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Autoimmune encephalitis (AE) is a neurological disorder caused by autoimmune attack on cerebral proteins. Experts currently recommend staged immunotherapeutic management, with first-line immunotherapy followed by second-line immunotherapy if response to first-line therapy is inadequate. Meta-analysis of the evidence base may provide higher quality evidence to support this recommendation. We undertook a systematic review of observational cohort studies reporting AE patients treated with either second-line immunotherapy or first-line immunotherapy alone, and outcomes reported using the modified Rankin Scale (mRS; search date: April 22, 2020). We performed several one-stage multilevel individual patient data (IPD) meta-analyses to examine the association between second-line immunotherapy and final mRS scores (PROSPERO ID CRD42020181805). IPD were obtained for 356 patients from 25 studies. Most studies were rated as moderate to high risk of bias. Seventy-one patients (71/356, 19%) were treated with second-line immunotherapy. We did not find a statistically significant association between treatment with second-line immunotherapy and final mRS score for the cohort overall (odds ratio [OR] = 1.74, 95% confidence interval [CI] = .98-3.08, p = .057), or subgroups with anti-N-methyl-D-aspartate receptor encephalitis (OR = 1.03, 95% CI = .45-2.38, p = .944) or severe AE (maximum mRS score 2; OR = 1.673, 95% CI = .93-3.00, p = .085). Treatment with second-line immunotherapy was associated with higher final mRS scores in subgroups with anti-leucine-rich glioma-inactivated 1 AE (OR = 6.70, 95% CI = 1.28-35.1, p = .024) and long-term (at least 12 months) follow-up (OR = 3.94, 95% CI = 1.67-9.27, p = .002). We did not observe an association between treatment with second-line immunotherapy and lower final mRS scores in patients with AE. This result should be interpreted with caution, given the risk of bias, limited adjustment for disease severity, and insensitivity of the mRS in estimating psychiatric and cognitive disability. more...

Moganite is a silica polymorph found intergrown with microcrystalline quartz. Raman spectroscopy is used to detect moganite using a band at 501 cm-1, generated by the vibration of a four-membered tetrahedral SiO2. This band is numerically distinct from the most intense band used to identify quartz at 465cm-1, and thus Raman spectroscopy might be considered a reliable methodology to detect moganite. However, the moganite detection using Raman spectra must be done with caution since a band at 503 cm-1 can be caused by a Si-O vibration of silanole (SiOH), and thus the two bands interfere and may mingle. Such interference might be mitigated or increased by sample preparation, but it has not previously been shown with certainty whether powdered or intact rock surfaces, would exhibit the greatest interference. Here, we present a Raman spectroscopic study of different particle sizes on moganite and flint to investigate how it affects moganite detection. We found a Raman band in pristine flint with a similar peak position to moganite, but subsequent to heat treatment at 700 ˚C for 6 hours, the band disappeared indicating the presence of silanole rather than moganite. Powdering the sample in combination with the use of higher laser powers increased this effect and the relative intensity of the silanole band. Overall, the Raman spectrum of flint was found to be more sensitive to laser-power-induced artifacts than moganite. Aggregated quartz powder is known to be affected by laser-induced heating during Raman spectroscopy. However, the effect of the heating on silanole and moganite bands is not as well documented. The peak shift of moganite has a similar trend to the phase transition detected by Raman Spectroscopy and XRD with heat thus the two approaches are consistent. Furthermore, the silanole band is known to change its position by 6 cm-1 at heating from room temperature to 600 ˚C. Based on the results from other research, the peak shift and broadening in the present study can be interpreted as an effect of laser-induced heating. To date, for mineral analyses, the number of studies reporting the effects of laser-induced heating on minerals is limited, which contrasts strongly with Raman spectroscopy of organic materials. The result in the present study suggests that the band shift of silanole and the transition of α-β moganite can be caused by the heat of the laser should be taken into consideration especially when small particle size moganite is being identified by Raman Spectrum. However, this same sensitivity to temperature may indicate potential as a measure of paleotemperature. more...

The authors aimed to assess, in patients with perirolandic gliomas and gliomas originating from other regions, survival, functional outcomes, and seizure control. Additionally, to identify any clinical characteristics predictive of progression-free (PFS), overall survival (OS), and seizure control.The authors retrospectively analyzed 87 patients who underwent resection of WHO grade II or III gliomas at a single institution between 2009 and 2021. Tumors were classified by topographic involvement. One-year postoperative functional status was quantified with Karnofsky Performance Score (KPS). One-year seizure control was defined by Engel's seizure classification. Dichotomous and categorical variables were reported as counts and percentages and compared using Fisher's exact test. A Cox regression model was used to identify covariates that affect PFS and OS.Patients with perirolandic gliomas had similar survival and functional outcomes to patients with gliomas from other regions, and a low rate of lasting neurologic deficits. Patients with perirolandic gliomas had comparatively worse long-term seizure outcomes (approached statistical significance). Perirolandic involvement (HR, 0.10, 95% CI, 0.02 to 0.46, p = 0.005) and preoperative seizures (HR, 0.14, 95% CI, 0.02 to 0.62, p=0.017) conferred a lower likelihood of durable seizure control while increased extent of resection (HR, 1.07, 95% CI, 1.03, 1.12, p=0.003) enhanced the likelihood of seizure freedom.Despite proximity to or presence in eloquent structures, perirolandic gliomas can largely be resected without incurring worse functional outcomes. Patients with perirolandic gliomas should be considered for maximal safe resection to optimize survival outcomes and improve seizure control. more...

Background: Cognitive impairment is a well-documented predictor of transition to a full-threshold psychotic disorder amongst individuals at ultra-high risk (UHR) for psychosis. However, less is known about whether change in cognitive functioning differs between those who do and do not transition to a psychotic disorder. Studies to date have not examined trajectories in intelligence constructs (e.g., acquired knowledge and fluid intelligence), which have demonstrated marked impairments in individuals with schizophrenia. This study aimed to examine intelligence trajectories using longitudinal data from three time-points, spanning an average of eight years.Methods: Participants (N=139) at UHR for psychosis completed the Wechsler Abbreviated Scale of Intelligence (WASI) at each follow-up. Linear mixed-effects models mapped changes in WASI Full-Scale IQ (FSIQ) and T-scores on Vocabulary, Similarities, Block Design, and Matrix Reasoning subtests.Results: The sample showed stable and improving trajectories for FSIQ and all subtests. There were no significant differences in trajectories between those who did and did not transition to psychosis and between individuals with good and poor functional outcomes. However, although not significant, the trajectories of the acquired knowledge subtests diverged between transitioned and non-transitioned individuals (β=−0.12, 95% CI [−0.29, 0.05] for Vocabulary and β=−0.14, 95% CI [−0.33, 0.05] for Similarities). Conclusions: There was no evidence for long-term deterioration in intelligence trajectories in this UHR sample. As the small sample of individuals who transitioned may have limited our ability to detect subtle differences, future studies with larger sample sizes are needed to explore potential differences in intelligence trajectories between UHR transition groups. more...

INTRODUCTION Corticosteroids are commonly used preoperatively in patients with brain metastases to mitigate symptoms related to vasogenic peritumoral edema (PTE). Though these tumors are highly prevalent, surprisingly few studies have examined the effect of steroids on PTE evident on MRI. We investigated whether steroid administration was associated with greater reduction in PTE in brain metastasis patients compared to steroid-naïve patients. Additionally, we sought to determine if PTE reductions reflect preoperative neurologic improvement and whether an association existed between change in PTE and preoperative steroid dosing. METHODS We identified 27 patients with brain metastases and two pre-operative MRIs—one pre- and one post-steroid administration. PTE and tumor volume was calculated from FLAIR or T2 sequences using 3D Slicer. PTE was quantified with Edema Index (EI). Pertinent demographic, clinical, and dexamethasone dosing data were extracted from patient charts. Descriptive statistics were performed to compare demographic, clinical, and radiographic data between patient strata. A Pearson's R correlation was performed to assess for an association between percent change in PTE and dexamethasone dosing. All statistics were computed in R with a threshold of α= 0.05. RESULTS Patients that received preoperative dexamethasone demonstrated significantly greater percent reduction in PTE compared to their steroid naïve counterparts (p = 0.02). This finding was despite similar time elapsed between MRI studies across both groups. Similar PTE changes were observed in those with and without preoperative neurologic improvement. No significant correlation was found between percent-change in PTE and dexamethasone dosing. CONCLUSIONS We are the first to demonstrate that preoperative dexamethasone administration significantly reduces PTE in patients with brain metastases when compared to a steroid naïve reference group. Curiously, a superior reduction in PTE was not reflective of neurologic improvement. The clinical significance of this merits further study. more...

OBJECTIVE In this article, the authors describe the impact of the COVID-19 virtual match cycle and discuss approaches to optimize future cycles through applicant and neurosurgical education leadership insights. METHODS Anonymous surveys of neurosurgery program leaders (program directors and program chairs), program administrators (PAs), and 2020–2021 neurosurgery residency match applicants were distributed by the SNS, in conjunction with the Association of Resident Administrators in Neurological Surgery and AANS Young Neurosurgeons Committee. RESULTS Responses were received from 77 (67.0%) of 115 PAs, 119 (51.7%) of 230 program leaders, and 124 (44.3%) of 280 applicants representing geographically diverse regions. During the virtual application cycle relative to the previous year, programs received more Electronic Residency Application Service applications (mean 314.8 vs 285.3, p < 0.0001) and conducted more applicant interviews (mean 45.2 vs 39.9, p = 0.0003). More than 50% of applicants applied to > 80 programs; 60.3% received ≤ 20 interview invitations, and 9% received > 40 invitations. Overall, 65% of applicants completed ≤ 20 interviews, whereas 34.7% completed > 20 interviews. Program leaders described one 4-week home subinternship (93.3%) and two 4-week external subinternships (68.9%) as optimal neurosurgical exposure; 62.8% of program leaders found the standardized letter of recommendation template to be somewhat (47.5%) or significantly (15.3%) helpful. Applicants, PAs, and program leaders all strongly preferred a hybrid model of in-person and virtual interview options for future application cycles over all in-person or all virtual options. Ninety-three percent of applicants reported matching within their top 10–ranked programs, and 52.9% of programs matched residents within the same decile ranking as in previous years. CONCLUSIONS Optimizing a national strategy for the neurosurgery application process that prioritizes equity and reduces costs, while ensuring adequate exposure for applicants to gain educational opportunities and evaluate programs, is critical to maintain a successful training system. more...

Synopsis Chris Morrison and two partners introduced the first Fairtrade bananas in New Zealand in a bid to improve the social and environmental impacts of banana consumption. The trio started All Good Bananas in 2010. Using social media as a key marketing tool, the startup had grown to take a 5 percent market share in a fiercely competitive industry dominated by big players. In 2012, the entrepreneurs needed to decide the best way to increase sales of ethically sourced products under the All Good brand. Should they expand their share of the banana market or diversify into drinks? Research methodology The case is primarily based on tape-recorded interviews by the authors with the founding entrepreneur and three employees of All Good from May to July 2012 and an analysis of the company’s website and social media activities. Other publicly available information sources were drawn upon, and a discussion held with a New Zealand national grocery chain CEO. Relevant courses and levels This case has been written for use in classes in undergraduate and graduate level entrepreneurship, strategic management and sustainability. The case can be used to illustrate how very small resource-constrained startups can compete in an industry dominated by large multinational corporations, and how Fairtrade might provide a worthy differentiation focus. It is open to a consideration of judo economics. While several of the questions ask students to consider the New Zealand context in which this case is set, knowledge of New Zealand and the various industries beyond what is offered in the case is not necessary. Theoretical bases At a broad level the case illustrates how a small, resource-constrained startup can compete against much, much larger players through a niche Fairtrade product focus and the use of alternative marketing strategies such as guerrilla marketing and social media. In relation to the competitive dynamics within an industry, this case can be used to illustrate the concept of judo economics (also referred to as judo strategy). Both the utility and potential limits of judo economics can be demonstrated through the case by considering current activities and potential future dynamics. more...

On 13 September 2012, the Good George Brewery and bar opened for business in the Hamilton, New Zealand suburb of Frankton. This case describes the start of the business, the environment that supported it and the resources and capabilities that were utilised. The case won the ANZAM award for best case study at the 2013 ANZAM Conference. more...

Our study aim was to determine encapsulated islet graft viability in an omentum pouch and the effect of fibroblast growth factor 1 (FGF-1) released from our redesigned alginate microcapsules on the function of the graft.Isolated rat islets were encapsulated in an inner core made with 1.5% low-viscosity-high-mannuronic-acid alginate followed by an external layer made with 1.25% low-viscosity high-guluronic acid alginate with or without FGF-1, in microcapsules measuring 300 to 400 µm in diameter. The 2 alginate layers were separated by a perm-selective membrane made with 0.1% poly-L-ornithine, and the inner low-viscosity-high-mannuronic-acid core was partially chelated using 55 mM sodium citrate for 2 minutes.A marginal mass of encapsulated islet allografts (∼2000 islets/kg) in streptozotocin-diabetic Lewis rats caused significant reduction in blood glucose levels similar to the effect observed with encapsulated islet isografts. Transplantation of alloislets coencapsulated with FGF-1 did not result in better glycemic control, but induced greater body weight maintenance in transplant recipients compared with those that received only alloislets. Histological examination of the retrieved tissue demonstrated morphologically and functionally intact islets in the microcapsules, with no signs of fibrosis.We conclude that the omentum is a viable site for encapsulated islet transplantation. more...

This paper examines four businesses that were located in Christchurch's CBD prior to the earthquake on February 22, 2011. Immediately following the quake Christchurch's CBD was cordoned off and for many Christchurch businesses it was necessary to find new premises in an environment of extreme uncertainty and very limited information. The four businesses used in this study were all required to relocate, however the specifics of their situations differed. All four businesses examined were larger professional services firms (lawyers, accountants, architects or engineers) who had a national presence. Given the limited number of suitable and available properties speed was of the essence in relocating. Through the four cases we explore how rapidly each firm initiated and completed the relocation process and the factors influencing their speed. We examine the means by which new premises were secured and the plans in regard to immediate and longer term business location. Finally, we explore the impact of relocation and the earthquake more broadly for these firms. The results obtained highlight the differences between the firms based on both initial conditions and the way each firm managed the process. more...

Sustainable entrepreneurs look for market entry opportunities that offer the promise of both economic reward and environmental and social enhancement. However, evidence to date has been mixed on th... more...

This article describes a case competition that reflects the four elements of a grounded learning exercise. These elements include creating a real-world experience, optimizing learning transfer, integrating theory and practice, and shifting learning responsibility to the students. The authors also provide details on implementing this exercise in an undergraduate capstone strategy course and using a real-time case that brings the competition to life. more...

The story of Kiwi International Airlines is a brief one. Begun on a 'shoe-string’ in 1994 by Ewan Wilson, the airline had collapsed by 1996. But during that brief time Kiwi Airlines had a dramatic effect on trans-Tasman airfares. This case is designed to allow a discussion of the reasons behind Kiwi Airlines initial success and ultimate failure. The case is particularly suited to explaining the concept of Judo economics or Judo strategy. more...

The Warehouse has been a company synonymous with growth and success in New Zealand since Stephen Tindall founded the company in 1982. By 1999, The Warehouse had become the largest retailer in New Zealand and had continued to steam ahead since. In early 2001, incoming CEO Greg Muir faced a real challenge in transferring that success across the Tasman into Australia. In August 2000, The Warehouse had acquired the Clint's Crazy Bargains/Silly Solly's chain of 115 discount variety stores in Australia. Could The Warehouse implement their format in Australia and would it be as successful as in New Zealand? INTRODUCTION In November 2000, The Warehouse Group was named New Zealand's Company of the Year at the annual business awards organised by Deloitte's and Management magazine. The award came on the heels of The Warehouse's Annual Meeting where the company was able to announce sales in excess of a billion dollars for the first time. Profits too were soaring, up almost 30% on the previous year. Excellent results, however, were not new to Warehouse shareholders. Stephen Tindall, the founder of the company, had built The Warehouse into a phenomenal success, with an average return on equity of 37% and compound sales growth of 29% over the last decade. The 2000 annual meeting did more than reflect on an excellent year, however. The meeting also served to publicly signal the succession of Stephen Tindall as CEO by Greg Muir in January 2001. The transition in CEO coincided with the transition of The Warehouse from a company focused solely on the New Zealand market to one focused on Australasia. On August 1 2000, The Warehouse took possession of their first Australian outlets. The company acquired a 115store Australian discount retail chain that operated as Glint's Crazy Bargains in New South Wales, ACT, and Victoria, and as Silly Solly's in Queensland. The Australian stores represented a major challenge for The Warehouse. They were less than a third of the size of the average Warehouse store in New Zealand and were supported by relatively immature logistics and IT. Stephen Tindall had described the Australian stores as being in a similar state to The Warehouse seven years ago (Management Magazine 2000, p. 28). Moreover, The Warehouse had no experience in acquisitions - let alone international acquisitions. Entering the Australian market meant competing against large, entrenched competitors with a history of retaliation against newcomers. However, while there were risks in the Australian expansion, The Warehouse had a history of setting and achieving bold challenges. THE NEW ZEALAND MARKET The New Zealand retail market was small, but well served. For the 2000 calendar year department store sales were almost $2.6b, although the total applicable market for The Warehouse (including specialty areas such as clothing, hardware, etc) was $11.9b. Growth over 1999 was 4.9% for general retail, 8.3% for department stores, and 6.5% for the applicable market. New Zealand had approximately 30,000 stores - dominated by small, owner-operated outlets. However, just as internationally, there has been a trend in New Zealand away from the independent retailers towards chains. The scale advantages of the larger chains have created significant pressure for smaller retailers to, at the very least, band together in a loose collective such as Paper Plus. The Warehouse faced direct competition from department stores Deka, Farmers, Kmart and Briscoes at a national level. Table 1 shows a comparison between these national competitors. At a regional level, department stores such as Arthur Barnett's (Dunedin) and Furlongs (Hamilton) also competed. Further competition was also provided by specialty stores - some national such as Glassons/Hallensteins (clothes), Whitcoulls (books) and Hannahs (shoes) - but predominantly localised. Market share information for department stores is provided in Figure 1. Retail competition in New Zealand has been very strong. … more...

E-business is touted as a key technology for developing the competitiveness of small and medium sized enterprises (SMEs) in New Zealand because it can help overcome the barriers of distance and limited resources that challenge these companies. However, it is important to know exactly where SMEs are in the adoption process. Such knowledge is critical to providing support and incentives for further adoption (Ivis, 2000). The purpose of the current study is to provide a relatively comprehensive description of SMEs’ e-technology adoption. We also examine strategies SMEs use to create competitive advantage through e-business. Findings reveal that medium-sized companies are poised to transact business and restructure business processes in the electronic medium. Strategies pursued by such enterprises include both low cost and differentiation. Micro and small companies lag behind medium-sized ones in embracing e-business and require support and incentives to achieve the “website” stage of adoption. more...

To assess the outcomes from temporal lobectomy for hippocampal sclerosis in patients 50 years or older. Controversy exists as to the suitability of older patients for epilepsy surgery, with most of the previous studies demonstrating a correlation between increasing age and poor outcome. However, the inclusion of temporal lobe epilepsy of multiple etiologies has confounded many previous studies of this age group.Twenty-one patients aged 50 years or older (mean 54.9 years) at the time of surgery were included in the study group. All patients had a pathologic diagnosis of hippocampal sclerosis. A retrospective analysis was performed comparing seizure outcomes following a standardized anterior temporal lobectomy with those from 103 patients younger than 50 (mean age 34.7 years) operated upon over the same time period. The mean follow-up period for the study was 9.57 years.Twenty of the 21 patients in the older group (95.2%) had a satisfactory seizure outcome (Engel classes I and II) compared with 90.3% of the younger patients. There was no statistically significant difference in the outcomes between the two groups (p = 0.719). Across both groups of patients combined, there was no significant difference between the mean age in the patients with a satisfactory seizure outcome compared to those with an unsatisfactory outcome (38.3 vs. 34.7 years, p = 0.213).Patients 50 years or older with intractable seizures from hippocampal sclerosis have seizure outcomes following temporal lobectomy that are comparable to young patients over the long term. Older patients should not be denied treatment on the basis of age. more...

This paper explores the use of regression analysis in conducting research on corporate governance. We highlight that combinations of governance mechanisms together act to mitigate the shareholder-manager agency problem, and examine the implications of this idea for designing empirical research on corporate governance using regression models. We outline the consequences of the omitted variable problem that arises if linkages between governance mechanisms are ignored. We describe two research studies to illustrate how linear regression and logistic regression may be used to examine the complex interlinkages among multiple governance mechanisms. These studies demonstrate approaches to model specification issues that arise in governance research, and also highlight how research designs may be constructed to avoid violation of important assumptions of the regression model. more...

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