bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge transfer within relationship portfolios: the creation of knowledge recombination rents
Authors: Pellegrini Massimiliano Matteo , Caputo Andrea , Matthews Lee
Published: July 2018

Purpose

The purpose of this paper is to clarify the underdeveloped conceptualization of a particular type network rents, defined as knowledge recombination rents, related to the possibility for a firm to transfer and recombine knowledge within and across its portfolio of inter-organizational relationships.

Design/methodology/approach

Adopting a contingency approach, the authors develop a comprehensive model with propositions drawn from an original synthesis of the extant literature on the management of inter-organizational relationships.

Findings

The authors summarize the most important internal and external variables that explain how knowledge recombination rents arise within a firm’s portfolio of inter-organizational relationships. The authors create a seven-proposition model that considers: an “internal fit,” related to internal contingencies of the firm, specifically life stage and its strategy; an “external fit,” related to external contingencies of the network of the firm, specifically past experience and current portfolio structure.

Research limitations/implications

The model is theory driven. Future research should validate empirically the relations proposed, especially in different industries and contexts.

Practical implications

The model, beyond the fact of being theoretically sounded, is also completely practical oriented. Indeed, the authors developed a comprehensive model articulated in seven propositions which relationship managers can easily use to analyze and manage their portfolios of inter-organizational relationships.

Originality/value

The model allows us to assert that the value of an inter-organizational relationship is neither fixed nor just related to the single dyadic interaction; rather before engaging with a relationship is crucial to ponder possible benefits and harms. This is the central element in the contribution that develops an easy-to-use and comprehensive model based on best practices.
Unlocking innovation in the sport industry through additive manufacturing
Authors: Meier Marlon , Tan Kim Hua , Lim Ming K. , Chung Leanne
Published: July 2018

Purpose

Fast-changing customer demands and rising requirements in product performance constantly challenge sports equipment manufacturers to come up with new and improved products to stay competitive. Additive manufacturing (AM), also referred to as 3D printing, can enhance the development of new products by providing an efficient approach of rapid prototyping. The purpose of this paper is to analyse the current adoption of AM technologies in the innovation process of the sports industry, i.e. level of awareness; how it is implemented; and it impact on the innovation process.

Design/methodology/approach

This work followed a qualitative research approach. After conducting a research of the current literature, this paper presents findings that include case studies from different companies, as well as a semi-structured interview with an outdoor sports equipment manufacturer. Companies from all over the world and of different sizes from under 100 employees to over 70,000 employees were considered in this research.

Findings

Literature research shows that AM brings many possibilities to enhance the innovation process, and case studies indicated several obstacles that hinder the technology from fully unfolding. AM is still at the early stage of entering the sports equipment industry and its potential benefits have not been fully exploited yet. The findings generated from the research of real-life practices show that AM provides several benefits when it comes to the innovation process, such as a faster development process, an optimised output, as well as the possibility to create new designs. However, companies are not yet able to enhance the innovation process in a way that leads to new products and new markets with AM. Limitations, including a small range of process able material and an inefficient mass production, still restrain the technology and lead to unused capability. Nevertheless, future prospects indicate the growing importance of AM in the innovation process and show that its advancement paves the way to new and innovative products.

Research limitations/implications

Limitations exist in the qualitative approach of this study, which does not include the quantitative verification of the results.

Originality/value

Very few studies have been conducted to investigate how firms can harvest AM to increase their innovation capabilities. How firms can use AM to shorten product development time is an emerging topic in business and operations but has not been studied widely. This paper aims to address this gap.
Servant leadership and transformational leadership: from comparisons to farewells
Authors: Andersen Jon Aarum
Published: July 2018

Purpose

The purpose of this paper is to question the usefulness of comparisons between theories on servant leadership and transformational leadership.

Design/methodology/approach

A review of scholarly works on these two theories is presented from the original works of Greenleaf, Burns and Bass to the current research.

Findings

Based on the four categories of construct clarity, two competing alternatives are identifiable in the scholarship of both servant and transformational leadership. There are thus 16 versions of each theory.

Research limitations/implications

The literature review contains no new empirical data. The many versions available today of each theory do not make comparisons meaningful. The prevalence of several versions of theories on servant leadership and transformational leadership implies that they are no longer specific and useful theories.

Originality/value

Critical comments are presented on the usefulness of comparisons between servant leadership and transformational leadership. Thus, the value of these theories is also questioned.
Are acceptance and commitment therapy-based interventions effective for reducing burnout in direct-care staff? A systematic review and meta-analysis
Authors: Reeve Andy , Tickle Anna , Moghaddam Nima
Published: July 2018

Purpose

Work-related stress amongst staff working in direct care roles in mental health and intellectual disability settings is associated with a range of problematic outcomes. There has been a proliferation of research into the use of acceptance and commitment therapy (ACT)-based interventions in this staff population. The purpose of this paper is to review the extant literature.

Design/methodology/approach

A systematic search of the literature was conducted, and seven studies identified which met the criteria for inclusion in the review, of which four were eligible for meta-analysis.

Findings

Results of the meta-analysis were most convincing for the effectiveness of ACT-interventions to reduce psychological distress within a subgroup of those with higher distress at baseline. There was no statistically significant effect for the amelioration of burnout, nor for an increase in psychological flexibility (a key ACT construct).

Research limitations/implications

Conceptual issues are considered including the purpose and treatment targets of ACT interventions, such as supporting valued living rather than diminishing stress per se. Methodological issues are discussed around the measurement of psychological flexibility.

Originality/value

This review makes recommendations for future research and for the implementation of ACT-interventions for work-related stress in these settings.
To err is human: medication patient safety in aged care, a case study
Authors: Gilbert Julia , Kim Jeong-ah
Published: July 2018

Purpose

The purpose of this paper is to explore an identified medication error using a root cause analysis and a clinical case study.

Design/methodology/approach

In this paper the authors explore a medication error through the completion of a root cause analysis and case study in an aged care facility.

Findings

Research indicates that medication errors are highly prevalent in aged care and 40 per cent of nursing home patients are regularly receiving at least one potentially inappropriate medicine (Hamilton, 2009; Raban et al., 2014; Shehab et al., 2016). Insufficient patient information, delays in continuing medications, poor communication, the absence of an up-to-date medication chart and missed or significantly delayed doses are all linked to medication errors (Dwyer et al., 2014). Strategies to improve medication management across hospitalisation to medication administration include utilisation of a computerised medication prescription and management system, pharmacist review, direct communication of discharge medication documentation to community pharmacists and staff education and support (Dolanski et al., 2013).

Originality/value

Discussion of the factors impacting on medication errors within aged care facilities may explain why they are prevalent and serve as a basis for strategies to improve medication management and facilitate further research on this topic.
Empirical test of the native–nonnative distinction: Native and nonnative assemblages of Anolis lizards are similar in morphology and phylogeny
Authors: Poe Steven , Latella Ian M.
Published: July 2018

Nonnative (“invasive,” “exotic,” “naturalized”) species frequently are vilified. However, some philosophers and ecologists have questioned whether nonnative species and assemblages are objectively, ahistorically identifiable as different entities relative to native species and assemblages, once selection biases are taken into account.

We used an unprecedented dataset of morphology, phylogeny and assemblage content for 336 species of Anolis lizard to compare morphological and phylogenetic characteristics of variability and central tendency between native assemblages and those that include nonnative species.

Equivalence tests demonstrated significant similarity between native and nonnative assemblages in trait variability, phylogenetic dispersion and mean trait values except for body size; logistic and zero‐inflated regression failed to distinguish native and nonnative assemblages. For most traits, similarity was not due to assemblages being structured randomly but rather to both native and nonnative assemblages including similar species.

Without historical information, a naïve observer would be unable to identify Anolis assemblages as native or nonnative based on morphological assemblage structure or most mean assemblage trait values, but would have some success categorizing assemblages based on average body size of species in the assemblage.

Significant phylogenetic and morphological clustering in native assemblages likely reflects source pools composed of close relatives that share traits, as well as some environmental filtering effects; the slightly less phylogenetically clustered but equally morphologically clustered nonnative assemblages are less constrained to proximal source pools but still probably subject to filtering. Differences between native and nonnative assemblages in mean body size likely reflect assemblage youth. The ontological status of nonnative species is discussed in the light of these results.

A plain language summary is available for this article.
Development and Validation of a Measure to Assess Patients’ Threat Perceptions in the Emergency Department
Authors: Cornelius Talea , Agarwal Sachin , Garcia Othanya , Chaplin William , Edmondson Donald , Chang Bernard P.
Published: July 2018

Objective

Threat perceptions in the emergency department (ED; e.g., patients’ subjective feelings of helplessness or lack of control) during evaluation for an acute coronary syndrome (ACS) are associated with the development of posttraumatic stress disorder (PTSD), and PTSD has been associated with medication nonadherence, cardiac event recurrence, and mortality. This study reports the development and validation of a seven‐item measure of ED threat perceptions in English‐ and Spanish‐speaking patients evaluated for ACS.

Methods

Participants were drawn from an observational cohort study of 1,000 patients evaluated for ACS between 2013 and 2016 in a large New York City hospital. Participants reported on threat perceptions in the ED and during inpatient stay (using 12 items previously identified as predictive of PTSD) and reported on cardiac‐induced PTSD 1 month postdischarge. Exploratory and confirmatory factor analyses were used to establish the factor structure and test measurement invariance. Validity and reliability were examined, as was the association of ED threat perceptions with cardiac‐induced PTSD.

Results

Factor analyses identified a seven‐item measure of ED threat perceptions (e.g., “I feel helpless,” “I am worried that I am going to die”) for both English‐ and Spanish‐speaking patients. ED threat perceptions demonstrated convergent validity, correlating with ED stress and ED crowdedness (r = 0.29 and r = 0.14), good internal consistency (α = 0.82), and stability (r = 0.61). Threat perceptions were associated with cardiac‐induced acute stress at inpatient and PTSD symptoms at 1 month (r = 0.43 and r = 0.39).

Conclusions

This brief tool assessing ED threat perceptions has clinical utility for providers to identify patients at risk for developing cardiac‐induced PTSD and is critical to inform research on whether threat may be modified in‐ED to reduce PTSD incidence.
Index serum hyaluronic acid independently and accurately predicts mortality in patients with liver disease
Authors: Plevris N. , Sinha R. , Hay A. W. , McDonald N. , Plevris J. N. , Hayes P. C.
Published: July 2018

Background

Hyaluronic acid is a recognised noninvasive marker of liver fibrosis. However, its prognostic ability has not been extensively studied.

Aims

To investigate the ability of an index serum hyaluronic acid measurement to independently predict transplant‐free survival in patients with liver disease of varying aetiology and severity.

Methods

This was a retrospective single‐centre cohort study. Serum hyaluronic acid was measured at the discretion of the attending clinicians, in patients attending the liver clinic, to assess disease severity. Patients with a hyaluronic acid measurement between 1995 and 2010 were identified. Patient characteristics at the point of hyaluronic acid measurement were recorded from medical records. Follow‐up was from date of index hyaluronic acid measurement to date of death, date of transplant or censor date (July 01, 2015). Primary outcomes were all‐cause and liver‐related mortality. Kaplan–Meier analysis was used to compare survival in 3 patient groups with hyaluronic acid levels of <100 μg/L, 100‐300 μg/L and >300 μg/L. Survival models were constructed using Cox proportional hazard and prediction accuracy was assessed by Harrell's C‐statistic.

Results

Five hundred and eighty nine patients fulfilled inclusion criteria. Median follow‐up was 5.6 years (range 0.1‐19.7). Transplant‐free survival was significantly different between patients with hyaluronic acid <100 μg/L, 100‐300 μg/L and >300 μg/L for liver‐related as well as all‐cause mortality (P < 0.001). Hyaluronic acid level was an independent predictor of survival (liver‐related: HR 1.39, 95% CI 1.20‐1.60, P < 0.001; all‐cause: HR 1.04, 95% CI 1.02‐1.06, P = 0.001). The liver‐related prediction accuracy of hyaluronic acid was 0.74 (Standard error 0.03).

Conclusion

Index hyaluronic acid measurement can accurately and independently predict liver‐related and all‐cause mortality in patients with liver disease.
Therapeutic drug monitoring‐guided definition of adherence profiles in resistant hypertension and identification of predictors of poor adherence
Authors: Avataneo Valeria , De Nicolò Amedeo , Rabbia Franco , Perlo Elisa , Burrello Jacopo , Berra Elena , Pappaccogli Marco , Cusato Jessica , D'Avolio Antonio , Di Perri Giovanni , Veglio Franco
Published: July 2018

Aims

Arterial hypertension is an important cardiovascular risk factor. A substantial proportion of patients show resistance to antihypertensive treatment but poor adherence to medication regimens is also a significant cause of treatment failure. In this context, therapeutic drug monitoring (TDM) could be useful. The objective of this study was to assess adherence to treatment in patients with resistant hypertension by TDM and to identify parameters that predict nonadherence.

Methods

Liquid chromatography tandem mass spectrometry was used to quantify a wide panel of antihypertensive drugs in human plasma to assess treatment compliance.

Associations between TDM‐determined adherence profiles, self‐reported adherence and other patient‐related clinical, anthropometric or demographic features were evaluated as potentially useful pre‐TDM predictors of poor adherence.

Results

TDM was performed on 50 patients with suspected resistant hypertension: 24% of patients partially complied to treatment and 18% were nonadherent. No concordance was observed with questionnaire results, while nonadherence was associated with high diastolic blood pressure, high heart rate, previous onset of stroke and previous use of invasive treatments, including renal denervation or baroreceptor stimulation.

Conclusions

This evidence highlights the high prevalence of poor adherence in patients with resistant hypertension and the need for caution in using invasive approaches. These preliminary data require validation in a larger cohort, to confirm the need for TDM in routine clinical practice.
Cryptotanshinone Attenuates Oxidative Stress and Inflammation through the Regulation of Nrf‐2 and NF‐κB in Mice with Unilateral Ureteral Obstruction
Authors: Wang Wei , Wang Xiao , Zhang Xian‐sheng , Liang Chao‐zhao
Published: July 2018

Oxidative stress and inflammatory responses are closely implicated in the progression of renal interstitial fibrosis, thereby leading to chronic kidney disease. Cryptotanshinone (CTS) is a natural compound involved in antioxidant and anti‐inflammatory activities. We evaluated the effects of CTS on inflammation and oxidative stress in obstructed kidneys. Mice received gastric gavage of CTS from 7 days before unilateral ureteral obstruction operation to 1 week after surgery. Administration of CTS at 50 and 100 mg/kg/day significantly decreased collagen production, as shown by Masson staining. Immunohistochemistry staining and RT‐PCR confirmed that CTS reduced extracellular matrix proteins, such as fibronectin and collagen‐1, in the obstructed kidneys in a dose‐dependent manner. Furthermore, immunohistochemistry staining indicated that CTS inhibited infiltration of the macrophage (CD68‐positive) and lymphocyte (CD3‐positive) cells, which were associated with the suppression of the nuclear factor‐κB signalling activation. CTS increased superoxide dismutase, catalase and glutathione while decreased malondialdehyde production. More importantly, CTS activated Nrf‐2 and HO‐1 in the obstructed kidneys for 7 days. CTS could protect renal interstitial fibrosis by ameliorating inflammation and oxidative stress, which might be through the regulation of NF‐κB and Nrf‐2/HO‐1 signalling pathways.
Collective Action, Business Cleavages and the Politics of Control: Segmentalism in the Swiss Skill Formation System
Authors: Emmenegger Patrick , Seitzl Lina
Published: July 2018

Collective skill formation systems have come under sustained pressure in recent years. Scholars observe a fragmentation process, which is the result of changing power relations, putting large training firms in a dominant position. However, so far the literature has examined neither the role of small firms and intermediary associations nor the source of power of the various business actors. In this case study, we ask: If business is pivotal, but divided, who prevails and why? We find that the availability of credible exit options and the ability to act collectively determines the degree of influence of the various business actors.
Selegiline reduces adiposity induced by high‐fat, high‐sucrose diet in male rats
Authors: Nagy Csilla Terézia , Koncsos Gábor , Varga Zoltán V , Baranyai Tamás , Tuza Sebestyén , Kassai Ferenc , Ernyey Aliz Judit , Gyertyán István , Király Kornél , Oláh Attila , Radovits Tamás , Merkely Béla , Bukosza Nóra , Szénási Gábor , Hamar Péter , Mathé Domokos , Szigeti Krisztián , Pelyhe Csilla , Jelemenský Marek , Onódi Zsófia , Helyes Zsuzsanna , Schulz Rainer , Giricz Zoltán , Ferdinandy Péter
Published: July 2018

Background and Purpose

Incidence and severity of obesity are increasing worldwide, however, efficient and safe pharmacological treatments are not yet available. Certain MAO inhibitors reduce body weight, although their effects on metabolic parameters have not been investigated. Here, we have assessed effects of a widely used, selective MAO‐B inhibitor, selegiline, on metabolic parameters in a rat model of diet‐induced obesity.

Experimental Approach

Male Long–Evans rats were given control (CON) or a high‐fat (20%), high‐sucrose (15%) diet (HFS) for 25 weeks. From week 16, animals were injected s.c. with 0.25 mg·kg−1 selegiline (CON + S and HFS + S) or vehicle (CON, HFS) once daily. Whole body, subcutaneous and visceral fat was measured by CT, and glucose and insulin tolerance were tested. Expression of glucose transporters and chemokines was assessed by quantitative RT‐PCR.

Key Results

Selegiline decreased whole body fat, subcutaneous‐ and visceral adiposity, measured by CT and epididymal fat weight in the HFS group, compared with HFS placebo animals, without influencing body weight. Oral glucose tolerance and insulin tolerance tests showed impaired glucose homeostasis in HFS and HFS + S groups, although insulin levels in plasma and pancreas were unchanged. HFS induced expression of Srebp‐1c, Glut1 and Ccl3 in adipose tissue, which were alleviated by selegiline.

Conclusions and Implications

Selegiline reduced adiposity, changes in adipose tissue energy metabolism and adipose inflammation induced by HFS diet without affecting the increased body weight, impairment of glucose homeostasis, or behaviour. These results suggest that selegiline could mitigate harmful effects of visceral adiposity.
Reflectance confocal microscopy features of melanomas on the body and non‐glabrous chronically sun‐damaged skin
Authors: Shahriari Neda , Grant‐Kels Jane M. , Rabinovitz Harold , Oliviero Margaret , Scope Alon
Published: July 2018

Background

Melanoma remains a challenge to diagnose, especially when appearing on the background of chronically sun‐damaged skin (CSDS). Our goal was to identify and quantify the reflectance confocal microscopy (RCM) features of melanoma on non‐facial CSDS.

Methods

Included lesions were biopsy‐proven melanomas, from anatomic sites other than the face, neck, scalp and acral skin, with histopathologic finding of solar elastosis in the underlying dermis. All included lesions underwent clinical, dermoscopic and RCM imaging, obtained in a standardized fashion, prior to biopsy. All images were retrospectively analyzed by four observers.

Results

We identified 33 melanomas from 33 patients with 63.6% male patients and overall mean age of 72.8 years. The salient RCM features included an atypical honeycomb or disarranged epidermal pattern (81.8%), pagetoid infiltration of the epidermis by both round and/or dendritic melanocytes (100%), focal proliferation of predominantly dendritic melanocytes as sheets (78.8%), foci with non‐edged papillae (84.8%), junctional thickening (60.6%), areas of irregular ring or meshwork pattern (78.8%), and underlying thickened collagen bundles (51.5%).

Conclusion

Non‐facial CSDS melanomas share features similar to other melanoma types including pagetoid cells and non‐edged papillae. The focal proliferation of dendritic pagetoid cells in sheets is similar to that seen in facial CSDS melanomas.
Instar‐specific effects of host plants on survival of endangered butterfly larvae
Authors: Haan Nathan L. , Bakker Jonathan D. , Dunwiddie Peter W. , Linders Mary J.
Published: July 2018

1. Outcomes for butterfly conservation can hinge on interactions with host plants during early larval instars. Ontogenetic changes in larvae may cause predictors of survival to shift quickly over time.

2. Survival from instar to instar was measured for an endangered oligophagous butterfly,Euphydryas edithassp.taylori(Taylor's checkerspot), which was experimentally released in the field on three host plants:Castilleja levisecta,Castilleja hispida, andPlantago lanceolata. Survival rates were quantified, from hatching to the second instar, from the second to the third instar, and from the third to the fourth instar.

3. This study tested whether host plant characteristics (degree of senescence and anthocyanin pigmentation) affected survival during each instar; the effects of oviposition timing and larval group size on survival were also tested, as these vary by group and could affect outcomes for larvae differently on different hosts.

4. Survival rates depended on the host species being consumed, mostly because of a disparity in survival during the transition from the second to the third instar. Survival was lowest onC. levisecta, intermediate onC. hispida, and highest onP. lanceolata.

5. Plant senescence, oviposition timing, and group size were predictors of survival, but their relevance depended on both the host plant being used and the instar being considered.

6. Host plant suitability can vary strongly both within and among species, changing quickly with caterpillar ontogeny during early instars.
Validation of previous prognostic models for thrombosis and exploration of modified models in patients with essential thrombocythemia
Authors: Hashimoto Yoshinori , Nakamae Hirohisa , Tanaka Takayuki , Omura Hiromi , Horiuchi Mirei , Yoshimura Takuro , Takakuwa Teruhito , Mugitani Atsuko , Hirose Asao , Nakamae Mika , Koh Hideo , Hino Masayuki
Published: July 2018

Objective

We examined the prognostic factors to validate previous prognostic models for survival and thrombosis with large‐scale data on Japanese patients with essential thrombocythemia (ET).

Method

We conducted a study in 352 patients with ET to validate previous prognostic models and search for new prognostic factors.

Results

The International Prognostic Score for essential thrombocythemia (IPSET), the conventional risk classification and the International Prognostic Score for thrombosis in essential thrombocythemia (IPSET‐T) were confirmed to be reproducible in Japanese patients. However, no significant difference was observed between the low‐risk and intermediate‐risk categories according to the revised IPSET‐T, which does not allow direct comparison of the four risk groups. We reevaluated the risk using a modified revised IPSET‐T, which was derived from the revised IPSET‐T by scoring the factors as follows: one point for age > 60 years, two points for past history of thrombosis, two points for JAK2 gene mutation‐positive; total points of 0 = very low risk, 1 =  low risk, 2 =  intermediate risk, 3 and above = high risk, with significantly different thrombosis‐free survival.

Conclusion

The modified revised IPSET‐T has been useful for 4‐group stratification to predict a population that requires therapeutic intervention, irrespective of the treatment regimens.
Financial Reforms and Corruption: Which Dimensions Matter?
Authors: Jha Chandan Kumar
Published: July 2018

This paper investigates the effects of reforms in different dimensions of the financial sector on corruption in a panel of 82 countries. It finds that several, but not all, of the policies targeted toward liberalizing financial sector reduce corruption. Specifically, entry barriers, directed credit, securities market development, and the extent of banking supervision are significantly negatively associated with corruption. The effects of reforms in different dimensions of the financial sector also depend on the quality of the governance (bad versus good governance) and whether the country is an advanced or a non‐advanced economy. Finally, a stronger democracy and better law and order are found to be associated with lower corruption.
Executive compensation and cash contributions to defined benefit pension plans
Authors: Cheng Qiang , Swenson Laura
Published: July 2018

Cash contributions to defined benefit pension (DB) plans reduce cash flows from operations without directly affecting the current year's net income. We utilize this unique setting to investigate how managerial incentives to report higher cash flows from operations, executive compensation in particular, affect contributions. Using a comprehensive dataset of DB plan contributions, we find that firms with higher chief executive officer (CEO) compensation contribute less to DB plans, consistent with managers benefiting from lower pension contributions. Results are stronger when CEO compensation is directly linked to cash flows from operations or when CEO compensation is more sensitive to cash flows from operations. We also find enhanced disclosure and more transparent reporting under the recent pension accounting regime mitigates the negative association between executive compensation and cash contributions.
Physicochemical characterization of inorganic deposits associated with granulomas in cutaneous sarcoidosis
Authors: Colboc H. , Moguelet P. , Bazin D. , Bachmeyer C. , Frochot V. , Weil R. , Letavernier E. , Jouanneau C. , Daudon M. , Bernaudin J.F.
Published: July 2018

Background

Sarcoidosis, characterized by epithelioid granulomas, is considered to be caused by a complex interplay between genetics and environmental agents. It has been hypothesized that exogenous inorganic particles as crystalline silica could be a causal or adjuvant agent in sarcoidosis onset.

Objectives

To investigate the location, frequency and physicochemical characteristics of foreign materials and mineral tissue deposits in the granulomatous area of cutaneous sarcoidosis.

Methods

Skin biopsies (n = 14) from patients diagnosed with cutaneous sarcoidosis (mean age 43 years; 11 patients with extracutaneous involvement) were investigated using polarized light examination (PLE), μFourier Transform Infra‐Red (μFT‐IR) spectroscopy and Field Emission Scanning Electron Microscopy coupled with Energy Dispersive X‐ray Spectroscopy (FE‐SEM/EDX).

Results

Combined PLE, μFT‐IR, FE‐SEM/EDX analysis allowed to characterize mineral deposits in 7/14 biopsies (50%). It identified crystalline silica (SiO2) inside granulomas in three biopsies and calcite (CaCO3) at their periphery in 4.

Conclusion

This study emphasizes the need of using combined methods for assessment of mineral deposits in granulomatous diseases. According to the location and characteristics of deposits, we can hypothesize that SiO2 particles contribute to the granuloma formation, whereas CaCO3 deposits are related to the granuloma biology. However, the significance of the association between SiO2 deposits and sarcoidosis is still disputed.
A randomized, double‐blind controlled study of the efficacy and safety of topical solution of 0.25% finasteride admixed with 3% minoxidil vs. 3% minoxidil solution in the treatment of male androgenetic alopecia
Authors: Suchonwanit P. , Srisuwanwattana P. , Chalermroj N. , Khunkhet S.
Published: July 2018

Background

The synergism of combined use between oral finasteride and topical minoxidil has been established in treating androgenetic alopecia among men. However, the concern regarding adverse effects of finasteride use has been rising.

Objective

To compare the efficacy and safety of topical solution of 0.25% finasteride admixed with 3% minoxidil vs. 3% minoxidil solution in men with androgenetic alopecia.

Methods

Forty men aged 18–60 years with androgenetic alopecia were randomized to 24 weeks of treatment with a finasteride/minoxidil or minoxidil solution twice daily. Primary efficacy endpoint was the change from baseline in hair density and hair diameter at week 24. Secondary endpoints included global photographic assessment by treatment‐blinded investigators and subjects. Changes in plasma dihydrotestosterone levels and adverse events were recorded.

Results

At week 24, the combined solution of finasteride and minoxidil was significantly superior to minoxidil alone in improvements of hair density, hair diameter and global photographic assessment (all P < 0.05). About 90% of patients treated with the combined solution experienced moderate to marked improvement. The combined solution also had minimal effect on plasma dihydrotestosterone levels, approximately 5% reduction. There were also no systemic adverse events reported by patients in both groups.

Conclusion

Treatment with topical solution of 0.25% finasteride admixed with 3% minoxidil was significantly superior to 3% minoxidil solution for promoting hair growth in male androgenetic alopecia, and well tolerated.
Indirect exposure to Bt maize through pig faeces causes behavioural changes in dung beetles
Authors: Campos Renata Calixto , Holderbaum Daniel Ferreira , Nodari Rubens Onofre , Hernandez Malva Isabel Medina
Published: July 2018

Genetically modified (GM) Bt plants currently represent a highly adopted alternative for pest control in agricultural crops. However, their safety to non‐target organisms has been an unsolved issue. Non‐target organisms associated to nutrient cycling in natural and agricultural systems, such as dung beetles, use faeces of mammals as a food resource and could be exposed to Bt‐plant material through faeces of livestock fed with Bt‐crops. The aim of this study was to assess whether indirect exposure to transgenic Bt maize MON810 can reduce fitness in dung beetles. Four dung beetles species, Canthon angularis, Canthon rutilans cyanescens, Coprophanaeus saphirinus and Phanaeus splendidulus, were reared under laboratory conditions and fed with pig faeces using two treatments/diets: faeces of pigs fed transgenic maize and of pigs fed conventional maize. The behaviour of insects was tested by experiments on the incorporation of organic matter in the soil and nesting, and experiments of foraging behaviour with olfactometry measures. Organic matter incorporation in the soil per male–female pairs of C. rutilans was similar between GM and conventional treatments, as was their reproductive success, but beetles fed with faeces from transgenic maize produced more brood balls. In another trial regarding the incorporation of organic matter in the soil, C. saphirinus fed with faeces derived from conventional maize showed greater ability to bury food resource in comparison with GM fed ones. In an olfactometer test, the time to reach the food source was longer for individuals of C. rutilans, previously fed with transgenic faeces during 1 month, than individuals fed with conventional faeces. Our results suggest that differences found in dung beetles’ ability represent potential indirect effects of transgenic maize through the food chain and may also affect ecological functions of these organisms in natural habitats, by means of reduced beetle efficiency in removal and burial of faecal masses.
The Value of Unstructured Electronic Health Record Data in Geriatric Syndrome Case Identification
Authors: Kharrazi Hadi , Anzaldi Laura J. , Hernandez Leilani , Davison Ashwini , Boyd Cynthia M. , Leff Bruce , Kimura Joe , Weiner Jonathan P.
Published: July 2018

Objectives

To examine the value of unstructured electronic health record (EHR) data (free‐text notes) in identifying a set of geriatric syndromes.

Design

Retrospective analysis of unstructured EHR notes using a natural language processing (NLP) algorithm.

Setting

Large multispecialty group.

Participants

Older adults (N=18,341; average age 75.9, 58.9% female).

Measurements

We compared the number of geriatric syndrome cases identified using structured claims and structured and unstructured EHR data. We also calculated these rates using a population‐level claims database as a reference and identified comparable epidemiological rates in peer‐reviewed literature as a benchmark.

Results

Using insurance claims data resulted in a geriatric syndrome prevalence ranging from 0.03% for lack of social support to 8.3% for walking difficulty. Using structured EHR data resulted in similar prevalence rates, ranging from 0.03% for malnutrition to 7.85% for walking difficulty. Incorporating unstructured EHR notes, enabled by applying the NLP algorithm, identified considerably higher rates of geriatric syndromes: absence of fecal control (2.1%, 2.3 times as much as structured claims and EHR data combined), decubitus ulcer (1.4%, 1.7 times as much), dementia (6.7%, 1.5 times as much), falls (23.6%, 3.2 times as much), malnutrition (2.5%, 18.0 times as much), lack of social support (29.8%, 455.9 times as much), urinary retention (4.2%, 3.9 times as much), vision impairment (6.2%, 7.4 times as much), weight loss (19.2%, 2.9 as much), and walking difficulty (36.34%, 3.4 as much). The geriatric syndrome rates extracted from structured data were substantially lower than published epidemiological rates, although adding the NLP results considerably closed this gap.

Conclusion

Claims and structured EHR data give an incomplete picture of burden related to geriatric syndromes. Geriatric syndromes are likely to be missed if unstructured data are not analyzed. Pragmatic NLP algorithms can assist with identifying individuals at high risk of experiencing geriatric syndromes and improving coordination of care for older adults.
Novel surfaces and osseointegration in implant dentistry
Authors: Pellegrini Gaia , Francetti Luca , Barbaro Bruno , del Fabbro Massimo
Published: July 2018

Survival, differentiation capability, and activity of cells are strictly related to structural features and the composition of the extracellular matrix, and its variation affects tissue homeostasis. Placement of a dental implant in bone tissue activates a sequence of molecular and cellular events that lead to the apposition of newly‐formed bone directly onto the titanium surface. Due to implant's interaction with the mineralized tissue, osseointegration is affected by the surface structure of the implanted material. Surface nanotopography and microtopography can modify the shape and activity of mesenchymal stem cells leading to a higher differentiation rate of these cells into osteogenic lineage with the upregulation of osteoblastic genes. Several approaches for implant surface modification are currently under investigation or have been recently proposed to improve osseointegration. Most surface treatments are aimed at the formation of a thick layer of titanium oxide, at the alteration of surface chemical composition by incorporating bioactive molecules and drugs, and at the creation of a surface topography that is more attractive for osteoblast differentiation, adhesion, and osteogenic activity. Data on the cellular‐substrate interaction, as well as in vivo studies assessing the response to these novel surfaces, are reviewed in the present study. The application of modern surfaces in dental clinical practice might increase and accelerate implant osseointegration, but could also reduce the occurrence of peri‐implant bone loss and favor the re‐osseointegration of an affected surface.
Towards Measuring the Informal City: A Societal Metabolism Approach
Authors: Smit Suzanne , Musango Josephine K. , Kovacic Zora , Brent Alan C.
Published: July 2018

The rapid growth of urban informal settlements, or slums, poses a particular challenge for balancing developmental and environmental goals. In South Africa, high levels of inequality, poverty, and unemployment contribute to widespread migration. The influx of migrant workers to cities, however, is rarely matched with adequate housing and infrastructure, resulting in the formation and growth of urban informal settlements. Despite the persistence of the slum phenomenon, very few studies provide an in‐depth understanding of the metabolic processes that link these spaces, and informal economies, to the broader urban environment and economy. This article therefore utilized a multiscale integrated assessment of the societal and ecosystem metabolism approach to examine human activity and land use in Enkanini, an urban informal settlement in Stellenbosch, South Africa. The results highlight a number of issues to be addressed through spatial, developmental, and local economic policy, such as the need for improved transport linkages. The time‐use results show that Enkanini is a net provider of labor to the surrounding area. Further, geographical mapping indicates Enkanini as a small, but vibrant, informal economy, while being grossly underserviced in terms of water, waste, and sanitation infrastructure. Key implications are discussed in terms of the theoretical, methodological, societal, and policy impact of the study, including the need for city observatories that conduct regular data collection and analysis.
Psychological Interventions for Runaway and Homeless Youth
Authors: Noh Dabok
Published: July 2018

Purpose

In this review we examined previous studies of psychological interventions for runaway and homeless youth and evaluated the effectiveness of these interventions in terms of mental health outcomes.

Design

Literature review.

Methods

A search of various databases, including PubMed, EMBASE, Cochrane Library, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), was conducted. In this review we systematically described the characteristics of the included studies and interventions, and conducted a narrative synthesis and meta‐analyses of the mental health outcomes of the interventions.

Findings

Five types of psychological interventions were identified in the included 11 studies: art therapy, cognitive behavioral therapy (CBT)‐based interventions, family therapy, motivational interviewing, and strengths‐based interventions. The narrative synthesis found positive effects of family therapy on substance use and positive effects of CBT‐based interventions on depression. However, according to the meta‐analyses, none of the interventions had any significant effects.

Conclusions

Family therapies are likely to be effective in cases of substance use, and CBT‐based interventions are likely to be effective in dealing with cases of depression. However, as the quantitative synthesis did not support the effects of any of the psychological interventions on mental health outcomes, further research is needed.

Clinical Relevance

Nurse‐led interventions were identified in two studies. Mental health nurses should assess the mental health status of runaway and homeless youth and provide timely and effective interventions.
Longitudinal Changes in Symptom Cluster Membership in Inflammatory Bowel Disease
Authors: Conley Samantha , Jeon Sangchoon , Proctor Deborah D. , Sandler Robert S. , Redeker Nancy S.
Published: July 2018

Purpose

To describe changes in symptom cluster membership over 1 year and to examine which demographic and clinical factors predict changes in symptom cluster membership among adults with inflammatory bowel disease.

Design

A retrospective longitudinal study of the Crohn's & Colitis Foundation of America Partners Cohort from 2012 to 2015.

Methods

We measured symptoms of pain interference, fatigue, sleep disturbance, depression, and anxiety. We used latent transition analysis to describe changes in symptom cluster membership (baseline, 6 months, and 12 months) and multinomial regressions to examine factors associated with symptom cluster membership transition.

Findings

Four groups were identified (N = 5,296): high symptom burden (32.3%–35.3%), low symptom burden (24.2%–27.1%), physical symptoms (19.0%–20.9%; pain, fatigue, sleep disturbance), and psychological symptoms (20.0%–21.5%; depression, anxiety). The probability of staying in the same group was .814 to .905. Moving from active disease into remission was associated with moving from the high burden to low burden and psychological symptom groups.

Conclusions

Symptom cluster membership was quite stable over 1 year. Research is needed to understand the underlying etiology of symptom clusters better and to develop interventions to reduce symptom burden in this vulnerable population.

Clinical Relevance

Careful consideration of symptom management options should be done with patients to select options that are effective and potentially target multiple symptoms.
Nurse Perspectives of Maintaining Patient Dignity in Indonesian Clinical Care Settings: A Multicenter Qualitative Study
Authors: Asmaningrum Nurfika , Tsai Yun‐Fang
Published: July 2018

Purpose

Nurses have a professional obligation to maintain patient dignity when providing nursing care. The concept of dignity, however, is dependent on cultural context. The aim of this study was to elicit nurses’ perspectives for maintaining patient dignity in Indonesian clinical care settings.

Design

A qualitative descriptive study was performed.

Methods

A total of 40 clinical nurse participants were recruited by purposive sampling from six general public hospitals in Eastern Java, Indonesia, including six medical and six surgical units. Data were collected in 2017 using individual face‐to‐face semistructured interviews. Inductive content analysis was employed.

Findings

The interview data revealed nurses considered three main elements were necessary to maintain patient dignity in clinical care: personalized care, which included prioritizing patients and treating as individuals; compassionate care, which included empathizing and providing emotional support; and patient care advocacy, which included protecting patient rights and being a representative for the patient.

Conclusions

This study provided knowledge on how to maintain patient dignity from the cultural perspective of clinical nurses in Indonesia. Our findings highlight the importance of providing dignified care in a manner that is congruent with culture. The nurses in our study considered compassion and beneficence necessary values for providing dignified patient‐centered care, which might be qualities that are culturally sensitive for an Indonesian population.

Clinical Relevance

Strategies should be developed to improve dignity of care for hospitalized patients in Indonesia as well as other cultural settings, which could be incorporated into patient care. These should include improving patients’ health literacy to increase patient‐centered communication, eliminating mixed‐gender wards to enhance patient privacy, and involving family members as partners in health care.
Toward the understanding of human tuberculosis
Authors: Brighenti S. , Lerm M.
Published: July 2018

Content List ‐ Read more articles from the symposium: “The 10th International Conference on the Pathogenesis of Mycobacterial Infections”.
Cheeky stowaway hitches ride aboard travelling toddler
Authors: Nogic Claire , Phuong Linny K , Osowicki Joshua
Published: July 2018

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