bluuebunny/crossref_metadata_2025 huggingface dataset:
The development of a South African Early Learning Outcomes Measure: A South African instrument for measuring early learning program outcomes
Authors: Snelling Matthew , Dawes Andrew , Biersteker Linda , Girdwood Elizabeth , Tredoux Colin
Published: January 2019

Background

Assessment of early childhood development programme effectiveness in South Africa is hampered by a lack of suitable measures that account for variations in cultural and socio‐economic backgrounds and can be administered by non‐professionals. This contribution reports the standardisation of the South African Early Learning Outcomes Measure (ELOM), an instrument designed for population level monitoring of the developmental status of children aged 50–69 months and for evaluation of early learning programmes.

Methods

The development of the ELOM was informed by South Africa's National Curriculum Framework from Birth to Four and its National Early Learning and Development Standards. ELOM items were drawn from reliable and valid instruments, particularly those used in Africa and other developing regions and were clustered in five domains: gross motor development, fine motor coordination and visual motor integration, emergent numeracy and mathematics, cognition and executive functioning, emergent literacy and language. The ELOM was standardised on a sample of 1,331 children aged 50–69 months, from five South African official languages and five socio‐economic strata. Item Response Theory techniques were used to establish reliability, validity, and differential item functioning.

Results

Confirmatory Factor Analysis established that ELOM domains are unidimensional and internally consistent. Items discriminate reliably between more and less able children and do not discriminate unfairly between children of the same ability from different language backgrounds. Socio‐economic gradients were evident in children's performance. South African Early Learning Development Standards (ELDS) based on standard scores were developed and set at the 60th percentile of the sample standard score distribution.

Conclusions

This research produced the first South African, age‐validated population‐level standardised instrument that can be administered relatively cheaply by trained non‐professionals. This will facilitate the assessment of the efficacy of early learning programmes in enabling children to reach ELDS prior to entering Grade R and track progress toward Sustainable Development Goal 4.2.
A reintroduction of environmental mite allergen control strategies for asthma treatment and the debate on their effectiveness
Authors: van Boven Frank E. , Arends Lidia R. , Braunstahl Gert‐Jan , van Wijk Roy Gerth
Published: January 2019

Asthma affects three hundred million people worldwide. The effectiveness of house dust mite allergen control for asthma treatment is debatable. One aspect that has been little discussed in existing meta‐analyses is the possible role of environmental strategies. Here, we reintroduce the previously defined strategies for mite allergen control and discuss their importance to the debate on clinical effectiveness. The strategy of concurrent bedroom interventions is related to the combined use of a priori defined interventions, while the strategy of exposure‐based control relates to the treatment of relevant textiles after assessing exposure. The air purification strategy aims to purify the human breathing zone of airborne allergens. In Western European patient practice, the use of these strategies differs. A post hoc study of the dominant Cochrane review by Gøtzsche and Johansen (Cochrane Database of Systematic Reviews, 2008, Art. No: CD001187) appears to indicate that a majority of the underlying trials reported on the strategy of concurrent bedroom interventions, which were mainly executed in a minimal manner. Some trials have reported on the air purification strategy and may potentially alter the debate on effectiveness. No trial has reported on the strategy of exposure‐based control. We therefore hypothesize that the absence of evidence for the effectiveness of mite allergen control for asthma treatment applies to the strategy of concurrent bedroom interventions. The evidence‐based effectiveness of the exposure‐based control strategy appears to be undetermined. The results of our post hoc reanalysis urge that future meta‐analyses of mite allergen control should a priori define the environmental strategy under study. Future trials of mite allergen control are warranted to test the exposure‐based strategy as well as the sparsely tested strategy of air purification.
Comparison of the efficiency of different enemas on patients with distal ulcerative colitis
Authors: Zhang Yujie , Chen Di , Wang Fang , Li Xiaowei , Xue Xianmin , Jiang Mingzuo , Xu Bing , Chu Yi , Wang Weijie , Wu Kaichun , Mao Ren , Shen Jun , Yang Shaoqi , Liang Jie
Published: January 2019

Objectives

Rectal application of steroids and 5‐aminosalicylic acid (5‐ASA) is associated with few side effects and has a high therapeutic efficacy in left‐sided colitis. Previous studies have shown that rectal administration of both steroids and 5‐ASA is superior to one single alone. However, some reports are still controversial. Therefore, it is necessary to investigate the treatment choice and efficacy of these different enemas in distal ulcerative colitis (UC) patients.

Materials and Methods

Questionnaire survey and a retrospective study were carried out in Chinese hospitals to investigate the efficacy of 5‐ASA or hydrocortisone/dexamethasone or their combination enema in patients with distal active UC. Dextran sodium sulphate (DSS)‐induced colitis model in mice was also utilized to evaluate the effects in vivo.

Results

The results from questionnaire survey showed that majority of physicians would prefer oral 5‐ASA with topical 5‐ASA therapy for distal UC patients. However, 43.01% of physicians would like to choose oral 5‐ASA and topical hydrocortisone/dexamethasone with or without 5‐ASA enema. A retrospective study demonstrated that 5‐ASA enema or 5‐ASA combined with hydrocortisone/dexamethasone enema therapy was superior to hydrocortisone/dexamethasone enema to decrease C‐reactive protein, erythrocyte sedimentation rate (ESR), Mayo score and induce clinical remission and clinical response. No superiority of combination therapy was further proved in DSS‐induced colitis in mice.

Conclusions

Although 43.01% of physicians would like to choose hydrocortisone/dexamethasone with or without 5‐ASA enema for the treatment of distal UC, the combination was not superior to 5‐ASA enema. Hydrocortisone/dexamethasone enema with 5‐ASA enema is not recommended for distal active UC patients.
Description and analysis of patients and outcomes following third‐time heart transplantation: An analysis of the United Network for Organ Sharing database from 1985 to 2017
Authors: Bhalla Sameer , Dubey Gaurav K. , Basu Sanjib , Kanangat Sivadasan , Dobrescu Cosmin , Nath Dilip S.
Published: January 2019

Background

Following second heart transplantation (HTx), some patients experience graft failure and require third‐time heart transplantation. Little data exist to guide decision‐making with regard to repeat retransplantation in older patients.

Methods

We performed a retrospective cohort analysis of patients receiving a third HTx, as identified in the United Network for Organ Sharing (UNOS) database from 1985 to 2017.

Results

The study cohort consisted of N = 60 patients, with an average age of 29 with a standard deviation of ±18 years. Overall survival for the cohort at 1, 5, and 10 years is 83%, 64%, and 44%, respectively. The rate of third‐time HTxs has steadily increased in all age groups. Patients older than 50 years now account for 18.3% of all third‐time HTxs. Although this group demonstrated longer average previous graft survival, after third HTx they demonstrate significantly poorer survival outcomes compared to third‐time HTx recipients younger than 21 (P = 0.05). Age over 50, BMI over 30, and diabetes were all found to be independent risk factors for decreased survival following third HTx.

Conclusions

We describe trends in patients undergoing third HTx. We highlight subsets of such recipients who exhibit decreased survival.
Cutaneous involvement as the first manifestation of T‐lymphoblastic lymphoma and review of the literature
Authors: Montes‐Torres Andrea , Llamas‐Velasco Mar , Capusan Tania M. , Aguado Beatriz , Adrados Magdalena
Published: January 2019

Lymphoblastic lymphomas (LBLs) are uncommon malignant neoplasms derived from immature T‐ or B‐lymphoid progenitor cells. Although cutaneous involvement may reach 33% in B‐LBL, only 12 cutaneous cases of T‐LBL have been published. We report the case of a 49‐year‐old woman with 2‐month history of erythematous‐violaceous plaques in the sternal region and breasts. Histopathologic examination showed a dense monomorphus infiltrate in dermis and positive immunostainings for CD3, CD99 and terminal deoxynucleotidyl transferase, thus indicating T‐LBL. Staging work‐up only revealed a mediastinal mass at diagnosis. After a 51‐month follow‐up and different treatment regimens, the patient remains alive although she has presented four relapses, all of them extramedullary.
Adaptive functioning in children with neurofibromatosis type 1: relationship to cognition, behavior, and magnetic resonance imaging
Authors: Eby Noah S , Griffith Jennifer L , Gutmann David H , Morris Stephanie M
Published: January 2019

Aim

To characterize the adaptive behavior profile of children with neurofibromatosis type 1 (NF1) and determine its relationship to neuropsychological functioning and non‐neoplastic T2‐weighted hyperintense brain lesions on brain magnetic resonance imaging (MRI).

Method

In this cross‐sectional study, we retrospectively reviewed neuropsychological reports from 104 children with NF1 (56 males, 48 females; mean age 10y 4mo; standard deviation [SD] 3y 4mo; range 3y 5mo–17y 6mo), and extracted data from a range of cognitive and behavioral measures, including the Adaptive Behavior Assessment System (ABAS). Brain MRI was retrospectively reviewed in 42 individuals.

Results

Adaptive Behavior Assessment System scores were continuously distributed and pathologically shifted by 0.79 to 1.26SD across Conceptual, Social, and Practical domains, and 46.5% of individuals had a composite score in the borderline or impaired range. Impairment in adaptive functioning was correlated with deficits in executive function (r=–9.543, p<0.001), externalizing problems (r=−0.366, p<0.001), and attention (r=−9.467, p=0.001). Cluster analysis revealed three distinct phenotypic subgroups, one of which exhibited normal cognitive ability, but impaired adaptive functioning, with persistent deficits in executive function, behavioral problems, and attention‐deficit/hyperactivity disorder symptomatology. There was no relationship between ABAS scores and the number or location of unidentified bright objects.

Interpretation

Adaptive functioning deficits are common among children with NF1 and are associated with impairment in other cognitive/behavioral domains, independent of general cognitive ability.

What this paper adds

Deficits in adaptive behavior are common in children with neurofibromatosis type 1 (NF1).

Poor adaptive functioning is associated with impairments in executive function, externalizing behaviors, and attention, regardless of cognitive ability.

The presence or location of unidentified bright objects do not predict adaptive behavior skills in children with NF1.
Utility and safety of plasma exchange in paediatric neuroimmune disorders
Authors: Eyre Michael , Hacohen Yael , Lamb Kate , Absoud Michael , Agrawal Shakti , Gadian Jonathan , Gupta Rajat , Kneen Rachel , Milford David V , Philip Sunny , Rose Katie , Smith Martin , Spinty Stefan , Wassmer Evangeline , Lim Ming , Hemingway Cheryl
Published: January 2019

Aim

Our aim was to ascertain the indications, side effects, and outcomes in children receiving therapeutic plasma exchange (TPE) for neurological disorders.

Method

Medical records were retrospectively reviewed for 58 consecutive children (age ≤16y) undergoing 67 courses ofTPEacross four tertiary centres. Patient characteristics, treatment schedules, complications, and outcomes were analysed.

Results

Median age at initiation ofTPEwas 9 years (range 1–15y). Indications included peripheral nervous system (PNS;n=18) and central nervous system (CNS;n=40) disorders. Courses comprised a median six exchanges (range 2–179) over 8 days (range 3–466). Forty‐two out of 58 (73%) children were severely disabled (bedridden) at initiation and 24 out of 58 (41%) were admitted to intensive care units. Treating clinicians’ impression of response was positive in 16 out of 18 of those withPNSdisorders versus 22 out of 40 withCNSdisorders (p=0.016). Improvements in disability (modified Rankin Scale) occurred in 13 out of 58 (22%) children by completion ofTPE(p=0.003). Complications occurred in 40 out of 67 (60%) courses, of which 16 out of 67 (24%) were line related. Potentially life‐threatening complications occurred in 2 out of 67 (3%) courses.

Interpretation

This cohort study provides safety and efficacy information for clinicians and families and a basis for future prospective studies.

What this paper adds

Disability scores for severe neuroimmune disorders remained stable or improved during therapeutic plasma exchange treatment.

Complications occurred frequently but were typically mild and correctable.
Participation‐based intervention in childhood disability: a family‐centred approach
Authors: Anaby Dana , Pozniak Kinga
Published: January 2019

This commentary is on the systematic review by Arakelyan et al. on pages 514–522 of this issue.
The 2017 Banting Memorial Lecture The diabetic lower limb – a forty year journey: from clinical observation to clinical science
Authors: Boulton Andrew J. M.
Published: January 2019

A series of clinical research projects conducted over the past 40 years, all of which were informed by clinical observation or discussions with people with diabetes and staff colleagues are described in this review. A study of necrobiosis lipoidica diabeticorum confirmed that this rare skin complication occurs predominantly in young women with Type 1 diabetes and other microvascular complications. Biopsies of necrobiotic lesions showed destruction of superficial nerve fibres by inflammatory tissue, which likely causes the sensory loss in lesions that is pathognomonic of the condition. The development of corneal confocal microscopy as a new non‐invasive surrogate marker of peripheral neuropathy in diabetes is described next and several small studies of the use of this new technique in clinical research are reported. The influence of blood glucose instability on the genesis of neuropathic pain is then explained, with results suggesting that the stability of glycaemic control may be more important than the level of control achieved. Lastly, in neuropathy, studies of gustatory sweating are discussed, including the observation that sweating in the head and neck region is more common in people with end‐stage diabetic nephropathy than in those with neuropathy. The disappearance of gustatory sweating after renal transplantation suggests a metabolic cause and for those with troublesome sweating, use of the anticholinergic, anti‐muscarinic, topical cream glycopyrrolate is confirmed in a randomized control trial. In the area of diabetic foot research, distended dorsal foot veins were observed to be a clinical sign of sympathetic autonomic neuropathy: raised venous Po2 and Doppler abnormalities of blood flow are highly suggestive of arteriovenous shunting. A series of studies of the abnormalities of pressures and loads under the neuropathic diabetic foot are described: high dynamic plantar pressures are highly predictive of subsequent ulceration in the neuropathic foot. Lastly, a number of recent studies on unsteadiness and gait abnormalities when climbing and descending stairs are described. It is hoped that the art of clinical observation survives in the highly technological 21st century.
Projected number of people with diagnosed Type 2 diabetes in Germany in 2040
Authors: Tönnies T. , Röckl S. , Hoyer A. , Heidemann C. , Baumert J. , Du Y. , Scheidt‐Nave C. , Brinks R.
Published: January 2019

Aims

To project the number of people with Type 2 diabetes in Germany between 2015 and 2040.

Methods

Based on data from 65 million insurees of the German statutory health insurance, we projected the age‐specific prevalence of diabetes using mathematical relations between prevalence, incidence rate and mortality. We compared several scenarios regarding temporal trends in the incidence and mortality rate. The projected age‐specific prevalence was applied to the projected age structure of the German population between 2015 and 2040 to calculate the number of people with Type 2 diabetes.

Results

Application of current age‐specific prevalence estimates to the projected age structure in 2040, although ignoring temporal trends in incidence and mortality, yielded an increase in the number of Type 2 diabetes cases from 6.9 million in 2015 to 8.3 million (+21%) in 2040. More realistic scenarios that account for decreasing mortality rates and different trends in the incidence rates project between 10.7 million (+54%) and 12.3 million (+77%) Type 2 diabetes cases in 2040.

Conclusions

For the first time, we projected the number of future Type 2 diabetes cases for the whole adult population in Germany. The results indicate a relative increase in the number of Type 2 diabetes cases of between 54% and 77% from 2015 to 2040. Temporal trends in the incidence rate are the main drivers of this increase. Simply applying current age‐specific prevalence to the future age structure probably underestimates the future number of Type 2 diabetes cases.
Anomalous outbreaks of an invasive defoliator and native bark beetle facilitated by warm temperatures, changes in precipitation and interspecific interactions
Authors: Ward Samuel F. , Aukema Brian H.
Published: January 2019

Biotic disturbance agents such as insects can be highly responsive to climatic change and have widespread ecological and economic impacts on forests. Quantifying the responses of introduced and native insects to climate, including how dynamics of one agent may mediate those of another, is important for forecasting disturbance and associated impacts on forest structure and function. We investigated drivers of outbreaks by larch casebearer Coleophora laricella, an invasive defoliator, and eastern larch beetle Dendroctonus simplex, a native, tree‐killing bark beetle, on tamarack Larix laricina from 2000 to in Minnesota, USA. We evaluated the utility of temporal, spatial and climatic variables in predicting the presence/absence of outbreaks of each insect in cells of rasterized aerial survey data. The role of defoliation by larch casebearer in outbreaks of eastern larch beetle was also investigated. For both species, the most important predictors of outbreak occurrence were proximity of conspecific outbreaks in space and time. For larch casebearer, outbreak occurrence was positively associated with spring precipitation and warmer growing seasons. Outbreak occurrence of eastern larch beetle was positively associated with warmer and dryer years and was more likely in cells with prior defoliation by larch casebearer. Our results demonstrate that climate can drive large scale outbreaks of introduced and non‐native disturbance agents on a single host species, and that interactions at the tree level between such agents may scale up to manifest across large temporal and spatial scales.
Rethinking long‐term vegetation dynamics: multiple glacial refugia and local expansion of a species complex
Authors: Napier Joseph D. , de Lafontaine Guillaume , Heath Katy D. , Hu Feng Sheng
Published: January 2019

Evidence is accumulating that some arcto‐boreal plant taxa persisted through the last glacial maximum (LGM) in Alaska and adjacent Canada. However, the spatial patterns of glacial persistence and associated postglacial colonization remain largely unknown. In this study, we investigated the LGM refugia of an alder (Alnus) species complex (n = 3 taxa) and assess the spatiotemporal dynamics of Alnus in this vast region. Specifically, we conducted high‐throughput DNA sequencing (ddRADseq) on Alnus foliar samples collected from a dense population network to investigate patterns of genetic structure and infer the presence of glacial lineages. Species distribution modeling (SDM) was used to investigate the probability and possible locations of glacial persistence. These analyses were integrated and then compared with fossil pollen data to identify the locations of refugial populations and spatial patterns of postglacial colonization. Our genetic analyses revealed two glacial lineages with separate geographic origins for each Alnus taxon, suggesting that the genus persisted in multiple LGM refugia. Non‐overlapping hindcast distributions based on SDMs further support the presence of multiple, spatially distinct refugia. These ddRADseq and SDM results, in conjunction with reassessment of fossil pollen records, suggest that Alnus expanded from several population nuclei that existed during the LGM and coalesced during the Holocene to form its present range. These results challenge the unidirectional model for postglacial vegetation expansion, implying that climate buffering associated with landscape heterogeneity and adaptation to millennial‐scale environmental variability played important roles in driving late‐Quaternary population dynamics.
Values related to professionalism in dental education at the University of Chile: Student and faculty perceptions
Authors: Alcota Marcela , Manríquez José M. , Cornejo‐Ovalle Marco , Salinas Juan C. , Catano Victor M. , Ruiz de Gauna Pilar , González Fermín E.
Published: January 2019

Objective

It is recognised that professionalism should play a central role in dental education. However, its implementation into the curricula of dental schools is still limited. Our objective was to identify the main values related to professionalism based on the perceptions of students and faculty members from the Faculty of Dentistry, University of Chile.

Methods

A Dental Values Survey was validated and culturally adapted in order to guarantee the greatest possible internal validity. The adapted survey was administered to students and faculty members (416 and 225, respectively). The final survey contained 64 items rated on a Likert scale of 1‐5. Each item was categorised according to five dimensions: Altruism, Consciousness, Personal Satisfaction, Quality of Life and Professional Status. The values were compared between faculty and students and among students at different courses. A values scale was constructed by selecting the five items with the highest average score for each dimension.

Results

Survey respondents composed 34.32% of the universe, of which 50.46% were faculty and 49.54% were students. Values associated with Altruism, Consciousness and Professional Status, were the highest rated by students and faculty. Values associated with Personal Satisfaction and Quality of Life received the lowest scores for both groups.

Conclusions

To provide the best possible attention to patients (Consciousness), and that patients have access to affordable dental care (Altruism), are the values at the top of our scale. On the other hand, to maintain financial stability and to be well paid (Quality of Life) were the less considered.
Students’ self‐assessment of competencies in the phantom course of operative dentistry
Authors: Ciardo Antonio , Möltner Andreas , Rüttermann Stefan , Gerhardt‐Szép Susanne
Published: January 2019

Introduction

The aim was to assess the competencies of undergraduate students in their roles of dental expert, scholar, communicator, collaborator, health advocate, manager and professional.

Materials and Methods

For this retrospective, pseudonymised observational study (pre‐/post‐testing), students in two cohorts in their first clinical semester in operative dentistry were asked to judge their competencies (1 = very good to 6 = insufficient) with a learning objective catalogue designed at the Goethe University Frankfurt (modelled after the National Competency‐Based Learning Objective Catalogue Dentistry), at the beginning and end of their phantom course. In order to relate the students’ subjective competency judgements to objective evidence of their skills, at the end of the semester their marks from the summative Objective Structured Practical Examination (OSPE) were compared with the subjective judgement of their exam performance before the final results were known.

Results

The reliability of the evaluation sheet was evaluated with Cronbach's alpha 0.98. The students judged their competencies as “sufficient” (4.23 ± 0.51) at the beginning and “satisfactory” (2.82 ± 0.43) at the end. A significant improvement in competencies was observed within all roles. The students’ subjective judgement of the exam results (3.66 ± 0.62) was significantly correlated with the actual marks (3.69 ± 0.83) in the OSPE at 0.3547 (P = 0.0015).

Conclusion

The evaluation instrument showed excellent reliability. The students judged that their competencies significantly increased during the semester. The triangulation with the actual marks in the context of an OSPE demonstrated a significant correlation with the students’ exam judgements.
Bleeding assessment in female patients with the Hermansky‐Pudlak syndrome—A case series
Authors: Rivera‐Concepción Joel , Acevedo‐Canabal Jorge , Burés Antonio , Vargas Gustavo , Cadilla Carmen , Izquierdo Natalio J.
Published: January 2019

Introduction

The Hermansky–Pudlak syndrome (HPS) is an autosomal recessive rare disorder characterized by oculocutaneous albinism, bleeding diathesis, chronic granulomatous colitis and/or pulmonary fibrosis. HPS is the most common single‐gene disorder in Puerto Rico with a prevalence of 1:1,800 in the Northwest of the island. Risk of menorrhagia and post‐partum hemorrhage (PPH) in cases of women with HPS have been described in the medical literature, but data regarding comprehensive description of bleeding diathesis remains lacking. For this reason, we aim to identify bleeding events using the International Society on Thrombosis and Hemostasis Bleeding Assessment Tool (ISTH‐BAT), a standardized quantitative tool that translates the range of severity of bleeding symptoms into a cumulative bleeding score (BS).

Objective

To use the ISTH‐BAT in HPS in order to describe bleeding symptoms and allow for comparison with other inherited bleeding disorders.

Methods

Puerto Rican females and adult participants with HPS based on genetic linkage were enrolled. The ISTH‐BAT was administered and results were identified using descriptive statistical analysis.

Results

Questionnaire answers of twelve women with HPS‐1 and HPS‐3 were evaluated. Participants’ mean BS was HPS‐1 (11.4) and HPS‐3 (8.0) Participants with HPS‐1 and HPS‐3 reported abnormal bleeding events that presented during dental extractions, menorrhagia, surgical interventions, gastrointestinal, oral cavity and post‐partum. Patients with history of pulmonary fibrosis (PF) showed a higher mean bleeding score than those who had no history of PF.

Conclusions

Female patients with HPS type 1 and 3 experienced abnormal bleeding events according to the ISTH‐BAT bleeding score. Bleeding medications were inconsistently used and varied independently from healthcare professionals. The benefits of this study were to understand the history of bleeding complications in patients with HPS type 1 and 3 using an international validated system. The results of this study will help design strategies to improve the care we provide to this population.
Increasing propensity to mind‐wander by transcranial direct current stimulation? A registered report
Authors: Boayue Nya Mehnwolo , Csifcsák Gábor , Aslaksen Per , Turi Zsolt , Antal Andrea , Groot Josephine , Hawkins Guy E. , Forstmann Birte , Opitz Alexander , Thielscher Axel , Mittner Matthias
Published: January 2019

Transcranial direct current stimulation (tDCS) has been proposed to be able to modulate different cognitive functions. However, recent meta‐analyses conclude that its efficacy is still in question. Recently, an increase in subjects’ propensity to mind‐wander has been reported as a consequence of anodal stimulation of the left dorsolateral prefrontal cortex (Axelrod et al., Proceedings of the National Academy of Sciences of the United States of America, 112, 2015). In addition, an independent group found a decrease in mind wandering after cathodal stimulation of the same region. These findings seem to indicate that high‐level cognitive processes such as mind wandering can reliably be influenced by non‐invasive brain stimulation. However, these previous studies used low sample sizes and are as such subject to concerns regarding the replicability of their findings. In this registered report, we implement a high‐powered replication of Axelrod et al. (2015) finding that mind‐wandering propensity can be increased by anodal tDCS. We used Bayesian statistics and a preregistered sequential‐sampling design resulting in a total sample size of N = 192 participants collected across three different laboratories. Our findings show support against a stimulation effect on self‐reported mind‐wandering scores. The effect was small, in the opposite direction as predicted and not reliably different from zero. Using a Bayes Factor specifically designed to test for replication success, we found strong evidence against a successful replication of the original study. Finally, even when combining data from both the original and replication studies, we could not find evidence for an effect of anodal stimulation. Our results underline the importance of designing studies with sufficient power to detect evidence for or against behavioural effects of non‐invasive brain stimulation techniques, preferentially using robust Bayesian statistics in preregistered reports.
Immunophenotyping of cerebrospinal fluid cells in ischaemic stroke
Authors: Schulte‐Mecklenbeck A. , Kleffner I. , Beuker C. , Wirth T. , Hartwig M. , Schmidt‐Pogoda A. , Klotz L. , Hansen W. , Wiendl H. , Meuth S. G. , Gross C. C. , Minnerup J.
Published: January 2019

Background and purpose

Post‐ischaemic immune cell invasion into the brain is well characterized in animal stroke models and contributes to neuronal damage. Therefore, it represents a promising therapeutic target. Cerebrospinal fluid (CSF) is easily accessible and may reflect cellular events within the parenchyma. However, comprehensive studies on CSF immune cells in patients with stroke are lacking.

Methods

In a retrospective cohort study, we performed extensive immune‐cell profiling in CSF and peripheral blood of patients with acute ischaemic stroke and healthy controls. In patients with stroke, infarct size was quantified on follow‐up imaging.

Results

Overall, 90 patients with ischaemic stroke and 22 controls were included in our study. After stroke, the total protein was increased (537.3 vs. 353.2 mg/L, P = 0.008) and the mean total white cell count was slightly but non‐significantly elevated (1.76 vs. 0.50 cells/μL, P = 0.059). Proportions of CSF lymphocytes, monocytes and granulocytes and their respective subsets did not differ between patients with stroke and controls. In addition, there were no associations between proportions of major leukocyte subsets in CSF and the time from symptom onset to CSF sampling, infarct size or infarct localization.

Conclusions

Ischaemic stroke induces only a very slight increase of CSF immune cells without changes in the composition of immune cell subsets, thus indicating that parenchymal inflammation is not sufficiently reflected in the CSF. Our findings suggest that CSF is not a major invasion route for immune cells and that CSF cell analyses are not suitable as biomarkers to guide future immune therapies for stroke.
Long‐term efficacy of opicapone in fluctuating Parkinson's disease patients: a pooled analysis of data from two phase 3 clinical trials and their open‐label extensions
Authors: Ferreira J. J. , Lees A. , Rocha J.‐F. , Poewe W. , Rascol O. , Soares‐da‐Silva P.
Published: January 2019

Background and purpose

The aim was to evaluate the efficacy of the catechol‐O‐methyltransferase inhibitor opicapone (25 and 50 mg) as adjunct therapy to levodopa in a pooled population of Parkinson's disease patients who participated in the pivotal double‐blind trials of opicapone and their 1‐year open‐label extensions.

Methods

Data (placebo, opicapone 25 mg and opicapone 50 mg) from the BIPARK‐1 and BIPARK‐2 double‐blind and open‐label studies were combined. The studies had similar designs, eligibility criteria and assessment methods. The primary efficacy variable in both double‐blind studies was the change from baseline in absolute OFF time based on patient diaries.

Results

Double‐blind treatment with opicapone (25 and 50 mg) significantly reduced absolute daily OFF time from a baseline of 6.1–6.6 h. The mean (and 95% confidence interval) treatment effect versus placebo was −35.1 (−62.1, −8.2) min (P = 0.0106) for the 25 mg dose and −58.1 (−84.5, −31.7) min (P < 0.0001) for the 50 mg dose. Reductions in OFF time were mirrored by significant increases in ON time without troublesome dyskinesia (P < 0.05 and P < 0.0001 for the 25 and 50 mg doses, respectively). No significant differences were observed for ON time with troublesome dyskinesia. Patient diary results from the open‐label phase indicated a maintenance of effect for patients previously treated with opicapone 50 mg. The group previously treated with the 25 mg dose benefitted with further optimization of therapy during the open‐label phase, whilst switching from placebo to opicapone led to significant reductions in OFF time and increased ON time.

Conclusions

Over at least 1 year of open‐label therapy, opicapone consistently reduced OFF time and increased ON time without increasing the frequency of troublesome dyskinesia.
Research trends in equine movement analysis, future opportunities and potential barriers in the digital age: A scoping review from 1978 to 2018
Authors: Egan S. , Brama P. , McGrath D.
Published: January 2019

Background

Since Muybridge's ‘horse in motion’, researchers in the equine movement analysis field continue to improve objective analysis and performance monitoring while ensuring representative data capture. However, subjective evaluation remains the primary method of equine gait analysis in the applied setting, despite evidence highlighting the unreliability of this approach.

Objectives

To map research trends, limitations and opportunities across the diverse equine gait analysis literature.

Study design

Joanna Briggs Institute and Cochrane systematic scoping review.

Methods

Search terms were chosen based on the ‘PICO’ framework and included keywords such as: Equine, Gait, Kinematics and Analysis. Studies were excluded based on predetermined criteria by two independent researchers. Data were extracted from 510 articles from 1978 to 2018.

Results

Insights derived from movement analysis appear to be driven by tool availability. Observational research (42.9%) was the most popular study design. Use of wearable technology as a primary research tool is established within the field, accounting for 13.5% of studies. Analysis of limitations identified 17.8% of studies citing challenges to the transferability of research results. Restricted sample size appears to be an underlying contributor to many of the limitations identified. In terms of research opportunities, advances in intervention studies were called for (10.4% of studies) in the following three areas; clinical, rehabilitative exercise and performance/training.

Main limitations

This review was confined to research in the English language.

Conclusions

Standardised research reporting may alleviate sample size issues by facilitating data pooling, database creation and meta‐analyses. Large holistic data collections and application frameworks based on wearable technologies are not reflected in the current equine gait analysis literature and thus represent an interesting opportunity for this field. Progress and lessons learned from the human field of movement analysis can be useful in supporting this potential development.
Replicative senescence of human dermal fibroblasts affects structural and functional aspects of the Golgi apparatus
Authors: Despres Julie , Ramdani Yasmina , di Giovanni Marine , Bénard Magalie , Zahid Abderrakib , Montero‐Hadjadje Maité , Yvergnaux Florent , Saguet Thibaut , Driouich Azeddine , Follet‐Gueye Marie‐Laure
Published: January 2019

It is well recognized that the world population is ageing rapidly. Therefore, it is important to understand ageing processes at the cellular and molecular levels to predict the onset of age‐related diseases and prevent them. Recent research has focused on the identification of ageing biomarkers, including those associated with the properties of the Golgi apparatus. In this context, Golgi‐mediated glycosylation of proteins has been well characterized. Additionally, other studies show that the secretion of many compounds, including pro‐inflammatory cytokines and extracellular matrix–degrading enzymes, is modified during ageing, resulting in physical and functional skin degradation. Since the Golgi apparatus is a central organelle of the secretory pathway, we investigated its structural organization in senescent primary human dermal fibroblasts using confocal and electron microscopy. In addition, we monitored the expression of Golgi‐related genes in the same cells. Our data showed a marked alteration in the Golgi morphology during replicative senescence. In contrast to its small and compact structure in non‐senescent cells, the Golgi apparatus exhibited a large and expanded morphology in senescent fibroblasts. Our data also demonstrated that the expression of many genes related to Golgi structural integrity and function was significantly modified in senescent cells, suggesting a relationship between Golgi apparatus function and ageing.
BARGAINING WITH OPTIMISM: IDENTIFICATION AND ESTIMATION OF A MODEL OF MEDICAL MALPRACTICE LITIGATION
Authors: Merlo Antonio , Tang Xun
Published: January 2019

We study a model of bargaining with optimism where players have heterogeneous beliefs about the final resolution. Beliefs and bargaining surplus are identified from the settlement probability and the distribution of accepted transfers. Using data from medical malpractice lawsuits in Florida, we estimate doctor and patient beliefs and the distribution of potential compensation. We find that patients are more optimistic and doctors more pessimistic when the severity of injury is higher, and the joint optimism diminishes as severity increases. We quantify the increase in settlement probability and the reduction in accepted settlement offers under counterfactual caps on the total compensation.
Measuring consumer understanding and perception of eco‐labelling: Item selection and scale validation
Authors: Taufique Khan Md Raziuddin , Polonsky Michael Jay , Vocino Andrea , Siwar Chamhuri
Published: January 2019

The use of “eco‐labels” by businesses, both as communication and positioning strategies, is increasing. For these eco‐labels to be effective, however, it requires consumers to understand and value what eco‐labels are communicating. Research suggests that there are many factors impeding consumers’ understanding of eco‐labels. Most of these studies have focused on single dimensions of a complex phenomenon and in doing so they have ignored the multifaceted aspects of the construct, suggesting that a more integrated representation is warranted. The work herein undertakes four studies to empirically test and validate a multidimensional measure that can be used to assess how consumers psychometrically understand and perceive eco‐labelling. The four‐study process involves qualitative interviews to extend the issues identified within the literature, followed by two studies using principal component analysis, confirmatory factor analysis and structural equation modelling analysis, each using separate samples, to test the reliability and validity of the proposed eight‐dimensional 27‐item ECOLSCALE. Another study is then undertaken to assess the nomological validity of the scale regarding to consumers’ environmental orientation. The ECOLSCALE developed in this work can be used to assist marketers, policy makers and researchers to evaluate the impact of eco‐labelling schemes on consumers’ understanding of eco‐labels, thereby enabling consumers to make more environmentally informed decisions.
Comparison of variation in frequency for SNPs associated with asthma or liver disease between Estonia, HapMap populations and the 1000 genome project populations
Authors: Reisberg Sulev , Galwey Nicholas , Avillach Paul , Sahlqvist Anna‐Stina , Kolberg Liis , Mägi Reedik , Esko Tõnu , Vilo Jaak , James Glen
Published: January 2019

Allele‐specific analyses to understand frequency differences across populations, particularly populations not well studied, are important to help identify variants that may have a functional effect on disease mechanisms and phenotypic predisposition, facilitating new Genome‐Wide Association Studies (GWAS). We aimed to compare the allele frequency of 11 asthma‐associated and 16 liver disease‐associated single nucleotide polymorphisms (SNPs) between the Estonian, HapMap and 1000 genome project populations. When comparing EGCUT with HapMap populations, the largest difference in allele frequencies was observed with the Maasai population in Kinyawa, Kenya, with 12 SNP variants reporting statistical significance. Similarly, when comparing EGCUT with 1000 genomes project populations, the largest difference in allele frequencies was observed with pooled African populations with 22 SNP variants reporting statistical significance. For 11 asthma‐associated and 16 liver disease‐associated SNPs, Estonians are genetically similar to other European populations but significantly different from African populations. Understanding differences in genetic architecture between ethnic populations is important to facilitate new GWAS targeted at underserved ethnic groups to enable novel genetic findings to aid the development of new therapies to reduce morbidity and mortality.
Are children with clinical obesity at increased risk of inpatient hospital admissions? An analysis using linked electronic health records in the UK millennium cohort study
Authors: Griffiths Lucy J. , Cortina‐Borja Mario , Bandyopadhyay Amrita , Tingay Karen , De Stavola Bianca L. , Bedford Helen , Akbari Ashley , Firman Nicola , Lyons Ronan A. , Dezateux Carol
Published: January 2019

Background

Few studies have examined health service utilization of children with overweight or obesity by using linked electronic health records (EHRs).

Objective/Methods

We analysed EHRs from 3269 children (1678 boys; 51.3% [weighted]) participating in the Millennium Cohort Study, living in Wales or Scotland at age seven whose parents consented to record linkage. We used height and weight measurements at age five to categorize children as obese (>98th centile) or overweight (>91st centile) (UK1990 clinical reference standards) and linked to hospital admissions, up to age 14 years, in the Patient Episode Database for Wales and Scottish Morbidity Records. Negative binomial regression models compared rates of inpatient admissions by weight status at age five.

Results

At age five, 11.5% and 6.7% of children were overweight or obese, respectively; 1221 (38%) children were subsequently admitted to hospital at least once. Admissions were not increased among children with overweight or obesity (adjusted rate ratio [RR], 95% confidence interval [CI]: 0.87, 0.68‐1.10 and 1.16, 0.87‐1.54, respectively).

Conclusions

In this nationally representative cohort of children in Wales and Scotland, those with overweight or obesity at entry to primary school did not have increased rates of hospital admissions in later childhood and early adolescence.
Sleep and body mass index in infancy and early childhood (6‐36 mo): a longitudinal study
Authors: Wang Lu , Jansen Wilma , Boere‐Boonekamp Magda M. , Vlasblom Eline , L'Hoir Monique P. , Beltman Maaike , van Grieken Amy , Raat Hein
Published: January 2019

Background

Relatively, few longitudinal studies have evaluated the association between sleep and body mass index (BMI) among younger children. In addition, few studies have evaluated the bidirectional longitudinal association between sleep duration and child BMI.

Objective

The objective of the study is to determine in children aged 6 to 36 months (1) the cross‐sectional association of sleep duration and sleep problems with child BMI z score, (2) whether sleep duration predicts changes in child BMI z score, and (3) and whether BMI z score can predict changes in child sleep duration.

Methods

This study used longitudinal data from the BeeBOFT study (N = 2308). Child sleep duration and sleep problems (indicated by night awakenings and sleep‐onset latency) were parent reported, and child BMI was measured using a standardized protocol by trained healthcare professionals at approximately 6, 14, and 36 months of age. Linear mixed models and linear regression models were applied to assess the cross‐sectional and bidirectional longitudinal associations between sleep and BMI z scores.

Results

Cross sectionally, shorter sleep duration was associated with higher BMI z scores at 14 (β = −0.034, P < 0.05) and 36 months (β = −0.045, P < 0.05). Sleep duration at 6 or 14 months did not predict BMI z score at either 14 or 36 months. Higher BMI z scores at 6 months predicted shorter sleep duration (hours) at 14 months (β = −0.129, P < 0.001). No association was found between sleep problems and child BMI z scores.

Conclusions

Cross‐sectional associations between shorter sleep duration and higher BMI z score emerged in early childhood (age 14 and 36 mo). Higher BMI z scores may precede shorter sleep duration but not vice versa.
Secure attachment predicts lower body mass index in young children with histories of child protective services involvement
Authors: Bernard Kristin , Frost Allison , Jelinek Caitlin , Dozier Mary
Published: January 2019

Background

Children who experience early adversity are at risk for obesity; secure attachment may be a protective factor as it has been linked to reduced obesity risk.

Objective

To evaluate whether (1) participation in a parenting intervention and (2) secure attachment were associated with body mass index (BMI) among young children with histories of child protective services (CPS) involvement.

Methods

A total of 105 parent‐child dyads referred following CPS involvement were randomly assigned to receive Attachment and Biobehavioral Catch‐up (ABC), which was designed to increase parental sensitivity, or a control intervention. Attachment security was assessed during infancy, and BMI was assessed at annual follow‐up visits until children were 4 years old.

Results

Children in the ABC group were more likely to have secure attachments (52%) than children in the control intervention group (32%). Although the ABC intervention did not have a direct effect on children's BMI, secure attachment was associated with a steeper decline in BMI from age 2 to age 4, with secure children showing significantly lower BMI (M = 15.4, SD = 2.08; 16.6% overweight/obese) than insecure children (M = 17.6, SD = 3.81; 35.7% overweight/obese) at age 4.

Conclusions

Secure attachment was associated with reduced BMI among CPS‐referred children; thus, secure attachment may be a novel target of early obesity prevention efforts.