bluuebunny/crossref_metadata_2025 huggingface dataset:
Islamic art and the ethos of spirituality within a civilizational context
Authors: Grine Fadila , Bensaid Benaouda , Zulkifli Mohd Yusoff M.Y.
Published: October 2013

Purpose

– Islamic art is characterized by a deep-rooted vitality and distinct form of expression that arises from its intimate position with regard to Islamic civilization. While civilizational turning points and major occurrences have held deep ramifications for its growth and development, the most prominent catalysts of civilizational status are not only found in the realm of the political and economic, but rather within a deeper expanse of ideas, spirituality, and societal consciousness; of which Islamic art acts as a prime indicator. The paper aims to discuss these issues.

Design/methodology/approach

– This paper would seek to survey the depths inherent within Islamic spirituality's relationship with Islamic art, and further isolate the reasons and source of their subsistence and continued prevalence.

Findings

– The paper further delves into the relationship shared by spirituality and art, and the influences they exert upon one another. Moreover, it attempts to delineate between the mundane and transcendental spheres of civilizational growth and development, while seeking to come to terms with the sustainability of Islamic art, and its position with respect to Islamic civilization.

Originality/value

– The paper concludes that Islamic art is sustained and defined by means of a unique catalyzing ethos responsible for Islamic civilizational culture that is altogether distinct from the temporal mundane reality of socio-political conditions of civilization.
Coping with the storm
Authors: Mak Lucas
Published: October 2013

Purpose

– The purpose of this paper is to present a process, as a proof-of-concept, that automates the tracking of updates to name authority records (NARs), the downloading of revised NARs into local catalog system, and subsequent bibliographic file maintenance (BFM), in response to the programmatic manipulation of the Library of Congress Name Authority File (LCNAF).

Design/methodology/approach

– A proof-of-concept process to automate NAR updates and BFM in local catalog, using OCLC LCNAF SRU Service, MARCEdit, XSLT, and AutoIt, is built and subsequently tested using data from both test and production catalog servers at Michigan State University Libraries.

Findings

– The proof-of-concept process tested is proved to be successful in general though scalability and diacritics issues have to be addressed before it can become fully operational in a production environment.

Originality/value

– This process enables libraries, especially those without third-party authority control service, to handle the phased reissuance of LCNAF and related BFM in an automatic fashion with minimal human intervention.
Lean and agile supply chain strategies and supply chain responsiveness: the role of strategic supplier partnership and postponement
Authors: Qrunfleh Sufian , Tarafdar Monideepa
Published: October 2013

Purpose

– The purpose of this paper is to examine the role of strategic supplier partnership and postponement respectively, on the relation between lean and agile supply chain strategy and supply chain responsiveness. Also, the authors look at the relation between supply chain responsiveness and firm performance.

Design/methodology/approach

– Applying the strategic-choice theory and the resource-based view of firms to the supply chain, the authors develop a research model to demonstrate the premise that implementing proper supply chain practices to support and execute supply chain strategy will enhance the responsiveness of the supply chain and the performance of the focal firm. The study utilizes survey data from 205 senior executives and managers in the purchasing and supply chain functions from manufacturing firms in the USA. The results are based on covariance-based analysis and structural equation modeling using AMOS software.

Findings

– The study finds that strategic supplier partnership fully mediates the relationship between a lean supply chain strategy and supply chain responsiveness, and that postponement partially mediates the relationship between an agile supply chain strategy and supply chain responsiveness. It is also shown that supply chain responsiveness is associated with enhanced firm performance.

Practical implications

– For supply chain practitioners, the results indicate that firms benefit greatly if they consider the resources of their supply chain, such as postponement and strategic supplier partnership in conjunction with their supply chain strategy and that such a matching yields improved supply chain responsiveness and firm performance.

Originality/value

– The paper theoretically develops logic for and empirically shows that strategic supplier partnership and postponement are appropriate practices for mediating the impact of lean and agile supply chain strategies, respectively, on supply chain responsiveness. Considered at a higher level of abstraction, these relationships indicate a contribution to theory that explains how supply chain strategy can beget supply chain responsiveness, through the concurrent deployment of appropriately matched supply chain practices.
The importance of contextual factors in the success of outsourcing contracts in the supply chain environment: the role of risk and complementary practices
Authors: Wiengarten Frank , Pagell Mark , Fynes Brian
Published: October 2013

Purpose

– Although outsourcing has emerged as a key business practice in global supply chain management it has not always been successfully adopted. Since the reasons for outsourcing success and failure are underexplored this research aims to investigate the role of contractual completeness and complementary enforcement practices such as cooperation and monitoring and sanctioning practices under varying risk scenarios. Critically, these relationships are examined in the context of two serious risks: legal risk in the guise of rule of law and supplier non-conformance risk.

Design/methodology/approach

– Cross-country, survey data was collected through the global manufacturing research group and combined with secondary data from the World Bank. The authors carried out a series of regression analysis to explore their research questions.

Findings

– The results indicate that risk is a critical component of outsourcing success with legal risk reducing outsourcing performance on both cost and quality and supplier risk reducing outsourcing performance on quality. The results also indicate that these outcomes can be mitigated in some settings via complete contracts and complementary practices. These findings are likely to be generalized throughout the supply chain and are of relevance beyond the dyad.

Originality/value

– In the realm of supply chain practices this study presents a comprehensive attempt to assess the importance of risk and complementary practices for the success of outsourcing contracts. Furthermore, it assesses the role of contextual factors such as risk and the rule of law.
Does firm innovativeness enable effective responses to supply chain disruptions? An empirical study
Authors: Golgeci Ismail , Y. Ponomarov Serhiy
Published: October 2013

Purpose

– The purpose of this paper is to investigate the nexus of relationships linking firm innovativeness, innovation magnitude, disruption severity, and supply chain resilience. These relationships are examined within a supply chain disruptions context.

Design/methodology/approach

– This study employed between subjects scenario-based experimental methodology combined with a survey method. Participants in the study were senior level logistics/supply chain and operations managers in US and European manufacturing companies. The hypotheses were tested via linear regression models.

Findings

– Findings suggest that both firm innovativeness and innovation magnitude are positively associated with supply chain resilience. In addition, it was found that disruption severity is positively associated with innovation magnitude.

Research limitations/implications

– Based on the findings, the authors expect that firm innovativeness as a dynamic capability should have a positive impact on achieving supply chain resilience. The more severe the disruption faced, the higher the magnitude of innovation adopted by firms. Therefore, firm innovativeness and innovation magnitude work in tandem to positively influence supply chain resilience.

Originality/value

– This paper contributes to the supply chain risk management literature by enhancing the understanding of both positive outcomes of firm innovativeness and drivers of supply chain resilience. It responds to the question, “What enables firms to respond effectively to supply chain disruptions?” from an innovation perspective that has been ignored in the previous literature.
Maternal and perinatal consequences of antepartum haemorrhage of unknown origin
Authors: Bhandari S , Raja EA , Shetty A , Bhattacharya S
Published: October 2013

Objective

To explore the risk of adverse maternal and perinatal outcomes in women with antepartum bleeding of unknown origin (ABUO).

Design

Cohort study based on data extracted from the Aberdeen Maternity and Neonatal Databank. Exposure was antepartum haemorrhage occurring after the first trimester not attributable to placenta praevia or placental abruption.

Setting

Aberdeen Maternity Hospital, Aberdeen, Scotland, UK.

Population

All primigravidae delivering between 1976 and 2010.

Methods

Data were analysed using univariate and multivariate statistical methods.

Main outcome measures

Pre‐eclampsia, induced labour, mode of delivery, preterm delivery, postpartum haemorrhage, admission to neonatal unit, perinatal death.

Results

Between 1976 and 2010, there were 7517 women with ABUO and 68 423 women without ABUO in the cohort. Women with ABUO were more likely to be non‐smokers, belong to a lower social class, and have a higher body mass index. ABUO was a significant risk factor for induced labour (adjusted odds ratio, aOR, 1.23; 95% CI 1.16–1.31), preterm delivery at <37 weeks of gestation (aOR 2.30; 95% CI 2.11–2.50), and postpartum haemorrhage (aOR 1.15; 95% CI 1.06–1.25). There was no significant association detected with pre‐eclampsia (aOR 0.93; 95% CI 0.83–1.05). Whereas there was an increased risk of low birthweight (aOR 0.90; 95% CI 0.79–1.03) and stillbirth (aOR 0.92; 95% CI 0.66–1.30) with ABUO on univariate analysis, once adjusted for confounding factors this risk was non‐significant.

Conclusion

Pregnancies complicated by ABUO are at a greater risk of preterm delivery and induced labour. There was no increase seen in perinatal mortality after adjusting for preterm birth.
Analysis of the Costs and Economic Feasibility of Requiring Postharvest Processing for Raw Oysters
Authors: Muth Mary K. , Viator Catherine L. , Karns Shawn A. , Cajka James C. , O'Neil Maggie
Published: October 2013

Because of concerns about Vibrio vulnificus, the U.S. Food and Drug Administration is considering requirements for postharvest processing (PHP) of oysters harvested from the Gulf of Mexico during warm‐weather months and intended for raw consumption. As described in the paper, feasible PHP methods for warm‐weather‐harvested oysters include cool pasteurization, high hydrostatic pressure, and low‐dose gamma‐irradiation. We estimate that the costs of applying PHP are approximately 5 to 6 cents per half‐shell oyster intended for raw consumption. However, most oyster processors have insufficient volumes to cost‐effectively install PHP equipment. To assist these smaller operations, central PHP facilities operated by a 3rd party would be needed. A geographic information system analysis that minimized volume‐weighted travel distances from each Gulf oyster operation identified 6 optimal PHP facility locations in the Gulf region. Even with the establishment of central PHP facilities, some oyster operations will become unprofitable and be at risk for closure.
Estimating heritability using genomic data
Authors: Stanton‐Geddes John , Yoder Jeremy B. , Briskine Roman , Young Nevin D. , Tiffin Peter
Published: October 2013

Heritability (h2) represents the potential for short‐term response of a quantitative trait to selection. Unfortunately, estimating h2 through traditional crossing experiments is not practical for many species, and even for those in which mating can be manipulated, it may not be possible to assay them in ecologically relevant environments.

We evaluated an approach, GCTA, that uses relatedness estimated from genomic data to estimate the proportion of phenotypic variance due to genotyped SNPs, which can be used to infer h2. Using phenotypic and genotypic data from eight replicates of experimentally grown plants of the annual legume Medicago truncatula, we examined how h2 estimates from GCTA (h2GCTA) related to traditional estimates of heritability (clonal repeatability for these inbred lines). Further, we examined how h2GCTA estimates were affected by SNP number, minor allele frequency, the number of individuals assayed and the exclusion of causative SNPs.

We found that the average h2GCTA estimates for each trait made with the full data set (>5 million SNPs, 200 individuals) were strongly correlated (r = 0·99) with estimates of clonal repeatability. However, this result masks considerable variation among replicate estimates of h2GCTA, even in relatively uniform greenhouse conditions. h2GCTA estimates with 250 000 and 25 000 SNPs were very similar to those obtained with >5 million SNPs, but with 2500 SNPs, h2GCTA were lower and had higher variance than those with ≥25 k SNPs. h2GCTA estimates were slightly lower when only common SNPs were used. Excluding putatively causative SNPs had little effect on the estimates of h2GCTA, suggesting that genotyping putatively causative SNPs is not necessary to obtain accurate estimates of h2. The number of accessions sampled had the greatest effect on h2GCTA estimates, and variance greatly increased as fewer accessions were included. With only 50 accessions sampled, the range of h2GCTA ranged from 0 to 1 for all traits.

These results indicate that the GCTA method may be useful for estimating h2 using data sets of a size that are available from reduced‐representation genotyping but that hundreds of individuals may need to be sampled to obtain robust estimates of h2.
Beyond the species–area relationship: improving macroecological extinction estimates
Authors: Kitzes Justin , Harte John
Published: October 2013

The species–area relationship is often used to predict extinction rates following habitat loss and climate change. This metric, however, has several shortcomings for conservation applications, as it does not predict extinction risk for individual species, only predicts the expected number of extinctions without an associated measure of uncertainty, and assumes that a species is protected if one individual of a species remains in a landscape.

Here, we propose two new metrics, the extinction–area relationship and probabilistic species–area relationship, that address these shortcomings, and present equations for each metric based on empirically well‐supported species abundance and spatial abundance distributions.

Extinction predictions are found to be strongly influenced by the choice of a minimum abundance required for a species to be considered protected, a parameter that cannot be adjusted explicitly in the classic power law form of the species–area relationship.

These new metrics provide a flexible and theoretically grounded means of applying macroecological principles to the prediction of extinction.
Parental Anxiety at Initial Acute Presentation Is Not Associated With Prolonged Symptoms Following Pediatric Concussion
Authors: Zemek Roger , Clarkin Chantalle , Farion Ken J. , Vassilyadi Michael , Anderson Peter , Irish Brendan , Goulet Kristian , Barrowman Nick , Osmond Martin H.
Published: October 2013

Objectives

Anxiety modulates symptom perception in adults following concussion, prolonging the time to full recovery. The authors sought to determine whether parental anxiety was associated with persistent postconcussive symptoms (PCS) in their children following concussion.

Methods

A prospective observational cohort with 98 children aged 5 to 17 years following concussion participated from a tertiary pediatric emergency department (ED). The main exposure was parental anxiety at the time of acute presentation following pediatric concussion, measured using the self‐administered, validated Spielberger State‐Trait Anxiety Inventory‐State Anxiety Scale (STAI‐S). The primary outcome measured was presence of PCS in the child at 1 month, per the validated Post‐Concussive Symptom Inventory (PCSI). Secondary outcome measures included parental anxiety score over time, school absenteeism, and return to sports. Data were collected during the initial ED visit and at 3‐day, 7‐day, 2‐week, 1‐month, and 3‐month follow‐ups.

Results

Of 98 children enrolled, 27% (95% confidence interval [CI] = 19% to 36%) developed PCS at 1 month. No significant associations were detected between parental anxiety at the index visits and the number of previous pediatric concussions (p = 0.73), sex (p = 0.61), loss of consciousness (p = 0.43), history of migraines (p = 0.31), or history of anxiety diagnosed in the patients (p = 0.09). A significant association was noted between patient diagnosis of attention deficit hyperactivity disorder (ADHD) and parental anxiety at the index visits (p = 0.001). Parental anxiety at acute presentation was not associated with children's prolonged symptoms at 1 month (p = 0.63). Parental anxiety remained elevated in parents whose children had prolonged symptoms compared to those parents whose children's symptoms resolved (median = 30, interquartile range [IQR] = 22 to 44; and median = 21, IQR = 20 to 25, respectively; p < 0.001). Initial parental anxiety presentation was not associated with school absenteeism (p = 0.23) or not returning to sport or gym class (p = 0.89). There were no significant effects involving ADHD alone (p = 0.44) or together with baseline parental anxiety (p = 0.36 for ADHD and p = 0.55 for anxiety) using logistic regression analysis to examine potential predictive effects of child's ADHD combined with parental anxiety at the index visit on persistent symptoms at 1 month.

Conclusions

Parental anxiety at time of acute presentation does not appear to be associated with prolongation of postconcussive symptoms in their children. However, parents of persistently symptomatic children remain significantly more anxious than those whose children's symptoms have resolved. Future research should attempt to reduce the familial burden of concussion through expectation management strategies.
Good virtual fences make good neighbors: opportunities for conservation
Authors: Jachowski D. S. , Slotow R. , Millspaugh J. J.
Published: October 2013

Fences can both enhance and detract from the conservation of wildlife, and many detrimental impacts are associated with creating physical barriers. By contrast, virtual fences can restrict, control or minimize animal movement without the creation of physical barriers, and present key benefits over traditional fences, including: (1) no need for construction, maintenance or removal of traditional fences; (2) rapid modification of boundaries both temporally and spatially based on specific conservation concerns; (3) application of novel conservation approaches for wildlife that integrate monitoring, research and management; and (4) social‐psychological benefits that may increase support for conservation. We review the various types of sensory, biological and mechanical virtual fences, and the potential benefits and costs associated with fully integrating virtual fences into protected area management and wildlife conservation. The recent development of real‐time virtual fences represents the potential for a new ‘virtual management’ era in wildlife conservation, where it is possible to initiate management actions promptly in response to real‐time data. Wide‐scale application of virtual fences faces considerable technological and logistical constraints; however, virtual fences are increasingly popular and soon will offer realistic management strategies for both terrestrial and avian wildlife conservation.
Long‐term follow‐up after urethral injection with polyacrylamide hydrogel for female stress incontinence
Authors: Mouritsen Lone , Lose Gunnar , Møller‐Bek Karl
Published: October 2013

Urethral injection therapy for treatment of stress urinary incontinence has been in use for years, but only a few long‐term follow‐up studies have been published. Twenty‐five women, injected with polyacrylamide hydrogel 8 years earlier, were invited for follow‐up. Twenty‐four could be contacted; 15 had had no further treatment, seven had been re‐operated with placement of mid‐urethral slings, and two had been re‐injected with polyacrylamide hydrogel. Eleven women attended for objective examination; all non‐attenders were interviewed by telephone. Subjectively, in 44% the stress incontinence was cured or much improved, with a positive outcome according to the King′s Health Questionnaire. Objectively, all patients had visible polyacrylamide hydrogel deposits on vaginal ultrasonography. No local adverse reactions were seen in the vaginal mucosa. The results of a later mid‐urethral sling were unaffected by previous polyacrylamide hydrogel injection.
Postnatal nutrition in extremely low birth weight infants and its impact on growth until the age of 6 years
Authors: Peiler Annika , Woelfle Joachim , Stutte Sonja , Schreiner Felix , Bartmann Peter , Gohlke Bettina
Published: October 2013

Aim

To examine the impact of postnatal nutrition on long‐term growth in extremely low birth weight infants.

Method

Retrospective analysis of postnatal nutrition and observational study of growth in 52 ELBW infants until the age of six.

Results

Changes (Δ) in weight and length standard deviation scores (SDS) between birth to term correlated with protein intake (rw = 0.36; p = 0.009; rL = 0.35; p = 0.01), whereas ΔHC correlated with lipid intake (rHC = 0.38; p = 0.005). Analysis of various intervals (0–2, 3–5, 6–8 and 9–11 weeks) only showed significant impact on growth for energy (r = 0.3; p < 0.05) and lipids (r = 0.23; p < 0.05) at 6–8 weeks. No significant correlations were found between postnatal nutritional parameters and long‐term growth. However, postnatal growth restraint was negatively associated with length SDS (r = −0.34; p = 0.015) and body mass index SDS (r = −0.34; p = 0.018) at the age of six. Infants with postnatal growth restraint (n = 25) caught up more in length (+1.78 SDS) than in weight (+0.43 SDS), whereas small for gestational age infants (n = 8) caught up more in weight (+1.35 SDS) than in length (+1.07 SDS). This difference remained significant at the age of six.

Conclusion

Although no direct association between postnatal nutrition and long‐term growth was found, weight at discharge was a strong predictor for long‐term growth.
Effect of cashew nut shell liquid on metabolic hydrogen flow on bovine rumen fermentation
Authors: Mitsumori Makoto , Enishi Osamu , Shinkai Takumi , Higuchi Koji , Kobayashi Yosuke , Takenaka Akio , Nagashima Kyo , Mochizuki Masami , Kobayashi Yasuo
Published: October 2013

Effect of cashew nut shell liquid (CNSL), a methane inhibitor, on bovine rumen fermentation was investigated through analysis of the metabolic hydrogen flow estimated from concentrations of short‐chain fatty acids (SCFA) and methane. Three cows were fed a concentrate and hay diet without or with a CNSL‐containing pellet. Two trials were conducted using CNSL pellets blended with only silica (trial 1) or with several other ingredients (trial 2). Methane production was measured in a respiration chamber system, and energy balance and nutrient digestibility were monitored. The estimated flow of metabolic hydrogen demonstrated that a part of metabolic hydrogen was used for hydrogen gas production, and a large amount of it flowed into production of methane and SCFA in both trial 1 and 2, when CNSL was administered to the bovine rumen. The results obtained by regression analyses showed that the effect of CNSL supply on methane reduction was coupled with a significant (P < 0.01) decrease of acetate and a significant (P < 0.01) increase of propionate and hydrogen gas. These findings reveal that CNSL is able to reduce methane and acetate production, and to increase hydrogen gas and propionate production in vivo.
Reliability in somatic cell count measurement of clinical mastitis milk using DeLaval cell counter
Authors: Kawai Kazuhiro , Hayashi Tomohito , Kiku Yoshio , Chiba Tomoyuki , Nagahata Hajime , Higuchi Hidetoshi , Obayashi Tetsu , Itoh Seigo , Onda Ken , Arai Sachiko , Sato Reiichiro , Oshida Toshio
Published: October 2013

Somatic cell counts (SCC) measurements are typically performed using quantitative methods, such as the Breed method (Breed) and the Fossomatic method (FSCC). The DeLaval cell counter (DCC) developed recently is a quantitative somatic cell counter with a low initial cost and superior portability. However, since the DCC was specifically developed for measuring SCC of ≤ 4 × 106 cells/mL milk from bulk tanks or individual cows, its reliability for estimating SCC that exceed this concentration has not yet been clarified. This study therefore examined whether it is possible to accurately measure SCC by diluting milk samples with initial SCC of 4 × 106 cells/mL, as seen in clinical mastitis milk. We collected milk samples from 99 quarters of 99 Holstein cows with clinical mastitis. These milk samples were diluted 10‐fold with saline and thoroughly mixed before performing SCC measurement with the DCC. The correlation coefficients of SCC measured by the FSCC, Breed and DCC methods indicated strong correlations between each pair of methods. The findings showed that DCC can be used to identify bovine clinical mastitis milk and is useful as a quantitative SCC measurement device on farm sites.
Biogeographic patterns of base‐rich fen vegetation across Europe
Authors: Jiménez‐Alfaro Borja , Hájek Michal , Ejrnaes Rasmus , Rodwell John , Pawlikowski Paweł , Weeda Eddy J. , Laitinen Jarmo , Moen Absjørn , Bergamini Ariel , Aunina Liene , Sekulová Lucia , Tahvanainen Teemu , Gillet François , Jandt Ute , Dítě Daniel , Hájková Petra , Corriol Gilles , Kondelin Hanna , Díaz Tomás E.
Published: October 2013

Questions

What is the distribution of base‐rich fen vegetation and the specialist species along European biogeographic regions? How do the gradients in species composition correlate to geography and climate at continental scale? What are the implications of such patterns for the classification of these habitats?

Location

Fifteen countries of Central, Western and Northern Europe.

Methods

We compiled a vegetation plot database of base‐rich fens and related communities including vascular plants and bryophytes. The initial data set with 6943 plots was filtered according to the presence of specialists using discriminant analysis. We used DCA to analyse the correlation of species composition with geography and climate, and kriging interpolation for mapping gradients in the study area. Modified TWINSPAN was used to detect major vegetation groups. The results of the whole data set (plot size 1–100 m2) were compared with those obtained from two subsets with plots of 1–5 m2 and 6–30 m2.

Results

Most of the specialists were distributed among all the biogeographic regions, but many were more represented in the Alpine than in the Atlantic, Boreal and Continental regions. Variation in species composition was mainly correlated to temperature, precipitation and latitude in the three data sets, showing a major gradient from (1) alpine belt fens characterized by spring species to (2) small sedge fens mainly distributed in mountain regions and (3) boreo‐temperate fens reflecting waterlogged conditions.

Conclusions

Base‐rich fen communities are widely distributed across European biogeographic regions, but the Alpine region can be considered as the compositional centre of this vegetation type. Large‐scale gradients of species composition are mainly explained by climate, while the influence of latitude is probably correlated to increasing water table in the boreo‐temperate regions. These gradients can be better understood by differentiating three major vegetation types, which should be considered when establishing classification systems of base‐rich fens in Europe.
Association between Clostridium difficile infection and antimicrobial usage in a large group of English hospitals
Authors: Pereira Joao B. , Farragher Tracey M. , Tully Mary P. , Cooke Jonathan
Published: October 2013

Aims

This study aimed to determine the association between the reduction in the number of Clostridium difficile infection (CDI) cases reported by the English National Health Service (NHS) hospitals and concurrent antimicrobial use.

Methods

A retrospective ecological study for January 2005 to December 2008 was conducted using data from 26 of the 29 NHS trusts (i.e. a trust manages one or more hospitals) located in the North West Strategic Health Authority of England. Antimicrobial use data, for patients of all ages, were provided by IMS Health, and CDI case data for patients aged ≥65 years were provided by the Health Protection Agency. Antimicrobial use was converted into defined daily doses (DDDs). The overall association between antimicrobial use and CDI for the trusts was investigated using multilevel models.

Results

Our study shows a positive significant association between the CDI cases and the use of the following antimicrobials: ‘third‐generation cephalosporins’ [11.62 CDI cases per 1000 DDDs; 95% confidence interval (CI), 5.92–17.31]; ‘fluoroquinolones’ (4.79 CDI cases per 1000 DDDs; 95% CI, 2.83–6.74); and ‘second‐generation cephalosporins’ (4.25 CDI cases per 1000 DDDs; 95% CI, 1.66–6.83). The strength of this association was not significantly different (95% CI) among the antimicrobial groups.

Conclusions

This study shows that the reduction in the number of CDI cases reported by the English NHS hospitals is associated with concurrent reductions in antimicrobial use. This means that the number of CDI cases over time decreased in a similar fashion to the usage of various antimicrobials.
Public health significance of bipolar disorder: implications for early intervention and prevention
Authors: Conus Philippe , Macneil Craig , McGorry Patrick D
Published: October 2013

Objectives

Early intervention and preventive strategies have become major targets of research and service development in psychiatry over the last few years. Compared to schizophrenia, bipolar disorder (BD) has received limited attention in this regard. In this paper, we review the available literature in order to explore the public health significance of BD and the extent to which this may justify the development of early intervention strategies for this disorder.

Methods

The main computerized psychiatric literature databases were accessed. This included Medline and PsychInfo, using the following keywords: bipolar, early intervention, staging model, burden, caregiver, public health, and manic depression.

Results

BD is often recurrent and has an impact that goes well beyond symptomatic pathology. The burden it incurs is linked not only to its cardinal clinical features, but also to cognitive dysfunction, poor functional outcome, poor physical health, high rate of comorbidities, and suicide. At a societal level, BD induces enormous direct and indirect costs and has a major impact on caregivers. The available literature reveals a usually long delay between illness onset and the start of treatment, and the absence of specific guidelines for the treatment of the early phase of BD.

Conclusions

Considering the major impact of BD on patients and society, there is an urgent need for the development of early intervention strategies aimed at earlier detection and more specific treatment of the early phase of the disorder.
Penile cancer and phallus preservation strategies: a review of current literature
Authors: Zukiwskyj Marianna , Daly Padraig , Chung Eric
Published: October 2013

Penile cancer is a rare malignancy in most developed nations but its management can have significant anatomical, functional and psychological effects in patients. Whilst total penectomy used to be widely practiced, it is associated with significant psychological consequences pertaining to body image and masculinity, with loss of sexual function and the ability to void upright. Recent advances in surgical techniques and technologies has allowed for many organ‐sparing techniques with acceptable psychosexual and oncological outcomes. Factors to be considered in phallus preservation treatment include: local invasion, tumour stage and the ability to achieve complete oncological control. Topical chemotherapeutic agents, laser ablation, radiotherapy, Mohs micrographic surgery, glansectomy and partial penectomy have been frequently used to interfere as little as possible with functional anatomy without compromising local cancer control. The difficulty with these phallus‐preserving techniques is the potential risk of disease recurrence both locally and distally. Providing that patients are suitable for penile‐sparing therapy, have been informed adequately on risk of tumour recurrence and are willing to commit to rigorous close surveillance, good functional outcome as well as oncological control can be achieved.
Diagnostic challenges in the evaluation of persistent or recurrent urinary incontinence after artificial urinary sphincter (AUS) implantation in patients after prostatectomy
Authors: Chung Eric , Cartmill Ross
Published: October 2013

There is a lack of information pertaining to the postoperative evaluation in patients with artificial urinary sphincter (AUS) implants who complain and continue to have urinary incontinence (UI). Two types of UI can occur after the activation of an AUS device these are: early or initial (persistent) UI, and delayed (recurrent) UI. There are many causes of persistent and/or recurrent UI and these can sometimes overlap. The potential causes include improper and/or accidental operation of the pump‐control unit, overactive bladder, cuff atrophy, cuff erosion, improper cuff size and pressure‐regulating balloon unit, as well as device malfunctions. The diagnostic evaluation in men with persistent and/or recurrent UI after AUS implantation requires sufficient understanding of the AUS mechanics and is a step‐wise and logical process with careful history and thorough clinical evaluation. Once a diagnosis is made, patients should be counselled and appropriate treatment instituted.
A randomised single‐blind comparison of the effectiveness of Tristel Fuse (chlorine dioxide) as an office‐based fluid soak, with Cidex OPA (ortho‐phthaldehyde) using an automated endoscopic reprocessor (AER) as high‐level disinfection for flexible cystoscopes
Authors: Gilling Peter J. , Reuther Rana M. , Addidle Michael , Lockhart Michelle M. , Frampton Christopher M. , Fraundorfer Mark R.
Published: October 2013

Objective

To compare the effectiveness, safety and cost of Tristel Fuse (chlorine dioxide) with Cidex OPA (ortho‐phthaldehyde; 1,2–benzenedicarboxaldehyde) in an automated endoscopic reprocessor (AER) for high‐level disinfection of flexible cystoscopes.

Patients and Methods

A randomised single‐blind study comparing the high‐level disinfectants Tristel Fuse as a simple office‐based soak and Cidex OPA using an AER was performed. Participants were ‘blinded’ to the agent used for disinfection of the flexible cystoscopes.

All patients had negative mid‐stream urine at baseline, (MSU) no symptoms suggestive of urinary tract infection (UTI) on the day of investigation, no recent antibiotic use or current indwelling urinary catheter.

Patients who underwent cystoscopic biopsy during the procedure were excluded.

A urine analysis was done before and 3–5 days after cystoscopy and multiple equipment cultures were performed.

The Urogenital Distress Inventory (UDI‐6 + two questions from the ‘long‐form’), symptom and quality‐of‐life scores were assessed before and after cystoscopy as were ease‐of‐use assessments and a full cost analysis.

Results

In all, 180 of 465 screened participants were randomised 1:1 and the mean age was 72.1 years, 17% were females and 57% of procedures were performed for bladder tumour surveillance.

The urine analysis was positive in 5.4% of patients in each group and 29% (Tristel) vs 20% (Cidex) of patients had urinary leukocyturia (p = ns) after cystoscopy.

The turnover (minutes per cycle) was 7.5 (Tristel) vs 26.7 (Cidex). The per‐procedure costs were $11.67 (American dollars) for Tristel Fuse and $21.82 for Cidex OPA with fixed costs of $4788 for Tristel Fuse and $60 514 for Cidex OPA.

Conclusions

Tristel Fuse appears to be as effective and more cost‐effective than Cidex OPA for high‐level disinfection of flexible cystoscopes. This has significant cost implications for the office urologist.
Jim Peters – Sportsman, Soldier, Surgeon
Authors: Webb David Rowan
Published: October 2013

Jim Peters, a country boy who excelled academically and in the sporting arena was a Victorian urological pioneer. His passion for teaching and belief in the development of Australasian urology resulted in the establishment of two of Melbourne's earliest Urology Units (which are now major academic University departments), the creation of a formal urological training program and the promotion of Australian urology within the International urological community.
Impact of the type of ureteroileal anastomosis on renal function measured by diuretic scintigraphy: long‐term results of a prospective randomized study
Authors: Harraz Ahmed M. , Mosbah Ahmed , Abdel‐Latif Mohamed , El‐Assmy Ahmed , Gad Hossam , Shaaban Atallah A.
Published: October 2013

Objective

To determine the long‐term effects of the direct refluxing‐type ureteroileal anastomosis technique with those of an antireflux technique on individual renal units, using diuretic scintigraphy in a prospectively randomized study.

Patients and Methods

Between 2002 and 2006, a prospective randomized study was conducted on 102 patients undergoing radical cystectomy and urinary diversion.

In every patient, both ureters were randomized to be implanted using a direct refluxing technique or an antireflux, serous‐lined extramural tunnel (SLET) technique.

Renal function (RF) was evaluated using 99mTc‐MAG‐3 diuretic scintigraphy. The serial changes in corrected glomerular filtration rate (cGFR) for each technique and for each side were compared.

Results

Over a median follow‐up of 6 years, the patients in both the direct refluxing and the SLET technique groups were found to have a significant reduction in mean (sd) cGFR between baseline and last follow‐up: cGFR decreased from 59.4 (12.4) to 45.6 (15.3) mL/min (P < 0.001) and from 54.3 (11.2) to 46.3 (12.8) mL/min (P = 0.002), respectively.

Five patients (4.9%) in the SLET group developed obstruction (four left‐sided and one right‐sided) compared with one (0.9%) in the direct refluxing group (right‐sided). The onset of obstruction was noted 1–7 months after radical cystectomy.

There was no significant difference between the groups in reductions in cGFR across the timepoints.

Comparison of the two techniques according to the side of ureter implantation showed that the direct refluxing technique trended towards better functional outcomes on the left side.

Conclusions

There was no observed difference in the RF of individual renal units between the SLET and the direct refluxing groups in the long term.

The need to incorporate an antireflux technique should be questioned and tailored according to the surgeon's experience and confidence.
Robustness as a non‐localizable relational phenomenon
Authors: Fernandez‐Leon Jose A.
Published: October 2013

A current challenge in neuroscience, systems and theoretical biology is to understand what properties allow organisms to exhibit and sustain behaviours despite perturbations (behavioural robustness). Indeed, there are still significant theoretical difficulties in this endeavour due to the context‐dependent nature of the problem. Contrary to the common view of biological robustness as a phenomenon that emerges internally, this article discusses the hypothesis that behavioural robustness is rooted in dynamical processes that distribute between internal controls, the organism body and the environment. This review highlights the varied perspectives and how they have led to the current focus on robustness as a relational phenomenon. A new perspective is proposed in which robustness is better understood in the context of agent‐environment dynamical couplings, in which such couplings are not always the full determinants of robustness. The challenges and limitations of the proposed approach are identified.
The High‐Affinity Maltose Switch MBP317‐347 has Low Affinity for Glucose: Implications for Targeting Tumors with Metabolically Directed Enzyme Prodrug Therapy
Authors: Valdes Gilmer , Schulte Reinhard W. , Ostermeier Marc , Iwamoto Keisuke S.
Published: October 2013

Development of agents with high affinity and specificity for tumor‐specific markers is an important goal of molecular‐targeted therapy. Here, we propose a shift in paradigm using a strategy that relies on low affinity for fundamental metabolites found in different concentrations in cancerous and non‐cancerous tissues: glucose and lactate. A molecular switch, MBP317‐347, originally designed to be a high‐affinity switch for maltose and maltose‐like polysaccharides, was demonstrated to be a low‐affinity switch for glucose, that is, able to be activated by high concentrations (tens of millimolar) of glucose. We propose that such a low‐affinity glucose switch could be used as a proof of concept for a new prodrug therapy strategy denominated metabolically directed enzyme prodrug therapy (MDEPT) where glucose or, preferably, lactate serves as the activator. Accordingly, considering the typical differential concentrations of lactate found in tumors and in healthy tissues, a low‐affinity lactate‐binding switch analogous to the low‐affinity glucose‐binding switch MBP317‐347 would be an order of magnitude more active in tumors than in normal tissues and therefore can work as a differential activator of anticancer drugs in tumors.
Escherichia coliinfection induces autoimmune cholangitis and anti-mitochondrial antibodies in non-obese diabetic (NOD).B6 (Idd10/Idd18) mice
Authors: Wang J J , Yang G-X , Zhang W C , Lu L , Tsuneyama K , Kronenberg M , Véla J L , Lopez-Hoyos M , He X-S , Ridgway W M , Leung P S C , Gershwin M E
Published: October 2013

Several epidemiological studies have demonstrated that patients with primary biliary cirrhosis (PBC) have a higher incidence of urinary tract infections (UTI) and there is significant homology of the immunodominant mitochondrial autoantigen, the E2 component of the pyruvate dehydrogenase complex (PDC-E2), between mammals and bacteria. Previous work has demonstrated that non-obese diabetic (NOD).B6 Idd10/Idd18 infected with Novosphingobium aromaticivorans developed liver lesions similar to human PBC. It was postulated that the biliary disease was dependent upon the presence of the unique N. aro glycosphingolipids in activating natural killer T (NK T) cells. To address this issue, we infected NOD.B6 Idd10/Idd18 mice with either Escherichia coli, N. aro or use of a phosphate-buffered saline (PBS) vehicle control and serially followed animals for the appearance of liver pathology and anti-mitochondrial autoantibodies (AMA). Of striking importance, the biliary disease of E. coli-infected mice was more severe than N. Aro-infected mice and the titre of AMA was higher in E. coli-infected mice. Furthermore, the immunopathology did not correlate with the ability of bacterial extracts to produce antigen-dependent activation of NK T cells. Our data suggest that the unique glycosphingolipids of N. aro are not required for the development of autoimmune cholangitis. Importantly, the data highlight the clinical significance of E. coli infection in a genetically susceptible host, and we suggest that the appearance of autoimmune cholangitis is dependent upon molecular mimicry. These data highlight that breach of tolerance to PDC-E2 is probably the first event in the natural history of PBC in genetically susceptible hosts.
Development of a standardized testing procedure for assessing the irritation potential of occupational skin cleansers
Authors: Elsner Peter , Seyfarth Florian , Antonov Dimitar , John Swen Malte , Diepgen Thomas , Schliemann Sibylle
Published: October 2013

Background

Frequent skin cleaning fulfils the definition of occupational ‘wet work’. Standardized methods are required to assess the irritation potential of workplace cleansers.

Objectives

To develop a standardized procedure for testing the irritation potential of occupational skin cleansers.

Methods

In this single‐blind, single‐centre trial in 25 healthy volunteers, the irritation potential of five generic reference cleansers was tested by three‐times‐daily washing with an automated skin cleaning device for 4 days, and quantification of cumulative skin barrier damage was performed by visual scoring, chromametry, transepidermal water loss TEWL, and corneometry. For two cleansers, reproducibility of the irritancy assessment was assessed. Furthermore, the irritation induced by four commercial workplace skin cleansers was studied.

Results

Whereas no significant changes were observed for any of the tested cleansers by either visual scoring or chromametry, significant increases in TEWL and significant decreases in stratum corneum hydration were found for all cleansers. Cleansers differed significantly in their irritation potential. On retesting of two cleansers, the first results were confirmed. Among the four commercial cleansers, one that was claimed to be mild was found to be disproportionally irritant.

Conclusions

The presented model for testing cleansing preparations allows a highly controlled, practically relevant and reproducible irritancy assessment of occupational skin cleansers.
Use of cannula ileostomy to protect a low colorectal anastomosis in patients having preoperative neoadjuvant chemoradiotherapy
Authors: Hanju H. , Jiahe X. , Caizhao L. , Sen L. , Jianjiang L.
Published: October 2013

Aim

This study evaluated the efficacy and safety of ileal diversion, using a tracheal cannula, to protect from a low colorectal anastomosis in patients treated with neoadjuvant chemoradiotherapy.

Method

Fifty patients who presented with rectal cancer and who had accepted neoadjuvant chemoradiotherapy were included. All underwent a low anterior resection with ileal diversion by either tracheal cannula ileostomy (n = 28) or conventional loop ileostomy (n = 22). Demographics, clinical features and operation data were recorded.

Results

Two patients developed anastomotic dehiscence after completion of the cannula ileostomy but neither patient required any further operation. There was no difference in anastomotic dehiscence, peritonitis or requirement for further surgery in patients treated with cannula ileostomy and loop ileostomy.

Conclusion

Cannula ileostomy is a safe, quick, effective and convenient means of intestinal diversion after low anterior resection. Its obvious advantage over loop ileostomy is a reduced overall hospital stay and avoidance of the need to close the stoma.