bluuebunny/crossref_metadata_2025 huggingface dataset:
Automated Pulmonary Embolism Risk Classification and Guideline Adherence for Computed Tomography Pulmonary Angiography Ordering
Authors: Koziatek Christian A. , Simon Emma , Horwitz Leora I. , Makarov Danil V. , Smith Silas W. , Jones Simon , Gyftopoulos Soterios , Swartz Jordan L.
Published: April 2018

Background

The assessment of clinical guideline adherence for the evaluation of pulmonary embolism (PE) via computed tomography pulmonary angiography (CTPA) currently requires either labor‐intensive, retrospective chart review or prospective collection of PE risk scores at the time of CTPA order. The recording of clinical data in a structured manner in the electronic health record (EHR) may make it possible to automate the calculation of a patient's PE risk classification and determine whether the CTPA order was guideline concordant.

Objectives

The objective of this study was to measure the performance of automated, structured data–only versions of the Wells and revised Geneva risk scores in emergency department (ED) encounters during which a CTPA was ordered. The hypothesis was that such an automated method would classify a patient's PE risk with high accuracy compared to manual chart review.

Methods

We developed automated, structured data–only versions of the Wells and revised Geneva risk scores to classify 212 ED encounters during which a CTPA was performed as “PE likely” or “PE unlikely.” We then combined these classifications with D‐dimer ordering data to assess each encounter as guideline concordant or discordant. The accuracy of these automated classifications and assessments of guideline concordance were determined by comparing them to classifications and concordance based on the complete Wells and revised Geneva scores derived via abstractor manual chart review.

Results

The automatically derived Wells and revised Geneva risk classifications were 91.5 and 92% accurate compared to the manually determined classifications, respectively. There was no statistically significant difference between guideline adherence calculated by the automated scores compared to manual chart review (Wells, 70.8% vs. 75%, p = 0.33; revised Geneva, 65.6% vs. 66%, p = 0.92).

Conclusion

The Wells and revised Geneva score risk classifications can be approximated with high accuracy using automated extraction of structured EHR data elements in patients who received a CTPA. Combining these automated scores with D‐dimer ordering data allows for the automated assessment of clinical guideline adherence for CTPA ordering in the ED, without the burden of manual chart review.
Electroconvulsive therapy increases brain volume in major depression: a systematic review and meta‐analysis
Authors: Gbyl K. , Videbech P.
Published: April 2018

Objective

The main purpose of this review was to synthesise evidence on ECT's effects on brain's structure.

Method

A systematic literature review of longitudinal studies of depressed patients treated with ECT using magnetic resonance imaging (MRI) and meta‐analysis of ECT's effect on hippocampal volume.

Results

Thirty‐two studies with 467 patients and 285 controls were included. The MRI studies did not find any evidence of ECT‐related brain damage. All but one of the newer MRI volumetric studies found ECT‐induced volume increases in certain brain areas, most consistently in hippocampus. Meta‐analysis of effect of ECT on hippocampal volume yielded pooled effect size: g = 0.39 (95% CI = 0.18–0.61) for the right hippocampus and g = 0.31 (95% CI = 0.09–0.53) for the left. The DTI studies point to an ECT‐induced increase in the integrity of white matter pathways in the frontal and temporal lobes. The results of correlations between volume increases and treatment efficacy were inconsistent.

Conclusion

The MRI studies do not support the hypothesis that ECT causes brain damage; on the contrary, the treatment induces volume increases in fronto‐limbic areas. Further studies should explore the relationship between these increases and treatment effect and cognitive side effects.
Does early exposure to caffeine promote smoking and alcohol use behavior? A prospective analysis of middle school students
Authors: Kristjansson Alfgeir L. , Kogan Steven M. , Mann Michael J. , Smith Megan L. , Juliano Laura M. , Lilly Christa L. , James Jack E.
Published: April 2018

Background and Aims

Despite the negative consequences associated with caffeine use among children and youth, its use is increasingly widespread among middle school students. Cross‐sectional studies reveal links between caffeine and other substance use. The potential for caffeine use to confer increased vulnerability to substance use, however, has not been investigated using prospective designs. We hypothesized that caffeine use at baseline would be associated positively with increased alcohol use, drunkenness, smoking and e‐cigarette use.

Design

Prospective cohort study with 12 months separating baseline from follow‐up.

Setting

West Virginia, USA.

Participants

Middle school students (6th and 7th grades; n = 3932) in three West Virginia (WV) counties provided data at baseline and follow‐up 12 months later.

Measurements

Youth self‐reported their use of caffeine from multiple sources (e.g. soda, energy drinks, coffee and tea), cigarette smoking, electronic cigarette use, alcohol use and drunkenness.

Findings

Cross‐lagged path models for individual substance use categories provided a good fit to the data. Controlling for demographic variables and other substance use at baseline, caffeine at time 1 (T1) was associated positively with T2 cigarette smoking (β = 0.27, P = 0.001), e‐cigarette use (β = 0.21, P = 0.001), alcohol use (β = 0.17, P = 0.001) and drunkenness (β = 0.15, P = 0.001). Conversely, non‐significant relations emerged between three of four substances at T1 and caffeine at T2. Positive relations were found between e‐cigarette use at T1 and caffeine use at T2 (β = 0.07, P = 0.006). These findings were supported by an omnibus model with all substances included. Specifically, significant relations were observed between caffeine at T1 and all substance use outcomes at T2, whereas no significant relations were observed between substance use and caffeine over time.

Conclusions

Caffeine may promote early use of other types of substances among middle school‐aged adolescents.
Parents with troubled upbringings and their perception of childhood
Authors: Herland Mari Dalen
Published: April 2018

Applying qualitative data from a 30‐year‐long follow‐up study, this article examines how 30 parents with troubled upbringings talk about and present their children through stories about parenthood. Two overall themes were identified: (a) the perception of childhood with the associated subcategories “being engaged in school” and “the value of eating rituals and leisure activities” and (b) having agency with the associated subcategories “being heard and put first” and “meeting the children's needs.” The findings exemplify how these parents' backgrounds build into current discursive understandings about parenthood and childhood and how conflicting emotions from their own childhood affect their present view of their children. Attention is paid to the idea of how these parents “invest” in discursive positions regarding their children. The findings apply to both theoretical and practical social work, addressing the need for an understanding of how parents with troubled childhoods understand and consequently interact with their children.
When and how to use Q methodology to understand perspectives in conservation research
Authors: Zabala Aiora , Sandbrook Chris , Mukherjee Nibedita
Published: April 2018

Understanding human perspectives is critical in a range of conservation contexts, for example, in overcoming conflicts or developing projects that are acceptable to relevant stakeholders. The Q methodology is a unique semiquantitative technique used to explore human perspectives. It has been applied for decades in other disciplines and recently gained traction in conservation. This paper helps researchers assess when Q is useful for a given conservation question and what its use involves. To do so, we explained the steps necessary to conduct a Q study, from the research design to the interpretation of results. We provided recommendations to minimize biases in conducting a Q study, which can affect mostly when designing the study and collecting the data. We conducted a structured literature review of 52 studies to examine in what empirical conservation contexts Q has been used. Most studies were subnational or national cases, but some also address multinational or global questions. We found that Q has been applied to 4 broad types of conservation goals: addressing conflict, devising management alternatives, understanding policy acceptability, and critically reflecting on the values that implicitly influence research and practice. Through these applications, researchers found hidden views, understood opinions in depth and discovered points of consensus that facilitated unlocking difficult disagreements. The Q methodology has a clear procedure but is also flexible, allowing researchers explore long‐term views, or views about items other than statements, such as landscape images. We also found some inconsistencies in applying and, mainly, in reporting Q studies, whereby it was not possible to fully understand how the research was conducted or why some atypical research decisions had been taken in some studies. Accordingly, we suggest a reporting checklist.
Detecting semantic‐based communities in node‐attributed graphs
Authors: Sun Heli , Du Hongxia , Huang Jianbin , Sun Zhongbin , He Liang , Jia Xiaolin , Zhao Zhongmeng
Published: April 2018

In social network analysis, community detection on plain graphs has been widely studied. With the proliferation of available data, each user in the network is usually associated with additional attributes for elaborate description. However, many existing methods only concentrate on the topological structure and fail to deal with node‐attributed networks. These approaches are incapable of extracting clear semantic meanings for communities detected. In this paper, we combine the topological structure and attribute information into a unified process and propose a novel algorithm to detect overlapping semantic communities. Moreover, a new metric is designed to measure the density of semantic communities. The proposed algorithm is divided into 3 phases. First, we detect local semantic subcommunities from each node's perspective using a greedy strategy on the metric. Then, a supergraph, which consists of all these subcommunities is created. Finally, we find global semantic communities on the supergraph. The experimental results on real‐world data sets show the efficiency and effectiveness of our approach against other state‐of‐the‐art methods.
Socio‐economic disadvantage is associated with heavier drinking in high but not middle‐income countries participating in the International Alcohol Control Study
Authors: Huckle Taisia , Romeo Jose S. , Wall Martin , Callinan Sarah , Holmes John , Meier Petra , Mackintosh Anne‐Maree , Piazza Marina , Chaiyasong Surasak , Cuong Pham Viet , Casswell Sally
Published: April 2018

Introduction and Aims

To investigate if socio‐economic disadvantage, at the individual‐ and country‐level, is associated with heavier drinking in some middle‐ and high‐income countries.

Design and Methods

Surveys of drinkers were undertaken in some high‐ and middle‐income countries. Participating countries were Australia, England, New Zealand, Scotland (high‐income) and Peru, Thailand and Vietnam (middle‐income). Disadvantage at the country‐level was defined as per World Bank (categorised as middle‐or high‐income); individual‐level measures were (i) years of education and (ii) whether and individual was under or over the poverty line in each country. Measures of heavier drinking were (i) proportion of drinkers that consumed 8+ drinks and (ii) three drinking risk groups (lower, increasing and higher). Multi‐level logistic regression models were used.

Results

Individual‐level measures of disadvantage, lower education and living in poverty, were associated with heavier drinking, consuming 8+ drinks on a typical occasion or drinking at the higher risk level, when all countries were considered together. Drinkers in the middle‐income countries had a higher probability of consuming 8+ drinks on a typical occasion relative to drinkers in the high‐income countries. Interactions between country‐level income and individual‐level disadvantage were undertaken: disadvantaged drinkers in the middle‐income countries were less likely to be heavier drinkers relative to those with less disadvantage in the high‐income countries.

Discussion and Conclusions

Associations between socio‐economic disadvantage and heavier drinking vary depending on country‐level income. These findings highlight the value of exploring cross‐country differences in heavier drinking and disadvantage and the importance of including country‐level measurements to better elucidate relationships.
Dorzagliatin (HMS5552), a novel dual‐acting glucokinase activator, improves glycaemic control and pancreatic β‐cell function in patients with type 2 diabetes: A 28‐day treatment study using biomarker‐guided patient selection
Authors: Zhu Xiao‐Xue , Zhu Da‐Long , Li Xiao‐Ying , Li Ya‐Lin , Jin Xiao‐Wei , Hu Tian‐Xin , Zhao Yu , Li Yong‐Guo , Zhao Gui‐Yu , Ren Shuang , Zhang Yi , Ding Yan‐Hua , Chen Li
Published: April 2018

Aims

To investigate the pharmacokinetics and pharmacodynamics of a dual‐acting glucokinase activator, dorzagliatin, and its safety, tolerability and effect on pancreatic β‐cell function in Chinese patients with type 2 diabetes (T2D).

Materials and methods

A total of 24 T2D patients were selected, utilizing a set of predefined clinical biomarkers, and were randomized to receive dorzagliatin 75 mg twice or once daily (BID, QD respectively) for 28 days. Changes in HbA1c and glycaemic parameters from baseline to Day 28 were assessed. In addition, changes in β‐cell function from baseline to Day 32 were evaluated.

Results

Significant reductions in HbA1c were observed in both regimens on Day 28 (−0.79%, 75 mg BID; −1.22%, 75 mg QD). Similar trends were found in the following parameters, including reductions from baseline in fasting plasma glucose by 1.20 mmol/L and 1.51 mmol/L, in 2‐hour postprandial glucose by 2.48 mmol/L and 5.03 mmol/L, and in glucose AUC0–24 by 18.59% and 20.98%, for the BID and QD groups, respectively. Both regimens resulted in improvement in β‐cell function as measured by steady state HOMA 2 parameter, %B, which increased by 36.31% and 40.59%, and by dynamic state parameter, ΔC30/ΔG30, which increased by 24.66% and 167.67%, for the BID and QD groups, respectively. Dorzagliatin was well tolerated in both regimens, with good pharmacokinetic profiles.

Conclusions

Dorzagliatin treatment for 28 days in Chinese T2D patients, selected according to predefined biomarkers, resulted in significant improvement in β‐cell function and glycaemic control. The safety and pharmacokinetic profile of dorzagliatin supports a subsequent Phase II trial design and continued clinical development.
Explaining regional disparities in Central and Eastern Europe
Authors: Chapman Sheila , Meliciani Valentina
Published: April 2018

The paper analyses the determinants and the evolution of income disparities across regions within Central and Eastern European Countries (CEECs) over 1991–2011. We add to the literature in different ways. First, we adapt the categories that Rodriguez‐Pose used for studying convergence among oldEUmembers toCEECs regions. This allows us to assess the relevance of geo‐sectoral groups (urban areas, old industrialized areas and peripheral areas) for newcomer regions. Second, we introduce a new category, that of ‘successful Foreign Direct Investment (FDI)‐based restructuring’ in order to capture regions that, often through considerableFDI, manage to reconvert their old industrial base. We then analyze whether this group helps understand catching‐up/falling behind processes inCEECs. We test the relevance of these groups by means of both non‐parametric and spatial regression analyses. We find that they help explain the increase in within‐countries’ regional disparities especially after the turn of the century.
Contrasting carbon and nitrogen rhizodeposition patterns of soya bean (Glycine max L.) and oat (Avena nuda L.)
Authors: Zang H. , Qian X. , Wen Y. , Hu Y. , Ren C. , Zeng Z. , Guo L. , Wang C.
Published: April 2018

Legumes can use photosynthetic energy to fix atmospheric nitrogen (N) by rhizobium‐legume symbiosis and this might result in contrasting patterns of carbon (C) and N rhizodeposition compared to those of cereals. Accurate quantification of C and N derived from rhizodeposition (CdfR and NdfR) is crucial to estimate the C and N input by legumes and cereals. We quantified the amounts of CdfR and NdfR from soya bean (Glycine max L.) and oat (Avena nuda L.) with the cotton‐wick labelling method. The plants were labelled twice with a pulse of a solution containing both 13C‐glucose and 15N‐urea at the fifth and sixth week after planting. The amount of CdfR and NdfR in soya bean was two to six times larger than that in oat. More than 70% of belowground C and N was contributed by rhizodeposition and 61–85% of this was present at a 0–25‐cm (top) depth. The 0–25 to 25–50‐cm (top‐to‐sub) ratio of rhizodeposition was larger than that of root biomass in soya bean, indicating stronger root activity and deposition capacity in topsoil than in subsoil. In contrast, a similar top‐to‐sub ratio of rhizodeposition and root biomass was observed in oat. The C:N ratio of rhizodeposition from soya bean was three times larger than that of roots, whereas the C:N ratios of roots and rhizodeposition were similar in oat. The larger N rhizodeposition from soya bean represents an important N pool, which increases the N‐availability for co‐existing or subsequent crops.

Highlights

We quantified the amounts of C and N rhizodeposition from soya bean and oat.

The plants were pulse labelled twice with 13C and15N using the cotton‐wick stem feeding method.

More than 70% of belowground C and N was contributed by rhizodeposition.

The larger N rhizodeposition from soya bean represents an important pool of N.
Demography and rapid local adaptation shape Creole cattle genome diversity in the tropics
Authors: Pitt Daniel , Bruford Michael W. , Barbato Mario , Orozco‐terWengel Pablo , Martínez Rodrigo , Sevane Natalia
Published: April 2018

The introduction of Iberian cattle in the Americas after Columbus’ arrival imposed high selection pressures on a limited number of animals over a brief period of time. Knowledge of the genomic regions selected during this process may help in enhancing climatic resilience and sustainable animal production. We first determined taurine and indicine contributions to the genomic structure of modern Creole cattle. Second, we inferred their demographic history using approximate Bayesian computation (ABC), linkage disequilibrium (LD) and Ne Slope (NeS) analysis. Third, we performed whole genome scans for selection signatures based on cross‐population extended haplotype homozygosity (XP‐EHH) and population differentiation (FST) to disentangle the genetic mechanisms involved in adaptation and phenotypic change by a rapid and major environmental transition. To tackle these questions, we combined SNP array data (~54,000 SNPs) in Creole breeds with their modern putative Iberian ancestors. Reconstruction of the population history of Creoles from the end of the 15th century indicated a major demographic expansion until the introduction of zebu and commercial breeds into the Americas ~180 years ago, coinciding with a drastic Ne contraction. NeS analysis provided insights into short‐term complexity in population change and depicted a decrease/expansion episode at the end of the ABC‐inferred expansion, as well as several additional fluctuations in Ne with the attainment of the current small Ne only towards the end of the 20th century. Selection signatures for tropical adaptation pinpointed the thermoregulatory slick hair coat region, identifying a new candidate gene (GDNF), as well as novel candidate regions involved in immune function, behavioural processes, iron metabolism and adaptation to new feeding conditions. The outcomes from this study will help in future‐proofing farm animal genetic resources (FAnGR) by providing molecular tools that allow selection for improved cattle performance, resilience and welfare under climate change.
Partitioning of the net CO2 exchange using an automated chamber system reveals plant phenology as key control of production and respiration fluxes in a boreal peatland
Authors: Järveoja Järvi , Nilsson Mats B. , Gažovič Michal , Crill Patrick M. , Peichl Matthias
Published: April 2018

The net ecosystem CO2 exchange (NEE) drives the carbon (C) sink–source strength of northern peatlands. Since NEE represents a balance between various production and respiration fluxes, accurate predictions of its response to global changes require an in depth understanding of these underlying processes. Currently, however, detailed information of the temporal dynamics as well as the separate biotic and abiotic controls of the NEE component fluxes is lacking in peatland ecosystems. In this study, we address this knowledge gap by using an automated chamber system established across natural and trenching/vegetation removal plots to partition NEE into its production (i.e., gross and net primary production; GPP and NPP) and respiration (i.e., ecosystem, heterotrophic and autotrophic respiration; ER, Rh and Ra) fluxes in a boreal peatland in northern Sweden. Our results showed that daily NEE patterns were driven by GPP while variations in ER were governed by Ra rather than Rh. Moreover, we observed pronounced seasonal shifts in the Ra/Rh and above/belowground NPP ratios throughout the main phenological phases. Generalized linear model analysis revealed that the greenness index derived from digital images (as a proxy for plant phenology) was the strongest control of NEE, GPP and NPP while explaining considerable fractions also in the variations of ER and Ra. In addition, our data exposed greater temperature sensitivity of NPP compared to Rh resulting in enhanced C sequestration with increasing temperature. Overall, our study suggests that the temporal patterns in NEE and its component fluxes are tightly coupled to vegetation dynamics in boreal peatlands and thus challenges previous studies that commonly identify abiotic factors as key drivers. These findings further emphasize the need for integrating detailed information on plant phenology into process‐based models to improve predictions of global change impacts on the peatland C cycle.
Mating system does not predict niche breath
Authors: Park Daniel S. , Ellison Aaron M. , Davis Charles C.
Published: April 2018

Aim

Self‐pollinating plants (‘selfers’) have larger geographical ranges and inhabit higher latitudes than their outcrossing relatives. This finding has led to the hypothesis that selfers also have broader climatic niches (‘niches’) because the increased likelihood of successful colonization into new areas and the initial purging of deleterious mutations could offset the inability of selfers to adapt to new environments owing to low heterozygosity. Here, we examine the niches of hundreds of closely related selfing and outcrossing species to determine whether selfers do indeed have larger niche breadths.

Location

Global.

Time period

Current.

Major taxa studied

Twenty clades of flowering plants comprising 424 species.

Methods

We estimated and compared the climatic niches of 194 pairs of sister species across 15 families, which differed in mating system. We incorporated these results into models predicting niche breadth and its change over time to estimate the effects of mating system on niche breadth. Furthermore, we compared the degree of niche divergence between sister‐species pairs of various mating system combinations.

Results

Selfers did not have wider niche breadths than their outcrossing sister taxa. Sister pairs of selfers also exhibited greater niche overlap than outcrossing sisters, implying that niche expansion becomes limited after the transition to selfing. Furthermore, the niche breadth of selfers was predicted to decrease significantly faster than that of closely related outcrossers.

Main conclusions

Our results demonstrate a decoupling in the range size and niche breadth of selfers. The larger geographical range and comparable niche breadths of many selfers is most likely to be a temporary phenomenon caused by a transiently expanded realized niche, and both will become constricted over time in comparison to outcrossers.
Tree species with limited geographical ranges show extreme responses to ectomycorrhizas
Authors: Karst Justine , Burns Cole , Cale Jonathan A. , Antunes Pedro M. , Woods Michaela , Lamit Louis J. , Hoeksema Jason D. , Zabinski Catherine , Gehring Catherine A. , La Flèche Marc , Rúa Megan A.
Published: April 2018

Aim

At continental scales, abiotic factors such as climate are typically used to explain differences in plant ranges. Although biotic interactions also underlie the biogeography of plants, the importance of plant‐associated microbes is often overlooked when predicting ranges. In particular, symbiotic microbes may influence the distribution of plants that engage in strong interactions with them. We tested whether seedling response to inoculation by ectomycorrhizal fungi explains range size of trees. To examine mechanisms underlying the relationship between range size and response to inoculation, we also examined to what extent sympatry between host and fungi influenced this relationship.

Location

Global.

Time period

Contemporary.

Major taxa studied

Trees and fungi forming ectomycorrhizas.

Methods

Using a dataset of 1,275 observations from 126 papers, we calculated mean biomass response (effect size) of 59 tree species to fungal inoculation. We extracted host range area from digitized maps of native distributions, and determined whether hosts were naturally sympatric with fungal species used as inoculum by searching herbaria databases with geospatially referenced data.

Results

Tree species with seedling effect sizes falling above or below the average response tended to have small ranges and those with average responses, large ranges. Moreover, hosts inoculated with fungi whose ranges were allopatric to their own had higher biomass compared to those that were inoculated by sympatric fungi, suggesting that the extent of geographical overlap between trees and symbiotic fungi may attenuate the mutualism.

Main conclusions

We demonstrate that mycorrhizas may underlie host biogeographical patterns at the continental scale. Our study is novel in the scope of species and scale tested, and points to a possible mechanism underlying this pattern related to the process of mutualism breakdown accruing over time at local geographical scales. For ectomycorrhizal tree species, performance may increase when exposed to fungal partners without a recent shared evolutionary history.
Perioperative replacement therapy in haemophilia B: An appeal to “B” more precise
Authors: Hazendonk H. C. A. M. , Preijers T. , Liesner R. , Chowdary P. , Hart D. , Keeling D. , Driessens M. H. E. , Laros‐van Gorkom B. A. P. , van der Meer F. J. M. , Meijer K. , Fijnvandraat K. , Leebeek F. W. G. , Mathôt R. A. A. , Collins P. W. , Cnossen M. H.
Published: April 2018

Introduction

Haemophilia B is caused by a deficiency of coagulation factor IX (FIX) and characterized by bleeding in muscles and joints. In the perioperative setting, patients are treated with FIX replacement therapy to secure haemostasis. Targeting of specified FIX levels is challenging and requires frequent monitoring and adjustment of therapy.

Aim

To evaluate perioperative management in haemophilia B, including monitoring of FIX infusions and observed FIX levels, whereby predictors of low and high FIX levels were assessed.

Methods

In this international multicentre study, haemophilia B patients with FIX < 0.05 IU mL−1 undergoing elective, minor or major surgical procedures between 2000 and 2015 were included. Data were collected on patient, surgical and treatment characteristics. Observed FIX levels were compared to target levels as recommended by guidelines.

Results

A total of 255 surgical procedures were performed in 118 patients (median age 40 years, median body weight 79 kg). Sixty percent of FIX levels within 24 hours of surgery were below target with a median difference of 0.22 IU mL−1 [IQR 0.12‐0.36]; while >6 days after surgery, 59% of FIX levels were above target with a median difference of 0.19 IU mL−1 [IQR 0.10‐0.39]. Clinically relevant bleeding complications (necessity of a second surgical intervention or red blood cell transfusion) occurred in 7 procedures (2.7%).

Conclusion

This study demonstrates that targeting of FIX levels in the perioperative setting is complex and suboptimal, but although this bleeding is minimal. Alternative dosing strategies taking patient and surgical characteristics as well as pharmacokinetic principles into account may help to optimize and individualize treatment.
Total elbow arthroplasty in haemophilia
Authors: Dale T. M. , Saucedo J. M. , Rodriguez‐Merchan E. C.
Published: April 2018

Introduction

Advanced haemophilic arthropathy of the elbow can be a devastating manifestation of severe haemophilia with significant implications for activities of daily living.

Aim

To summarize the currently available data on total elbow arthroplasty (TEA) for haemophilic arthropathy of the elbow, to draw comparisons to TEA for other indications, and to outline some considerations regarding TEA in this unique population.

Methods

A narrative review of the literature has been performed.

Results

The scant data regarding outcomes of TEA for haemophilic arthropathy are limited to small case series and case reports. A review of the available literature shows that, while pain relief and patient satisfaction are promising, variable outcomes with significant complications and infection rates may discourage routine use of TEA for haemophilic arthropathy of the elbow.

Conclusion

While patients with severe haemophilic arthropathy of the elbow are likely to make gains in terms of pain control and range of motion following TEA, there are insufficient data to routinely recommend its use. Complication and infection rates are concerning, and the lack of survival analysis data makes it difficult to quantify the benefit to the patient in light of the risks and resources involved in the procedure.
Cross‐cultural comparisons between Korean and U.S. adults with respect to texture perception and acceptance of cooked milled rice
Authors: Choi Won Seok , Jarma Arroyo Sara E. , Seo Han‐Seok
Published: April 2018

This study aimed to determine whether texture perception and acceptance of cooked rice could differ with cultural background, especially between Korean and American participants. Participants evaluated eight cooked rice samples with respect to intensities of textural attributes such as visual stickiness, hardness, stickiness and chewiness. Participants also rated the acceptability of and familiarity with those samples. Results showed that Americans gave higher ratings to cooked rice samples with respect to visual stickiness, stickiness and chewiness, while Koreans gave higher ratings to hardness than their counterpart. For Americans, chewiness was considered as a negative driver; whereas for Koreans, visual stickiness and stickiness were identified as positive drivers of overall liking for cooked rice samples. Moreover, a familiarity level of cooked rice samples was a pronounced positive driver of liking for both American and Korean participants. In conclusion, our findings provide empirical evidence that cultural background influences texture perception and liking of cooked rice.
Exploitation, Working Poverty, and the Expressive Power of Wages
Authors: Dobos Ned
Published: April 2018

The ‘working poor’ are paid below‐subsistence wages for full‐time employment. What, if anything, is wrong with this? The extant philosophical literature offers two kinds of answers. The first says that failing to pay workers enough to live on takes unfair advantage of them; the workers are exploited. The second says that employers who fail to pay living wages default on a duty of care grounded in a special relationship; the workers are neglected. These arguments, though generally sound, provide an incomplete picture of the wrongdoing involved. Neither adequately captures the intuition that a firm treats its employees not just badly, but disdainfully, by failing to pay them a living wage. My goal is to bring this particular feature of the relationship to salience. Working full‐time in return for below‐subsistence, I will argue, is an arrangement under which the worker is demeaned. This becomes apparent once we appreciate the expressive power of wages, and the intimate connection between one's labour and one's self.
Thermal energy and stress properties as the main drivers of regional distribution of coral species richness in the Indian Ocean
Authors: Ateweberhan Mebrahtu , McClanahan Tim R. , Maina Joseph , Sheppard Charles
Published: April 2018

Aim

Large‐scale variation in species richness results from multiple environmental controls. We proposed to identify the main factors that influence species richness of reef corals to provide insight into natural forces and their implications for future climate impacts.

Location

Indian Ocean.

Methods

We applied quantile regression (QR) to predict coral species richness and to evaluate the influence of reef area, biogeographical connection – represented by reef area up‐current, geological provinces defined by plate tectonics, latitude, longitude and mainland‐island separation, the physico‐chemical factors of photosynthetically active radiation (PAR), salinity and primary productivity and seven properties of sea surface temperature (mean, minimum, maximum, standard deviation, range, kurtosis and skewness) on coral species richness. Predictions at three quantiles (0.50, 0.75 and 0.95) were compared against ordinary least squares regression (OLS) analysis.

Results

All four models successfully predicted species richness, with the 95%QRmodel showing the best fit. According to this model, reef area, number of reefs up‐current and mean‐SSThad positive effects while maximum and kurtosis‐SSThad negative effects on richness. The distribution of observed richness values in relation to the regression line suggested this model revealed the main limiting factors. High predicted richness sites were located in the region from Western Australia to Central Indian Ocean Islands and southern India, the Mozambique Channel and East Africa and Southern Red Sea and Gulf of Aden. Sites with low predicted richness were Arabian/Persian Gulf and Gulf of Oman, South Africa and south‐west Madagascar, Gulf of Kutch, Bay of Bengal and the Mascarenes.

Conclusions

Temperature properties played a prominent role in influencing species richness mainly as latent energy and stress rather than thermal stability. These thermal properties indicate the conditions needed to promote coral diversity and selecting climate refugia for conservation management.
Predicting suicide attempts in adolescents with longitudinal clinical data and machine learning
Authors: Walsh Colin G. , Ribeiro Jessica D. , Franklin Joseph C.
Published: April 2018

Background

Adolescents have high rates of nonfatal suicide attempts, but clinically practical risk prediction remains a challenge. Screening can be time consuming to implement at scale, if it is done at all. Computational algorithms may predict suicide risk using only routinely collected clinical data. We used a machine learning approach validated on longitudinal clinical data in adults to address this challenge in adolescents.

Methods

This is a retrospective, longitudinal cohort study. Data were collected from the Vanderbilt Synthetic Derivative from January 1998 to December 2015 and included 974 adolescents with nonfatal suicide attempts and multiple control comparisons: 496 adolescents with other self‐injury (OSI), 7,059 adolescents with depressive symptoms, and 25,081 adolescent general hospital controls. Candidate predictors included diagnostic, demographic, medication, and socioeconomic factors. Outcome was determined by multiexpert review of electronic health records. Random forests were validated with optimism adjustment at multiple time points (from 1 week to 2 years). Recalibration was done via isotonic regression. Evaluation metrics included discrimination (AUC, sensitivity/specificity, precision/recall) and calibration (calibration plots, slope/intercept, Brier score).

Results

Computational models performed well and did not require face‐to‐face screening. Performance improved as suicide attempts became more imminent. Discrimination was good in comparison with OSI controls (AUC = 0.83 [0.82–0.84] at 720 days; AUC = 0.85 [0.84–0.87] at 7 days) and depressed controls (AUC = 0.87 [95% CI 0.85–0.90] at 720 days; 0.90 [0.85–0.94] at 7 days) and best in comparison with general hospital controls (AUC 0.94 [0.92–0.96] at 720 days; 0.97 [0.95–0.98] at 7 days). Random forests significantly outperformed logistic regression in every comparison. Recalibration improved performance as much as ninefold – clinical recommendations with poorly calibrated predictions can lead to decision errors.

Conclusions

Machine learning on longitudinal clinical data may provide a scalable approach to broaden screening for risk of nonfatal suicide attempts in adolescents.
Optimising the combination strategies for pipe and infiltration‐based low impact development measures using a multiobjective evolution approach
Authors: Zhou Q. , Lai Z. , Blohm A.
Published: April 2018

This study contributes to the literature by exploring the individual role and combination strategies of conventional pipe system and low impact development (LID) measures under different optimization schemes considering their physical and economic feasibility. Hydrodynamics of urban runoff are simulated using the one‐dimensional Storm Water Management Model. A genetic algorithm‐based multiobjective optimization technique is employed to derive the optimal trade‐off between physical performance and implementation costs under changing conditions. The results show that from a hydrological point of view, the dominant solution for flood mitigation is the pipe system due to its high efficiency in handling local overloading problems. However, if additional benefits of LID measures are taken into account, the optimal combination strategy shifts towards a higher share of LIDs. The relations revealed help to improve the planning and investment of alternative flood mitigation measures in an integrated system.
Copper chelators promote nonamyloidogenic processing of AβPP via MT1/2/CREB‐dependent signaling pathways in AβPP/PS1 transgenic mice
Authors: Wang Zhuo , Zhang Ya‐Hong , Zhang Wei , Gao Hui‐Ling , Zhong Man‐Li , Huang Ting‐Ting , Guo Rui‐Fang , Liu Na‐Na , Li Dan‐Dan , Li Yin , Wang Zhan‐You , Zhao Pu
Published: April 2018

Copper is essential for the generation of reactive oxygen species (ROS), which are induced by amyloid‐β (Aβ) aggregation; thus, the homeostasis of copper is believed to be a therapeutic target for Alzheimer’s disease (AD). Although clinical trials of copper chelators show promise when applied in AD, the underlying mechanism is not fully understood. Here, we reported that copper chelators promoted nonamyloidogenic processing of AβPP through MT1/2/CREB‐dependent signaling pathways. First, we found that the formation of Aβ plaques in the cortex was significantly reduced, and learning deficits were significantly improved in AβPP/PS1 transgenic mice by copper chelator tetrathiomolybdate (TM) administration. Second, TM and another copper chelator, bathocuproine sulfonate (BCS), promoted nonamyloidogenic processing of AβPP via inducing the expression of ADAM10 and the secretion of sAβPPα. Third, the inducible ADAM10 production caused by copper chelators can be blocked by a melatonin receptor (MT1/2) antagonist (luzindole) and a MT2 inhibitor (4‐P‐PDOT), suggesting that the expression of ADAM10 depends on the activation of MT1/2 signaling pathways. Fourth, three of the MT1/2‐downstream signaling pathways, Gq/PLC/MEK/ERK/CREB, Gs/cAMP/PKA/ERK/CREB and Gs/cAMP/PKA/CREB, were responsible for copper chelator‐induced ADAM10 production. Based on these results, we conclude that copper chelators regulate the balance between amyloidogenic and nonamyloidogenic processing of AβPP via promoting ADAM10 expression through MT1/2/CREB‐dependent signaling pathways.
Exploring relationships between body condition score, body fat, activity level and inflammatory biomarkers
Authors: Pearson W. , Wood K. , Stanley S. , MacNicol J.
Published: April 2018

Obesity is associated with inflammatory disorders in humans, including degenerative joint disease. While obesity is endemic in horses, its relationship to equine degenerative joint disease has not been explored. The current study sought to describe relationships between: body weight (BW), body condition score (BCS), lameness grade (AAEP), total body fat mass (kg; FM) and fat per cent (FP) [multifrequency bioelectrical impedance analysis (mfBIA)], age, gender, activity level (AL), synovial fluid (SF) and plasma (PL) PGE2 and glycosaminoglycan (GAG) in horses. During this field investigation, the BCS (of nine) of 54 horses at multiple farms in southern Ontario, Canada, was determined. Horses were categorized as thin (BCS=3/9; n = 6), moderate (BCS=4 or 5/9; n = 18), overweight (BCS=6 or 7/9; n = 19) or obese (BCS=8 or 9/9; n = 11). Total fat mass (kg) and body fat% was measured using mfBIA, lameness was assessed (AAEP lameness scale) and synovial fluid was collected via aseptic arthrocentesis from the left intercarpal joint for assessment of inflammatory biomarkers (PGE2, GAG). Means were compared with a one‐way ANOVA; correlation coefficients were calculated using a Spearman Rank Order Correlation to reveal correlations between variables. BCS was positively correlated with BW, FM, FP, AL and PL‐PGE2. BW was also significantly positively correlated with PL‐PGE2. It is concluded that BCS is significantly correlated with PL‐PGE2, due in part to the combined effect of AL and body condition. Net inflammatory effects of body fat on risk for joint disease require further study.
Effects of pure plant secondary metabolites on methane production, rumen fermentation and rumen bacteria populations in vitro
Authors: Joch M. , Mrázek J. , Skřivanová E. , Čermák L. , Marounek M.
Published: April 2018

In this study, the effects of seven pure plant secondary metabolites (PSMs) on rumen fermentation, methane (CH4) production and rumen bacterial community composition were determined. Two in vitro trials were conducted. In trial 1, nine concentrations of 8‐hydroxyquinoline, α‐terpineol, camphor, bornyl acetate, α‐pinene, thymoquinone and thymol were incubated on separate days using in vitro 24‐hr batch incubations. All compounds tested demonstrated the ability to alter rumen fermentation parameters and decrease CH4 production. However, effective concentrations differed among individual PSMs. The lowest concentrations that reduced (p < .05) CH4 production were as follows: 8 mg/L of 8‐hydroxyquinoline, 120 mg/L of thymoquinone, 240 mg/L of thymol and 480 mg/L of α‐terpineol, camphor, bornyl acetate and α‐pinene. These concentrations were selected for use in trial 2. In trial 2, PSMs were incubated in one run. Methane was decreased (p < .05) by all PSMs at selected concentrations. However, only 8‐hydroxyquinoline, bornyl acetate and thymoquinone decreased (p < .05) CH4 relative to volatile fatty acids (VFAs). Based on denaturing gradient gel electrophoresis analysis, different PSMs changed the composition of bacterial communities to different extents. As revealed by Ion Torrent sequencing, the effects of PSMs on relative abundance were most pronounced in the predominant families, especially in Lachnospiraceae, Succinivibrionaceae, Prevotellaceae, unclassified Clostridiales and Ruminococcaceae. The CH4 production was correlated negatively (−.72; p < .05) with relative abundance of Succinivibrionaceae and positively with relative abundance of Ruminococcaceae (.86; p < .05). In summary, this study identified three pure PSMs (8hydroxyquinoline, bornyl acetate and thymoquinone) with potentially promising effects on rumen CH4 production. The PSMs tested in this study demonstrated considerable impact on rumen bacterial communities even at the lowest concentrations that decreased CH4 production. The findings from this study may help to elucidate how PSMs affect rumen bacterial fermentation.
Additivity of standardized ileal digestibility of amino acids in mixed diets containing multiple protein sources for growing pigs fed three crude protein levels
Authors: Liu Z. , Liu J. , Chen L. , Lv S. , Liu L. , Tang X. , Zhang H.
Published: April 2018

This study was conducted to investigate the effect of dietary crude protein (CP) levels of semi‐purified diets on the additivity of values for standardized ileal digestibility (SID) of amino acids (AA) in mixed diets from multiple protein sources for growing pigs. A total of 28 barrows (initial BW, 66.4 ± 1.3 kg) were surgically fitted with simple T‐cannulas at the distal ileum and assigned to a replicated 14 × 4 incomplete Latin square design with 14 diets and 4 periods. The 14 experimental diets consisted of a nitrogen‐free diet; a corn‐based diet (80 g CP/kg); nine semi‐purified diets containing soya bean meal (SBM), canola meal (CM) or corn distillers dried grains with solubles (cDDGS), each type (protein source) of semi‐purified diets supplied 80, 120 or 160 g CP/kg, respectively; three mixed diets based on corn, SBM, CM and cDDGS formulated to contain 120, 160 and 200 g CP/kg respectively. Pigs were fed each of the 14 diets during a seven‐day period, and ileal digesta were collected from 08:00 a.m to 6:00 p.m on day 6 and 7. Chromic oxide was added as an indigestible marker. Results indicated that the SID of CP and AA were not affected by CP levels (p > .05). Values for SID of AA were additive (p > .05) with the exception of His and Lys; Arg and Lys; Arg, Lys, Thr, Asp, Cys and Gly in the mixed diets containing 120, 160 and 200 g CP/kg respectively (p < .05). In conclusion, additivity of SID values of AA in the mixed diets at different CP levels was not affected by the CP levels of semi‐purified diets for growing pigs. Therefore, it is recommended that SID values of AA should be used to formulate practical diets containing multiple ingredients for pigs.
Narrative intelligence in nursing: Storying patient lives in dementia care
Authors: Witham Gary , Haigh Carol
Published: April 2018

This paper examines narrative approaches to care within the context of dementia. It reviews the function of stories and explores some of the narrative genres that shape the cultural perceptions of dementia. We argue that narrative intelligence within healthcare is an important element in nurturing communal self‐identity for people living with dementia. Listening and responding to stories and the cultural framework that this encompasses is an embodied action that is not just related to cognitive recall but situates us within a cultural community. People with dementia may have challenges in maintaining narrative legitimacy in the face of fractured stories and incoherent narratives. Health professionals can offer support in reframing and presenting counterstories that maintain identities that can potentially be marginalised, silenced and open to narrative foreclosure. This process requires health professionals to be attentive and responsive to how patients with dementia and their supporters construct and position the stories they tell and the meaning(s) they attach to them.