bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of Improved Feeding Methods in the Culture of Yellow Tang, Zebrasoma flavescens
Authors: Callan Chatham K. , Burgess Aurora I. , Rothe Cara R. , Touse Renee
Published: January 2018

Yellow tang, Zebrasoma flavescens, are one of the most heavily traded marine aquarium fish species, with nearly 400,000 individuals collected annually from Hawaii's reefs. Despite recent success culturing this species, significant challenges in the rearing processes remain to be overcome before commercialization is feasible. This study compared two feeding regimens, an original diet treatment, which was initially used to successfully culture yellow tang, and a revised diet, which differed in the timing of the introduction of feed items and weaning periods. Both diet regimens consisted of Parvocalanus crassirostris nauplii, enriched Brachionus rotundiformis rotifers, and Artemia nauplii, followed by a transition to dry and frozen feed items. The revised feeding regimen aimed to considerably reduce the amount of copepods and rotifers needed in the rearing process. Eggs were stocked at 40/L into replicate (n = 3) 200‐L tanks for the feeding regimen trial. A follow‐up rearing study, in which eggs were stocked at 19/L in a single 1000‐L tank, tested the revised feeding method at pilot scale. Fish reared on the revised feeding regimen were observed to grow faster in body length and body depth after 2 wk in culture and transitioned more quickly to juveniles as 41% had completed their transition to juvenile coloration by 70 d after hatch. None of the fish reared under the original feeding regimen attained full juvenile coloration during the study period. Survival was not significantly different between treatments and was 0.13% ± 0.13 and 0.29% ± 0.17 in the original and revised feeding regimens, respectively. In the pilot‐scale study, growth was comparable to that of both treatments in the 200‐L scale trial, but survival was much better at 1.9%. This study successfully shortened the copepod and rotifer feeding periods for yellow tang, while not jeopardizing growth or survival. This outcome enhances the commercialization potential for this and likely other Acanthuridae species.
The physiology of leadership in fish shoals: leaders have lower maximal metabolic rates and lower aerobic scope
Authors: Ward A. J. W. , Herbert‐Read J. E. , Schaerf T. M. , Seebacher F.
Published: January 2018

The question of who leads and who follows is crucial to our understanding of the collective movements of group‐living animals. Various characteristics associated with leadership have been documented across a range of social taxa, including hunger, motivation, dominance and personality. Comparatively little is known about the physiological mechanisms that underlie leadership. Here, we tested whether the metabolic phenotype of individual fish (x‐ray tetras, Pristella maxillaris) determined their relative position within a moving shoal and their tendency to act as leaders. In contrast to previous work, we found that individuals with low maximal metabolic rates and low aerobic scope tended to be more likely to be found at the front of shoals and were more likely to act as leaders. We suggest that leadership by low‐performing individuals leads to greater group cohesion. However, in more challenging environmental contexts, such as flowing water, higher performing animals may be more likely to become leaders while low‐performing individuals seek the more favourable hydrodynamic conditions at the rear of the group. Hence, the travelling speed of the group may mediate the relationship between metabolic phenotype and leadership.
How Litigants in Dutch Courtrooms Come to Trust Judges: The Role of Perceived Procedural Justice, Outcome Favorability, and Other Sociolegal Moderators
Authors: Grootelaar Hilke A. M. , van den Bos Kees
Published: January 2018

This paper examines the hypothesis that litigants' perceived procedural justice is positively associated with their trust in judges. We argue that although this association might seem quite robust, it can vary across contexts. In particular, we suggest that the nature and magnitude of the association between procedural justice and trust in judges depends on outcome concerns, and other sociolegal moderators such as outcome importance and prior court experience. We tested our predictions in three different types of law cases among 483 litigants at court hearings of the district court of the Mid-Netherlands. As predicted, our results indicate that perceived procedural justice was positively associated with trust in judges when outcomes were relatively favorable, and that this association was even stronger when outcomes were relatively unfavorable. The courtroom context studied here enabled us to explore how other sociolegal variables moderated these relationships.
Transmitting Ainu traditional food knowledge from mothers to their daughters
Authors: Iwasaki‐Goodman Masami
Published: January 2018

Since 2004, research has been conducted in the Ainu Indigenous community of the Saru River Region of Biratori in Northern Japan examining traditional food use knowledge. The purpose was to improve the socio‐cultural environment for the Ainu People by implementing interventions meant to reintroduce traditional Ainu food use, so that they can live with dignity and in harmony with non‐Ainu people in the heterogeneous community where Japanese cultural values dominate. Ten years after the start of this research, a series of interviews was conducted with Ainu mothers and daughters active in the community to evaluate the result of the interventions because, in accordance with culturally established Ainu gender roles, the Ainu women prepare the Ainu dishes. The interviews indicated that the community of both Ainu and non‐Ainu people shared traditional Ainu food as a communal food at community events organized by the Ainu members of the community. The people in the community now identify traditional Ainu dishes with Ainu names, indicating the establishment of culinary and linguistic boundaries between Ainu traditional food and mainstream Japanese food. This also signals that the Ainu People have begun to establish a basis for reconstructing their unique ethnic identity, once suppressed by the government's former assimilation policy.
Reclaiming food security in the Mohawk community of Kahnawà:ke through Haudenosaunee responsibilities
Authors: Delormier Treena , Horn‐Miller Kahente , McComber Alex M. , Marquis Kaylia
Published: January 2018

Indigenous Peoples are reclaiming their food security, nutrition, and well‐being by revitalizing food systems, livelihoods, knowledge‐systems, and governance. Our food security research is guided by sustainable self‐determination that focuses on restoring Indigenous cultural responsibilities and relationships to land, each other, and the natural world (Corntassel, 2008). Our Kanien'kehá:ka (Mohawk) research team from Kahnawà:ke, in Quebec, Canada, examines food insecurity experiences in our community to explore ways of upholding our Haudenosaunee responsibilities and enhancing local food security. We collaboratively designed the study and interviewed Kahnawakehró:non (people from the Kahnawake community) with traditional knowledge, extensive community experience, and interests in food and culture. Interviews were audio‐recorded, transcribed, and analysed by the team. Analysis characterized food insecurity experiences and conditions that challenge and enable food security with attention to traditional food systems, relationships to land, and gender‐related responsibilities. Findings show that communal responsibilities generate resilient strategies that provide for all in times of crisis, and long‐term food insecurity is managed through social programs, organized charities, and family support. Enhancing food security involves healing and protecting a limited land‐base for food production, integrating food production with community priorities for education, training, health, economic development, and scientific innovation. Nurturing spiritual connections with tionhnhéhkwen (life sustaining foods), the natural world, and each other calls for accelerated teaching and practicing our original instructions. Challenges in developing food security leadership, balancing capitalism and subsistence economies, and strengthening social relationships are rooted in the historical colonial and current settler‐colonial context that disrupts all aspects of Kanien'kehá:ka society.
A comparison of monetary and fiscal policy interaction under ‘sound’ and ‘functional’ finance regimes
Authors: Mason J. W. , Jayadev Arjun
Published: January 2018

The interest rate and the fiscal balance can be thought of as two independent instruments to be assigned to two targets, the path of output and the path of public debt. Under what we term a ‘sound finance rule’ the interest rate targets output while the fiscal balance targets public debt; under a ‘functional finance rule’ the budget balance targets the output gap and the interest rate targets the debt ratio. The same unique combination of interest rate and fiscal balance will be consistent with output at potential and a constant debt‐GDP ratio regardless of which instrument is assigned to which target. The stability characteristics of the two rules differ, however. At low levels of debt, both rules converge to the targets, but there is a threshold debt level above which only the functional finance rule converges. Contrary to conventional wisdom, therefore, the case for countercyclical fiscal policy becomes stronger, not weaker, when the ratio of public debt to GDP is already high. We apply our framework to describe the possibility of policy‐generated cycles in the United States over the past five decades.
Periodontal and chronic kidney disease association: A systematic review and meta‐analysis
Authors: Kapellas Kostas , Singh Ankur , Bertotti Maitê , Nascimento Gustavo G. , Jamieson Lisa M ,   on behalf of the Perio‐CKD collaboration
Published: January 2018

Aim

Chronic kidney disease (CKD) and kidney failure is increasing globally and evidence from observational studies suggest periodontal disease may contribute to kidney functional decline.

Methods

Electronic searches of the PubMed, EMBASE, Web of Science, Scopus and Cochrane Library databases were conducted for the purposes of conducting a systematic review. Hand searching of reference lists was also performed. Meta‐analysis of observational studies involving periodontal disease and chronic kidney disease in adults was performed.

Results

A total of 17 studies was selected from an initial 4055 abstracts. Pooled estimates indicated the odds of having CKD were 60% higher among patients with periodontitis: pooled OR 1.60 (95% CI 1.44–1.79, I235.2%,P = 0.11) compared to those without. Conversely, a similar magnitude but non‐significant higher odds of having periodontal disease was found among people with CKD 1.69 (95% CI: 0.84, 3.40, I2= 89.8%,P < 0.00) versus non‐CKD. Meta‐regression revealed study quality based on the Newcastle‐Ottawa Scale and statistical adjustment for potential confounders explained almost 35% of the heterogeneity in the studies investigating the association between CKD and periodontitis.

Conclusions

Moderate evidence for a positive association between periodontitis and CKD exists. Evidence for the opposite direction is extremely weak based on significant heterogeneity between studies.
Plant genetic resources for food and agriculture: opportunities and challenges emerging from the science and information technology revolution
Authors: Halewood Michael , Chiurugwi Tinashe , Sackville Hamilton Ruaraidh , Kurtz Brad , Marden Emily , Welch Eric , Michiels Frank , Mozafari Javad , Sabran Muhamad , Patron Nicola , Kersey Paul , Bastow Ruth , Dorius Shawn , Dias Sonia , McCouch Susan , Powell Wayne
Published: January 2018

Contents

Summary
1407

I.
Introduction
1408

II.
Technological advances and their utility for gene banks and breeding, and longer‐term contributions to SDGs
1408

III.
The challenges that must be overcome to realise emerging R&D opportunities
1410

IV.
Renewed governance structures for PGR (and related big data)
1413

V.
Access and benefit sharing and big data
1416

VI.
Conclusion
1417

Acknowledgements
1417

ORCID
1417

References
1417

Over the last decade, there has been an ongoing revolution in the exploration, manipulation and synthesis of biological systems, through the development of new technologies that generate, analyse and exploit big data. Users of Plant Genetic Resources (PGR) can potentially leverage these capacities to significantly increase the efficiency and effectiveness of their efforts to conserve, discover and utilise novel qualities in PGR, and help achieve the Sustainable Development Goals (SDGs). This review advances the discussion on these emerging opportunities and discusses how taking advantage of them will require data integration and synthesis across disciplinary, organisational and international boundaries, and the formation of multi‐disciplinary, international partnerships. We explore some of the institutional and policy challenges that these efforts will face, particularly how these new technologies may influence the structure and role of research for sustainable development, ownership of resources, and access and benefit sharing. We discuss potential responses to political and institutional challenges, ranging from options for enhanced structure and governance of research discovery platforms to internationally brokered benefit‐sharing agreements, and identify a set of broad principles that could guide the global community as it seeks or considers solutions.
Market size and TFP in the Melitz model
Authors: Felbermayr Gabriel , Jung Benjamin
Published: January 2018

Trade theory in the Krugman tradition predicts a positive correlation between market size and countries' total factor productivity (TFP). However, in the data, there is no such correlation. Models with heterogeneous firms and selection can reconcile theory and empirics, when the degree of external economies of scale is lower than assumed in the standard CES case. Realistically, larger countries have an over‐proportionate share of firms. With export selection, these countries have more input varieties available, but they also have a lower average productivity of firms. Which of these effects dominates depends on the degree of external economies of scale.
Autologous hematopoietic stem cell transplant in a patient with leprosy: Is it safe?
Authors: Salomão Matias Chiarastelli , Batista Marjorie Vieira , de Macedo Maria Cristina , Sotto Mirian Nacagami , Duarte Amaro Nunes , Rocha Vanderson Geraldo , Higashino Hermes Ryoiti , Costa Silvia Figueiredo
Published: January 2018

A patient with non‐Hodgkin lymphoma, preparing for an autologous hematopoietic stem cell transplant (HSCT), developed leprosy. The patient was successfully treated with rifampicin, ofloxacin, and doxycycline, and the HSCT was performed without complications, being the first report, to our knowledge, of leprosy in an autologous HSCT patient.
Carcinocythemia: First report in a cat and literature review
Authors: Sá e Lemos Eva , Lima de Carvalho Hugo , Gil da Costa Rui M. , Pinto da Cunha Nazaré
Published: January 2018

A 6‐year‐old female neutered European Shorthair cat was presented with a 2‐day history of lethargy and hyporexia. On physical examination, the cat was slightly depressed and had a 2.5 cm nodule in the left 3rd mammary gland. The hemogram revealed mild leukocytosis with mature neutrophilia and moderate thrombocytopenia. On blood smear evaluation, rare pleomorphic cells, possibly of epithelial origin, were observed mainly at the feathered edge. The animal died about 12 hours after presentation, and a necropsy was performed. On histopathology, the mammary nodule was diagnosed as a tubulopapillary adenocarcinoma with vascular invasion and widespread metastases. Immunocytochemical tests for cytokeratins (AE1/AE3) confirmed the epithelial phenotype of the neoplastic cells observed on the blood smear. The present report describes a feline mammary carcinoma with widespread metastases and the presence of malignant epithelial cells in the peripheral blood referred to as carcinocythemia. This condition has been previously described in people and dogs. To the author's knowledge, this is the first reported case of feline carcinocythemia. As in other species, the phenomenon was associated with a terminal phase of systemic malignancy.
A high plasma: red blood cell transfusion ratio during liver transplantation is associated with decreased blood utilization
Authors: Pagano M. B. , Metcalf R. A. , Hess J. R. , Reyes J. , Perkins J. D. , Montenovo M. I.
Published: January 2018

Background

During massive transfusion, the volume ratio of administered plasma (PL Vol) to red blood cell (RBC Vol) appears to be associated with reduced blood utilization and improved survival. The aim of this study was to evaluate the optimal component ratio in the setting of liver transplantation.

Methods

This is a retrospective chart review of patients who underwent liver transplantation and received at least 500 ml of red blood cells from January 2013 through December 2015. Kernel smoothing analysis determined the proper component ratios to evaluate were a ≥0·85:1 ratio (high) to a ≤0·85:1 ratio (low). Two groups, plasma volume to RBC volume (PL Vol/RBC Vol) and plasma contained in the platelet units added to the plasma calculation [PL + PLT (platelet)] Vol/RBC Vol, were used to evaluate the component ratios.

Results

A total of 188 patients were included in the analysis. In the PL Vol/RBC Vol evaluation, a low ratio revealed that 1238 ml (977–1653 ml) (P < 0·0001) and 1178 ml (747–1178) (P < 0·0001) of RBC were used in excess compared to the high ratio, in the univariable and multivariable analysis, respectively. In the PL +PLT Vol/RBC Vol evaluation, a low ratio used 734 ml (193–1275) (P = 0·008) and 886 ml (431–1340) (P < 0·0001) of RBC in excess when compared to high ratio in the univariable and multivariable analysis, respectively.

Conclusion

In patients undergoing liver transplantation, the transfusion of plasma to RBC ratio ≥0·85 was associated with decreased need of RBC transfusions.
Working together on transfusion audits to improve clinical practice
Authors: Zhong X. , Heng M.L. , Lam J.C.M.
Published: January 2018

Background

For many years, great efforts have been put in place to ensure quality and safety of blood and blood products during collection and processing. In recent years, the focus has shifted to enhancement of clinical transfusion processes. Conducting audits is one effective mechanism of evaluating the ongoing blood administration process against set standards.

Methods

Random transfusion audits were conducted jointly by both Blood Bank technical staff and the transfusion nurse in Paediatric and Obstetric wards using a checklist. This checklist consisted of essential procedures and checks during blood transfusion. Transfusion slips were also audited against defined standards.

Results

Many good transfusion practices were observed. In the majority of cases, there was positive identification of patients before transfusion by doctor and nurse. However, there were many areas requiring improvement, including inconsistency in setting up transfusions across different clinical areas in the hospital. Knowledge deficit was identified in eight key areas when results of a transfusion knowledge questionnaire were reviewed. Audit of the transfusion slips revealed a major concern with putting up blood for transfusion within 30 minutes. All findings were reviewed, and interventions were undertaken. A formal transfusion training programme was implemented, and the institution's clinical transfusion protocol was revised for better clarity.

Conclusion

Initiatives implemented after reviewing all findings from the transfusion audits lead to improved practice, thereby enhancing patients’ safety. Continuous audit will be required to monitor and sustain improvements.
The value of glycated albumin for the prediction of graft outcome in the non‐human primate porcine islet transplantation model
Authors: Kang Hee Jung , Lee Haneulnari , Park Eun Mi , Kim Jong‐Min , Shin Jun‐Seop , Park Chung‐Gyu
Published: January 2018

Background

The development of a precise and easy‐to‐use tool for monitoring islet graft function is important in clarifying the causes of graft loss, identifying appropriate therapy, and ensuring graft survival in the nonhuman primate (NHP) model of porcine islet transplantation (PITx). Glycated albumin (GA) is an indicator of intermediate‐term changes in blood glucose control and is useful in clinical diabetes management. The validity of GA for monitoring graft function in NHP recipients of PITx was evaluated using a retrospective analysis of cohort samples.

Methods

Data from a total of 23 PITxs performed in 20 recipients (3 were retransplanted) were included in this study. Islet clusters purified from adult wild‐type pigs were transplanted via the intraportal route into streptozotocin‐induced diabetic rhesus monkeys with immune suppression. Blood samples were obtained once per week from the recipients until they lost insulin‐independence. Blood samples were also obtained from 69 non‐diabetic monkeys that served as a control group. The levels of GA and albumin in stored plasma aliquots were measured using each enzymatic method, and the GA result was expressed as the percentage of GA level to the total albumin level.

Results

The median level of GA in the recipients on the day of PITx (median 18.6%, 95% confidence interval [CI] 16.7%‐20.4%) was significantly higher than that of healthy controls (median 9.14%, 95% CI 9.0%‐9.3%, P < .0001). However, the level decreased after PITx and remained low or increased depending on the extent of residual graft function. The GA level at a nadir (median 11.6%, 95% CI 10.8%‐13.0%) and the time to reach a nadir (median 43 days, 95% CI 21.7‐69.3 days) both correlated with the duration of insulin‐independence (rho [ρ] = −.605, P = .0028 and ρ = .662, P = .0008, respectively). The GA level strongly correlated with KG, the glucose disappearance rate during intravenous glucose tolerance testing (ρ = −.76, P < .0001). At post‐transplant week (PTW) 3 and at PTW 4, the GA levels in recipients with long‐term insulin‐independence (>90 days) were significantly lower than those with short‐term insulin‐independence, which revealed the excellent performance for the prediction of long‐term insulin‐independence that is comparable to that of porcine C‐peptide (historic data).

Conclusions

As a surrogate indicator for graft function, serial measurement of GA may provide Supporting Information to that obtained from conventional monitoring techniques of graft function for assessing porcine islet grafts in NHP models.
Plasma-assisted atomic layer deposition of germanium antimony tellurium compounds
Authors: Šilinskas Mindaugas , Kalkofen Bodo , Balasubramanian Ramasubramanian , Batmanov Anatoliy , Burte Edmund P. , Harmgarth Nicole , Zörner Florian , Edelmann Frank T. , Garke Bernd , Lisker Marco
Published: January 2018

Plasma atomic layer deposition of Ge-Sb-Te (GST) thin films using halogen-free precursors is reported. The Sb and Te precursors tris(aziridinyl)antimony (III) (Sb[cyclo-NC2H4]3) and di-n-butylditelluride [Te2(n-C4H9)2] were employed for the first time in the deposition of GST thin films. Conformal filling of trenches has been demonstrated. The film thickness ratio between the top and the wall/bottom of trenches was evaluated: for “wide” (7:1 aspect ratio) trenches—dbottom/dtop ≈ 0.65, and for “narrow” (23:1 aspect ratio) trenches dwall/dtop > 0.63. Due to the use of amino precursors the as-deposited GST films were doped with nitrogen.
Ultrasonic defect characterisation—Use of amplitude, phase, and frequency information
Authors: Bai Long , Velichko Alexander , Drinkwater Bruce W.
Published: January 2018

This paper studies ultrasonic defect characterisation with the aim of reducing the characterisation uncertainty. Ultrasonic array data contain a mixture of responses from all reflecting features, and the scattering matrix for each defect can be extracted in post-processing, which describes how ultrasonic waves at a given incident angle are scattered by a defect. In this paper, it is shown that defect characterisation performance can be improved by the inclusion of phase and frequency information relative to current single-frequency-amplitude approaches. This superior characterisation performance is due to the increased number of informative principal components (PCs) and higher signal-to-noise ratios in the PC directions. Scattering matrix phase measurement is very sensitive to localisation errors, and an effective approach is proposed, which can be used to reliably extract phase from experimental data. Nine elliptical defects having different aspect ratios and orientation angles are characterised experimentally. The complex multi-frequency defect database has achieved up to 90.60% reduction in the quantified sizing uncertainty compared to the results obtained using only the amplitude at a single frequency.
Signal Peptidase Is Necessary and Sufficient for Site 1 Cleavage of RsiV in Bacillus subtilis in Response to Lysozyme
Authors: Castro Ana N. , Lewerke Lincoln T. , Hastie Jessica L. , Ellermeier Craig D.
Published: January 2018

Extracytoplasmic function (ECF) σ factors are a diverse family of alternative σ factors that allow bacteria to sense and respond to changes in the environment. σ
V
is an ECF σ factor found primarily in low-GC Gram-positive bacteria and is required for lysozyme resistance in several opportunistic pathogens. In the absence of lysozyme, σ
V
is inhibited by the anti-σ factor RsiV. In response to lysozyme, RsiV is degraded via the process of regulated intramembrane proteolysis (RIP). RIP is initiated by cleavage of RsiV at site 1, which allows the intramembrane protease RasP to cleave RsiV within the transmembrane domain at site 2 and leads to activation of σ
V
. Previous work suggested that RsiV is cleaved by signal peptidase at site 1. Here we demonstrate
in vitro
that signal peptidase is sufficient for cleavage of RsiV only in the presence of lysozyme and provide evidence that multiple
Bacillus subtilis
signal peptidases can cleave RsiV
in vitro
. This cleavage is dependent upon the concentration of lysozyme, consistent with previous work that showed that binding to RsiV was required for σ
V
activation. We also show that signal peptidase activity is required for site 1 cleavage of RsiV
in vivo
. Thus, we demonstrate that signal peptidase is the site 1 protease for RsiV.

IMPORTANCE
Extracytoplasmic function (ECF) σ factors are a diverse family of alternative σ factors that respond to extracellular signals. The ECF σ factor σ
V
is present in many low-GC Gram-positive bacteria and induces resistance to lysozyme, a component of the innate immune system. The anti-σ factor RsiV inhibits σ
V
activity in the absence of lysozyme. Lysozyme binds RsiV, which initiates a proteolytic cascade leading to destruction of RsiV and activation of σ
V
. This proteolytic cascade is initiated by signal peptidase, a component of the general secretory system. We show that signal peptidase is necessary and sufficient for cleavage of RsiV at site 1 in the presence of lysozyme. This report describes a role for signal peptidase in controlling gene expression.
Convergent Evolution Driven by Rifampin Exacerbates the Global Burden of Drug-Resistant Staphylococcus aureus
Authors: Guérillot Romain , Gonçalves da Silva Anders , Monk Ian , Giulieri Stefano , Tomita Takehiro , Alison Eloise , Porter Jessica , Pidot Sacha , Gao Wei , Peleg Anton Y. , Seemann Torsten , Stinear Timothy P. , Howden Benjamin P.
Published: January 2018

Increasing antibiotic resistance in the major human pathogen
Staphylococcus aureus
is threatening the ability to treat patients with these infections. Recent laboratory studies suggest that mutations in the gene commonly associated with rifampin resistance may also impact susceptibility to other last-line antibiotics in
S. aureus
; however, the overall frequency and clinical impact of these mutations are unknown. By mining a global collection of clinical
S. aureus
genomes and by mutagenesis experiments, this work reveals that common rifampin-induced
rpoB
mutations promote phenotypic plasticity that has led to the global emergence of stable, multidrug-resistant
S. aureus
lineages that are associated with increased risk of therapeutic failure through coresistance to other last-line antimicrobials. We recommend decreasing susceptibility breakpoints for rifampin to allow phenotypic detection of critical
rpoB
mutations conferring low resistance to rifampin and reconsidering the appropriate use of rifampin to reduce the fixation and spread of these deleterious mutations globally.
Evaluation and management of patients with acute chest pain in China (EMPACT): protocol for a prospective, multicentre registry study
Authors: Zheng Wen , Wang Jiali , Xu Feng , Zheng Jiaqi , Zhang He , Ma Jingjing , Wang Guangmei , Wang Hao , Chew Derek P , Chen Yuguo
Published: January 2018

Introduction

Acute chest pain represents a major healthcare burden in emergency departments (ED) throughout the world. Among these patients, rapidly determining whether an acute coronary syndrome (ACS) is evolving remains difficult. In China, there are limited data correlating the baseline characteristics, evaluation and management of ED patients with acute chest pain and ACS-related symptoms with clinical outcomes. Nor has there been an evaluation of outcomes at different levels of hospitals. The Evaluation and Management of Patients with Acute ChesT pain in China (EMPACT) study will address this evidence gap through a regional representative prospective registry.

Methods and analysis

Twenty-two public hospitals with ED in Shandong province have been selected based on a stratified random sampling approach. A total of 10 000 patients with acute chest pain or suspected ACS presenting to the ED will be consecutively enrolled from January 2016 to September 2017. Episodes of care will be evaluated for key performance measures such as the time to first ECG, receipt of troponin testing, receipt of reperfusion therapy for ST segment elevation ACS and provision of angiography for troponin-positive patients. All patients will be assessed for the composite endpoint of adjudicated major adverse cardiac events in 30 days after presentation, including death from all causes, non-fatal myocardial infarction, urgent revascularisation, stroke, cardiac arrest and cardiogenic shock. The secondary outcomes include revisit to ED and rehospitalisation within 30 days.

Ethics and dissemination

Ethics approval was obtained at all participating centres. The registry is the first attempt to comprehensively evaluate the current emergency care of acute chest pain from a regional representative sample in China. Findings will allow new opportunities to facilitate the clinical quality improvements and ultimately reduce the mortality in patients with acute chest pain and suspected ACS.

Trial registration number

NCT02536677; Pre-results.
Incremental predictive value of screening for anxiety and depression beyond current type 2 diabetes risk models: a prospective cohort study
Authors: Atlantis Evan , Ghassem Pour Shima , Girosi Federico
Published: January 2018

Objectives

We sought to determine whether screening for anxiety and depression, an emerging risk factor for type 2 diabetes (T2D), adds clinically meaningful information beyond current T2D risk assessment tools.

Design

Prospective cohort.

Participants and setting

The 45 and Up Study is a large-scale prospective cohort of men and women aged 45 years and over, randomly sampled from the general population of New South Wales, Australia. 51 588 participants without self-reported diabetes at baseline (2006–2009) were followed up for approximately 3 years (2010).

Methods

T2D status was determined by self-reported doctor who diagnosed diabetes after the age of 30 years, and/or current use of metformin. Current symptoms of anxiety and/or depression were measured by the 10-item Kessler Psychological Distress Scale (K10). We determined the optimal cut-off point for K10 for predicting T2D using Tjur’s R2 and tested risk models with and without the K10 using logistic regression. We assessed performance measures for the incremental value of the K10 using the area under the receiver operating characteristic (AROC), net reclassification improvement (NRI) and net benefit (NB) decision analytics with sensitivity analyses.

Results

T2D developed in 1076 individuals (52.4% men). A K10 score of ≥19 (prevalence 8.97%), adjusted for age and gender, was optimal for predicting incident T2D (sensitivity 77%, specificity 53% and positive predictive value 3%; OR 1.70 (95% CI 1.41 to 2.03, P<0.001). K10 score predicted incident T2D independent of current risk models, but did not improve corresponding AROC, NRI and NB statistics. Sensitivity analyses showed that this was partially explained by the baseline model and the small effect size of the K10 that was similar compared with other risk factors.

Conclusions

Anxiety and depressing screening with the K10 adds no meaningful incremental value in addition to current T2D risk assessments. The clinical importance of anxiety and depression screening in preventing T2D requires ongoing consideration.
Inversed relationship between completeness of follow-up and coverage of postoperative complications in gallstone surgery and ERCP: a potential source of bias in patient registers
Authors: Enochsson Lars , Blohm My , Sandblom Gabriel , Jonas Eduard , Hallerbäck Bengt , Lundell Lars , Österberg Johanna
Published: January 2018

Objective

To analyse the completeness in GallRiks of the follow-up frequency in relation to the intraoperative and postoperative outcome.

Design

Population-based register study.

Setting

Data from the national Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (ERCP), GallRiks.

Population

All cholecystectomies and ERCPs recorded in GallRiks between 1 January 2006 and 31 December 2014.

Main outcome measures

Outcomes for intraprocedural as well as postprocedural adverse events between units with either a 30-day follow-up of ≥90% compared with those with a less frequent follow-up (<90%).

Results

Between 2006 and 2014, 162 212 cholecystectomies and ERCP procedures were registered in GallRiks. After the exclusion of non-index procedures and those with incomplete data 152 827 procedures remained for final analyses. In patients having a cholecystectomy, there were no differences regarding the adverse event rates, irrespective of the follow-up frequency. However, in the more complicated endoscopic ERCP procedures, the postoperative adverse event rates were significantly higher in those with a more frequent and complete 30-day follow-up (OR 1.92; 95% CI 1.76 to 2.11).

Conclusions

Differences in the follow-up frequency in registries affect the reported outcomes as exemplified by the complicated endoscopic ERCP procedures. A high and complete follow-up rate shall serve as an additional quality indicator for surgical registries.
Does vitamin D supplementation improve bone density in vitamin D-deficient children? Protocol for an individual patient data meta-analysis
Authors: Winzenberg Tania , Lamberg-Allardt Christel , El-Hajj Fuleihan Ghada , Mølgaard Christian , Zhu Kun , Wu Feitong , Riley Richard D
Published: January 2018

Introduction

Our previous study-level (aggregate data) meta-analysis suggested that vitamin D supplements may be beneficial for bone density specifically in children with vitamin D deficiency. However, the misclassification of vitamin D status inherent in study-level data means that the results are not definitive and cannot provide an accurate assessment of the size of any effect. Therefore, we propose to undertake an individual patient data (IPD) meta-analysis to determine whether the effect of vitamin D supplementation on bone density in children differs according to baseline vitamin D status, and to specifically estimate the effect of vitamin D in children who are vitamin D deficient.

Methods and analysis

This study has been designed to adhere to the Preferred Reporting Items for Systematic Review and Meta-Analyses of IPD statement. We will include randomised placebo-controlled trials of vitamin D supplementation reporting bone density outcomes at least 6 months after the study commenced in children and adolescents (aged <20 years) without coexistent medical conditions or treatments causing osteoporosis. We will update the search of the original review to cover the period 2009–2017, using the same methods as the original review. Fully anonymised data on all randomised patients will be requested. Outcomes will be femoral neck, total hip, lumbar spine and proximal and distal forearm bone mineral density, and total body bone mineral content. A two-stage IPD meta-analysis will be used to examine the effect of baseline serum 25-hydroxyvitamin D (25(OH)D) on treatment effect for each bone density outcome. Restricted maximum likelihood will be used to estimate the random-effects meta-analysis models, with 95% CI for summary effects. Heterogeneity will be assessed by I2and potential publication bias (small-study effects) and availability bias by funnel plots, Egger’s test and Peter’s test.

Ethics and dissemination

Ethics approval will not be required as the data are to be used for the primary purpose for which they were collected and all original individual studies had ethics approval. Results of the IPD meta-analysis will be submitted for publication in a peer-reviewed journal.

PROSPERO registration number

CRD42017068772.
Investigation assessing the publicly available evidence supporting postmarketing withdrawals, revocations and suspensions of marketing authorisations in the EU since 2012
Authors: Lane Samantha , Lynn Elizabeth , Shakir Saad
Published: January 2018

Objectives

To assess the sources of publicly available evidence supporting withdrawal, revocation or suspension of marketing authorisations (‘regulatory actions’) due to safety reasons in the EU since 2012 and to investigate the time taken since initial marketing authorisation to reach these regulatory decisions.

Setting

This investigation examined the sources of evidence supporting 18 identified prescription medicinal products which underwent regulatory action due to safety reasons within the EU in the period 1 July 2012 to 31 December 2016.

Results

Eighteen single or combined active substances (‘medicinal products’) withdrawn, revoked or suspended within the EU for safety reasons between 2012 and 2016 met the inclusion criteria. Case reports were most commonly cited, supporting 94.4% of regulatory actions (n=17), followed by randomised controlled trial, meta-analyses, animal and in vitro, ex vivo or in silico study designs, each cited in 72.2% of regulatory actions (n=13). Epidemiological study designs were least commonly cited (n=8, 44.4%). Multiple sources of evidence contributed to 94.4% of regulatory decisions (n=17). Death was the most common adverse drug reaction leading to regulatory action (n=5; 27.8%), with four of these related to medication error or overdose. Median (IQR) time taken to reach a decision from the start of regulatory review was found to be 204.5 days (143, 535 days) and decreased across the study period. Duration of marketing prior to regulatory action, from the medicinal product’s authorisation date, increased across the period 2012–2016.

Conclusions

The sources of evidence supporting pharmacovigilance regulatory activities appear to have changed since implementation of Directive 2010/84/EU and Regulation (EU) No. 1235/2010. This, together with a small improvement in regulatory efficiency, suggests progress towards more rapid regulatory decisions based on more robust evidence. Future research should continue to monitor sources of evidence supporting regulatory decisions and the time taken to reach these decisions over time.
Natural disease course of Crohn’s disease during the first 5 years after diagnosis in a European population-based inception cohort: an Epi-IBD study
Authors: Burisch Johan , Kiudelis Gediminas , Kupcinskas Limas , Kievit Hendrika Adriana Linda , Andersen Karina Winther , Andersen Vibeke , Salupere Riina , Pedersen Natalia , Kjeldsen Jens , D’Incà Renata , Valpiani Daniela , Schwartz Doron , Odes Selwyn , Olsen Jóngerð , Nielsen Kári Rubek , Vegh Zsuzsanna , Lakatos Peter Laszlo , Toca Alina , Turcan Svetlana , Katsanos Konstantinos H , Christodoulou Dimitrios K , Fumery Mathurin , Gower-Rousseau Corinne , Zammit Stefania Chetcuti , Ellul Pierre , Eriksson Carl , Halfvarson Jonas , Magro Fernando Jose , Duricova Dana , Bortlik Martin , Fernandez Alberto , Hernández Vicent , Myers Sally , Sebastian Shaji , Oksanen Pia , Collin Pekka , Goldis Adrian , Misra Ravi , Arebi Naila , Kaimakliotis Ioannis P , Nikuina Inna , Belousova Elena , Brinar Marko , Cukovic-Cavka Silvija , Langholz Ebbe , Munkholm Pia
Published: January 2018

Objective

The Epi-IBD cohort is a prospective population-based inception cohort of unselected patients with inflammatory bowel disease from 29 European centres covering a background population of almost 10 million people. The aim of this study was to assess the 5-year outcome and disease course of patients with Crohn’s disease (CD).

Design

Patients were followed up prospectively from the time of diagnosis, including collection of their clinical data, demographics, disease activity, medical therapy, surgery, cancers and deaths. Associations between outcomes and multiple covariates were analysed by Cox regression analysis.

Results

In total, 488 patients were included in the study. During follow-up, 107 (22%) patients received surgery, while 176 (36%) patients were hospitalised because of CD. A total of 49 (14%) patients diagnosed with non-stricturing, non-penetrating disease progressed to either stricturing and/or penetrating disease. These rates did not differ between patients from Western and Eastern Europe. However, significant geographic differences were noted regarding treatment: more patients in Western Europe received biological therapy (33%) and immunomodulators (66%) than did those in Eastern Europe (14% and 54%, respectively, P<0.01), while more Eastern European patients received 5-aminosalicylates (90% vs 56%, P<0.05). Treatment with immunomodulators reduced the risk of surgery (HR: 0.4, 95% CI 0.2 to 0.6) and hospitalisation (HR: 0.3, 95% CI 0.2 to 0.5).

Conclusion

Despite patients being treated early and frequently with immunomodulators and biological therapy in Western Europe, 5-year outcomes including surgery and phenotype progression in this cohort were comparable across Western and Eastern Europe. Differences in treatment strategies between Western and Eastern European centres did not affect the disease course. Treatment with immunomodulators reduced the risk of surgery and hospitalisation.
Flavour capsule cigarette use among US adult cigarette smokers
Authors: Emond Jennifer A , Soneji Samir , Brunette Mary F , Sargent James D
Published: January 2018

Introduction

Flavour capsule cigarettes are a recent product worldwide, and little is known about the epidemiology of their use. We used data from a nationally representative survey to understand the sociodemographic characteristics of flavour capsule cigarette smokers and reasons for flavour capsule use.

Methods

Data were from the nationally representative, U.S. Population Assessment of Tobacco and Health survey (2013–2014). Analyses included 7181 adults, aged 18–44 years, who were current or former established (≥100 lifetime cigarettes) cigarette smokers. Participants reported their usual brand of cigarettes which were classified as non-menthol, menthol or flavour capsule. Analyses assessed differences in participant demographics, smoking patterns and reasons for use by product type among those aged 18–24 years. Analyses were weighted to account for the survey design.

Results

Flavour capsule cigarettes were the usual cigarettes among 9.4% of smokers aged 18–24 years and 6.0%, 3.7% and <1% of smokers aged 25–34, 35–44 and ≥45 years, respectively. Among smokers aged 18–24 year, a significantly higher percentage of Hispanic smokers (17.3%) usually used flavour capsule cigarettes versus non-Hispanic white (8.4%, P<0.05) and non-Hispanic black (3.2%, P<0.05) smokers. Flavour capsule use was associated with later onset of smoking and lower levels of nicotine dependency and flavour capsule users placed more emphasis on taste, lower price and pack design than menthol or non-menthol users.

Conclusions

Flavour capsule cigarettes use is highest in young adults, particularly Hispanics. Young adult predominance, lower level of addiction symptoms and emphasis on pack design by flavour capsule users suggest that these products may be positioned as starter products.
Are They Really Different: The Entrepreneurial Process from the Perspective of First and Second Generation Immigrant Entrepreneurs
Authors: Chababi Maria , Chreim Samia , Spence Martine
Published: January 2018

There is limited research on similarities and differences in entrepreneurial experiences of first and second generation immigrant entrepreneurs. Using in-depth interviews with Lebanese entrepreneurs in two Canadian cities, we analyze how entrepreneurs belonging to two different generations of immigrants experience and enact opportunity identification and assessment, and business development and operation. The analysis shows that first and second generation immigrant entrepreneurs diverge in their views of macro-institutional structures (such as regulation), risk, trust, and the role of divine providence in the entrepreneurial venture. The findings highlight the importance of understanding how first generation immigrant entrepreneurs’ past frames — developed in the pre-migration context — interact with the environment in the country of settlement in shaping entrepreneurial undertaking. The study also highlights second generation immigrant entrepreneurs’ perceived similarities to and differences from mainstream entrepreneurs. Implications for research and policy are addressed.
Motivation, Networking and Business Growth: Perspectives of Ghanaian Female Entrepreneurs
Authors: Erogul Murat Sakir , Quagrainie Fanny Adams
Published: January 2018

This paper explores the experiences of Ghanaian female entrepreneur’s motivation for establishing their own business and the level of support they receive from their personal social network. Findings indicate that both push and pull factors motivate Ghanaian women to start their own business; however, initial motivation for becoming an entrepreneur does not appear to determine characteristics of the dichotomous labelling in relation to networking activity engagement or business growth relationship. This paper seeks to enable decision makers in Ghana to better formulate policy and support programs aimed at creating an environment more accepting of female Ghanaian entrepreneurs, regardless of what may trigger them into pursuing entrepreneurship as a career.
Methods of Stochastic Analysis of Complex Regimes in the 3D Hindmarsh–Rose Neuron Model
Authors: Bashkirtseva Irina , Ryashko Lev , Slepukhina Evdokia
Published: January 2018

A problem of the stochastic nonlinear analysis of neuronal activity is studied by the example of the Hindmarsh–Rose (HR) model. For the parametric region of tonic spiking oscillations, it is shown that random noise transforms the spiking dynamic regime into the bursting one. This stochastic phenomenon is specified by qualitative changes in distributions of random trajectories and interspike intervals (ISIs). For a quantitative analysis of the noise-induced bursting, we suggest a constructive semi-analytical approach based on the stochastic sensitivity function (SSF) technique and the method of confidence domains that allows us to describe geometrically a distribution of random states around the deterministic attractors. Using this approach, we develop a new algorithm for estimation of critical values for the noise intensity corresponding to the qualitative changes in stochastic dynamics. We show that the obtained estimations are in good agreement with the numerical results. An interplay between noise-induced bursting and transitions from order to chaos is discussed.