. The narrative responses were analysed using content analysis and grounded theory. The results of this study led to develop a new theory called ‘Female Empowerment through Higher Education’, which has several key constituents of female empowerment including: social presence, the power to make decision, autonomy, education and building up a new value framework.
Consumers’ prepurchase satisfaction with the attributes and information of food labels
Authors: van der Colff Nadia , van der Merwe Daleen , Bosman Magdalena , Erasmus Alet , Ellis Susanna
Published: October 2015

This study aimed to describe consumers’ retrospective satisfaction with food labels within the expectancy (dis)confirmation paradigm and to investigate the likelihood of food labels influencing consumers’ product choices. A quantitative, descriptive, cross‐sectional survey approach was followed to explore and describe consumers’ satisfaction with attributes of and information on food labels. Self‐administered questionnaires (n = 279) were distributed in Gauteng, South Africa, through convenience sampling. On average, respondents were dissatisfied with label attributes (believability, readability, comprehensibility and adequacy) and with primary information (expiry date, allergens, nutrition/health, ingredient list, quality guarantees), but satisfied with secondary information (usage instructions, manufacturer name, symbols, serving numbers, country of origin). Respondents had higher expectations of primary information and considered it more influential for their purchasing decisions and, therefore, judged the performance of this information more critically than the secondary information. When amendments to and the presentation of food label information are considered, primary information should be a priority. Consumers, who are satisfied with food labels, might be inclined to choose one product over another. This study was the first of its kind, linking satisfaction and product choice to different dimensions of food labels.
Impact of parental weight status on a school‐based weight management programme designed for Mexican–American children
Authors: Moreno J. P. , Johnston C. A. , Hernandez D. C. , LeNoble J. , Papaioannou M. A. , Foreyt J. P.
Published: October 2015

Background

While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes.

Objectives

This study was a secondary data analysis of a randomized controlled trial and investigated the impact of having zero, one or two obese parents on children's success in a school‐based weight management programme.

Methods

Sixty‐one Mexican–American children participated in a 24‐week school‐based weight management intervention which took place in 2005–2006. Children's heights and weights were measured at baseline, 3, 6 and 12 months. Parental weight status was assessed at baseline. Repeated measures anova and ancova were conducted to compare changes in children's weight within and between groups, respectively.

Results

Within‐group comparisons revealed that the intervention led to significant decreases in standardized body mass index (zBMI) for children with zero (F = 23.16, P < .001) or one obese (F = 4.99, P < .05) parent. Between‐group comparisons indicated that children with zero and one obese parents demonstrated greater decreases in zBMI compared to children with two obese parents at every time point.

Conclusions

The school‐based weight management programme appears to be most efficacious for children with one or no obese parents compared to children with two obese parents. These results demonstrate the need to consider parental weight status when engaging in childhood weight management efforts.
Impact of the emergency department streaming decision on patients' outcomes
Authors: Kim S. W. , Horwood C. , Li J. Y. , Hakendorf P. H. , Teubner D. J. O. , Thompson C. H.
Published: October 2015

Background

Streaming occurs in emergency department (ED) to reduce crowding, but misallocation of patients may impact patients' outcome.

Aim

The study aims to determine the outcomes of patients misallocated by the ED process of streaming into likely admission or discharge

Methods

This is a retrospective cohort study, at an Australian, urban, tertiary referral hospital's ED between January 2010 and March 2012, using propensity score matching for comparison. Total and partitioned ED lengths of stay, inpatient length of stay, in‐hospital mortality and 7‐ and 28‐day unplanned readmission rate were compared between patients who were streamed to be admitted against those streamed to be discharged.

Results

Total ED length of stay did not differ significantly for admitted patients if allocated to the wrong stream (median 7.6 h, interquartile range 5.7–10.6, cf. 7.5 h, 5.3–11.2; P = 0.34). The median inpatient length of stay was shorter for those initially misallocated to the discharge stream (1.8 days, 1.1–3.0, cf. 2.4 days, 1.4–3.9; P < 0.001). In‐hospital mortality and 7‐ and 28‐day readmission rates were not adversely affected by misallocation. When considering patients eventually discharged from the ED, those allocated to the wrong stream stayed in the ED longer than those appropriately allocated (5.2 h, 3.7–7.3, cf. 4.6 h, 3.3–6.4; P < 0.001).

Conclusion

There were no significant adverse consequences for an admitted patient initially misallocated by an ED admission/discharge streaming process. Patients' discharge from the ED was slower if they had been allocated to the admission stream. Streaming carries few risks for patients misallocated by such a process.
Stability of unstimulated and stimulated whole saliva flow rates in children
Authors: Sánchez‐Pérez Leonor , Irigoyen‐Camacho Esther , Sáenz‐Martínez Laura , Zepeda Zepeda Marco , Acosta‐Gío Enrique , Méndez‐Ramírez Ignacio
Published: October 2015

Objective

To analyze the stability of the unstimulated saliva flow rate (USFR) and the stimulated saliva flow rate (SSFR) in children followed from age 7 to 12 years old.

Methods

Longitudinal study. Whole saliva samples were collected from school children (50 girls and 50 boys). Forty‐four girls and 32 boys remained in this cohort for 6 years (dropout rate 24%). Variables that could influence USFR or SSFR patterns were analyzed in a repeated‐measures manova.

Results

Over a 6‐year follow‐up, the children's USFR ranged from 0.41 to 0.46 mL/min in the initial and final observation, respectively, and showed no significant differences (P = 0.4455) during the follow‐up. The children consistently belonged to one of three distinct SSFR groups (P < 0.0001). A repeated‐measures manova model showed that USFR and SSFR were not associated with sex, body mass index, or indoor temperature during sampling.

Conclusion

These results indicate that USFR and SSFR patterns were stable from 7 to 12 years old. This finding may be useful in oral health prevention or treatment and in the search for biomarkers in saliva for screening or diagnostic purposes.
A review of the changes to the licensing of influenza vaccines in Europe
Authors: Wijnans Leonoor , Voordouw Bettie
Published: October 2015

In 2014, the European Committee for Medicinal Products for Human Use (CHMP) published a draft regulatory guideline for the evaluation of influenza vaccines. Following a public consultation round, the final guidance will be published in the near future. Here, we highlight the main changes in the clinical section in this guideline and discuss the background to these changes and whether the new consolidated guidance document can be expected to achieve a better understanding of the performance of seasonal, zoonotic and pandemic influenza vaccines during the regulatory licensing process. The new influenza guideline reflects a changed approach to the regulatory assessment of influenza vaccines, resulting in the abolition of serological criteria, known as the CHMP criteria, which have been the mainstay for evaluating the influenza vaccine immunogenicity for several decades. The new guideline adopts a more diversified approach to the measurement and reporting of the immune response to influenza vaccines and sets a requirement to conduct clinical outcome trials in young children. Importantly, more emphasis is placed on the post‐licensure monitoring of the benefit risk of influenza vaccines, including a request for continuous monitoring of efficacy and enhanced safety surveillance. Despite the improvements these new requirements will expectedly bring to the regulatory assessment of influenza vaccines, major challenges remain which cannot be overcome by new guidance alone. Ongoing initiatives in which academia, manufacturers, public health institutes and regulators work together to address these challenges are central to the development of robust tools to evaluate and monitor performance of influenza vaccines in the future.
Thermoelectric Materials: A New Rapid Synthesis Process for Nontoxic and High‐Performance Tetrahedrite Compounds
Authors: Barbier Tristan , Rollin‐Martinet Sabrina , Lemoine Pierric , Gascoin Franck , Kaltzoglou Andreas , Vaqueiro Paz , Powell Anthony V. , Guilmeau Emmanuel
Published: October 2015

The feasibility to synthesize, in large quantity, pure, and nontoxic tetrahedrite compounds using high‐energy mechanical‐alloying from only elemental precursors is reported in this study for the first time. Our processing technique allows a better control of the final product composition and leads to high thermoelectric performances (ZT of 0.75 at 700 K), comparable to that reported on sealed tube synthesis samples. Combined with spark plasma sintering, the production of highly pure and dense samples is achieved in a very short time, at least 8 times shorter than in conventional liquid–solid–vapor synthesis process. The process described in this study is a promising way to produce high‐performance tetrahedrite materials for cost‐effective and large‐scale thermoelectric applications.
The Anisotropy of Dimensional Change on Sintering of Iron
Authors: Molinari Alberto , Torresani Elisa , Menapace Cinzia , Larsson Mats
Published: October 2015

The anisotropy of dimensional change on the sintering of iron was investigated by dilatometry. Dimensional changes are different along the longitudinal and transversal directions, and shrinkage is more pronounced parallel to the compaction direction. This phenomenon is particularly pronounced during the early stage of sintering, in the alpha field below the Curie temperature. The results were elaborated according to the kinetics model for shrinkage to calculate an effective diffusion coefficient along the two directions. Such an effective diffusion coefficient is higher parallel to the compaction direction than perpendicular to it, and both are larger than the diffusion coefficient calculated on the basis of the activation energy reported in the literature for pure iron. This discrepancy is attributed to the defectiveness introduced by cold compaction in the particle contact regions, which may enhance diffusivity owing to the dislocation pipe mechanism, which, in turn, is particularly intense below the Curie temperature. This interpretation may also justify anisotropy of shrinkage because the powder particles are inhomogeneously deformed by uniaxial cold compaction. The enhanced diffusion coefficient increases with time and shows a maximum at temperatures below the Curie point. This trend was discussed with reference to the self‐activated sintering mechanism.
Densification and Thermal Stability of Hot‐Pressed Si3N4–ZrB2 Ceramics
Authors: Guo Wei‐Ming , Gu Shang‐Xian , You Yang , Jiang Qiang‐Guo , Wu Shang‐Hua , Lin Hua‐Tay
Published: October 2015

Densification and thermal stability of hot‐pressed Si3N4–ZrB2 ceramics with and without additives were investigated in N2 atmosphere. The addition of MgO–Yb2O3, MgO–Y2O3, and Al2O3–Yb2O3 resulted in significant increase in relative density of the ceramics hot‐pressed at 1500°C from 48.5% to 98.0%, 97.3%, and 95.6%, respectively. There was weak reaction of ZrB2 with N2 to form ZrN in hot‐pressed ceramics. Then heat treatment at 1550°C resulted in the further reactions to produce ZrN, ZrSi2, and BN. The Si3N4–ZrB2 ceramics with MgO–Yb2O3 showed much better thermal stability as compared to the ceramics with Al2O3–Yb2O3. The small difference in density led to the obvious difference in thermal stability. Therefore, Si3N4–ZrB2 ceramics should be densified to full density, to obtain high thermal stability.
Warming alters the body shape of European perch Perca fluviatilis
Authors: Rowiński P. K. , Mateos‐Gonzalez F. , Sandblom E. , Jutfelt F. , Ekström A. , Sundström L. F.
Published: October 2015

The consequences of elevated temperature on body shape were investigated by comparing European perch Perca fluviatilis from the Forsmark area of the Baltic Sea to P. fluviatilis from a nearby Biotest enclosure. The Biotest is a man‐made enclosure within the Baltic Sea that has received warm water from a nuclear power plant since 1980, resulting in temperatures that are elevated 5–10° C relative to the surrounding Baltic Sea. Sampled fish ranged from young‐of‐the‐year to 14 years. Geometric morphometrics and multivariate statistical analysis revealed significant morphological differences between individuals of P. fluviatilis from these two habitats. Most importantly, relative shape changed with size, with small individuals of P. fluviatilis from Biotest being characterized by a deeper body shape and a larger caudal peduncle than the smaller Baltic individuals. In large specimens, smaller differences were found with Biotest individuals being more slender than Baltic individuals. These results show that, in order to have a full understanding of the biological effects of elevated temperatures, studies that cover the entire size range of organisms will be important. Apart from the direct influence of temperature on growth rate and body shape, other ecological factors affected by temperature are discussed as possible contributors to the observed differences between the two populations.
Influence of Hydrocolloids on Batter Properties and Textural Kinetics of Sponge Cake during Storage
Authors: Poonnakasem Naratip , Laohasongkram Kalaya , Chaiwanichsiri Saiwarun
Published: October 2015

The influence of hydrocolloids, including hydroxypropyl methylcellulose (HPMC), xanthan gum (XG) and sodium alginate (AG) at 0.5 and 1.0% (w/w, based on the wheat flour), on batter properties and textural kinetics of sponge cake during storage was studied. It was found that the addition of XG and AG dose‐dependently increased the batter density and the viscosity of all the samples and also decreased the cake specific volume but increased the crumb moisture. The firmness change of sponge cake at different storage temperatures followed a first‐order kinetic reaction, where the activation energy (Ea) decreased in the following order: HPMC > AG > XG, which is in contrast to the firmness change rate constant (k). Addition of 0.5% (w/w) HPMC gave the lowest k (0.1156 day−1) and highest Ea (11.23 kJ/mol) values, reflecting its better firmness retarding property. However, the use of HPMC at 1.0% (w/w) gave an adverse effect.

Practical Applications

Convenient baked snack foods, such as sponge cakes, are in increasing demand as a result of the changing lifestyles and economics of the global populations. However, the quality of sponge cakes changes (deteriorate) during storage. This study evaluated the use of three different hydrocolloids as potential firmness retarding agents during cake storage. Kinetics measurements were the key parameter used to describe the rate of reaction. Hydrocolloids that help to improve the texture of sponge cake are of a significant interest in the baked goods industry, and such archived research will benefit the industrial cake production for better distribution and marketing of these products.
Creditor Rights, Country Governance, and Corporate Cash Holdings
Authors: Seifert Bruce , Gonenc Halit
Published: October 2015

This study examines the impact of creditor rights and country governance on cash holdings using a sample of firms from 47 countries. We hypothesize that cash holdings are smaller when both creditor rights and country governance are high. In these circumstances firms will not need to hold as much cash for future investments needs (precautionary funds) because firms will expect that funds will be available in the future. Our findings support our hypothesis and hold for alternative definitions for cash holdings, different country samples, different definitions of governance and concerns about endogeneity.