bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilingual Development in Children of Immigrant Families
Authors: Hoff Erika
Published: October 2017

Early exposure to two languages is widely thought to guarantee successful bilingual development. Contradicting that belief, children in bilingual immigrant families who grow up hearing a heritage language and a majority language from birth often reach school age with low levels of skill in both languages. This outcome cannot be explained fully by influences of socioeconomic status. In this article, I summarize research that helps explain the trajectories of observed dual language growth among children in immigrant families in terms of the amount and quality of their language exposure as well as their own language use.
Cutaneous reactive hyperaemia is unaltered by dietary nitrate supplementation in healthy humans
Authors: Wong Brett J. , Keen Jeremy T. , Levitt Erica L.
Published: October 2017

The purpose of this study was to determine whether nitrate supplementation augments cutaneous reactive hyperaemia. Seven participants were tested pre‐ and postnitrate supplementation (25 ml beetroot juice); participants consumed one shot per day for 3 days. Participants were instrumented with two microdialysis fibres: control (Ringer's solution) and NO synthase inhibition (20 mM L‐NAME). Skin blood flow was measured via laser‐Doppler flowmetry (LDF). A blood pressure cuff was placed on the experimental arm and inflated to 250 mmHg for 5 mins to occlude arterial inflow. The cuff was released, and the resultant reactive hyperaemia was measured. Blood pressure was continuously measured via plethysmography from a finger on the non‐experimental arm. Cutaneous vascular conductance was calculated (LDF/MAP) and normalized to maximal vasodilatation (%CVCmax). Only diastolic blood pressure was reduced following nitrate supplementation (71 ± 2 vs. 66 ± 1 mmHg; P<0·05). There was no effect of nitrate supplementation on peak reactive hyperaemia at control (Pre: 52 ± 3 vs. Post: 57 ± 2%CVCmax) or L‐NAME (Pre: 52 ± 2 vs. Post: 59 ± 4%CVCmax) sites. There was no effect of nitrate supplementation on total reactive hyperaemia at either control (Pre: 4197 ± 943 vs. Post: 4523 ± 1040%CVCmax * sec) or L‐NAME (Pre: 5108 ± 997 vs. Post: 5694 ± 1002%CVCmax * sec) sites. These data suggest cutaneous reactive hyperaemia is unaffected by dietary nitrate supplementation in healthy humans.
68Ga‐PSMA PET/CT for the detection of bone metastases in prostate cancer: a systematic review of the published literature
Authors: Zacho Helle D. , Nielsen Julie B. , Haberkorn Uwe , Stenholt Louise , Petersen Lars J.
Published: October 2017

Background

68Ga‐labelled prostate‐specific membrane antigen (PSMA) is a promising PET ligand for the detection of prostate cancer. Little attention has been given to the ability of 68Ga‐PSMA PET/CT to detect malignant bone lesions and whether this approach is superior to existing bone imaging modalities.

Aim

To review the existing data of 68Ga‐PSMA PET/CT for the diagnosis of bone metastases in prostate cancer.

Methods

Systematic review of the peer‐reviewed literature.

Results

Among 1858 papers in the original search, 37 papers were included in the analysis (six case reports and 31 case series). The vast majority of the studies were low‐level evidence studies. Most studies presented data on detection rates without a reference standard. All but two studies were of a retrospective nature. Several cohort studies showed bone metastasis in 5–60% of patients with prostate cancer, including in patients with very low‐PSA values. For primary staging, 68Ga‐PSMA PET/CT outperformed bone scans, while the superiority of 68Ga‐PSMA PET/CT compared with bone scans with respect to biochemical recurrence and metastatic castration‐resistant prostate cancer (mCRPC) remains to be demonstrated.

Conclusion

68Ga‐PSMA PET/CT has shown to be a promising technique for use in prostate cancer. 68Ga‐PSMA PET/CT shows more lesions than bone scans, but data on diagnostic performance are very limited and indicate improved diagnostic performance in primary staging but not in mCRPC. Properly designed studies are needed to clarify the diagnostic performance of 68Ga‐PSMA PET/CT as well as its superiority over existing methods before 68Ga‐PSMA PET/CT can be routinely used for bone imaging.
Electronic Health Record Phenotypes for Precision Medicine: Perspectives and Caveats From Treatment of Breast Cancer at a Single Institution
Authors: Breitenstein Matthew K. , Liu Hongfang , Maxwell Kara N. , Pathak Jyotishman , Zhang Rui
Published: October 2017

Precision medicine is at the forefront of biomedical research. Cancer registries provide rich perspectives and electronic health records (EHRs) are commonly utilized to gather additional clinical data elements needed for translational research. However, manual annotation is resource‐intense and not readily scalable. Informatics‐based phenotyping presents an ideal solution, but perspectives obtained can be impacted by both data source and algorithm selection. We derived breast cancer (BC) receptor status phenotypes from structured and unstructured EHR data using rule‐based algorithms, including natural language processing (NLP). Overall, the use of NLP increased BC receptor status coverage by 39.2% from 69.1% with structured medication information alone. Using all available EHR data, estrogen receptor‐positive BC cases were ascertained with high precision (P = 0.976) and recall (R = 0.987) compared with gold standard chart‐reviewed patients. However, status negation (R = 0.591) decreased 40.2% when relying on structured medications alone. Using multiple EHR data types (and thorough understanding of the perspectives offered) are necessary to derive robust EHR‐based precision medicine phenotypes.
A giant pseudoaneurysm of coronary artery in a young patient with Behçet's disease
Authors: Pu Lihong , Li Rongjuan , Xie Jinjie , Liu Guowen , Yang Ya
Published: October 2017

As an uncommon multisystem inflammatory disease, Behçet's syndrome is characterized by mouth and genital ulcers, skin lesions, and eye inflammation, which may also affect joints, blood vessels, central nervous system, or digestive tract. However, the inflammation of coronary artery is relatively rare. We thereby reported a young male of Behçet's syndrome presenting left anterior descending artery pseudoaneurysm with myocardial infarction. Surgical resection was performed with coronary bypass grafting.
From worker to self‐entrepreneur: The transformation of homo economicus and the freedom of movement in the European Union
Authors: Kramer Dion
Published: October 2017

This paper seeks to make a contribution to the study of personhood in EU free movement law by linking a historical and doctrinal analysis with the internal transformation of the homo economicus in economic liberalism. It is argued that a shift can be observed in the government of mobility from “freeing up” the ability of the worker as a relatively passive subject tied to external economic mechanisms to the targeting of the individual him/herself as a responsible, active bearer of economic capability or “human capital”, whereby past socio‐economic conduct and prospective economic activity serve as the thresholds for the entitlement to rights. The essence of the “new” homo economicus of EU free movement law is situated at the intersection of the social and economic, serving as a rational frame for the government of the European mover on the basis of a mutual responsibility between the Union citizen and his/her host Member State towards social and economic activity, self‐sufficiency and integration.
Guidelines for planning genomic assessment and monitoring of locally adaptive variation to inform species conservation
Authors: Flanagan Sarah P. , Forester Brenna R. , Latch Emily K. , Aitken Sally N. , Hoban Sean
Published: October 2017

Identifying and monitoring locally adaptive genetic variation can have direct utility for conserving species at risk, especially when management may include actions such as translocations for restoration, genetic rescue, or assisted gene flow. However, genomic studies of local adaptation require careful planning to be successful, and in some cases may not be a worthwhile use of resources. Here, we offer an adaptive management framework to help conservation biologists and managers decide when genomics is likely to be effective in detecting local adaptation, and how to plan assessment and monitoring of adaptive variation to address conservation objectives. Studies of adaptive variation using genomic tools will inform conservation actions in many cases, including applications such as assisted gene flow and identifying conservation units. In others, assessing genetic diversity, inbreeding, and demographics using selectively neutral genetic markers may be most useful. And in some cases, local adaptation may be assessed more efficiently using alternative approaches such as common garden experiments. Here, we identify key considerations of genomics studies of locally adaptive variation, provide a road map for successful collaborations with genomics experts including key issues for study design and data analysis, and offer guidelines for interpreting and using results from genomic assessments to inform monitoring programs and conservation actions.
A Comparative Discourse Analysis of Spanish Past Narrations From the ACTFL OPI and OPIc
Authors: Brown Alan V. , Cox Troy L. , Thompson Gregory L.
Published: October 2017

The ACTFL Oral Proficiency Interview (OPI) and accompanying proficiency guidelines have become a mainstay in academic foreign language assessment. In 2006, an asynchronous electronic interface of the OPI was made available in which candidates are asked to record themselves responding to questions delivered aurally via computer, labeled the Oral Proficiency Interview‐computer (OPIc). Thompson, Cox, and Knapp () found that both instruments produced similar results but that many students in their sample who scored at the Advanced Low level on the traditional OPI scored one sublevel higher on the OPIc. The primary objective of the present study is to analyze lexical features, i.e., lexical diversity and lexical density, and discursive features, i.e., temporal and repair fluency, of students’ speech from a subset of OPI and OPIc exams to examine the relationship between the language elicited from each exam type, i.e., face‐to‐face and via computer. The research consists of two studies that focus on candidates who received (1) an Advanced Mid rating on both assessments, and (2) those who received Advanced Mid on the OPIc and Advanced Low on the OPI. While the two exams did not seem to elicit disparate levels of lexical density and diversity, significant differences surfaced in measures of fluency.
Why Did Income Inequality in Germany Not Increase Further After 2005?
Authors: Biewen Martin , Ungerer Martin , Löffler Max
Published: October 2017

While income inequality in Germany considerably increased in the years before 2005, this trend stopped after 2005. We address the question of what factors were responsible for the break in the inequality trend after 2005. Our analysis suggests that income inequality in Germany did not continue to rise after 2005 for the following reasons. First, we observe that the general rise in wage inequality that explained a lot of the inequality increase before 2005, became less steep (but did not stop) after 2005. Second, despite further increases in wage inequality after 2005, inequality in annual labour incomes did not increase further after 2005 because increased within-year employment opportunities compensated otherwise rising inequality in annual labour incomes. Third, income inequality did not fall in a more marked way after 2005 because also the middle and the upper part of the distribution benefited from the employment boom after 2006. Finally, we provide evidence that the effect of a wide range of other factors that are often suspected to have influenced the distribution such as capital incomes, household structures, population ageing, changes in the tax and transfer system and the financial crisis of 2008 did not significantly alter the distribution after 2005.
Effects of deep‐fat frying temperature on antioxidant properties of whole wheat doughnuts
Authors: Nsabimana Phénias , Powers Joseph R. , Chew Boon , Mattinson Scott , Baik Byung‐Kee
Published: October 2017

The total phenolic (TP) content, phenolic acid composition and in vitro antioxidant capacity of whole wheat doughnuts fried at 120–180 °C were determined to identify the effects of frying temperature. Significant differences (P < 0.05) in TP content were observed between doughnuts fried at different temperatures. The TP content of doughnuts decreased significantly when doughnuts were deep‐fat fried. The TP content of doughnuts increased with elevation with frying temperatures. These increases in TP content of doughnuts were also detected in the determination of individual phenolic compounds using HPLC. DPPH radical and iron‐chelating capacity of deep‐fat fried doughnuts exhibited increases with elevation of frying temperature from 120 to 180 °C. Deep‐fat frying at 120 °C lowered lipid peroxidation inhibition capacity of doughnuts prepared from both refined flour and whole‐grain meals and increased consistently with increased frying temperature from 120 to 180 °C. Moderate deep‐fat frying temperature would increase the content and activity of antioxidants of doughnuts.
A “Swedish” actuarial balance for a notional defined contribution pension scheme with disability and minimum pension benefits
Authors: Pérez‐Salamero González Juan M. , Ventura‐Marco Manuel , Vidal‐Meliá Carlos
Published: October 2017

This article proposes a “Swedish” type actuarial balance sheet (ABS) for a notional defined contribution (NDC) scheme with disability and minimum pension benefits. The proposed ABS splits the pension system in two parts: the pure NDC part and the redistributive part, which includes the assets and liabilities originating from non‐contributory rights. The article contains a numerical example that sheds light on the real applicability of our proposal. The model has practical implications that could be of interest to policy‐makers, given that it integrates actuarial and social aspects of public pensions and discloses the real cost of redistribution through minimum pensions.
Divergent strategies displayed by potato (Solanum tuberosum L.) cultivars to cope with soil drought
Authors: Boguszewska‐Mańkowska D. , Pieczyński M. , Wyrzykowska A. , Kalaji H. M. , Sieczko L. , Szweykowska‐Kulińska Z. , Zagdańska B.
Published: October 2017

The physiological responses of potato (Solanum tuberosum L) cultivars to soil drought at the tuberization phase and their impact on agronomically important traits were investigated in potted plants under semi‐controlled conditions. Genotype‐dependent responses of potato to water deficiency were evaluated on two pairs (tolerant/sensitive) of Polish cultivars. Each pair of cultivars had a similar genetic background but was extremely different in terms of drought tolerance evaluated on the basis of loss of tuber yield under field conditions. The results clearly indicate different mechanisms of tolerance to water deficiency and the ability to recover from soil drought in two tolerant but genetically unrelated cultivars. When subjected to soil drought, the cultivar Gwiazda had low rates of transpiration and photosynthesis and low levels of stomatal conductance due to hypersensitivity to ABA, but its maximal photochemistry efficiency and PSII performance index were unchanged. Another strategy was displayed by the dehydration‐avoidant cultivar Tajfun, which kept the stomata partially open. Thus, the plants were able to retain a relatively high rate of photosynthesis over transpiration. The parameters measured for cultivar Tajfun for photosynthesis and transpiration were the same after plant rewatering, similar to the control plants. This was not the case for the cultivar Gwiazda. The ability of plants to regenerate after soil drought relief appears to be a good indicator of potato susceptibility to soil drought and allows the yield of potato tubers to be predicted. The physiological traits identified in closely related potato cultivars but differed in their drought tolerance seem to be useful for genetic engineering and breeding programmes.
Therapeutic application of extracellular vesicles in kidney disease: promises and challenges
Authors: Lv Lin‐Li , Wu Wei‐Jun , Feng Ye , Li Zuo‐Lin , Tang Tao‐Tao , Liu Bi‐Cheng
Published: October 2017

Extracellular vesicles (EVs) are nanosized, membrane‐bound vesicles released from different cells. Recent studies have revealed that EVs may participate in renal tissue damage and regeneration through mediating inter‐nephron communication. Thus, the potential use of EVs as therapeutic vector has gained considerable interest. In this review, we will discuss the basic characteristics of EVs and its role in nephron cellular communication. Then, the application of EVs as therapeutic vector based on its natural content or as carriers of drug, in acute and chronic kidney injury, was discussed. Finally, perspectives and challenges of EVs in therapy of kidney disease were described.
Practitioner Review: Definition, recognition, and treatment challenges of irritability in young people
Authors: Stringaris Argyris , Vidal‐Ribas Pablo , Brotman Melissa A. , Leibenluft Ellen
Published: October 2017

Background

Irritability is one of the most common reasons for referral to child and adolescent mental health services and is the main characteristic of the new diagnosis of disruptive mood dysregulation disorder (DMDD). However, the recognition and management of irritability presents a major challenge in clinical practice and may be partly responsible for the dramatic increase in antipsychotic prescribing in recent years.

Methods

In this review, we provide up‐to‐date information on the definition and mechanisms underlying irritability, and its assessment in clinical practice. We aim to discuss the latest research on DMDD, and the presence of severe irritability in the context of other disorders, as well as to recommend a treatment algorithm.

Results

Severe irritability is associated with aberrant reward processing and bias toward threatening stimuli. Several measures are available to easily assess irritability. The recent diagnosis of DMDD captures children whose main problem is severe irritability and differ from those with bipolar disorder in longitudinal outcomes, family history, and behavioral and neural correlates. Treatment of irritability might depend on the context it appears. Indirect evidence suggests that parent management training (PMT) and cognitive behavioral therapy (CBT) are the most supported psychological treatments for irritability.

Conclusions

Irritability, recognized as a mood problem rather than a purely behavioral manifestation, is a common condition for young people. Practitioners should not ignore irritability as it is associated with substantial morbidity and impairment. Although there are no trials with irritability as main outcome, clinicians can apply several existing pharmacological and psychological interventions for its treatment. Also, new promising approaches relying on pathophysiological findings, such as exposure‐based cognitive behavioral therapy techniques and interpretation bias training (IBT), are being currently investigated.
Forming first impressions of children: the role of attention‐deficit/hyperactivity disorder symptoms and emotion dysregulation
Authors: Lee Christine A. , Milich Richard , Lorch Elizabeth P. , Flory Kate , Owens Julie Sarno , Lamont Andrea E. , Evans Steven W.
Published: October 2017

Background

Previous research on peer status of children with attention‐deficit/hyperactivity disorder (ADHD) has focused on already‐established peer groups, rendering the specific social behaviors that influence peers' initial impressions largely unknown. Recently, theorists have argued that emotion dysregulation is a key aspect of ADHD, with empirical work finding relations between emotion dysregulation and social outcomes. Therefore, the current study focuses on the initial interactions among children varying in ADHD symptoms duringh a novel playgroup, proposing that emotion dysregulation displayed during the playgroup may serve as a possible pathway between ADHD symptoms and peers' initial negative impressions.

Methods

Participants were 233 elementary‐age children ranging from 8 to 10 years old (M = 8.83, 70% male). Parents and teachers rated children's ADHD symptoms and related impairment; 51% of the children met criteria for an ADHD diagnosis. Then, children participated with unfamiliar peers in a three‐hour playgroup that included three structured and two unstructured tasks. After the tasks, children and staff rated each child on social outcomes. Coders unaware of child's diagnostic status watched videos of the groups and rated each child's global emotion dysregulation during each task.

Results

Using multiple raters and methods, ADHD severity was associated with more negative peer ratings, through observed emotion dysregulation. Results were consistent for both parent and teacher ratings of ADHD severity as well as for both peer ratings of likeability and staff ratings of perceived peer likeability.

Conclusions

When focusing on improving peers' initial impressions of children with ADHD symptoms, emotion dysregulation may be a valuable target for intervention.
Belgian flood risk governance: explaining the dynamics within a fragmented governance arrangement
Authors: Mees H. , Crabbé A. , Suykens C.
Published: October 2017

Despite some inertia, flood risk governance in Belgium has been fairly dynamic between 1995 and 2015. In this paper, change and stability during this period are described and explained in the four dimensions of the Policy Arrangement Approach: actors, discourses, rules, and resources. The analysis is based on 72 semi‐structured stakeholder interviews and legal document analysis.

Belgian flood risk governance is characterised by a high level of fragmentation. Our analysis found that this can form a barrier to change, but at the same time it creates multiple entry points for policy innovation and thereby increases the dynamics within the governance arrangement.
Long Term Effect of Intensive Lifestyle Intervention on Cerebral Blood Flow
Authors: Espeland Mark A. , Luchsinger Jose A. , Neiberg Rebecca H. , Carmichael Owen , Laurienti Paul J. , Pi‐Sunyer Xavier , Wing Rena R. , Cook Delilah , Horton Edward , Casanova Ramon , Erickson Kirk , Nick Bryan R. ,   the Action for Health in Diabetes Brain Magnetic Resonance Imaging Research Group
Published: October 2017

Objectives

To determine whether long‐term behavioral intervention targeting weight loss through increased physical activity and reduced caloric intake would alter cerebral blood flow (CBF) in individuals with type 2 diabetes mellitus.

Design

Postrandomization assessment of CBF.

Setting

Action for Health in Diabetes multicenter randomized controlled clinical trial.

Participants

Individuals with type 2 diabetes mellitus who were overweight or obese and aged 45 to 76 (N = 310).

Interventions

A multidomain intensive lifestyle intervention (ILI) to induce weight loss and increase physical activity for 8 to 11 years or diabetes support and education (DSE), a control condition.

Measurements

Participants underwent cognitive assessment and standardized brain magnetic resonance imaging (MRI) (3.0 Tesla) to assess CBF an average of 10.4 years after randomization.

Results

Weight changes from baseline to time of MRI averaged −6.2% for ILI and −2.8% for DSE (P < .001), and increases in self‐reported moderate or intense physical activity averaged 444.3 kcal/wk for ILI and 114.8 kcal/wk for DSE (P = .03). Overall mean CBF was 6% greater for ILI than DSE (P = .04), with the largest mean differences between ILI and DSE in the limbic region (3.39 mL/100 g per minute, 95% confidence interval (CI) = 0.07–6.70 mL/100 g per minute) and occipital lobes (3.52 mL/100 g per minute, 95% CI = 0.20–6.84 mL/100 g per minute). In ILI, greater CBF was associated with greater decreases in weight and greater increases in physical activity. The relationship between CBF and scores on a composite measure of cognitive function varied between intervention groups (P = .02).

Conclusions

Long‐term weight loss intervention in overweight and obese adults with type 2 diabetes mellitus is associated with greater CBF.
Evaluating Eco‐Efficiency of 3D Printing in the Aeronautic Industry
Authors: Mami Fares , Revéret Jean‐Pierre , Fallaha Sophie , Margni Manuele
Published: October 2017

New technologies such as 3D printing, also known as rapid manufacturing or additive manufacturing, are promising technologies to support the aeronautics sector moving toward its ambitious environmental goals. An eco‐efficiency method combining life cycle costs and life cycle environmental assessment is developed to support eco‐design initiatives in the aeronautics industry that accounts for specific reduction targets. Eco‐efficiency results are computed through a normalization procedure and a target‐driven trade‐off and displayed as an XY diagram. Applied to an aircraft doorstop manufacturing, results show that 3D printing has clear benefits both in terms of costs and environmental impacts compared to conventional machining. Nevertheless, 3D printing equipment costs are still high, and a sensitivity analysis shows that, for lower productivity levels, the optimal scenario relies on the chosen trade‐off between environmental impacts and costs reduction.
ENDOGENOUS TECHNICAL CHANGE IN ALTERNATIVE THEORIES OF GROWTH AND DISTRIBUTION
Authors: Tavani Daniele , Zamparelli Luca
Published: October 2017

This paper surveys the last two and a half decades of non‐neoclassical literature on endogenous technical change and the functional income distribution. We distinguish between classical‐Marxian and post‐Keynesian models, and analyze them under three different assumptions on the determinants of technical change: capital accumulation, income distribution, and labor market tightness. The balanced growth implications of alternative models are compared with neoclassical exogenous and endogenous growth theories. Despite the strong differences in the assumptions regarding the substitutability between capital and labor, the role of different classes in society, and whether or not productive factors are fully employed, the various alternative models can be classified in a way that highlights remarkable similarities with their neoclassical counterparts. Both neoclassical and alternative theories of endogenous growth: (i) have shown that long‐run growth is sensitive to investment decisions, and (ii) rely on a linear spillover from the stock of knowledge to the production of innovations. The comparison highlights the different channels emphasized by competing theories: saving behavior and market structure in the neoclassical theories, as opposed to income distribution, the state of the labor market, and investors' behavior in alternative theories.
SOUTH–SOUTH AND NORTH–SOUTH ECONOMIC EXCHANGES: DOES IT MATTER WHO IS EXCHANGING WHAT AND WITH WHOM?
Authors: Dahi Omar S. , Demir Firat
Published: October 2017

This paper surveys the literature on costs and benefits of South–South versus North–South economic exchanges. Unlike the case for North–South exchanges, academic work on South–South economic relations has been historically limited given their marginal importance in the global economy. After the 1990s, the literature has changed in two main ways. First, South–South trade and finance since then has increased dramatically, leading to a bourgeoning literature on the topic. Second, the rise of the Emerging South has opened up new lines of inquiry to include not just the traditional topics of trade and preferential trading agreements, but also cover technology transfer, capital flows, labor migration, institutions, and environment. We discuss how this literature has evolved to take into account the greater complexity of South–South relations with a focus on China in Africa as well as the blurring of the lines between heterodox and mainstream analysis of South–South relations. We end the review by showing how the empirical and theoretical literature is exploring the increasing divergence within the global South between what we refer to as the Emerging South and the Rest of South.
THE AGENT‐BASED APPROACH TO POST KEYNESIAN MACRO‐MODELING
Authors: Di Guilmi Corrado
Published: October 2017

The paper presents a survey of Post Keynesian (PK) agent‐based (AB) models and AB models with PK features. It is argued that AB modeling is fully consistent with the PK approach and that the cross‐fertilization can benefit both areas of research. The survey focuses on how the various models have faced the issues implied by adopting a bottom–up approach in a traditionally aggregative structure and highlights the additional insights coming from this modeling strategy. Particular attention is devoted to stock‐flow consistent AB models for theivvr potential in defining a new benchmark for this type of research.
Fever under 3 months and the full septic screen: Time to think again? A retrospective cohort study at a tertiary‐level paediatric hospital
Authors: Aldridge Patrick , Rao Arjun , Sethumadavan Rebecca , Briggs Nancy
Published: October 2017

Aim

To assess adherence to the Iocal guideline (LG) for the management of fever in infants under 3 months and whether the application of a risk‐stratified protocol (RSP) to this population would miss any serious bacterial infections (SBI) compared to current practice (CP) and LG.

Methods

All presentations to the authors’ Emergency Department of infants 0–3 months with fever from 1 July 2015 to 28 April 2016 were included (n = 219), along with a detailed analysis of CP. The initial history, examination and pathology results were applied to the LG and RSP to assess what changes in management would occur. The primary end point was a missed SBI, with secondary outcomes measuring the number of invasive procedures performed, antibiotics prescribed and admissions.

Results

Adherence to the LG was 83% with three missed SBIs. Strict adherence would have resulted in eight missed SBIs. This indicates that both warranted and unwarranted variation exists in current clinical practice. Application of the RSP showed no missed SBIs but, compared to CP, indicates a statistically significant increase in admissions and full septic screens (admissions 95% vs. 83%, P < 0.05; full septic screens 82% vs. 72%, P < 0.05). Chest X‐rays were infrequently requested (10%) and the validity of use in this group warrants further study.

Conclusion

An ad hoc risk‐stratified practice already exists at the authors’ institution, and application of an RSP did not miss any SBIs. Adoption and implementation of a formal RSP is currently being formulated.
Political priority of oral health in India: analysis of the reasons for neglect
Authors: Janakiram Chandrashekar , Sanjeevan Vinita , BR Rajeev , Joseph Joe , Stauf Nicole , Benzian Habib
Published: October 2017

Objectives

To examine the political priority of oral health in India and to understand the underlying reasons for the political support oral health receives.

Methods

The analysis is based on the political power framework developed by Shiffman and Smith and modified by Benzian et al. to examine the factors that contribute to the political priority of oral health in India. The framework comprises four main analysis categories, further subdivided into 11 dimensions. Based on the set of criteria, each dimension was analyzed and rated by assigning a score to assess to what extend the criteria were met.

Results

There is a good understanding on what defines an oral health problem, however, there is no consolidated and comprehensive approach to address oral diseases. Despite India's efforts to improve oral health‐related research, its poor utilization in terms of public health and population‐based approaches is apparent. The absence of a national surveillance system for oral health masks the severity and extent of the oral disease burden and limits the basis for advocacy on improving oral health to health decision makers. The fragmentation of actors and institutions and the absence of leaders uniting various actors in oral public health impede changes toward improving the oral health status of the population.

Conclusions

Limited accessibility to oral health care, poor portrayals of the severity and extent of the burden, and inertia to address‐related challenges are important factors contributing to the low political priority of oral health.
Prospective cohort study on the efficacy and safety of telbivudine used throughout pregnancy in blocking mother‐to‐child transmission of hepatitis B virus
Authors: Yi W. , Li M.‐H. , Xie Y. , Wu J. , Hu Y.‐H. , Zhang D. , Zhang Y. , Cao W.‐H.
Published: October 2017

Women with chronic hepatitis B should maintain nucleotide analogue treatment to prevent disease progression during pregnancy. The aim of this study was to prospectively evaluate the efficacy and safety of telbivudine used throughout pregnancy for preventing hepatitis B virus (HBV) mother‐to‐child transmission (MTCT). From January 2012 to June 2014, women who were receiving telbivudine therapy and became pregnant were enrolled in group A at 28 weeks of gestation. Pregnant women with an HBV DNA level >106 IU/mL were enrolled in either group B (telbivudine started at 28 weeks of gestation) or group C (control group without treatment). MTCT was defined as infants who were positive for serum hepatitis B surface antigen at 7 months after birth. There were 41, 179 and 177 pregnant women (397 infants) enrolled in groups A, B and C, respectively. The HBV DNA load at 28 weeks of gestation and delivery was 1.50 ± 0.62 vs 1.45 ± 0.61, 8.05 ± 0.37 vs 4.24 ± 0.89 and 7.94 ± 0.62 vs 7.86 ± 0.73 log10 IU/mL in groups A, B and C, respectively. The rate of MTCT in group C was 4.60%, which was significantly higher than the rates in groups A and B (0% and 0.6%, respectively) (P = .043). The difference between group A and group B was not significant. The rates of neonatal congenital abnormalities were 2.4%, 0.6% and 2.3% in groups A, B and C, respectively, and there were no significant differences (P = .140). Telbivudine used throughout pregnancy may be safe and effective for mothers and infants, but it may not enhance the efficacy of an HBV MTCT block compared with treatment starting at 28 weeks of gestation (NCT02253485).
Recognition of Core‐ and Polymerase‐derived immunogenic peptides included in novel therapeutic vaccine by T cells from Chinese chronic hepatitis B patients
Authors: Huang D. , Sansas B. , Jiang J. H. , Gong Q. M. , Jin G. D. , Calais V. , Yu D. M. , Zhu M. Y. , Wei D. , Zhang D. H. , Inchauspé G. , Zhang X. X. , Zhu R.
Published: October 2017

Chronic hepatitis B (CHB) is one of the major public health challenges in the world. Due to a strong interplay between specific T‐cell immunity and elimination of hepatitis B virus (HBV), efforts to develop novel immunotherapeutics are gaining attention. TG1050, a novel immunotherapy, has shown efficacy in an animal study. To support the clinical development of TG1050 in China, specific immunity to the fusion antigens of TG1050 was assessed in Chinese patients. One hundred and thirty subjects were divided into three groups as CHB patients, HBV spontaneous resolvers, and CHB patients with HBsAg loss after antiviral treatment. HBV‐specific T‐cell responses to pools of HBV Core or Polymerase genotype D peptides included in TG1050 were evaluated. HBV Core‐ or Polymerase‐specific cells were detected in peripheral blood mononuclear cells (PBMCs) from the different cohorts. The frequencies and intensities of HBV Core‐specific immune responses were significantly lower in CHB patients than in HBsAg loss subjects. In CHB patients, a dominant pool derived from Polymerase (Pol1) was the most immunogenic. CHB patients with low viral loads (<106 IU/mL) were more likely to have a positive response specific to the Core peptide pool. Overall, genotype D‐derived peptides included in TG1050 could raise broad and functional T‐cell responses in PBMCs from Chinese CHB patients infected with genotype B/C isolates. Core‐specific immunogenic domains appeared as “hot spots” with the capacity to differentiate between CHB vs HBsAg loss subjects. These observations support the extended application and associated immune monitoring of TG1050 in China.
Efficacy and safety of three adefovir‐based combination therapies in HBeAg‐positive chronic hepatitis B patients with suboptimal response to adefovir monotherapy
Authors: Wang M.‐L. , Chen E.‐Q. , Zhang D.‐M. , Du L.‐Y. , Yan L.‐B. , Zhou T.‐Y. , Lei X.‐Z. , Lei B.‐J. , Lu J.‐J. , Liao J. , Tang H.
Published: October 2017

Although high potent nucleos(t)ide analogues are strongly recommended as first‐line therapy for chronic hepatitis B (CHB) in China, some patients are still being treated with adefovir disoproxil (ADV), especially those low‐income patients whose health insurance could not reimburse the drug cost. Therefore, the management of patients who have failed ADV therapy or who sustained renal damage during ADV therapy remains an important clinical problem in China. This retrospective study aimed to compare the efficacy and safety of lamivudine (LAM), telbivudine (LdT) or entecavir (ETV) add‐on strategies to optimize the treatment of patients with prior suboptimal response to ADV monotherapy. A total of 277 eligible patients were included in this study, and the baseline characteristics were similar among the LAM + ADV (n = 116), LdT + ADV (n = 72) and ETV + ADV (n = 89) groups. At week 96, both the proportion of undetectable HBV DNA (81.03% for LAM + ADV, 84.72% for LdT + ADV and 88.76% for ETV + ADV; P = .317) and ALT elevation (5.17% for LAM + ADV, 4.17% for LdT + ADV and 4.49% for ETV + ADV; P = 1.000) were similar among the three groups; also, a significant decline in liver stiffness was observed in each group from baseline to week 96. At week 96, the rate of HBeAg seroconversion was significantly higher in LdT + ADV than in LAM + ADV (26.39% vs 13.79%, P = .031) and ETV + ADV (26.39% vs 10.11%, P = .007). During the 96 weeks, no obvious renal injury was reported in any of the three groups, but an improvement in eGFR was found in LdT + ADV compared with LAM + ADV and ETV + ADV. In summary, all three combination strategies provide good control of virus replication, but the LdT + ADV combination therapy may yield better HBeAg seroconversion and eGFR improvement.
Long‐term outcome of telbivudine versus entecavir in treating higher viral load chronic hepatitis B patients without cirrhosis
Authors: Pan H.‐Y. , Pan H.‐Y. , Song W.‐Y. , Zheng W. , Tong Y.‐X. , Yang D.‐H. , Dai Y.‐N. , Chen M.‐J. , Wang M.‐S. , Huang Y.‐C. , Zhang J.‐J. , Huang H.‐J.
Published: October 2017

Chronic hepatitis B (CHB) patients with higher hepatitis B virus (HBV) load (higher viral load [HVL], HBV DNA ≥1 × 107 copies/mL) require antiviral therapy, but data for evaluating the long‐term outcome of this therapy with antiviral agents remain limited. We comparatively evaluated the efficacy and the safety of nucleoside analogues in 179 noncirrhotic CHB patients with HVL over 5 years. The HBeAg‐positive (n = 104) or HBeAg‐negative (n = 75) patients were treated consecutively with telbivudine (LdT, n = 88) or entecavir (ETV, n = 91) and evaluated for viral response, drug resistance and safety. HBV DNA, viral serology, biochemistries, HBV mutation and off‐therapy relapse were determined. The cumulative rates of HBV DNA negativity were 86.4% and 94.5% for LdT and ETV at year 5, respectively. The rates of early viral response (EVR, HBV DNA <103 copies/mL at month 6) under LdT and ETV treatments were 58.0% and 34.1%, respectively (P < .05). Hepatitis B e antigen (HBeAg) and Hepatitis B surface antigen (HBsAg) loss‐seroconversions were 47.7% and 18.2% on LdT and 16.5% and 2.2% on ETV (P < .01). Eighteen patients (age 28.2 ± 3.1) experienced HBsAg loss‐seroconversion, followed by 33 ± 4.6 month off‐therapy without a relapse. Viral mutations and serum creatine kinase elevation were 9.1% and 8.0% on LdT, but only 1.1% and 0% on ETV. Both LdT and ETV suppressed HBV replication in HVL CHB patients within 5 years. LdT therapy achieved a higher EVR, HBeAg and HBsAg seroconversion, especially in the younger patients, whereas ETV caused lower drug resistance and fewer adverse events. This finding might help to identify the optimal treatment for CHB patients with HVL.
Which Desires Are Relevant to Well‐Being?
Authors: Heathwood Chris
Published: October 2017

The desire‐satisfaction theory of well‐being says, in its simplest form, that a person's level of welfare is determined by the extent to which their desires are satisfied. A question faced by anyone attracted to such a view is,Which desires?This paper proposes a new answer to this question by characterizing a distinction among desires that isn't much discussed in the well‐being literature. This is the distinction between what a person wants in a merely behavioral sense, in that the person is, for some reason or other, disposed to act so as to try to get it, and what a person wants in a more robust sense, the sense of beinggenuinely attractedto the thing. I try to make this distinction more clear, and I argue for its axiological relevance by putting it to work in solving four problem cases for desire satisfactionism. The theory defended holds that only desires in the latter, genuine‐attraction sense are relevant to welfare.
Is there foul play in the leaf pocket? The metagenome of floating fern Azolla reveals endophytes that do not fix N2 but may denitrify
Authors: Dijkhuizen Laura W. , Brouwer Paul , Bolhuis Henk , Reichart Gert‐Jan , Koppers Nils , Huettel Bruno , Bolger Anthony M. , Li Fay‐Wei , Cheng Shifeng , Liu Xin , Wong Gane Ka‐Shu , Pryer Kathleen , Weber Andreas , Bräutigam Andrea , Schluepmann Henriette
Published: October 2017

Dinitrogen fixation by Nostoc azollae residing in specialized leaf pockets supports prolific growth of the floating fern Azolla filiculoides. To evaluate contributions by further microorganisms, the A. filiculoides microbiome and nitrogen metabolism in bacteria persistently associated with Azolla ferns were characterized.

A metagenomic approach was taken complemented by detection of N2O released and nitrogen isotope determinations of fern biomass. Ribosomal RNA genes in sequenced DNA of natural ferns, their enriched leaf pockets and water filtrate from the surrounding ditch established that bacteria of A. filiculoides differed entirely from surrounding water and revealed species of the order Rhizobiales. Analyses of seven cultivated Azolla species confirmed persistent association with Rhizobiales.

Two distinct nearly full‐length Rhizobiales genomes were identified in leaf‐pocket‐enriched samples from ditch grown A. filiculoides. Their annotation revealed genes for denitrification but not N2‐fixation. 15N2 incorporation was active in ferns with N. azollae but not in ferns without. N2O was not detectably released from surface‐sterilized ferns with the Rhizobiales.

N2‐fixing N. azollae, we conclude, dominated the microbiome of Azolla ferns. The persistent but less abundant heterotrophic Rhizobiales bacteria possibly contributed to lowering O2 levels in leaf pockets but did not release detectable amounts of the strong greenhouse gas N2O.
QTL analysis for alkaline tolerance of rice and verification of a major QTL
Authors: Li Ning , Sun Jian , Wang Jingguo , Liu Hualong , Zheng Hongliang , Yang Luomiao , Liang Yingpei , Li Xianwei , Zou Detang
Published: October 2017

Alkaline stress causes injuries to rice seedlings in many parts of the world and is therefore an important factor affecting rice production in such areas. In this study, we preliminarily located quantitative trait loci (QTLs) for survival days of seedlings (SDS) and the concentrations of Na+ and K+ in shoots (SNC and SKC) and roots (RNC and RKC) under alkaline stress using an F2:3 population, which was derived from a cross between Caidao and WD20342 with 151 simple sequence repeat (SSR) markers. A total of seven QTLs were detected. Of these QTLs, qSNC3 had the largest effect, which explained 21.24% of the total phenotypic and is a major QTL. Next, a mapping population consisting of 190 BC2F2 plants was constructed using WD20342 as a donor parent to verify qSNC3. As a result, qSNC3 was delimited to an 81.7‐kb region between markers RM1221 and RM4404. In this region, LOC_Os03 g62500 and LOC_Os03 g62620 exhibited different expression between Caidao and WD20342 under alkaline stress. These results provide a basis for identifying genes related to alkaline tolerance in rice.
Seeing through your daughter's eyes: Factors associated with maternal meta‐accuracy
Authors: MILAN STEPHANIE , RAMIREZ JENNIFER , CARLONE CHRISTINA
Published: October 2017

Dyadic meta‐accuracy reflects the ability to judge how one is viewed by a relationship partner. Drawing from the attachment literature on parental mentalization, it is tested whether maternal meta‐accuracy is associated with (a) mothers' history of maltreatment or maternal absence during her childhood and (b) observed relational behaviors during an interaction task. Participants included 182 low‐income mother–daughter dyads (adolescent mean age = 15.1). Mothers were modestly accurate in judging how daughters rated their warmth and hostility. Mothers with histories of maltreatment or maternal absence showed less meta‐accuracy, but the nature of their inaccuracies (e.g., self‐enhancement) differed. Differences in maternal meta‐accuracy were also associated with relationship quality as rated by independent observers. The relevance of meta‐accuracy for mentalization‐based interventions with families is discussed.
Early bacterial and fungal infection in children receiving allogeneic stem cell transplantation for acute lymphoblastic leukemia in Argentina
Authors: Gomez S. , Fynn A. B. , Fernanda S. , Cecilia V. , Sung L.
Published: October 2017

Infections are important complications associated with allogeneic HSCT. Describing infection rates in low‐ and middle‐income countries provides data to infer efficacy of supportive care practices in these settings. In this retrospective cohort study, we included patients (age ≤ 18 years) who underwent a first allogeneic HSCT for ALL in a single center in Argentina between 1998 and 2016. The primary outcome was sterile site bacterial infection. Secondary outcomes were proven or probable invasive fungal infection, TRM, and infectious deaths. There were 68 allogeneic HSCT recipients with ALL included in this analysis. Overall, 17 (25.0%) experienced at least one sterile site bacterial infection and 10 (14.7%) experienced at least one proven or probable invasive fungal infection. The TRM rate was 19.1%, and 3 (4.4%) patients died of infection. In a middle‐income country center in Argentina, pediatric allogeneic HSCT infection rates, TRM, and infection‐related mortality were comparable to high‐income countries. These data support continuation of allogeneic HSCT programs in similar resource‐limited settings provided that adequate supportive care and monitoring of outcomes can be performed.