bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of the adoption of an alternative corporate governance system on firms’ performances
Authors: Bellavite Pellegrini Carlo , Sergi Bruno S. , Sironi Emiliano
Published: April 2016

Purpose

– Alternative corporate governance systems (CGSs) have attracted a significant bulk of research recently. While the connection between the adoption of an alternative system (one tier board or two tier board system) and firms’ performances has not been fully analysed yet, the purpose of this paper is to analyse whether companies which have turned into an alternative board system have eventually improved their performance over time.

Design/methodology/approach

– Using a sample of more than 15,000 Italian unlisted joint stock companies, the authors compare performance outcomes in 2009 of firms adopting alternative systems with performances of firms that maintained the system in force before the 2003 Corporate Law Reform (defined as “traditional”). Because of the choice of an alternative system (one tier or two tier board) instead of a traditional one is not random, the authors reduce selection bias implementing matching methods and comparing firms that are close in terms of propensity score measured in 2003 (the year before the new CGSs have been introduced by a corporate law reform).

Findings

– The authors do not find evidence of a significant improvement of performances in 2009 concerning those firms that have adopted a one tier or two tier board systems with respect to those which maintained a traditional one.

Originality/value

– The novelty of the study concerns the application of propensity score matching for the evaluation of the impact of the change of the CGS that is possible in presence of two conditions that are all verified in our setting: first, to have a country where corporate law allows for choosing among different systems; in this case Italy is a good laboratory, because it allows for the choice among three different systems; and second, to have the opportunity to evaluate the effect of the change in light of a relatively recent “pre-treatment” condition; this is made possible by the fact that before the 2003 Reform of corporate law all the companies had a traditional system.
High-performance work systems, joint impact of transformational leadership, an empowerment climate and organizational ambidexterity
Authors: Chang Yi-Ying
Published: April 2016

Purpose

– The purpose of this paper is to test a multilevel model, supported by an ambidexterity perspective, to examine the process linking high-performance work systems (HPWS) and organizational ambidexterity using both unit- and firm-level analyses.

Design/methodology/approach

– The author collected multisource and multilevel data from 346 employees and 184 managers of 33 electronic engineering firms.

Findings

– The results revealed that unit HPWS were positively related to unit organizational ambidexterity. The author considers that the role of firm-level transformational leadership (TFL) is to create a climate of autonomy that can be delegated to promote organizational ambidexterity within units. Furthermore, a firm-level empowerment climate moderates the effect of unit-level HPWS on a unit’s organizational ambidexterity. The author contributes to the research on leadership and ambidexterity by revealing the impact of HPWS as experienced in the unit- and of firm-level TFL. The author also identify boundary conditions for pursuing unit organizational ambidexterity.

Originality/value

– Responding to the call for more research into the effects of the empowerment climate on employees’ behaviors and the behavioral outcomes of employees, this research reveals that not only is the macro perspective of HPWS at the organizational level useful to promote ambidextrous activities at lower levels, but also that the unit experience of HPWS more directly affects employees’ behaviors in engaging in the search for new opportunities for new products/services and refining current products simultaneously at the unit level. The broader implication is that the effectiveness of HPWS as an antecedent for organizational ambidexterity (Gibson and Birkinshaw, 2004; Kang and Snell, 2009) depends on the unit experience of HPWS being used to influence autonomous employees to actively undertake ambidextrous activities at the unit level.
Exploring antecedents and consequences of young consumers’ perceived global brand equity
Authors: Frank Phillip , Watchravesringkan Kittichai (Tu)
Published: April 2016

Purpose

With the expansion of globalization, the increased competitive environment has led to the diffusion of brands across borders and cultures. Furthermore, young consumers represent an optimal segment for the proliferation of global consumer culture (GCC). This paper aims to examine the relationship between acculturation to global consumer culture (AGCC), perceived brand equity, attitudes toward the brand and brand resonance in the global sportswear brands context among young consumers in the USA.

Design/methodology/approach

A total of 394 undergraduate student participants ranging in age from 18 years to 24 years completed a multisectional structured survey. Model construct validity was tested using a confirmatory factor analysis. A structure equation model was used to test hypotheses and relationships.

Findings

Results showed that while cosmopolitan and self-identification with GCC dimensions of ACGG had a positive association with perceived brand equity, exposure to marketing activities of MNCs and global mass media exposure dimensions of AGCC had a negative association with perceived brand equity. Perceived brand equity also revealed a positive association with attitudes toward the brand, which in turn, affected brand resonance.

Research limitations/implications

The research used a sample of 18-24-year-old youth consumers. Future research could be extended to include younger (15-17-year old) sample to provide a broader sample of the youth market. In addition, future replication of findings should seek through cross-cultural investigation of multiple youth segments.

Practical implications

Findings suggest support multiple dimensions of the AGCC scale as holding significant influence on young consumers’ brand equity consisting of brand image and brand awareness. Managerially, the findings provide support on the youth consumer’s affinity toward self-identification with a GCC and cosmopolitan openness to foreign cultures as being positively related to the adoptions and retention of apparel brands.

Social implications

Theoretically, the results provide empirical evidence for the debate on the interrelationship between brand equity and attitudes toward brands. The theoretical model guiding the current study reflects the notion of an emerging acculturation process among a segment of the world’s population to a set of global consumer preferences and ideals that are increasingly being embodied in global brands.

Originality/value

This is among one of the first studies attempting to explore the applicability of Cleveland and Laroche’s (2007) AGCC concepts in predicting young consumers’ attitudes and behavioral responses toward global brands.
Country-of-origin versus brand: consumers’ dilemma when choosing between generic and branded drugs in emerging countries
Authors: Smaoui Fatma , Abdellah Kilani Fatma , Touzani Mourad
Published: April 2016

Purpose

Taking an emerging country perspective, this paper aims to investigate consumers’ preferences for over-the-counter (OTC) drugs, regarding three attributes: country-of-origin (COO), brand status (branded versus generic) and price. The second purpose is to test the effect of COO and brand status on consumers’ perceptions of quality, trust and purchasing intentions.

Design/methodology/approach

After a preliminary qualitative study, consumers answered a follow-up questionnaire to evaluate eight product combinations (COO/brand status/price) for three categories of OTC drugs. Conjoint analysis allowed assessing the importance of COO compared to brand status and price, while ANOVA was used to test the effect of COO and branding status on consumers’ responses.

Findings

Findings show that, in an emerging countries context, COO is less important than brand status in consumers’ preferences. COO and brand status have a greater effect on consumers’ perceptions of drug quality and trust than on purchasing intentions.

Research limitations/implications

The limited number of factors (brand status/COO/price) could have amplified their relative importance.

Practical implications

Pharmaceutical companies from industrialized countries, exporting generic drugs to emerging markets, can benefit from the favorably perceived COO of their drugs and thus help the acceptance of generic drugs in these markets.

Originality/value

The study has two major contributions. It aims to contribute to a better understanding of consumer behavior in the pharmaceutical field. It also transposes the framework on COO to the context of an emerging country: Tunisia.
Beyond rarity: the paths of luxury desire. How luxury brands grow yet remain desirable
Authors: Kapferer Jean-Noël , Valette-Florence Pierre
Published: April 2016

Purpose

Luxury is a growing sector worldwide. This creates a major managerial challenge: How can luxury brands prevent becoming a victim of their own success? Once objective rarity is lost, what other levers still sustain desire for these luxury brands, nurture their dream and, thus, prevent the dilution of desirability created by their growing penetration and sales?

Design/methodology/approach

Based on 1,286 actual luxury consumers interviewed about 12 highly known and successful luxury brands on 42 experiential and perceptual items, a PLS hierarchical fourth-order latent variables model unveils the paths of luxury dream building.

Findings

The authors have identified how, beyond mere physical rarity and very high quality, eight experiential and perceptual levers fuel luxury desirability through two structural paths: selection and seduction.

Research limitations/implications

The concept of luxury is associated to rarity. But to grow, luxury brands need to abandon mere scarcity and selectivity (value created by limitation of production, highly selective distribution and selection of customers) and switch instead to an “abundant rarity”, where feelings of privilege are attached to the brand itself, seducing through its experiential facets, pricing, prestige and the world it symbolizes.

Practical implications

Luxury executives can use this paper as a compass to manage, sustain and monitor their brand desirability, all along the brand’s growth, as it moves away from being niche and rare.

Social implications

Considering the growing social diffusion of the need for luxury in different strata of the population, this paper reveals the levers of the attractiveness of the mega-brands of luxury.

Originality/value

This paper addresses the main problem of the luxury industry: How to grow yet remain desirable. It is based on 1,286 actual luxury buyers and 12 actual brands. Thanks to PLS modelization, the structure of the levers of brand desirability is revealed.
The stable isotope ecology of mycalesine butterflies: implications for plant–insect co‐evolution
Authors: van Bergen Erik , Barlow Henry S. , Brattström Oskar , Griffiths Howard , Kodandaramaiah Ullasa , Osborne Colin P. , Brakefield Paul M.
Published: April 2016

One of the most dramatic examples of biome shifts in the geological record is the rapid replacement of C3 vegetation by C4 grasses in (sub‐) tropical regions during the Late Miocene–Pliocene. Climate‐driven biome shifts of this magnitude are expected to have a major impact on diversification and ecological speciation, especially in grazing taxa. Mycalesine butterflies are excellent candidates to explore the evolutionary impact of these C3/C4 shifts on insect grazer communities.

Mycalesine butterflies feed on grasses as larvae, have radiated spectacularly and occur in almost all extant habitats across the Old World tropics. However, at present, we lack a comprehensive understanding of the larval ecology of these butterflies and this hampers investigations of co‐evolutionary patterns among the geographically parallel radiations of mycalesine butterflies and the remarkable evolutionary history of their host plants.

By conducting several experiments under defined environmental conditions, we demonstrate that the feeding history of mycalesine larvae on C3 and C4 grasses can be traced by analysing δ13C in the organic material of the adult exoskeleton, while values of δ18O in the adult reflect atmospheric humidity during larval development.

To show the power of these isotopic proxies for ecological studies, we analysed the isotopic composition of organic material obtained from adult butterflies sampled in two extensive longitudinal surveys.

We observed strong associations among the larval ecology, habitat preferences of the adult butterflies and patterns of seasonality, such that mycalesine species that inhabit open environments are more opportunistic in their host plant choice but utilize C3 grasses more frequently during the dry season. Crucially, the ability to process the less palatable C4 grasses appears to be phylogenetically clustered within mycalesine species, suggesting that novel feeding adaptations may have evolved in response to the ecological dominance of C4 grasses in open savanna habitats.

A lay summary is available for this article.
A history of the treatment of appendicitis in children: lessons learned
Authors: Hamill James K. , Hill Andrew G.
Published: April 2016

During the latter half of the 19th century, surgeons increasingly reported performing appendicectomies. Fitz from Harvard, Groves from Canada and Tait from Britain all recorded successful removal of the appendix. McBurney described the point of maximal tenderness in classic appendicitis and also the muscle‐splitting incision centred on this point. Priority is given to McArthur in describing the lateral muscle‐splitting incision. The direction of the cutaneous incision was later modified by Elliott and Lanz. Incisions that healed well were essential to recovery. Appendicectomy became a ‘fashionable’ operation after the London surgeon, Treves, removed the appendix of King Edward VII. Through the 20th century, the mortality from appendicitis fell notably with the advent of sulphonamide and penicillin, improvements in fluid therapy and safer anaesthesia. By 1990, diagnostic delay was the main cause of death. Semm performed the first laparoscopic appendicectomy in 1990, roundly criticized at the time for what is now a routine procedure. We view contemporary debates on the indications for appendicectomy, the best approach and how to optimize recovery in the light of the history of this intriguing disease.
Prospective study of patient satisfaction and postoperative quality of life after laparoscopic colectomy in Japan
Authors: Matsumoto Sumio , Bito Seiji , Fujii Shoichi , Inomata Masashi , Saida Yoshihisa , Murata Kohei , Saito Shuji
Published: April 2016

Introduction

This prospective cohort study was designed to compare the short‐term and intermediate health‐related quality of life of Japanese patients after laparoscopic colectomy (LC) or open colectomy (OC) for colonic cancer.

Methods

Seventeen hospitals participated, and 240 colonic cancer patients with T3 or T4 invasion that were estimated as curatively resected were enrolled. Three patients were excluded as ineligible, one patient died suddenly before operation, and one patient was not registered based on the doctor's decision. Therefore, analysis was done on 235 patients who underwent either LC (n = 165) or OC (n = 70) in accordance with their stated preference. The major outcome scale end‐point was health‐related quality of life as assessed by the 36‐item Short Form Health Survey (Japanese version 2.0). Accessory end‐points were feeling of satisfaction 1 month after operation and recovery time needed to perform normal activities after operation. Observations were performed on enrollment, postoperative day 3, postoperative day 7, discharge day or postoperative month 1, and postoperative month 6.

Results

Defecation condition, wound pain score, and abdominal pain score were better in the LC group than in the OC group on postoperative day 7 and in postoperative month 1. Recovery time to normal daily activity took 30 days in the LC group, whereas the OC group needed 44 days.

Conclusion

Patients' subjective responses indicated that LC was more beneficial than OC for patients with stage II or III colonic cancer. LC's superiority was seen particularly in the following indicators: (i) health‐related quality of life during early postoperative days; (ii) recovery to normal daily activities; and (iii) defecation after surgery.
Meat quality, fatty acid composition and sensory evaluation of Cherry Valley, Spent Layer and Crossbred ducks
Authors: Qiao Yan , Huang Jichao , Chen Yulian , Chen Haochun , Zhao Liang , Huang Ming , Zhou Guanghong
Published: April 2016

The aim of this research was to compare meat quality characteristics of Cherry Valley (CV), Spent Layer (SL) and Crossbred (CB) ducks. Meat quality, proximate and fatty acid composition were measured in breast and thigh muscles from CV, SL and CB, as well as sensory evaluation of duck soup made from three breeds. The results showed SL contained a highest percentage of protein but lowest moisture than those of CV and intermediate CB (P< 0.05). The L* and b* value of SL ducks were lowest among three breeds (P< 0.05). The breast of SL had higher water‐holding capacity compared to CV (P< 0.05), although CV was the most tender among the three breeds (P< 0.05). SL had lower contents of saturated fatty acid and higher contents of unsaturated fatty acids with a more acceptable P/S ratio of 0.57 and n‐6/n‐3 ratio of 1.52 (P< 0.05). Intramuscular fat and polyunsaturated fatty acids were involved in producing intense aroma and flavor of duck meats. Differences of color and tenderness in meats were attributed to values of L* and cooking loss of muscles. In conclusion, it would be suggested that SL was more suitable for producing duck soup among the three breeds.
Effect of ensiling process of total mixed ration on fermentation profile, nutrient loss and in situ ruminal degradation characteristics of diet
Authors: Miyaji Makoto , Matsuyama Hiroki , Nonaka Kazuhisa
Published: April 2016

This experiment aimed to determine the changes in chemical composition, fermentation profile, in situ disappearance characteristics, and nutrient losses of ensiled total mixed ration (TMR) containing steam‐flaked corn or brown rice (BR) during storage. TMRs for dairy cows, containing either steam‐flaked corn or BR at 31.9% with 15.2% rye silage, 40.5% alfalfa silage, 5.0% beet pulp and 7.0% soybean meal, were prepared (dry matter (DM) basis). Each TMR was placed in a plastic drum silo, stored at 23°C in an air‐conditioned room and sampled 0, 7, 14, 30, 90 and 210 days after preparation. In both grain sources, the fermentation products increased, while DM and starch storage losses increased and starch content greatly decreased during storage. The rapidly degradable fraction and effective ruminal degradability of DM, crude protein and starch increased during storage. These changes of dietary characteristics were large during 30 days of storage, but small after 90 days of storage. Replacing corn with BR led to increased fermentation products, starch loss and effective ruminal degradability of the ensiled TMR. These results indicate that the ensiling process of TMR changes the dietary characteristics and replacing corn with BR in TMR had a large impact on these dietary characteristics.
Factors associated with fertility of nulliparous dairy heifers following a 10‐day fixed‐time artificial insemination program with sex‐sorted and conventional semen
Authors: Noonan EJ , Kelly JC , Beggs DS
Published: April 2016

Objective

To examine factors associated with fertility on dairy farms that used a common fixed‐time artificial insemination (FTAI) program in yearling heifers.

Methods

Records were analysed from 954 yearling heifers on 10 south‐west Victorian dairy farms that used a common FTAI program, involving the insertion of a 1.9‐g progesterone‐releasing device for 10 days; 2 mg oestradiol benzoate at insertion; 500 µg cloprostenol on day 7; and FTAI 48 h after device removal. Weight, age, expression of oestrus, sire, semen type (frozen sex‐sorted or frozen conventional) and timing of insemination were examined for their relationship with first‐service conception rates.

Results

Heifers over 300 kg body weight were 1.18‐fold more likely to express oestrus during the FTAI program. For every extra 1 kg, there was a 1.5% increase in the likelihood of expressing oestrus. First‐service conception rates were 40.3% and 56.0% for sex‐sorted and conventional semen, respectively, and were significantly higher when oestrus was expressed. The difference was greater for sex‐sorted semen (3.4‐fold) compared with conventional semen (1.5‐fold). The interval from device removal to insemination varied between 47 and 51.4 h and had no significant effect on conception rates. However, there was a trend towards a higher conception rate for sex‐sorted semen when inseminations were performed >50 h after device removal.

Conclusions

Increased fertility was associated with larger heifers and heifers that expressed oestrus, particularly when sexed‐sorted semen was used. Variation in the timing of AI with respect to device removal between 47 and 51.4 h did not adversely affect conception rates.
A novel approach for custom three‐dimensional printing of a zirconia root analogue implant by digital light processing
Authors: Anssari Moin David , Hassan Bassam , Wismeijer Daniel
Published: April 2016

Objectives

This study aimed to explore the feasibility of fabrication of three‐dimensional (3D)‐printed zirconia root analogue implant (RAI) through digital light processing (DLP) technology.

Material and methods

One partially edentulous mandibular human cadaver was scanned with a cone‐beam computed tomography (CBCT) system. The scan volumes and data sets were used to create computer‐aided design (CAD) model of the RAI. A high‐end DLP 3D printing technology was used to fabricate the RAI from the CAD model. Within this approach, solid 3D objects are built using a DLP projector to translate voxel data so it is reproduced in liquid photopolymer dispersed with a commercial ceramic, thereby light polymerizing the resin to solid. Optical scanning technology was used to measure the tooth and 3D‐printed RAI. To validate the accuracy of the printed zirconia RAI, the optical surface model of the original tooth and CAD model were superimposed.

Results

The differences between the optical scans of the RAI and original tooth are most noticeable towards the apical foramen, showing a disparity for the RAI with a maximum deviation of 0.86 mm. When setting a maximum threshold of 0.5 mm for the 3D‐printed RAI surface to be deviating from the original tooth model and CAD model, measurements show 1.55% and 4.86% of the surface areas are exceeding the threshold distance, respectively.

Conclusion

With the use of currently available technology, it is well feasible to 3D print in zirconia a custom RAI.
Contributions of paraecologists and parataxonomists to research, conservation, and social development
Authors: Schmiedel Ute , Araya Yoseph , Bortolotto Maria Ieda , Boeckenhoff Linda , Hallwachs Winnie , Janzen Daniel , Kolipaka Shekhar S. , Novotny Vojtech , Palm Matilda , Parfondry Marc , Smanis Athanasios , Toko Pagi
Published: April 2016

Citizen science has been gaining momentum in the United States and Europe, where citizens are literate and often interested in science. However, in developing countries, which have a dire need for environmental data, such programs are slow to emerge, despite the large and untapped human resources in close proximity to areas of high biodiversity and poorly known floras and faunas. Thus, we propose that the parataxonomist and paraecologist approach, which originates from citizen‐based science, is well suited to rural areas in developing countries. Being a paraecologist or a parataxonomist is a vocation and entails full‐time employment underpinned by extensive training, whereas citizen science involves the temporary engagement of volunteers. Both approaches have their merits depending on the context and objectives of the research. We examined 4 ongoing paraecologist or parataxonomist programs in Costa Rica, India, Papua New Guinea, and southern Africa and compared their origins, long‐term objectives, implementation strategies, activities, key challenges, achievements, and implications for resident communities. The programs supported ongoing research on biodiversity assessment, monitoring, and management, and participants engaged in non‐academic capacity development in these fields. The programs in Southern Africa related to specific projects, whereas the programs in Costa Rica, India, and Papua New Guinea were designed for the long term, provided sufficient funding was available. The main focus of the paraecologists’ and parataxonomists’ activities ranged from collection and processing of specimens (Costa Rica and Papua New Guinea) or of socioeconomic and natural science data (India and Southern Africa) to communication between scientists and residents (India and Southern Africa). As members of both the local land user and research communities, paraecologists and parataxonomists can greatly improve the flow of biodiversity information to all users, from local stakeholders to international academia.
Initial experience of restorative proctocolectomy for ulcerative colitis by transanal total mesorectal rectal excision and single‐incision abdominal laparoscopic surgery
Authors: Leo C. A. , Samaranayake S. , Perry‐Woodford Z. L. , Vitone L. , Faiz O. , Hodgkinson J. D. , Shaikh I. , Warusavitarne J.
Published: April 2016

Aim

Laparoscopic surgery is well established for colon cancer, with defined benefits. Use of laparoscopy for the performance of restorative proctocolectomy (RPC) with ileoanal anastomosis is more controversial. Technical aspects include difficult dissection of the distal rectum and a potentially increased risk of anastomotic leakage through multiple firings of the stapler. In an attempt to overcome these difficulties we have used the technique of transanal rectal excision to perform the proctectomy. This paper describes the technique, which is combined with an abdominal approach using a single‐incision platform (SIP).

Method

Data were collected prospectively for consecutive operations between May 2013 and October 2015, including all cases of restorative proctocolectomy with ileoanal pouch anastomosis performed laparoscopically. Only patients having a transanal total mesorectal excision (TaTME) assisted by SIP were included. The indication for RPC was ulcerative colitis (UC) refractory to medical treatment.

Results

The procedure was performed on 16 patients with a median age of 46 (26–70) years. The male:female ratio was 5:3 and the median hospital stay was 6 (3–20) days. The median operation time was 247 (185–470) min and the overall conversion rate to open surgery was 18.7%. The 30‐day surgical complication rate was 37.5% (Clavien–Dindo 1 in four patients, 2 in one patient and 3 in one patient). One patient developed anastomotic leakage 2 weeks postoperatively.

Conclusion

This initial study has demonstrated the feasibility and safety of TaTME combined with SIP when performing RPC with ileal pouch–anal anastomosis for UC.
Primary care referral practice, variability and socio‐economic deprivation in colorectal cancer
Authors: Borowski D. W. , Cawkwell S. , Zaidi S. M. A. , Toward M. , Maguire N. , Gill T. S.
Published: April 2016

Aim

The reasons for pre‐hospital delay of the diagnosis of cancer are multifactorial, but include a physician‐related component. Urgent cancer pathways and direct‐to‐test approaches have been implemented, but the emergency presentation of colorectal cancer (CRC) remains little changed over recent years. We examined the variability between primary care providers in referral patterns and its effect on outcome.

Method

A retrospective analysis was performed of a prospectively maintained database for 2009–2014 in aUKdistrict hospital providing bowel cancer screening and tertiary rectal cancer services.

Results

Of 1145CRCpatients, 937 (81.8%) were diagnosed with a symptomatic cancer; 229/937 (24.4%) initially presented as an emergency. Between 44 primary care providers, emergency presentation varied between 8.3% and 57.1%. Patients of providers with high levels of emergency presentations (HV) had more advanced cancers than those of providers with medium (MV) or low levels (LV) [103/253 (40.7%), 154/461 (33.4%), 65/223 (29.1%);P = 0.025] and a lower 3‐year overall survival (50.2%, 57.8%, 65.6%;P = 0.013), but with no difference in case‐mix or deprivation levels. In adjusted analysis, this difference remained significant (advanced disease,OR1.663,P = 0.011; 3‐year hazard ratio 1.479,P = 0.010; comparingHVwithLV). Conversely, elective suspected cancer referrals were less often used amongst diagnosed cancers [LV136/223 (61.0%),MV228/461 (49.5%),HV114/253 (45.1%),P < 0.001] with limited evidence for a more selective approach in the use of the 2‐week rule amongst all 2‐week rule referrals [LV136/2508 (5.4%);MV228/4239 (5.4%);HV115/1526 (7.8%); positive cancer diagnosis,P = 0.005].

Conclusion

Significant variability in emergency presentation ofCRCrequires local audit and examination of the reasons for delay in diagnosis and targeted measures to improve performance in non‐emergency referral pathways.
Modeling the autistic cell: iPSCs recapitulate developmental principles of syndromic and nonsyndromic ASD
Authors: Ben‐Reuven Lihi , Reiner Orly
Published: April 2016

The opportunity to model autism spectrum disorders (ASD) through generation of patient‐derived induced pluripotent stem cells (iPSCs) is currently an emerging topic. Wide‐scale research of altered brain circuits in syndromic ASD, including Rett Syndrome, Fragile X Syndrome, Angelman's Syndrome and sporadic Schizophrenia, was made possible through animal models. However, possibly due to species differences, and to the possible contribution of epigenetics in the pathophysiology of these diseases, animal models fail to recapitulate many aspects of ASD. With the advent of iPSCs technology, 3D cultures of patient‐derived cells are being used to study complex neuronal phenotypes, including both syndromic and nonsyndromic ASD. Here, we review recent advances in using iPSCs to study various aspects of the ASD neuropathology, with emphasis on the efforts to create in vitro model systems for syndromic and nonsyndromic ASD. We summarize the main cellular activity phenotypes and aberrant genetic interaction networks that were found in iPSC‐derived neurons of syndromic and nonsyndromic autistic patients.
Narratives of success and narratives of failure: representations of the career of King Hugh of Italy (c.885–948)
Authors: Balzaretti Ross
Published: April 2016

Hugh of Arles, king of Italy between 926 and 947, has come to be regarded as one of the more successful kings of Italy in the tenth century. The evidence of his charters supports this conclusion, showing how effectively he managed to insert members of his own Provençal family into the existing political fabric of northern Italy. Contemporary narrative sources tell the same story, but as one of failure. For Rather of Verona, Liutprand of Cremona and even Flodoard of Reims, Hugh and his family were suspect and their sexual mores questionable. Their texts intervened in contemporary politics not simply as records of Hugh's inadequacies but as real political actors that helped to make that failure happen.
Becoming an expert carer: the process of family carers learning to manage technical health procedures at home
Authors: McDonald Janet , McKinlay Eileen , Keeling Sally , Levack William
Published: April 2016

Aims

To describe the learning process of family carers who manage technical health procedures (such as enteral tube feeding, intravenous therapy, dialysis or tracheostomy care) at home.

Background

Increasingly, complex procedures are being undertaken at home but little attention has been paid to the experiences of family carers who manage such procedures.

Design

Grounded theory, following Charmaz's constructivist approach.

Methods

Interviews with 26 family carers who managed technical health procedures and 15 health professionals who taught carers such procedures. Data collection took place in New Zealand over 19 months during 2011–2013. Grounded theory procedures of iterative data collection, coding and analysis were followed, with the gradual development of theoretical ideas.

Findings

The learning journey comprised three phases: (1) an initial, concentrated period of training; (2) novice carers taking responsibility for day‐to‐day care of procedures while continuing their learning; and (3) with time, experience and ongoing self‐directed learning, the development of expertise. Teaching and support by health professionals (predominantly nurses) was focussed on the initial phase, but carers’ learning continued throughout, developed through their own experience and using additional sources of information (notably the Internet and other carers).

Conclusion

Further work is needed to determine the best educational process for carers, including where to locate training, who should teach them, optimal teaching methods and how structured or individualized teaching should be. Supporting carers well also benefits patient care.
Potentials of single‐cell biology in identification and validation of disease biomarkers
Authors: Niu Furong , Wang Diane C. , Lu Jiapei , Wu Wei , Wang Xiangdong
Published: April 2016

Single‐cell biology is considered a new approach to identify and validate disease‐specific biomarkers. However, the concern raised by clinicians is how to apply single‐cell measurements for clinical practice, translate the message of single‐cell systems biology into clinical phenotype or explain alterations of single‐cell gene sequencing and function in patient response to therapies. This study is to address the importance and necessity of single‐cell gene sequencing in the identification and development of disease‐specific biomarkers, the definition and significance of single‐cell biology and single‐cell systems biology in the understanding of single‐cell full picture, the development and establishment of whole‐cell models in the validation of targeted biological function and the figure and meaning of single‐molecule imaging in single cell to trace intra‐single‐cell molecule expression, signal, interaction and location. We headline the important role of single‐cell biology in the discovery and development of disease‐specific biomarkers with a special emphasis on understanding single‐cell biological functions, e.g. mechanical phenotypes, single‐cell biology, heterogeneity and organization of genome function. We have reason to believe that such multi‐dimensional, multi‐layer, multi‐crossing and stereoscopic single‐cell biology definitely benefits the discovery and development of disease‐specific biomarkers.
Down‐regulation of microRNAs of the miR‐200 family and up‐regulation of Snail and Slug in inflammatory bowel diseases — hallmark of epithelial−mesenchymal transition
Authors: Zidar Nina , Boštjančič Emanuela , Jerala Miha , Kojc Nika , Drobne David , Štabuc Borut , Glavač Damjan
Published: April 2016

Fibrosis is an important feature of inflammatory bowel diseases (IBD), particularly Crohn's disease (CD), but its pathogenesis is poorly understood. To determine the postulated involvement of epithelial−mesenchymal transition (EMT) in the development of fibrosis in IBD, we analysed the expression profiles of the miR‐200 family which has been shown to induce EMT in experimental models and various human diseases. We also analysed the expression of Snail and Slug, postulated targets of the investigated microRNAs. Ten patients with ulcerative colitis (UC) and 10 patients with CD who underwent colon resection were included. From each, two tissue samples were chosen (one with the most severely and one with the least affected or normal mucosa) for analysis of microRNAs expression using real‐time polymerase chain reaction, and Snail and Slug expression using immunohistochemistry. We found significant down‐regulation of all investigated microRNAs in CD, and of three investigated microRNAs in UC, in comparison to the normal or the least affected mucosa. Comparing UC and CD, four microRNAs were significantly more down‐regulated in CD than in UC. Snail and Slug were expressed in the injured epithelium and occasionally in mesothelial cells and submesothelial fibroblasts. Our finding of down‐regulation of the miR‐200 family and up‐regulation of transcription repressors Snail and Slug supports the postulated role of EMT in the pathogenesis of fibrosis in IBD. The described expression patterns are consistent with the notion that fibrosis does not occur only in CD but also in UC, being much more severe in CD.
Glycemic control and adherence to basal insulin therapy in Taiwanese patients with type 2 diabetes mellitus
Authors: Chien Ming‐Nan , Chen Yen‐Ling , Hung Yi‐Jen , Wang Shu‐Yi , Lu Wen‐Tsung , Chen Chih‐Hung , Lin Ching‐Ling , Huang Tze‐Pao , Tsai Ming‐Han , Tseng Wei‐Kung , Wu Ta‐Jen , Ho Cheng , Lin Wen‐Yu , Chen Bill , Chuang Lee‐Ming
Published: April 2016

Aims/Introduction

The aim of the present study was to assess the glycemic control, adherence and treatment satisfaction in a real‐world setting with basal insulin therapy in type 2 diabetes patients in Taiwan.

Materials and Methods

This was a multicenter, prospective, observational registry. A total of 836 patients with type 2 diabetes taking oral antidiabetic drugs with glycated hemoglobin (HbA1c) >7% entered the study. Basal insulin was given for 24 weeks. All treatment choices and medical instructions were at the physician's discretion to reflect real‐life practice.

Results

After 24‐week treatment, 11.7% of patients reached set HbA1c goals without severe hypoglycemia (primary effectiveness end‐point). HbA1c and fasting blood glucose were significantly decreased from (mean ± SD) 10.1 ± 1.9% to 8.7 ± 1.7% (−1.4 ± 2.1%, P < 0.0001) and from 230.6 ± 68.8 mg/dL to 159.1 ± 55.6 mg/dL (−67.4 ± 72.3 mg/dL, P < 0.0001), respectively. Patients received insulin therapy at a frequency of nearly one shot per day on average, whereas self‐monitoring of blood glucose was carried out approximately four times a week. Hypoglycemia was reported by 11.4% of patients, and only 0.7% of patients experienced severe hypoglycemia. Slight changes in weight (0.7 ± 2.4 kg) and a low incidence of adverse drug reactions (0.4%) were also noted. The score of 7‐point treatment satisfaction rated by patients was significantly improved by 1.9 ± 1.7 (P < 0.0001).

Conclusions

Basal insulin therapy was associated with a decrease in HbA1c and fasting blood glucose, and an improved treatment satisfaction. Most patients complied with physicians' instructions. The treatment was generally well tolerated by patients with type 2 diabetes, but findings pointed out the need to reinforce the early and appropriate uptitration to achieve treatment targets.
Clinical predictive factors in diabetic kidney disease progression
Authors: Radcliffe Nicholas J , Seah Jas‐mine , Clarke Michele , MacIsaac Richard J , Jerums George , Ekinci Elif I
Published: April 2016

Diabetic kidney disease (DKD) represents a major component of the health burden associated with type 1 and type 2 diabetes. Recent advances have produced an explosion of ‘novel’ assay‐based risk markers for DKD, though clinical use remains restricted. Although many patients with progressive DKD follow a classical albuminuria‐based pathway, non‐albuminuric DKD progression is now well recognized. In general, the following clinical and biochemical characteristics have been associated with progressive DKD in both type 1 and type 2 diabetes: increased hemoglobin A1c, systolic blood pressure, albuminuria grade, early glomerular filtration rate decline, duration of diabetes, age (including pubertal onset) and serum uric acid; the presence of concomitant microvascular complications; and positive family history. The same is true in type 2 diabetes for male sex category, in patients following an albuminuric pathway to DKD, and also true for the presence of increased pulse wave velocity. The following baseline clinical characteristics have been proposed as risk factors for DKD progression, but with further research required to assess the nature of any relationship: dyslipidemia (including low‐density lipoprotein, total and high‐density lipoprotein cholesterol); elevated body mass index; smoking status; hyperfiltration; decreases in vitamin D, hemoglobin and uric acid excretion (all known consequences of advanced DKD); and patient test result visit‐to‐visit variability (hemoglobin A1c, blood pressure and high‐density lipoprotein cholesterol). The development of multifactorial ‘renal risk equations’ for type 2 diabetes has the potential to simplify the task of DKD prognostication; however, there are currently none for type 1 diabetes‐specific populations. Significant progress has been made in the prediction of DKD progression using readily available clinical data, though further work is required to elicit the role of several variables, and to consolidate data to facilitate clinical implementation.
Concept Analysis of Maternal Autonomy in the Context of Breastfeeding
Authors: Hirani Shela Akbar Ali , Olson Joanne
Published: April 2016

Purpose

The purpose of this article is to analyze the concept of maternal autonomy in the context of breastfeeding and propose a clearer definition of the concept.

Methods

A concept analysis was undertaken using Walker and Avant's eight‐stage approach.

Findings

The concept analysis suggests that maternal autonomy in the context of breastfeeding refers to a mother's ability to make autonomous decisions using her control, agency, independence, and ethical reasoning. The antecedents are maternal competence, availability of support, nature of the setting, and available alternatives with respect to breastfeeding. The consequences are improvement in child health, maternal–child bonding, breastfeeding decisions, and maternal healthcare‐seeking behavior.

Conclusions

A clearer understanding of maternal autonomy in the context of breastfeeding will guide the development of a conceptual framework and expand nursing knowledge development.

Clinical Relevance

A clearer definition of the concept of maternal autonomy in the context of breastfeeding will guide clinicians, researchers, and policy makers in protecting, promoting, and supporting breastfeeding globally towards achieving the United Nations Sustainable Development Goals, 2015–2030.
The fundus photo has met its match: optical coherence tomography and adaptive optics ophthalmoscopy are here to stay
Authors: Morgan Jessica I. W.
Published: April 2016

Purpose

Over the past 25 years, optical coherence tomography (OCT) and adaptive optics (AO) ophthalmoscopy have revolutionised our ability to non‐invasively observe the living retina. The purpose of this review is to highlight the techniques and human clinical applications of recent advances in OCT and adaptive optics scanning laser/light ophthalmoscopy (AOSLO) ophthalmic imaging.

Recent findings

Optical coherence tomography retinal and optic nerve head (ONH) imaging technology allows high resolution in the axial direction resulting in cross‐sectional visualisation of retinal and ONH lamination. Complementary AO ophthalmoscopy gives high resolution in the transverse direction resulting in en face visualisation of retinal cell mosaics. Innovative detection schemes applied to OCT and AOSLO technologies (such as spectral domain OCT, OCT angiography, confocal and non‐confocal AOSLO, fluorescence, and AO‐OCT) have enabled high contrast between retinal and ONH structures in three dimensions and have allowed in vivo retinal imaging to approach that of histological quality. In addition, both OCT and AOSLO have shown the capability to detect retinal reflectance changes in response to visual stimuli, paving the way for future studies to investigate objective biomarkers of visual function at the cellular level. Increasingly, these imaging techniques are being applied to clinical studies of the normal and diseased visual system.

Optical coherence tomography and AOSLO technologies are capable of elucidating the structure and function of the retina and ONH noninvasively with unprecedented resolution and contrast. The techniques have proven their worth in both basic science and clinical applications and each will continue to be utilised in future studies for many years to come.
Bilateral population receptive fields in congenital hemihydranencephaly
Authors: Fracasso Alessio , Koenraads Yvonne , Porro Giorgio L. , Dumoulin Serge O.
Published: April 2016

Purpose

Congenital hemihydranencephaly (HH) is a very rare disorder characterised by prenatal near‐complete unilateral loss of the cerebral cortex. We investigated a patient affected by congenital right HH whose visual field extended significantly into the both visual hemifields, suggesting a reorganisation of the remaining left visual hemisphere. We examined the early visual cortex reorganisation using functional MRI (7T) and population receptive field (pRF) modelling.

Methods

Data were acquired by means of a 7T MRI while the patient affected by HH viewed conventional population receptive field mapping stimuli. Two possible pRF reorganisation schemes were evaluated: where every cortical location processed information from either (i) a single region of the visual field or (ii) from two bilateral regions of the visual field.

Results

In the patient affected by HH, bilateral pRFs in single cortical locations of the remaining hemisphere were found. In addition, using this specific pRF reorganisation scheme, the biologically known relationship between pRF size and eccentricity was found.

Conclusions

Bilateral pRFs were found in the remaining left hemisphere of the patient affected by HH, indicating reorganisation of intra‐cortical wiring of the early visual cortex and confirming brain plasticity and reorganisation after an early cerebral damage in humans.