bluuebunny/crossref_metadata_2025 huggingface dataset:
Toyota Kata as a KM solution to the inhibitors of implementing lean service in service companies
Authors: Ferenhof Helio Aisenberg , Da Cunha Andre Henrique , Bonamigo Andrei , Forcellini Fernando Antônio
Published: July 2018

Purpose

This paper aims to resolve the inhibitors of lean service using knowledge management (KM) concepts through the use of Toyota Kata. To achieve this, the authors updated the research on lean supportive practices and inhibitors of lean technical practices presented by Hadid and Afshin Mansouri (2014) through a systematic literature review (SLR). The SLR focused on empirical studies/cases from the past 15 years and confirmed the inhibitors of lean technical practices. As a result, Toyota Kata is proposed as a KM solution to the inhibitors of lean service implementation in service companies.

Design/methodology/approach

The authors carried out an SLR to identify inhibitors of lean service in real case applications and analyzed the resulting bibliographic portfolio using KM as a lens, along with three theories: universal theory, socio-technical systems theory and contingency theory, which assist in highlighting and clarifying the potential impact of using Toyota Kata as a solution to the inhibitors of lean technical practices.

Findings

When the authors analyzed the inhibitors of lean technical practices, they discovered that there is a strong relationship between the inhibitors and the individual (staff) personal characteristics regarding commitment, involvement, communication and preparation. These inhibitors and characteristics should work as a system, and Toyota Kata improves people’s skills and process performance by connecting people, processes and technology. Also, the authors noted that the Toyota Kata concept used can provide benefits in the implementation of lean service for companies, such as the internalization of continuous improvement, this becoming part of the company culture. Moreover, it has been demonstrated that Toyota Kata provides an effective way to achieve KM.

Research limitations/implications

This study may not have enabled a complete coverage of all existing peer-reviewed articles in the field of practices and inhibitors presented by Hadid and Afshin Mansouri (2014). However, it seems reasonable to assume that in this review, a large proportion of the studies available was included.

Practical implications

This paper opens a new perspective on the use of Toyota Kata by managers as a solution to implement KM, spinning the spiral of knowledge.

Originality/value

This is the first study that seeks empirical evidence of inhibitors of lean technical practices and proposes Toyota Kata as a KM Solution for these issues. As a result, this study advances the facility to overcome these inhibitors, opening a new perspective for management to lead in achieving operational excellence.
Naturalness as a safe haven: parental consumption practices and the management of risk
Authors: Andersen Sidse Schoubye , Holm Lotte
Published: July 2018

Purpose

This paper aims to present an analysis of the various dimensions of naturalness that shape the consumption practices of parents with young children.

Design/methodology/approach

The study builds on semi-structured interviews with 17 mothers and fathers focusing on parental decision-making in everyday consumption from pregnancy to the first years of the child’s life.

Findings

Naturalness is a tool allowing parents to navigate in a world of risks and part of an everyday consumption practice that constructs and maintains children as vulnerable and parents as responsible. Parents perceive naturalness as something with three dimensions: familiarity, purity and culture. These three dimensions lead to different parental practices around consumption.

Originality/value

The analysis contributes to the authors’ understanding of parenting, childhood, risk, safety and consumption by showing how and why parents of young children construct naturalness as a three-dimensional ideal in their consumption practices.
Biodiversity along temperate forest succession
Authors: Hilmers Torben , Friess Nicolas , Bässler Claus , Heurich Marco , Brandl Roland , Pretzsch Hans , Seidl Rupert , Müller Jörg
Published: July 2018

The successional dynamics of forests—from canopy openings to regeneration, maturation, and decay—influence the amount and heterogeneity of resources available for forest‐dwelling organisms. Conservation has largely focused only on selected stages of forest succession (e.g., late‐seral stages). However, to develop comprehensive conservation strategies and to understand the impact of forest management on biodiversity, a quantitative understanding of how different trophic groups vary over the course of succession is needed.

We classified mixed mountain forests in Central Europe into nine successional stages using airborne LiDAR. We analysed α‐ and β‐diversity of six trophic groups encompassing approximately 3,000 species from three kingdoms. We quantified the effect of successional stage on the number of species with and without controlling for species abundances and tested whether the data fit the more‐individuals hypothesis or the habitat heterogeneity hypothesis. Furthermore, we analysed the similarity of assemblages along successional development.

The abundance of producers, first‐order consumers, and saprotrophic species showed a U‐shaped response to forest succession. The number of species of producer and consumer groups generally followed this U‐shaped pattern. In contrast to our expectation, the number of saprotrophic species did not change along succession. When we controlled for the effect of abundance, the number of producer and saproxylic beetle species increased linearly with forest succession, whereas the U‐shaped response of the number of consumer species persisted. The analysis of assemblages indicated a large contribution of succession‐mediated β‐diversity to regional γ‐diversity.

Synthesis and applications. Depending on the species group, our data supported both the more‐individuals hypothesis and the habitat heterogeneity hypothesis. Our results highlight the strong influence of forest succession on biodiversity and underline the importance of controlling for successional dynamics when assessing biodiversity change in response to external drivers such as climate change. The successional stages with highest diversity (early and late successional stages) are currently strongly underrepresented in the forests of Central Europe. We thus recommend that conservation strategies aim at a more balanced representation of all successional stages.
Livestock in diverse cropping systems improve weed management and sustain yields whilst reducing inputs
Authors: MacLaren Chloe , Storkey Jonathan , Strauss Johann , Swanepoel Pieter , Dehnen‐Schmutz Katharina
Published: July 2018

Intensive cropping systems select for a low diversity of weeds tolerant of chemical control, leading to persistent weed‐crop competition and declining biodiversity. Crop rotation can mitigate this by introducing variable filters on the weed community through increasing management diversity. In this study, we investigate the effect of integrating livestock into no‐till crop rotations to complement chemical weed control.

We analysed 12 years of weed seedbank data from a trial of eight rotation systems with different crop sequence diversities, of which four included grazed forage phases. Linear mixed models and ordination were used to assess how weed abundance, diversity, and community composition responded to management filters, defined in terms of levels of disturbance strength and diversity (grazing and herbicides), and resource availability and diversity (inorganic fertilizers, legumes, and manure).

Grazed rotation systems had less herbicide applied than ungrazed rotation systems, and had the lowest weed abundance and highest weed diversity. Herbicides and grazing apply contrasting selection pressures on weeds, and this combination was more effective in reducing weed pressure than increasing herbicide quantity or mode‐of‐action diversity. Lower resource availability and higher nitrogen source diversity in grazed systems may have further reduced weed abundance and promoted diversity.

Crop sequence diversity also reduced weed abundance and promoted weed diversity, indicating that variable crop‐weed interactions can enhance weed management. In addition, yields in the main cash crop (wheat) were highest where crop diversity was highest, regardless of whether the system contained grazed phases.

Synthesis and applications. Diverse rotation systems produced high yields, and the inclusion of grazed forage phases maintained these yields at lower applications of herbicides and fertilizers: integrated livestock can therefore improve the sustainability of no‐till systems. The role of grazing as a filter imposing a contrasting selection pressure to other weed control options could be further explored to improve weed management in different farming systems.
China's ‘New Normal’: How will China's Growth Slowdown Affect Australia's Growth?
Authors: Groenewold Nicolaas
Published: July 2018

China's ‘New Normal’ has been widely discussed in both the press and in academic circles. While many aspects of the Chinese economy are expected to change in this situation, an important component of the change is a significant and persistent growth slowdown. Not surprisingly, Australian commentary on China's growth slowdown has focussed on the implications for Australia's growth rate. Evaluations of this effect vary widely but are generally not firmly based on empirical research. This paper helps to fill this gap by analysing the likely effect on Australia's growth rate of a reduction in China's rate of economic growth. The analysis begins with a simple back‐of‐the‐envelope calculation and then moves to regression analysis and the simulation of a vector‐autoregressive model. Estimates are remarkably consistent across a range of models and suggest that the effect on Australia of a permanent fall in China's growth rate from 10% per annum to 7% per annum will be to reduce Australia's growth rate by about 0.2 percentage points in the short run and approximately 0.5 percentage points in the long run. While not trivial, given Australia's current growth rate, these estimates are hardly enough to justify prophesies of doom.
Climate change policy discontinuity and its effects on Australia's national electricity market
Authors: Simshauser Paul , Tiernan Anne
Published: July 2018

Australia's National Electricity Market (NEM) became unstable in 2016/2017 after 20 years of consistent performance. The South Australian grid collapsed on 28 September 2016 – Australia's first black system event since 1964. Wholesale prices in the region trebled to $120+/MWh; soon after Hazelwood power station announced its exit with just 5 months’ notice. The problem spread as prices elsewhere doubled to $89/MWh from a long‐run average of $42.50. The NEM is experiencing a supply‐side crisis. Consistent with the requirement to decarbonise the system, aged coal‐fired generators are exiting but decades of climate change policy discontinuity has frustrated the entry of new plant. Long‐dated capital‐intensive asset industries like electricity supply anticipate a conventional policy cycle. What they have experienced instead is consistent with garbage can theory. Policy clarity may be emerging for only the second time in two decades. As with the NEM, its durability will depend on cooperative federalism.
Vaginal prevalence of human papillomavirus infections in women with uterovaginal aplasia before and after laparoscopically assisted creation of a neovagina: a prospective epidemiological observational study
Authors: Rall KK , Schoenfisch B , Schoeller D , Stefanescu D , Koelle A , Henes M , Huebner M , Taran FA , Seeger H , Iftner A , Iftner T , Brucker SY
Published: July 2018

Objective

To study vaginal as opposed to cervical human papillomavirus (HPV) acquisition with regard to true prevalence, HPV types, and the role of co‐factors in virgins and after their sexual debut.

Design

Prospective epidemiological observational study.

Setting

University hospital specialised in genital malformations.

Population

Women diagnosed with Mayer–Rokitansky–Küster–Hauser syndrome (MRKHS) and undergoing neovaginoplasty between November 2011 and July 2017.

Methods

This is a prospective study including 186 women with MRKHS before and after sexual debut.

Main outcome measures

Conventional vaginal cytology and different HPV tests were performed at surgery and during routine gynaecological follow‐up 1, 3, 6 and ≥ 11 months after surgery and risk factors were documented.

Results

The mean age of all women at surgery was 20.1 years (SD 5.4), mean body mass index (BMI) was 22.1 kg/m2 (SD 4.6). In 83 vaginal samples from 41 different women at least one of the HPV tests was positive. Thirty‐three different HPV types were detected. The prevalence of 41/186 = 22.0% as well as type distribution are comparable with those found in a young German female population. The overall rate of acquisition was clearly associated with sexual activity and smoking habits. Out of 367 Papanicolaou smears only six were abnormal with Pap IIID (MN II) and no obvious vaginal lesion was detected.

Conclusions

Vaginal HPV prevalence and HPV types in previously virgin women after creation of a neovagina are not different from the acquisition of cervical infections in the general population and is clearly associated with sexual activity and with smoking habits. However, abnormal Papanicolaou smears are rarely seen.

Tweetable abstract

Vaginal HPV prevalence after creation of a neovagina is similar to that on the cervix in the general population.
VCAM‐1 upregulation accompanies muscle remodeling following resistance‐type exercise in Snell dwarf (Pit1dw/dw) mice
Authors: Rader Erik P. , Naimo Marshall A. , Ensey James , Baker Brent A.
Published: July 2018

Snell dwarf mice (Pit1dw/dw) exhibit deficiencies in growth hormone, prolactin, and thyroid stimulating hormone. Besides being an experimental model of hypopituitarism, these mice are long‐lived (>40% lifespan extension) and utilized as a model of slowed/delayed aging. Whether this longevity is accompanied by a compromised quality of life in terms of muscular performance has not yet been characterized. In this study, we investigated nontrained and trained muscles 1 month following a general validated resistance‐type exercise protocol in 3‐month‐old Snell dwarf mice and control littermates. Nontrained Snell dwarf gastrocnemius muscles exhibited a 1.3‐fold greater muscle mass to body weight ratio than control values although muscle quality, maximum isometric torque normalized to muscle mass, and fatigue recovery were compromised. For control mice, training increased isometric torque (17%) without altering muscle mass. For Snell dwarf mice, isometric torque was unaltered by training despite decreased muscle mass that rendered muscle mass to body weight ratio comparable to control values. Muscle quality and fatigue recovery improved twofold and threefold, respectively, for Snell dwarf mice. This accompanied a fourfold increase in levels of vascular cell adhesion molecule‐1 (VCAM‐1), a mediator of progenitor cell recruitment, and muscle remodeling in the form of increased number of central nuclei, additional muscle fibers per unit area, and altered fiber type distribution. These results reveal a trade‐off between muscle quality and longevity in the context of anterior pituitary hormone deficiency and that resistance‐type training can diminish this trade‐off by improving muscle quality concomitant with VCAM‐1 upregulation and muscle remodeling.
Lost in virtual gaming worlds: Grit and its prognostic value for online game addiction
Authors: Borzikowsky Christoph , Bernhardt Fabian
Published: July 2018

Background and Objectives

The personality construct grit is defined as the ability to be persistent in pursuit of long‐term goals in spite of challenges or obstacles. Grit is an emerging concept in positive psychology and has gained much attention because of its relevance for success and well‐being across different domains. The aim of the present study was to examine the prognostic value of grit for online game addiction.

Methods

We surveyed German speaking online gamers (N = 305: 193 males and 112 females, Mage = 28.44 years, SDage = 8.88) in an online cross‐sectional self‐report study. We measured grit with the German version of the Short Grit Scale (BISS‐8), online game addiction with the short version of the Game Addiction Scale (GAS), and participants’ age and gender.

Results

Structural equation modeling supported the higher‐order factor structure of grit in our sample (χ2[18] = 29.31, p < .05; CFI = .980; TLI = .969; RMSEA = .045; SRMR = .038). A logistic regression revealed that both grit (OR = 0.62, 95%CI [.42; .89], p < .05) as well as age (OR = .92, 95%CI [.88; .97], p < .01) significantly reduced the likelihood of being addicted to online games.

Discussion and Conclusions

In line with previous research on grit in patients with substance use disorders, we found grit to be a protective factor against online game addiction. We concluded that higher grit scores and older ages decrease the likelihood of being addicted to online games.

Scientific Significance

This study provides initial support for the clinical relevance of grit for online game addiction. (Am J Addict 2018;27:433–438)
Donor sclera versus bovine pericardium as patch graft material in glaucoma implant surgery and the impact of a drainage suture
Authors: van Hoefen Wijsard Milo , Haan Michiel , Rietveld Eelco , van Rijn Laurentius J.
Published: July 2018

Purpose

To compare the use of human donor sclera with bovine pericardium as patch graft material for a glaucoma drainage device (GDD), with respect to the incidence of tube exposure, and to study the role of a drainage suture.

Methods

All GDD surgeries between 2010 and 2014 performed at the VU Medical Center were examined in this comparative, retrospective cohort study. A total of 244 cases were included; 163 in the human donor sclera cohort and 81 in the bovine pericardium cohort with a median follow‐up of 31 and 36 months, respectively. The primary outcome measure was occurrence of tube exposure. Survival analysis for tube exposure was carried out and Kaplan–Meier curves compared. Secondary outcomes were postoperative intraocular pressure (IOP), number of glaucoma medications and the effect of a drainage suture.

Results

In the bovine pericardium cohort, eleven (13.6%) eyes developed tube exposure compared to none in the human donor sclera cohort. Their Kaplan–Meier survival curves differed significantly from each other (χ² = 21.1, p < 0.001, log‐rank test). Mean IOP and number of glaucoma medications did not differ significantly between patch graft materials at three months of follow‐up. The use of a drainage suture directly lowered IOP after surgery in both cohorts. Within the bovine pericardium cohort, eyes with a drainage suture experienced more tube exposure, although this difference was not statistically significant (p = 0.09).

Conclusion

Human donor sclera leads to less tube exposure than bovine pericardium. A drainage suture directly lowers IOP after surgery. With bovine pericardium, but not with donor sclera, exposure tends to be enhanced by a drainage suture.
Behavioural dysfunctions of 10‐year‐old children born extremely preterm associated with corticotropin‐releasing hormone expression in the placenta
Authors: Leviton Alan , Allred Elizabeth N. , Joseph Robert M. , O'Shea Thomas Michael , Majzoub Joseph , Kuban Karl C. K. ,   the ELGAN Study Investigators
Published: July 2018

Aim

To evaluate the relationship between corticotropin‐releasing hormone (CRH) expression in the placenta and the risk of school‐related dysfunctions at the age of 10 years among children born extremely preterm (EP).

Methods

Corticotropin‐releasing hormone expression was measured in the placenta of 761 EP children, who had the following assessments at the age of 10 years: Differential Ability Scales, Oral and Written Language Scales, the Wechsler Individual Achievement Test‐III, NEPSY‐II and the Child Symptom Inventory‐4. We evaluated whether lowest and highest quartiles of CRH mRNA were associated with undesirable scores on these assessments. With 272 evaluations, we would expect 14 to be significant at p < 0.05.

Results

Only 16 associations were statistically significant. On the other hand, seven of these were social limitations among girls whose placenta CRH mRNA was in the top quartile. Adjusting for delivery indication or restricting the sample to one delivery indication group resulted in few differences.

Conclusion

Overall, placenta CRH mRNA concentrations in the top or bottom quartiles were not associated with increased risks of dysfunctions 10 years later. Girls whose placenta CRH expression was in the top quartile, however, were at increased risk of seven indicators/correlates of social limitations.
Clarifying the Associations between Mindfulness Meditation and Emotion: Daily High‐ and Low‐arousal Emotions and Emotional Variability
Authors: Jones Dusti R. , Graham‐Engeland Jennifer E. , Smyth Joshua M. , Lehman Barbara J.
Published: July 2018

Background

Research examining the effects of mindfulness meditation (MM) on emotion seldom considers differences by arousal level or emotion variability.

Methods

In the present study, 115 participants (64% Female, 72% White, Mage = 19.03) were randomly assigned to a brief MM intervention condition (n = 60) or a wait‐list control condition (n = 51). Participants in the MM condition were trained in MM and instructed to practice MM daily for one week. All participants provided daily diary reports of both higher‐ and lower‐arousal positive (PE) and negative (NE) emotions. Emotions were weighted by valence and arousal. Multilevel modeling was used to examine valence, arousal, and their interaction; multivariate regression was used to examine emotional variability.

Results

More time spent meditating (but not the MM condition itself) was associated with increased lower arousal emotions, and exhibited a significant effect on the interaction between valence and arousal. Examination of individual emotion items suggested that more time meditating significantly predicted increased feelings of quiet and calm and marginally increased relaxation and sleepiness among participants, but did not predict any other emotions assessed in daily life. MM was not associated with emotional variability.

Conclusion

These results may suggest that PE should be separated by arousal when examining the effects of MM interventions.
Absorbable barbed suture device for laparoscopic peritoneal closure after hernia repair via the transabdominal preperitoneal approach: A single‐center experience with 257 cases
Authors: Chihara Naoto , Suzuki Hideyuki , Sukegawa Makoto , Watanabe Masanori , Oyama Rina , Shimizu Takao , Uchida Eiji
Published: July 2018

Introduction

The laparoscopic transabdominal preperitoneal approach requires peritoneal closure and technically skilled knotting. We have started to use a barbed running suturing device (V‐Loc 180) without knotting for transabdominal preperitoneal repair of hernias. This study aimed to determine whether using V‐Loc 180 was safe and shortened the time for laparoscopic peritoneal closure.

Methods

Between December 2010 and February 2017, 3‐0 V‐Loc 180 and a multifilament absorbable running suture (3‐0 Vicryl) were used for three‐port transabdominal preperitoneal repair of inguinal hernia in 363 cases. Data including peritoneal closure time and the complications were retrospectively recorded.

Results

Factors identified as significantly prolonging the peritoneal closure time were the hernia side (P = 0.0269), the type of hernia (P = 0.001), the suture device used (P < 0.0001), and the surgeon's experience (P < 0.0001). Use of the barbed suture was associated with a significantly shorter peritoneal closure time than the multifilament suture (mean closure time: 10.2 and 12.7 min, respectively). While there were no postoperative complications in the barbed suture group, there were two cases (1.9%) of postoperative complications in the multifilament suture group (P = 0.0272).

Conclusion

We demonstrated that the use of the barbed suturing device for laparoscopic peritoneal closure was safe and feasible.
A Robust Approach to Sample Size Calculation in Cancer Immunotherapy Trials with Delayed Treatment Effect
Authors: Ye Ting , Yu Menggang
Published: July 2018

Immunotherapies are taking the center stage for cancer drug development and research. Many of these therapies, for example, immune checkpoint inhibitors, are known to have possible lag periods to achieve their full effects. Therefore, the proportional hazard assumption is violated when comparing survival curves in randomized clinical trials evaluating such therapies. Limited work exists in determining sample size to account for the lag period which is usually unknown. Assuming that the lag period is within some reasonable range, this article presents an approach to calculate sample size based on a maximin efficiency robust test. Both theoretical derivations and simulation results show the proposed approach can guarantee the desired power in worst case scenarios and often much more efficient than existing approaches. Application to a real trial design is also illustrated.
Model Assisted Sensitivity Analyses for Hidden Bias with Binary Outcomes
Authors: Nattino Giovanni , Lu Bo
Published: July 2018

In medical and health sciences, observational studies are a major data source for inferring causal relationships. Unlike randomized experiments, observational studies are vulnerable to the hidden bias introduced by unmeasured confounders. The impact of unmeasured covariates on the causal effect can be assessed by conducting a sensitivity analysis. A comprehensive framework of sensitivity analyses has been developed for matching designs. Sensitivity parameters are introduced to capture the association between the missing covariates and the exposure or the outcome. Fixing sensitivity parameter values, it is possible to compute the bounds of the p-value of a randomization test on causal effects. We propose a model assisted sensitivity analysis with binary outcomes for the general 1:k matching design, which provides results equivalent to the conventional nonparametric approach in large sample. By introducing a conditional logistic outcome model, we substantially simplify the implementation and interpretation of the sensitivity analysis. More importantly, we are able to provide a closed form representation for the set of sensitivity parameters for which the maximum p-values are non-significant. This methodology can be easily extended to matching designs with multilevel treatments. We illustrate our method using a U.S. trauma care database to examine mortality difference between trauma care levels.
Estimating the Causal Effect of Treatment Regimes for Organ Transplantation
Authors: Boatman Jeffrey A. , Vock David M.
Published: July 2018

Patients awaiting cadaveric organ transplantation face a difficult decision if offered a low-quality organ: accept the organ or remain on the waiting list and hope a better organ is offered in the future. A dynamic treatment regime (DTR) for transplantation is a rule that determines whether a patient should decline an offered organ. Existing methods can estimate the effect of DTRs on survival outcomes, but these were developed for applications where treatment is abundantly available. For transplantation, organ availability is limited, and existing methods can only estimate the effect of a DTR assuming a single patient follows the DTR. We show for transplantation that the effect of a DTR depends on whether other patients follow the DTR. To estimate the anticipated survival if the entire population awaiting transplantation were to adopt a DTR, we develop a novel inverse probability weighted estimator (IPCW) which re-weights patients based on the probability of following their transplant history in the counterfactual world in which all patients follow the DTR of interest. We estimate this counterfactual probability using hot deck imputation to fill in data that is not observed for patients who are artificially censored by IPCW once they no longer follow the DTR of interest. We show via simulation that our proposed method has good finite-sample properties, and we apply our method to a lung transplantation observational registry.
Biological Sensitivity to the Effects of Maternal Postpartum Depressive Symptoms on Children's Behavior Problems
Authors: Somers Jennifer A. , Luecken Linda J. , Spinrad Tracy L. , Crnic Keith A.
Published: July 2018

Resting respiratory sinus arrhythmia (RSA) may confer infant susceptibility to the postpartum environment. Among infants with higher RSA, there may be a positive relation between depressive symptoms across the first 6 months postpartum (PPD) and later behavior problems, and toddlers’ dysregulation during mother–child interactions may partially explain the effects. Among a sample of low‐income Mexican‐American families, infant RSA (N = 322; 46% male) was assessed at 6 weeks of age; mothers (Mage = 27.8, SD = 6.5) reported PPD symptoms every 3 weeks from 6 to 24 weeks and infant behavior problems at 36 months. Dysregulation was observed at 24 months. PPD was positively associated with behavior problems only among infants with lower RSA; however, this relation was not mediated by dysregulation.
Gly m 5/Gly m 8 fusion component as a potential novel candidate molecule for diagnosing soya bean allergy in Japanese children
Authors: Maruyama Nobuyuki , Sato Sakura , Cabanos Cerrone , Tanaka Akira , Ito Komei , Ebisawa Motohiro
Published: July 2018

Background

Soya bean is a major food allergen in children. Component‐resolved diagnostics has improved the accuracy of diagnosing immunoglobulin E (IgE)‐mediated food allergies.

Objective

We aimed to develop a novel component for the diagnosis of soya bean allergy using recombinant technology.

Methods

Japanese paediatric patients with suspected soya bean allergy (n = 91) were included, and symptomatic (n = 40) and asymptomatic (n = 51) cases were divided through oral food challenge testing. Specific IgE (sIgE) antibodies to each recombinant allergen component were analysed by enzyme‐linked immunosorbent assay, and the diagnostic performances of the components were assessed by area under the receiver operating characteristic curves (AUC).

Results

Among the recombinant components, sIgE antibody levels to Gly m 8 showed the highest AUC (0.706). A combination of Gly m 8 and α’ subunit of Gly m 5, improved the diagnostic performance of the single components. Moreover, the N‐terminal extension region of α’ subunit of Gly m 5, which has low cross‐reactivity among the vicilins, showed higher diagnostic performance (AUC 0.695) than the full‐length α’ subunit of Gly m 5 (AUC 0.613). Based on these findings, we developed a fusion protein of Gly m 8 plus the extension region of α’ subunit of Gly m 5; this fusion protein was very efficient for diagnosing soya bean allergy (AUC 0.801).

Conclusion

A fusion protein of Gly m 8 and the extension region of α’ subunit of Gly m 5 could potentially diagnose soya bean allergy in paediatric patients. Fusion proteins may be useful for producing novel allergen components with improved diagnostic value.
Inter‐related effects of insulin resistance, hyperandrogenism, sympathetic dysfunction and chronic inflammation in PCOS
Authors: Shorakae Soulmaz , Ranasinha Sanjeeva , Abell Sally , Lambert Gavin , Lambert Elisabeth , de Courten Barbora , Teede Helena
Published: July 2018

Objective

Insulin resistance, hyperandrogenism, sympathetic dysfunction and chronic low‐grade inflammation may act together in a vicious cycle in the pathophysiology of PCOS. However, the inter‐relationships of these components are not fully understood. We aimed to study these mechanisms in the pathophysiology of PCOS.

Participants and methods

Premenopausal women with PCOS (Rotterdam diagnostic criteria) and without PCOS were recruited from a community setting into a cross‐sectional substudy within a randomized control trial. Insulin resistance (fasting insulin and glucose), hyperandrogenism (testosterone, sex hormone‐binding globulin [SHBG] and Free Androgen Index [FAI]), muscle sympathetic nerve activity (MSNA) and markers of chronic low‐grade inflammation (high sensitivity C‐reactive protein [hs‐CRP] and high molecular weight adiponectin [HMW‐adiponectin]) were measured.

Results

Forty‐nine women with PCOS (mean age 30 ± 6 mean BMI 29 ± 5) and 23 controls (mean age 29 ± 8 mean BMI 33 ± 7) with included in this analysis. MSNA and testosterone level were most significantly associated with PCOS status, after adjustment for age and BMI. In women with PCOS, markers of sympathetic activity correlated inversely with HMW‐adiponectin and HMW‐adiponectin correlated inversely with FAI. Testosterone and FAI both correlated positively with insulin resistance in women PCOS.

Conclusion

Sympathetic dysfunction and hyperandrogenism are significantly associated with PCOS. Chronic low‐grade inflammation potentially mediates the effect of sympathetic dysfunction on hyperandrogenism and insulin resistance.
Transanal endoscopic microsurgery as day surgery – a single‐centre experience with 500 patients
Authors: Brown C. J. , Gentles J. Q. , Phang T. P. , Karimuddin A. A. , Raval M. J.
Published: July 2018

Aim

Transanal endoscopic microsurgery (TEM) is the current treatment of choice for rectal adenomas and early rectal cancer. Postoperative admission to hospital is common but possibly unnecessary. Our objective was to analyse predictors and outcomes of TEM patients having same day discharge (TEM‐D) compared with those who were admitted to hospital (TEM‐A).

Method

At St Paul's Hospital (SPH), demographic, surgical, pathological and follow‐up data have been collected prospectively since TEM was started in 2007. Trends in admission and readmission rates were analysed using the Cochran–Armitage trend test, and predictors of admission were analysed using univariate and multivariate logistic regressions.

Results

Between 2007 and 2016, 500 patients were treated by TEM at SPH. The overall admission rate was 29% (145/500), but this decreased to 19% in the last 3 years of the study (P < 0.001). The readmission rate was 5.2% (n = 26/500) and did not change significantly over the study period (P = 0.30). Reasons for admission included the following: surgeon discretion/monitoring (35%), urinary retention (26%), haemorrhage (10%), breach of peritoneal cavity (7%), infection (7%) and other (15%). The most common reasons for readmission were haemorrhage (54%, n = 14), pain (19%, n = 5) and infection (12%, n = 3). Factors associated with admission were as follows: tumour height (OR 1.09, 1.02–1.17), prolonged operative time (OR 1.25, 1.14–1.37), unsutured surgical defect (OR 1.99, 1.22–3.25) and surgeon experience (OR 4.62, 2.75–7.77).

Conclusion

Outpatient TEM is safe and carries a low risk of readmission. In centres with an outpatient TEM strategy, predictors of hospital admission include proximal tumours, prolonged surgical time and open management of the surgical defect.
The synthesis and spectroscopic characterisation of 3‐formyl‐2‐quinolones in the presence of biothiols
Authors: Grzelakowska Aleksandra , Kolińska Jolanta , Mąkiewicz Mariusz
Published: July 2018

The derivatives of 3‐formyl‐2(1H)‐quinolones and N‐methyl‐3‐formyl‐2‐quinolones substituted in the 6‐position with either a methyl or a methoxy group were synthesised and evaluated as potential sensors for the detection of thiol amino acids. Their spectroscopic properties, including absorption and emission spectra, fluorescence quantum yields and singlet lifetimes, were examined. The behaviour of the obtained compounds was studied at pH 7.4 in the presence of various amino acids. The results show that these compounds demonstrate a high turn‐off fluorescence response and selectivity toward L‐cysteine in the presence of other amino acids, and have the potential to act as sensors to L‐cysteine.
Spawning aggregations act as a bottleneck influencing climate change impacts on a critically endangered reef fish
Authors: Asch Rebecca G. , Erisman Brad
Published: July 2018

Aim

Most projections of how climate change will affect species distributions and phenology are based on a species’ most conspicuous life stage. However, not all life stages are equally sensitive to temperature. Among fishes, spawning adults often have narrower thermal tolerances than other life stages and may constrain population responses to climate change. We tested this hypothesis using data on Nassau Grouper (Epinephelus striatus), an endangered coral reef fish.

Location

Greater Caribbean.

Methods

Species distribution models of spawning and nonspawning adults were compared to determine which environmental variables exerted the greatest influence on grouper distribution. We calculated the thermal niche and ecological niche breadth of both life stages. An earth system model was applied to project how species distribution and phenology shift under two climate change scenarios.

Results

Sea surface temperature and seasonal temperature gradients affected the distribution of both spawning and nonspawning adults, but these life stages differed in their preferred temperatures and reaction to oceanic currents. While the two life stages exhibited similar ecological niche breadth, the thermal niche of spawners was narrower. By 2081–2100, potential spawning habitat was projected to decline under a business‐as‐usual scenario by 82% relative to 1981–2000, whereas suitable habitat for nonspawners decreased by 46%. Poleward shifts in latitude occurred 3.8–4.2 times faster for spawners than nonspawners. These changes were attributed to rising temperatures, whereas hydrographical changes did not have a substantial impact. Spawning phenology changed little, with a slight contraction in spawning season but a large reduction in spawning probability across all months.

Main Conclusions

A narrow thermal tolerance range among spawning fishes indicates that this life stage may be a bottleneck constraining responses to climate change. Future research should consider the reaction of each life stage to changing conditions. Conservation of E. striatus should take shifting distribution and phenology into account, as climate effects may exacerbate population declines due to fishing and reduce the efficacy of conservation measures.
Mycorrhizal symbiosis increases the benefits of plant facilitative interactions
Authors: Montesinos‐Navarro Alicia , Valiente‐Banuet Alfonso , Verdú Miguel
Published: July 2018

The diversity of pathways through which mycorrhizal fungi alter plant coexistence hinders the understanding of their effects on plant‐plant interactions. The outcome of plant facilitative interactions can be indirectly affected by mycorrhizal symbiosis, ultimately shaping biodiversity patterns. We tested whether mycorrhizal symbiosis enhances plant facilitative interactions and whether its effect is consistent across different methodological approaches and biological scenarios. We conducted a meta‐analysis of 215 cases (involving 21 nurse and 29 facilitated species), in which the performance of a facilitated plant species is measured in the presence or absence of mycorrhizal fungi. We show that mycorrhizal fungi significantly enhance plant facilitative interactions mainly through an increment in plant biomass (aboveground) and nutrient content, although their effects differ across biological contexts. In semiarid environments mycorrhizal symbiosis enhances plant facilitation, while its effect is non‐significant in temperate ecosystems. In addition, arbuscular but not ecto‐mycorrhizal (EMF) fungi significantly enhance plant facilitation, particularly increasing the P content of the plants more than EMF. Some knowledge gaps regarding the importance of this phenomenon have been detected in this meta‐analysis. The effect of mycorrhizal symbiosis on plant facilitation has rarely been assessed in other ecosystems different from semiarid and temperate forests, and rarely considering other fungal benefits provided to plants besides nutrients. Finally, we are still far from understanding the effects of the whole fungal community on plant‐plant interactions, and on plant species coexistence.
Tolerance traits related to climate change resilience are independent and polygenic
Authors: Healy Timothy M. , Brennan Reid S. , Whitehead Andrew , Schulte Patricia M.
Published: July 2018

The resilience of organisms to climate change through adaptive evolution is dependent on the extent of genetically based variation in key phenotypic traits and the nature of genetic associations between them. For aquatic animals, upper thermal tolerance and hypoxia tolerance are likely to be a important determinants of sensitivity to climate change. To determine the genetic basis of these traits and to detect associations between them, we compared naturally occurring populations of two subspecies of Atlantic killifish,Fundulus heteroclitus, that differ in both thermal and hypoxia tolerance. Multilocus association mapping demonstrated that 47 and 35 single nucleotide polymorphisms (SNPs) explained 43.4% and 51.9% of variation in thermal and hypoxia tolerance, respectively, suggesting that genetic mechanisms underlie a substantial proportion of variation in each trait. However, no explanatory SNPs were shared between traits, and upper thermal tolerance varied approximately linearly with latitude, whereas hypoxia tolerance exhibited a steep phenotypic break across the contact zone between the subspecies. These results suggest that upper thermal tolerance and hypoxia tolerance are neither phenotypically correlated nor genetically associated, and thus that rates of adaptive change in these traits can be independently fine‐tuned by natural selection. This modularity of important traits can underpin the evolvability of organisms to complex future environmental change.
Mountain glaciers under a changing climate
Authors: Rowan Ann V.
Published: July 2018

Mountain glaciers are found around the world in ranges such as the Himalaya, the Andes and the European Alps. The majority of mountain glaciers world‐wide are shrinking. However, the rugged alpine topography through which these glaciers flow governs their dynamics and impacts on the regional climate systems that modify glacier mass balance. As a result, the response of mountain glaciers to climate change is difficult to predict, and highly spatially variable even across one mountain range, particularly where orography controls precipitation distributions. To understand how mountain glaciers behave and change, geologists combine many different techniques based on direct observations and dating of glacial geology, measurements of present‐day glaciers, and predictive numerical (computer) models. Recent advances in these techniques and their applications to glacial environments have demonstrated that the glacial geological record is a rich archive of information about how climate has changed in the past, and gives greater confidence in predictions of glacier change in the future, which is required if populations living in glacerised catchments are able to adapt to the rapid response of glaciers to a changing climate.
A comparative study of various modalities in the treatment of keloids
Authors: Aggarwal Archit , Ravikumar Banavase C. , Vinay K. Nirvanappa , Raghukumar Sonia , Yashovardhana D. P.
Published: July 2018

Introduction

Treatment of keloids is a challenge as a result of paucity of effective treatment modalities, significant side effects, and their recurrent nature. In this study, various treatment modalities were compared to search for a treatment option with maximum efficacy and minimum side effects.

Methods

One hundred patients were recruited into five treatment groups of 20 patients in each. Intralesional triamcinolone acetonide, intralesional triamcinolone acetonide with hyaluronidase, intralesional verapamil hydrochloride, intralesional radiofrequency, and intralesional radiofrequency with triamcinolone acetonide were the different modalities received. The treatment in groups 1, 2, and 3 were given at 3‐week intervals for 8 times or till complete flattening, whichever was earlier. In groups 4 and 5, treatment was given at six weekly intervals for 4 times or till complete flattening. For statistical comparison, all patients were followed up at three weekly intervals.

Results

In total, 16, 16, 15, 17, and 16 patients completed the study in groups 1, 2, 3, 4, and 5, respectively. Treatment modalities in groups 1, 2, and 5 were more or less equally efficacious with clearance rate of 75, 68.75, and 75% respectively, whereas groups 3 and 4 had clearance rate of 0 and 11.76%, respectively (P value <0.01, Chi‐square test).

Conclusion

Intralesional triamcinolone acetonide, intralesional triamcinolone acetonide with hyaluronidase, and intralesional radiofrequency with triamcinolone acetonide are effective modalities for the treatment of keloids. However, intralesional triamcinolone acetonide with hyaluronidase fares better than other two as far as safety is concerned with least side effects.
Cross‐sex hormone therapy in Australia: the prescription patterns of clinicians experienced in adult transgender healthcare
Authors: Bretherton Ingrid , Thrower Emily , Grossmann Mathis , Zajac Jeffrey D. , Cheung Ada S.
Published: July 2018

Background

Despite increasing demand for transgender healthcare, guidelines for cross‐sex hormone therapy are based on low‐level evidence only. As most data are based on international expert opinions, interpretations and practices vary significantly.

Aims

To aid the development of Australian clinical guidelines, we aimed to identify cross‐sex hormone therapy prescribing patterns among medical practitioners experienced in adult transgender healthcare.

Methods

We conducted an anonymous online survey of experienced hormone prescribers who were members of the Australian and New Zealand Professional Association for Transgender Health (ANZPATH).

Results

We received 35 responses from 43 individuals listed with ANZPATH. Mental health assessments prior to commencement of hormonal therapy were recommended by 80% of prescribers. The preferred first‐line masculinising hormone therapy was intramuscular testosterone undecanoate (46% of respondents). The most commonly prescribed feminising agents were oral estradiol valerate (first line in 71.4%), with either spironolactone or cyproterone acetate. Most respondents (>90%) targeted sex steroid reference ranges of the affirmed gender, and 71.4% reviewed individuals every 2–3 months in the first year. Better training for doctors was seen as the most pressing priority for government funding, and 79.3% supported the development of local Australian‐based guidelines.

Conclusions

Experienced hormone prescribers in Australia largely use medication regimens and monitor sex steroid levels and potential adverse effects of sex hormone therapy in accordance with broad, subjective recommendations listed in international guidelines. Additional practitioner training is necessary, and local Australian‐based guidelines would offer specific, relevant guidance to clinicians in the initiation and monitoring of cross‐sex hormone therapy for adult transgender individuals.