bluuebunny/crossref_metadata_2025 huggingface dataset:
Talent management collides with corporate social responsibility: creation of inadvertent hypocrisy
Authors: Y. Lacey Miriam , Groves Kevin
Published: April 2014

Purpose

– The purpose of this paper is to reveal the unintended effects of talent management (TM) practices on employees excluded from high potential (HiPo) programs. Excluding the majority of employees from the numerous developmental benefits and privileges of HiPo programs runs contrary to the ideals of corporate social responsibility (CSR), an increasingly common espoused value of organizations. This paper discusses the inadvertent hypocrisy of organizations seeking to demonstrate CSR actions for their employees while simultaneously barring the vast majority of employees access to targeted development opportunities. While many organizations are proud of developing exemplary TM systems and executing effective CSR initiatives, further analysis suggests an inherent incompatibility between these approaches as commonly practiced. This paper concludes with a discussion of possible solutions to ameliorate the disconnect between exclusionary TM practices and CSR outcomes.

Design/methodology/approach

– Through the theoretical lens of organizational justice, the paper critically reviews relevant research on the impact of TM policies and practices on CSR initiatives. To spur further interest from scholars and practitioners, the paper offers responses to the following questions: What is the usual array of TM practices? What is the organization's social responsibility to its workforce at large and to individual employees? With resources devoted to developing HiPo talent, what is the organization's social responsibility to those in the ranks who have not been identified as HiPo?

Findings

– The critical review revealed that organizations seeking to simultaneously pursue TM best practices and CSR initiatives must tackle several fundamental issues, including expanding employee access to HiPo programs, enhancing the HiPo selection processes via greater emphasis on lead indicators of HiPo, and improving rater reliability across assessment tools. The paper concludes with practical suggestions to ameliorate the unintended consequences of disparate treatment of employees by creating a permeable boundary for broader employee inclusion in HiPo programs.

Originality/value

– The literature is remarkably deficient in research addressing the effects of TM practices on employees who are excluded from leadership development opportunities, and the resulting implications for CSR outcomes. Given the rapidly growing importance of CSR initiatives for many organizations, research on the impact of TM policies and practices is sorely needed. This paper addresses an important gap in the research literature on the unintended consequences of disparate treatment of employees and offers practical suggestions for more inclusive leadership development systems.
(Re)Locating boundaries: a systematic review of online ethnography
Authors: Tunçalp Deniz , L. Lê Patrick
Published: April 2014

Purpose

– The purpose of this paper is to systematically review online ethnography and its boundary challenges. The paper especially focusses on how researchers draw space boundaries, set time boundaries and engage their online field.

Design/methodology/approach

– The authors perform a systematic review of extant literature and identify 59 papers in 40 different journals as online ethnographies from various management disciplines. The authors perform both qualitative and quantitative analyses on papers in the sample.

Findings

– The paper identifies how online ethnographers both define boundaries and engage their online field. The paper shows that some of the advantages of online ethnography actually prompt researchers to favor-specific research designs over others.

Research limitations/implications

– The authors only focussed on articles adopting online ethnography in organization and management studies that are listed in Social Sciences Citation Index database. Online ethnographies in other research fields and indexes are not studied in this paper.

Practical implications

– The paper makes suggestions on how to complement existing online ethnographies to reach a more comprehensive practice of online ethnography.

Social implications

– The systematic review may help researchers to locate useful online ethnography examples across various management disciplines and may contribute to the maturation of online ethnography.

Originality/value

– The paper synthesizes emerging trends in online ethnography and identifies how specific advantages actually prompt online ethnographers to limit themselves in their research designs.
Study on manufacture method of poplar laminated composite floor by compression densification and gluing technology
Authors: Cheng R.X.
Published: April 2014

Purpose

– This paper developed a new method of making floor from poplar using glued technology and densification technology. This paper aimed to use fast-grown poplar wood to produce floor to expand material supply range of floor in order to solve problem of material supply shortage for floor industry.

Design/methodology/approach

– Densification technology and gluing technology were used to obtain high-density surface materials of floor under high pressure, meanwhile in order to reduce loss of poplar wood caused by compressing, high-density surface materials floor and substrate are glued and pressed under low pressure.

Findings

– The method of compressing poplar wood under high pressure can improve poplar's physical and mechanical properties. Adopting densification technology and gluing technology can produce the poplar laminated composite floor which meets the requirements of Chinese standard GB/T 18103.

Research limitations/implications

– This method of producing floor by compression densification technology would cause wood loss from reduction in thickness because poplar was pressed under high pressure.

Practical implications

– This method of making floor from poplar wood concerned in this study allows the floor making industry to eliminate its dependence on precious wood resource, expand supply range of floor material, and then solve problem of wood supply shortage of floor industry.

Originality/value

– This study may help solve the difficult problem that poplar cannot directly be used to produce floor because of its softness, low density and low strength. Through densification technology, great improvement in strength and hardness of poplar had been made.
Exploring the personality of sportswear brands
Authors: Tong Xiao , Su Jin
Published: April 2014

Purpose

– The purpose of this paper is to identify the personalities that are associated with sportswear brands and tests the applicability of Aaker's brand personality framework in the context of sportswear brands.

Design/methodology/approach

– This study employed Aaker's brand personality framework to empirically investigate the personality of sportswear brands based on data collected from 420 college students.

Findings

– Results revealed that consumers perceive seven distinct personality dimensions and 53 personality traits in sportswear brands: Competence, Attractiveness, Sincerity, Innovation, Activity, Excitement, and Ruggedness.

Originality/value

– This research developed a valid and reliable scale that measures personality for sportswear products and confirms that consumers do associate particular brand personality dimensions with sportswear brands. The findings would help managers in the sportswear market better understand the image of their brand in the minds of consumers and better distinguish their brand from competing brands.
Managing interactions in the tourism industry – a strategic tool for success
Authors: Ajagunna Ibrahim , Crick Ann P.
Published: April 2014

Purpose

– This conceptual paper aims to examine how the concept of host and guest interaction could help remedy the socio-economic impacts as created by tourism in Jamaica. The paper identifies that tourism development in Jamaica has created a range of negative social impacts, which include changes in attitude, aspirations and lifestyles of young people, who may come from poor backgrounds but are increasingly exposed to the consumerist lifestyles of wealthy visitors and the so-called role models in the society, “the Dons”.

Design/methodology/approach

– A qualitative approach was employed as the focus for this study. The survey of residents, and tourists in Ocho Rios and Negril in Jamaica were primary sources of data for this paper.

Findings

– The tourism industry in Jamaica has seen a great diversification in recent years. The industry now ranges from conventional tourism (sun, sand, sea and sex) to cruise tourism, moderate community based tourism, heritage and cultural tourism, and more recently nature-tourism. However, social factors remain a deterrent. It is apparent that relying on the concept and principles of host and guest interaction presents a strategic option for success and if one is to understand the impact of tourism on the residents, the inter-action between the various elements in the system must be understood.

Originality/value

– The attitudes of Jamaicans are important in determining the level of host and guest interaction and the level of success in the industry. Attitude is the fulcrum from which quality service is delivered; as such, the people must be in tune with the industry at all levels in order to achieve a sustainable tourism industry.
The future of tourism in an emerging economy: the reality of the cruise industry in Caribbean
Authors: Pinnock Fritz
Published: April 2014

Purpose

– In the face of newly industrialised nations, there is the tendency that there will be a shift or redirect of tourists from old tourism destinations to the newly industrialised ones. While there has been a consistent growth in cruising to the Caribbean, the question is whether the growth in cruise ship calls and increase in cruise passenger arrivals to the Caribbean translate into greater development for the region ' s stakeholders or whether this just creates increased profits for the cruise lines, and whether there will be a shift from the Caribbean to the newly industrialised nation in years to come. This paper seeks to address these issues.

Design/methodology/approach

– This research employed mixed methods approach to answer the research question. The nature of the question and data necessary to answer the question led to the choice of qualitative and quantitative techniques.

Findings

– The findings from this research will, hopefully, serve as a guide for Caribbean nations to develop a better strategy to cope with the cruise tourism industry; an approach based more along the lines of inter-island collaboration as opposed to competition.

Research limitations/implications

– Lack of ample data on cruise tourism in the Caribbean was one of the limitations of the study. Another drawback involved the high level of secrecy which surrounds the industry and the unwillingness of cruise lines and their associates to provide access to operational data, which they regard as confidential.

Originality/value

– The Caribbean, particularly Caribbean governments, will benefit from a greater understanding of the power relations among the cruise tourism stakeholder chain and the profile of costs and benefits associated with the industry. Over the years, the Caribbean has relied solely on the economic impact surveys produced by Florida Caribbean Cruise Association (FCCA) and Cruise Lines International Association (CLIA), both of whom represent the cruise lines, in order to make projections and development plans for the industry.
Unveiling Urban Sprawl in the Mediterranean Region: Towards a Latent Urban Transformation?
Authors: Salvati Luca , Gargiulo Morelli Vittorio
Published: April 2014

The relationship between form and function in European Mediterranean cities has been widely addressed from various perspectives. A number of studies indicate that, until the 1980s, compactness was a key trait of several cities of the Northern Mediterranean. However, after the ‘compact growth’ period, these cities experienced patterns of urbanization that differed from their traditional trends. Since the 1990s, sprawl, coupled with population decline in the inner cities, has become the main pattern of urban development. This article explores the key features of exurban development in the Mediterranean region in order to provide material for a discussion based on the differences and similarities in the characteristics of sprawl processes originating in the US and Northern Europe. It concludes that any debate on policy responses to sprawl must be specifically formulated according to the scope, administrative level, housing and planning system, territorial and socioeconomic characteristics of the urban system under examination. It is our belief that sprawl requires site‐specific analyses and policy strategies for the region being studied if the process is to be effectively controlled.
Defining and classifying technocrat‐led and technocratic governments
Authors: McDonnell Duncan , Valbruzzi Marco
Published: April 2014

Governments led by technocrats remain a nebulous category in political science literature, with little clarity about how they differ from party governments, how many have existed and how we can differentiate between them. This article aims to provide that conceptual and empirical clarity. Having proposed an ideal type definition of ‘technocratic government’, it sets out three conditions for an operational definition of a ‘technocrat’ and, on that basis, lists the 24 technocrat‐led governments that have existed in 27 European Union (EU) democracies from the end of the Second World War until June 2013. It then classifies these according to their partisan/technocrat composition and remit. This allows for the presentation of a typology of four different types of technocrat‐led governments and the definition of ‘full technocratic governments’ as those which contain a majority of technocrats and – unlike caretaker governments – have the capacity to change the status quo. The article concludes that full technocratic governments remain extremely rare in EU democracies since there have been only six cases – of which three have occurred in the last decade.
Practical Approach to Evaluate Asymptomatic Coronary Artery Disease in End‐Stage Renal Disease Patients at the Initiation of Dialysis
Authors: Tanaka Akihito , Sakakibara Masaki , Asada Hiroaki , Tanaka Toshikazu , Ishii Hideki , Murohara Toyoaki
Published: April 2014

The high prevalence of significant asymptomatic coronary artery disease (CAD) has been reported in patients with end‐stage renal disease (ESRD) at the initiation of dialysis. However, the approach to evaluate asymptomatic CAD for these patients has not been established. The aim of this study is to assess the applicability of our practical approach at the initiation of dialysis. We prospectively enrolled 182 consecutive ESRD patients who initiated dialysis. After echocardiography as primary screening, pharmacologic stress thallium‐201 scintigraphy and/or coronary angiography (CAG) were performed to diagnose CAD. The patients were classified into two groups: those with coronary artery stenosis by CAG (CAD+ group), those without coronary artery stenosis by CAG or with negative scintigraphy examination (CAD− group). Of the eligible 93 patients without the history of CAD, 22 patients were allocated to the CAD+ group (18 of 26 patients with abnormal echocardiography and 4 of 13 patients with positive scintigraphy examination) and 71 patients to the CAD− group. Patients were followed up for an average of 520 ± 304 days. The event‐free survival rate of major adverse cardiac events was significantly lower in the CAD+ group than in the CAD− group (P < 0.001). There was no cardiovascular event including major adverse cardiac events, unstable angina, coronary revascularization or stroke in the CAD− group during the first year of dialysis. Patients without CAD diagnosed by our approach had favorable clinical outcomes. Our approach may be useful for screening of occult CAD in ESRD patients at the initiation of dialysis.
Relationship of serum bisphenol A with diabetes in the Thai population, National Health Examination Survey IV, 2009 在泰国人群中血清双酚丙烷与糖尿病的关系，2009年第4次全国健康调查研究
Authors: Aekplakorn Wichai , Chailurkit La‐or , Ongphiphadhanakul Boonsong
Published: April 2014

Background

Epidemiological studies of the association between bisphenol A (BPA) exposure and diabetes have been inconsistent. The present study determined serum BPA concentrations in the Thai population and their association with hyperglycemia and diabetes.

Methods

In all, 2581 serum samples from the Thai National Health Examination Survey (2009) were used to determine BPA levels. Impaired fasting glucose (IFG) was defined as fasting plasma glucose ≥100 and <126 mg/dL. Diabetes was defined as a history of a physician's diagnosis or fasting plasma glucose ≥126 mg/dL. Multinomial logistic regression was used to examine the association of serum BPA with IFG and diabetes.

Results

Of 2581 samples tested, BPA was detected in 2135 samples (weighted percentage 78.1%), with a geometric mean concentration of 0.34 ng/mL BPA. Serum BPA levels were significantly higher among those with diabetes or IFG compared with normoglycemic individuals (0.52 and 0.38 vs 0.33 ng/mL, respectively; P < 0.001). After adjusting for potential confounders, compared with the first quartile (≤0.071 ng/mL), the overall adjusted odds ratios (OR) of serum BPA concentration in the third and fourth quartiles (0.319–0.745 and ≥0.746 ng/mL, respectively) for IFG were 1.72 (95% confidence interval [CI] 1.19, 2.49) and 1.23 (95% CI 0.80, 1.89), respectively; for diabetes, the adjusted OR were 1.88 (95% CI 1.18, 2.99) and 1.83 (95% CI 1.12, 2.95), respectively, with a slightly stronger association among men than in women.

Conclusions

Serum BPA concentrations were not associated with IFG, but were positively associated with diabetes in the Thai population. Further prospective studies are needed to confirm the relationship.
Osteoblastic potential of infrapatellar fat pad‐derived mesenchymal stem cells from rheumatoid arthritis and osteoarthritis patients
Authors: Skalska Urszula , Prochorec‐Sobieszek Monika , Kontny Ewa
Published: April 2014

Aim

To evaluate the osteoblastic potential of adipose‐derived mesenchymal stem cells (ASCs) from infrapatellar fat pad (IPFP) of rheumatoid arthritis (RA) patients in comparison to osteoarthritis (OA) patients, as well as the influence of tumor necrosis factor alpha (TNFα) on osteoblastic ASC differentiation in vitro.

Methods

ASCs were isolated from IPFP of RA and OA patients. After expansion, cells were cultured in osteogenic medium with or without TNFα. After 2 weeks, expression of BMP‐2, Runx‐2, osterix (Osx), collagen 1a1 (Col1a1) and osteopontin (OPN) messenger RNA (mRNA) was assessed by reverse transcription polymerase chain reaction and calcium deposition by alizarin red staining. Dickkopf‐1 (DKK‐1) and osteoprotegerin (OPG) protein concentrations were measured in culture supernatants using enzyme‐linked immunosorbent assay.

Results

Both RA‐ and OA‐ASCs cultured in osteogenic medium showed calcium deposition. The expression of Runx2 and OPN mRNA was increased in RA‐ASCs. These cells expressed significantly more Osx and OPN than OA‐ASCs. TNFα potentiated calcium deposition, up‐regulated Runx2 and BMP‐2 but down‐regulated Col1a1 and OPN expression. In osteogenic cultures DKK‐1 concentration was increased but that of OPG decreased, whereas TNFα elevated secretion of both cytokines.

Conclusion

RA‐ASCs have comparable or slightly stronger osteogenic potential than OA‐ASCs. RA‐ASCs seem to be more sensitive to TNFα treatment. TNFα exerts complex effects on ASC osteoblastogenesis, enhances expression of early osteogenic markers and calcium deposition, inhibits expression of mRNA coding for non‐mineral bone components and alters ASC secretory activity.
Efficacy and safety of docetaxel plus oxaliplatin as a first‐line chemotherapy in patients with advanced or metastatic non‐small cell lung cancer
Authors: Ban Heejung , Kim Kyu‐Sik , Oh In‐Jae , Yoon Seong‐Hoon , Lee Boram , Yu Jinyeong , Kim Sunmin , Lee Ho‐Sung , Shin Hong‐Joon , Park Cheol‐Kyu , Kwon Yong‐Soo , Kim Yu‐Il , Lim Sung‐Chul , Kim Young‐Chul
Published: April 2014

Background

Platinum doublets are standard first‐line treatment for stage IV non‐small cell lung cancer (NSCLC) without targetable driver mutations. Oxaliplatin is more potent than cisplatin, requiring fewer DNA adducts to provide equivalent cytotoxicity. The objective of this study was to evaluate the efficacy and safety of oxaliplatin combined with docetaxel as a first‐line treatment for stage IV NSCLC.

Methods

This was a prospective, single‐center, phase II trial. Patients with chemotherapy‐naive NSCLC received 60 mg/m2 docetaxel (day 1) and 70 mg/m2 oxaliplatin (day 2) every three weeks for up to six cycles. The primary endpoint was objective response rate (ORR), and the secondary endpoints were progression‐free survival (PFS), overall survival (OS), and safety. Treatment response was evaluated according to Response Evaluation Criteria in Solid Tumors version 1.1.

Results

Thirty‐three patients were enrolled and a response evaluation was available in 31 patients. There were 11 patients with a partial response, 15 with stable disease, and five with progressive disease. Two patients ceased further treatment after the first cycle of chemotherapy. Thus, the ORR was 33.3% in the 33 patients of the intention‐to‐treat population. Median PFS was 3.6 months (95% confidence interval [CI], 2.8–4.5), and median OS was 10.9 months (95% CI, 8.2–13.6). The most common hematologic toxicity was neutropenia. Grade 3–4 neutropenia occurred in 51.5% of patients.

Conclusion

The results suggest that the combination of oxaliplatin and docetaxel is effective in patients with NSCLC with reasonable toxicity.
A retrospective review of the therapeutic response with remission in patients with newly diagnosed bullous pemphigoid
Authors: Chuah Sai Yee , Tan Suat Hoon , Chua Sze Hon , Tang Mark B.Y. , Lim Yen Loo , Neoh Ching Yin , Tan Audrey WH
Published: April 2014

We reviewed the clinical characteristics and therapeutic response in cases of newly diagnosed bullous pemphigoid at the National Skin Centre between June 2009 and December 2010. Most (76%, n = 68/90) achieved clinical remission within 6 months of commencement of therapy. Oral mucosal involvement was identified as a risk factor associated with a prolonged duration of treatment beyond 6 months.
The Geochemistry of Basalt Handaxes from the Lower Palaeolithic Site of Ma‛ayan Baruch, Israel—A Perspective on Raw Material Selection
Authors: Rosenberg D. , Shimelmitz R. , Gluhak T. M. , Assaf A.
Published: April 2014

The Upper Acheulian site of Ma‛ayan Baruch, northern Israel, is primarily known for its exceptionally large assemblage of thousands of flint handaxes. Within this assemblage, a minute collection of basalt handaxes was retrieved as well, representing particular technological choice within the Upper Acheulian. Using geochemistry, we were able to determine that these basalt handaxes were not made from local basalt, but from different sources. Thus, the use of basalt at the site does not represent an ad hoc choice of using local raw material but, rather, a more complex technological choice pertaining to variability in raw material selection in the Lower Palaeolithic Levant.
The Responsibility Objection to Abortion: Rejecting the Notion that the Responsibility Objection Successfully Refutes a Woman's Right to Choose
Authors: McDaniel Ian
Published: April 2014

This article considers the objection to abortion that a woman who voluntarily engages in sexual activity is responsible for her fetus and so cannot have an abortion. The conclusion argued for is that the conceptions of responsibility that can ground the objection that are considered do not necessitate a requirement on the part of a pregnant woman to carry her pregnancy to term. Thus, the iterations of the responsibility objection presented cannot be used to curtail reproductive choice.
Comorbid Rat Model of Ischemia and β‐Amyloid Toxicity: Striatal and Cortical Degeneration
Authors: Amtul Zareen , Whitehead Shawn N. , Keeley Robin J. , Bechberger John , Fisher Alicia L. , McDonald Robert J. , Naus Christian C. , Munoz David G. , Cechetto David F.
Published: April 2014

Levels of cerebral amyloid, presumably β‐amyloid (Abeta), toxicity and the incidence of cortical and subcortical ischemia increases with age. However, little is known about the severe pathological condition and dementia that occur as a result of the comorbid occurrence of this vascular risk factor and Abeta toxicity. Clinical studies have indicated that small ischemic lesions in the striatum are particularly important in generating dementia in combination with minor amyloid lesions. These cognitive deficits are highly likely to be caused by changes in the cortex. In this study, we examined the viability and morphological changes in microglial and neuronal cells, gap junction proteins (connexin43) and neuritic/axonal retraction (Fer Kinase) in the striatum and cerebral cortex using a comorbid rat model of striatal injections of endothelin‐1 (ET1) and Abeta toxicity. The results demonstrated ventricular enlargement, striatal atrophy, substantial increases in β‐amyloid, ramified microglia and increases in neuritic retraction in the combined models of stroke and Abeta toxicity. Changes in connexin43 occurred equally in both groups of Abeta‐treated rats, with and without focal ischemia. Although previous behavioral tests demonstrated impairment in memory and learning, the visual discrimination radial maze task did not show significant difference, suggesting the cognitive impairment in these models is not related to damage to the dorsolateral striatum. These results suggest an insight into the relationship between cortical/striatal atrophy, pathology and functional impairment.
Meta‐Analysis of the Effects of Forest Fragmentation on Interspecific Interactions
Authors: MAGRACH AINHOA , LAURANCE WILLIAM F. , LARRINAGA ASIER R. , SANTAMARIA LUIS
Published: April 2014

Forest fragmentation dramatically alters species persistence and distribution and affects many ecological interactions among species. Recent studies suggest that mutualisms, such as pollination and seed dispersal, are more sensitive to the negative effects of forest fragmentation than antagonisms, such as predation or herbivory. We applied meta‐analytical techniques to evaluate this hypothesis and quantified the relative contributions of different components of the fragmentation process (decreases in fragment size, edge effects, increased isolation, and habitat degradation) to the overall effect. The effects of fragmentation on mutualisms were primarily driven by habitat degradation, edge effects, and fragment isolation, and, as predicted, they were consistently more negative on mutualisms than on antagonisms. For the most studied interaction type, seed dispersal, only certain components of fragmentation had significant (edge effects) or marginally significant (fragment size) effects. Seed size modulated the effect of fragmentation: species with large seeds showed stronger negative impacts of fragmentation via reduced dispersal rates. Our results reveal that different components of the habitat fragmentation process have varying impacts on key mutualisms. We also conclude that antagonistic interactions have been understudied in fragmented landscapes, most of the research has concentrated on particular types of mutualistic interactions such as seed dispersal, and that available studies of interspecific interactions have a strong geographical bias (arising mostly from studies carried out in Brazil, Chile, and the United States).

Meta‐Análisis de los Efectos de la Fragmentación del Bosque sobre las Interacciones Interespecíficas
Implants and contact allergy: are sensitizing metals released as haptens from coronary stents?
Authors: Svedman Cecilia , Möller Halvor , Gruvberger Birgitta , Gustavsson Carl‐Gunnar , Dahlin Jakob , Persson Lena , Bruze Magnus
Published: April 2014

Background

The possible impact of metal release from coronary artery stents has, with their increased use, become a concern.

Objectives

To study in vitro metal release in biologically relevant milieu from coronary stents made of different alloys.

Materials and method

Coronary stents in common use in a department of cardiology at the time of the study were tested. A previously described in vitro technique was used, whereby the stents were kept in the extraction media for a week. Two different extraction media were used to show the necessity of studying the actual biological surrounding of the implant when metal release is investigated. Metal release was determined with atomic absorption spectrometry.

Results

In this study, we show metal release from stents after immersion in extraction media of artificial sweat and cysteine solution, as illustrative media.

Conclusion

Metal release from coronary stents is shown. The magnitude of release is influenced by several factors. The extent to which metal release in vitro has potential biological effects, in terms of elicitation of an allergic reaction or induction of sensitization, in vivo needs to be explored. However, as metal release from an implant in a biologically appropriate medium has been established, better risk assessments in relation to delayed hypersensitivity may be undertaken.
The acute effect of moderate intensity aquatic exercise on coagulation factors in haemophiliacs
Authors: Beltrame Luis Gustavo Normanton , Abreu Laurinda , Almeida Jussara , Boullosa Daniel Alexandre
Published: April 2014

The objective of this cross‐sectional study was to analyse the acute effect of aquatic exercise on haemostasis in persons with haemophilia. Ten adult haemophiliacs (8 type A, 2 type B) familiarized with aquatic training performed a 20‐min exercise session in a swimming pool at an intensity of ~70% maximum heart rate (HR). Blood samples were collected immediately after the training session. The haemostatic parameters selected for analyses were factor VIII (FVIII), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen. There were unclear effects of the exercise bout on FVIII and APTT, with a possibly beneficial effect on PT (−11·4%; 90% confidence interval: −26·1;3·3%), and a trivial change on fibrinogen levels. It was found an association between the mean rise in HR during exercise and the decrement in PT after exercise (r = 0·729; P = 0·026). The greater changes were observed in the patients diagnosed with a moderate level of haemophilia. It is concluded that a short bout of moderate intensity of aquatic exercise may have a positive influence on PT in adults with haemophilia with greater changes in those individuals exhibiting a greater rise in HR during exercise. This may be an important issue to the haemostatic control of haemophiliacs in clinical settings. Further studies are warranted for testing the influence of different aquatic exercise intensities on haemostasis.
The cigarette as style accessory
Authors: Harvey A.D.
Published: April 2014

Now that cigarette‐smoking seems on its way to the dustbin of history, it is worth reflecting on its status as one of the defining elements of twentieth‐century style.
The prognostic value of D‐dimer in lung cancer
Authors: İnal Tuba , Anar Ceyda , Polat Gülru , Ünsal İpek , Halilçolar Hüseyin
Published: April 2014

Background and Aim

Activation of coagulation and fibrinolysis is frequently encountered among cancer patients. Such tumors are supposed to be associated with higher risk of invasion, metastases and eventually worse outcome. The aim of this study is to explore the prognostic value of blood coagulation tests for lung cancer patients.

Methods

Between 2009 and 2012, 72 newly diagnosed patients with lung cancer and 40 healthy subjects as control group were included in this prospective study. Patients were staged according to the seventh edition of the tumor, node, metastasis (TNM) classification. The treatment responses of patients were evaluated according to the World Health Organization (WHO) criteria. We measured plasma D‐dimer level, activated partial thromboplastin time (APTT), prothrombin time (PT), international normalized ratio (INR), lactate dehhydrogenase (LDH), hemoglobin (Hb), platelet (Plt), white blood cells (WBC) count before, during and after chemotherapy. We investigated association of the results with stage and histologic type of the disease, as well as with response to therapy and survival in lung cancer patients.

Results

The median D‐dimer, PT and INR levels of the patients with lung cancer were significantly higher than in the control group (P = 0,000). D‐dimer, APTT, PT, INR, LDH levels after four cycles of treatment were significantly lower in responders than in nonresponders (P = 0,000). Plasma D‐dimer levels were evaluated according to histopathological type and stage of diseases; D‐dimer level was found significantly higher in metastatic disease (P < 0,5) and significantly lower in small cell lung cancer (SCLC) (P < 0,05). The mean follow‐up was 574,14 ± 463,48 days. The mean survival was 750 866 ± 74 857 days (95% CI: 604 147 – 897 586). After second and fourth cycles of treatment, the plasma D‐dimer, APTT, and LDH levels were higher in mortality group than in survival group (P = 0,000). After four cycles of treatment, the mean survival of the patients with serum D‐dimer level above and below 1900 ng/mL was found to be significantly different (P = 0,000).

Conclusion

The results suggest that determination of D–dimer plasma levels that is an inexpensive, easy and non invasive method may be useful in predicting clinical outcome, survival and treatment response of patients with lung cancer.
Physical fitness and amount of asthma and asthma‐like symptoms from childhood to adulthood
Authors: Guldberg–Møller Jørgen , Hancox Bob , Mikkelsen Dennis , Hansen Henrik Steen , Rasmussen Finn
Published: April 2014

Objective

The potential benefits of physical activity on the development of respiratory symptoms are not well known. The present study investigated the longitudinal association between physical fitness and the development of asthma‐like symptoms from childhood to adulthood in a longitudinal community‐based study.

Methods

Participants were assessed at ages 9, 15, 20 and 29 years. Asthma‐like symptoms and physical fitness was assessed at each age.

Results

Tracking for physical fitness was high from age 9 to 29 years. Using logistic regression, high physical fitness at age 9 predicted a lower prevalence of asthma‐like symptoms at ages 9, 20 and 29 years. Asthma at age 9 and female sex and smoking at any age were also independently associated with the presence of asthma‐like symptoms. Our findings suggest that the risk for the development of asthma is reduced by 3% and of asthma‐like symptoms reduced by 2% from early adolescence to young adulthood (ages 9–29 years) by increasing the maximal workload with 1 W/kg.

Conclusion

This finding provide further evidence of a possible beneficial effect of physical activity in childhood on the development of respiratory symptoms in adulthood and supports the notion that the lower levels of physical activity in recent decades may have contributed to an increase in the prevalence of asthma and asthma‐like symptoms.
Usefulness of over‐the‐scope clipping system for closing digestive fistulas
Authors: Mercky Pascale , Gonzalez Jean‐Michel , Aimore Bonin Eduardo , Emungania Olivier , Brunet Julie , Grimaud Jean‐Charles , Barthet Marc
Published: April 2014

Background and Aim

Therapeutic endoscopy has recently evolved into the treatment of complex gastrointestinal (GI) postoperative leakage, especially with over‐the‐scope clips (OTSC). We describe our 2‐year experience of 30 patients treated for digestive fistulas using the OTSC device.

Methods

This was a retrospective study conducted on patients referred for GI fistulas in two French hospitals. Technical aspects, clinical outcomes and closure rates were recorded.

Results

Thirty patients were treated for GI leaks: 19 (63%) had a gastric fistula after laparoscopic sleeve gastrectomy (LSG); the others had rectovaginal, urethrorectal, rectovesical, gastrogastric, gastrocutaneous, esophagojejunal fistulas and colorectal anastomotic leak. Average follow up was 10.4 months. Eighteen (60%) had undergone previous endoscopic or surgical treatment. Orifice size was 3–20 mm (average 7.2 mm). Successful OTSC placement was achieved in 30 out of 34 attempts. There were four intraoperative undesired events (13.3%) but these were successfully managed. Overall success rate was 71.4% and 16 patients (53%) recovered with primary efficacy. Six patients (20%) required a subsequent endoscopic treatment. Eight patients (26.7%) required surgery for failure. In nine cases, we used one or more additional endoscopic procedures concomitantly with the OTSC combining self‐expandable metal stents, standard clips and glue injection. Healing rate after LSG fistula was 88.9%, which was significantly higher than the overall rate (P = 0.01).

Conclusion

OTSC placement seems to be safe and effective for the treatment of GI fistulas. Better results were seen in leaks after LSG.
Perceived Quality of Informed Refusal Process: A Cross‐Sectional Study from Iranian Patients' Perspectives
Authors: Farzandipour Mehrdad , Sheikhtaheri Abbas , Sadeqi Jabali Monireh
Published: April 2014

Patients have the right to refuse their treatment; however, this refusal should be informed. We evaluated the quality of the informed refusal process in Iranian hospitals from patients' viewpoints. To this end, we developed a questionnaire that covered four key aspects of the informed refusal process including; information disclosure, voluntariness, comprehension, and provider‐patient relationship. A total of 284 patients who refused their treatment from 12 teaching hospitals in the Isfahan Province, Iran, were recruited and surveyed to produce a convenience sample. Patients' perceptions about the informed refusal process were scored and the mean scores of the four components were calculated. The findings showed that the practice of information disclosure (9.6 ± 6.4 out of 22 points) was perceived to be moderate, however, comprehension (2.3 ± 1.4 out of 4 points), voluntariness (8.7 ± 1.5 out of 12 points) and provider–patient relationship (10.2 ± 5.2 out of 16 points) were perceived to be relatively good. We found that patients, who refused their care before any treatment had commenced, reported a lower quality of information disclosure and voluntariness. Patients informed by nurses and those who had not had a previous related admission, reported lower scores for comprehension and relationship. In conclusion, the process of obtaining informed refusal was relatively satisfactory except for levels of information disclosure. To improve current practices, Iranian patients need to be better informed about; different treatment options, consequences of treatment refusal, costs of not continuing treatment and follow‐ups after refusal. Developing more informative refusal forms is needed.
Nutritional assessment: new tools and knowledge translation
Authors: Samson‐Fang Lisa
Published: April 2014

This commentary is on the original article by Oeffinger et al. on pages 475‐481 of this issue.
Effect of hyperglycaemia on muscarinic M3 receptor expression and secretory sensitivity to cholinergic receptor activation in islets
Authors: Hauge‐Evans A. C. , Reers C. , Kerby A. , Franklin Z. , Amisten S. , King A. J. , Hassan Z. , Vilches‐Flores A. , Tippu Z. , Persaud S. J. , Jones P. M.
Published: April 2014

Aims

Islets are innervated by parasympathetic nerves which release acetylcholine (ACh) to amplify glucose‐induced insulin secretion, primarily via muscarinic M3 receptors (M3R). Here we investigate the consequence of chronic hyperglycaemia on islet M3R expression and secretory sensitivity of mouse islets to cholinergic receptor activation.

Methods

The impact of hyperglycaemia was studied in (i) islets isolated from ob/ob mice, (ii) alginate‐encapsulated mouse islets transplanted intraperitoneally into streptozotocin‐induced diabetic mice and (iii) mouse and human islets maintained in vitro at 5.5 or 16 mmol/l glucose. Blood glucose levels were assessed by a commercial glucose meter, insulin content by RIA and M3R expression by qPCR and immunohistochemistry.

Results

M3R mRNA expression was reduced in both ob/ob islets and islets maintained at 16 mmol/l glucose for 3 days (68 and 50% control, respectively). In all three models of hyperglycaemia the secretory sensitivity to the cholinergic receptor agonist, carbachol, was reduced by 60–70% compared to control islets. Treatment for 72 h with the irreversible PKC activator, PMA, or the PKC inhibitor, Gö6983, did not alter islet M3R mRNA expression nor did incubation with the PI3K‐inhibitor, LY294002, although enhancement of glucose‐induced insulin secretion by LY294002 was reduced in islets maintained at 16 mmol/l glucose, as was mRNA expression of the PI3K regulatory subunit, p85α.

Conclusions

Cholinergic regulation of insulin release is impaired in three experimental islet models of hyperglycaemia consistent with reduced expression of M3 receptors. Our data suggest that the receptor downregulation is a PKC‐ and PI3K‐independent consequence of the hyperglycaemic environment, and they imply that M3 receptors could be potential targets in the treatment of type 2 diabetes.
Association between first‐line monotherapy with sulphonylurea versus metformin and risk of all‐cause mortality and cardiovascular events: a retrospective, observational study
Authors: Morgan C. Ll. , Mukherjee J. , Jenkins‐Jones S. , Holden S. E. , Currie C. J.
Published: April 2014

Aims

To evaluate the risk of all‐cause mortality and major adverse cardiovascular events (MACE) for patients exposed to first‐line monotherapy with sulphonylurea or metformin.

Methods

Data were from the Clinical Practice Research Datalink (CPRD). Patients with type 2 diabetes were selected if initiated with metformin or sulphonylurea monotherapy as their first‐line glucose‐lowering regimen 2000–2012. The primary endpoint was all‐cause mortality; the secondary endpoint was MACE (myocardial infarction or stroke). Times to endpoints were compared using Cox proportional hazards models. Additional analyses were performed on subsets matched directly on key characteristics and by propensity score.

Results

In the main analysis, 76 811 patients were prescribed metformin monotherapy (mean follow‐up 2.9 years) and 15 687 sulphonylurea monotherapy (mean follow‐up 3.1 years). A total of 2604 patients were included in each arm of the directly matched cohorts and 8836 in the propensity‐matched. With respect to all‐cause mortality, using all three analytical approaches the hazard ratio (HR) was significantly increased for sulphonylurea compared with metformin: adjusted HR = 1.580 (95% CI 1.483–1.684) for the main analysis, 1.902 (1.733–2.088) for those matched on propensity score, and 1.272 (1.021–1.584) for the directly matched cohort analysis. For MACE, the respective HRs were 1.196 (1.090–1.313), 1.202 (1.001–1.442) and 0.814 (0.578–1.148), respectively.

Conclusions

All‐cause mortality was significantly increased in patients prescribed sulphonylurea compared with metformin monotherapy. Whilst residual confounding and confounding by indication may remain, this study indicates that first‐line treatment with sulphonylurea monotherapy should be reconsidered.
Insulin lispro low mixture twice daily versus basal insulin glargine once daily and prandial insulin lispro once daily in patients with type 2 diabetes requiring insulin intensification: a randomized phase IV trial
Authors: Tinahones F. J. , Gross J. L. , Onaca A. , Cleall S. , Rodríguez A.
Published: April 2014

Aims

To compare the efficacy and safety of two insulin intensification strategies in patients with type 2 diabetes inadequately controlled on basal insulin glargine with metformin and/or pioglitazone.

Methods

A multinational, randomized, open‐label trial that compared insulin lispro low mixture (LM25; n = 236) twice daily with a basal–prandial regimen of insulin glargine once daily and insulin lispro once daily (IGL; n = 240) over 24 weeks in patients with HbA1c 7.5–10.5% and fasting plasma glucose ≤6.7 mmol/l. The primary objective was to assess non‐inferiority [per‐protocol (PP) population], and then superiority [intention‐to‐treat (ITT) population], of LM25 versus IGL according to change in HbA1c after 24 weeks (non‐inferiority margin 0.4%, two‐sided significance level 0.05).

Results

Estimated change [least squares (LS) mean (95% CI)] in HbA1c after 24 weeks: −1.30 (−1.44, −1.16)% with LM25 and −1.08 (−1.22, −0.94)% with IGL. Non‐inferiority was shown [LS mean (95% CI) HbA1c treatment difference −0.21 (−0.38, −0.04) (PP population)]; gated superiority assessment showed a statistically significant advantage for LM25 (p = 0.010; ITT population). Mean blood glucose, glycaemic variability, overall tolerability and hypoglycaemic episodes per patient‐year did not show significant differences between treatments during the study.

Conclusions

In patients with type 2 diabetes inadequately controlled on once‐daily basal insulin glargine and metformin and/or pioglitazone, intensification with LM25 was superior to a basal–prandial approach in terms of reduction in HbA1c after 24 weeks and did not increase hypoglycaemia episodes.
Plant traits mediate effects of predators across pepper (Capsicum annuum) varieties
Authors: ABDALA‐ROBERTS LUIS , BERNY‐MIER Y TERÁN JORGE C. , MOONEY KAILEN A. , MOGUEL‐ORDONEZ YOLANDA B. , TUT‐PECH FELIPE
Published: April 2014

The magnitude of plant intra‐specific variation for indirect defence and the underlying plant traits influencing predators remain relatively unstudied, particularly in cultivated plants.

We tested whether differences in flower number, pollen production, and leaf trichome density among 17 pepper (Capsicum annuumLinnaeus) varieties influenced the abundance and predation intensity by the omnivorous miteAmblyseius swirskiiAthias‐Henriot.

A greenhouse experiment was conducted where pepper plants were infested with thrips (Frankliniella cephalicaCrawford DL) and subsequently exposed toA. swirskii. We estimated thrips and mite density based on arthropod counts conducted over a 4‐week period, and also performed flower and trichome counts, and estimated pollen production per anther.

Significant differences were found among varieties for all three traits, as well as mite and thrips density. After accounting for all traits in a multiple regression model, we found that flower and trichome number had significant positive effects on mite density (by providing food and shelter, respectively). Increased mite density was in turn associated with a decrease in thrips density, presumably as a result of mite predation. Moreover, we found that flower number (but not trichome density) increased the strength of thrips suppression and that such an effect was mediated by mite density.

These findings suggest that genetic variation for plant traits may indirectly influence herbivore suppression in peppers (although traits may vary in the strength or direction of their effects), and underscore the evolutionary potential and importance of selection not only for direct but also indirect resistance in crops.