bluuebunny/crossref_metadata_2025 huggingface dataset:
Procurement reform in the Philippines: the impact of elite capture and informal bureaucracy
Authors: Seth Jones David
Published: June 2013

Purpose

The purpose of the paper is to examine features and impact of recent reforms introduced by the Philippines government to deal with the longstanding shortcomings in its procurement system.

Design/methodology/approach

The research for the paper is based on reports by international organizations, official documents of the Philippines government, surveys by international and domestic organizations, interviews with relevant officials and media reports.

Findings

The findings show that the reforms have focused on fostering competition, increasing transparency, standardizing procedures, enhancing end‐product quality and contractor reliability, ensuring proper planning and budgeting, combatting corruption, and strengthening accountability. These reforms were intended to create a procurement system more in line with international best practices. However the paper shows that the impact has been less than promised. This is due to limitations of certain provisions of the reforms and weaknesses in both implementation and in the accountability of the procuring entities. A key factor in undermining the reforms is widespread corruption, which continues to affect many aspects of the procurement system. The article identifies two important and related reasons for such failings: elite capture of the government and bureaucracy by a powerful network of business leaders from well‐established landed families, who have close links with the political establishment; and second, a long‐established culture of informal influence in the Philippine state bureaucracy (what may be termed the informal bureaucracy), which has been used to maximum effect by the elite network of business leaders. As a result, this network has been able to influence the reforms to serve its own interests and ensure its continued dominance of the procurement market.

Originality/value

The value of the paper is to show how administrative reforms, no matter how well formulated they are, may be readily undermined in the process of implementation by elite groups able to influence government bureaucracy through an informal culture.
Industry strategic variety and performance
Authors: Qin Linghua , Jing Runtian , Long Cheryl
Published: June 2013

Purpose – Market‐based theories assume that firms’ different strategic commitments to businesses lead to different strategic positions within the industry. While the institutional perspective from organization theory emphasizes the institutional pressures which lead to legitimacy and firm isomorphism, it is not clear yet how intra‐industry organizations behave during institutional transitions. The purpose of this paper is to combine the insights of these theories by examining the role of market and institutional forces in affecting industry strategic variety and its impact on average industry performance in transitional China, based on the strategic view of neoinstitutional theory. Design/methodology/approach – Empirical tests are carried out using industrial enterprise data of China from 2000 to 2006. Findings – Empirical results using industrial enterprise data of China from 2000 to 2006 suggest that: industry competitiveness has a strong positive influence on strategic variety; the weakening relationship between government and market leads to increased strategic variety; and indicators of strategic variety have complicated effects on industry performance. Originality/value – The strategic view of neoinstitutional theory was used to gain a better understanding of intra‐industry strategic variety during the institutional transition of China. Thus this paper combines seemingly contradictory theories in our understanding of how intra‐industry organizations behave in response to institutional change.
Experiential learning for developing managers: a practical model
Authors: Frost Dean E. , Wallingford Valerie
Published: June 2013

Purpose

The purpose of this paper is to create a practical system for assessing the need for developmental opportunities for management development while functioning on the job and to assist managers in selecting from those opportunities. This includes assessment strategies, discussion of developmental patterns, and potential gains in organizational commitment and managerial performance.

Design/methodology/approach

A model is proposed for connecting previously established management competencies to developmental opportunities in the manager's current task and group environments.

Findings

Self‐assessment instruments are presented for general management competencies and for task structure with notes on how managers, their supervisors and/or mentors might complete those ratings, in order to then use the proposed action model for learning/development.

Practical limitations

The potential impact of managerial coaching processes or diversity in organizational cultural contexts on the use of this model are noted.

Social implications

Improved managerial competencies and organizational performance may be obtained from following this model along with increased organizational commitment by the managers.

Originality/value

This paper presents a new model for self‐assessment of managerial development needs, discusses how those can be linked with on‐the‐job tasks within an existing job placement and organization. While the literature documents the value of developmental opportunities, no system exists for the assessment or selection of a developmental plan within an existing job title or organization. The proposed model fills a large conceptual gap in mapping a manager's personal career goals onto the organization's career paths or management development system objectives.
Communication is the key: improving outcomes for people with learning disabilities
Authors: Lewer Alix , Harding Celia
Published: June 2013

Purpose

This paper aims to introduce the open communication tool (OCT) as described in “From ‘What do you do?’ to ‘a leap of faith’: developing more efficient indirect intervention for adults with learning disabilities”.

Design/methodology/approach

Qualitative data from a study identifying barriers to effective intervention was used to create a model of working practice.

Findings

This paper introduces a model of addressing intervention which could be used by the broader multidisciplinary team to increase successful intervention outcomes and pinpoint concerns about care providers who do not enhance communication effectively.

Originality/value

The authors suggest that a more consistent and robust approach to delivering indirect intervention could be used to bridge communication gaps between healthcare providers and commissioners/monitoring bodies of services for people with learning disabilities.
From physiology to space use: energy reserves and androgenization explain home‐range size variation in a woodland rodent
Authors: Godsall Ben , Coulson Tim , Malo Aurelio F.
Published: June 2013

This study tested the relationships between both individual‐level and predation‐risk factors and the size of two home‐range regions (HRR), defined as areas of different intensities of use.

We have expanded on previous home‐range studies by testing the effects of two previously ignored individual‐level factors: androgenization and energy reserves (body fat).

Location data were collected for wild individuals of Apodemus sylvaticus using the novel method of implanted PIT tags and mobile recording stations. A total of 68 home ranges were estimated using kernel density estimation. Home ranges were split into two regions (HRR): the ‘core’, representing the most intensively used areas, and ‘periphery’ regions. Body mass, body fat, sex, anogenital distance (AGD) (a proxy for androgenization) and the proportion of HRR, covered by antipredatory features (shrubs and fallen trees), were tested for their relationship with the size of core and periphery HRRs. Models were constructed for each HRR for three seasons: nonbreeding season (NBS), early and late breeding seasons (LBSs), to account for seasonal variation in behaviour associated with changes in food abundance and reproductive cycles.

Body fat had a negative relationship with periphery size and an interaction with sex on core size in the early breeding season (EBS). Body mass also had a significant interaction with sex on core size in the EBS. Androgenization has a strong effect on home range size in both sexes: AGD had a positive relationship with both HRRs for males in the LBS and females in the NBS. Males had larger peripheries than females in both early and LBSs. Habitat features that reduce predation risk explain HRR size throughout the breeding period.

This study emphasizes the importance of embracing natural complexity to gain insight into the drivers of space use behaviour; the consideration of individual and ecological factors, the recognition of the species‐specific selective pressures that seasonal change presents for each sex and the identification of biologically meaningful home range areas will help advance the field.
Barriers to dance training for young people with disabilities
Authors: Aujla Imogen J. , Redding Emma
Published: June 2013

Dance is a viable and enjoyable activity – and potential career – for young people with disabilities, yet they face several barriers to participation and training. The aim of this article, by Imogen J. Aujla of the University of Bedfordshire and Emma Redding of Trinity Laban Conservatoire of Music and Dance, is to review the literature on barriers to dance training for young disabled people and to put forward practical recommendations for overcoming these challenges. The main barriers identified were aesthetic, attitudinal, training‐related and logistical in nature, with further barriers related to physical access and a lack of knowledge or available information about opportunities. One of the key recommendations for overcoming these barriers is to build an effective network between special and mainstream schools, dance studios, youth dance groups and professional integrated dance companies in order to encourage dance participation at a range of levels and support young disabled people throughout their dance journeys.
Options for managing chrysomelid leaf beetles in Australian eucalypt plantations: reducing the chemical footprint
Authors: Elek Jane , Wardlaw Tim
Published: June 2013

In Australia, eucalypt plantations require management to prevent economic damage by native chrysomelid leaf beetles, generally by aerially spraying a broad‐spectrum insecticide. These beetles also pose a serious threat to plantations in other countries.

Various alternatives, both ‘landscape’ and ‘control’ options, for managing leaf beetles were reviewed and evaluated by a panel of experts. Options were scored on effectiveness, feasibility for use, impact on the environment, perceived social acceptability (including by certification bodies) and perceived cost.

None of the options were scored as well as broad‐spectrum insecticide for effectiveness, feasibility and perceived cost, although virtually all of the other options scored better for environmental and social outcomes.

The highest ranked options were the ‘landscape’ option of tree improvement to reduce susceptibility to insect attack, and the ‘control’ option of attract‐and‐kill traps. The next three ranks were two ‘landscape’ options aimed at enhancing the effectiveness of natural enemy populations by conserving their overwintering sites and their alternative food and hosts, and then silvicultural management.

The best strategy for an Integrated Pest Management programme would be a combination of ‘landscape’ options to reduce the frequency of pest outbreaks and, if outbreaks occur, spraying with biological insecticides until attract‐and‐kill traps become available, possibly in combination with repellent sprays in a push–pull strategy. If control measures fail to prevent damaging defoliation, plantations could be fertilized to encourage recovery.

Because most of the alternative options are not yet available, many research directions were identified, with the highest priorities being to develop plantation stock that is less susceptible to defoliation and to develop attractants for leaf beetles.
Genital psoriasis among Indians: A prospective cross‐sectional study
Authors: Mahajan Rahul , Kumaran Muthu Sendhil , Narang Tarun , Handa Sanjeev , Dogra Sunil
Published: June 2013

There are limited epidemiological data on genital involvement in psoriasis. In this prospective study, 852 psoriasis patients were screened of whom 100 had genital psoriasis lesions, with a prevalence rate of 11.7%. The mean duration of genital involvement was 19.3 ± 40.9 months. In 4% of the patients, genital psoriasis was the initial presentation of disease. The commonest site of genital involvement was the scrotum followed by glans and labia, corona and prepuce. There was no significant correlation between the severity of genital involvement and overall disease severity and body mass index. Morphologically, the commonest presentation was erythematous scaly plaques followed by thin non‐scaly plaques and certain rare patterns such as pseudo‐candidal balanitis, pseudo‐circinate balanitis, annular psoriasis and pustular psoriasis.
Human baroreflex rhythms persist during handgrip and muscle ischaemia
Authors: Eckberg D. L. , Cooke W. H. , Diedrich A. , Levine B. D. , Pawelczyk J. A. , Buckey J. C. , Ertl A. C. , Biaggioni I. , Cox J. F. , Robertson D. , Baisch F. J. , Blomqvist C. G. , Kuusela T. A. , Tahvanainen K. U. O.
Published: June 2013

Aim

To determine whether physiological, rhythmic fluctuations of vagal baroreflex gain persist during exercise, post‐exercise ischaemia and recovery.

Methods

We studied responses of six supine healthy men and one woman to a stereotyped protocol comprising rest, handgrip exercise at 40% maximum capacity to exhaustion, post‐exercise forearm ischaemia and recovery. We measured electrocardiographic R‐R intervals, photoplethysmographic finger arterial pressures and peroneal nerve muscle sympathetic activity. We derived vagal baroreflex gains from a sliding (25‐s window moved by 2‐s steps) systolic pressure–R‐R interval transfer function at 0.04–0.15 Hz.

Results

Vagal baroreflex gain oscillated at low, nearly constant frequencies throughout the protocol (at approx. 0.06 Hz – a period of about 18 s); however, during exercise, most oscillations were at low‐gain levels, and during ischaemia and recovery, most oscillations were at high‐gain levels.

Conclusions

Vagal baroreflex rhythms are not abolished by exercise, and they are not overwhelmed after exercise during ischaemia and recovery.
Chachawarmi: Rhetorics and Lived Realities
Authors: MACLEAN KATE
Published: June 2013

Latin America's turn away from neoliberalism and adoption of decolonising alternatives to development has been spearheaded—nowhere more so than Bolivia—by indigenous movements. The gender ideology of chachawarmi is part of this decolonisation programme, but has been criticised for disguising gendered exploitation. These tensions are explored by looking at, in Escobar's words, ‘the concrete struggles within particular communities’. Based on long‐term research in rural Bolivia, this article situates the chachawarmi ideal in the multiple influences on the recreation of gender identities, and considers the complex ways in which chachawarmi as mobilised politically may influence gendered power.
CA‐S27: A novel Lewis a associated carbohydrate epitope is diagnostic and prognostic for cholangiocarcinoma
Authors: Silsirivanit Atit , Araki Norie , Wongkham Chaisiri , Vaeteewoottacharn Kulthida , Pairojkul Chawalit , Kuwahara Kazuhiko , Narimatsu Yoshiki , Sawaki Hiromichi , Narimatsu Hisashi , Okada Seiji , Sakaguchi Nobuo , Wongkham Sopit
Published: June 2013

Early and specific diagnosis is critical for treatment of cholangiocarcinoma (CCA). In this study, a carbohydrate antigen‐S27 (CA‐S27) monoclonal antibody (mAb) was established using pooled CCA tissue‐extract as immunogen. The epitope recognized by CA‐S27‐mAb was a new Lewis‐a (Lea) associated modification of MUC5AC mucin. A Soybean agglutinin/CA‐S27‐mAb sandwich ELISA to determine CA‐S27 in serum was successfully developed. High level of CA‐S27 was detected in serum of CCA patients and could differentiate CCA patients from those of gastro‐intestinal cancers, hepatomas, benign hepatobiliary diseases and healthy subjects with high sensitivity (87.5%) and high negative predictive value (90.4%). The level of serum CA‐S27 was dramatically reduced after tumor removal, indicating tumor origin of CA‐S27. Patients with high serum CA‐S27 had significantly shorter survivals than those with low serum CA‐S27 regardless of serum MUC5AC levels. Fucosyltransferase‐III (FUT3) was shown to be a regulator of CA‐S27 expression. Suppression of CA‐S27 expression with siRNA‐FUT3 or neutralization with CA‐S27 mAb significantly reduced growth, adhesion, invasion and migration potentials of CCA cells in vitro. In summary, we demonstrate that serum CA‐S27, a novel carbohydrate antigen, has potential as diagnostic and prognostic markers for CCA patients. CA‐S27 involves in promoting cell growth, adhesion, migration and invasion of CCA cells.
Economic evaluation of an integrated care programme for patients with hand dermatitis
Authors: van Gils Robin F. , Bosmans Judith E. , Boot Cécile R. L. , Rustemeyer Thomas , van Mechelen Willem , van der Valk Pieter G. M. , Anema Johannes R.
Published: June 2013

Background

Hand dermatitis has a large impact on society as a whole.

Objectives

To evaluate the cost‐effectiveness of integrated, multidisciplinary care as compared with usual care (UC) for patients with moderate to severe chronic hand dermatitis after 52 weeks.

Methods

Patients (n = 196) visiting the dermatology department at one of the participating hospitals for hand dermatitis were randomized to integrated care (IC) or UC. IC was provided by a multidisciplinary team, and integrated clinical and occupational care to optimize treatment of hand dermatitis. Effect outcomes were clinical assessment of hand dermatitis with the Hand Eczema Severity Index (HECSI), and disease‐specific quality of life, work performance and quality‐adjusted life‐years with the EQ‐5D. Incremental cost‐effectiveness ratios (ICERs) were calculated. The ICER indicates the additional investment needed to gain one unit of effect.

Results

The HECSI difference between both groups after 52 weeks was 8.7 (standard error 5.3, 95% confidence interval −1.8–18.9). No differences were found on secondary outcome measures. Mean total costs with IC (€3613; SD 798) were significantly higher than with UC (€1576, SD 430). The ICER for improvement in HECSI score was − 247. IC was not considered to be cost‐effective as compared with UC. The probability that IC was cost‐effective was 90% at a ceiling ratio of €1500 per additional point improvement in HECSI score.

Conclusion

Integrated care was neither cost‐effective, nor effective after 12 months follow‐up, in contrast to our findings after 6 months. Decision makers should decide whether the clinical benefits of integrated care on the short term outweigh the higher costs compared to usual care.
Contact sensitization to calocephalin, a sesquiterpene lactone of the guaianolide type from cushion bush (Leucophyta brownii, Compositae)
Authors: Paulsen Evy , Christensen Lars P. , Hindsén Monica , Andersen Klaus E.
Published: June 2013

Background

Cushion bush [Leucophyta brownii Cass. = Calocephalus brownii (Cass.) F. Muell.] is an Australian Compositae shrub that has been introduced into Scandinavia as a pot plant. The first case of sensitization occurred in a gardener, and the main allergen was identified as the guaianolide calocephalin.

Objective

To present the identification of the main allergen, and to assess the prevalence of sensitization to calocephalin in Compositae‐allergic patients.

Materials and methods

Calocephalin was isolated from a dichloromethane extract of aerial parts of cushion bush. Calocephalin 0.1% ethanol was included in the plant series in Malmö, Sweden, and Odense, Denmark.

Results

Nuclear magnetic resonance (NMR) analysis of calocephalin resulted in a revision of its chemical structure to 4α‐acetoxy‐1α,2α‐epoxy‐5α,10αH‐guai‐11(13)‐en‐12,8β‐olide. The prevalence of patch test positivity was up to 28% in aimed patch testing. Despite strongly positive patch test reactions, the relevance was unknown in the majority of cases, and only 1 person was occupationally sensitized.

Conclusion

Calocephalin is a potent contact allergen, but, as cushion bush is a low‐maintenance pot plant, primary sensitization is most likely to occur through occupational exposure. Positive reactions in Compositae‐sensitive persons probably occur because of cross‐reactivity, and patients should be warned about contact with cushion bush plants.
Carriers of filaggrin gene (FLG) mutations avoid professional exposure to irritants in adulthood
Authors: Bandier Josefine , Ross‐Hansen Katrine , Carlsen Berit C. , Menné Torkil , Linneberg Allan , Stender Steen , Szecsi Pal B. , Meldgaard Michael , Thyssen Jacob P. , Johansen Jeanne D.
Published: June 2013

Background

Loss‐of‐function mutations in the filaggrin gene (FLG) are associated with xerosis, atopic dermatitis, and early onset of hand eczema. Irritant exposure is a risk factor for occupational hand eczema, and FLG mutations increase the risk of occupational irritant contact dermatitis on the hands in hospital cohorts. It is unknown whether FLG mutations affect the level of irritant exposure.

Objectives

To evaluate whether exposure to occupational irritants was dependent on FLG mutations, atopic dermatitis, and age at hand eczema onset.

Methods

Randomly chosen Danish adults completed a questionnaire on general health and occupational exposures. Genotyping for FLG mutations (R501X, 2282del4, and R2447X) and patch testing were performed.

Results

Overall, 38.7% of subjects reported present or previous occupational exposure to irritants. Among individuals who reported hand eczema onset before entering their work life, 50.6% (45/89) of FLG non‐mutation carriers became exposed to irritants, as compared with 28.6% (4/14) of heterozygous and 0% (0/6) of homozygous mutation carriers (p = 0.006). Avoidance was conspicuous among mutation carriers reporting childhood hand eczema and atopic dermatitis (odds ratio 0.08, 95% confidence interval 0.01–0.65).

Conclusions

Carriers of FLG mutations who have had hand eczema onset in childhood avoid occupational exposure to irritants; the association is most marked with homozygous mutation status combined with atopic dermatitis.
Suitability, success and sinks: how do predictions of nesting distributions relate to fitness parameters in high arctic waders?
Authors: Pellissier Loïc , Meltofte Hans , Hansen Jannik , Schmidt Niels M. , Tamstorf Mikkel P. , Maiorano Luigi , Aastrup Peter , Olsen Jeppe , Guisan Antoine , Wisz Mary S.
Published: June 2013

Aim

Although habitat suitability maps derived from species distribution models (SDMs) are often assumed to highlight locations that can sustain healthy populations over time, the relationship between suitability scores and fitness parameters has rarely been tested thoroughly.

Location

Zackenberg Valley, north‐east Greenland.

Methods

Using 14 years of data (1997–2010) representing three wader species (dunlin Calidris alpina, sanderling Calidris alba and ruddy turnstone Arenaria interpres), we tested the relationships between modelled suitability and fitness parameters at nesting locations.

Results

Among the three species examined, only the ruddy turnstone exhibited significant relationships between suitability and nest success, but over time rather than space. During years with extensive snow cover in the landscape, the nesting sites of ruddy turnstone occurred in different habitats than were typically used across years. Moreover, in years with extensive snow cover, the ruddy turnstone initiated nests later and suffered from higher egg predation rates.

Main conclusion

Our results suggest that SDMs derived from species occurrences that include years of low reproductive success may over‐estimate the potential suitable habitat in the landscape. Whenever possible, variation in reproductive success should be considered when building models to inform species' response to environmental change.
Theory of mind and epilepsy: What clinical implications?
Authors: Giovagnoli Anna Rita , Parente Annalisa , Villani Flavio , Franceschetti Silvana , Spreafico Roberto
Published: June 2013

Purpose

Epilepsy can impair theory of mind (ToM), but the clinical significance of such a deficit is unknown. This study evaluated the influence of selective ToM deficits on self‐appraisal, coping, and quality of life (QoL) in patients with focal epilepsy.

Methods

Data were collected from 66 patients with temporal or frontal lobe epilepsy, and from 42 healthy controls. The Faux Pas Task (FPT), Multiple Ability Self‐report Questionnaire (MASQ), Coping Responses Inventory‐Adult (CRI‐Adult), and World Health Organization QoL 100 (WHOQoL 100) evaluated ToM, self‐rated cognitive abilities, coping to stressful events, and QoL. Different tests and inventories assessed other cognitive functions, depression, and anxiety.

Key Findings

Patients were impaired in the recognition and comprehension of social faux pas. The FPT scores contributed to predict the MASQ, CRI‐Adult, and WHOQoL overall scores; the comprehension of others' mental states and interactions score exerted a prominent influence.

Significance

In patients with focal epilepsy, selective ToM deficits may have clinical implications, with specific influence on self‐appraisal, coping, and overall QoL. ToM evaluation may contribute in explaining some psychobehavioral difficulties and to plan nonpharmacological treatment.
Beyond Affective Valence: Untangling Valence and Activation Influences on Opportunity Identification
Authors: Foo Maw–Der , Uy Marilyn A. , Murnieks Charles
Published: June 2013

Research surrounding how entrepreneurs identify opportunities focuses on the impact of affective valence on entrepreneurs’ cognitive processes. Extending this body of research, we theorize how affective valence and affective activation work together to impact opportunity identification. We emphasize that to understand affective influences, both valence and activation should be included because they each influence active search effort and knowledge integration. We discuss the theoretical and practical implications of our study and suggest that future research should include more dynamic relationships among affect and entrepreneurial outcomes.
Different Strokes for Different Folks: Entrepreneurial Narratives of Emotion, Cognition, and Making Sense of Business Failure
Authors: Byrne Orla , Shepherd Dean A.
Published: June 2013

This multiple case study of eight entrepreneurial narratives of failed businesses examines how narratives that express different emotional states (folks) reflect different efforts to make sense of failure experiences (strokes). Our comparisons of the narratives’ emotional content (describing emotional states at the time of business failure and presently) revealed some new insights. First, high negative emotions motivate making sense of a loss, while high positive emotions provide cognitive resources to facilitate and motivate making sense of the failure event. Second, emotion–focused coping helped deal with negative emotions. Finally, sensemaking was also facilitated by cognitive strategies that focused attention on the failure event and promoted self–reflection.
Crop‐to‐wild gene flow and spatial genetic structure in the closest wild relatives of the cultivated apple
Authors: Cornille Amandine , Gladieux Pierre , Giraud Tatiana
Published: June 2013

Crop‐to‐wild gene flow have important evolutionary and ecological consequences and require careful consideration in conservation programs for wild genetic resources of potential use in breeding programs and in assessments of the risk of transgene escape into natural ecosystems. Using 26 microsatellites and a set of 1181 trees, we investigated the extent of introgression from the cultivated apple, Malus domestica, to its three closest wild relatives, M. sylvestris in Europe, M. orientalis in the Caucasus, and M. sieversii in Central Asia. We found footprints of introgression from M. domestica to M. orientalis (3.2% of hybrids), M. sieversii (14.8%), and M. sylvestris (36.7%). Malus sieversii and M. orientalis presented weak, but significant genetic structures across their geographic range. Malus orientalis displayed genetic differentiation with three differentiated populations in Turkey, Armenia, and Russia. Malus sieversii consisted of a main population spread over Central Asia and a smaller population in the Tian Shan Mountains. The low Sp values suggest high dispersal capacities for the wild apple relatives. High potential for crop‐to‐wild gene flow in apples needs to be considered in the implementation of in situ and ex situ actions for the conservation of wild apple genetic resources potentially useful to plant breeding.
Targeting iHSP 70 in vitiligo: a critical step for cure?
Authors: Taïeb Alain , Seneschal Julien
Published: June 2013

The group of Caroline Le Poole has produced a series of elegant papers suggesting an innovative rationale for the treatment of vitiligo by limiting native iHSP70 expression, with subsequent blockade of DC activation and melanocyte loss via T‐cell‐specific autoimmune responses. The proof of concept was made in a mouse model of the use of a mutant iHSP70 blunting this response. The comment emphasizes that in vitiligo, a skin and possibly epidermal defect underlies the initial steps leading to inflammation and subsequent melanocyte demise and discusses the relevance of targeting iHSP in this context.
Effects of hyperoxia on the permeability of 16HBE14o– cell monolayers – the protective role of antioxidant vitamins E and C
Authors: Al‐Shmgani Hanady S. , Moate Roy M. , Macnaughton Peter D. , Sneyd J. Robert , Moody A. John
Published: June 2013

The use of hyperoxia for critically ill patients is associated with adverse impacts resulting in lung injury accompanied by inflammation. The aim of this study was to evaluate aspects of mechanisms that contribute to hyperoxia‐induced disruption of the epithelial permeability barrier, and also the protective effects of the antioxidants α‐tocopherol and ascorbate. 16HBE14o– cells were cultured as monolayers at an air–liquid interface for 6 days, after which transepithelial electrical resistance reached 251.2 ± 4.1 Ω.cm2 (mean ± standard error of the mean). They were then exposed for 24 h to normoxia (21% O2, 5% CO2), hyperoxia (95% O2, 5% CO2), hyperoxia with 10−7 m α‐tocopherol, hyperoxia with 10−7 m ascorbate, hyperoxia with 10−6 m ascorbate, and hyperoxia with a combination of α‐tocopherol and ascorbate (10−7 m and 10−6 m, respectively). Significant reductions (P < 0.05) in transepithelial electrical resistance seen after hyperoxia (with or without antioxidants) were associated with reductions in the levels of zona occludens‐1 (ZO‐1) observed by immunohistochemistry, and downregulation of ZO‐1 expression (P < 0.01) as compared with normoxia. In contrast, the expression levels of interleukin (IL)‐8, IL‐6 and tumour necrosis factor‐α (TNF‐α) were increased after hyperoxia (P < 0.01), and marked increases in the levels of these cytokines (ELISA) were seen in the medium (P < 0.001) as compared with normoxia. The antioxidant vitamins E and C had a partial protective effect against the hyperoxia‐induced reduction in ZO‐1 levels and the increase in levels of the proinflammatory cytokines IL‐8, IL‐6, and TNF‐α. In conclusion, hyperoxia‐induced epithelial disruption is associated with tight junction weakening, and induction of a proinflammatory environment.
Cystic fibrosis transmembrane conductance regulator degradation: cross‐talk between the ubiquitylation and SUMOylation pathways
Authors: Ahner Annette , Gong Xiaoyan , Frizzell Raymond A.
Published: June 2013

Defining the significant checkpoints in cystic fibrosis transmembrane conductance regulator (CFTR) biogenesis should identify targets for therapeutic intervention with CFTR folding mutants such as F508del. Although the role of ubiquitylation and the ubiquitin proteasome system is well established in the degradation of this common CFTR mutant, the part played by SUMOylation is a novel aspect of CFTR biogenesis/quality control. We identified this post‐translational modification of CFTR as resulting from its interaction with small heat shock proteins (Hsps), which were found to selectively facilitate the degradation of F508del through a physical interaction with the SUMO (small ubiquitin‐like modifier) E2 enzyme, Ubc9. Hsp27 promoted the SUMOylation of mutant CFTR by the SUMO‐2 paralogue, which can form poly‐chains. Poly‐SUMO chains are then recognized by the SUMO‐targeted ubiquitin ligase, RNF4, which elicited F508del degradation in a Hsp27‐dependent manner. This work identifies a sequential connection between the SUMO and ubiquitin modifications of the CFTR mutant: Hsp27‐mediated SUMO‐2 modification, followed by ubiquitylation via RNF4 and degradation of the mutant via the proteasome. Other examples of the intricate cross‐talk between the SUMO and ubiquitin pathways are discussed with reference to other substrates; many of these are competitive and lead to different outcomes. It is reasonable to anticipate that further research on SUMO–ubiquitin pathway interactions will identify additional layers of complexity in the process of CFTR biogenesis and quality control.
Impact of personality and depression on quality of life in patients with severe haemophilia in Korea
Authors: Kim S.‐Y. , Kim S.‐W. , Kim J.‐M. , Shin I.‐S. , Baek H.‐J. , Lee H.‐S. , Hwang T.‐J. , Yoon J.‐S.
Published: June 2013

Among reports on the psychological variables that influence quality of life (QoL), none has addressed the impact of personality on QoL in patients with haemophilia. We investigated the impact of psychosocial variables including depression and personality on QoL in patients with severe haemophilia. A cross‐sectional survey examining psychosocial and clinical characteristics was administered to Korean patients with severe haemophilia. Personality traits were ascertained using the 10‐item short version of the Big Five Inventory, which quantifies five personality dimensions including extraversion, agreeableness, conscientiousness, neuroticism and openness. Patient QoL and depression were measured by the World Health Organization Quality of Life‐abbreviated version and the Beck Depression Inventory (BDI) respectively. Multivariate linear regression analyses were used for each domain to determine the impact of psychological variables on QoL. Of the 53 subjects who consented to participate, 46 cases were finally analysed. Multivariate linear regression analyses demonstrated that agreeableness was significantly and positively associated with the physical health domain of QoL. Openness was independently and positively associated with the psychological and social relationship domains of QoL. BDI scores were significantly and negatively associated with all four domains of the QoL. Persistent pain and joint impairment showed strong associations with all domains in a univariate analysis, but the impact was attenuated after adjusting for psychosocial variables. Personality and depression had strong impacts on QoL independent of physical status in patients with severe haemophilia. Providing psychological screening and intervention are recommended for enhancing QoL in patients with severe haemophilia.
Identifying information needs among children and teens living with haemophilia
Authors: Simmons G. M. , Frick N. , Wang A. , Miller M. E. , Fragueiro D.
Published: June 2013

Transitioning from one life stage to the next can be difficult, but for those living with a chronic condition, it can be even more challenging. Children and adolescents with haemophilia need help to manage transitions while dealing with the complications of their disorder. The National Haemophilia Foundation (NHF), headquartered in New York City, has an extensive information centre on bleeding disorders, but it was not clear how much material existed on the topic of transition. The objectives of this project were to (i) assess the availability of literature about transition for children and adolescents living with haemophilia, (ii) determine which transition issues were the most relevant and (iii) develop and test information products that would address those transition issues. An inventory of NHF's resources and an environmental scan over the Internet was performed. Focus groups were conducted to determine messaging. Video prototypes containing messages were created, tested by focus groups and revised. The literature search yielded limited information available on transition for children and adolescents with haemophilia. Results of the formative research indicated that adolescents wanted more information on sports participation and disclosure of their condition (e.g. to peers, teachers, coaches, health care providers). Video was found to be the preferred delivery format. Children and adolescents living with haemophilia need information to help them transition through life. As a result of this study, two educational products were produced, but several more are recommended to guide these individuals in making healthy transitions into adulthood.
Autonomic Function in Migraine Patients: Ictal and Interictal Pupillometry
Authors: Cambron Melissa , Maertens Heidi , Paemeleire Koen , Crevits Luc
Published: June 2013

Objective and Background

Pupillometric investigations into migraine have suggested that an autonomic disturbance is part of the pathogenesis of that condition. This observation is controversial, however, which may reflect that the putative sympathetic hypofunction is either subtle or transient. In this study, we assessed the sympathetic function of migraine patients and controls during both a symptom‐free phase and a migraine attack, and challenged patients with apraclonidine to reveal small changes in autonomic function.

Methods

Infrared pupillometry was used to measure pupillometric parameters in 37 controls and 46 migraine patients in the interictal phase of disease. Fifteen migraine patients were also studied during a migraine attack. In addition, 26 controls and 18 migraine patients were tested interictally both with and without apraclonidine. Of these 18 migraine patients, seven were also tested with and without apraclonidine during a migraine attack.

Results

We found no significant differences between migraine patients and controls in the interictal phase. Additionally, no differences in pupil parameters were detected during the migraine attack. However, after administration of apraclonidine, migraine patients had a longer latency of the light reflex compared with controls. This increase in latency was more pronounced ictally (oculus dexter: P = .046, oculus sinister: P = .023) than interictally (oculus dexter: P = .075, oculus sinister: P = .021).

Conclusions

We conclude that there is evidence for a subtle pupillary sympathetic hypofunction in migraine patients, observed as a prolonged latency to light reflex, which is revealed after the administration of apraclonidine.
Evaluating Migraineurs' Preferences for Migraine Treatment Outcomes Using a Choice Experiment
Authors: Gonzalez Juan M. , Johnson F. Reed , Runken Michael C. , Poulos Christine M.
Published: June 2013

Objective

The impact of migraines on patients is commonly divided between the level of impairment associated with headache symptoms (headache phase) and the quality‐of‐life effects immediately following the headache (post‐headache phase). Evaluations of migraineurs' productivity losses and health‐related quality of life have provided an understanding of the burden associated with the headache and post‐headache symptoms, but do not quantify the relative importance of each phase from a patient perspective. In this study, we evaluated migraineurs' willingness to accept trade‐offs among symptom severity in the headache and post‐headache phases, symptom duration in the headache and post‐headache phases, and symptom‐free time within a general‐preference theoretic framework.

Methods

We administered a choice‐format, conjoint‐analysis survey, also called a discrete‐choice experiment, to a sample of migraineurs from a nationally representative online consumer panel. After inclusion and exclusion criteria were applied, 510 eligible subjects completed the survey. The survey elicited choices between pairs of migraine profiles describing symptom durations and symptom‐free time for the headache and post‐headache phase.

Results

Migraineurs in our study were strongly affected by the pain associated with the headache phase. However, experiencing difficulty with daily social and family activities in the post‐headache phase also had a statistically significant impact on migraineurs' perceived level of well‐being. Migraineurs reported that hypothetical treatments that limited the duration of headache symptoms without allowing them to resume their daily activities for 16 hours after a headache, on average, were less than half as good as treatments that limited both headache and post‐headache symptoms.

Conclusion

Our results suggest that treatments that relieve and shorten symptoms during the post‐headache phase can offer significant benefits to migraineurs.
Cluster Headache: Potential Options for Medically Refractory Patients (When All Else Fails)
Authors: Tepper Stewart J. , Stillman Mark J.
Published: June 2013

The most evidence exists for mixed anesthetic/steroid occipital nerve blocks (which are also useful in non‐refractory patients), deep brain stimulation, sphenopalatine ganglion (SPG) blocks, SPG radiofrequency ablation, and SPG stimulation with the Autonomic Technologies, Inc (ATI) SPG Neurostimulator, the latter approved in the European Union and reimbursed in several countries.
Spontaneous Low Pressure, LowCSFVolume Headaches: SpontaneousCSFLeaks
Authors: Mokri Bahram
Published: June 2013

Spontaneous intracranial hypotension typically results from spontaneous cerebrospinal fluid (CSF) leak, often at spine level and only rarely from skull base. Once considered rare, it is now diagnosed far more commonly than before and is recognized as an important cause of headaches.CSFleak leads to loss ofCSFvolume. Considering that the skull is a rigid noncollapsible container, loss ofCSFvolume is typically compensated by subdural fluid collections and by increase in intracranial venous blood which, in turn, causes pachymeningeal thickening, enlarged pituitary, and engorgement of cerebral venous sinuses on magnetic resonance imaging (MRI). Another consequence ofCSFhypovolemia is sinking of the brain, with descent of the cerebellar tonsils and brainstem as well as crowding of the posterior fossa noted on headMRI. The clinical consequences of these changes include headaches that are often but not always orthostatic, nausea, occasional emesis, neck and interscapular pain, cochleovestibular manifestations, cranial nerve palsies, and several other manifestations attributed to pressure upon or stretching of the cranial nerves or brain or brainstem structures.CSFlymphocytic pleocytosis or increase inCSFprotein concentration is not uncommon.CSFopening pressure is often low but can be within normal limits. Stigmata of disorders of connective tissue matrix are seen in some of the patients. An epidural blood patch, once or more, targeted or distant, at one site or bilevel, has emerged as the treatment of choice for those who have failed the conservative measures. Epidural injection of fibrin glue of both blood and fibrin glue can be considered in selected cases. Surgery to stop the leak is considered when the exact site of the leak has been determined by neurodiagnostic studies and when less invasive measures have failed. Subdural hematomas sometimes complicate theCSFleaks; a rebound intracranial hypertension after successful treatment of a leak is not rare. Cerebral venous sinus thrombosis as a complication is fortunately less common, and superficial siderosis and bibrachial amyotrophy are rare. Short‐term recurrences are not uncommon, and long‐term recurrences are not rare.
Executive Dysfunctions in Migraine With and Without Aura: What Is the Role of White Matter Lesions?
Authors: Le Pira Francesco , Reggio Ester , Quattrocchi Graziella , Sanfilippo Cristina , Maci Tiziana , Cavallaro Tiziana , Zappia Mario
Published: June 2013

Objective/Background

Executive dysfunctions and white matter lesions on magnetic resonance imaging have been reported in migraine. The aim of this study was to determine whether any correlation between these 2 variables exists.

Materials and Methods

Forty‐four subjects affected by migraine with or without aura were compared with 16 healthy subjects. A battery of neuropsychological tests assessing executive functions was administered to all subjects. Number and total volume of white matter lesions were assessed in the whole brain and in the frontal lobe.

Results

The performances of both groups of migraineurs, with and without aura, were significantly worse when compared with controls on Boston Scanning Test. Moreover, we found lower performances compared with controls respectively on Frontal Assessment Battery in patients with migraine with aura and on Controlled Oral Word Association Test in patients with migraine without aura. Nineteen patients (43.2%) and one control subject (6.2%) had white matter lesions. We did not find any significant correlation between white matter lesions load and neuropsychological performances.

Conclusions

On the basis of our results, white matter lesions load on magnetic resonance imaging do not seem to contribute to neuropsychological performances deficit in migraineurs.
Impact of renal dysfunction in cirrhotic patients with bacterial infections other than spontaneous bacterial peritonitis
Authors: Hung Tsung‐Hsing , Chou Chu‐Lin , Fang Te‐Chao
Published: June 2013

Aim

The impact of renal dysfunction has not been well evaluated among cirrhotic patients having bacterial infections other than spontaneous bacterial peritonitis (SBP). We aimed to examine the impact of renal function impairment (RFI) among cirrhotic patients with non‐SBP bacterial infections.

Methods

Data of 7134 cirrhotic patients with non‐SBP bacterial infections extracted from the Taiwan National Health Insurance Database, derived from the Taiwan National Health Insurance Program, in 2004 were analyzed.

Results

A total of 579 (8.1%) patients had renal dysfunction. Of these, 223 patients had acute renal failure (ARF), and 141 had end‐stage renal disease (ESRD) requiring hemodialysis before admission. The overall 30‐day, 1‐year and 3‐year mortalities were 15.8%, 39.3% and 54.5%, respectively. Compared with the non‐RFI group, the adjusted hazard ratios (HR) of 30‐day mortality for RFI, ARF and ESRD were 3.20 (P < 0.001), 4.81 (P < 0.001) and 1.59 (P = 0.015); the adjusted HR of 1‐year mortality for RFI, ARF and ESRD were 2.68 (P < 0.001), 3.50 (P < 0.001) and 1.84 (P < 0.001), and adjusted HR of 3‐year mortality for RFI, ARF and ESRD were 2.34 (P < 0.001), 2.97 (P < 0.001) and 1.76 (P < 0.001). The adjusted HR of 30‐day, 1‐year and 3‐year mortalities for the ARF group were 2.98 (P < 0.001), 1.74 (P < 0.001) and 1.58 (P = 0.001) compared with the ESRD group, respectively.

Conclusion

This population‐based cohort study shows that RFI, especially ARF, is an independent poor prognostic factor in cirrhotic patients with non‐SBP bacterial infections.