bluuebunny/crossref_metadata_2025 huggingface dataset:
Can pathological reports of rectal cancer provide national quality indicators?
Authors: Keane Celia , Lin Anthony Y. , Kramer Nicole , Bissett Ian
Published: March 2018

Background

Rectal cancer care has become increasingly complex and requires accurate information. The pathology report is a vital tool for accessing information to gauge a patient's prognosis and to guide treatment decisions. The aim of this study was to assess the quality of histopathological reporting and surgery for rectal cancer in New Zealand using defined quality indicators.

Methods

This is a retrospective audit of pathological reports of all resected rectal cancer pathology reports submitted to the New Zealand Cancer Registry (NZCR) in 2015. The quality of reporting was assessed using specified criteria: synoptic report, adequate lymph node retrieval, reporting of circumferential resection margin (CRM) and mesorectal excision quality. Surgical outcomes were sphincter preservation rate, CRM clearance and complete mesorectal excision.

Results

A total of 803 patients with rectal cancer were reported to the NZCR in 2015, 505 underwent proctectomy. A total of 89.5% of reports were structured, 81.8% reported mesorectal excision quality and 86.7% reported CRM status. Adequate lymph node retrieval was obtained in 65.1%, complete mesorectal excision in 84.6% and positive CRM in 6.2% of cases. Quality varied between laboratories and district health boards. High‐volume laboratories had higher quality reporting. Surgeon volume and training was related to adequate lymph node retrieval but not CRM clearance nor mesorectal excision quality.

Conclusion

High‐quality pathological reporting is associated with the use of synoptic reporting templates. Surgical outcomes for rectal cancer in New Zealand, especially the low rate of CRM involvement, compare favourably with international audits.
State Spaces of Resistance: Industrial Tree Plantations and the Struggle for Land in Laos
Authors: Kenney‐Lazar Miles , Suhardiman Diana , Dwyer Michael B.
Published: March 2018

Land grabbing has transformed rural environments across the global South, generating resistance or political reactions “from below”. In authoritarian countries like Laos, where resource investments are coercively developed and insulated from political dissent, resistance appears absent at first glance. Yet, it is occurring under the radar, largely outside transnational activist networks. In this article, we examine how resistance can protect access to rural lands in contexts where it is heavily repressed. Resistance here occurs with, rather than against the state by foregrounding the contradictions of land use and ownership within state spaces, such as competing goals of large‐scale industrial plantations versus smallholder agriculture and national forest conservation. Such contradictions are engaged by using historical, place‐based political connections to exploit the scalar frictions of a fragmented state and occupying plantation clearance sites to highlight contested lands in situ. Nonetheless, such strategies remain spatially and socially uneven amongst the Lao peasantry.
Waist‐to‐height ratio remains an accurate and practical way of identifying cardiometabolic risks in children and adolescents
Authors: Jiang Yuan , Dou Ya‐lan , Xiong Feng , Zhang Lan , Zhu Gao‐hui , Wu Ting , Zhang Yi , Yan Wei‐li
Published: March 2018

Aim

We evaluated how effectively the waist‐to‐height ratio (WHtR) identified cardiometabolic risk (CMR) in children and adolescents, compared with the tri‐ponderal mass index, percentage of body fat and other obesity indexes.

Methods

Eligible subjects were recruited from three metropolitan regions of China from May 2013 to June 2014. Subjects with at least three of the following abnormalities – hypertension, dyslipidemia, elevated fasting blood glucose and central obesity – were defined as CMR1 and children with at least two were defined as CMR2. The area under the curve (AUC) of the receiver operating characteristic curve was used to compare how effectively obesity indexes predicted CMR.

Results

We recruited 3556 subjects aged 7–18 years. All five obesity indexes showed good, comparable performances in identifying CMR and the AUCs ranged from 0.89 to 0.90 for CMR1 and 0.83 to 0.85 for CMR2. The cut‐off of 0.467 for WHtR achieved a sensitivity of 0.91 and specificity of 0.80 for predicting CMR1, with the best cut‐offs being 0.463 for boys and 0.469 for girls.

Conclusion

The WHtR was a superior and practical screening tool for detecting CMR in this paediatric population, as it provided comparable accuracy to other methods and just required a simple calculation.
Extraintestinal manifestations were common in children with coeliac disease and were more prevalent in patients with more severe clinical and histological presentation
Authors: Nurminen Samuli , Kivelä Laura , Huhtala Heini , Kaukinen Katri , Kurppa Kalle
Published: March 2018

Aim

This study investigated the prevalence of extraintestinal manifestations (EIM) in paediatric coeliac disease and their associations with other disease features.

Methods

Researchers at the University of Tampere, Finland, compared EIM in 511 children diagnosed with coeliac disease from 2003 to 2014 and 180 diagnosed with functional gastrointestinal disorders from 2007 to 2013. Disease severity and dietary responses were also compared between coeliac children diagnosed by screening (n = 146) or because of EIM (n = 116) or gastrointestinal symptoms (n = 249).

Results

Coeliac patients had more EIM (62%) than those with functional disorders (33%). The most common EIM in coeliac children were poor growth (27%) and anaemia (18%). Children with coeliac disease often showed fatigue (8%) and symptoms affecting the skin (15%), nervous system (9%) and joints (6%). Coeliac patients with EIM as their main clinical presentation had more severe symptoms and histological damage at diagnosis than those with gastrointestinal presentation and screen‐detected cases. The subgroups did not differ with regard to other clinical and laboratory parameters and dietary adherence. Concomitant EIM were also common in children diagnosed because of gastrointestinal presentation (60%) and by screening (37%).

Conclusion

EIM were common in coeliac disease and associated with more severe clinical and histological presentation.
WHY FARMERS INVOLVE THEMSELVES IN CO‐OPERATIVE DISTRICT COUNCILS
Authors: MORFI Chrysoula , NILSSON Jerker , ÖSTERBERG Hanna
Published: March 2018

This study finds that selective incentives induce district council members and chairpersons to work for the collective best of a co‐operative membership. Being the lowest echelon of a co‐operative's internal governance hierarchy, district councils constitute a link between the membership and the board of directors. Previous research indicates that district council members are often driven by a co‐operative conviction and social concerns. The present study challenges this view. On the basis of a survey of all 191 district council members and council chairpersons of a large Swedish agricultural co‐operative, it is found that the elected representatives rank low in terms of co‐operative conviction and social concerns. They involve themselves mainly in order to get personal benefits; they want to gain access to information, mature personally and obtain inputs to develop their farm enterprises. The financial compensation is of limited importance.
Diabetes, Cardiovascular Disorders and 2,3,7,8‐Tetrachlorodibenzo‐p‐Dioxin Body Burden in Czech Patients 50 Years After the Intoxication
Authors: Pelcl Tomas , Skrha Jan , Prazny Martin , Vlckova Stepanka , Fenclova Zdenka , Navratil Tomas , Malik Jan , Diblik Pavel , Zikan Vit , Pelclova Daniela
Published: March 2018

The correlation between 2,3,7,8‐tetrachlorodibenzo‐p‐dioxin (TCDD) intoxication and the parameters of metabolic impairment was examined in the last eight male survivors of 80 workers exposed to TCDD during the production of herbicides in a chemical factory in 1965–1967. Their median TCDD blood level was 112 (46–390) pg/g lipids, and the median TCDD body deposit was 3.9 (0.8–11.7) μg. This puts these patients into the most severely intoxicated group of subjects, according to back‐calculated levels of TCDD. The median TCDD blood level in eight controls was 12 pg/g (<0.10 to 22.2 pg/g). Markers of metabolic impairment – diabetes, dyslipidaemia, arterial hypertension, carotid artery plaque, skin microvascular reactivity, eye fundus hypertensive angiopathy and history of coronary heart disease – were assessed and compared to a general male population of comparable age. Measured parameters compared with a population of comparable age were as follows: prevalence of diabetes (62.5% versus 17.6%), arterial hypertension (87.5% versus 71.8%), dyslipidaemia (87.5% versus 88.8%), history of coronary heart disease (62.5% versus 26.0%) and eye fundus hypertension angiopathy (50% versus 14%). All eight patients (100% versus 43%) developed plaques in carotid arteries, six had stenosis >50% and two had a carotid intervention (stenting or endarterectomy). Total cholesterol levels decreased compared to the earlier study this patient group in 2008, most likely due to a more intensive use of lipid‐lowering drugs. Several metabolic parameters were higher (diabetes as much as 3.5‐fold) in the group of severely TCDD‐intoxicated subjects than in a general population of comparable age. This suggests that TCDD plays a role in the development of metabolic impairment and vascular changes.
A D-Vine Copula-Based Model for Repeated Measurements Extending Linear Mixed Models with Homogeneous Correlation Structure
Authors: Killiches Matthias , Czado Claudia
Published: March 2018

We propose a model for unbalanced longitudinal data, where the univariate margins can be selected arbitrarily and the dependence structure is described with the help of a D-vine copula. We show that our approach is an extremely flexible extension of the widely used linear mixed model if the correlation is homogeneous over the considered individuals. As an alternative to joint maximum–likelihood a sequential estimation approach for the D-vine copula is provided and validated in a simulation study. The model can handle missing values without being forced to discard data. Since conditional distributions are known analytically, we easily make predictions for future events. For model selection, we adjust the Bayesian information criterion to our situation. In an application to heart surgery data our model performs clearly better than competing linear mixed models.
Determining the optimal time for radical cystectomy after neoadjuvant chemotherapy
Authors: Mmeje Chinedu O. , Benson Cooper R. , Nogueras‐González Graciela M. , Jayaratna Isuru S. , Gao Jianjun , Siefker‐Radtke Arlene O. , Kamat Ashish M. , Dinney Colin P. , Navai Neema , Shah Jay B.
Published: March 2018

Objective

To determine whether the recovery window (RW) between neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) affects 90‐day postoperative morbidity and incidence of lymph node metastasis.

Patients and methods

We reviewed patients treated with NAC and RC from 1995 to 2013 for ≤cT4N0M0 bladder cancer. The association of the RW with 90‐day perioperative morbidity and lymph node metastasis was determined. Generalised linear models were used to determine predictors of each endpoint. Patients were stratified into four RWs by 21‐day intervals (18–42; 43–63; 64–84; and ≥85 days) from last day of NAC to RC.

Results

We evaluated 306 patients with RW information during the study period. The median (range) RW was 46 (18–199) days. There was no difference in overall morbidity, re‐admission, or major complication rates amongst the four RWs. In the multivariable analysis extravesical disease was an independent predictor of overall morbidity (odds ratio [OR] 1.95, 95% confidence interval [CI] 1.16–3.26; P = 0.011). Age (OR 1.05, 95% CI: 1.02–1.09; P = 0.004), and surgical duration ≥7 h (OR 2.87, 95% CI: 1.52–5.42; P = 0.001) were independent predictors of major complications. Only surgical duration ≥7 h was a predictor of re‐admission (OR 2.24; 95% CI: 1.26–3.98; P = 0.006). A RW of ≥85 days had the highest incidence of node‐positive disease (pN+; 40%). In a separate multivariable model that included clinical predictors for pN+, a RW of ≥85 days was an independent predictor of nodal metastasis (OR 2.92, 95% CI: 1.20–7.09; P = 0.018).

Conclusion

Patients treated with NAC for bladder cancer can undergo RC between 18 and 84 days (2.5–12 weeks) after NAC with no difference in the risk of perioperative morbidity. Delaying surgery beyond 12 weeks was associated with a significant risk of lymph node metastasis.
CAN INFORMATION AND COMMUNICATION TECHNOLOGY IMPROVE STOCK MARKET EFFICIENCY? A CROSS‐COUNTRY STUDY
Authors: Lee Ming‐Hsuan , Tsai Tou‐Chin , Chen Jau‐er , Lio Mon‐Chi
Published: March 2018

The rapid advance of information and communication technology (ICT) has revolutionized the dissemination of stock market information. Based on the noise trading theory, this study discusses whether the changes brought by ICT have promoted the transparency of stock market information or instead flooded the stock market with misinformation. A cross‐country panel dataset of 71 countries from 2002 to 2014 was established. The empirical methodologies include panel unit root tests, panel variance ratio tests, and panel multiple regressions. The results of panel unit root tests and panel variance ratio tests show that stock markets in countries with high ICT diffusion are efficient while stock markets in countries with low or medium ICT diffusion are not all efficient. The results of panel regressions further show that the effect of ICT diffusion in reducing market noises was more significant than its effect in magnifying the noises.
Crowdsourced idea generation: The effect of exposure to an original idea
Authors: Wang Kai , Nickerson Jeffrey , Sakamoto Yasuaki
Published: March 2018

Crowdsourcing is an increasingly important approach to pursuing innovation. In crowdsourcing ideation websites, crowd members are often exposed to some stimulus ideas, such as examples provided by companies or peers' ideas. Understanding the effect of being exposed to original stimulus ideas in this context may inform the design of the crowdsourcing process. To test this effect, an experiment was conducted where crowd workers were asked to design a public service advertisement. Depending on the experimental condition, the participants were exposed to an original idea, or a common idea, or no idea. As compared to the absence of exposure, exposure to an original idea decreased fluency, defined as the number of ideas generated by each person, and increased the average originality of ideas generated by each person. By contrast, exposure to a common idea had no effect on either idea originality or fluency. The semantic similarity between the stimulus idea and the first idea generated was higher when the stimulus was common versus original as measured by latent semantic analysis. The implications of these results for research and practice are discussed.
Induction of chemokine (C‐C motif) ligand 5 by Epstein–Barr virus infection enhances tumor angiogenesis in nasopharyngeal carcinoma
Authors: Ma Wenlong , Feng Lin , Zhang Shanshan , Zhang Haojiong , Zhang Xiao , Qi Xuekang , Zhang Yuchen , Feng Qisheng , Xiang Tong , Zeng Yi‐Xin
Published: March 2018

Nasopharyngeal carcinoma (NPC) is etiologically associated with Epstein–Barr virus (EBV) infection and is known to be highly vascularized. Previous studies have suggested that EBV oncoproteins contribute to NPC angiogenesis. However, the regulatory network of EBV in angiogenesis still remains elusive. Herein, we reveal a novel mechanism of EBV‐induced angiogenesis in NPC. First, we showed that EBV‐infected NPC cell lines generated larger tumors with more microvessels in mouse xenograft models. Subsequent proteomic analysis revealed that EBV infection increased the expression of a series of angiogenic factors, including chemokine (C‐C motif) ligand 5 (CCL5). We then proved that CCL5 was a target of EBV in inducing tumor angiogenesis and growth. Further investigation through transcriptome analysis indicated that the pro‐angiogenic function of CCL5 might be mediated by the PI3K/AKT pathway. Furthermore, we confirmed that activation of the PI3K/AKT and hypoxia‐inducible factor‐1α pathways was essential for CCL5‐promoted angiogenesis. Finally, the immunohistochemical analysis of human NPC specimens also showed that CCL5 was correlated with angiogenesis. Taken together, our study identifies CCL5 as a key EBV‐regulated molecular driver that promotes NPC angiogenesis, suggesting it as a potential therapeutic target.
Evaluation of a bone substitute covered with a collagen membrane for ridge preservation after tooth extraction. Clinical and tomographic randomized controlled study in humans
Authors: Nunes Felipe Anderson Sousa , Pignaton Túlio B. , Novaes Arthur B. , Taba Mário , Messora Michel R. , Palioto Daniela B. , Spin‐Neto Rubens , de Souza Sérgio Luís Scombatti
Published: March 2018

Objective

To evaluate the use of a synthetic bone substitute covered with a collagen membrane for ridge preservation after tooth extraction, by clinical and tomographic analysis.

Material and Methods

Fifteen patients, presenting at least two maxillary anterior teeth indicated for extraction, were selected: in the test group (TG), post‐extraction sockets were filled by a synthetic bone substitute; in the control group (CG), by blood clot. In both groups, the sockets were covered by a collagen membrane. Cone‐beam computerized tomography (CBCT) scans were acquired immediately after and 6 months post‐surgically, and horizontal and vertical dimensional bone changes were quantified.

Results

Transurgical clinical analysis presented no statistically significant differences between TG and CG (p > .05). CBCT intragroup evaluation presented statistically significant reduction for the buccal alveolar measurement (TG = 1.58 mm or 21.82%, and CG = 1.66 mm or 24.08%) and horizontal cervical measurement (TG = 0.55 mm or 8.30% and CG = 1.30 mm or 17.68%), and not significant for palatal alveolar measurement (TG = 0.44 mm or 3.42% and CG = 0.26 mm or 3.89%). For alveolar height and horizontal apical measurements, this decrease was significant only for the CG, with reductions of 1.03 mm and 0.50 mm, respectively, compared to a decrease of 0.57 mm and 0.19 mm for the TG. The intergroup analysis showed significant difference for cervical horizontal measurement after 6 months (p < .05).

Conclusion

The results showed that the use of the bone substitute covered with a collagen membrane resulted in less changes in vertical and horizontal alveolar ridge dimensions than the collagen membrane alone.
Due Process in Dual Process: Model‐Recovery Simulations of Decision‐Bound Strategy Analysis in Category Learning
Authors: Edmunds Charlotte E. R. , Milton Fraser , Wills Andy J.
Published: March 2018

Behavioral evidence for the COVIS dual‐process model of category learning has been widely reported in over a hundred publications (Ashby & Valentin, ). It is generally accepted that the validity of such evidence depends on the accurate identification of individual participants' categorization strategies, a task that usually falls to Decision Bound analysis (Maddox & Ashby, ). Here, we examine the accuracy of this analysis in a series of model‐recovery simulations. In Simulation 1, over a third of simulated participants using an Explicit (conjunctive) strategy were misidentified as using a Procedural strategy. In Simulation 2, nearly all simulated participants using a Procedural strategy were misidentified as using an Explicit strategy. In Simulation 3, we re‐examined a recently reported COVIS‐supporting dissociation (Smith et al., ) and found that these misidentification errors permit an alternative, single‐process, explanation of the results. Implications for due process in the future evaluation of dual‐process theories, including recommendations for future practice, are discussed.
Do talented managers invest more efficiently? The moderating role of corporate governance mechanisms
Authors: García‐Sánchez Isabel‐María , García‐Meca Emma
Published: March 2018

Manuscript type

Empirical

Research question/issue

The main objective of this paper is to examine the influence of managerial ability on investment efficiency. Using a sample of 2185 firms from 24 countries for the period 2006–2015, we hypothesize a positive association between investment efficiency and managerial ability and suggest that able managers make fewer over‐ and underinvestment decisions. As a unique and helpful feature of this study, we also employ a model to capture the different interactions between internal and external corporate governance mechanisms and managerial ability.

Research findings/insights

Our results show that managerial ability is an economically relevant determinant of investment efficiency, resulting in lower levels of underinvestment and overinvestment. Additionally, our findings note that the benefits of able managers for investment efficiency are reinforced when companies are located in countries with better board effectiveness, superior investor protection, and better legal enforcement, suggesting that governance mechanisms are effective complementary measures to constrain inefficient investment decisions. The results also indicate that the advantages of having able managers are especially noticeable during a financial crisis and under conditions of greater information asymmetry.

Theoretical/academic implications

Our findings suggest that governance mechanisms are effective complementary measures to constrain inefficient investment decisions. Specifically, our results highlight the relevance of the monitoring role of the board, noting that the efficiency of this internal control mechanism complements the effect that able managers have on investment efficiency.

Practitioner/policy implications

The paper has relevant implications. First, boards of directors must be aware that, although the access to financial resources is a determinant of firms' financial success, the individual ability to manage them is essential in making efficient investment decisions, which should be considered when recruiting new managers and establishing compensation schemes. Second, the paper shows that managerial ability is reinforced when the company is in a country with strong corporate governance mechanisms, implying that regulators should be aware of the relevance of investor protection, legal enforcement, and board effectiveness to improve the benefits of managerial attributes and therefore the financial efficiency of firms.
Industrial foundations as long‐term owners
Authors: Thomsen Steen , Poulsen Thomas , Børsting Christa , Kuhn Johan
Published: March 2018

Manuscript Type

Empirical

Research Question/Issue

Does foundation ownership lead to long‐term corporate governance and business behavior in foundation‐owned companies?

Research Findings/Insights

Short‐termism has become a serious concern for corporate governance, and this has inspired a search for institutional arrangements to promote long‐term decision‐making. In this paper, we call attention to long‐term ownership by industrial foundations, which is common in Northern Europe but little known in the rest of the world. We use a unique Danish data set to document that industrial foundations are long‐term owners that practice long‐term governance. We show that foundation ownership is highly stable compared to other ownership structures. Foundation‐owned companies replace managers less frequently. They have conservative capital structures with low financial leverage. They score higher on an index of long‐termism in finance, investment, and employment. They survive longer. Overall, our paper supports the hypothesis that corporate time horizons are influenced by ownership structures, and particularly that industrial foundations possess characteristics that promote long‐termism. Policymakers, business owners, and managers interested in promoting long‐term governance models should therefore reconsider the role of ownership structure.

Theoretical/Academic Implications

This paper supports the hypothesis that time horizons are influenced by ownership commitment and particularly that industrial foundations promote long‐termism. We contribute to the corporate governance literature by further developing the concept of long‐termism as a multi‐faceted corporate governance concept associated with ownership commitment. We also show that foundation ownership is associated with long‐termism.

Practitioner/Policy Implications

Policymakers interested in promoting long‐termism should encourage long‐term ownership, for example by industrial foundations. Practitioners should consider the importance of ownership commitment in ensuring long‐term corporate governance.
Lung ultrasound in diagnosis and follow up of community acquired pneumonia in infants younger than 1‐year old
Authors: Omran Ahmed , Eesai Samah , Ibrahim Mostafa , El‐Sharkawy Sonya
Published: March 2018

Background

Pneumonia is still a leading cause of illness and death in infants worldwide. Lung ultrasound (LUS) is emerging as an extremely valuable non‐ionizing radiation diagnostic tool in diagnosis and follow up of multiple paediatric pulmonary diseases.

Objective

To assess the applicability of LUS in diagnosis and follow up of community acquired pneumonia (CAP) in Egyptian infants younger than 1‐year old.

Methods

LUS and chest X‐ray (CXR) were performed in 50 infants presented with clinical symptoms and signs suggestive of CAP within the first 6 hours of admission in our inpatient department, then follow up LUS was performed 5 days after admission.

Results

This study showed that LUS was superior to CXR in initial diagnosis of CAP in infants. LUS detected pneumonia in 49 (98%) compared to 36 (72%) infants diagnosed by CXR (P < .05). On follow up, 5 days later, consolidation patch disappeared in 13 (26.5%) infants, diminished in size in 27 (55.1%) infants, remained at the same size in 2 (4.1%) infants and increased in size in 7 (14.3%) infants.

Conclusion

This study showed that LUS is superior to CXR in diagnosing infants with CAP who are younger than 1‐year old. It also serves as a safe follow up tool and could support the decision of hospital discharge in this category of patients. Further studies with larger sample size and longer follow up duration are recommended to confirm the results of the present study.
Primary cutaneous ganglioneuroma: anatomico‐clinical study of 4 cases with focus on Merkel cells
Authors: Romero‐Pérez David , Jegou Marie‐Hélène , Lecointre Claire , Penchet Isabelle , Cribier Bernard
Published: March 2018

Cutaneous ganglioneuromas (CGNs) are exceptional. We aim to describe the anatomico‐clinical profile of primary CGN and report 4 cases. Patients were 2 men and 2 women aged 53 to 76 years, who had flesh‐colored nodules on the back, associated with adjacent keratotic changes, that is, epidermal nevus (1 case) or seborrheic keratosis (3 cases). Histopathology showed ganglion cells within a proliferation of Schwann cells. The epidermis was acanthotic, associated with sebaceous induction in 2 cases, with follicular hyperplasia as in fibroepithelial tumors (1 case) or with tricholemmoma (2 cases). Cytokeratin‐20 immunostaining showed Merkel cells in the epidermis. A higher density of Merkel cells was observed in BerEP4+ follicular structures. Along with 16 published cases, our study indicates that a nodule associated with seborrheic keratosis on the back may represent a CGN, a complex mesenchymal and epidermal/follicular lesion of neuroectodermal lineage, associating neuronal proliferation and Merkel cell hyperplasia with follicular induction.
Prediction of responders to ketogenic diet based on syndrome and etiology: identification of a new target population?
Authors: Auvin Stéphane
Published: March 2018

This commentary is on the original article by Villaluz et al. on pages 718–723 of this issue.
Comparative efficacy and safety of the duodenal‐jejunal bypass liner in obese patients with type 2 diabetes mellitus: A case control study
Authors: Laubner Katharina , Riedel Nina , Fink Katharina , Holl Reinhard W. , Welp Reinhard , Kempe Hans‐Peter , Lautenbach Anne , Schlensak Matthias , Stengel Rainer , Eberl Thomas , Dederichs Frank , Schwacha Henning , Seufert Jochen , Aberle Jens
Published: March 2018

Aims

The duodenal‐jejunal bypass liner (DJBL) is an endoscopic device mimicking surgical duodenal‐jejunal bypass, and is indicated for the treatment of obesity‐associated type 2 diabetes mellitus. This analysis was conducted to evaluate the efficacy and safety of the DJBL in comparison to lifestyle changes and antidiabetic drugs.

Materials and Methods

To determine the efficacy and long‐term safety of the DJBL, data concerning 235 obese patients with type 2 diabetes mellitus from the German DJBL registry were analysed. For comparison with standard treatment, propensity‐score‐matching with patients from the German DPV registry, including the matching parameters sex, age, diabetes duration, baseline BMI and baseline HbA1c, was applied. The final matched cohort consisted of 111 patients in the DJBL group and 222 matched control DPV patients.

Results

Mean treatment time with the DJBL was 47.5 ± 12.2 weeks, mean BMI reduction was 5.0 kg/m2 (P < .001) and mean HbA1c reduction was 1.3% (11.9 mmol/mol) (P < .001). Reduction of antidiabetic medications and improvements in other metabolic and cardiovascular risk parameters was observed. In comparison to the matched control group, mean reductions in HbA1c (−1.37% vs −0.51% [12.6 vs 3.2 mmol/mol]; P < .0001) and BMI (−3.02 kg/m2 vs −0.39 kg/m2; P < .0001) were significantly higher. Total cholesterol, LDL cholesterol and blood pressure were also significantly better.

Conclusion

This study provides the largest, so far, hypothesis‐generating evidence for a putative positive risk/benefit ratio for treatment of obese patients with type 2 diabetes mellitus with the DJBL as an alternative treatment option for this patient population.
Male harassment, female movements, and genetic diversity in a fragmented metapopulation
Authors: Severns Paul M. , Breed Greg A.
Published: March 2018

Interactions with males often alter the short‐term behaviors of reproductive females. Yet, the influence of different internal and external factors, such as sexual conflict, on animal movement and patch dynamics is not well understood. We studied associations between courtship, movements of reproductive females, and genetic diversity in a small, fragmented network of Euphydras editha taylori (Taylor's checkerspot butterfly). In the absence of courtship, female movements (step lengths) were restricted (< 2 m) and tortuous, and females never departed reproductive habitat. However, when courted by males, step lengths increased markedly and movements were straighter (less tortuous). Female habitat departures were associated with interactions between patch identity and courtship. All tracked females remained in reproductive habitat in the smallest patch, whereas 32% of females departed the larger patch (over forest) while eluding courting males. Genotyping (simple sequence repeats – SSRs) suggested low levels of genetic differentiation (Fst ~ 0.02; Analysis of molecular variance p = 0.02) with inter‐patch distances of ≤ 0.3 km. Tests for a recent genetic bottleneck were negative, but heterozygous deficient deviations from Hardy–Weinberg equilibrium expectations may indicate a developing bottleneck. Patch‐specific female movement behaviors and the distribution of SSR alleles across the network suggest the possibility of a predominantly unidirectional transfer of reproducing females from the largest to smaller patches, with the smaller patches mostly closed to emigration. Our study suggests short‐lived intraspecific interactions may influence dispersal in unanticipated ways and that understanding these interactions will provide a more holistic view of habitat fragmentation and network functioning.
Risk factors for blood stream infections in multiple myeloma: A population‐based study of 1154 patients in Denmark
Authors: Sørrig Rasmus , Klausen Tobias W. , Salomo Morten , Vangsted Annette , Gimsing Peter
Published: March 2018

Objectives

Multiple myeloma (MM) patients are at high risk of developing infections. The risk factors for blood stream infections (BSI) in MM patients are, however, less described. The aim of this study was to analyze the epidemiology of and risk factors for BSI in an unselected MM population.

Methods

Nationwide Danish MM data of 1154 patients diagnosed from 2010 to 2013 were linked with nationwide data on blood cultures (BCs; from 2010 to 2016) to assess the peak period of having a BC taken and BC positive for pathogenic microorganisms.

Results

The highest number of BC was taken in the period from day −30 to day +180 from date of MM diagnosis. Risk factors for having a BC sampling within the peak period were as follows: immunoparesis (HR 1.5 [1.1‐2.1]; P = .007), ISS‐III (HR 1.3 [1.0‐1.7]; P = .035), high creatinine (HR 1.4 (1.0‐2.0); P = .046), and high lactate dehydrogenase (LDH) (HR 2.8 (1.6‐4.7; P < .001). Risk factors for positive BC during the peak period were ISS‐III (HR 2.0 (1.1‐3.7); P = .023) and high LDH (HR 3.4 [1.1‐10.3]; P = .028).

Conclusions

Our results show that MM patients with aggressive disease presentation are at the highest risk of developing BSI. Furthermore, our study implies that MM is diagnosed in relation to a serious infection for a large number of patients.
Food web structure of aphids and their parasitoids in Belgian fruit agroecosystems
Authors: Alhmedi Ammar , Raymaekers Stijn , Tomanović Željko , Bylemans Dany , Beliën Tim
Published: March 2018

Community structures of aphids and their parasitoids were studied in fruit crop habitats of eastern Belgium in 2014 and 2015. Quantitative food webs of these insects were constructed separately for each year, and divided into subwebs on three host‐plant categories, fruit crop plants, non‐crop woody and shrub plants and non‐crop herbaceous plants. The webs were analyzed using the standard food web statistics designed for binary data. During the whole study period, 78 plant species were recorded as host plants of 71 aphid species, from which 48 parasitoid species emerged. The community structure, aphid / parasitoid species‐richness ratio and trophic link number varied between the two years, whereas the realized connectance between parasitoids and aphids was relatively constant. A new plant–aphid–parasitoid association for Europe was recorded. Dominant parasitoid species in the study sites were Ephedrus persicae, Binodoxys angelicae and Praon volucre: the first species was frequently observed on non‐crop trees and shrubs, but the other two on non‐crop herbaceous plants. The potential influence, through indirect interactions, of parasitoids on aphid communities was assessed with quantitative parasitoid‐overlap diagrams. Symmetrical links were uncommon, and abundant aphid species seemed to have large indirect effects on less abundant species. These results show that trophic indirect interactions through parasitoids may govern aphid populations in fruit crop habitats with various non‐crop plants, implying the importance for landscape management and biological control of aphid pests in fruit agroecosystems.
Phenotypic and functional alterations of myeloid‐derived suppressor cells during the disease course of multiple sclerosis
Authors: Iacobaeus Ellen , Douagi Iyadh , Jitschin Regina , Marcusson‐Ståhl Maritha , Andrén Anton Törnqvist , Gavin Caroline , Lefsihane Katia , Davies Lindsay C , Mougiakakos Dimitrios , Kadri Nadir , Le Blanc Katarina
Published: March 2018

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system involving dysregulated encephalitogenic T cells. Myeloid‐derived suppressor cells (MDSCs) have been recognized for their important function in regulating T‐cell responses. Recent studies have indicated a role for MDSCs in autoimmune diseases, but their significance in MS is not clear. Here, we assessed the frequencies of CD14+HLA‐DRlow monocytic MDSCs (Mo‐MDSCs) and CD33+CD15+CD11b+HLA‐DRlow granulocytic MDSCs (Gr‐MDSCs) and investigated phenotypic and functional differences of Mo‐MDSCs at different clinical stages of MS and in healthy subjects (HC). Increased frequencies of Mo‐MDSCs (P < 0.05) and Gr‐MDSCs (P < 0.05) were observed in relapsing‐remitting MS patients during relapse (RRMS‐relapse) compared to stable RRMS (RRMS‐rem). Secondary progressive MS (SPMS) patients displayed a decreased frequency of Mo‐MDSCs and Gr‐MDSCs compared to HC (P < 0.05). Mo‐MDSCs within RRMS patients expressed significantly higher cell surface protein levels of CD86 and CD163 compared to SPMS patients. Mo‐MDSCs within SPMS exhibited decreased mRNA expression of interleukin‐10 and heme oxygenase 1 compared to RRMS and HC. Analysis of T‐cell regulatory function of Mo‐MDSCs demonstrated T‐cell suppressive capacity in RRMS and HCs, while Mo‐MDSCs of SPMS promoted autologous T‐cell proliferation, which aligned with a differential cytokine profile compared to RRMS and HCs. This study is the first to show phenotypic and functional shifts of MDSCs between clinical stages of MS, suggesting a role for MDSCs as a therapeutic target to prevent MS disease progression.
The roles of resident, central and effector memory CD4 T‐cells in protective immunity following infection or vaccination
Authors: Gray Joshua I. , Westerhof Lotus M. , MacLeod Megan K. L.
Published: March 2018

Immunological memory provides rapid protection to pathogens previously encountered through infection or vaccination. CD4 T‐cells play a central role in all adaptive immune responses. Vaccines must, therefore, activate CD4 T‐cells if they are to generate protective immunity. For many diseases, we do not have effective vaccines. These include human immunodeficiency virus (HIV), tuberculosis and malaria, which are responsible for many millions of deaths each year across the globe. CD4 T‐cells play many different roles during the immune response coordinating the actions of many other cells. In order to harness the diverse protective effects of memory CD4 T‐cells, we need to understand how memory CD4 T‐cells are generated and how they protect the host. Here we review recent findings on the location of different subsets of memory CD4 T‐cells that are found in peripheral tissues (tissue resident memory T‐cells) and in the circulation (central and effector memory T‐cells). We discuss the generation of these cells, and the evidence that demonstrates how they provide immune protection in animal and human challenge models.
Antigen‐specific airway IL‐33 production depends on FcγR‐mediated incorporation of the antigen by alveolar macrophages in sensitized mice
Authors: Nabe Takeshi , Matsuda Masaya , Ishida Tomoki , Tsujimoto Nau , Kido Hitomi , Kanaya Haruna , Takahashi Hiromu , Takemoto Naoki , Nomura Miku , Ishihara Keiichi , Akiba Satoshi , Mizutani Nobuaki
Published: March 2018

Although interleukin (IL)‐33 is a candidate for the aggravation of asthma, the mechanisms underlying antigen‐specific IL‐33 production in the lung are unclear. Therefore, we analysed the mechanisms in mice. Intra‐tracheal administration of ovalbumin (OVA) evoked increases in IL‐33 and IL‐33 mRNA in the lungs of both non‐sensitized and OVA‐sensitized mice, and the increases in the sensitized mice were significantly higher than in the non‐sensitized mice. However, intra‐tracheal administration of bovine serum albumin did not increase the IL‐33 level in the OVA‐sensitized mice. Depletion of neither mast cells/basophils nor CD4+ cells abolished the OVA‐induced IL‐33 production in sensitized mice, suggesting that the antigen recognition leading to the IL‐33 production was not related with either antigen‐specific IgE‐bearing mast cells/basophils or memory CD4+ Th2 cells. When a fluorogenic substrate‐labelled OVA (DQ‐OVA) was intra‐tracheally administered, the lung cells of sensitized mice incorporated more DQ‐OVA than those of non‐sensitized mice. The lung cells incorporating DQ‐OVA included B‐cells and alveolar macrophages. The allergic IL‐33 production was significantly reduced by treatment with anti‐FcγRII/III mAb. Depletion of alveolar macrophages by clodronate liposomes significantly suppressed the allergic IL‐33 production, whereas depletion of B‐cells by anti‐CD20 mAb did not. These results suggest that the administered OVA in the lung bound antigen‐specific IgG Ab, and then alveolar macrophages incorporated the immune complex through FcγRII/III on the cell surface, resulting in IL‐33 production in sensitized mice. The mechanisms underlying the antigen‐specific IL‐33 production may aid in development of new pharmacotherapies.
Biocontrol: the response of native oystercatchers to a non‐native clam invasion
Authors: Ferreira‐Rodríguez Noé , Pardo Isabel
Published: March 2018

Global change, including invasive species introduction, has already had observable effects on migrant bird species, from northern breeding areas to wintering grounds. In this study we analyze the response of the Eurasian oystercatcher abundance to the density of an invasive clam species (Corbicula fluminea) and its potential role as biological control. As a case study, the oystercatcher population fluctuations over a 30‐yr time period, coupled with video‐recorded estimates of its feeding behavior on C. fluminea, and results from an exclosure experiment, were analyzed in the NW of the Iberian Peninsula. Results showed that oystercatchers exert a top‐down control over C. fluminea density. In addition, oystercatchers doubled its wintering numbers in a C. fluminea invaded estuary where they actively feed upon this invasive clam. Given that, the facilitative interaction between the invasive C. fluminea and the migratory Eurasian oystercatcher seems to respond to bottom‐up forces. Altogether, our results suggest that control measures applied to long term biological invasions must be carefully analyzed since non‐native species may be sustaining dependent native communities.
Polylepiswoodland dynamics during the last 20,000 years
Authors: Valencia Bryan G. , Bush Mark B. , Coe Angela L. , Orren Elizabeth , Gosling William D.
Published: March 2018

Aim

To determine the palaeoecological influences of climate change and human land use on the spatial distribution patterns ofPolylepiswoodlands in the Andes.

Location

Tropical Andes above 2,900 m between 2°S and 18°S of latitude.

Methods

Pollen and charcoal data were gathered from 13 Andean lake sediment records and were rescaled by the maximum value in each site. The rescaled pollen data were used to estimate a mean abundance and coefficient of variation to show woodland expansions/contractions and woodland fragmentation over the last 20,000 years. The rescaled charcoal was displayed as a 200‐year moving median using 500‐year bins to infer the influence of fire on woodland dynamics at landscape scale. Pollen and charcoal were compared with speleothem, clastic flux and archaeological data to assess the influence of moisture balance, glacial activity and human impact on the spatial distribution ofPolylepiswoodlands.

Results

Woodland expansion and fire were correlated with precipitation changes and glacier dynamics fromc. 20 to 6 kcalbp(thousands of calibrated years before present). Charcoal abundances between 20 and 12 kcalbpwere less common than from 12 kcalbpto modern. However, human‐induced fires were unlikely to be the main cause of a woodland decline centred at 11 kcalbp, as woodlands recovered from 10.5 to 9.5 kcalbp(about twofold increase). Charcoal peaks analogous to those that induced the woodland decline at 11 kcalbpwere commonplace post‐9.5 kcalbpbut did not trigger an equivalent woodland contraction. An increase in the coefficient of variation afterc. 5.5 kcalbpsuggests enhanced fragmentation and coincided with the shift from logistic to exponential growth of human populations. Over the last 1,000 years,Polylepisbecame hyper‐fragmented with over half of sites losingPolylepisfrom the record and with coefficients of variation paralleling those of glacial times.

Main conclusions

Polylepiswoodlands formed naturally patchy woodlands, rather than a continuous vegetation belt, prior to human occupation in the Andes. The main factors controlling pre‐human woodland dynamics were precipitation and landscape heterogeneity. Human activity led to hyper‐fragmentation during the lastc. 1,000 years.
Folic acid delays development of atherosclerosis in low‐density lipoprotein receptor‐deficient mice
Authors: Pan Sunlei , Liu Huahua , Gao Feidan , Luo Hangqi , Lin Hui , Meng Liping , Jiang Chengjian , Guo Yan , Chi Jufang , Guo Hangyuan
Published: March 2018

Many studies support the cardioprotective effects of folic acid (FA). We aimed to evaluate the utility of FA supplementation in preventing the development of atherosclerotic in low‐density lipoprotein receptor‐deficient (LDLR−/−) mice and to elucidate the molecular processes underlying this effect. LDLR−/− mice were randomly distributed into four groups: control group, HF group, HF + FA group and the HF + RAPA group. vascular smooth muscle cells (VSMCs) were divided into the following four groups: control group, PDGF group, PDGF + FA group and PDGF + FA + RAPA group. Blood lipid levels, oxidative stress and inflammatory cytokines were measured. Atherosclerosis severity was evaluated with oil red O staining. Haematoxylin and eosin (H&E) staining was used to assess atherosclerosis progression. Immunohistochemical staining was performed with antismooth muscle α‐actin (α‐SMA) antibodies and anti‐osteopontin (OPN) antibodies that demonstrate VSMC dedifferentiation. The protein expression of α‐SMA, OPN and mechanistic target of rapamycin (mTOR)/p70S6K signalling was detected by Western blot analysis. FA and rapamycin reduced serum levels of total cholesterol, triacylglycerol, LDL, inhibiting oxidative stress and the inflammatory response. Oil red O and H&E staining demonstrated that FA and rapamycin inhibited atherosclerosis. FA and rapamycin treatment inhibited VSMC dedifferentiation in vitro and in vivo, and FA and rapamycin attenuated the mTOR/p70S6K signalling pathway. Our findings suggest that FA attenuates atherosclerosis development and inhibits VSMC dedifferentiation in high‐fat‐fed LDLR−/− mice by reduced lipid levels and inhibiting oxidative stress and the inflammatory response through mTOR/p70S6K signalling pathway.