bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing price and production postponement strategies of substitutable product
Authors: Kristianto Nugroho Yohanes
Published: June 2013

Purpose

This paper aims to focus on duopolistic competition under dynamic price and production postponement for two differentiable products that share common product platform at a certain degree of product commonality.

Design/methodology/approach

Both price and production postponement modelling are benchmarked according to their profit in order to investigate the product substitutability effect to the profit and also their appropriateness to different competition situations. In addition, dynamic property is applied to show the demand changes effect of both strategic decisions (price and production) against demand uncertainty.

Findings

The results show that the pure price postponement is appropriate to be applied into highly customized products while pure production postponement to configurable products.

Research limitations/implications

Price and production postponement decisions help managers to optimize product development as well as production strategy by considering demand and supply sides.

Practical implications

Price and production postponements give alternative ways to managers for deciding on how to produce products as fighting product and mass customized product.

Originality/value

Innovative price and production postponement models are the novelty of this paper.
Charismatic leaders: the role of admiration and system justification
Authors: Michel John W. , Wallace Devin L. , Rawlings Rachel A.
Published: June 2013

Purpose

This paper aims to use the stereotype content model to explore the extent to which voter admiration for presidential candidates mediates the charismatic leadership – voting behavior relationship. The paper also seeks to test whether system justification beliefs moderate the mediated relationship.

Design/methodology/approach

Using data collected both before and after the 2008 US presidential election, this paper tested the hypothesized relationships using a conditional indirect effects model with 126 undergraduate students enrolled in the psychology department and business school of a large university in the USA.

Findings

Results demonstrated that admiration mediates the charismatic leadership – voting behavior relationship. Moreover, this mediated relationship varied by system justification beliefs.

Practical implications

These results suggest that charismatic leaders arouse specific emotions (i.e. admiration) in followers and that emotional arousal inspires followers to act on the behalf of the leader. However, this relationship only holds when people are motivated to embrace change. This suggests that not all followers will be responsive to charismatic leaders.

Social implications

For political leaders, these findings suggest that being charismatic is important when change motives are high, but it may be less important when stability is highly valued.

Originality/value

The paper demonstrates that charismatic leaders do arouse the emotions of followers and that such emotions motivate followers to engage in behaviors on behalf of the leader.
Corporate social responsibility disclosures over time: evidence from Malaysia
Authors: Ahmed Haji Abdifatah
Published: June 2013

Purpose

The purpose of this paper is to examine corporate social responsibility (CSR) disclosures over a period of time when the business environment, particularly the Malaysian environment, experienced several significant changes including the recent financial crises and regulatory changes. The paper also examines factors influencing the CSR disclosures before and after the aforementioned changes.

Design/methodology/approach

A self‐constructed CSR checklist was used to measure the extent and quality of CSR disclosures in the annual reports of 85 companies listed on Bursa Malaysia for the years 2006 and 2009. A number of statistical techniques were employed to assess the CSR disclosures over time, as well as factors influencing the CSR disclosures.

Findings

Results revealed a significant overall increase in both the extent and quality of CSR disclosures between the two years covered in the study. In terms of factors influencing the CSR disclosures, director ownership, government ownership and company size were found to be significant in explaining both the extent and quality of CSR disclosures in the year 2006. Board size was found to have a significant relationship with only the extent of CSR disclosures in 2006. However, the results in the year 2009, a period following the policy changes, revealed an improved significant association between board size and CSR disclosures.

Research limitations/implications

The results, which showed a significant increasing trend in CSR disclosures following changes in the market place of an emerging economy, lend some support to legitimacy theory's conjecture that CSR disclosures are used to reduce exposure arising from the public. Hence, this study suggests corporate legitimation practices, which were previously renowned in the economically developed countries, also exist in the emerging economies. The empirical observations asserted in this study, however, were only drawn from the Malaysian context. Therefore, future research involving several emerging countries is needed to ascertain the existence of corporate legitimation exercises in the developing countries.

Practical implications

In terms of practical implications, the dominance of narrative CSR disclosures in the annual reports as opposed to verifiable information, even after the CSR mandatory requirement, could be due to the absence of a detailed CSR framework for Malaysian public listed companies. Policy makers in Malaysia may therefore want to devise detailed and specific CSR disclosure requirements, rather the current general mandatory requirement, to enhance the quality of CSR disclosures.

Originality/value

This study can be considered one of limited empirical studies to have assessed CSR disclosures following changes in the market place.
Aldosterone, organ damage and dietary salt
Authors: Catena Cristiana , Colussi GianLuca , Sechi Leonardo A
Published: June 2013

Long‐term exposure to elevated aldosterone levels or activation of the mineralocorticoid receptors results in cardiac, vascular and renal tissue injury with mechanisms that are independent of blood pressure levels. This evidence has been obtained in experiments carried out in hypertensive animal models, and clinical studies involving patients with heart failure, essential hypertension and primary aldosteronism.

Animal studies have shown that aldosterone causes cardiovascular and renal tissue damage only in the context of an inappropriate salt status. It has also been suggested that some of the untoward effects of high‐salt intake might depend on activation of mineralocorticoid receptors resulting from increased generation of reactive oxygen species and changes in the intracellular redox potential.

Although the interaction between dietary salt intake and circulating aldosterone in causing organ damage has received robust support from the results of animal experiments, the evidence of such interaction in the clinical setting is only preliminary and will require further investigation in appropriately designed studies.
Diversity and distribution of a key sulpholipid biosynthetic gene in marine microbial assemblages
Authors: Villanueva Laura , Bale Nicole , Hopmans Ellen C. , Schouten Stefan , Damsté Jaap S. Sinninghe
Published: June 2013

Sulphoquinovosyldiacylglycerols (SQDG) are polar sulphur‐containing membrane lipids, whose presence has been related to a microbial strategy to adapt to phosphate deprivation. In this study, we have targeted the sqdB gene coding the uridine 5′‐diphosphate‐sulphoquinovose (UDP‐SQ) synthase involved in the SQDG biosynthetic pathway to assess potential microbial sources of SQDGs in the marine environment. The phylogeny of the sqdB‐coding protein reveals two distinct clusters: one including green algae, higher plants and cyanobacteria, and another one comprising mainly non‐photosynthetic bacteria, as well as other cyanobacteria and algal groups. Evolutionary analysis suggests that the appearance of UDP‐SQ synthase occurred twice in cyanobacterial evolution, and one of those branches led to the diversification of the protein in members of the phylum Proteobacteria. A search of homologues of sqdB‐proteins in marine metagenomes strongly suggested the presence of heterotrophic bacteria potential SQDG producers. Application of newly developed sqdB gene primers in the marine environment revealed a high diversity of sequences affiliated to cyanobacteria and Proteobacteria in microbial mats, while in North Sea surface water, most of the detected sqdB genes were attributed to the cyanobacterium Synechococcus sp. Lipid analysis revealed that specific SQDGs were characteristic of microbial mat depth, suggesting that SQDG lipids are associated with specific producers.
Impaired emotional empathy and related social network deficits in cocaine users
Authors: Preller Katrin H. , Hulka Lea M. , Vonmoos Matthias , Jenni Daniela , Baumgartner Markus R. , Seifritz Erich , Dziobek Isabel , Quednow Boris B.
Published: June 2013

Chronic cocaine users consistently display neurochemical and functional alterations in brain areas involved in social cognition (e.g. medial and orbitofrontal cortex). Although social functioning plays a crucial role in the development and treatment of drug dependence, studies investigating social cognition in cocaine users are lacking. Therefore, we investigated mental perspective taking (‘theory of mind’) and emotional and cognitive empathy in recreational (RCU) and dependent (DCU) cocaine users. Furthermore, we related these measures to real‐life indicators of social functioning. One‐hundred cocaine users (69 RCU, 31 DCU) and 68 stimulant‐naïve healthy controls were tested with the Multifaceted Empathy Test (MET), Movie for the Assessment of Social Cognition (MASC) and Reading the Mind in the Eyes Test (RMET). The Social Network Questionnaire was conducted to assess social network size. Furthermore, participants provided information on committed criminal offenses. RCU and DCU showed less emotional empathy compared to controls (MET), whereas cognitive empathy was not impaired (MET, RMET). Additionally, DCU made more errors in mental perspective taking (MASC). Notably, cocaine users committed more criminal offenses and displayed a smaller social network and higher cocaine use was correlated with less social contacts. Diminished mental perspective taking was tentatively correlated with more intense cocaine use as well. Finally, younger age of onset of cocaine use was associated with more pronounced empathy impairment. In conclusion, social cognition impairments in cocaine users were related to real‐life social functioning and should therefore be considered in therapy and prevention strategies.
A review of ecological interactions between native frogs and invasive cane toads in Australia
Authors: Shine Richard
Published: June 2013

Translocated from their native range in the Americas in 1935, cane toads (Rhinella marina, Bufonidae) have now spread through much of tropical and subtropical Australia. The toad's invasion and impact have attracted detailed study. In this paper, I review information on ecological interactions between cane toads and Australian anurans. The phylogenetic relatedness and ecological similarity between frogs and toads creates opportunities for diverse interactions, ranging from predation to competition to parasite transfer, plus a host of indirect effects mediated via impacts of toads on other species, and by people's attempts to control toads. The most clear‐cut effect of toads on frogs is a positive one: reducing predator pressure by fatally poisoning anuran‐eating varanid lizards. However, toads also have a wide range of other effects on frogs, some positive (e.g. taking up parasites that would otherwise infect native frogs) and others negative (e.g. eating frogs, poisoning frogs, competing with tadpoles). Although information on such mechanisms predicts intense interactions between toads and frogs, field surveys show that cane toad invasion has negligible overall impacts on frog abundance. That counter‐intuitive result is because of a broad balancing of negative and positive impacts, coupled with stochastic (weather‐induced) fluctuations in anuran abundance that overwhelm any impacts of toads. Also, the impacts of toads on frogs differ among frog species and life‐history stages, and depend upon local environmental conditions. The impacts of native frogs on cane toads have attracted much less study, but may well be important: frogs may impose biotic resistance to cane toad colonization, especially via competition in the larval phase. Overall, the interactions between native frogs and invasive toads illustrate the diverse ways in which an invader's arrival can perturb the native fauna by both direct and indirect mechanisms, and by which the native species can curtail an invader's success. These studies also offer a cautionary tale about the difficulty of predicting the impact of an invasive species, even with a clear understanding of mechanisms of direct interaction.
Vietnam's Domestic–Foreign Policy Nexus:DoiMoi, Foreign Policy Reform, andSino‐Vietnamese Normalization
Authors: Hiep Le Hong
Published: June 2013

This article examines the link betweenVietnam's adoption of theDoiMoi(renovation) policy and transformations in itsChina policy in the late 1980s and early 1990s as a case study of the domestic–foreign policy nexus. The article argues that during this period, changes inVietnam's foreign policy in general and itsChina policy in particular originated first and foremost from theVietnameseCommunistParty's (VCP) domestic agenda of promoting economic reform and protecting the regime's survival. As theVCPconsidered hostile relations withChina as detrimental to both its economic reform and regime security, it strived to mend relations withChina as quickly as possible. Against this backdrop,Vietnam made a number of important concessions toChina regarding theCambodian issue in order to accelerate the normalization process, which eventually concluded in late 1991.
Novel drugs and intervention strategies for the treatment of chronic kidney disease
Authors: Lambers Heerspink Hiddo Jan , de Zeeuw Dick
Published: June 2013

Chronic kidney disease (CKD) is a worldwide health problem. The disease is most often progressive of nature with a high impact on patients and society. It is increasingly recognized that CKD can be detected in the early stages and should be managed as early as possible. Treatment of the cause, but in particular control of the main risk markers, such as high blood pressure, glucose and albuminuria, has been instrumental in delaying the progression to end‐stage renal disease (ESRD). However, despite the state of the art therapy, the absolute risk of renal and cardiovascular morbidity and mortality in CKD patients remains devastatingly high. Novel drugs are therefore highly desirable to halt effectively the progressive renal (and cardiovascular) function loss. Recently, several novel strategies have been tested targeting traditional risk factors such as blood pressure (combination therapy of angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) and novel mineralocorticoid receptor antagonists) as well as dyslipidaemia (statins) with surprising results. In addition, drug targets specifically related to the kidney, such as vitamin D, uric acid, erythropoietin and phosphate, have been the subject of clinical trials, in some instances with unexpected results. Finally, novel targets including endothelin receptors and inflammatory pathways are increasingly explored as potential avenues to improve renal and cardiovascular protection, albeit that the drugs tested have not been unequivocally successful. In this article we review novel drugs or intervention strategies for the management of CKD, we try to provide explanations for the failure of some promising drugs and hypothesize on the potential success of new strategies.
Renal function assessment in older adults
Authors: Drenth‐van Maanen A. Clara , Jansen Paul A. F. , Proost Johannes H. , Egberts Toine C. G. , van Zuilen Arjan D. , van der Stap Dawi , van Marum Rob J.
Published: June 2013

Aims

The Cockcroft‐Gault (CG), the Modification of Diet in Renal Disease (MDRD) and the CKD‐EPI (Chronic Kidney Disease Epidemiology Collaboration) formulae are often used to estimate glomerular filtration rate (GFR). The objective was to determine the best method for estimating GFR in older adults.

Methods

A cross‐sectional study was conducted at the geriatric wards of two hospitals in The Netherlands. Patients aged 70 years or above with an estimated (e)GFR below 60 ml min−1 1.73 m−2 were included. The CG, CG calculated with ideal bodyweight (IBW), MDRD and CKD‐EPI formulae were compared with a criterion standard, sinistrin clearance. Renal function was classified into five stages according to the National Kidney Foundation Disease Outcomes Quality Initiative chronic kidney disease classification, as follows (in ml min−1 1.73 m−2): stage 1, eGFR ≥ 90; stage 2, eGFR of 60–89; stage 3, eGFR of 30–59; stage 4, eGFR of 15–29; and stage 5, eGFR < 15.

Results

Sixteen patients, 50% male, with a mean age of 82 years (range 71–87 years) and mean body mass index 26 kg m−2 (range 18–36 kg m−2), were included. On average, all formulae slightly overestimated GFR, as follows (in ml min−1 1.73 m−2): CG +0.05 [95% confidence interval (CI) −28 to +28]; CG with IBW +0.03 (95% CI −20 to +20); MDRD +9 (95% CI −16 to +34); and CKD‐EPI +5 (95% CI −20 to +29). They classified kidney disease correctly in 68.8% (CG), 75% (CG with IBW), 43.8% (MDRD) and 68.8% (CKD‐EPI) of the participants, respectively.

Conclusions

The CG, CG with IBW, MDRD and CKD‐EPI formulae estimate the mean GFR of a population rather well. In individual cases, all formulae may misclassify kidney disease by one stage.
Designing leadership and soft skills in educational games: The e‐leadership and soft skills educational games design model (ELESS)
Authors: de Freitas Sara , Routledge Helen
Published: June 2013

While the field of leadership studies includes a large corpus of literature and studies, the literature and scientific research in the field of e‐leadership and soft skills used in learning game environments are at present small in scale. Towards contributing to this newly emerging field of literature and study, this research paper presents a new model, the e‐Leadership and Soft Skills Educational Design Model (ELESS) for assessing the use and constructing the effective design of soft skills and leadership skills in multiplayer learning game environments. The central research question considers: what is the role of e‐leadership and how can it be designed and tested in the context of educational games? To address this question, the research paper includes a review of the current literature around distributed (shared) leadership models and presents some examples of studies assessing how leadership is designed, used and tested in available game environments. The paper then presents the ELESS model and validates it within the context of a case study of the Leadership Game. As a result, the ELESS model can be used to test the efficacy of existing games and to inform the effective design of new games that focus upon developing leadership and soft skills.
Increasing paternal age at childbirth is associated with taller stature and less favourable lipid profiles in their children
Authors: Savage Tim , Derraik José G. B. , Miles Harriet L. , Mouat Fran , Hofman Paul L. , Cutfield Wayne S.
Published: June 2013

Background

Paternal age at childbirth has been increasing worldwide, and we assessed whether this increase affects growth, body composition and metabolism in their children.

Methods

We studied 277 children (aged 3–12 years) born to fathers aged 19·8–51·8 years. Clinical assessments were height and weight adjusted for parental measurements, DEXA‐derived body composition, fasting lipids, glucose homoeostasis and hormonal profiles.

Results

Children born to fathers aged 31–35 (P = 0·009) and >35 years (P = 0·021) were 2 cm taller than those of fathers aged ≤30 years. Children of fathers aged >35 years at childbirth had a lower body mass index (BMI) (−0·32 SDS) than offspring of fathers aged 31–35 (−0·01 SDS; P = 0·043) and ≤30 (0·22 SDS; P = 0·019). There were marked effects of paternal age at childbirth on childhood blood lipids. LDL‐C concentrations in children born to fathers aged >35 years were 11% and 21% higher than in children of fathers aged 31–35 and ≤30 years, respectively (P < 0·01). Total cholesterol to HDL‐C ratio was also higher among the children of fathers aged 31–35 (12%; P = 0·014) and >35 (16%; P = 0·004) years at childbirth compared with the ≤30 group. In addition, HOMA‐IR in girls (but not boys) born of fathers aged 31–35 (0·99) and >35 years (1·11) indicated better insulin sensitivity compared with offspring in the ≤30 group (1·63; P < 0·05).

Conclusions

Increasing paternal age at childbirth is associated with a more favourable phenotype in their children (taller and slimmer, with better insulin sensitivity in girls) but with a less favourable lipid profile.
Gene expression and regulation in systemic lupus erythematosus
Authors: Frangou Eleni A. , Bertsias George K. , Boumpas Dimitrios T.
Published: June 2013

Background

Systemic lupus erythematosus (SLE) is the prototypic systemic autoimmune disease. Genome‐wide (GW) association studies have identified more than 40 disease‐associated loci, together accounting for only 10–20% of disease heritability. Gene expression represents the intermediate phenotype between DNA and disease phenotypic variation, and provides insights regarding genetic and epigenetic effects. We review data on gene expression and regulation in SLE by our group and other investigators.

Materials and methods

Systematic PubMed search for GW expression studies in SLE published since the year 2000.

Results

Deregulation of genes involved in type I interferon signaling is a consistent finding in the peripheral blood of active and severe SLE patients. Upregulation of granulocyte‐specific transcripts especially in bone marrow mononuclear cells (BMMCs), and of myeloid lineage transcripts in lupus nephritis, provide evidence for pathogenic role of these cells. Gene network analysis in BMMCs identified central gene regulators which could represent therapeutic targets and a high similarity between SLE and non‐Hodgkin lymphoma providing a molecular basis for the reported association of the two diseases. Gene expression abnormalities driven by deregulated expression of certain microRNAs in SLE contribute to interferon production, T‐ and B‐cell hyperactivity, DNA hypomethylation, and defective tissue response to injury. Methylation arrays have revealed alterations in white blood cell DNA methylation in SLE suggesting an important role of epigenetics and the environment.

Conclusions

Gene expression studies have contributed to the characterization of pathogenic processes in SLE. Integrated approaches utilizing genetic variation, transcriptome and epigenome profiling will facilitate efforts towards a molecular‐based disease taxonomy.
Authority, The Autonomy of The University, and Neoliberal Politics
Authors: Kodelja Zdenko
Published: June 2013

Zdenko Kodelja's purpose in this essay is not to give a comprehensive explanation of the impact of neoliberal ideas and politics on authority (in all of its forms) of universities and their professors. His aims are much more modest: to sketch a theoretical framework for better understanding what the essence of authority is; to show that the relation between authority and trust is the key to explaining the effect of neoliberal politics on the authority of the university and university professors; to discuss professors' autonomy as deriving primarily from epistemic authority and to point out that what makes professors epistemic authorities is not the truth of what they say, but rather the students' belief that it is true; and to disclose some problems related to authority, university autonomy, and neoliberal politics.
Impact of derived global weather data on simulated crop yields
Authors: van Wart Justin , Grassini Patricio , Cassman Kenneth G.
Published: June 2013

Crop simulation models can be used to estimate impact of current and future climates on crop yields and food security, but require long‐term historical daily weather data to obtain robust simulations. In many regions where crops are grown, daily weather data are not available. Alternatively, gridded weather databases (GWD) with complete terrestrial coverage are available, typically derived from: (i) global circulation computer models; (ii) interpolated weather station data; or (iii) remotely sensed surface data from satellites. The present study's objective is to evaluate capacity of GWDs to simulate crop yield potential (Yp) or water‐limited yield potential (Yw), which can serve as benchmarks to assess impact of climate change scenarios on crop productivity and land use change. Three GWDs (CRU, NCEP/DOE, and NASA POWER data) were evaluated for their ability to simulate Yp and Yw of rice in China, USA maize, and wheat in Germany. Simulations of Yp and Yw based on recorded daily data from well‐maintained weather stations were taken as the control weather data (CWD). Agreement between simulations of Yp or Yw based on CWD and those based on GWD was poor with the latter having strong bias and large root mean square errors (RMSEs) that were 26–72% of absolute mean yield across locations and years. In contrast, simulated Yp or Yw using observed daily weather data from stations in the NOAA database combined with solar radiation from the NASA‐POWER database were in much better agreement with Yp and Yw simulated with CWD (i.e. little bias and an RMSE of 12–19% of the absolute mean). We conclude that results from studies that rely on GWD to simulate agricultural productivity in current and future climates are highly uncertain. An alternative approach would impose a climate scenario on location‐specific observed daily weather databases combined with an appropriate upscaling method.
Shedding light on junior doctors' work practices after hours
Authors: Arabadzhiyska P. N. , Baysari M. T. , Walter S. , Day R. O. , Westbrook J. I.
Published: June 2013

Background

It is imperative to understand the current work practices of hospital personnel to inform efforts and secure resources towards the improvement of hospital systems. Research examining doctors' work during night‐shifts is limited.

Aim

To describe and quantify the night‐shift work practices of junior doctors.

Methods

An observational time and motion study was conducted. Eight resident doctors in four general wards were observed for 96 h during night shifts (Monday–Friday, 2200–0800).

Results

Doctors spent the highest proportion (28%; 95% CI 21–35) of their time performing social/personal tasks (e.g. sleeping, eating) and indirect care (24%; 95% CI 22–25) (e.g. reviewing notes, ordering tests). Work‐related discussion comprised 15% (95% CI 13–17), and most took place at the beginning of the night. Medication‐related tasks consumed a small proportion of time (4%; 95% CI 3–4) but attracted a higher level of multitasking and interruptions than most other tasks. On average, 2 h of every shift were spent at a computer and 1.3 h with patient notes. Doctors spent 72% of the night‐shift alone, multitasked 6.4% of the time and were interrupted, on average, once every 46 min.

Conclusions

This study provides new data about junior doctors' work at night. Relative to doctors during the day, greater proportions of time were devoted to social/personal tasks (including sleep) and indirect care, but a similar proportion to direct care. Multitasking and interruptions were minimal. Computer activities were an integral part of work. Handovers were observed at the beginning but not the completion of the night shift, which may have implications for patient safety.
Imipenem versus piperacillin/tazobactam for empiric treatment of neutropenic fever in adults
Authors: Roohullah A. , Moniwa A. , Wood C. , Humble M. , Balm M. , Carter J. , Weinkove R.
Published: June 2013

Australian guidelines for neutropenic fever recommend piperacillin/tazobactam (PIP‐TAZ) or cefepime for first‐line empiric treatment of neutropenic fever. We compared outcomes among haematology patients before and after changing our first‐line neutropenic fever treatment from imipenem to PIP‐TAZ. Forty‐five patients received imipenem and 60 PIP‐TAZ. Despite a higher rate of antibiotic modification in the PIP‐TAZ cohort, treatment success and time to defervescence were similar, with a trend towards fewer Clostridium difficile infections in the PIP‐TAZ cohort.
MD‐2 is involved in the stimulation of matrix metalloproteinase‐1 expression by interferon‐γ and high glucose in mononuclear cells – a potential role of MD‐2 in Toll‐like receptor 4‐independent signalling
Authors: Lu Zhongyang , Li Yanchun , Samuvel Devadoss J. , Jin Junfei , Zhang Xiaoming , Lopes‐Virella Maria F. , Huang Yan
Published: June 2013

We reported recently that treatment of diabetic apolipoprotein E‐deficient mice with the Toll‐like receptor 4 (TLR4) antagonist Rs‐LPS, a lipopolysaccharide isolated from Rhodobacter sphaeroides, inhibited atherosclerosis. Since it is known that Rs‐LPS antagonizes TLR4 by targeting TLR4 co‐receptor MD‐2, this finding indicates that MD‐2 is a potential target for the treatment of atherosclerosis. In this study, we determined if MD‐2 is involved in the gene expression regulated by signalling pathways independent of TLR4. Given that interferon‐γ (IFNγ) and hyperglycaemia play key roles in atherosclerosis, we determined if MD‐2 is involved in IFN‐γ and high‐glucose‐regulated gene expression in mononuclear cells. Results showed that IFN‐γ and high glucose synergistically stimulated matrix metalloproteinase 1 (MMP‐1), a proteinase essential for vascular tissue remodelling and atherosclerosis, in U937 mononuclear cells, but Rs‐LPS inhibited the MMP‐1 stimulation. To provide more evidence for a role of MD‐2 in IFN‐γ‐stimulated MMP‐1, studies using antibodies and small interfering RNA demonstrated that MD‐2 blockade or knockdown attenuated the effect of IFN‐γ on MMP‐1. Furthermore, studies using PCR arrays showed that MD‐2 blockade had a similar effect as IFN‐γ receptor blockade on the inhibition of IFN‐γ‐stimulated pro‐inflammatory molecules. Although these findings indicate the involvement of MD‐2 in IFN‐γ signalling, we also observed that MD‐2 was up‐regulated by IFN‐γ and high glucose. We found that MD‐2 up‐regulation by IFN‐γ played an essential role in the synergistic effect of IFN‐γ and LPS on MMP‐1 expression. Taken together, these findings indicate that MD‐2 is involved in IFN‐γ signalling and IFN‐γ‐augmented MMP‐1 up‐regulation by LPS.
Does experiencing homelessness affect women's motivation to change alcohol or drug use?
Authors: Upshur Carole C. , Weinreb Linda , Cheng Debbie M. , Kim Theresa W. , Samet Jeffrey H. , Saitz Richard
Published: June 2013

Background and Objectives

Homeless women are at high risk of drug and alcohol dependence and may receive less opportunity for treatment. Our objective was to examine the association between experiencing homelessness and motivation to change drug or alcohol use.

Methods

Women (n = 154) participants in a study of substance dependence at an urban medical center (69 with some homeless days in the last 90 days; 85 continuously housed at baseline) completed six items rating motivation to change alcohol or drug use (ie, importance, readiness, and confidence) at baseline and in 3‐, 6‐, and 12‐month follow‐up interviews. Unadjusted and longitudinal analyses controlling for covariates (eg, demographics, insurance status, substance use consequences, mental health status, and participation in treatment) were conducted.

Results

There were no significant differences between women experiencing homeless days versus continuously housed women in the odds of reporting high motivation to change alcohol or drug use, either in unadjusted baseline analyses or longitudinal analyses adjusted for covariates. Covariates that were significantly associated with high importance, readiness or confidence to change behavior were higher life time consequences of substance use, and participation in 12‐step programs.

Discussion and Conclusions

The findings suggest that clinicians should not make assumptions that homeless women have low motivation to change their substance use.

Scientific Significance and Future Directions

The same opportunities for addiction treatment should be offered to homeless as to housed women. (Am J Addict 2014;23:76–83)
Associations between Post‐Traumatic Stress Symptoms, Stimulant Use, and Treatment Outcomes: A Secondary Analysis of NIDA's Women and Trauma Study
Authors: Ruglass Lesia M. , Hien Denise A. , Hu Mei‐Chen , Campbell Aimee N.C.
Published: June 2013

Background and Objectives

To examine the associations between post‐traumatic stress disorder (PTSD) symptoms, stimulant use, and treatment outcomes among dually diagnosed women.

Methods

Participants were 141 women who participated in a multisite clinical trial of group treatments for PTSD and addictions.

Results

Generalized linear models indicated Seeking Safety (SS; a cognitive‐behavioral intervention) was significantly more effective than Women's Health Education (WHE; a control group intervention) in reducing stimulant use at follow‐up among women who were heavy stimulant users at pre‐treatment and who showed improvements in PTSD symptoms. There were no significant differences between the interventions among women who were light stimulant users at treatment entry.

Conclusions and Scientific Significance

These findings suggest that integrated treatment of co‐occurring PTSD and addictions may be more effective than general health education approaches for heavy stimulant users. Assessment of frequency of stimulant use among individuals with PTSD symptoms may inform treatment selection for this population. (Am J Addict 2014;23:90–95)
Is It Time For A Computer In Your Practice?: III: Types of Computer Systems for Medical Offices
Authors: RIGEL DARRELL S.
Published: June 2013

The next article of this series will discuss a method for evaluating the suitability of any computer system for your needs and will describe how to select the “best” one for you.
Techniques of Facial Lesion Excision and Closure
Authors: SPICER THOMAS E.
Published: June 2013

Healing of skin always produces a scar. Scars become more noticeable when they differ from surrounding tissue in contour, color, or texture. Careful planning and execution of the surgery will minimize unsightly blemishes.
Principles of Nasal Reconstruction
Authors: BARTON FRITZ E.
Published: June 2013

The principles of nasal reconstruction and of wound closure are reviewed, and repairs by full‐thickness graft, midline forehead and upper lip advancement flaps, and scalping flap are illustrated.
Mohs' Surgery, Fresh‐Tissue Technique: Our Technique with a Review
Authors: COTTEL WILLIS I. , PROPER STEVEN
Published: June 2013

A modified method of the fresh‐tissue technique of Mohs' surgery is presented with a discussion of its developmental background and advantages. The refinements obviate the need for the chemical fixative. We therefore advocate acceptance of this technique in all cases of cutaneous carcinomas requiring Mohs' surgery.
“Pinch Modification” of the Linear Advancement Flap
Authors: PENG VINCENT T. , STURM RICHARD L. , MARSH TERRY W.
Published: June 2013

Abstract. Pinch modification of linear advancement flap is a hybrid of advancement and bilateral rotation flaps. This modification, which shortens and widens the flap, shows an increase in flap survival rate over the traditional advancement technique.
Pregnancy and Hormonal Influences on Malignant Melanoma
Authors: SCHWARTZ BENNETT K. , ZASHIN SCOTT J. , SPENCER STEVEN K. , MILLS LETHA E. , SOBER ARTHUR J.
Published: June 2013

Abstract. Halo cutaneous melanoma developed in a 30‐year‐old woman. Following wide excision of the melanoma, she remained clinically free of tumor for 5 years. In a subsequent pregnancy, she developed metastases to the liver which became evident in the immediate postpartum period. Long‐term survival associated with cutaneous hypopigmentation has been reported and occurred in our patient. The interaction between hormonal and immunologic factors and melanoma is explored.
Expression of Keratin Proteins in Deeply Invasive Basal and Squamous Cell Carcinoma: An Immunohistochemical Study
Authors: ROBINSON JUNE K.
Published: June 2013

Abstract. The expression of certain classes of keratin is associated with cell maturation and differentiation. During cell transformation and tumor development, the cell specificity of intermediate filament, keratin, is largely conserved. Taking advantage of this, we utilized monoclonal antikeratin immunohistochemical techniques to examine basal and squamous cell carcinomas as they became deeply invasive.

Dyskeratotic keratinocytes and keratin pearls in squamous cell carcinomas (SCCs) stain with antikeratin anti‐sera to larger keratins (65–67 Kd). At the deep tumor margins, SCCs no longer express larger keratins but retain expression of 50, 58 Kd, which are markers of keratinocytes derived from stratified squamous epithelial cells. This selective loss of expression of keratin polypeptide markers of differentiation in SCC is associated with progressively more aggressive biologic behavior as the tumor invades deeper structures such as muscle and bone.

Recurrent basal cell carcinoma (BCC) which was of the nodular type when first excised, shows features of morphea‐like BCC and of aggressive growth patterns at the deep invasive margin. At these deep margins, some tumors express markers of keratinization (65–67 Kd).

While tumor cells retain the specificity of the intermediate filament, keratin, the individual cells express products of differentiation as measured by keratin expression independently of their cytologic atypia. At the deeper invasive margin of the tumor, the neoplastic cells synthesize keratin proteins in an unpredictable fashion.
Influence of Estrogens and Progesterone on the Venous System of the Lower Limbs in Women
Authors: VIN F. , ALLAERT F. A. , LEVARDON M.
Published: June 2013

Treatments with estrogens and progestogens are suspected of causing vascular complications either directly or by metabolic consequences. Although many studies have demonstrated an increased incidence of arterial and deep venous thrombosis, since 1970 the dose of estrogens and progesterones have been lowered with a proportional lowering of side effects. After classification of estrogens and progestogens, we studied their peripheral vascular effects. In our study, we demonstrated that the effects of estroprogestogen treatment on the superficial venous system depend on the dose of estrogen and progestogen.
Modifications of Electrosurgery Electrodes
Authors: SEBBEN JACK E.
Published: June 2013

Dermatologists often find that electrosurgical electrodes that are commercially available do not always suit their specific clinical requirements. Some physicians modify electrodes to achieve specific electrosurgical effects. The more popular modifications have given rise to new varieties of commercially available electrodes.
Pharmacokinetics, pharmacodynamics, safety and tolerability of 4 weeks' treatment with empagliflozin in Japanese patients with type 2 diabetes mellitus
Authors: Kanada Shigeto , Koiwai Kazuki , Taniguchi Atsushi , Sarashina Akiko , Seman Leo , Woerle Hans J
Published: June 2013

Introduction

To evaluate the pharmacodynamics, pharmacokinetics, safety and tolerability of empagliflozin in Japanese patients with type 2 diabetes mellitus.

Materials and methods

In this 4‐week, multiple dose, randomized, parallel‐group, double‐blind, placebo‐controlled trial, patients (n = 100) were randomized to receive 1, 5, 10 or 25 mg of empagliflozin, or placebo once daily. Key end‐points were urinary glucose excretion (UGE), fasting plasma glucose (FPG) and eight‐point glucose profile.

Results

Data are presented for 1, 5, 10, 25 mg of empagliflozin and placebo groups, respectively. Adjusted mean changes from baseline to day 27 in UGE were 40.8, 77.1, 80.9, 93.0 and −2.1 g (P < 0.0001 for all empagliflozin groups vs placebo). Adjusted mean changes from baseline to day 28 in FPG were −1.56, −1.96, −2.31, −2.37 and −0.86 mmol/L (P < 0.01 for all empagliflozin groups vs placebo). Adjusted mean changes from baseline to day 27 in eight‐point glucose profile were −1.96, −2.21, −2.42, −2.54 and −0.97 mmol/L (P < 0.01 for all empagliflozin groups vs placebo). Empagliflozin reached peak plasma concentration 1.5–2 h after dosing. Mean steady state terminal elimination half‐lives ranged from 13.2 to 18.0 h. Of 100 patients, 25 experienced an adverse event, occurring more frequently for empagliflozin (29.1%) than placebo (9.5%); frequency was not dose related.

Conclusions

In Japanese patients with type 2 diabetes mellitus, empagliflozin at doses up to 25 mg once daily for 4 weeks was well tolerated and resulted in significant improvements in glycemic control compared with placebo. This trial was registered with ClinicalTrials.gov (no. NCT00885118).
Potential predictors of disease progression for main‐duct intraductal papillary mucinous neoplasms of the pancreas
Authors: Ogura Takeshi , Masuda Daisuke , Kurisu Yoshitaka , Edogawa Shoko , Imoto Akira , Hayashi Michihiro , Uchiyama Kazuhisa , Higuchi Kazuhide
Published: June 2013

Background and Aim

The evidence for main pancreatic duct intraductal papillary mucinous neoplasms (MPD‐IPMN) malignancy is based predominantly on investigation of resected cases, and the natural history is still unclear. The aim of the present study is to investigate the natural history of MPD‐IPMN and examine potential predictors of disease progression in MPD‐IPMN patients who conformed to “high‐risk stigmata” criteria.

Methods

This study included consecutive 20 follow‐up patients and 19 surgical patients with “high‐risk stigmata” MPD‐IPMN, in whom the diameter of the MPD was > 10 mm, branch duct was < 5 mm, and who underwent clinical follow up for ≥ 2 years.

Results

Among surgical patients, mural nodules and MPD diameter of invasive patients were significantly different compared with non‐invasive patients. On the other hand, among follow‐up patients, univariate analysis revealed the following potential predictors for disease progression: diameter of MPD ≥ 15 mm (hazard ratio [HR], 20.9; 95% confidence interval [CI], 2.59–173.4; P < 0.01); and diffuse lesions of MPD‐IPMN (HR, 4.46; 95% CI, 1.10–18.0; P = 0.04). On the other hand, multivariate analysis identified only diameter of MPD ≥ 15 mm (HR, 19.2; 95%CI, 1.87–198.5; P = 0.01) as a potential predictor of disease progression.

Conclusion

If MPD‐IPMN patients have other severe complications or reasons for not undergoing surgical treatment, MPD diameter < 15 mm, negative cytology, and no mural nodules, conservative clinical follow up for several years may be an option.
Is the double‐guidewire technique superior to the pancreatic duct guidewire technique in cases of pancreatic duct opacification?
Authors: Tanaka Reina , Itoi Takao , Sofuni Atsushi , Itokawa Fumihide , Kurihara Toshio , Tsuchiya Takayoshi , Tsuji Shujiro , Ishii Kentaro , Ikeuchi Nobuhito , Umeda Junko , Tonozuka Ryosuke , Honjo Mitsuyoshi , Mukai Shuntaro , Moriyasu Fuminori
Published: June 2013

Background and Aims

Pancreatic duct guidewire placement (P‐GW) techniques include both the injection cannulation technique with a contrast medium and wire‐guided cannulation without contrast injection for selective biliary cannulation; the latter is the so‐called “double‐guidewire technique” (D‐GW). The aim of this study was to compare the outcomes between P‐GW and D‐GW for biliary cannulation.

Methods

The procedures for biliary cannulation with a naïve papilla were performed in a total of 363 cases. We divided the patients chronologically, according to the time period during which the procedures were performed, into two groups: group A, P‐GW performed from March 2008 to June 2009; and group B, D‐GW performed from July 2009 to December 2010. The success rates and complication rates were evaluated in each group.

Results

Biliary cannulation was successful in 31 (81.6%) patients in the P‐GW group and 34 patients (82.9%) in the D‐GW group. The onsets of postendoscopic retrograde cholangiopancreatography pancreatitis (PEP) occurred in the P‐GW and D‐GW groups were four (10.5%) and three (7.3%) patients, respectively, and all were mild cases (P = 0.616). The frequency of hyperamylasemia and the serum amylase level tended to be lower in the D‐GW group than in the P‐GW group (P = 0.213). There was a statistically significant difference on the onsets of PEP in the GW and non‐GW groups (P = 0.04, 8.9% and 1.1%, respectively).

Conclusions

Both the D‐GW and P‐GW techniques were equally effective for difficult biliary cannulation. Furthermore, the complication rates, including PEP, were similar in both techniques. A prospective randomized trial is warranted.
Effect of probiotic bacteria on the intestinal microbiota in irritable bowel syndrome
Authors: Ng Siew Chien , Lam Emma F C , Lam Tommy T Y , Chan Yawen , Law Wendy , Tse Pete C H , Kamm Michael A , Sung Joseph J Y , Chan Francis K L , Wu Justin C Y
Published: June 2013

Background and Aim

In irritable bowel syndrome (IBS), the gut microbiota may be altered. Probiotic bacteria appear to be therapeutically effective. We characterized the mucosa‐associated microbiota, and determined the clinical and microbiological effects of orally administered probiotic bacteria, in patients with IBS.

Methods

Mucosal microbiota from rectal biopsies of IBS patients and controls were assessed on the V1 and V2 variable regions of the 16S ribosomal RNA gene amplified using 454 pyrosequencing. Clinical symptoms and changes in mucosal microbiota were assessed in IBS patients before and after 4 weeks of treatment with probiotic mix VSL#3.

Results

Ten IBS subjects (eight female; mean age 46 years) were included. At week 4 of probiotic therapy, six patients showed symptom improvement on global symptom assessment compared with baseline (P = 0.031). Before therapy, intestinal microbiota of IBS subjects differed significantly from that of healthy controls, with less diversity and evenness than controls (n = 9; P < 0.05), increased abundance of Bacteroidetes (P = 0.014) and Synegitestes (P = 0.017), and reduced abundance of Actinobacteria (P = 0.004). The classes Flavobacteria (P = 0.028) and Epsilonproteobacteria (P = 0.017) were less enriched in IBS. Abundance differences were largely consistent from the phylum to genus level. Probiotic treatment in IBS patients was associated with a significant reduction of the genus Bacteroides (all taxonomy levels; P < 0.05) to levels similar to that of controls.

Conclusion

In this pilot study, global and deep molecular analysis demonstrates an altered mucosal microbiota composition in IBS. Probiotic leads to detectable changes in the microbiota. These effects of probiotic bacteria may contribute to their therapeutic benefit.
Achievement of 10‐year survival: A case of pubic bone recurrence as the primary failure site of chemo‐refractory ovarian clear cell carcinoma
Authors: Akashi Daisuke , Todo Yukiharu , Okamoto Kazuhira , Minobe Shinichiro , Kato Hidenori
Published: June 2013

Clear cell carcinoma of the ovary tends to have a poor response to conventional platinum‐based chemotherapy. Bone recurrence from ovarian cancer is rare and prognosis of patients with such a condition is poor. We report a patient with chemo‐refractory ovarian clear cell carcinoma who developed pubic bone recurrence and subsequent para‐aortic node recurrence. The patient achieved long‐term survival after salvage surgery twice in spite of these inauspicious conditions. Surgical treatment should be taken into consideration for skeletal recurrence from ovarian clear cell carcinoma.