bluuebunny/crossref_metadata_2025 huggingface dataset:
Sustainable development in East Africa: impact evaluation of regional agricultural development projects in Burundi, Kenya, Rwanda, Tanzania, and Uganda
Authors: Warinda Enock , Nyariki Dickson M , Wambua Stephen , Muasya Reuben M , Hanjra Munir A
Published: February 2020

Investments in agricultural technologies, capacity building and policy harmonization are needed to support sustainable development across Africa. Regional development projects can facilitate the adoption of agricultural technologies and innovations across nation‐state borders and generate benefits for shared prosperity. This paper uses panel data from 1,160 smallholder households including beneficiaries and non‐beneficiaries from five countries in East Africa ‐ Burundi, Kenya, Rwanda, Tanzania, and Uganda. From a pool of over 90 projects implemented over a span of 15 years, 23 regional projects are included in this study. The major economic benefits to smallholder participants are higher crop productivity and income, access to adaptable technologies, access to markets, higher livestock and milk production, gender equality, enhanced food security, resilience and capacity building for uptake and scaling up of future innovation platforms. For example, the adoption of low‐cost tissue culture banana by the beneficiaries increased their incomes by 15% in Rwanda while the adoption of appropriate land and water management technologies increased the potato yields from 2.8 tons (USD 2,840/ha) to over 7.5 tons (USD 7,410/ha) in Kenya. The beneficiaries ensured value added to commodities like bananas (for export) and orange‐fleshed sweet potatoes (a nutrition‐sensitive intervention for enhancing domestic intake of vitamin A) in Burundi, Kenya, Rwanda and Uganda. Additionally, milk production increased from 6 to 11 L per cow per day in Uganda and from 6 to 8 L per cow per day in Tanzania, with increases in sales generating USD 115 per cow per month above the non‐beneficiaries. These results are supported by previous studies on technology adoption, investments in agriculture and well‐being outcomes. Our findings with the higher farm income Difference‐in‐Differences (DiD) estimator for the female beneficiaries compared to male beneficiaries might have important implications for investing in regional development projects that will close the gender gap in agricultural productivity in Africa. Regional projects can also support post‐conflict development efforts for food security and peace in fragile contexts such as in Burundi. Our findings might serve as an input to the African Union's Comprehensive Africa Agriculture Development Programme, localization of the United Nations Sustainable Development Goals related to food security and agriculture in Africa and an input to monitoring, evaluation and learning.
Using firefighters as medical first responders to shorten response time in rural areas in Sweden
Authors: Svensson Anders , Elmqvist Carina , Fridlund Bengt , Rask Mikael , Andersson Richard , Stening Kent
Published: February 2020

Objective

To map out and describe an earlier response by using firefighters as medical first responders on while waiting for the ambulance and first incident person assignments focusing on frequency, event time and survival >30 days after performed cardiopulmonary resuscitation.

Design

Retrospective descriptive design.

Setting

Ambulance service in a county of southern Sweden with a population of 200 000 inhabitants (23/km2).

Participants

Data were collected from four data systems within different organizations; emergency medical communication centre, fire deparment, ambulance services and conty hospital analysis unit.

Main outcome measure(s)

Data from 600 while waiting for the ambulance assignments, whereof 120 with first incident person present, collected between 1 January 2012 and 31 December 2016. Between 1 June 2014 and 1 October 2015, the two fire departments were dually dispatched on out‐of‐hospital cardiac arrests.

Results

Three main findings were made: there was a prolonged process time for dispatching fire fighters on while waiting for the ambulance assignments. Dual dispatches did not shorten the process time for dispatching full‐time firefighters, and, in a majority of while waiting for the ambulance assignments where cardiopulmonary resuscitation was performed, firefighters or first incident persons arrived first on the scene.

Conclusion

Minimising every minute that delays the performance of life‐saving actions is crucial. By dispatching firefighters on while waiting for the ambulance assignments in rural areas, the response time in a majority of assignments was shortened. However, there was substantial delay in dispatching firefighters due to prolonged process time at the emergency medical communication centre. The emergency medical communication centre operator's ability to quickly assess the need for while waiting for the ambulance assignments plays a crucial role in the chain of survival.
Custody Judgments, Ex‐offender Parents, and Best Interests of the Child
Authors: Wertheimer Julie , Wiener Richard L.
Published: February 2020

One collateral consequence of a criminal conviction for parents with young children is the loss of custody, which turns on the subjective “best interests of the child” standard. This research explored whether criminal conviction and substance abuse history influenced custody decisions. Experiment 1 presented community participants with a vignette describing a parent with combinations of manipulated stigmatized characteristics (i.e., gender, race, offender status, and substance abuse). Participants completed a custody determination scale, which showed that mothers with an offense received more favorable custody decisions than fathers with an offense, as did ex‐offenders without substance abuse. Experiment 2 added a positive or negative psychological fitness evaluation of the ex‐offender. It found main effects of the professional parenting evaluation and replicated the parent's substance abuse findings from Experiment 1, but not the offense status result. Most importantly, these results were significant after controlling for the participants’ ratings of the best interests of the child in question and mediation analyses revealed that the child's best interests only partially explained the relationships between substance abuse, the parental evaluation, and the custody determination. This suggests that participants made custody decisions based on factors extraneous to the current legal standard, namely, the best interests of the child.
Interim thymus and activation regulated chemokine versus interim 18F‐fluorodeoxyglucose positron‐emission tomography in classical Hodgkin lymphoma response evaluation
Authors: Plattel Wouter J. , Visser Lydia , Diepstra Arjan , Glaudemans Andor W. J. M. , Nijland Marcel , van Meerten Tom , Kluin‐Nelemans Hanneke C. , van Imhoff Gustaaf W. , van den Berg Anke
Published: February 2020

Serum thymus and activation regulated chemokine (TARC) levels reflect classical Hodgkin lymphoma (cHL) disease activity and correspond with treatment response. We compared mid‐treatment interim TARC (iTARC) with interim 18F‐fluorodeoxyglucose positron‐emission tomography (iPET) imaging to predict modified progression‐free survival (mPFS) in a group of 95 patients with cHL. High iTARC levels were found in nine and positive iPET in 17 patients. The positive predictive value (PPV) of iTARC for a 5‐year mPFS event was 88% compared to 47% for iPET. The negative predictive value was comparable at 86% for iTARC and 85% for iPET. Serum iTARC levels more accurately reflect treatment response with a higher PPV compared to iPET.
Technology licensing or cost‐reducing outsourcing? Game theoretical analysis on consumers' home bias effects and firms' optimal strategies
Authors: Chen Tai‐Liang , Huang Zuyi
Published: February 2020

International cost‐reducing outsourcing lowers consumers' perceived quality of products due to home bias. This paper envisages a vertically differentiated Cournot duopoly associated with international, cost‐reducing outsourcing and non‐outsourcing schemes in both licensing and non‐licensing cases. It examines the impacts of home bias effect on the behaviour of firms and welfare. It shows that the optimal strategy of the patent holder varies from situation to situation associated with the home bias effect. In equilibrium, the dominant strategy for the patent holder is licencing and no outsourcing. If a licensee will outsource its inputs after upgrading the quality of its products, then the patent holder will earn higher profits than one in a case where the licensee does not outsource. If both the patent holder and the licensee produce without outsourcing, a welfare‐reducing licensing occurs. On the other hand, if the licensee outsources its production inputs but the patent holder does not outsource, then a welfare‐improving licensing generates a win‐win situation for the patent holder and for society. Furthermore, the smaller the quality gap between two goods prior to implementing licensing, the lower the royalty rate imposed by the patent holder.
An improved long short‐term memory networks with Takagi‐Sugeno fuzzy for traffic speed prediction considering abnormal traffic situation
Authors: George Shiju , Santra Ajit Kumar
Published: February 2020

Traffic speed prediction is an emerging paradigm for achieving a better transportation system in smart cities and improving the heavy traffic management in the intelligent transportation system (ITS). The accurate traffic speed prediction is affected by many contextual factors such as abnormal traffic conditions, traffic incidents, lane closures due to construction or events, and traffic congestion. To overcome these problems, we propose a new method named fuzzy optimized long short‐term memory (FOLSTM) neural network for long‐term traffic speed prediction. FOLSTM technique is a hybrid method composed of computational intelligence (CI), machine learning (ML), and metaheuristic techniques, capable of predicting the speed for macroscopic traffic key parameters. First, the proposed hybrid unsupervised learning method, agglomerated hierarchical K‐means (AHK) clustering, divides the input samples into a group of clusters. Second, based on parameters the Gaussian bell‐shaped fuzzy membership function calculates the degree of membership (high, low, and medium) for each cluster using Takagi‐Sugeno fuzzy rules. Finally, the whale optimization algorithm (WOA) is used in LSTM to optimize the parameters obtained by fuzzy rules and calculate the optimal weight value. FOLSTM evaluates the accurate traffic speed from the abnormal traffic data to overcome the nonlinear characteristics. Experimental results demonstrated that our proposed method outperforms the state‐of‐the‐art approaches in terms of metrics such as mean square error (MSE), root mean square error (RMSE), mean absolute error (MAE), and mean absolute percentage error (MAPE).
Human disease/clinical medical sciences in dentistry: Current state and future development of undergraduate assessments in the UK and Ireland
Authors: Atkin Philip A. , Willis Amanda , Doncahie Clare , Elledge Ross O. C. , Thomas Steven J. , Ni Riordain Richeal , Galvin Sheila , Marney Clare , Setterfield Jane F. , Smith Peter M. , Hammond Douglas
Published: February 2020

Introduction

The United Kingdom and Ireland teachers of Human Disease/Clinical Medical Science for Dentistry (HD/CMSD) group continue to work together and most recently collaborated to review current and future assessments.

Materials and methods

The first part of the review of assessments in HD/CMSD took place at a face‐to‐face meeting with presentations from delegates on assessments in their home institutions. The second and larger part comprised an online survey where all eighteen schools in the UK and Ireland participated.

Results

All schools had some element of formative assessment, and the majority had a stand‐alone summative assessment at the end of the HD/CMSD teaching block. Most schools had a written paper and practical elements to their assessments, most commonly a combination of a multiple‐choice type question combined with an objective structured clinical examination (OSCE). There was a trend towards the use of single best answer (SBA) questions and a willingness amongst participants to share a question bank. All schools incorporated elements of HD/CMSD in their final examinations.

Discussion and Conclusion

This collaboration promoted the sharing of developments in assessment for HD/CMSD and demonstrated a willingness to cooperate between institutions. Assessment in HD/CMSD in the UK and Ireland continues to be refined by those responsible for its content and delivery, and assessment methods are progressing following evidence‐based best practice.
Post‐stocking movement and survival of hatchery‐reared bloater (Coregonus hoyi) reintroduced to Lake Ontario
Authors: Klinard Natalie V. , Matley Jordan K. , Halfyard Edmund A. , Connerton Michael , Johnson Timothy B. , Fisk Aaron T.
Published: February 2020

Determining the movement and fate of fishes post‐stocking is challenging due to the difficulty in monitoring them, particularly immediately after release. Bloater (Coregonus hoyi; Salmonidae) is a deepwater cisco that has been extirpated from Lake Ontario for several decades and is presently the focus of binational restoration stocking efforts; however, there is limited information to evaluate the efficacy of these efforts. The aim of this study was to examine the initial post‐release survival, 3D movement, and behaviour of hatchery‐reared bloater stocked in Lake Ontario to expand knowledge of post‐stocking ecology of fish and inform stocking practices for deepwater ciscoes.

In total, 74 hatchery‐reared bloater were tagged with acoustic transmitters with depth and temperature sensors in 2016, 2017, and 2018 and passively monitored on an array of 105 69‐kHz acoustic receivers deployed in north‐eastern Lake Ontario. Several spatial metrics analysed movements after release to investigate immediate post‐stocking survival and behaviour for the first time in a pelagic freshwater forage fish.

Estimated survival for tagged bloater was low (≤42%) and detection periods of live bloater ranged from 0.2 to 12.1 days (mean ± SD: 2.9 ± 2.9 days). Following release, tagged bloater dispersed quickly and exhibited an association with deeper water (>40 m). Despite overlap in space use for some bloater, there was no evidence of schooling behaviour. Bloater underwent extensive diel vertical migration from near bottom to within metres of the surface. These results demonstrated that, despite high initial mortality, some hatchery‐reared bloater survived the initial stress of release and displayed characteristic behaviour of the species.

This study demonstrated the value of acoustic telemetry in restoration efforts and revealed survival and behaviour of bloater that has never been observed at this resolution, providing novel information for the management of reintroduced species. Establishment of a self‐sustaining population of bloater will help restore fish native to Lake Ontario thus increasing prey fish diversity, improving ecological integrity and resilience, and serving as a model for the reintroduction and management of other native species throughout the Great Lakes.
A cross‐cultural translation and adaptation of the Arabic Cardiac Self‐Efficacy Questionnaire for patients with coronary heart disease
Authors: Shajrawi Abedalmajeed , Khalil Heba , Al‐Smadi Ahmed Mohammad , Al Dweik Ghadeer , Slater Paul , Granat Malcolm , Jones Ian , Astin Felicity
Published: February 2020

Aim

The aim of this study is to cross‐culturally translate and adapt the Cardiac Self‐Efficacy Questionnaire into Arabic and subsequently evaluate the psychometric properties of that translation in a population of Arabic patients.

Method

The original English version of the Cardiac Self‐Efficacy Questionnaire was translated into Arabic following a process recommended by the World Health Organization. A convenience sample consisting of 268 Jordanian patients with coronary heart disease was recruited from a university‐affiliated hospital in Amman, Jordan. Data were collected from October 2018 to March 2019. The factor structure, face and content validities, and internal consistency of the Arabic Cardiac Self‐Efficacy Questionnaire (A‐CSEQ) were evaluated.

Results

The factor structure analysis supported a three‐factor high‐order structure of the A‐CSEQ. Face validity showed that the language used, style, and format were clear. The content validity demonstrated a very good content validity index. The reliability was good with ranging from 0.89 to 0.93 for all questionnaire subscales.

Conclusion

The A‐CSEQ is a valid and reliable instrument to assess the cardiac self‐efficacy of Arabic patients diagnosed with coronary heart disease. Further assessment of the psychometric properties of the A‐CSEQ with different cardiac problems is now recommended.
Cross‐lagged associations between behaviour problems and obesity in head start preschoolers
Authors: Martoccio Tiffany L. , Senehi Neda , Brophy‐Herb Holly E. , Miller Alison L. , Horodynski Mildred A. , Kaciroti Niko , Contreras Dawn , Peterson Karen E. , Lumeng Julie C.
Published: February 2020

Background

Behaviour problems and obesity are related but research findings have been inconclusive regarding the direction of effects.

Objectives

This study examined the cross‐lagged associations between behaviour problems, body mass index (BMI) and obesity in preschoolers, and whether sex modified these associations.

Methods

Repeated measures of teacher‐reported externalizing (EXT) and internalizing behaviour problems (clinically significant T scores were >90th percentile), BMI z‐scores (BMI‐Z) and obesity status (BMI ≥95th for age and sex) were assessed in the fall (T1) and spring (T2) of the school year in Head Start preschoolers (N = 423). Associations were examined with cross‐lagged modelling.

Results

Prospective paths from T1 clinically significant EXT to both T2 BMI‐Z (β = .05) and obesity (β = .18) were significant. There was no evidence that T1 BMI‐Z or obesity preceded T2 behaviour problems. However, sex‐specific models indicated that T1 BMI‐Z was prospectively associated with higher T2 EXT for boys (β = .13), but not girls. T1 EXT was predictive of subsequent BMI‐Z (β = .09) and obesity (β = .33) at T2 for girls only.

Conclusion

Findings suggest that behaviour problems, particularly externalizing behaviours, are prospectively related to childhood obesity, and early prevention methods should reflect sex‐specific modifications.
Activity niches outperform thermal physiological limits in predicting global ant distributions
Authors: Guo Fengyi , Guénard Benoit , Economo Evan P. , Deutsch Curtis A. , Bonebrake Timothy C.
Published: February 2020

Aim

Thermal physiology is commonly used in mechanistic models to predict species distribution and project distribution change. Such thermal constraints for ants are often measured under laboratory conditions as critical thermal limits (CTmax and CTmin), but have also been observed in the field as foraging thermal limits (FTmin and FTmax). Here we compared distribution projections based on ant physiological and behavioural thermal limits with their realized distributions to assess the validity of using ecophysiological models to predict species ranges over large scales.

Location

Global.

Taxon

Ants.

Methods

From published literature, we compiled a database of 148 lab‐measured critical thermal limits and 137 field‐observed foraging thermal limits for 20 ant genera distributed around the world. We projected their potential ranges using active hour thresholds by matching their thermal limits or preferred thermal breadth (incorporating thermal optima) with hourly surface temperature data. We then compared the projections against a comprehensive global database of ant distributions to assess the validity of physiologically and behaviourally based models.

Results

We found that surface temperature plays a clear role in generic‐level ant biogeography. Projections based on foraging thermal limits were more conservative in constraining ranges to observed distributions, while projections based on critical thermal limits often overestimated ranges. Furthermore, thermal limit models can be improved by incorporating behaviourally derived thermal optima.

Main conclusions

Our results suggest that temperature‐dependent activity niches and thermal optima better reveal species realized thermal niches than critical thermal limits, and hence can improve predictions of species distributions and future distribution changes under climate change.
High correlation of species diversity patterns between specialist herbivorous insects and their specific hosts
Authors: Du Congcong , Chen Jing , Jiang Liyun , Qiao Gexia
Published: February 2020

Aim

The relative importance of biotic and abiotic factors in shaping the species diversity of temperate organisms has been debated for a long time. Here, we used drepanosiphine aphids as a model group to validate the ‘resource‐dependent hypothesis’ based on the biotic interactions for specialist herbivorous insects, a hypothesis stating that their intricate relationship with host plants for resources might constrain their species diversity from being positively correlated with the species diversity of their hosts, and to assess the role of biotic and abiotic factors in shaping the global species diversity pattern of temperate organisms.

Location

Global and regional.

Time period

Current.

Taxon

Drepanosiphine aphids (Insecta: Hemiptera: Aphidoidea).

Methods

We first investigated the global species diversity pattern of drepanosiphine aphids. Then we used ordinary least squares (OLS) and spatial simultaneous autoregressive (SAR) models to conduct regression analyses to test for the relationships of global and regional species richness between drepanosiphine aphids and their host plants, and other predictor variables describing entire woody plants, environmental energy, water availability, climate seasonality, topographical heterogeneity and land cover. Finally, structural equation models (SEMs) were further used to test for direct and indirect effects of key ecological variables.

Results

The distribution hotspots of species richness and endemism were both located in temperate zones, supporting the notion that drepanosiphine aphids were representative of temperate organisms. The specific host plant was the most important ecological variable in explaining global and regional drepanosiphine species richness, showing a strong positive relationship. The climatic variables mainly showed an indirect effect on global and regional drepanosiphine species richness via specific hosts.

Main Conclusions

The global and regional drepanosiphine species richness was primarily shaped by specific host plants as opposed to all woody trees, with indirect effects of climatic factors via host plants, which supported the ‘resource‐dependent hypothesis’ based on the biotic interactions for specialist herbivorous insects. This finding sheds new light on the ‘biotic interactions hypothesis’ that states biotic interactions can primarily affect the distributions and diversity patterns of both tropical and temperate organisms not only at the local scale but also at the regional to global scales.
Prognostic factors in 161 patients with mucosal melanoma: a study of German Central Malignant Melanoma Registry
Authors: Sarac E. , Amaral T. , Keim U. , Leiter U. , Forschner A. , Eigentler T.K. , Garbe C.
Published: February 2020

Background

Mucosal melanoma is a rare malignancy which represents approximately 1% of all melanomas. It is shown that mucosal melanomas have a different biology and less favourable prognosis than its cutaneous counterpart.

Objectives

Predictive and prognostic factors of survival for mucosal melanoma have not yet been elucidated. The aim of this study was to investigate risk factors affecting the course of mucosal melanoma patients followed in our clinic.

Methods

One hundred and sixty‐one patients with mucosal melanoma prospectively documented in the German Central Malignant Melanoma Registry (CMMR) were included in this study. Gender, age, localization, stage at first medical examination, tumour thickness and mutational status were documented. The American Joint Committee on Cancer (AJCC), 7th edition was used to define tumour stage. Kaplan–Meier survival curves were evaluated compared with the log‐rank test. Multivariate Cox proportional hazard models were used to identify significant independent prognostic factors.

Results

According to the localization, patients were categorized in 44.7% oral–nasal, 28.6% genital, 20.5% anorectal and 6.2% visceral. Genital mucosal melanomas had the most favourable 5‐year OS rate (58.6%) followed by visceral (58.3%) and oral–nasal (39.3%). Anorectal melanomas had the worst OS time (median: 21 ± 4.8 months) and 5‐year survival rate (22.7%). Patients <60 years had a better survival than the older group (P = 0.013). Tumour stage at the time of the first medical examination was also a significant factor for survival (P = 0.001). Gender and mutational status were found to have no effect on survival. Age (<60 years vs. ≥60 years; HR = 2.1) and stage at first medical examination (Stage I vs. Stage IV; HR = 8.2) are shown to be significant independent prognostic factors on multivariate Cox regression analysis, but not localization.

Conclusion

In this study, we observed that older age and advanced stage have significant negative effects on the survival of mucosal melanoma. Thus, the AJCC staging system is applicable for mucosal melanoma.
Food safety risk posed to consumers of table eggs from layer farms in Gauteng Province, South Africa: Prevalence of Salmonella species and Escherichia coli, antimicrobial residues, and antimicrobial resistant bacteria
Authors: Adesiyun Abiodun A. , Nkuna Charlotte , Mokgoatlheng‐Mamogobo Malesedi , Malepe Keleabetswe , Simanda Liberty
Published: February 2020

The study conducted on 39‐layer farms in Gauteng Province, South Africa determined the prevalence and resistance of enteropathogens, and antimicrobial residues in table eggs collected from the farms. Eggs were tested for the presence of bacteria using standard methods. The resistance of bacteria to eight antimicrobial agents was determined using the disc diffusion method. Antimicrobial residues were detected in table eggs using the microbial inhibition test, enzyme‐linked immunosorbent assay (ELISA), and high performance liquid chromatography (HPLC). Risk factors for egg contamination by bacteria and antimicrobial residues were determined through a questionnaire survey of farmers. The farm prevalence of Salmonella spp. and Escherichia coli in table eggs was 7.7 and 48.7%, respectively. Nineteen (48.7%) and 2 (5.1%) of eggshells and egg contents, respectively, were positive for E. coli but only eggshells yielded Salmonella species, 2.0% (4 of 196). Overall, 71.4% of 49 E. coli isolates exhibited resistance to one or more antimicrobial agents. The farm prevalence and egg content prevalence of antimicrobial residues was 2.6 and 0.5%, respectively, with the detection of sulfonamide (79 ppb) and oxytetracycline (106 ppb). The prevalence of resistant E. coli and Salmonella spp. and the occurrence of antimicrobial residues in egg content may pose food safety and therapeutic threats to consumers.
Evaluation of complications after endoscopic retrograde cholangiopancreatography using a short type double balloon endoscope in patients with altered gastrointestinal anatomy: a single‐center retrospective study of 1,576 procedures
Authors: Tokuhara Mitsuo , Shimatani Masaaki , Mitsuyama Toshiyuki , Masuda Masataka , Ito Takashi , Miyamoto Sachi , Fukata Norimasa , Miyoshi Hideaki , Ikeura Tsukasa , Takaoka Makoto , Kouda Katsuyasu , Okazaki Kazuichi
Published: February 2020

Background and Aim

Endoscopic retrograde cholangiopancreatography (ERCP) using balloon‐assisted endoscope such as double‐balloon endoscope is even effective for patients with surgically altered anatomy. Yet comprehensive studies on complications of ERCP using balloon‐assisted endoscope have not been made. We analyzed the characteristics and the causes of complications of ERCP using double‐balloon endoscope (DB‐ERCP) procedures and aimed to suggest effective managements.

Methods

A total of 1576 procedures of DB‐ERCP in 714 patients with surgically altered gastrointestinal anatomy in our hospital were evaluated retrospectively using a statistic analysis.

Results

The overall complication occurrence rate was 5.8%. By type of complications are perforation 3.2%, mucosal laceration 0.5%, hemorrhage 1.0%, pancreatitis 0.6%, respiratory disorder 0.4%, and others 0.2%. By type of surgical reconstruction methods were Roux‐en‐Y reconstruction with choledocho‐jejunal anastomosis 4.2%, Roux‐en‐Y reconstruction without choledocho‐jejunal anastomosis 6.7%, pancreaticoduodenectomy 4.5%, pylorus preserving pancreaticoduodenectomy 4.2%, Billroth II gastrectomy (B‐II) 11.6%, and other reconstruction method (others) 7.4%. The contributing factors calculated by a multivariate analysis were B‐II (odds ratio: 1.864, 95% confidence interval: 1.001–3.471, P = 0.050) and the presence of naïve papilla (odds ratio: 3.268, 95% confidence interval: 1.426–7.490, P = 0.005).

Conclusions

DB‐ERCP is a safe method with a total complication rate of 5.8% that could be considered within an acceptable range. The most common complication was the injury of the digestive tract such as perforation. Affecting risk factors for complications were B‐II and the presence of naïve papilla. DB‐ERCP procedures should be performed carefully of these factors.
Dexamethasone on postoperative gastrointestinal motility: A placebo‐controlled, double‐blinded, randomized controlled trial
Authors: Chen Yuezhi , Dong Chenyang , Lian Guodong , Li Dongsheng , Yin Yuehan , Yu Wenhai , Du Changkun , Liu Chen , Li Leping , Tian Feng , Jing Changqing
Published: February 2020

Background and Aim

Following abdominal surgery, patients usually experience a transient episode of impaired gastrointestinal motility. This study aimed to determine whether a single preoperative dose of dexamethasone can promote the recovery of gastrointestinal function in patients following elective gastrointestinal surgery.

Methods

In this single‐center, two‐arm, parallel, randomized controlled trial, we studied 126 patients (aged 18–80 years) who underwent elective open or laparoscopic bowel surgery for malignant or benign pathology. At the induction of anesthesia, a treatment group (n = 64) received a single dose of 8‐mg intravenous dexamethasone, and a control group (n = 62) received normal saline.

Results

Intravenous administration of 8‐mg dexamethasone significantly decreased the time to return of flatus by an average of approximately 8 h (P < 0.05). Abdominal distension was significantly reduced on the third day after surgery in the dexamethasone group (P < 0.05), and the time to tolerance of a liquid diet was shorter in the dexamethasone group (P < 0.01). There were no significant differences in other secondary outcomes, including postoperative pain, complication rates, length of hospital stay, or time to first defecation, between the two groups.

Conclusions

A single intravenous dose of 8‐mg dexamethasone at induction of anesthesia significantly decreases the time to return of flatus, improves abdominal distension at 72 h, and promotes tolerance of a liquid diet. Although further studies are required to confirm our results, we recommend that dexamethasone should be used more widely in gastrointestinal surgery.
Cost‐Effectiveness of Pharmacist‐Led Deprescribing ofNSAIDsin Community‐Dwelling Older Adults
Authors: Sanyal Chiranjeev , Turner Justin P. , Martin Philippe , Tannenbaum Cara
Published: February 2020

OBJECTIVES

Older adults are often prescribed potentially inappropriate medications associated with adverse health outcomes and increased health services utilization. Developing Pharmacist‐led Research to Educate and Sensitize Community Residents to the Inappropriate Prescriptions Burden in the Elderly (D‐PRESCRIBE), a pragmatic randomized clinical trial, demonstrated how a community pharmacist‐led evidence‐based educational intervention successfully empowered community‐dwelling older adults and their physicians to reduce chronic use of inappropriate medications. The objective of this study was to evaluate the cost‐effectiveness of the D‐PRESCRIBE intervention for discontinuing nonsteroidal anti‐inflammatory drugs (NSAIDs).

DESIGN

Cost‐effectiveness analysis.

SETTING

Canada.

PARTICIPANTS

Community‐dwelling adults aged 65 years and older.

MEASUREMENTS

Decision analysis combining decision tree and Markov state transition modeling was developed to estimate the cost‐effectiveness of D‐PRESCRIBE (NSAIDs) compared with usual care from a Canadian healthcare system perspective with a time horizon of 1 year. Data from the D‐PRESCRIBE trial and published literature were used to calculate effectiveness, utilities, and costs. Reference case and scenario analyses were conducted using probabilistic modeling. Sensitivity analyses assessed the robustness of the reference case model.

RESULTS

D‐PRESCRIBE (NSAIDs) was less costly (−$1008.61) and more effective (.11 quality‐adjusted life‐years [QALYs]) than usual care and was the dominant strategy. At willingness‐to‐pay thresholds of $50 000 per QALY and $100 000 per QALY, D‐PRESCRIBE (NSAIDs) incurred a positive incremental net benefit compared with usual care, suggesting it is cost‐effective. Compared with the reference case, scenario analyses gave comparable QALYs with modest variation in cost estimates.

CONCLUSION

For community‐dwelling older adults, D‐PRESCRIBE (NSAIDs) provides greater benefits at lower system costs, making it a compelling strategy to reduce the use and harms associated with chronic NSAID consumption. Our findings support reimbursing community pharmacists’ clinical professional services for deprescribing inappropriate NSAIDs in community‐dwelling older adults.J Am Geriatr Soc 68:1090–1097, 2020
Primary localized amyloidosis of the uterine cervix during pregnancy
Authors: Takimoto Yumi , Kogiku Ai , Konda Eri , Samoto Takashi , Ishihara Misa , Yamashita Taro
Published: February 2020

Amyloidosis of the uterine cervix is rare. A 35‐year‐old pregnant woman underwent a cervical biopsy and was found to have amyloid deposits. The results of liquid chromatography–tandem mass spectrometry revealed that these deposits mainly consisted of immunoglobulin light chain (kappa chain). After undergoing several examinations, the patient was diagnosed with localized amyloidosis, without systemic or secondary amyloidosis. She underwent a normal delivery without disease exacerbation. The possible presence of systemic and secondary amyloidosis must be evaluated carefully during the diagnosis of localized cervical amyloidosis.
Ovarian size as a risk factor for recurrent adnexal torsion: Smaller is not better
Authors: Daykan Yair , Bogin Rona , Sharvit Merav , Yaniv Rina Tamir , Josephy Dana , Klein Zvi , Arbib Nissim , Schonman Ron
Published: February 2020

Aim

To investigate characteristics and risk factors for recurrent adnexal torsion (AT).

Methods

Retrospective cohort study in a university‐affiliated medical center included 320 Women with AT verified by laparoscopy, from January 2005 through January 2017. Demographic data, clinical symptoms, surgical findings and treatment were retrospectively reviewed from patient records. Data from primary and secondary AT of patients in the recurrent torsion group was compared to those with single torsion, to evaluate risk factors for recurrent AT.

Results

Two hundred and sixty seven (83.4%) patients had a single event of AT and 53 (16.5%) had recurrent AT. Patients with recurrent torsion had significantly fewer previous non‐gynecologic surgeries (4.3% and 9.8% of the study groups vs 32.2% of the control group, P = 0.001 for both). Ovarian size was significantly smaller in the recurrent torsion groups (47.5 mm and 48.3 mm vs 63.9 mm, P = 0.045 and P = 0.012, respectively). Polycystic ovary was significantly more common in the recurrent AT group (P = 0.028 and P = 0.005), with risk ratio 4.4 (95% confidence interval, 1.66 to 11.63). Ovaries without any specific findings were also more common among recurrent AT cases (P = 0.001 for both groups). Logistic regression analysis demonstrated that smaller ovarian size is an independent risk factor for recurrent AT.

Conclusion

Recurrent torsion correlated with fewer previous surgeries, small ovarian mass, polycystic ovaries and ovaries without specific findings, which might indicate that additional pathophysiological factors contribute to the recurrent event. Ovarian fixation might be recommended in patients with primary torsion of normal or polycystic ovaries.
Comparison of acupuncture on specific and non‐specific points for the treatment of painful temporomandibular disorders: A randomised controlled trial
Authors: Şen Sinan , Orhan Gül , Sertel Serkan , Schmitter Marc , Schindler Hans J. , Lux Christopher J. , Giannakopoulos Nikolaos Nikitas
Published: February 2020

Background and Objective

The aim of this single‐centre, two‐arm, parallel‐group, double‐blinded, randomised controlled trial was to investigate the disputed specific effectiveness of acupuncture by comparing acupuncture on specific and non‐specific points among patients with non‐chronic, painful TMDs.

Methods

Following predefined eligibility criteria, 49 consecutive patients of both sexes were recruited to the study. All subjects were diagnosed with a non‐chronic (Graded Chronic Pain Scale grade <3) painful TMD, as assessed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Patients were randomly assigned to group A (acupuncture on specific points) or group B (acupuncture on non‐specific points) after the initial examination (T0). Both acupuncture treatment sessions were conducted by a trained dentist once a week for four weeks. The examination was repeated five weeks (T5) after T0 by one calibrated examiner who was unaware of the study groups. Characteristic pain intensity (CPI) was evaluated as the main outcome criterion and compared between times and treatment groups by means of non‐parametric tests (significance level set at P = .05). Secondary outcomes comprised the maximum corrected active mouth‐opening without pain (MAO); patients’ expectations regarding acupuncture treatment and pain development; depressivity; and oral health‐related quality of life (OHRQoL).

Results

A total of 41 patients (38 female) successfully completed the study (mean age: 40.17 ± 16.61). The two groups did not differ significantly at any time in terms of age and CPI. However, CPI was significantly (P < .05) lower at T5 than at T0 for both groups (29.66 and 30.35% lower in group A and group B, respectively). An increase in MAO was observed at T5 for both groups but was significant for group B only (P = .016). All patients had positive expectations of acupuncture therapy, and the two groups did not differ significantly at T5 with regard to the extent to which their expectations had been fulfilled by the treatment (P = .717). Comparison of T0 and T5 showed a statistically significant reduction of depressivity for group A (P = .0205), but no significant change for group B (P = .329). At T5, OHRQoL had improved significantly for both groups (group A, P = .018; group B, P < .001) compared with at T0.

Conclusions

Acupuncture on both specific and non‐specific points reduces the non‐dysfunctional pain of TMD patients. The effect of acupuncture on painful TMD cannot be attributed to the specific point selection.
Correlates of Ethnicity‐related Dating Preferences among Asian American Adolescents across the High School Years
Authors: Chan Michele , Kiang Lisa , Witkow Melissa
Published: February 2020

Ethnicity‐related dating preferences among Asian American adolescents and the links between preferences (i.e., for a same‐ethnic dating partner) and ethnic identity centrality and regard, American identity centrality and regard, parent–adolescent closeness, and perceptions of discrimination were investigated. Data from 175 self‐identified Asian American high school students were collected yearly for four consecutive years. Higher levels of ethnic identity centrality and regard and parent–adolescent closeness averaged across four years were associated with preferring a same‐ethnic partner. Moreover, foreign‐born adolescents were less likely to prefer a same‐ethnic partner when they encountered a higher than average level of discrimination on any given year. Results highlight variability in the developmental and individual‐level factors that shape how adolescents navigate their dating relationships.
Chytrid fungus dynamics and infections associated with movement distances in a red‐listed amphibian
Authors: Kärvemo S. , Wikström G. , Widenfalk L.A. , Höglund J. , Laurila A.
Published: February 2020

Amphibians are among the most threatened vertebrate taxa due to anthropogenic habitat change and emerging pathogens. The fungus Batrachochytrium dendrobatidis (Bd) may cause trade‐offs between the immune responses and other important functions, such as mobility. The pool frog (Pelophylax lessonae) is red‐listed in Sweden, and an earlier study conducted in our study area did not detect the fungus. In this study, 67 Swedish pool frogs were tested for Bd. Of these, 28 adults were provided with external radio transmitters and tracked during the summer and autumn to compare movement among infected and non‐infected individuals. Additionally, we tested some individuals for Bd twice during the summer to study intra‐seasonal variation in individual infections. Our results suggest that Bd has recently invaded these pool frog populations. During autumn, movement distances of infected pool frogs were shorter compared to uninfected individuals, and summer movements within ponds were reduced by increasing Bd load. We also found that the frogs can clear (or reduce) Bd infection during their active season. The results from this study increase understanding of the implications of Bd infections in an anuran fringe population, as well as in amphibian metapopulations, and can further guide amphibian conservation planning and management.
Will we need novel combinations to cure HBV infection?
Authors: Dusheiko Geoffrey
Published: February 2020

Chronic hepatitis B is a numerically important cause of cirrhosis and hepatocellular carcinoma. Nucleoside analogue therapy may modify the risk. However, maintenance suppressive therapy is required, as a functional cure (generally defined as loss of HBsAg off treatment) is an uncommon outcome of antiviral treatment. Chronic hepatitis B is a numerically important cause of cirrhosis and hepatocellular carcinoma. Nucleoside analogue therapy may modify the risk. However, maintenance suppressive therapy is required, as a functional cure (generally defined as loss of HBsAg off treatment) is an uncommon outcome of antiviral treatment. Currently numerous investigational agents being developed to either interfere with specific steps in HBV replication or as host cellular targeting agents, that inhibit viral replication, and deplete or inactivate cccDNA, or as immune modulators. Synergistic mechanisms will be needed to incorporate a decrease in HBV transcription, impairment of transcription from HBV genomes, loss of cccDNA or altered epigenetic regulation of cccDNA transcription, and immune modulation or immunologically stimulated hepatocyte cell turnover. Nucleoside analogue suppressed patients are being included in many current trials. Trials are progressing to combination therapy as additive or synergistic effects are sought. These trials will provide important insights into the biology of HBV and perturbations of the immune response, required to effect HBsAg loss at different stages of the disease. The prospect of cures of hepatitis B would ensure that a wide range of patients could be deemed candidates for treatment with new compounds if these were highly effective, finite and safe. Withdrawal of therapy in short‐term trials is challenging because short‐term therapies may risk severe hepatitis flares, and hepatic decompensation. The limited clinical trial data to date suggest that combination therapy is inevitable.
Drivers of longitudinal telomere dynamics in a long‐lived bat species, Myotis myotis
Authors: Foley Nicole M. , Petit Eric J. , Brazier Thomas , Finarelli John A. , Hughes Graham M. , Touzalin Frédéric , Puechmaille Sébastien J. , Teeling Emma C.
Published: February 2020

Age‐related telomere shortening is considered a hallmark of the ageing process. However, a recent cross‐sectional ageing study of relative telomere length (rTL) in bats failed to detect a relationship between rTL and age in the long‐lived genus Myotis (M. myotis and M. bechsteinii), suggesting some other factors are responsible for driving telomere dynamics in these species. Here, we test if longitudinal rTL data show signatures of age‐associated telomere attrition in M. myotis and differentiate which intrinsic or extrinsic factors are likely to drive telomere length dynamics. Using quantitative polymerase chain reaction, rTL was measured in 504 samples from a marked population, from Brittany, France, captured between 2013 and 2016. These represent 174 individuals with an age range of 0 to 7+ years. We find no significant relationship between rTL and age (p = .762), but demonstrate that within‐individual rTL is highly variable from year to year. To investigate the heritability of rTL, a population pedigree (n = 1744) was constructed from genotype data generated from a 16‐microsatellite multiplex, designed from an initial, low‐coverage, Illumina genome for M. myotis. Heritability was estimated in a Bayesian, mixed model framework, and showed that little of the observed variance in rTL is heritable (h2 = 0.01–0.06). Rather, correlations of first differences, correlating yearly changes in telomere length and weather variables, demonstrate that, during the spring transition, average temperature, minimum temperature, rainfall and windspeed correlate with changes in longitudinal telomere dynamics. As such, rTL may represent a useful biomarker to quantify the physiological impact of various environmental stressors in bats.
Impact of chronic kidney disease on mortality and cardiovascular outcomes after acute coronary syndrome: A nationwide data linkage study (ANZACS‐QI 44)
Authors: Pilmore Helen L. , Xiong Fei , Choi Yeunhyang , Poppe Katrina , Lee Mildred , Legget Malcolm , Kerr Andrew
Published: February 2020

Aims

Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular disease (CVD). We examined the characteristics, management and outcomes of patients with CKD in the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS‐QI) national registry.

Methods

The cohort comprised New Zealand (NZ) patients with an acute coronary syndrome undergoing coronary angiography between January 2013 and December 2016. Patients were categorized according to their stage of CKD. Outcomes included all‐cause and cause‐specific mortality and hospitalization with myocardial infarction (MI), stroke and major bleeding.

Results

Of the 20 604 patients, 20.3% had normal renal function, with 53.3%, 23.3%, 1.7% and 1.4% having CKD stages 2, 3, 4 and 5 CKD, respectively. Patients with severe CKD were more likely to be Māori or Pacific and live in an area with greater socioeconomic deprivation. Death, recurrent MI or stroke, and major bleeding all increased incrementally with each worsening stage of CKD severity. Compared with those with normal renal function, patients with stage 5 CKD had a much higher all‐cause (hazard ratio [HR] 16.41, 95% CI 13.06‐20.61), cardiovascular (HR 16.38, 95% CI 12.17‐22.04) and non‐cardiovascular mortality (HR 13.66 9, 95% CI.56‐19.51). In addition, patients with stage 5 CKD were at a higher risk of recurrent MI or stroke (HR 4.73, 95% CI 3.86‐5.80) and bleeding (HR 5.84, 95% CI 4.39‐7.76).

Conclusion

CKD was associated with increased mortality and a high incidence of morbidity in patients undergoing coronary angiography in New Zealand. Initiatives to understand and improve outcomes in this group of patients are urgently needed.