bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conclusion: what marketing strategy for destinations with a negative image?
Authors: Séraphin Hugues , Gowreesunkar Vanessa G.B. 
Published: November 2017

Purpose
This concluding paper filters out meaningful marketing strategies that could be used to re-position and re-establish tourism destinations struggling with negative image. Drawing from a collection of case studies around the world, this paper aims to provide evidence from post-colonial, post-conflict and post-disaster destinations to anchor the overall conclusion of the theme issue.

Design/methodology/approach
This paper summarizes key issues faced by destinations plagued with a negative image and identifies adaptive marketing strategies based on existing marketing theories and success stories from struggling destinations.

Findings
Destinations with a negative image are mostly post-colonial, post-conflict or post disaster destinations (or all of the three combined), and despite their poor (if no) marketing strategies, they continue to struggle to find their share in the tourism market. This paper highlights four main challenges of such destinations and proposes that adaptive marketing strategies can turn the situation of struggling destinations to a situation of emerging destinations. Marketing strategies that are cited in this theme are based on empirical evidence and they are communication strategy, differentiation and promotion of responsible and health tourism, heritage tourism, cluster tourism and the involvement of destination marketing organisations.

Originality/value
This paper takes a somewhat different approach and proposes adaptive marketing strategies for struggling destinations. These are based on the notion that the consequences of not addressing negative image also impacts on established destinations that have to cope with increased capacity. The value of this paper is that it draws from empirical evidence, each unique in their own right and re-establishes how post-colonial, post-conflict and post-disaster destinations could improve while highlighting their potential and limiting factors.
Role of chemokines and the corresponding receptors in vitiligo: A pilot study
Authors: Yang Lingling , Yang Sailing , Lei Jiehao , Hu Wenting , Chen Rong , Lin Fuquan , Xu Ai‐e 
Published: November 2017

AbstractTo determine the levels and sources of chemokines in the serum and epidermis of vitiligo patients, we examined 80 active patients, 80 stable patients and 40 healthy controls. First, the serum levels of candidate chemokines were measured by Luminex assay, and levels of CCR5, CXCR1 and CXCR3 were measured in peripheral mononuclear cells (PMBC) by flow cytometry. Then, the local epidermis levels of elevated chemokines in vitiligo were tested by Luminex. Finally, the mRNA and protein expression levels of elevated chemokines in HaCaT cells stimulated with interferon (IFN)‐γ or tumor necrosis factor (TNF)‐α were tested by quantitative real‐time polymerase chain reaction and Luminex. The serum levels of CCL5, CXCL8 and CXCL10 in active vitiligo were significantly elevated compared with those in stable vitiligo patients. Furthermore, the levels of CCL3 and CCL4 had weak and positive correlations with the Vitiligo Area Scoring Index. In the peripheral blood of active vitiligo patients, the percentages of CD3+CD8+CCR5+ and CD3+CD8+CXCR3+ T cells were significantly increased compared with those in stable vitiligo and healthy controls. In the epidermis of lesions, the expression levels of CCL5 and CXCL10 in active vitiligo were significantly increased. In addition, the mRNA and protein levels of CCL5, CXCL8 and CXCL10 were significantly elevated in HaCaT cells after stimulation with TNF‐α or IFN‐γ. The CCR5/CCL5 and CXCR3/CXCL10 axes may play an important role in the progression and maintenance of vitiligo. Moreover, keratinocytes stimulated with TNF‐α and IFN‐γ may be a primary source of CCL5 and CXCL10.
Imiquimod 5% cream as a therapeutic option for extramammary Paget's disease
Authors: Sawada Masahide , Kato Junji , Yamashita Toshiharu , Yoneta Akihiro , Hida Tokimasa , Horimoto Kohei , Sato Sayuri , Uhara Hisashi 
Published: November 2017

AbstractA wide local excision is the standard treatment for extramammary Paget's disease (EMPD), though this treatment often leads to permanent anogenital mutilation and functional impairment. The purpose of our study is to evaluate the efficacy and safety of the topical application of imiquimod 5% cream for non‐invasive EMPD. We examined nine patients with EMPD. Eight of the nine patients were treated with imiquimod 5% cream three times per week for 16 weeks; one case was treated for 6 weeks. The response rate was 100% including five complete remissions. Local irritation was observed in three patients, which was controlled by a provisional withdrawal of the treatment. These results suggest that imiquimod 5% cream may be considered an alternative therapeutic option for the treatment of non‐invasive EMPD.
MASTDISCS combi Carba plus, a simple method for discriminating carbapenemase‐producing Enterobacteriaceae, including OXA‐48‐type producers
Authors: Ohsaki Yusuke , Kubo Ryoichi , Hobson Jonathan , Davies Mya , Osaka Shunsuke , Hayashi Wataru , Taniguchi Yui , Koide Shota , Nagano Yukiko , Nagano Noriyuki 
Published: November 2017

ABSTRACTAccurate and rapid detection of carbapenemases and identification of their types in Enterobacteriaceae are both still major challenges for clinical laboratories in attempting to prevent the intrusion and transmission of carbapenemase‐producing Enterobacteriaceae. This study aimed to evaluate the performance of the MASTDISCS combi Carba plus disc system in identification of different carbapenemase types, including OXA‐48‐type carbapenemase, for which no specific enzyme inhibitors have so far been available. The simple disc system discriminates carbapenemases, including OXA‐48‐types exhibiting low carbapenem minimum inhibitory concentrations, by targeting Enterobacteriaceae isolates with a EUCAST meropenem screening cut‐off of ≥0.25 mg/L.
Mapping an Australian Occupational Therapy curriculum: Linking intended learning outcomes with entry‐level competency standards
Authors: Sellar Ben , Murray Carolyn M. , Stanley Mandy , Stewart Hugh , Hipp Helene , Gilbert‐Hunt Susan 
Published: November 2017

BackgroundCurriculum mapping involves systematic charting of programme content against professional competencies. This process can reveal strengths, gaps and redundancies within educational programmes.MethodsCurriculum mapping occurred using intended learning (ILOs) as documented in individual courses and linking them to units and elements within the occupational therapy minimum competency standards (ACSOT) and Miller's Framework of competency. Five occupational therapy academics and two impartial research assistants identified links between ILOs and units and elements of the ACSOT. Analysis of each course in the curriculum was completed by two reviewers. A systematic protocol was developed that enabled a transparent process and resolution of discrepancies between reviewers.ResultsThere were many links (47% of total) between the documented curriculum and ACSOT Unit 1 Professional attitudes and behaviours. The other six units of the ACSOT had between 5% (Unit 7) and 16% links (Unit 3). No links were made between ILOs and the elements of evaluation (4.4), cessation (3.7) and quality assurance of services (7.3). Difficulties mapping ILOs to units and elements revealed inconsistencies in specificity and language in the ILOs and also ambiguities and gaps within the standards themselves. Mapping against Miller's framework showed a steady increase in performance expectations of students across the four years levels.ConclusionCurriculum mapping is recommended for critical reflection about content of occupational therapy programmes and to review pedagogical approaches. This process revealed strengths and weaknesses of the occupational therapy curriculum being mapped but also revealed insight into the current ACSOT that may inform future iterations.
The accuracy and consistency of nutrition care process terminology use in cases of refeeding syndrome
Authors: Matthews Kylie L. , Palmer Michelle A. , Capra Sandra M. 
Published: November 2017

AimUsing standardised terminology in acute care has encouraged consistency in patient care and the evaluation of outcomes. As such, the Nutrition Care Process (NCP) and Nutrition Care Process Terminology (NCPT) may assist dietitian nutritionists in the delivery of high quality nutrition care worldwide; however, limited research has been conducted examining the consistency and accuracy of its use. We aimed to examine the NCPT that dietitian nutritionists would use to formulate a diagnostic statement relating to refeeding syndrome (RFS).MethodsA multimethod action research approach was used, incorporating two projects. The first was a survey examining Australian dietitian nutritionists’ (n = 195) opinions regarding NCPT use in cases of RFS. To establish if results were similar internationally, an interview was then conducted with 22 dietitian nutritionists working within 10 different countries.Results‘Imbalance of nutrients’ was only identified as a correct code by 17% of respondents in project 1. No mention of this term was made in project 2. Also 86% of respondents incorrectly selected more than one diagnostic code. The majority of respondents (80%, n = 52/65) who incorrectly selected ‘Malnutrition’, without also selecting ‘Imbalance of nutrients’, selected ‘reduce intake’ as an intervention, suggesting some misunderstanding in the requirement for interrelated diagnoses, interventions and goals.ConclusionsOur findings demonstrate that there is limited accuracy and consistency in selecting nutritional diagnostic codes in relation to RFS. Respondents also demonstrated limited knowledge regarding appropriate application of the NCP and NCPT. Implementation practices may require further refinement, as accurate and consistent use is required to procure the benefits of standardised terminology.
The Venus of Margate: Fashion and Disease at the Seaside
Authors: Johnson Rachael 
Published: November 2017

AbstractThrough an examination of sea‐bathing at Margate this article explores the interactions between fashion and disease at the eighteenth‐century English seaside. Drawing on Thomas Rowlandson's companion prints Venus's Bathing (Margate), this article will show how a new trend in resort literature portrayed the sea‐bathing body as young, healthy and sexually attractive. This new narrative, it will be argued, was slowly replacing that of the fashionable sufferer: those who sought to gain cultural capital through the exaggerated display of symptoms were ridiculed, as visitors began to view a healthy body as a greater cultural asset than a sick one.
Role of imaging studies in Kawasaki disease
Authors: Tsuda Etsuko , Singhal Manphool 
Published: November 2017

AbstractKawasaki disease is a medium vessel vasculitis which may be associated with coronary artery abnormalities. Recognition of these abnormalities depends upon various imaging modalities. While two‐dimensional echocardiography remains the first line modality to identify coronary artery abnormalities, it is subject to several fallacies and is operator dependent. Computed tomography coronary angiography is rapidly emerging as a useful imaging modality for better characterization of dilatations, ectasia and aneurysms in the mid‐ and distal segments of coronary arteries. It provides precise details in terms of aneurysm size and morphology. In this review we here described the importance of computed tomography coronary angiography and have also given a brief description of magnetic resonance coronary angiography.
Differences between adult and pediatric onset Henoch‐Schonlein purpura from North India
Authors: Gupta Vikas , Aggarwal Amita , Gupta Ranjan , Chandra Chowdhury Abhra , Agarwal Vikas , Lawrence Able , Misra Ramnath 
Published: November 2017

AbstractAimHenoch‐Schönlein purpura (HSP), a primary vasculitis, characterized by purpura, abdominal pain, arthritis and renal involvement, is predominantly a disease of childhood. However, rarely it can occur in adults in whom it is believed to be a more severe form with poor renal outcomes. We aimed to answer if the age of onset affected the clinical spectrum and renal outcomes of the disease in a north Indian population. Hence, we studied the differences in clinical spectrum and renal outcomes between adult‐onset HSP and childhood‐onset HSP.MethodsCase records of all adult patients diagnosed with HSP (onset ≥ 18 years) over the last 25 years in our department (1992–2017) were retrieved. Data on clinical features, lab abnormalities and outcomes were extracted and compared with that in pediatric HSP patients (onset < 18 years) seen during the same period.ResultsA total of 87 patients, including 30 adults and 57 children, were seen during this period. Compared to children, most of the adults had purpura as the first clinical manifestation (86.7% vs. 56.1%, P < 0.01) whereas abdominal pain was only rarely the initial symptom in adults (10.0% vs. 36.8%, P < 0.02). During the disease course, adults had a higher frequency of joint involvement as compared to children (90.0% vs. 43.9%, P < 0.001). There was no significant difference in the frequency of renal involvement (60.0% vs. 50.9%, P = NS) and gastrointestinal involvement (66.7% vs. 84.2%, P = NS) between adults and children. Outcomes were good in both groups and most adults and children achieved complete recovery (83.3% and 86.0%, respectively). There was no difference in the frequency of immunosuppressive treatment required by the two groups. None of the patients developed renal insufficiency on follow‐up.ConclusionCompared to children, adults with HSP seldom have abdominal pain as the first clinical manifestation while joint involvement is seen more commonly in them during the disease course.
Monogenic interferonopathies: Phenotypic and genotypic findings of CANDLE syndrome and its overlap with C1q deficient SLE.
Authors: Al‐Mayouf Sulaiman M. , AlSaleem Alhanouf , AlMutairi Nora , AlSonbul Abdullah , Alzaid Tariq , Alazami Anas M. , Al‐Mousa Hamoud 
Published: November 2017

AbstractObjectiveTo report the clinical and genetic features of the first cases of chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) syndrome in an Arab population and to compare them with patients of C1q deficient systemic lupus erythematosus (SLE).Materials and MethodsThis is a retrospective case series of patients with CANDLE syndrome and C1q deficient SLE seen at a single tertiary hospital. Medical records were reviewed for demographic data, clinical and laboratory features, histopathology and imaging findings, and response to therapeutic intervention. Descriptive data were summarized.ResultsThree patients from unrelated families fulfilled the clinical manifestations of CANDLE syndrome. The disease onset was within the first 4 months of age. Two patients had uncommon features including uveitis, pulmonary involvement, aseptic meningitis and global delay. Skin biopsy showed heterogeneous findings. Genomic DNA screening was homozygous for mutation in PSMB8, (NM_004159.4:c.212C>T, p.T71M) in one patient and inconclusive for the other two patients. The comparison group was three patients with familial C1q deficient SLE from three unrelated families, who were born to consanguineous parents with at least one affected sibling. They presented with extensive mucocutaneous lesions, discoid rash and scarring alopecia. They required frequent admissions due to infections.ConclusionThis is the first report of CANDLE syndrome in an Arab population; our patients had heterogeneous phenotypic and genetic features with overlap manifestations with C1q deficient SLE. Both are monogenic interferonopathies. However, C1q deficient SLE had more systemic inflammatory disease.
Suicide attempt predicted by academic performance and childhood IQ: a cohort study of 26 000 children
Authors: Sörberg Wallin A. , Zeebari Z. , Lager A. , Gunnell D. , Allebeck P. , Falkstedt D. 
Published: November 2017

ObjectiveAcademic performance in youth, measured by grade point average (GPA), predicts suicide attempt, but the mechanisms are not known. It has been suggested that general intelligence might underlie the association.MethodsWe followed 26 315 Swedish girls and boys in population‐representative cohorts, up to maximum 46 years of age, for the first suicide attempt in hospital records. Associations between GPA at age 16, IQ measured in school at age 13 and suicide attempt were investigated in Cox regressions and mediation analyses.ResultsThere was a clear graded association between lower GPA and subsequent suicide attempt. With control for potential confounders, those in the lowest GPA quartile had a near five‐fold risk (HR 4.9, 95% CI 3.7–6.7) compared to those in the highest quartile. In a mediation analysis, the association between GPA and suicide attempt was robust, while the association between IQ and suicide attempt was fully mediated by GPA.ConclusionsPoor academic performance in compulsory school, at age 16, was a robust predictor of suicide attempt past young adulthood and seemed to account for the association between lower childhood IQ and suicide attempt.
Molecular targets for the therapy of cancer associated with metabolic syndrome (transcription and growth factors)
Authors: Yunusova Natalia V. , Kondakova Irina V. , Kolomiets Larisa A. , Afanas'ev Sergey G. , Chernyshova Alena L. , Kudryavtsev Igor V. , Tsydenova Anastasia A. 
Published: November 2017

AbstractMetabolic syndrome (MS) is one of the leading risk factors for the development of cardiovascular diseases, type II diabetes mellitus and reproductive system diseases. Currently, not only cardiovascular disease and reproductive history risks related with MS are frequently discussed, but it has been also shown that MS is associated with increased risk of some common cancers (endometrial cancer, postmenopausal breast cancer, colorectal cancer, biliary tract cancers and liver cancer for men). Further studies are required to understand the mechanisms of the involvement of MS components in the pathogenesis of malignant neoplasms. Changes in the expression of transcription and growth factors in the peripheral tissues as well as in cancer tissues of patients with MS were revealed. Transcription factors (AMP‐activated protein kinase‐1, STAT3, sterol regulatory element‐binding protein‐1 and peroxisome proliferator‐activated receptor‐γ), leptin and adiponectin receptors seem to be the most promising molecular targets for the therapy of cancers associated with MS.
Comparison between site and central radiological assessments for patients with recurrent glioblastoma on a clinical trial
Authors: Field Kathryn M. , Fitt Greg , Rosenthal Mark A. , Simes John , Nowak Anna K. , Barnes Elizabeth H. , Sawkins Kate , Goh Christine , Moffat Bradford A. , Salinas Simon , Cher Lawrence , Wheeler Helen , Hovey Elizabeth J. , Phal Pramit M. ,   CABARET/COGNO Investigators
Published: November 2017

AbstractAimAssessment of magnetic resonance imaging (MRI) in glioblastoma can be challenging. For patients with recurrent glioblastoma managed on the CABARET trial, we compared disease status assessed at hospitals and subsequent blinded central expert radiological review.MethodsMRI results and clinical status at specified time points were used for site and central assessment of disease status. Clinical status was determined by the site. Response Assessment in Neuro‐Oncology (RANO) criteria were used for both assessments. Site and central assessments of progression‐free survival (PFS) and response rates were compared. Inter‐rater variability for central review progression dates was assessed.ResultsCentral review resulted in shorter PFS in 45% of 89 evaluable patients (n = 40). Median PFS was 3.6 (central) versus 3.9 months (site) (hazard ratio 1.5, 95% confidence interval 1.3–1.8, P < 0.001). Responses were documented more frequently by sites (n = 16, 18%) than centrally (n = 11, 12%). Seven of 120 patients continued on trial without site‐determined progression for more than 6 months beyond the central review determination of progression. Of scans reviewed by all three central reviewers, 33% were fully concordant for progression date.ConclusionWhile the difference between site and central PFS dates was statistically significant, the 0.3‐month median difference is small. The variability within central review is consistent with previous studies, highlighting the challenges in MRI interpretation in this context. A small proportion of patients benefited from treatment well beyond the centrally determined progression date, reinforcing that clinical status together with radiology results are important determinants of whether a therapy is effective for an individual.
Effects of foetal growth restriction and preterm birth on cardiac morphology and function during infancy
Authors: Cohen Emily , Whatley Christie , Wong Flora Y. , Wallace Euan M. , Mockler Joanne C. , Odoi Alexsandria , Hollis Samantha , Horne Rosemary S. C. , Yiallourou Stephanie R. 
Published: November 2017

AbstractAimTo investigate the effects of foetal growth restriction (FGR) and prematurity on cardiac morphology and function in infancy. We hypothesised that FGR and prematurity would both alter cardiac development.MethodsCardiac morphology and function were evaluated in 24 preterm FGR infants (p‐FGR) and 23 preterm and 19 term appropriately grown for gestational age infants (p‐AGA and t‐AGA, respectively) by conventional echocardiography and Tissue Doppler Imaging. p‐FGR and p‐AGA infants were studied on postnatal day 1 and all groups were studied at one‐and six‐months post‐term age.Resultsp‐FGR infants demonstrated increased cardiac sphericity compared to AGA peers on postnatal day 1 (p = 0.004) and at one‐month post‐term age (p = 0.004). Posterior and relative wall thickness increased overtime in the p‐FGR group only (p < 0.05). Systolic function was not different between groups. E/e’ ratio was higher in both preterm groups compared to the term group at one‐month post‐term age (p = 0.01). No statistically significant group differences were found at six‐months post‐term age.ConclusionFoetal growth restriction was associated with subtle cardiac morphological changes, whereas both prematurity and FGR were associated with subclinical alterations in diastolic function.