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PurposeThis study aims to advance the scholarship of yachting in the context of wellness by exploring the following research question: in what ways is wellness created and experienced by luxury yachting?Design/methodology/approachSince the extant journal literature from 2012–2023 in peer-reviewed journals is limited on the topic that links luxury yachting and wellness, the authors drew on other sources such as books and chapters in edited volumes. A third layer of material was drawn from the grey literature such as mass media and business websites. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) method, the authors examined 18 publications relating to the intersectionality of yachting and wellness.FindingsManufacturing and charter companies in the yachting industry are focused on creating and emphasizing features onboard that create a self-caring and wellness experience. The yacht design, spatial influences and the leisure time spent at destinations on anchor can also add value to wellness. This study enables us to understand the kinds of signals received by manufacturers and the media from yachting clients. These signals relate to the types of wellness needs and activities, as well as how crews and chefs create the best hospitality experiences for their clients.Originality/valueGiven the scarce and niche nature of research on yachting and wellness, this paper explores future research areas in wellness through luxury yachting which include hospitality aspects of creating and co-creating wellness experience on board the yacht and viewing yachting as a lifestyle necessity product for all levels of wealth and well-being.

Despite luxury brands’ efforts to incorporate sustainable development into their branding and product design, studies have shown inconclusive evidence about consumers’ reaction towards such efforts. This study investigates how consumption values (i.e. the need for exclusivity, conformity, and hedonism) affect consumers’ acceptance of luxury brands’ sustainable efforts. It adopts a cross-cultural framework by analysing two countries, namely China and the UK, which differ substantially in some of Hofstede’s cultural dimensions, namely power distance, individualism, and indulgence. Using the structural equation modelling in analysing 677 survey responses from actual luxury goods’ consumers in the two countries, we suggest that hedonic needs drive consumers’ purchase intentions in China and the UK. We find that the need for exclusivity in sustainable luxury items is negatively related to consumers’ purchase intentions in China, while the need for conformity is positively related. In contrast, these effects are reversed in the UK. Our study implies the need to align the marketing of sustainable luxury with consumption values of consumers to reflect the cultural differences. In theorizing sustainable luxury research, this study provides a deeper understanding of value perceptions pertaining to luxury product consumption and sustainability. Supplementary Information The online version contains supplementary material available at 10.1057/s41262-020-00228-0.

Background/Objectives To describe the visual and clinical outcomes of patients with post endothelial keratoplasty (EK) cystoid macular oedema (CMO) refractory to topical treatment with intravitreal sustained-release dexamethasone implant (Ozurdex). Subjects/Methods 131 eyes from 111 patients undergoing solitary or combined EK (52 DSAEK (40.0%) and 79 DMEK (60.0%)) at Southend University Hospital between January 2020 and February 2022 with a minimum follow-up of 6 months were evaluated. Patients suspected of having CMO underwent spectral-domain macular optical coherence tomography (SD-OCT) Patients with diabetes were not included in this series. Results CMO was identified in 5.3% (n = 7) of cases, with 2 of these patients responding to topical corticosteroid treatment. The remaining 5 patients underwent intravitreal dexamethasone implant, with 1 patient requiring repeat implant due to CMO recurrence. All presented within 2 months postoperatively. 4 out of 5 eyes treated with intravitreal dexamethasone achieved a Snellen BCVA ≤6/9.5. 1 patient had an uncontrolled rise in intraocular pressure (IOP) despite maximal medical treatment requiring an urgent PreserFlo Ab-Externo MicroShunt. Conclusions The use of intravitreal sustained-release dexamethasone implant in the management of post EK CMO refractory to topical therapy is effective and safe in most cases, but patients should be monitored and treated promptly for any secondary IOP response.

Recent efforts to diversify participation in STEM (Science, Technology, Engineering & Math) activities through informal learning environments, such as hackathons and makerspaces, confirm a real desire for inclusion among potential female participants. However, understanding factors that may contribute to longer-term, sustainable diversification of such groups remains a challenge. In this paper, we present the results of a mixed-methods study of two microcosms of making: game development, and quilting. Our findings reveal parallel structures within these groups despite being highly skewed towards male or female participation, respectively. Our results shed light on attitudes, behaviours, and experiences indicating that similar desires for wider community support among other factors exist in both groups, but these needs are not satisfied in the STEM context. We conclude by discussing the implications of our findings as opportunities for rethinking how we design the environments that are meant to support design itself, considering the role of technology in these spaces, and prioritizing nurturing the development of the maker community beyond the maker space.

To assess the role of clinical features in diagnosing seizures in children with autism spectrum disorder who present with staring spells. A 10-year retrospective chart analysis of autism spectrum disorder patients aged 3–14 years was performed at a tertiary care children’s hospital. Patient demographics, clinical presentation, and epileptic seizure versus non-epileptic spell diagnosis were assessed. Target episodes of staring spells were captured during a long-term electroencephalogram monitoring record. Multilevel likelihood ratios and a receiver operating characteristic curve were determined using 8 of the 11 clinical variables. Among the cohort of 140 patients with autism spectrum disorder, 16% were diagnosed with epileptic seizures with the most common seizure being atypical absence seizures (64%). Clinical semiology differed between those diagnosed with epileptic seizures versus those diagnosed with non-epileptic spells in the average duration of episodes (42 s vs 87 s), frequency of spells per week (6 vs 11.5 spells), increase in frequency of staring spells over time (100% vs 40%), and response to verbal stimulation (0% vs 100%), respectively. Multilevel likelihood ratios based on the receiver operating characteristic curves and clinical semiology features may be helpful in differentiating epileptic seizures from non-epileptic spells in children with autism spectrum disorder. Lay Abstract It is a common occurrence for children with autism spectrum disorder to be diagnosed with staring spells. Staring spells are defined as periods of time when children “space out” and are subcategorized as either “absence seizures” (brain activity resembling a seizure but with no physical seizure symptoms) or “non-epileptic spells” (inattentiveness or daydreaming). Due to the subtle characteristics of staring spells, they are usually diagnosed via long-term video electroencephalogram. The child is monitored for 3–5 days with an electroencephalogram which records brain waves. An electroencephalogram may be difficult to perform in children with autism spectrum disorder due to behavior, cognitive, or sensory concerns. Therefore, we wanted to investigate other clinical characteristics that may help us differentiate between epileptic seizures versus non-epileptic spells in children with autism spectrum disorder presenting with staring spells. We reviewed 140 charts retrospectively from the years of 2010–2021. We abstracted demographic and clinical information from the electronic medical record system and reviewed electroencephalogram videos to group the 140 children into epileptic seizure diagnosis group versus non-epileptic spell group. Of the 140 children in this study, 22 were diagnosed with epileptic seizures and the remaining were diagnosed with non-epileptic spells. We found that the two groups differed in certain clinical characteristics such as how long the staring spells lasted, how many staring spells the child had in 1 week, and whether they responded to verbal commands. We believe that clinical features may be helpful in differentiating epileptic seizures from non-epileptic spells in children with autism spectrum disorder.

The spate of natural disasters in recent years has spawned a great deal of research on various challenges in disaster preparation, response, and recovery. Not much attention has been given to scholarly analyses of policies adapting to post–disaster management that have implications for key sectors of a country’s economy. The strong inverse relationship between tourism and natural disasters underscores the vulnerability of tourism determined by the extent of direct and indirect impact from natural disasters, hence a need to evaluate post–disaster management. This study examines the 2018 Kerala flood and its impact on tourism through a critical assessment of the responses of government agencies and organizations. Understanding the extent of policy adaptations during and after the 2018 Kerala flood in India allows us to develop a framework for policymakers and other stakeholders to consider impact-limiting measures and construct built-in resilience in the tourism industry.

Our research investigates how the issue of food security is addressed through an effective urban planning strategy and legislative agenda in resource-constrained urban environments. As part of our study, we assess the degree to which urban planners have embraced the issue of food security. We also examine the importance of urban agriculture in facilitating narrower supply chains, which enhance food security. Finally, to further our understanding of the field, this study provides urban farming examples from Canada, Brazil, and Singapore to shed light on how a combination of community and NGOs support, public and private sector investments, as well as specific government regulatory provisions can help alleviate most of the food security challenges that resource-constrained environments present.

This study seeks to analyse the effectiveness of waste management in a highly developed, smart city like Singapore. It reviews the various approaches undertaken by the Singapore Government to align its waste management efforts with the Sustainable Development Goals (SDGs) in the UN 2030 Agenda. It also examines the contributions of other important stakeholders such as businesses and start-ups in the private sector, the so-called ‘informal sector’ and the wider community in managing waste. This research uses a qualitative methodology, through an integrative review of the literature, which offers insights into the challenges of waste management and in particular Singapore’s efforts in plastic waste management given its Smart Nation agenda. The findings and analysis reveal that while Singapore has taken some important first steps in raising awareness about the need to implement plastic and e-waste management practises, it is still very much a country in transition in the area of plastic waste management. The most pressing issue is about shifting consumption behaviour patterns in a manner that sees individual consumers becoming more active participants in the circular economy highlighting the significance of cultural norms in shaping household consumption behaviours.

We conducted a randomized controlled trial to examine choral singing's effect on cognitive decline in aging. Older Singaporeans who were at high risk of future dementia were recruited: 47 were assigned to choral singing intervention (CSI) and 46 were assigned to health education program (HEP). Participants attended weekly one-hour choral singing or weekly one-hour health education for two years. Change in cognitive function was measured by a composite cognitive test score (CCTS) derived from raw scores of neuropsychological tests; biomarkers included brain magnetic resonance imaging, oxidative damage and immunosenescence. The average age of the participants were 70 years and 73/93 (78.5%) were female. The change of CCTS from baseline to 24 months was 0.05 among participants in the CSI group and -0.1 among participants in the HEP group. The between-group difference (0.15, p=0.042) became smaller (0.12, p=0.09) after adjusting for baseline CCTS. No between-group differences on biomarkers were observed. Our data support the role of choral singing in improving cognitive health in aging. The beneficial effect is at least comparable than that of health education in preventing cognitive decline in a community of elderly people. Biological mechanisms underlying the observed efficacy should be further studied. Ministry of Health (MOH) Published version This work is supported by the National Innovation Challenge on Active and Confident Ageing Programme, Ministry of Health of Singapore (Award No.: MOH/NIC/COG06/2017) and the National University of Singapore Society (NUSS) Choir Dementia Research Fund. The funders played no role in the study design, data acquisition, analysis, or manuscript preparation. The views expressed are those of the authors and are not an official view of the institutions or funders.

Federal and local governments around the world usually hail urbanisation as a sign of economic progress. However, the relationship is not that simple. The existence of agglomeration economies does not mean that urbanisation will directly result in positive economic outcomes. Also, there is significant diversity in urban growth patterns, with each pattern resulting in different economic and social outcomes. The diversity in patterns of urban growth and transformation implies that different economies can grow at different speeds in achieving socioeconomic goals. This study explores the urban development of two tropical cities – Cairns and Singapore – with a focus on their different urban growth patterns. Cairns is an expanding tropical Australian city located far from main urban centres, meaning it needs attention to foster positive change that will produce distinctive urban spaces which improve quality of life while providing economic growth opportunities. The city of Singapore is a tropical island-state situated near the equator with limited land and natural resources, and one of the largest urban populations in Southeast Asia. Its landscapes are constantly changing as urban planning plays a key role in formulating and guiding the physical terrains of modern Singapore, thereby shaping the quality of life of its population.

Urban planners, government leaders, and the farming community have noted the important role cities play in producing their own food to manage higher levels of domestic demand, food insecurity, environmental concerns and affordability. To better understand these issues our research examines urban farming; in particular, the use of vertical farming methods. Such approaches can be used to overcome not only food safety and land resource issues, but also better manage the threats posed by rapid urbanisation. With technological developments in hydroponics, aeroponics and aquaponics, vertical farming has become a much more efficient and affordable means of farming in urban spaces. Overall, these high-tech systems signify a shift in the ways farming and food production can be operationalised. The results from our analysis show that Singapore, a tropical city in Asia, is making significant strides in vertical farming with substantial public and private investment in R&D through high-tech, high-yielding, land-limited farms in high-rise buildings. Despite these initiatives, Singapore faces a highly constrained urban environment where land scarcity is exacerbated by a complex regulatory land use framework.

OBJECTIVE To compare central nervous system (CNS) activation in patients with and without diabetic peripheral neuropathy (DPN) during motor and motor imagery tasks and to correlate activation with functional performance. RESEARCH DESIGN AND METHODS Twenty-six participants (13 with DPN, 13 without DPN) underwent functional MRI during three tasks: ankle dorsi plantar flexion (motor task [MT]) and motor imagery tasks of walking on a smooth surface (SMIT) and rough surface (RMIT). Functional assessment included gait analysis, ankle muscle strength, and ankle range of motion. RESULTS The tasks activated the sensorimotor, motor preparation, visual processing, and decision-making regions. Activation was significantly lower in patients with DPN than in those without DPN during MT and SMIT but not RMIT. Poor functional performance in patients with DPN was associated with greater activation in motor preparation regions. CONCLUSIONS In patients with DPN, CNS responses appear muted compared with patients without DPN, but they remain capable of enhancing CNS activation when tasks are more challenging or when functional deficits are substantial.

Plain English summary There have been many attempts to improve how healthcare services are developed and delivered. Despite this, we know that there are many gaps and differences in practice and that these can lead to poor patient outcomes. In addition, there are also concerns that research is being undertaken that does not reflects the realities or needs of those using healthcare services, and that the use of research findings in practice is slow. As such, shared approaches to research, such as integrated knowledge translation, are being used. Integrated knowledge translation (IKT) is a research approach that brings together researchers, along with other stakeholders that have knowledge about a particular healthcare issue. Stakeholders may include healthcare providers and policy-makers. More recently, there has been a growing awareness of the need to include patients and members of the public within research processes. These collaborative and patient-oriented research approaches are seen as a way to develop research that tackles ongoing gaps in practice and reflect the insights, needs and priorities of those most affected by health research outcomes. Despite great support, little is known about how these major research approaches are connected, or how they may bring about improvements in the development and use of research evidence. In this paper, we examine how IKT and patient engagement processes are linked, as well as exploring where differences exist. Through this, we highlight opportunities for greater patient engagement in IKT research and to identify areas that need to be understood further. Abstract Healthcare organizations across the world are being increasingly challenged to develop and implement services that are evidence-based and bring about improvement in patient and health service outcomes. Despite an increasing emphasis upon evidence-based practice, large variations in practice remain and gaps pervade in the creation and application of knowledge that improves outcomes. More collaborative models of health research have emerged over recent years, including integrated knowledge translation (IKT), whereby partnerships with key knowledge users are developed to enhance the responsiveness and application of the findings. Likewise, the meaningful engagement of patients, in addition to the inclusion of patient-reported outcomes and priorities, has been hailed as another mechanism to improve the relevance, impact and efficiency of research. Collectively, both IKT and patient engagement processes provide a vehicle to support research that can address health disparities and improve the delivery of effective and responsive healthcare services. However, the evidence to support their impact is limited and while these approaches are inextricably connected through their engagement focus, it is unclear how IKT and patient engagement processes are linked conceptually, theoretically, and practically. In this paper, we will begin to critically examine some of the linkages and tensions that exist between IKT and patient-engagement for research and will examine potential opportunities for IKT researchers as they navigate and enact meaningful partnerships with patients and the public.

Prior research has shown that large interactive displays deployed in public spaces are often underutilized, or even un- noticed, phenomena connected to 'interaction' and 'display blindness', respectively. To better understand how designers can mitigate these issues, we conducted a field experiment that compared how different visual cues impacted engagement with a public display. The deployed interfaces were designed to progressively reveal more information about the display and entice interaction through the use of visual content designed to evoke direct or indirect conation (the mental faculty related to purpose or will to perform an action), and different animation triggers (random or proxemic). Our results show that random triggers were more effective than proxemic triggers at overcoming display and interaction blindness. Our study of conation - the first we are aware of - found that "conceptual" visuals designed to evoke indirect conation were also useful in attracting people's attention.

Higher education is increasingly focusing on facilitating agentic, outward-looking, globally minded graduates. International mobility experiences are positioned as key to developing these qualities; however, not all students have the inclination, resources, or support to enable them to participate in such experiences. Student surveys reveal that the top barriers to participation—time, finances, work, and family commitments—are outside the influence of educators. In response, educators need to look to opportunities afforded through both local and international experiences. Service learning can enable students to explore democratic action in a local space within a framework that accounts for global perspectives. This chapter draws on findings of six local and international case studies to explore curriculum and pedagogical frameworks that facilitate global perspectives through community-based learning experiences.

Objective: Approximately 20% of patients admitted to hospital with drug overdose will require intensive care unit (ICU) admission. An understanding of the characteristics of these patients may assist with their management and identify those patients at risk of multiple hospital presentations due to drug overdose. Our aim was to examine the characteristics of patients admitted to ICU following drug overdoses and identify the predictors of multiple hospital presentations due to drug overdose. Methods: Patients admitted to a metropolitan ICU over a three-year period following drug overdoses were identified using ICU patient databases, and their medical records. Results: There were 254 admissions due to drug overdoses. The majority of overdoses were intentional (82.7%) and included multiple agents (68.1%). Two-thirds of patients had psychiatric diagnosis, and 54% had documented history of substance use disorders. In-hospital mortality was 2.8%. Over half of patients admitted had documented history of prior hospital presentation due to overdoses. Personality disorder and schizophrenia were independent predictors of multiple hospital presentations due to overdoses. Conclusion: Personality disorders or schizophrenia were independent predictors of patients with multiple overdose presentations. Preventative strategies focusing on these patients may reduce the incidence of their hospital presentations and ICU admissions.

1Montreal Heart Institute, Montreal, Quebec; 2CIHR Institute of Circulatory and Respiratory Health, Ottawa, Ontario, Canada Correspondence: Ms Caroline Wong, CIHR Institute of Circulatory and Respiratory Health, 5000 Belanger St – S2580, Montreal, Quebec H1T 1C8, Canada. Telephone 514-593-7433, fax 514-376-7070, e-mail caroline.wong@icm-mhi.org Received for publication October 4, 2014, Accepted October 9, 2014 The Institute of Circulatory and Respiratory Health (ICRH) – 1 of the 13 Institutes of the Canadian Institutes of Health Research (CIHR) – supports research that focuses on cardiovascular health, respiratory health, blood and blood vessels, stroke, critical/intensive care, and sleep/circadian rhythms. Together, the disease areas that are covered under the mandate of the ICRH represent conditions with the largest health, societal, and economic burden of any of the other Institutes within CIHR. This reality and the extraordinary diversity of these medical conditions present a major operational challenge for the ICRH. Despite these difficulties and limited resources, the Institute’s 2013-2016 Strategic Plan1 demonstrates a commitment to ensuring that research excellence, capacity, competitiveness, innovation, and impact are enhanced across all research fields affiliated with the Institute. Moreover, building on previous successes, the ICRH continues to nurture past collaborations and work to establish new meaningful national and international alliances with the research community, partners, and other stakeholders to develop interdisciplinary, integrative health research that reflects Canada’s emerging health needs, gaps, and opportunities. The ICRH also strongly supports partnerships with relevant stakeholders to accelerate the transfer of new knowledge into benefits for Canadians. Notably, patient engagement is an important priority that will serve as 1 of the major building blocks of all clinically related initiatives of the ICRH. Based on identified gaps, opportunities, and feedback received from the International External Review Panel,2 ICRH research communities and partners, and in alignment with the CIHR 2014-2018 Strategic Plan, the ICRH identified 4 research priorities for 2013-2016. The first priority focuses on enhancing capacity, competitiveness, and impact of our communities through networking. This objective is consistent with the importance of aligning with CIHR’s largest comprehensive Roadmap Signature Initiative (RSI) the Strategy for Patient-Oriented Research (SPOR). In 2013, the Institute launched the ICRH Emerging Networks program in 3 gap areas, funding the Canadian Vascular Network, Canadian Respiratory Research Network, and the Canadian Stroke Prevention Intervention Network. In addition, through focused community development programs in critical care, stroke treatment and recovery, sleep and circadian rhythms, blood diseases, and resuscitation clinical research, the ICRH has targeted 5 additional research communities in need of networking. Aligned with CIHR’s Patient Engagement Framework,3 the ICRH will use specific actions and tools to enhance patient engagement in health research, implement patient engagement as a core priority in strategic initiatives, and offer programs that will allow patients to be true partners in research. Finally, the ICRH is continuing its collaboration with the National Heart, Lung, and Blood Institute of the National Institutes of Health in the ongoing support of 2 large Canada-US networks––the Resuscitation Outcomes Consortium and the Cardiothoracic Surgical Network, and will explore other international network opportunities. The second priority of the ICRH targets training, mentoring, and early career development to promote capacity-building––areas with an identified need. Recently, data have shown that the growth of funding within the ICRH’s mandated research areas has been slower than in all other areas at the CIHR, in particular for the cardiovascular and respiratory communities (Fig. 1A). Evidence suggests that this is primarily due to declining numbers of young investigators (Fig. 1B). The development of research capacity related to health systems/services and population/public health has been identified as requiring particular attention. In the upcoming years, the ICRH will work closely with relevant CIHR Institutes and various working groups to address this important and persistent capacity problem, focusing on training/mentoring issues and issues affecting the career success of young investigators. In 2014, the ICRH facilitated the development of the Emerging Research Leaders Initiative, which was launched as a joint initiative between the Heart and Stroke Foundation and the Canadian Lung Association––2 of the ICRH’s key partners. The ICRH will also continue its collaborative work with key stakeholders to develop a comprehensive training and mentoring strategy that will directly align with partner-led programs. A recent national ICRH survey (data not yet published) also confirmed the need for improved mentoring and the ICRH will work with its networks, partners, and the CIHR to improve the quality of mentoring based on current best practices. The third priority of the ICRH focuses on the expansion of clinical research opportunities, health systems/services research, and population health through cohort linkage and data enhancement. This initiative will provide Canadian scientists with a unique opportunity to boost knowledge development and translation at a fraction of the cost of developing new cohorts and will enable Canada to develop better population-based research, and design individualized and community-based prevention and intervention programs. In addition, this initiative will contribute to improving the potential for health and health systems research by creating a pool of population-based data that can be linked to Canada’s uniquely powerful administrative databases. Data enhancement and linkage will also directly assist in gathering and analyzing data related to Canada’s Aboriginal people and other vulnerable populations that are presently lacking. Finally, by helping to address issues such as data storage and access, this initiative will support research on ethics, and increase the use and sustainability of existing cohorts. Along with the CIHR and its other Institutes, the ICRH is helping to coordinate disparate and multidisciplinary communities to bridge gaps and identify ways for harmonizing and sharing population-relevant data sets and their efficient utilization. In the context of the increasing prevalence of cardiovascular and respiratory risk factors, many of which are also risk factors for other serious chronic diseases, this initiative provides a unique opportunity for the ICRH community to link with other research communities in building tools to fuel clinical research and population health, health services, and policy research. Through the Environments and Health Signature Initiative, the ICRH is coleading the Data Platforms component, COMMENTARy

e12540Background: Low serum vitamin D (Vit-D) is associated with an increased risk of breast cancer (BC). Patients with adequate levels of Vit-D/replacement have lower rates of BC incidence. Aims: ...

The effect of uterine artery embolization (UAE) on symptomatic adenomyosis was evaluated in a systematic review and meta-analysis. Four groups were evaluated: short-term (< 12 months) pure adenomyosis, short-term adenomyosis with fibroids (combined adenomyosis), long-term (> 12 months) pure adenomyosis, and long-term combined adenomyosis. Improvement of symptoms occurred in 83.1% (872/1,049) of patients. Reported symptom reduction was 4.8% greater in the short-term combined group (P = .169) and 11.4% greater in the long-term combined group (P = .003). Uterine volume was reduced in all patients at 3 months. The effects of UAE on symptom improvement and uterine volume reduction in patients with adenomyosis are encouraging.

Growth cone response to the bifunctional guidance cue netrin-1 is regulated by the activity of intracellular signaling intermediates such as protein kinase C-alpha (PKCalpha) and adenylyl cyclase. Among the diverse cellular events these enzymes regulate is receptor trafficking. Netrin-1, itself, may govern the activity of these signaling intermediates, thereby regulating axonal responses to itself. Alternatively, other ligands, such as activators of G protein-coupled receptors, may regulate responses to netrin-1 by governing these signaling intermediates. Here, we investigate the mechanisms controlling activation of PKCalpha and the subsequent downstream regulation of cell surface UNC5A receptors. We report that activation of adenosine receptors by adenosine analogs, or activation of the putative netrin-1 receptor, the G protein-coupled receptor adenosine A2b receptor (A2bR) results in PKCalpha-dependent removal of UNC5A from the cell surface. This decrease in cell surface UNC5A reduces the number of growth cones that collapse in response to netrin-1 and converts repulsion to attraction. We show these A2bR-mediated alterations in axonal response are not because of netrin-1 because netrin-1 neither binds A2bR, as assayed by protein overlay, nor stimulates PKCalpha-dependent UNC5A surface loss. Our results demonstrate that netrin-1-independent A2bR signaling governs the responsiveness of a neuron to netrin-1 by regulating the levels of cell surface UNC5A receptor.

Singapore's commitment to knowledge-based economy (KBE) development in the past decade has enabled it to make a rapid and successful transition to a newly industrialized economy. Having invested heavily in ICT, the Singapore government is now keen to use content and creativity to enter the next wave of development. The film industry is chosen as a microcosm level of analysis to examine the creative economy as the latest phase in Singapore's current economic development, especially when technology and information are used to navigate and mediate its people, resources and capital. The objective of this research is to examine the types of competencies that enable firms to stay competitive in the contemporary knowledge-based economy in the light of technological advancement made in the industry. Examining the types of resources, especially the intangible ones that enable the film industry to thrive, develops our understanding of the complexity of this industry at a time when digital technology is leading to a period of great change in it. It also seeks to examine the extent to which digitalization contributes to the growth and expansion of the Singapore film and animation industry and whether the film and animation industry can leverage on digitalization to bring about competitive advantage. The analysis is based on surveys and interviews conducted on the local film and animation producers in the industry. Singapore was chosen as the subject of the analysis for two reasons. First, a great deal of government attention is currently being directed to the film industry there. Film now represents an emerging industry in Singapore. From 1995 to 1999, an average of less than four local films was produced per year. Singapore aims to build a sustainable industry producing 10 to 15 films per annum in three to five years. This evokes comparisons with the 'golden age of cinema' in the 1950s and 1960s, when the combined average annual output for Malay films was about 18 features. Second, the Singaporean government, responding to global developments, has recognised that creative industries, including the motion picture, television and digital media production industries are becoming powerful engines of economic growth. In recent years, efforts have been made to exploit the economic benefits of culture. Film is one of the contenders in the new era as Singapore seeks to rebrand its image from a conservative society to a 'new Asian creative hub' (ERC Report, September 2002, p.8). This study shows how the film industry in Singapore is transforming. Singaporean film remains marginal in the global circuit of film production and distribution. Can it rise to become more recognised while delivering economic returns on creative investment?

Aim: Cardiac amyloidosis is a protein deposition disease that can be difficult to diagnose and has a poor prognosis if diagnosis or treatment are delayed. The two major subtypes are AL and transthyretin (ATTR). Both have vastly different treatments so confirming the correct amyloid subtype is crucial. A tissue biopsy is usually required for the diagnosis of amyloidosis and to distinguish between the subtypes. No blood test, echocardiography or cardiac MRI can reliably distinguish between AL and ATTR. With a cardiac biopsy, distinguishing AL from ATTR can be challenging with immunohistochemistry, and time consuming with mass spectrometry. Recently, Gillmore et al demonstrated bone scintigraphy with 99mTc-DPD tracer can reliably diagnose ATTR, avoiding endomyocardial biopsies to confirm the subtype in most cases. [1] 99mTc-HDP is a tracer similar to 99mTc-DPD and is more readily available in Australian and the USA. We sought to examine the use of 99mTcHDP bone scintigraphy in Australia and determine the accuracy of this tracer to diagnose cardiac amyloidosis and distinguish between the AL and ATTR subtypes. Methods: All patients with confirmed ATTR or AL who had 99mTcHDP bone scintigraphy were analysed. Results were correlated with histology, NT ProBNP, Troponin-T, free light chains, cardiac MRI and echocardiography. Grading was conducted with Perugini scoring.[1] Results: 25 patients with amyloidosis diagnosed by cardiac MRI and/or biopsy, had 99mTcHDP bone scintigraphy. 18 were confirmed ATTR, 7 AL. Two ATTR patients had hereditary disease (Thy60Ala and Gly109Lys), the remainder were wildtype. 17 (94%) patients with ATTR and 2 (29%) AL had positive scans. The negative ATTR patient had localized bladder disease only with a normal echocardiogram and cardiac biomarkers. All ATTR patients with positive scans had Perugini scores of 2 or 3, including the 2 patients with hereditary mutations, while the two positive AL only had scores of 1. All 11 patients with amyloid features on cardiac MRI had positive scans. Mean NTproBNP values for ATTR and AL were 530pmol/L and 1396pmol/L respectively. The two AL amyloidosis patients with positive bone scans had higher NTproBNP values. No ATTR patient had a detectable plasma cell dyscrasia. Conclusion: Bone scintigraphy with 99mTcHDP tracer is an easily accessible, rapid and non-invasive method of diagnosing cardiac amyloidosis. In our small series, all patients with Perugini scores 2 or 3 had ATTR, while those with negative or Perugini score 1 scan either had AL or no cardiac amyloidosis. There was a suggestion that AL patients with higher NTproBNP scores were more likely to have positive scans. This suggests that the 99mTcHDP tracer can be used like 99mTc-DPD to aid in the diagnosis of cardiac amyloidosis, and, as suggested by Gillmore et al, can confirm the ATTR subtype in those with no detectable plasma cell dyscrasia and Perugini score 2 or 3 scans, thus hastening accurate diagnosis and avoiding cardiac biopsies. Reference: Gillmore JD, Maurer MS, Falk RH, Merlini M, Damy T, Dispenzieri A, et al. Non-biopsy diagnosis of cardiac transthyretin amyloidosis. Circulation. 2016 Jun 14;133(24):2404-12 Disclosures No relevant conflicts of interest to declare.

Keratinocyte growth factor (KGF or FGF-7) is a member of the heparin binding fibroblast growth factor (FGF) family and is a paracrine mediator of proliferation and differentiation of a wide variety of epithelial cells. To examine the stoichiometry of complexes formed between KGF and its receptor, we have utilized a soluble variant of the extracellular region of the KGF receptor containing two tandem immunoglobulin-like loops, loops II and III (sKGFR). Ligand-receptor complexes were examined by size exclusion chromatography, light scattering, N-terminal protein sequencing, and sedimentation velocity. In the presence of low-molecular mass heparin ( approximately 3 kDa), we demonstrate the formation of complexes containing two molecules of sKGFR and one molecule of KGF. In the absence of heparin, we were unable to detect any KGF-sKGFR complexes using the above techniques, and additional studies in which sedimentation equilibrium was used show that the binding is very weak (Kd >/= 70 microM). Furthermore, using heparin fragments of defined size, we demonstrate that a heparin octamer or decamer can promote formation of a 2:1 complex, while a hexamer does not. Utilizing the highly purified proteins and defined conditions described in this study, we find that heparin is obligatory for formation of a KGF-sKGFR complex. Finally, 32D cells, which appear to lack low-affinity FGF binding sites, were transfected with a KGFR-erythropoeitin receptor chimera and were found to require heparin to achieve maximal KGF stimulation. Our data are consistent with the previously described concept that cell- or matrix-associated heparan sulfate proteoglycans (HSPGs) and FGF ligands participate in a concerted mechanism that facilitates FGFR dimerization and signal transduction in vivo.

Recombinant human brain-derived neurotrophic factor (BDNF) is now under extensive investigation because of its potential clinical applications. Radioactively labeled proteins are usually required to study receptor binding and pharmacokinetic properties of proteins. This study was undertaken to see if iodination affects the biological and conformational properties of a recombinant BDNF. BDNF was iodinated using a stoichiometric amount of nonradioactive cold NaI to minimize multiple iodinations. Of the four tyrosines present in BDNF--Tyr-52, Tyr-54, Tyr-63, and Tyr-86--only Tyr-63 and Tyr-86 were iodinated under the experimental conditions used. Iodination of Tyr-63 resulted in modification without alteration of the biological activity, whereas iodination of Tyr-86 resulted in a molecule with highly compromised biological activity. Similar inactivation was observed if both Tyr-63 and Tyr-86 were iodinated. These modified proteins exhibited conformation and dimerization apparently identical to those of the native protein, as demonstrated by analytical ultracentrifugation, gel filtration, light scattering, and circular dichroism. From these results, we concluded that Tyr-52 and Tyr-54 are not accessible to the reagent and are probably buried in the hydrophobic core, whereas Tyr-63 and Tyr-86 are exposed on the surface of the molecule; of the two exposed residues, only Tyr-86 contributes to the biological activity.

Singapore’s commitment to knowledge-based economy (KBE) development in the past decade has enabled it to make a rapid and successful transition to knowledge-based city. This chapter focuses on how Singapore government has forged an environment that is conducive to innovations, new discoveries and the creation of new knowledge. In the process, Singapore has emerged as one of the top knowledge-based cities in the world through various frameworks used globally. In this period, Singapore strengthened its engagement with the global knowledge economy developing a creative industries development strategy which endorsed the importance of creative industries, aiming to position Singapore as a ‘new Asian creative hub’ (ERC Report, 2002, p.8). The Singapore experience represents one of few examples of how knowledge can become the driving force of economic growth and transformation. It provides valuable insight into how public policies have successfully negotiated the current global network economy to suit economic changes. Although Singapore’s developmental model has created benefits in many ways, it had also negatively constrained its development particularly in the area of knowledge creation and application to entrepreneurship and creativity.

This chapter presents Singapore as a case study for the management of change as Singapore transits from a knowledge-based economy to the creative economy. Analysis of the knowledge-based economy suggests that competitive advantage is increasingly derived from investment in intangibles, particularly information and knowledge-based competencies. The film industry is chosen as a microcosm level of analysis to examine the state of the creative economy as the latest phase in Singapore’s economic development as technology and information are increasingly used to navigate and mediate its people, resources and capital. The objective of this research is to examine the types of competencies that enable firms in the industry to stay competitive in the contemporary knowledge-based economy in the light of technological development in the industry. In so doing, it seeks to shed light on what matters for the industry and the role that government has in shaping the creative economy.

PurposeThis paper aims to present an approach to the knowledge‐based economy that focuses on the developmental synergies between technology (especially information and communication technologies), culture and place (hub) as expressed in the innovative milieu of the inner city.Design/methodology/approachThis paper draws on research in city and urban planning, which emphasizes the importance of quality of a place, location or city and the more intentional emphasis given to development of human and cultural resources, which are conducive to innovation, learning, creativity and change in a knowledge‐based economy.FindingsSingapore is chosen as a case study of analysis for a knowledge‐based economy in transition because of its developmental approach and strategic shift from one focused on technology‐intensive sectors to one focused on high knowledge‐intensive companies and towards a free‐spirited dynamic creative hub in the making. It displays many characteristics typical of a knowledge‐based economy in which people, their ideas and capabilities are the key sources of wealth and opportunities.Practical implicationsThe paper observes a missing link in the transition from technology to knowledge to culture hub, which might have implications for Singapore's effort towards establishing itself as a cultural industries metropolis, a renaissance city using culture to re‐position its international image as a global city for the arts.Originality/valueThe originality and value of the paper lie in this analysis, which makes one conclude that, although Singapore's developmental model had created benefits in many ways, it had also negatively constrained its development, particularly in the area of knowledge creation and application to entrepreneurship, innovation and creativity.

Already in 1945 Hayek pointed out that it was difficult and complex to analyse knowledge as a resource due to its intangibility and randomness: the knowledge of the circumstances of which we must make use never exists in concentrated or integrated form, but solely as the dispersed hits of incomplete and frequently contradictory knowledge…a problem of the utilisation of knowledge not given to anyone in its totality. Hayek, 1945, p. 520

This chapter combines looking at complexity with a consideration of value creation in knowledge-based industries. Our main conjecture is that indices (Jervis, 1985), or external truthful signals, can be used by the market to certify and rank the value of an actor’s product or services. Such path-dependent effects can lead to winner-take-all (Frank and Cook, 1995) results, where ranked actors gain a disproportionately large part of the market or value relative to unranked actors. This framework helps to illustrate the complexities of competition when our analysis integrates both markets and institutions.

This chapter seeks to draw a parallel between organizations and households in the areas of knowledge and value creation. We introduce comparisons between firms and households because factors such as the nature of competition, collaboration, community and sharing within households provide examples of effective knowledge and value creation and exchange carried out within an ‘organization’-structured social unit. Our objective is to underpin the view that understanding of organizations can be improved by drawing out the analogy with households, where knowledge and value are created informally and holistically. Not just production can create value in the organization: value creation is also evident in the consumption decisions as they are made in households.

An organization’s ability to create and exchange knowledge within a network of social and technological relationships has become crucial in today’s international business world. The ability to measure and value such knowledge assets has become important because of the role they have as fundamental drivers of global success. This is especially true in the service industries, which are increasingly knowledge-based (Coe, 2003b; Herbert et al, 2003).