bluuebunny/crossref_metadata_2025 huggingface dataset:
The independence referendum in Scotland: a tourism perspective on different political options
Authors: Hay Brian
Published: October 2016

Purpose

During the 2014 independence referendum in Scotland, there was much debate about the future broader political direction of the country but little discussion about its impact on Scottish tourism. The purpose of this paper is to explore and discuss the impact of the different future political options from a tourism perspective.

Design/methodology/approach

From the literature, four main political drivers were identified, and using Scotland as a reference, they were used in discussions with six experts to explore how tourism could develop under different political options. The outcomes from these discussions were combined by the researcher to develop in conjunction with the experts an agreed discussion note. This discussion note formed the basis for the exploration of the impact on tourism under four different future political options.

Findings

Of the four political options (devolution limited, devolution plus, devolution max/fiscal autonomy/federation and full independence), it is clear that all options had different positive and negative impacts for tourism. The devolution max option, however, was perceived as most damaging to tourism, because tourism would not be considered a priority, relative to other policy issues. The study concludes with six key lessons that destination management organisations (DMOs) should contemplate when considering the impacts of different political futures.

Research limitations/implications

Being focussed on one country with a strong political party whose raison d'être is independence makes it difficult to extrapolate the results. Nevertheless, given the strong commonality of agreement of the impacts within the experts consulted, this study suggests that DMOs can and should engage in political debates about the future of tourism in their destination.

Originality/value

The 2014 independence referendum in Scotland failed to achieve its primary aim of independence for Scotland, but it did provide space for other political options to be explored. This paper provides a perspective on how tourism could develop under different political options, and so help raise its profile in any future debates, both in Scotland and other destinations.
Keeping it pure – a pedagogical case study of teaching soft systems methodology in scenario and policy analysis
Authors: Yeoman Ian , McMahon-Beattie Una , Wheatley Carol
Published: October 2016

Purpose

Soft systems methodology (SSM) is well documented in the academic and management literature. Over the last 40 years, the methodology has come to be adapted depending on the tool users’ skills and experience in order to fit the problem. The purpose of this paper is to demonstrate good teaching and learning practice from a pedagogical perspective.

Design/methodology/approach

Dr Ian Yeoman of Victoria University of Wellington provides a personal reflection of how the methodology is used in the teaching and learning of TOUR301 Tourism Policy and Planning as a policy and scenario analysis method.

Findings

The paper articulates the seven stages of SSM from problem situation unstructured, through to Rich Pictures, vision and guiding principles, policy solutions, comparisons, feasibility and implementation stages. The paper uses a series of teaching tasks to breakdown the complexity of the methodology thus guiding students and teachers in how to deploy the methodology in the classroom.

Originality/value

The value of the paper demonstrates the reflective practice of SSM in action as an exemplar of good practice. The paper clearly articulates the stages of the methodology so students and teachers can adopt this approach in classroom environments following a scaffolding learning approach. The use of teaching tasks throughout the paper helps bring clarity and order thus enabling the teacher to effectively teach the subject and the students to learn. The most significant contribution of this paper is the articulation of good teaching practice in policy and scenario analysis which articulated through four learning lessons: facilitating a learning environment; the impact of visual thinking; political theory; the importance of incremental learning; and problem-based learning and international students.
Following traces: an organizational ethnography in the midst of trauma
Authors: Cruz Joelle
Published: October 2016

Purpose

The purpose of this paper is twofold. First, it brings forth a methodology of “traces” for organizational ethnography of the shadow, also understood as the realm of the repressed. Second, it highlights the emotional disconnect that organizational ethnographers encounter in traumatized communities and provides suggestions to bridge them.

Design/methodology/approach

The paper – drawing on autoethnography – incorporates the author’s fieldwork experiences conducted with market women in postconflict Monrovia, Liberia. In the tradition of “confessional tales,” it includes vignettes from fieldnotes and in-depth qualitative interviews.

Findings

The paper highlights three types of traces for research on the shadow: memorial, interactional, and material.

Research limitations/implications

The paper is important because it provides a methodology to recover information pertaining to the organizational shadow, where silence, absence, and suppression dominate. It extends existing literature focused on visuality to consider alternative and holistic epistemologies in line with African worldviews.

Practical implications

This paper will help practitioners working with traumatized communities as it suggests the use of memory as a more indirect route to recover information rather than direct questioning.

Originality/value

The paper juxtaposes poignant stories with academic prose and is valuable in terms of content and form. First, it addresses the topics of emotion and discomfort, seldom incorporated in organization studies. Second, it is valuable to scholars wishing to experiment with more intuitive forms of writing.
Solving organisational conflicts in public matrix organisation
Authors: Pakarinen Mikko , Virtanen Petri
Published: October 2016

Purpose

The purpose of this paper is to examine the matrix organisation in one municipality. It focusses on whether decisions can be based on shared understanding, as well as identifying conflicts and proposed solutions between central administration and the line divisions.

Design/methodology/approach

The case study is founded on empirical data from city of Turku, Finland. The data are based on two surveys and participant observation data (employees’ meetings and workshops during 2013-2015).

Findings

Conflicts were categorised based on structure, processes, resources, people, and rewards. Conflicts emerged on an individual level, such as role conflict, role ambiguity, and role overload. Administrative procedures, personnel resources, scheduling, and personality issues emerged on an organisational level. Conflicts were greater in the line organisation than in central administration, but they did not differ much. Proposed solutions were few, but jointly determined. The value of the matrix was in the creation of a coherent vision. Cross-dimensional steering groups offered fora for identifying problems and solving conflicts, but the ability to realise change was limited, mainly because of a lack of decision-making power.

Research limitations/implications

Methodological limitations relate to the generalisation of the findings.

Practical implications

The study findings call for developing network-based communication models, as well as public management styles adjusted to matrix-type organisations.

Originality/value

The conflicts raised are similar in public-sector organisations and private companies. However, the proposed solutions may vary because of the limited possibilities for a municipal organisation to rectify the problems that emerged.
Place revisited: class, stigma and urban restructuring in the case of Glasgow’s Commonwealth Games
Authors: Paton Kirsteen , McCall Vikki , Mooney Gerry
Published: October 2016

This paper reappraises the meaning of space and place in contemporary class analysis. We explore how class is reshaped and mediated by neoliberal urban restructuring, of which the processes of gentrification and territorial stigmatization form critical parts. We focus on the contemporary interrelation of class and urban restructuring in the post-crash city by looking at the local lived experiences of the 2014 Commonwealth Games (CWG) in Glasgow’s East End. This high-profile regeneration effort in a deprived working-class neighbourhood reveals much about the functions of neoliberal financial capitalism, austerity and contemporary class formation. We show that gentrification and territorial stigmatization work in tandem within urban regeneration policy interventions as a punitive strategy for managing poor populations. This involves land value and (de)valuing of people and creates new localized class inequalities and insecurities. Our research highlights that in the face of national level cuts and commodification, residents’ local relations and support become essential social, economic and political resources. Yet, paradoxically, at the very same time, their local attachment to place is devalued, stigmatized and is at its most precarious. This exposes the coercive elements of the neoliberal class project; a distinct urban class inequality of our time and therefore, we suggest, a critical direction in class analysis.
‘Who do you want to kill?’ Affectual and relational understandings at a sorcery rock art site in the southwest Gulf of Carpentaria, northern Australia
Authors: Brady Liam M. , Bradley John J.
Published: October 2016

This article explores the affectual and relational contexts in which rock art is embedded through an exploration of the encounters, reactions, and responses to a well‐known sorcery rock art site known as Kurrmurnnyini in northern Australia's southwest Gulf country. These encounters with a culturally powerful place, and the emotions derived from people's personal memories and experiences of Kurrmurnnyini and its sorcery‐infused rock art, are vital to establishing an understanding of contemporary perceptions of what is clearly more than an ‘archaeological site’. We contend that by turning our attention to the often‐overlooked affectual and relational dimensions of rock art and the contexts in which it is found, researchers place themselves in a better position to access and become aware of the agency and affect of graphic imagery as well as the significance these powerful images and places hold for people today.
Recent Developments in Productivity Analysis
Authors: Lovell C. A. K.
Published: October 2016

I provide a selective and idiosyncratic examination of several recent, and in some cases not‐so‐recent, developments in productivity analysis that I find interesting. Some have been influential, among them being an analysis of the linkage between management and productivity, an analysis of productivity dispersion (or productivity gaps) and productivity‐enhancing resource reallocation, the incorporation of environmental impacts into productivity measurement, and an analysis of the impact of productivity on business financial performance. Others, for whatever reason, have had less impact, including an analysis of two quite different productivity indices bearing the same name, developing the linkage between empirical and theoretical productivity indices, and the derivation, interpretation and implementation of indirect productivity indices.
Jung's psychoid concept and Bion's proto‐mental concept: a comparison
Authors: Addison Ann
Published: October 2016

Jung and Bion both developed theoretical concepts propounding a deeply unknowable area of the psyche in which body and mind are undifferentiated and the individual has no distinct identity, from which a differentiated consciousness arises. In Jung's case, this is enshrined in his psychoid concept and the associated notion of synchronicity and, in Bion's case, in his proto‐mental concept and his ideas on group dynamics. It is by means of these two concepts that Jung and Bion approach and locate a combined body‐mind, a monism, in which body and mind are seen as different aspects of the same thing. This paper reviews the claim that although the two concepts are associated clinically with very different situations, their commonality may arise from a similar intellectual basis: both men appear to have been influenced by the same source of vitalist ideas in philosophy including Henri Bergson, and Jung's ideas also exerted a direct influence on Bion.
Through the Looking Glass: Estimating Effects of Medical Homes for People with Severe Mental Illness
Authors: Domino Marisa Elena , Kilany Mona , Wells Rebecca , Morrissey Joseph P.
Published: October 2016

Objective

To examine whether medical homes have heterogeneous effects in different subpopulations, leveraging the interpretations from a variety of statistical techniques.

Data Sources/Study Setting

Secondary claims data from the NC Medicaid program for 2004–2007. The sample included all adults with diagnoses of schizophrenia, bipolar disorder, or major depression who were not dually enrolled in Medicare or in a nursing facility.

Study Design

We modeled a number of monthly service use, adherence, and expenditure outcomes using fixed effects, generalized estimating equation with and without inverse probability of treatment weights, and instrumental variables analyses.

Data Collection

Data were received from the Carolina Cost and Quality Initiative.

Principal Findings

The four estimation techniques consistently revealed generally positive associations between medical homes and access to primary care, specialty mental health care, greater medication adherence, slightly lower emergency room use, and greater expenditures. These findings were consistent across all three major severe mental illness diagnostic groups. Some heterogeneity in effects were noted, especially in preventive screening.

Conclusions

Expanding access to primary care–based medical homes for people with severe mental illness may not save money for insurance providers, due to greater access for important outpatient services with little cost offset. Health services research examining more of the treatment heterogeneity may contribute to more realistic projections about medical homes outcomes.
Physician EHR Adoption and Potentially Preventable Hospital Admissions among Medicare Beneficiaries: Panel Data Evidence, 2010–2013
Authors: Lammers Eric J. , McLaughlin Catherine G. , Barna Michael
Published: October 2016

Objective

To test for correlation between the growth in adoption of ambulatory electronic health records (EHRs) in the United States during 2010–2013 and hospital admissions and readmissions for elderly Medicare beneficiaries with at least one of four common ambulatory care–sensitive conditions (ACSCs).

Data Sources

SK&A Information Services Survey of Physicians, American Hospital Association General Survey and Information Technology Supplement; and the Centers for Medicare & Medicaid Services Chronic Conditions Data Warehouse Geographic Variation Database for 2010 through 2013.

Study Design

Fixed effects model estimated the relationship between hospital referral region (HRR) level measures of physician EHR adoption and ACSC admissions and readmissions. Analyzed rates of admissions and 30‐day readmissions per beneficiary at the HRR level (restricting the denominator to beneficiaries in our sample), adjusted for differences across HRRs in Medicare beneficiary age, gender, and race. Calculated physician EHR adoption rates as the percentage of physicians in each HRR who report using EHR in ambulatory care settings.

Principal Findings

Each percentage point increase in market‐level EHR adoption by physicians is correlated with a statistically significant decline of 1.06 ACSC admissions per 10,000 beneficiaries over the study period, controlling for the overall time trend as well as market fixed effects and characteristics that changed over time. This finding implies 26,689 fewer ACSC admissions in our study population during 2010 to 2013 that were related to physician ambulatory EHR adoption. This represents 3.2 percent fewer ACSC admissions relative to the total number of such admissions in our study population in 2010. We found no evidence of a correlation between EHR use, by either physicians or hospitals, and hospital readmissions at either the market level or hospital level.

Conclusions

This study extends knowledge about EHRs' relationship with quality of care and utilization. The results suggest a significant association between EHR use in ambulatory care settings and ACSC admissions that is consistent with policy goals to improve the quality of ambulatory care for patients with chronic conditions. The null findings for readmissions support the need for improved interoperability between ambulatory care EHRs and hospital EHRs to realize improvements in readmissions.
Does Homeownership Prolong the Duration of Unemployment?
Authors: Taşkın Ahmet Ali , Yaman Fırat
Published: October 2016

We examine the effects of homeownership on individuals' unemployment durations. An unemployment spell can terminate with a job or with nonparticipation. The endogeneity of homeownership is addressed by estimating a full maximum likelihood function jointly modeling the competing hazards and the probability of being a homeowner. Unobserved factors contributing to the probability of being a homeowner are allowed to be correlated with unobservable heterogeneity in the hazard rates. Not controlling for ownership selection, there is neither a significant difference in the job‐finding hazard nor in the nonparticipation hazard of unemployed owners and renters. If we jointly model the ownership selection, we find that unemployed homeowners are more likely to find a job than renters.
Intracranial translucency assessment at first trimester nuchal translucency ultrasound
Authors: Lane Annah , Lee Ling , Traves Donna , Lee Andreas
Published: October 2016

Introduction

The antenatal diagnosis of open spina bifida (OSB), a neural tube defect, is predominantly made at the second trimester morphology scan by ultrasound detection of structural abnormalities resulting from the associated Chiari II malformation. Evidence has emerged suggesting that these structural abnormalities can be detected earlier, by examination of the posterior fossa as part of the first trimester nuchal translucency scan. In particular, absence of the intra‐cranial translucency (IT) of the fourth ventricle has shown promise as a diagnostic marker of OSB, although the sensitivity and specificity of this finding varies widely in the literature. The aim of this study is to assess the feasibility of obtaining the image of the IT at our institution as part of the routine first trimester scan.

Methods

This is a prospective study of 900 obstetric patients who presented to a tertiary women's imaging centre for routine first trimester nuchal translucency screening ultrasound for the year 2014. Their risk status was that of the general population (low risk) prior to presentation. A total of 158 patients were excluded, leaving a study group of 742. Sonographers obtained a mid‐sagittal view of the fetal face with particular focus on optimum viewing of the IT. All images were examined by a Radiology Registrar for presence or absence of IT. Duration of each scan was documented.

Results

The IT image was successfully acquired in 94.9% of scans. Maternal pre‐pregnancy BMI and fetal lie were shown to have a statistically significant effect on success of acquisition of the IT image. No cases of OSB were diagnosed during the study. Scan times were not lengthened by the addition of the image.

Conclusion

We consider that acquisition of an image of the IT as part of the routine first trimester nuchal translucency scan is feasible, without lengthening appointment times.
A combined field survey and molecular identification protocol for comparing forest arthropod biodiversity across spatial scales
Authors: Emerson Brent C. , Casquet Juliane , López Heriberto , Cardoso Pedro , Borges Paulo A. V. , Mollaret Noémy , Oromí Pedro , Strasberg Dominique , Thébaud Christophe
Published: October 2016

Obtaining fundamental biodiversity metrics such as alpha, beta and gamma diversity for arthropods is often complicated by a lack of prior taxonomic information and/or taxonomic expertise, which can result in unreliable morphologically based estimates. We provide a set of standardized ecological and molecular sampling protocols that can be employed by researchers whose taxonomic skills may be limited, and where there may be a lack of robust a priori information regarding the regional pool of species. These protocols combine mass sampling of arthropods, classification of samples into parataxonomic units (PUs) and selective sampling of individuals for mtDNA sequencing to infer biological species. We sampled ten lowland rainforest plots located on the volcanic oceanic island of Réunion (Mascarene archipelago) for spiders, a group with limited taxonomic and distributional data for this region. We classified adults and juveniles into PUs and then demonstrated the reconciliation of these units with presumed biological species using mtDNA sequence data, ecological data and distributional data. Because our species assignment protocol is not reliant upon prior taxonomic information, or taxonomic expertise, it minimizes the problem of the Linnean shortfall to yield diversity estimates that can be directly compared across independent studies. Field sampling can be extended to other arthropod groups and habitats by adapting our field sampling protocol accordingly.
A comparison of DNA extraction methods for high‐throughput DNA analyses
Authors: Schiebelhut Lauren M. , Abboud Sarah S. , Gómez Daglio Liza E. , Swift Holly F. , Dawson Michael N
Published: October 2016

The inclusion of next‐generation sequencing technologies in population genetic and phylogenetic studies has elevated the need to balance time and cost of DNA extraction without compromising DNA quality. We tested eight extraction methods – ranging from low‐ to high‐throughput techniques – and eight phyla: Annelida, Arthropoda, Cnidaria, Chordata, Echinodermata, Mollusca, Ochrophyta and Porifera. We assessed DNA yield, purity, efficacy and cost of each method. Extraction efficacy was quantified using the proportion of successful polymerase chain reaction (PCR) amplification of two molecular markers for metazoans (mitochondrial COI and nuclear histone 3) and one for Ochrophyta (mitochondrial nad6) at four time points – 0.5, 1, 2 and 3 years following extraction. DNA yield and purity were quantified using NanoDrop absorbance ratios. Cost was estimated in terms of time and material expense. Results show differences in DNA yield, purity and PCR success between extraction methods and that performance also varied by taxon. The traditional time‐intensive, low‐throughput CTAB phenol–chloroform extraction performed well across taxa, but other methods also performed well and provide the opportunity to reduce time spent at the bench and increase throughput.
Rock art on Socotra, Yemen: the discovery of a petroglyph site on the island's south coast.
Authors: van Rensburg Julian Jansen
Published: October 2016

Recent fieldwork on the south coast of the island of Socotra, Yemen, has revealed a hitherto unknown petroglyph site. This site represents the first rock art to have been recorded on the south coast, an area generally regarded as being unpopulated up until the recent past. The corpus of recorded petroglyphs includes feet, cupules, anthropomorphic figures and geometric motifs, whose designs parallel those from known rock‐art sites on the north coast. The importance of this site is that it provides us with the first glimpse into the religious and socio‐political lives of the inhabitants of the previously unknown southern half of Socotra. Placing these petroglyphs within the broader context of rock‐art studies on the island of Socotra has also allowed us to begin to disentangle the skewed view of Socotra's inhabitants.
Bilad al‐Qadim revisited: recent archaeological research at the Al‐Khamis Mosque, Ain Abu Zaydan and Abu Anbra, Bahrain
Authors: Insoll Timothy , Almahari Salman , MacLean Rachel , Priestman Seth , Al‐Mearaj Muhammad , Overton Nick J.
Published: October 2016

In comparison to our understanding of pre‐Islamic occupation and land use on Bahrain, that of the Islamic period has remained less well known. In connection with the building of a visitor centre at the Al‐Khamis Mosque and the planning of an associated heritage trail, renewed archaeological research has taken place in Bilad al‐Qadim, an archaeologically important area of Islamic settlement in the north‐east of the main island of Awal. This has involved excavations in the Abu Anbra cemetery, at Ain Abu Zaydan and at the Al‐Khamis Mosque. The results of these excavations are reported here and these contribute to our understanding of Islamic settlement on Bahrain by supporting the interpretation that Bilad al‐Qadim was the main centre of Islamic settlement in the eleventh–thirteen century AD.
Carotid Doppler flowmetry correlates poorly with thermodilution cardiac output following cardiac surgery
Authors: Roehrig C. , Govier M. , Robinson J. , Aneman A.
Published: October 2016

Background

It remains unclear whether measuring carotid arterial flow by the time velocity integral using vascular Doppler ultrasound can be used to monitor cardiac output and volume responsiveness.

Methods

The carotid Doppler flow (time velocity integral and peak flow velocity variation) was assessed in triplicate by an intensivist with formal vascular ultrasound training. Thirty‐three patients admitted following coronary by‐pass surgery were studied before and after a passive leg‐raising manoeuvre to investigate volume responsiveness (more than 10% increase in cardiac output) along with indices of arterial load measuring cardiac output by thermodilution. Pearson's correlation coefficient and area under the curve (AUC) by receiver operating characteristics were calculated.

Results

A significant correlation between carotid Doppler flow and cardiac output was demonstrated in post‐operative cardiac surgery patients (r = 0.80 [95%CI 0.61–0.89]), including relative changes following passive leg raising (r = 0.79 [95%CI 0.60–0.89]) that showed a mean difference of 2% with wide limits of agreements (−19% to 16%). Changes in carotid Doppler flow following passive leg raising correlated with the baseline arterial resistance but not with compliance or effective elastance. A peak flow variation > 10% before passive leg raising discriminated responders to the manoeuvre with an AUC of 0.81 [95% CI 0.55–0.95].

Conclusions

Weak correlations between common carotid Doppler flow and cardiac output mean that the methods cannot be used interchangeably in post‐operative cardiac surgery patients.
Region specific activation of the AKT and mTORC1 pathway in response to excessive alcohol intake in rodents
Authors: Laguesse Sophie , Morisot Nadege , Phamluong Khanhky , Ron Dorit
Published: October 2016

We previously reported that the kinase AKT is activated in the nucleus accumbens (NAc) of rodents in response to excessive consumption of alcohol. One of the important downstream targets of AKT is the mammalian Target Of Rapamycin in Complex 1 (mTORC1), which was also activated by alcohol intake. mTORC1 controls dendritic protein translation, and we showed that the mTORC1‐dependent translational machinery is activated in the NAc in response to alcohol intake. Importantly, systemic or intra‐NAc inhibition of the AKT/mTORC1 pathway attenuated alcohol‐drinking behaviors. Here, we mapped the activation patterns of AKT and mTORC1 in corticostriatal regions of rodents consuming large amounts of alcohol. We found that the activation of AKT and mTORC1 in response to cycles of binge drinking of 20 percent alcohol was centered in the NAc shell. Both kinases were not activated in the dorsolateral striatum (DLS); however, AKT, but not mTORC1, was activated in the dorsomedial striatum (DMS) of mice but not rats. Interestingly, excessive intake of alcohol produced a selective activation of the AKT/mTORC1 pathway in the orbitofrontal cortex (OFC), which was not observed in medial prefrontal cortex (mPFC). Furthermore, this signaling pathway was not activated in the NAc shell or OFC of rats consuming moderate amounts of alcohol nor was it activated in rats consuming sucrose. Together, our results suggest that excessive alcohol intake produces a brain region selective activation of the AKT/mTORC1 pathway, which is likely to contribute to NAc shell and OFC‐dependent mechanisms that underlie the development and maintenance of alcohol drinking behavior.
Alpha‐7 nicotinic acetylcholine receptor (nAChR) agonist inhibits the development of endometriosis by regulating inflammation
Authors: Yamada‐Nomoto Kaori , Yoshino Osamu , Akiyama Ikumi , Ushijima Akemi , Ono Yosuke , Shima Tomoko , Nakashima Akitoshi , Hayashi Shusaku , Kadowaki Makoto , Osuga Yutaka , Saito Shigeru
Published: October 2016

Objective

We investigated α‐7 nAchR expression in human peritoneal macrophages and examined whether activation of nAchR might be a new therapy for endometriosis.

Materials and methods

Human peritoneal fluid mononuclear cells (PFMC) were stimulated with lipopolysaccharide (LPS) in the presence of α‐7 nAChR agonists. In a murine endometriosis model, α‐7 nAChR modulators were administered.

Results

Human PFMC expressed α‐7 nAChR at the mRNA and protein levels. Activation of α‐7 nAChR with its agonists led to significant (P<.01) suppression of LPS‐induced interleukin (IL) ‐1β expression. In a murine endometriosis model, one week after inoculation of endometrium to the peritoneal cavity, α‐7 nAChR agonist significantly suppressed the expression of IL‐1β mRNA (P<.01), which was negated when α‐7 nAChR antagonist was administered simultaneously. α‐7 nAChR agonist significantly suppressed the formation of endometriotic lesions, which was reversed with α‐7 nAChR antagonist.

Conclusion

Activation of nAChR might be a new candidate for treatment of endometriosis.
Modified esophagogastrostomy in laparoscopy‐assisted proximal gastrectomy: A reverse‐Tornado anastomosis
Authors: Kubota Keisuke , Suzuki Akihiro , Fujikawa Aoi , Watanabe Takayuki , Sekido Yuki , Shiozaki Hironori , Taketa Takashi , Shimada Gen , Ohigashi Seiji , Sakurai Shintaro , Kishida Akihiro
Published: October 2016

Introduction

The aim of this study was to introduce and examine a modified mechanical end‐to‐side esophagogastrostomy method (“reverse‐Tornado" anastomosis) in laparoscopy‐assisted proximal gastrectomy.

Methods

Five patients with gastric cancer who underwent laparoscopy‐assisted proximal gastrectomy were analyzed retrospectively. Esophagogastrostomy in the anterior wall was performed in three patients, and esophagogastrostomy in the posterior wall was performed in two patients. Clinicopathological features, operative outcomes (operative time, operative blood loss), and postoperative outcomes (complications, postoperative hospital stay, reflux esophagitis) were evaluated.

Results

Operative time was normal (278 min). There was no marked operative blood loss, postoperative complications, prolonged hospital stay, or reflux esophagitis.

Conclusion

Esophagogastrostomy was completed in a normal time with reverse‐Tornado anastomosis. This method can be safe and can enable good postoperative quality of life.
Forty years of vegetation change in former coppice‐with‐standards woodlands as a result of management change and N deposition
Authors: Becker Thomas , Spanka Julia , Schröder Lothar , Leuschner Christoph
Published: October 2016

Question

Did vegetation of former coppice‐with‐standards woodlands, which were in conversion towards high forest for about 100 yrs, change over the last 41 yrs (1970–2011)? What were the main drivers of vegetation change?

Location

Dransfeld Plateau, central Germany.

Methods

Repetition of 85 historical semi‐permanent vegetation plots located in 13 forest patches on limestone soil. Differences in species composition and plant functional types between historical and recent plots were analysed using a block multi‐response permutation procedure (bMRPP), NMDS, indicator species analysis (ISA) and ANOVA.

Results

We found significant changes in all vegetation layers. In the tree layer, Fagus sylvatica and Hedera helix had increased, while Quercus robur and Carpinus betulus had decreased. In the understorey, tree regeneration had strongly increased. In the herbaceous layer, species richness had decreased from 30 to 24 species per 100 m², and the abundance of plant functional types had changed: the proportion of geophytes and therophytes had increased, while the proportion of hemicryptophytes had decreased. Spring‐green species (i.e. species active mainly before tree foliation) had increased, while summer‐green species had decreased. In addition, the estimated mean SLA of herbaceous species had increased. The proportion of closed‐forest species had slightly increased, while the proportion of species of forest edges and clearings had decreased. NMDS ordination separated the herbaceous layers from 1970 and 2011 along the second axis, which correlated with the indicator values for continentality (decrease over time) and N (increase over time).

Conclusions

Although the stands still shared many characteristics of coppice‐with‐standards woodlands, the vegetation had clearly shifted towards that of darker and more nutrient‐rich forest. This indicates both a marked legacy of historic coppice management and a strong influence of recent high forest management, as well as N deposition.
Increased prevalence of potential right‐to‐left shunting in children with sickle cell anaemia and stroke
Authors: Dowling Michael M. , Quinn Charles T. , Ramaciotti Claudio , Kanter Julie , Osunkwo Ifeyinwa , Inusa Baba , Iyer Rathi , Kwiatkowski Janet L. , Johnson Clarissa , Rhodes Melissa , Owen William , Strouse John J. , Panepinto Julie A. , Neumayr Lynne , Sarnaik Sharada , Plumb Patricia A. , Dlamini Nomazulu , Kirkham Fenella , Hynan Linda S. ,   the PFAST Investigators
Published: October 2016

‘Paradoxical’ embolization via intracardiac or intrapulmonary right‐to‐left shunts (RLS) is an established cause of stroke. Hypercoagulable states and increased right heart pressure, which both occur in sickle cell anaemia (SCA), predispose to paradoxical embolization. We hypothesized that children with SCA and overt stroke (SCA + stroke) have an increased prevalence of potential RLS. We performed contrasted transthoracic echocardiograms on 147 children (aged 2–19 years) with SCA + stroke) mean age 12·7 ± 4·8 years, 54·4% male) and a control group without SCA or stroke (n = 123; mean age 12·1 ± 4·9 years, 53·3% male). RLS was defined as any potential RLS detected by any method, including intrapulmonary shunting. Echocardiograms were masked and adjudicated centrally. The prevalence of potential RLS was significantly higher in the SCA+stroke group than controls (45·6% vs. 23·6%, P < 0·001). The odds ratio for potential RLS in the SCA + stroke group was 2·7 (95% confidence interval: 1·6–4·6) vs controls. In post hoc analyses, the SCA + stroke group had a higher prevalence of intrapulmonary (23·8% vs. 5·7%, P < 0·001) but not intracardiac shunting (21·8% vs. 18·7%, P = 0·533). SCA patients with potential RLS were more likely to report headache at stroke onset than those without. Intrapulmonary and intracardiac shunting may be an overlooked, independent and potentially modifiable risk factor for stroke in SCA.
Advances in understanding the pathogenesis of CNS acute lymphoblastic leukaemia and potential for therapy
Authors: Frishman‐Levy Liron , Izraeli Shai
Published: October 2016

Central nervous system acute lymphoblastic leukaemia (CNS‐ALL) is a major clinical problem. CNS‐directed ‘prophylactic’ chemo‐ or radio – therapy is associated with significant early and long‐term toxicity. Moreover, greater than a third of the relapses occur in the CNS. To design specific, more effective and less toxic therapy and for personalized precise adjustment of prophylactic therapy there is a need for better understanding of the biology of this disease. Specifically, the precise neurotropic mechanisms of ALL are currently unclear, as is the pathogenesis of CNS relapse. Here we review and contrast the recent findings with earlier studies of pathogenesis of CNS leukaemia. We also describe the challenges in research of this devastating complication of ALL.
Pictures on My Analyst's Walls: Reflections on the Art of Käthe Kollwitz, the Nazis and the Art of Psychoanalysis
Authors: Coulter Helga
Published: October 2016

The author's reaction to the sight of two of the works of the German expressionist artist Käthe Kollwitz on the walls of the rooms of her prospective training analyst forms the starting point for an exploration of art, totalitarianism and the art of psychoanalysis. The art and life of Kollwitz are used as the basis of an attempt to grasp the meaning of art together with how and why art can speak so powerfully to us. The impact of the Nazi regime on Kollwitz and her contemporaries leads to consideration of the totalitarian view of the purpose of art and consequently what we mean by ‘art’. Finally, the author perceives the art of Kollwitz as a life‐long self‐analysis and considers this as a mirror to the concept of psychoanalysis as an art. In her exploration of the arts she applies Bion's concept of ‘O’ (the thing‐in‐itself) and its transformations to understand and give meaning to the arts.
A Prime Example of the Maluma/Takete Effect? Testing for Sound Symbolic Priming
Authors: Sidhu David M. , Pexman Penny M.
Published: October 2016

Certain nonwords, like maluma and takete, are associated with roundness and sharpness, respectively. However, this has typically been demonstrated using explicit tasks. We investigated whether this association would be detectable using a more implicit measure—a sequential priming task. We began with a replication of the standard Maluma/Takete effect (Experiments 1a and 1b) before examining whether round and sharp nonword primes facilitated the categorization of congruent shapes (Experiment 2). We found modest evidence of a priming effect in response accuracy. We next examined whether nonword primes affected categorization of ambiguous shapes, using visual (Experiment 3) and auditory primes (Experiment 4). We found that ambiguous shapes were categorized as round (sharp) more often following the presentation of a round (sharp) nonword. This suggests that phonemes may activate related shape information which then affects the processing of shapes, and that this association emerges even when participants are not explicitly searching for it.
Diagnostic investigation of BIRC6 and SIRT1 protein expression level as potential prognostic biomarkers in patients with non‐small cell lung cancer
Authors: Gharabaghi Mehrnaz Asadi
Published: October 2016

Background/Aim

Lung cancer is the major contributor to overall cancer‐related mortality. Biomarkers are important in early detection and prognosis, in addition to developing treatment regimes, which may improve the patient survival rates. Therefore, the present study was designed to evaluate the prognostic and diagnostic value of SIRT1/BIRC6 expression in non‐small cell lung cancer (NSCLC).

Methods

The data on the prognostic impact of SIRT1/BIRC6 in NSCLC were collected from September 11, 2006 to July 10, 2014. Immunoexpressions and real‐time quantitative reverse transcription‐PCR of SIRT1/BIRC6 were analyzed and the outcomes were correlated with clinicopathological features and patient survivals.

Results

MRNA level of SIRT1 was upregulated in NSCLC tissues as compared to normal tissues (3.18 ± 0.77 vs. 1.27 ± 0.62; P = .001). BIRC6 mRNA was upregulated in cancer tissues when compared with normal tissues (4.13 ± 0.91 vs. 1.51 ± 0.72; P = .001). SIRT1 protein was overexpressed in 27 patients (67.5%), while normal tissues showed weak or negative staining to SIRT1 (P = .002). Furthermore, these findings suggested that advanced pathological T stage, and poor differentiation were significantly associated with expression of SIRT1 (P < .05). Increased expression of BIRC6 was detected in 75% of patients, while weak or negative expression were detected in normal tissues (P = .001). Furthermore, increased expression of BIRC6 was linked to advanced pathological T stage, poor differentiation, and lymph node metastasis (P < .05).

Conclusions

SIRT1 and BIRC6 may be linked to tumor progression and could be useful for the treatment of NSCLC.
Relation between neutrophil/lymphocyte ratio and primary tumor metabolic activity in patients with malign pleural mesothelioma
Authors: Özyürek Berna Akıncı , Özmen Özlem , Özdemirel Tuğçe Şahin , Erdoğan Yurdanur , Kaplan Bekir , Kaplan Tuğba
Published: October 2016

The aim of this study was to evaluate the relationship of the pre‐treatment blood neutrophil/lymphocyte count ratio (NLR) with the maximum standard uptake value (SUVmax) of primary masses on positron emission tomography/computed tomography (PET/CT) taken before treatment in patients diagnosed with malignant pleural mesothelioma (MPM) and to evaluate the contribution to prognosis. A retrospective evaluation was made of 73 patients diagnosed with MPM in our hospital between January 2006 and January 2014. The SUVmax value of the primary mass on pre‐treatment PET/CT, the haemogram parameters (Hb, Hct, NLR, MPV, PLT) at the time of diagnosis, the progression history, the date of the final visit, and the date of death of exitus patients was recorded from patient files PET/CT. The study group comprised 37 males (50.7%) with a mean age of 56.1 ± 11.4 years. The median survival time of these patients was 13 months. The survival time of the patient group aged <55 years was significantly longer (P = .006). Although the survival time of patients with NLR < 3 and SUVmax < 5 was longer, the difference was not statistically significant (P = .63, P = 0.08). A statistically significant difference was determined between the mean (or median) SUVmax values of the patient groups with NLR < 3 and NLR ≥3 (P = .019) with the SUVmax value of the NLR < 3 group found to be low. In conclusion, in patients with MPM, NLR ≥3 and high SUVmax values at the time of diagnosis can be considered an indicator of poor prognosis but are not a guide in the prediction of progression.
PTTG1 Levels Are Predictive of Saracatinib Sensitivity in Ovarian Cancer Cell Lines
Authors: Nakachi I , Helfrich BA , Spillman MA , Mickler EA , Olson CJ , Rice JL , Coldren CD , Heasley LE , Geraci MW , Stearman RS
Published: October 2016

Src kinase is recognized as a key target for molecular cancer therapy. However, methods to efficiently select patients responsive to Src inhibitors are lacking. We explored the sensitivity of ovarian cancer cell lines to the Src kinase inhibitor saracatinib to identify predictive markers of drug sensitivity using gene microarrays. Pituitary tumor transforming gene 1 (PTTG1) was selected as a potential biomarker as mRNA levels were correlated with saracatinib resistance, as well as higher PTTG1 protein expression. PTTG1 expression was correlated with proliferation, cell division, and mitosis in ovarian cancer tissues data sets. In sensitive cell lines, saracatinib treatment decreased PTTG1 and fibroblast growth factor 2 (FGF2) protein levels. Downregulating PTTG1 by siRNAs increased saracatinib sensitivity in two resistant cell lines. Our results indicate PTTG1 may be a valuable biomarker in ovarian cancer to predict sensitivity to saracatinib, and could form the basis of a targeted prospective saracatinib trial for ovarian cancer.
The histopathologic features of autoimmune progesterone dermatitis
Authors: James Travis , Ghaferi Jessica , LaFond Ann
Published: October 2016

Background

The histologic features of autoimmune progesterone dermatitis (APD) are generally non‐specific and have been described only in brief case reports. We present a case of APD and review the literature with a focus on the histologic findings described.

Methods

A review of the English literature on APD was performed using PubMed and MEDLINE.

Results

A total of 39 patients, including our patient are included in this review. The most consistent histologic finding reported was a perivascular inflammatory infiltrate, being seen in 72% of cases. A non‐specific or interstitial inflammatory infiltrate was described in 31% of the cases, with 41% having an eosinophilic component and 21% having a neutrophilic component mixed with the predominant lymphocytic infiltrate. Interface dermatitis was the second most common finding with 36% showing a mild to exaggerated interface dermatitis.

Conclusion

Although histopathologic changes are non‐specific, perivascular dermatitis with eosinophils and interface changes are common in APD.
Trizentrische Analyse von Kofaktoren und Komorbidität des Pyoderma gangraenosum
Authors: Jockenhöfer Finja , Herberger Katharina , Schaller Jörg , Hohaus Katja Christina , Stoffels‐Weindorf Maren , Al Ghazal Philipp , Augustin Matthias , Dissemond Joachim
Published: October 2016

Einleitung

Das Pyoderma gangraenosum (PG) ist eine seltene, inflammatorische destruktiv‐ulzerierende neutrophile Erkrankung mit weitgehend unklarer Pathophysiologie.

Material und Methodik

In dieser Studie wurden die potenziell relevanten Kofaktoren und Begleiterkrankungen von Patienten mit PG aus drei dermatologischen Wundzentren in Deutschland differenziert ausgewertet.

Ergebnisse

Von den insgesamt 121 analysierten Patienten waren Frauen (66,9 %) häufiger betroffen als Männer. Das Alter der Patienten war 18–96 Jahre (Mittelwert [MW]: 59,8); die Wunden hatten eine Größe von 1–600 cm² (MW: 65,6 cm²) und waren überwiegend sehr schmerzhaft (VAS 1–10, MW: 7). Die Unterschenkel waren am häufigsten (71,9 %) betroffen. Bei 12 (9,9 %) Patienten bestanden chronisch entzündliche Darmerkrankungen (5,8 % Colitis ulcerosa; 4,1 % Morbus Crohn), bei 14,1 % der Patienten wurde eine Begleiterkrankung aus dem rheumatischen Formenkreis beschrieben. Neoplasien bestanden bei 20,6 % der Patienten, von denen 6,6 % als hämatologische und 14,1 % als solide Neoplasien klassifiziert wurden. Aus dem Kreis des metabolischen Syndroms wurde bei 69,4 % Patienten eine Adipositas, bei 57,9 % eine arterielle Hypertonie und bei 33,9 % ein Diabetes mellitus diagnostiziert.

Schlussfolgerungen

Diese Datenanalyse bestätigt Assoziationen des PG mit dem metabolischen Syndrom und mit Neoplasien, die zukünftig frühzeitig bei einer zielgerichteten Diagnostik der Patienten beachtet und behandelt werden sollten.