bluuebunny/crossref_metadata_2025 huggingface dataset:
Faeyee: allocation of constrained business resources for production of competitive products from cost accounting perspectives
Authors: Li Ji , Wu Di
Published: December 2017

Synopsis

Faeyee Electronics was an electronics company that manufactured and sold smartphones including XS and XT types. The management of Faeyee wanted to pursue the maximum contribution margin as much as possible, especially since they were faced with limited resources. It was necessary to apply analytical tools and cost accounting concepts to study this case including cost-volume-profit analysis, learning curve analysis, regression analysis, definitions of competitive products, constrained non-linear optimization, and contribution margin.

Research methodology

The case uses business analytics tools and cost accounting concepts, including regression models and constrained optimization approaches, to study how to maximize business outcomes, such as contribution margin and profits when limited business resources are available. The company and individuals are disguised.

Relevant courses and levels

This case can be used in any junior-, senior-, masters- or MBA-level managerial accounting course. Students need to have at least one course of introduction to statistics or instructors review required statistics concepts or techniques before assigning this case. Students are exposed to the challenges of deriving learning curve models, using regression analysis to study collected data and allocating limited resources to maximize contribution margin.
A profile of high-performing global virtual teams
Authors: Lippert Helge , Dulewicz Victor
Published: December 2017

Purpose

There is a paucity of research into high-performing virtual teams. This study aims to design and test a model of virtual team performance and to produce a profile of high-performing teams.

Design/methodology/approach

The main constructs found to have influenced virtual team performance in business were trustworthiness, commitment, communication characteristics, cross-cultural communication style and structure effects. New or revised scales to measure these and a new performance measure, based on five performance criteria, were developed. A research model was designed and tested, and a profile of high-performance teams produced. The sample from a global telecoms company comprised 108 global virtual teams. Two senior managers rated performance independently.

Findings

Hierarchical regression results explained 75.7 per cent of the variance of performance. Analysis of variance revealed that model fit was highly statistically significant. Trustworthiness was identified as the predominant factor, explaining a majority of the dependent variable’s variance, while interpersonal communication, commitment and cross-cultural communication style were also identified as important. The 52 items differentiating high- and low-performing teams are reported and discussed.

Originality/value

The research model makes a contribution to team performance theory and understanding, especially the relative importance of constructs for explaining performance. The profile of high-performing teams adds greatly to our knowledge and provides valuable guidance for team management, selection and development.
Interleukin‐17 family cytokines in protective immunity against infections: role of hematopoietic cell‐derived and non‐hematopoietic cell‐derived interleukin‐17s
Authors: Matsuzaki Goro , Umemura Masayuki
Published: December 2017

Interleukin‐17 family cytokines, consisting of six members, participate in immune response in infections and autoimmune and inflammatory diseases. The prototype cytokine of the family, IL‐17A, was originally identified from CD4+ T cells which are now termed Th17 cells. Later, IL‐17A‐producing cells were expanded to include various hematopoietic cells, namely CD8+ T cells (Tc17), invariant NKT cells, γδ T cells, non‐T non‐B lymphocytes (termed type 3 innate lymphoid cells) and neutrophils. Some IL‐17 family cytokines other than IL‐17A are also expressed by CD4+ T cells: IL‐17E by Th2 cells and IL‐17F by Th17 cells. IL‐17A and IL‐17F induce expression of pro‐inflammatory cytokines to induce inflammation and anti‐microbial peptides to kill pathogens, whereas IL‐17E induces allergic inflammation. However, the functions of other IL‐17 family cytokines have been unclear. Recent studies have shown that IL‐17B and IL‐17C are expressed by epithelial rather than hematopoietic cells. Interestingly, expression of IL‐17E and IL‐17F by epithelial cells has also been reported and epithelial cell‐derived IL‐17 family cytokines shown to play important roles in immune responses to infections at epithelial sites. In this review, we summarize current information on hematopoietic cell‐derived IL‐17A and non‐hematopoietic cell‐derived IL‐17B, IL‐17C, IL‐17D, IL‐17E and IL‐17F in infections and propose functional differences between these two categories of IL‐17 family cytokines.
Nesting sites of giant honeybees modulated by landscape patterns
Authors: Pavageau Charlotte , Gaucherel Cédric , Garcia Claude , Ghazoul Jaboury
Published: December 2017

The composition of agro‐ecological landscapes is thought to have important implications for the production of major crops through its effects on pollinator abundance and behaviour.

We explored the roles of land cover and land cover heterogeneity on bee nest distribution for the giant honeybee Apis dorsata, a key species for coffee pollination, in a complex agroforest landscape. We emphasized scaling and non‐uniform effects by combining two different approaches of spatial analysis, the point‐pattern analysis and surface‐pattern analysis.

We found non‐exclusive, positive effects of agroforests, forest fragments and land‐cover heterogeneity on the presence and number of nests. The distribution of nests responded to habitat heterogeneity at small scale (<100 m), forest fragments at medium scale (<300 m) and to agroforest at larger scales (500 m to 2 km). Our multiple approaches highlight that the landscape effects were neither linear nor uniform within the study zone. Nests were consistently located in areas of medium agroforest density or medium to high forest density, but were absent where forest fragments are the most concentrated.

The agroforest matrix was particularly important in shaping the size of nest aggregates. Nests tended to be few when there is low tree cover at broad scale, while nests were numerous when agroforest patches are abundant within the bees’ foraging range.

Synthesis and applications. Our study revealed that structurally complex landscapes appear to support bee populations. The spatial arrangement of different land covers affected honeybee nest distributions by providing nesting and foraging resources across multiple scales. The results suggest that continued intensification of small forest fragments and expansion of large monospecies plantations will be deleterious to the populations of giant honeybees A. dorsata. Fragmentation of the agroforestry matrix at small scales (100s m) does not, however, appear detrimental for A. dorsata as long as sufficient diversified resources are available at the landscape scale (kms).
Teacher–child relationships and classroom‐learning behaviours of children with developmental language disorders
Authors: Rhoad‐Drogalis Anna , Justice Laura M. , Sawyer Brook E. , O'Connell Ann A.
Published: December 2017

Background

Children with developmental language disorders (DLDs) often struggle with classroom behaviour. No study has examined whether positive teacher–child relationships may act as a protective factor for children with DLDs in that these serve to enhance children's important classroom‐learning behaviours.

Aims

To examine the association between the quality of teacher–child relationships and teacher‐rated classroom‐learning behaviours of children with DLDs in both preschool and kindergarten.

Methods & Procedures

Longitudinal data were collected on 191 preschoolers (mean = 42.4 months of age, SD = 11.6 months) with DLDs in special education classrooms during preschool and in kindergarten. Teacher–child relationship quality was assessed in preschool, and children's classroom‐learning behaviours were measured in preschool and kindergarten. Regression models were used to examine the relationship between teacher–child relationship quality and children's concurrent and future classroom‐learning behaviours.

Outcomes & Results

Positive teacher–child relationship quality in preschool was associated with better classroom‐learning behaviours in preschool and kindergarten for children with DLDs. Preschool teacher–child relationship quality characterized by low levels of conflict and high levels of closeness was associated with positive classroom‐learning behaviours during preschool. Teacher–child conflict but not closeness was predictive of children's classroom‐learning behaviours in kindergarten.

Conclusions & Implications

These results suggest that the quality of the teacher–child relationship for children with DLDs during preschool is associated within their learning‐related behaviours in the classroom both concurrently and in the subsequent year. Findings suggest that teacher–child relationships should be explored as a mechanism for improving the learning‐related behaviours of children with DLDs.
Spatially distinct, temporally stable microbial populations mediate biogeochemical cycling at and below the seafloor in hydrothermal vent fluids
Authors: Fortunato Caroline S. , Larson Benjamin , Butterfield David A. , Huber Julie A.
Published: December 2017

At deep‐sea hydrothermal vents, microbial communities thrive across geochemical gradients above, at, and below the seafloor. In this study, we determined the gene content and transcription patterns of microbial communities and specific populations to understand the taxonomy and metabolism both spatially and temporally across geochemically different diffuse fluid hydrothermal vents. Vent fluids were examined via metagenomic, metatranscriptomic, genomic binning, and geochemical analyses from Axial Seamount, an active submarine volcano on the Juan de Fuca Ridge in the NE Pacific Ocean, from 2013 to 2015 at three different vents: Anemone, Marker 33, and Marker 113. Results showed that individual vent sites maintained microbial communities and specific populations over time, but with spatially distinct taxonomic, metabolic potential, and gene transcription profiles. The geochemistry and physical structure of each vent both played important roles in shaping the dominant organisms and metabolisms present at each site. Genomic binning identified key populations of SUP05, Aquificales and methanogenic archaea carrying out important transformations of carbon, sulfur, hydrogen, and nitrogen, with groups that appear unique to individual sites. This work highlights the connection between microbial metabolic processes, fluid chemistry, and microbial population dynamics at and below the seafloor and increases understanding of the role of hydrothermal vent microbial communities in deep ocean biogeochemical cycles.
Survival at the Intersection of Government and Business: The Unique Case of the Australian Trade and Investment Commission (Austrade)
Authors: Mascitelli Bruno , Chung Mona
Published: December 2017

The Australian Trade and Investment Commission (Austrade) is a government organization whose responsibility is to promote Australian exports and investment facilitation in global markets. It has a unique position of being a government agency and at the same time working alongside and with business in assisting exporters enter overseas markets. This relationship is often strained both for reasons of changing government preferences in terms of assisting exporters as well as pressures on the government budgets. Yet Austrade has been able to remain a steadfast intersection between government and business despite the competing strategies of its two main stakeholders – government and business. This paper assesses Austrade as a case of organizational survival maintaining its equilibrium through sound management and serendipity.
The biofilm hypothesis: The formation mechanism of Tibetan kefir grains
Authors: Dong Jian , Liu Bin , Jiang Tiemin , Liu Yanpin , Chen Lijun
Published: December 2017

The anatomical structure of Tibetan kefir grains (TKGs), and the monosaccharides and characteristics of the exopolysaccharides (EPS) under different conditions were explored. Tibetan kefir grains are internal vesicle‐like grains containing liquid polysaccharides, and these proliferate in an ‘umbilical cord'‐like manner. Lactic acid bacteria are located on the outside and acetic acid bacteria on the inner surface of the TKGs. Biofilms of Acetobacter orientalis and the TKGs showed that they had similar monosaccharide compositions. The apparent viscosity of the EPS positively correlated with the polysaccharide concentration and negatively correlated with the shear rate. A biofilm hypothesis of the TKG formation mechanism was proposed.
Bacillus and Paenibacillus species associated with extended shelf life milk during processing and storage
Authors: Mugadza Desmond Tichaona , Buys Elna
Published: December 2017

Characterisation of spore formers associated with extended shelf life milk was performed by analysing the bacteriological quality of milk samples collected at various processing stages and during storage. Isolates were identified with MALDI‐TOF‐MS. Milk had spore counts <2 log10 cfu/mL and 4 log10 cfu/mL during processing and storage, respectively. Bacillus pumilus dominated the bacterial population. Bacterial species were inoculated into sterile milk for a shelf life study, and the population change was observed over 42 days at 7 °C. Although the extended shelf life milk process was effective in reducing bacterial counts and species diversity, the presence of Bacillus cereus shows a potential safety problem in extended shelf life milk.
Exploring the Potential of Mesquite Gum–Nopal Mucilage Mixtures: Physicochemical and Functional Properties
Authors: Cortés‐Camargo Stefani , Gallardo‐Rivera Raquel , Barragán‐Huerta Blanca E. , Dublán‐García Octavio , Román‐Guerrero Angélica , Pérez‐Alonso César
Published: December 2017

In this work the physicochemical and functional properties of mesquite gum (MG) and nopal mucilage (NM) mixtures (75‐25, 50‐50, 25‐75) were evaluated and compared with those of the individual biopolymers. MG–NM mixtures exhibited more negative zeta potential (ZP) values than those displayed by MG and NM, with 75‐25 MG–NM showing the most negative value (–14.92 mV at pH = 7.0), indicative that this biopolymer mixture had the highest electrostatic stability in aqueous dispersions. Viscosity curves and strain amplitude sweep of aqueous dispersions (30% w/w) of the individual gums and their mixtures revealed that all exhibited shear thinning behavior, with NM having higher viscosity than MG, and all displaying fluid‐like viscoelastic behavior where the loss modulus predominated over the storage modulus (G″>G′). Differential Scanning Calorimetry revealed that MG, NM, and MG–NM mixtures were thermally stable with decomposition peaks in a range from 303.1 to 319.6 °C. From the functional properties viewpoint, MG (98.4 ± 0.7%) had better emulsifying capacity than NM (51.9 ± 2.0%), while NM (43.0 ± 1.4%) had better foaming capacity than MG. MG–NM mixtures acquired additional functional properties (emulsifying and foaming) regarding the individual biopolymers. Therefore, MG–NM mixtures represent interesting alternatives for their application as emulsifying and foaming agents in food formulations.

Practical Application

Mesquite gum (MG) and nopal mucilage (NM) are promising raw materials with excellent functional properties whose use has been largely neglected by the food industry. This work demonstrates MG–NM mixtures acquired additional functional properties regarding the individual biopolymers, making these mixtures multifunctional ingredients for the food industry.
The race for antimicrobials in the multidrug resistance era
Authors: Molina‐Santiago Carlos , de Vicente Antonio , Romero Diego
Published: December 2017

The appearance of multidrug‐resistant pathogens is a major threat to human health with the reemergence of fatal and untreatable diseases. In addition to a rational use of the well‐known and available antibiotics, two complementary ways to overcome this public health issue are (i) the discovery of new antimicrobials and (ii) the chemical modification of pre‐existing potent antibiotics. In this article, we highlight some of the strategies to generate new and promising antimicrobials for use in the management of these so‐called ‘superbugs’.
Clinical features and outcome of lymphoma patients with pre‐existing autoimmune diseases
Authors: Shih Yu‐Hsuan , Yang Youngsen , Chang Kuang‐Hsi , Chen Yi‐Hsing , Teng Chieh‐Lin Jerry
Published: December 2017

Aims

Previous epidemiological studies have shown that autoimmune diseases increase the risk of lymphoma development. However, whether autoimmune diseases deteriorate the outcomes for lymphoma patients remains unclear. This study aimed to identify the clinical features of lymphoma patients with pre‐existing autoimmune diseases. Whether pre‐existing autoimmune diseases impacted progression‐free survival (PFS) and overall survival (OS) in lymphoma patients was further investigated.

Methods

We retrospectively reviewed medical records of 913 newly diagnosed lymphoma patients from January 2008 to November 2016. Thirty‐four lymphoma patients with pre‐existing autoimmune disorders were identified. Six of these 34 patients were lost to follow‐up; their data was used to examine baseline clinical characteristics but not survival. Therefore, 28 lymphoma patients with autoimmune diseases were included in the autoimmune disease group for comparing the remission rate, PFS and OS to lymphoma patients without autoimmune diseases (control group; n = 56).

Results

Diffuse large B‐cell lymphoma was the most common histological subtype (18/34; 52.94%). Complete remission rates in the autoimmune disease and control groups were 72.0% and 83.3%, respectively (P = 0.178). Patients with and without autoimmune diseases had similar PFS (45.4 ± 59.9 months vs. 51.5 ± 42.8 months; P = 0.398) and OS (46.4 ± 52.6 months vs. 50.1 ± 47.3 months; P = 0.352). By univariate analysis, pre‐existing autoimmune diseases were not associated with inferior PFS (P = 0.326) or OS (P = 0.627).

Conclusions

Lymphoma patients with and without autoimmune disorders had comparable outcomes. Autoimmune diseases are not an obstacle to lymphoma treatment.
Effects of oral glucosamine hydrochloride and mucopolysaccharide protein in a rabbit model of osteoarthritis
Authors: Jeong Da‐Hee , Ullah H. M. Arif , Goo Moon‐Jung , Ghim Soong‐Gu , Hong Il‐Hwa , Kim Ah‐Young , Jeon Sun‐Min , Choi Myung‐Sook , Elfadl Ahmed K. , Chung Myung‐Jin , Lee Eun‐Joo , Kim Yong D. , Kim Jun‐Hyung , Kim Shin‐Yoon , Jeong Kyu‐Shik
Published: December 2017

Aim

The aim was to study whether oral glucosamine hydrochloride (GlcN.HCl) or mucopolysaccharide protein (MucoP) has a structure‐modifying effect on an anterior cruciate ligament transection (ACLT) rabbit model of osteoarthritis (OA).

Methods

OA was surgically induced in the right knees of rabbits by transection of the ACLT. The left knees served as a sham‐operated control. The animals were divided into four groups (n = 6 each): negative control (phosphate buffered saline, orally), positive control (oral celecoxib 10 mg/kg body weight/day), GlcN.HCl (oral 100 mg/kg/day) and MucoP (oral 100 mg/kg/day). Experimental animals were sacrificed after 8 weeks of treatment and the distal femur was removed for macroscopic examination, histological assessment, and terminal deoxynucleotidyl transferase‐mediated nick‐end labeling (TUNEL) assay of the OA rabbits.

Results

On gross morphology, severe lesions were observed in articular cartilage in the negative control group. In the GlcN.HCl and MucoP treatment groups, fibrillations and cartilaginous lesions were significantly (P < 0.05) decreased compared to the negative control group. In particular, degenerative changes in cartilage and chondrocyte cellularity were significantly reduced (P < 0.05) in the positive control (celecoxib) group, GlcN.HCl treatment group and MucoP treatment group compared with the negative control group. TUNEL assay showed that apoptotic chondrocytes were significantly suppressed in the celecoxib group. Similar significant (P < 0.05) results were seen in the GlcN.HCl group and MucoP group but apoptosis of chondrocytes were high in the negative control group.

Conclusion

These data suggest that the protective effects of GlcN.HCl and MucoP may play a useful role in the clinical treatment of OA.
Integrating genetic analysis of mixed populations with a spatially explicit population dynamics model
Authors: Whitlock Rebecca , Mäntyniemi Samu , Palm Stefan , Koljonen Marja‐Liisa , Dannewitz Johan , Östergren Johan
Published: December 2017

Inferring the dynamics of populations in time and space is a central challenge in ecology. Intra‐specific structure (for example genetically distinct sub‐populations or meta‐populations) may require methods that can jointly infer the dynamics of multiple populations. This is of particular importance for harvested species, for which management must balance utilization of productive populations with protection of weak ones.

Here we present a novel method for simultaneous learning about the spatio‐temporal dynamics of multiple populations that combines genetic data with prior information about abundance and movement, akin to an integrated population modelling approach. We apply the Bayesian genetic mixed stock analysis to 17 wild and 10 hatchery‐reared Baltic salmon (S. salar) stocks, quantifying uncertainty in stock composition in time and space, and in population dynamics parameters such as migration timing and speed.

The genetic data were informative about stock‐specific movement patterns, updating priors for migration path, timing and speed. Use of a population dynamics model allowed robust interpolation of expected catch composition at areas and times with no genetic observations. Our results indicate that the commonly used “equal prior probabilities” assumption may not be appropriate for all mixed stock analyses: incorporation of prior information about stock abundance and movement resulted in more plausible and precise estimates of mixture compositions in time and space.

The model we present here forms the basis for optimizing the spatial and temporal allocation of harvest to support the management of mixed populations of migratory species.
Prenatal Alcohol Exposure Increases Histamine H3 Receptor‐Mediated Inhibition of Glutamatergic Neurotransmission in Rat Dentate Gyrus
Authors: Varaschin Rafael K. , Allen Nyika A. , Rosenberg Martina J. , Valenzuela C. Fernando , Savage Daniel D.
Published: December 2017

Background

We have reported that prenatal alcohol exposure (PAE)‐induced deficits in dentate gyrus, long‐term potentiation (LTP), and memory are ameliorated by the histamine H3 receptor inverse agonist ABT‐239. Curiously, ABT‐239 did not enhance LTP or memory in control offspring. Here, we initiated an investigation of how PAE alters histaminergic neurotransmission in the dentate gyrus and other brain regions employing combined radiohistochemical and electrophysiological approaches in vitro to examine histamine H3 receptor number and function.

Methods

Long‐Evans rat dams voluntarily consumed either a 0% or 5% ethanol solution 4 hours each day throughout gestation. This pattern of drinking, which produces a mean peak maternal serum ethanol concentration of 60.8 ± 5.8 mg/dl, did not affect maternal weight gain, litter size, or offspring birthweight.

Results

Radiohistochemical studies in adult offspring revealed that specific [3H]‐A349821 binding to histamine H3 receptors was not different in PAE rats compared to controls. However, H3 receptor‐mediated Gi/Go protein–effector coupling, as measured by methimepip‐stimulated [35S]‐GTPγS binding, was significantly increased in cerebral cortex, cerebellum, and dentate gyrus of PAE rats compared to control. A LIGAND analysis of detailed methimepip concentration–response curves in dentate gyrus indicated that PAE significantly elevates receptor–effector coupling by a lower affinity H3 receptor population without significantly altering the affinities of H3 receptor subpopulations. In agreement with the [35S]‐GTPγS studies, a similar range of methimepip concentrations also inhibited electrically evoked field excitatory postsynaptic potential responses and increased paired‐pulse ratio, a measure of decreased glutamate release, to a significantly greater extent in dentate gyrus slices from PAE rats than in controls.

Conclusions

These results suggest that a PAE‐induced elevation in H3 receptor‐mediated inhibition of glutamate release from perforant path terminals as 1 mechanism contributing the LTP deficits previously observed in the dentate gyrus of PAE rats, as well as providing a mechanistic basis for the efficacy of H3 receptor inverse agonists for ameliorating these deficits.
Gross anatomy of the heart of the alpaca (Vicugna pacos, Linnaeus 1758)
Authors: Pérez W. , Méndez V. , Vazquez N. , Navarrete M. , König H. E.
Published: December 2017

The available information about anatomical characteristics of the cardiovascular system of the alpaca (Vicugna pacos, Linnaeus 1758) is scarce. The general objective of this work was to describe its heart anatomy. We dissected six adult animals and five neonates. The heart of the alpaca was located in the middle mediastinum, with a craniocaudal extension from the third to the sixth rib. No ligament that connected the fibrous pericardium to the sternum or to the diaphragm was detected. In the right atrium, there was a developed crista terminalis and small pectinate muscles. In the right ventricle, the septomarginal trabecula was very large. From the proximities of the interventricular septum arose small septomarginal trabeculae that ended in carnous trabeculae of the septal wall. The left atrium included little developed pectinate muscles. On the left ventricle, both papillary muscles were bilobed. Two left septomarginal trabeculas were detected in this ventricle. The left subclavian artery was originated from the aortic arch separately from the brachiocephalic trunk, and bicarotid trunk was present. The other branches of the subclavian artery were similar to the domestic ruminants. The arterial supply of the heart was of the right type. In conclusion, the heart anatomy of alpaca and the irrigation of thoracic cavity were more similar to those of old world camels and different from domestic ruminants.
Histomorphological features of the tongue of the Eurasian teal (Anas crecca)
Authors: Marzban Abbasabadi B. , Sayrafi R.
Published: December 2017

This study presents the histomorphological features of tongue in Eurasian teal (Anas crecca); the smallest extant dabbling duck. Heads of four adult males and four adult females were used in this study. The results illustrate a tongue with three different parts; the apex with a lingual nail in ventral surface, the body with a lingual prominence in caudal part and some large and small conical papillae in lateral sides and the root, that was covered with many conical papillae in different sizes. Histological results revealed two types of keratinized and non‐keratinized epithelium covering parts of the tongue. The lingual salivary glands were observed in the lamina propria of the body and root of the tongue showed strongly periodic acid–Schiff (PAS)‐positive reaction. The yellow adipose tissue was located under the lamina propria on the body and root of the tongue. The filiform papillae between the conical papillae of the body were arranged densely. The sensory organs, which contain sensory receptors (Grandry and Herbst corpuscles), were located in the lamina propria of the body of the tongue. In conclusion, the anatomical and histological structure of the Eurasian teal’ tongue was generally similar to its family members such as domestic goose and duck but showed some differences that may be adoptions to the bird's habitat and mode of feeding.
Frailty prevalence and factors associated with the Frailty Phenotype and Frailty Index: Findings from the North West Adelaide Health Study
Authors: Thompson Mark Q , Theou Olga , Yu Solomon , Adams Robert J , Tucker Graeme R , Visvanathan Renuka
Published: December 2017

Objective

To determine the prevalence of frailty and associated factors in the North West Adelaide Health Study (2004–2006) using the Frailty Phenotype (FP) and Frailty Index (FI).

Methods

Frailty was measured in 909 community‐dwelling participants aged ≥65 years using the FP and FI.

Results

The FP classified 18% of participants as frail and the FI 48%. The measures were strongly correlated (r = 0.76, P < 0.001) and had a kappa agreement of 0.38 for frailty classification, with 37% of participants classified as non‐frail by the FP being classified as frail by the FI. Being older, a current smoker, and having multimorbidity and polypharmacy were associated with higher frailty levels by both tools. Female, low income, obesity and living alone were associated with the FI.

Conclusion

Frailty prevalence was higher when assessed using the FI. Socioeconomic factors and other health determinants contribute to higher frailty levels.
Treatment of severe recalcitrant pyoderma gangrenosum with ustekinumab
Authors: Low Zhi Mei , Mar Adrian
Published: December 2017

An increased expression of interleukin‐23 has been observed in patients with pyoderma gangrenosum, leading to the use of ustekinumab as a therapeutic option. We report the successful use of ustekinumab in three patients with treatment‐resistant pyoderma gangrenosum of varying clinical presentations.
Transanal endoscopic microsurgery: a New Zealand experience
Authors: Bloomfield Ian , Van Dalen Roelof , Lolohea Simione , Wu Linus
Published: December 2017

Background

Transanal endoscopic microsurgery (TEMS) is a proven alternative therapy to either radical surgery or endoscopic mucosal resection for rectal neoplasms. It has proven benefits with lower morbidity and mortality compared with total mesorectal excision, and a lower local recurrence rate when compared to endoscopic mucosal techniques.

Methods

A retrospective data collection of TEMS procedures performed through Waikato District Health Board, New Zealand, from 2010 to 2015 was conducted. Supportive follow‐up data were sourced from patient records and from local centres around New Zealand.

Results

A total of 137 procedures were performed over the study period, with five being repeat procedures. Procedures were mostly performed for benign lesions (66.4%) with an overall complication rate of 15.3%, only five of which were Clavien–Dindo grade III (3.6%). Our local recurrence rate after resection of benign lesions was 5.1%.

Conclusion

Our data set demonstrates the TEMS procedure to be safe compared to radical resection (total mesorectal excision) for sessile rectal lesions. Close endoscopic follow‐up is recommended, especially for close or incomplete margins. Good therapeutic results can be obtained for appropriately selected early malignant lesions. TEMS provides better oncological results than endoscopic mucosal resection or transanal excision.
Prognostic significance of pre‐operative inflammatory markers in resected gallbladder cancer: a systematic review
Authors: Saqib Rukhtam , Pathak Samir , Smart Neil , Nunes Quentin , Rees Jonathan , Finch Jones Margaret , Poston Graeme
Published: December 2017

Background

Neutrophil to lymphocyte ratio (NLR), C‐reactive protein (CRP) and Glasgow Prognostic Score (GPS) have demonstrated good prognostic value in several cancers but their role in gallbladder cancer (GBC) remains unclear. The aim of this study is to systematically review the current literature to determine their role in predicting survival outcomes in GBC.

Methods

Using a pre‐specified inclusive search strategy MEDLINE, EMBASE and CINAHL databases were used to identify studies describing survival in patients after GBC resection with high or low pre‐operative CRP, GPS or NLR. A proforma was used to extract study author and date, number of patients, age, gender, tumour stage, use of adjuvant therapy and primary outcome data.

Results

In all, 46 studies were identified after initial screening with four studies reporting survival outcomes. All studies described a reduction in survival in patients with an elevated NLR, GPS or CRP. Three studies showed NLR to be an independent prognostic marker and one study additionally demonstrated that elevated CRP and GPS were associated with poorer survival.

Conclusions

Elevated pre‐operative inflammatory markers are inversely related to survival outcomes. They are relatively inexpensive, easy measurable parameters that could aid in the decision making process involved in the management of GBC. Sub‐stratification of groups utilizing inflammatory markers may help guide surgical strategy. However, these studies are retrospective and of low to moderate quality. High quality, prospective studies with well‐defined inclusion criteria and outcomes are needed to guide the role of inflammatory markers in the management of GBC.
Cosmetic tourism for breast augmentation: a systematic review
Authors: Brightman Louise , Ng Sze , Ahern Susannah , Cooter Rodney , Hopper Ingrid
Published: December 2017

Background

The medical tourism industry, and in particular cosmetic tourism for breast augmentation, is becoming an increasingly popular global phenomenon. The objective of this study is to determine the extent of medical literature and the patient risk profiles associated with cosmetic tourism for breast augmentation both locally and abroad. Data sources: OVID MEDLINE, OVID Embase, Cochrane Central and Proquest electronic databases.

Methods

The search was conducted through to April 2017. Studies pertaining entirely or partly to cosmetic tourism for breast augmentation were considered for inclusion. Exclusion criteria included non‐English articles, studies relating to non‐cosmetic or non‐implant breast augmentation, and studies that did not separately report on findings associated with breast augmentation abroad.

Results

We identified 17 observational studies. Common destinations included Europe, South America and South East Asia. Infectious complications were common. Wound dehiscence and aesthetic dissatisfaction also featured. Catastrophic outcomes such as sepsis, intubation and ventilation, radical bilateral mastectomy, irreversible hypoxic brain injury and death were also reported. There were expectations that home country health systems would treat complications and provide non‐medically indicated revision procedures. The burden on home country health systems was evident from a public health perspective.

Conclusion

Determining the extent of cosmetic tourism for breast augmentation, including outcomes and complications, will help to inform Australian patients who this seek procedure abroad. Furthermore, it will aid in better understanding the health system implications and may help to guide future research and public health interventions both locally and internationally.
Regulated Cell Death of Lymphoma Cells after Graded Mitochondrial Damage is Differentially Affected by Drugs Targeting Cell Stress Responses
Authors: Lombardo Tomás , Folgar Martín Gil , Salaverry Luciana , Rey‐Roldán Estela , Alvarez Elida M. , Carreras María C. , Kornblihtt Laura , Blanco Guillermo A.
Published: December 2017

Collapse of the mitochondrial membrane potential (MMP) is often considered the initiation of regulated cell death (RCD). Carbonyl cyanide 3‐chlorophenylhydrazone (CCCP) is an uncoupler of the electron transport chain (ETC) that facilitates the translocation of protons into the mitochondrial matrix leading to the collapse of the MMP. Several cell stress responses such as mitophagy, mitochondrial biogenesis and the ubiquitin proteasome system may differentially contribute to restrain the initiation of RCD depending on the extent of mitochondrial damage. We induced graded mitochondrial damage after collapse of MMP with the mitochondrial uncoupler CCCP in Burkitt's lymphoma cells, and we evaluated the effect of several drugs targeting cell stress responses over RCD at 72 hr, using a multiparametric flow cytometry approach. CCCP caused collapse of MMP after 30 min., massive mitochondrial fission, oxidative stress and increased mitophagy within the 5–15 μM low‐dose range (LDR) of CCCP. Within the 20–50 μM high‐dose range (HDR), CCCP caused lysosomal destabilization and rupture, thus precluding mitophagy and autophagy. Cell death after 72 hr was below 20%, with increased mitochondrial mass (MM). The inhibitors of mitophagy 3‐(2,4‐dichloro‐5‐methoxyphenyl)‐2,3‐dihydro‐2‐thioxo‐4(1H)‐quinazolinone (Mdivi‐1) and vincristine (VCR) increased cell death from CCCP within the LDR, while valproic acid (an inducer of mitochondrial biogenesis) also increased MM and cell death within the LDR. The proteasome inhibitor, MG132, increased cell death only in the HDR. Doxycycline, an antibiotic that disrupts mitochondrial biogenesis, had no effect on cell survival, while iodoacetamide, an inhibitor of glycolysis, increased cell death at the HDR. We conclude that mitophagy influenced RCD of lymphoma cells after MMP collapse by CCCP only within the LDR, while proteasome activity and glycolysis contributed to survival in the HDR under extensive mitochondria and lysosome damage.
Expertise in physiological breech birth: A mixed‐methods study
Authors: Walker Shawn , Parker Pam , Scamell Mandie
Published: December 2017

Background

The safety of vaginal breech birth depends on the expertise of birth attendants, yet the meaning of “expertise” remains unclear and subjectively defined. The objective of this study was to define expertise and the roles experts may play in expanding access to this service.

Methods

We performed an integrative analysis of two strands of data concerning expertise in physiological breech birth, including the following: survey data from a Delphi study involving 26 very experienced clinicians (mean experience = 135 breech births) and 2 service user representatives, and interviews from a grounded theory study of 14 clinicians more moderately experienced with physiological methods (5‐30 upright breech births). Data were pooled and analyzed using constant comparative methods.

Results

Expertise is defined by its ongoing function, the generation of comparatively good outcomes, and confidence and competence among colleagues. Although clinical experience is important, expertise is developed and expressed in social clinical roles, which expand as experience grows: clinician, mentor, specialist, and expert. To develop expertise within a service, clinicians who have an interest in breech birth should be supported to perform these roles within specialist teams.

Conclusions

Specialist breech teams may facilitate the development of expertise within maternity care settings. Evaluation of expertise based on enablement of women and colleagues, as well as outcomes, will potentially avoid the pitfalls of alienation produced by some forms of specialist authority.
Improving services for people with learning disabilities and dementia: Findings from a service evaluation exploring the perspectives of health and social care professionals
Authors: Chapman Melanie , Lacey Huma , Jervis Nicola
Published: December 2017

Accessible summary

Dementia is an illness caused by damage to a person's brain.

People with learning disabilities, especially people with Down's Syndrome, are more likely to get dementia, and when they are younger.

We talked to people working in community learning disability teams to find out what they thought about services and support for people with learning disabilities and dementia and carers.

Screening and assessments mean that people get diagnosis and support more quickly and other problems are picked up.

More appropriate housing and support is needed so people can stay at home for longer.

Research needs to look at the best ways to support people with learning disabilities and dementia.

It is important to find ways to involve people with learning disabilities and dementia and carers in meetings about their support and future research.

Background

Dementia prevalence rates are higher amongst people with learning disabilities than the general population. People with Down's syndrome are at even greater risk of developing dementia and of developing dementia at an earlier age. This study, conducted as part of a wider service evaluation, explored community learning disability team perspectives on screening, pathways, training, information and supports developed to improve services for people with learning disabilities and dementia.

Methods

A focus group was held with health and social care professionals working in community learning disability services. Thematic analysis was used to analyse the data.

Results

The dementia screening, pathways and processes had become embedded in practice, leading to a common framework, an efficient, multidisciplinary, proactive approach, earlier detection and diagnosis of dementia and identification of other health needs and issues. This avoided crisis situations supporting people to remain at home longer. Training and information were felt to improve care quality and reduce caregiver anxiety. People with learning disabilities and caregivers were involved to varying extents. External influences impacting on support included the availability, appropriateness, cost and effectiveness of different models of service provision.

Conclusions

Service developments have been made as a result of the findings which suggest that dementia pathways and supports improve service provision and outcomes for people with learning disabilities. It is important to develop the evidence base on the effectiveness of different service models for people with learning disabilities and dementia. Future studies need to gather views of people with learning disabilities and carers.
Repository corticotrophin injection exerts direct acute effects on human B cell gene expression distinct from the actions of glucocorticoids
Authors: Benko A L , McAloose C A , Becker P M , Wright D , Sunyer T , Kawasawa Y I , Olsen N J , Kovacs W J
Published: December 2017

Repository corticotrophin injection (RCI, H.P Acthar® gel) has been approved for use in the management of multiple autoimmune and inflammatory diseases for more than a half-century, but its mechanism of action is not well understood. We used RNA-Seq methods to define RCI-regulated mRNAs in cultured human B cells under conditions of activation by interleukin (IL)-4 and CD40 ligand. Following IL-4/CD40L activation and RCI treatment we found up-regulation of 115 unique mRNA transcripts and down-regulation of 80 unique mRNAs. The effect on these RNA levels was dose-dependent for RCI and was distinct from changes in mRNA expression induced by treatment with a potent synthetic glucocorticoid. RCI down-regulated mRNAs were observed to include a significant over-representation of genes critical for B cell proliferation under activating conditions. These data confirm that RCI exerts direct effects on human B cells to modulate mRNA expression in specific pathways of importance to B cell function and that, at the molecular level, the effects of RCI are distinct from those exerted by glucocorticoids.
Multidisciplinary management of refractory insulinomas
Authors: Brown Emily , Watkin Daniel , Evans Jonathan , Yip Vincent , Cuthbertson Daniel J.
Published: December 2017

Insulinomas are predominantly benign (~90%), pancreatic neuroendocrine tumours characterized by hyperinsulinaemic hypoglycaemia. They usually present as a small (<2 cm), well‐demarcated, solitary nodule that can arise in any part of the organ. Treatment for sporadic insulinomas is generally aimed at curative surgical resection with special consideration in genetic syndromes. Patients with significant hypoglycaemia can pose a difficult management challenge. In isolated cases where the patient is not medically fit for surgery or with metastatic spread, other treatment options are employed. Medical therapy with diazoxide or somatostatin analogues is commonly used first line for symptom control, albeit with variable efficacy. Other medical options are emerging, including newer targeted biological therapies, including everolimus (an mTOR inhibitor), sunitinib (a tyrosine kinase inhibitor) and pasireotide, a multisomatostatin receptor ligand. Pasireotide and everolimus both cause hyperglycaemia by physiological mechanisms synergistic with its antitumour/antiproliferative effects. Minimally invasive treatment modalities such as ethanol ablation are available in selected cases (particularly in patients unfit for surgery), peptide receptor radionuclide therapy (PRRT) can effectively control tumour growth or provide symptomatic benefit in metastatic disease, while cytotoxic chemotherapy can be used in patients with higher‐grade tumours. This review considers the developments in the medical and other nonsurgical management options for cases refractory to standard medical management. Early referral to a dedicated neuroendocrine multidisciplinary team is critical considering the array of medical, oncological, interventional radiological and nuclear medical options. We discuss the evolving armamentarium for insulinomas when standard medical therapy fails.
Retinal pigment epithelium in the pathogenesis of age‐related macular degeneration and photobiomodulation as a potential therapy?
Authors: Ao Jack , Wood John PM , Chidlow Glyn , Gillies Mark C , Casson Robert J
Published: December 2017

The retinal pigment epithelium (RPE) comprises a monolayer of cells located between the neuroretina and the choriocapillaries. The RPE serves several important functions in the eye: formation of the blood‐retinal barrier, protection of the retina from oxidative stress, nutrient delivery and waste disposal, ionic homeostasis, phagocytosis of photoreceptor outer segments, synthesis and release of growth factors, reisomerization of all‐trans‐retinal during the visual cycle, and establishment of ocular immune privilege. Age‐related macular degeneration (AMD) is the leading cause of blindness in developed countries. Dysfunction of the RPE has been associated with the pathogenesis of AMD in relation to increased oxidative stress, mitochondrial destabilization and complement dysregulation. Photobiomodulation or near infrared light therapy which refers to non‐invasive irradiation of tissue with light in the far‐red to near‐infrared light spectrum (630–1000 nm), is an intervention that specifically targets key mechanisms of RPE dysfunction that are implicated in AMD pathogenesis. The current evidence for the efficacy of photobiomodulation in AMD is poor but its safety profile and proposed mechanisms of action motivate further research as a novel therapy for AMD.