bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of lymph node dissection in the management of renal cell carcinoma: a systematic review and meta‐analysis
Authors: Bhindi Bimal , Wallis Christopher J. D. , Boorjian Stephen A. , Thompson R. Houston , Farrell Ann , Kim Simon P. , Karam Jose A. , Capitanio Umberto , Golijanin Dragan , Leibovich Bradley C. , Gershman Boris
Published: January 2018

Our objective was to evaluate the role of retroperitoneal lymph node dissection (LND) in non‐metastatic (M0) and metastatic (M1) renal cell carcinoma (RCC). We searched Medline, EMBASE, Web of Science and Scopus from database inception to 29 August 2017 for studies of patients who underwent partial or radical nephrectomy for M0 or M1 RCC. Two investigators independently selected studies for inclusion. Risk of bias was assessed using the Newcastle–Ottawa scale, Cochrane Collaboration tool and National Heart, Lung and Blood Institute Quality Assessment Tool. Random effects meta‐analysis was performed for all‐cause‐mortality. The GRADE approach was used to characterize quality of evidence. A total of 51 unique studies were included in the qualitative systematic review. Risk of bias was low in 41/51 (80%) studies. LND was not associated with all‐cause mortality in either M0 (hazard ratio [HR] 1.02, 95% confidence interval [CI] 0.92–1.12; I2 = 0%; four studies), M1 (HR 1.04, 95% CI 0.83–1.29; I2 = 0%; two studies), or pooled M0 and M1 settings (HR 1.00, 95% CI 0.92–1.09; I2 = 0%; seven studies), with no statistically significant differences according to M stage subgroups (P = 0.50). In the three studies that examined M0 subgroups with a high risk of nodal metastasis, LND was not associated with improved oncological outcomes. Studies on the association of extent of LND with survival reported inconsistent results. Meanwhile, a small proportion of patients with pN1M0 disease demonstrate durable long‐term oncological control after surgery, with 10‐year cancer‐specific survival of 21–31%. Nodal involvement is independently associated with adverse prognosis in both M0 and M1 settings. GRADE quality of evidence was moderate or low for the outcomes examined. Although LND yields independent prognostic information, the existing literature does not support a therapeutic benefit to LND in either M0 or M1 RCC. High‐risk M0 patient groups warrant further study, as a subset of patients with isolated nodal metastases experience long‐term survival after surgical resection.
New perspectives on the role of melatonin in human sleep, circadian rhythms and their regulation
Authors: Zisapel Nava
Published: January 2018

In mammals, a central circadian clock, located in the suprachiasmatic nuclei (SCN) of the hypothalamus, tunes the innate circadian physiological rhythms to the ambient 24 h light–dark cycle to invigorate and optimize the internal temporal order. The SCN‐activated, light‐inhibited production of melatonin conveys the message of darkness to the clock and induces night‐state physiological functions, for example, sleep/wake blood pressure and metabolism. Clinically meaningful effects of melatonin treatment have been demonstrated in placebo‐controlled trials in humans, particularly in disorders associated with diminished or misaligned melatonin rhythms, for example, circadian rhythm‐related sleep disorders, jet lag and shift work, insomnia in children with neurodevelopmental disorders, poor (non‐restorative) sleep quality, non‐dipping nocturnal blood pressure (nocturnal hypertension) and Alzheimer's disease (AD). The diminished production of melatonin at the very early stages of AD, the role of melatonin in the restorative value of sleep (perceived sleep quality) and its sleep‐anticipating effects resulting in attenuated activation of certain brain networks are gaining a new perspective as the role of poor sleep quality in the build‐up of β amyloid, particularly in the precuneus, is unravelled. As a result of the recently discovered relationship between circadian clock, sleep and neurodegeneration, new prospects of using melatonin for early intervention, to promote healthy physical and mental ageing, are of prime interest in view of the emerging link to the aetiology of Alzheimer's disease.

Linked Articles

This article is part of a themed section on Recent Developments in Research of Melatonin and its Potential Therapeutic Applications. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.16/issuetoc
Gaze Following Is Not Dependent on Ostensive Cues: A Critical Test of Natural Pedagogy
Authors: Gredebäck Gustaf , Astor Kim , Fawcett Christine
Published: January 2018

The theory of natural pedagogy stipulates that infants follow gaze because they are sensitive to the communicative intent of others. According to this theory, gaze following should be present if, and only if, accompanied by at least one of a set of specific ostensive cues. The current article demonstrates gaze following in a range of contexts, both with and without expressions of communicative intent in a between‐subjects design with a large sample of 6‐month‐old infants (n = 94). Thus, conceptually replicating prior results from Szufnarowska et al. (2014) and falsifying a central pillar of the natural pedagogy theory. The results suggest that there are opportunities to learn from others’ gaze independently of their displayed communicative intent.
Safety of extraperitoneal rectal resection and ileorectal or colorectal anastomosis without loop ileostomy in patients with peritoneal metastases treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy
Authors: Brandl A. , Raue W. , Aigner F. , Arroyave M. C. , Pratschke J. , Rau B.
Published: January 2018

Aim

Extraperitoneal rectal resection combined with complete peritonectomy of the pelvis in patients with peritoneal metastases is associated with a high rate of morbidity and mortality due to anastomotic leakage (AL). Therefore, many centres tend to perform loop ileostomy to reduce the clinical impact of AL. The aim of this study was to analyse the need for protective stoma creation in this patient group to avoid major complications and mortality in the case of AL.

Method

We analysed 53 patients who underwent extraperitoneal rectal resection from 409 consecutive patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) at our department between January 1997 and December 2016.

Results

The mean age of the patients was 56.7 (SD 12.2) years and the mean Peritoneal Cancer Index was 24.6 (SD 12.0). Complete cytoreduction was achieved in 33 patients (62.3%). Six patients received an ileostomy or a colostomy, five of six with permanent intention. One patient (2.1%) developed AL postoperatively. Overall, 21 patients (39.6%) developed surgical complications, while 41 (77.3%) developed medical complications. The mortality rate was 7.5% (n = 4). In total, 26 patients (49.1%) developed Clavien–Dindo Grade III/IV complications.

Conclusions

These results demonstrate the safety of colorectal anastomosis in combination with HIPEC in the absence of loop ileostomy. Loop ileostomy may be omitted for patients with low risk for AL in experienced centres with adequate postoperative care, possibilities for postoperative assessment and radiological intervention to avoid stoma‐related complications and increase the quality of life of patients with peritoneal metastases.
Isolation‐based anomaly detection using nearest‐neighbor ensembles
Authors: Bandaragoda Tharindu R. , Ting Kai Ming , Albrecht David , Liu Fei Tony , Zhu Ye , Wells Jonathan R.
Published: January 2018

The first successful isolation‐based anomaly detector, ie, iForest, uses trees as a means to perform isolation. Although it has been shown to have advantages over existing anomaly detectors, we have identified 4 weaknesses, ie, its inability to detect local anomalies, anomalies with a high percentage of irrelevant attributes, anomalies that are masked by axis‐parallel clusters, and anomalies in multimodal data sets.

To overcome these weaknesses, this paper shows that an alternative isolation mechanism is required and thus presents iNNE or isolation using Nearest Neighbor Ensemble.

Although relying on nearest neighbors, iNNE runs significantly faster than the existing nearest neighbor–based methods such as the local outlier factor, especially in data sets having thousands of dimensions or millions of instances. This is because the proposed method has linear time complexity and constant space complexity.
Automated classification of content components in technical communication
Authors: Oevermann Jan , Ziegler Wolfgang
Published: January 2018

Automated classification is usually not adjusted to specialized domains due to a lack of suitable data collections and insufficient characterization of the domain‐specific content and its effect on the classification process. This work describes an approach for the automated multiclass classification of content components used in technical communication based on a vector space model. We show that differences in the form and substance of content components require an adaption of document‐based classification methods and validate our assumptions with multiple real‐world data sets in 2 languages. As a result, we propose general adaptions on feature selection and token weighting, as well as new ideas for the measurement of classifier confidence and the semantic weighting of XML‐based training data. We introduce several potential applications of our method and provide prototypical implementation. Our contribution beyond the state of the art is a dedicated procedure model for the automated classification of content components in technical communication, which outperforms current document‐centered or domain‐agnostic approaches.
Dominance of free wall radial motion in global right ventricular function of heart transplant recipients
Authors: Lakatos Bálint Károly , Tokodi Márton , Assabiny Alexandra , Tősér Zoltán , Kosztin Annamária , Doronina Alexandra , Rácz Kristóf , Koritsánszky Kinga Bianka , Berzsenyi Viktor , Németh Endre , Sax Balázs , Kovács Attila , Merkely Béla
Published: January 2018

Assessment of right ventricular (RV) function using conventional echocardiography might be inadequate as the radial motion of the RV free wall is often neglected. Our aim was to quantify the longitudinal and the radial components of RV function using three‐dimensional (3D) echocardiography in heart transplant (HTX) recipients. Fifty‐one HTX patients in stable cardiovascular condition without history of relevant rejection episode or chronic allograft vasculopathy and 30 healthy volunteers were enrolled. RV end‐diastolic (EDV) volume and total ejection fraction (TEF) were measured by 3D echocardiography. Furthermore, we quantified longitudinal (LEF) and radial ejection fraction (REF) by decomposing the motion of the RV using the ReVISION method. RV EDV did not differ between groups (HTX vs control; 96 ± 27 vs 97 ± 2 mL). In HTX patients, TEF was lower, however, tricuspid annular plane systolic excursion (TAPSE) decreased to a greater extent (TEF: 47 ± 7 vs 54 ± 4% [−13%], TAPSE: 11 ± 5 vs 21 ± 4 mm [−48%], P < .0001). In HTX patients, REF/TEF ratio was significantly higher compared to LEF/TEF (REF/TEF vs LEF/TEF: 0.58 ± 0.10 vs 0.27 ± 0.08, P < .0001), while in controls the REF/TEF and LEF/TEF ratio was similar (0.45 ± 0.07 vs 0.47 ± 0.07). Current results confirm the superiority of radial motion in determining RV function in HTX patients. Parameters incorporating the radial motion are recommended to assess RV function in HTX recipients.
De novo donor‐specific antibody following BK nephropathy: The incidence and association with antibody‐mediated rejection
Authors: Cheungpasitporn Wisit , Kremers Walter K. , Lorenz Elizabeth , Amer Hatem , Cosio Fernando G. , Stegall Mark D. , Gandhi Manish J. , Schinstock Carrie A.
Published: January 2018

Background and objectives

The risk of de novo donor‐specific antibody (dnDSA) development following BK viremia (BKV) or nephropathy (BKN) after kidney transplant remains unclear. We aimed to evaluate the relationships among dnDSA, BKV (BK blood PCR > 15 000 copies), BKN, antibody‐mediated rejection (AMR), and allograft loss.

Patients and methods

We performed a retrospective cohort study of 904 solitary kidney transplant recipients transplanted between 10/2007 and 5/2014. Cox proportional hazards regression with time‐dependent covariates were used to assess the relationships among BKN, isolated BKV, dnDSA, and the subsequent risk of AMR and allograft loss.

Results

In multivariate analysis, we observed that BKN, but not BKV was a risk factor for dnDSA (HR, 3.18, P = .008). Of the patients with BK nephropathy, 14.0% (6/43) developed dnDSA, which occurred within 14 months of BK diagnosis. DnDSA in this setting remains a risk factor for subsequent AMR (HR 4.75, P = .0001) and allograft loss (HR 2.63, P = .018).

Conclusions

BKN is an independent risk factor for development of dnDSA. Improved understanding of the characteristics of patients with BKN who are at highest risk for development of dnDSA would be valuable to customize immunosuppression reduction in this population.
Economic evaluation and cost of interventions for cerebral palsy: a systematic review
Authors: Shih Sophy T F , Tonmukayakul Utsana , Imms Christine , Reddihough Dinah , Graham H Kerr , Cox Liz , Carter Rob
Published: January 2018

Aim

Economic appraisal can help guide policy‐making for purchasing decisions, and treatment and management algorithms for health interventions. We conducted a systematic review of economic studies in cerebral palsy (CP) to inform future research.

Method

Economic studies published since 1970 were identified from seven databases. Two reviewers independently screened abstracts and extracted data following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Any discrepancies were resolved by discussion.

Results

Of 980 identified references, 115 were included for full‐text assessment. Thirteen articles met standard criteria for a full economic evaluation, two as partial economic evaluations, and 18 as cost studies. Six were full economic evaluations alongside clinical studies or randomized controlled trials, whereas seven involved modelling simulations. The economic case for administration of magnesium sulfate for imminent preterm birth is compelling, achieving both health gain and cost savings. Current literature suggests intrathecal baclofen therapy and botulinum toxin injection are cost‐effective, but stronger evidence for long‐term effects is needed. Lifestyle and web‐based interventions are inexpensive, but broader measurement of outcomes is required.

Interpretation

Prevention ofCPwould avoid significant economic burden. Some treatments and interventions have been shown to be cost‐effective, although stronger evidence of clinical effectiveness is needed.

What this paper adds

Cost‐effectiveness evidence shows prevention is the most significant strategy.

Some treatments are cost‐effective, but stronger evidence for long‐term effectiveness is required.

Comparison of treatment costs is challenging owing to variations in methodologies and varying clinical indications.
Demographic and modifiable factors associated with knee contracture in children with cerebral palsy
Authors: Cloodt Erika , Rosenblad Andreas , Rodby‐Bousquet Elisabet
Published: January 2018

Aim

To identify the prevalence of knee contracture and its association with gross motor function, age, sex, spasticity, and muscle length in children with cerebral palsy (CP).

Method

Cross‐sectional data for passive knee extension were analysed in 3 045 children with CP (1 756 males, 1 289 females; mean age 8y 1mo [SD 3.84]). CP was classified using the Gross Motor Function Classification System (GMFCS) levels I (n=1 330), II (n=508), III (n=280), IV (n=449), and V (n=478). Pearson's χ2 test and multiple binary logistic regression were applied to analyse the relationships between knee contracture and GMFCS level, sex, age, spasticity, hamstring length, and gastrocnemius length.

Results

Knee contracture greater than or equal to 5 degrees occurred in 685 children (22%). The prevalence of knee contracture was higher in older children and in those with higher GMFCS levels. Odds ratios (ORs) for knee contracture were significantly higher for children at GMFCS level V (OR=13.17), with short hamstring muscles (OR=9.86), and in the oldest age group, 13 years to 15 years (OR=6.80).

Interpretation

Knee contracture is associated with higher GMFCS level, older age, and shorter muscle length; spasticity has a small effect. Maintaining muscle length, especially of the hamstrings, is important for reducing the risk of knee contracture.

What this paper adds

Knee contracture occurs in children with cerebral palsy at all Gross Motor Function Classification System (GMFCS) levels.

Knee contracture in children is associated with short hamstring muscles, higher GMFCS level, and older age.

Short hamstring muscles present a greater risk for knee contracture than spasticity.
The Tyneside Pegboard Test: balancing clinical utility against ecological validity
Authors: Green Dido
Published: January 2018

This commentary is on the original article by Basu et al. on pages 314–321 of this issue.
Efficacy and safety of fast‐acting insulin aspart in comparison with insulin aspart in type 1 diabetes (onset 1): A 52‐week, randomized, treat‐to‐target, phase III trial
Authors: Mathieu Chantal , Bode Bruce W. , Franek Edward , Philis‐Tsimikas Athena , Rose Ludger , Graungaard Tina , Birk Østerskov Anne , Russell‐Jones David
Published: January 2018

Aims

To compare the safety and efficacy of fast‐acting insulin aspart (faster aspart) with conventional insulin aspart (IAsp) in adults with type 1 diabetes (T1D).

Materials and methods

onset 1 was a randomized, multicentre, treat‐to‐target, phase III, 52‐week (initial 26 weeks + additional 26 weeks) trial conducted at 165 sites across 9 countries. Adults with T1D were randomly allocated to double‐blind mealtime faster aspart or IAsp, each with once‐ or twice‐daily insulin detemir. The primary endpoint, change in glycated haemoglobin (HbA1c) from baseline after the initial 26 weeks, has been reported previously. In the present paper, we report data from the full 52‐week study period.

Results

Between August 2013 and June 2015, 381 participants were assigned to double‐blind faster aspart and 380 participants to IAsp. After 52 weeks, estimated mean changes from baseline in HbA1c levels were −0.08% (faster aspart) and +0.01% (IAsp); estimated treatment difference significantly favoured faster aspart (−0.10% [95% confidence interval {CI} −0.19;−0.00]; P = .0424). Changes from baseline in 1‐hour postprandial plasma glucose (PPG) increment (meal test; faster aspart −1.05 mmol/L; IAsp −0.14 mmol/L) also significantly favoured faster aspart (estimated treatment difference −0.91 mmol/L [95% CI −1.40;−0.43]; −16.48 mg/dL [95% CI −25.17;−7.80]; P = .0002). There was no difference in overall severe or blood glucose‐confirmed hypoglycaemic episodes or treatment‐emergent adverse events between treatments.

Conclusions

At 52 weeks, overall glycaemic control had significantly improved with faster aspart vs IAsp, consistent with the 26‐week study findings. Achieving an insulin profile closer to physiological insulin secretion with faster aspart translates into lower PPG and HbA1c levels compared with those achieved with IAsp in people with T1D.
Have we really demonstrated the cardiovascular safety of anti‐hyperglycaemic drugs? Rethinking the concepts of macrovascular and microvascular disease in type 2 diabetes
Authors: Packer Milton
Published: January 2018

A primary goal of the treatment of type 2 mellitus is the prevention of morbidity and mortality associated with cardiovascular disease; however, anti‐hyperglycaemic drugs have the capacity to cause deleterious effects on the circulation, a risk that is not adequately reflected by the endpoints selected for emphasis in large‐scale clinical trials that are designed to evaluate cardiovascular safety. The primary endpoint of the large‐scale studies mandated by regulatory authorities focuses only on 3 to 4 events that depict only a limited view of the circulatory system. One of the most serious adverse effects of many glucose‐lowering drugs is new‐onset or worsening heart failure. Most antidiabetic drugs can aggravate heart failure because they exert anti‐natriuretic actions, and possibly, adverse effects on the myocardium. In addition, certain anti‐hyperglycaemic agents may worsen peripheral vascular disease and trigger cardiac arrhythmias that may lead to sudden death. Initiation of treatment with antidiabetic medications may also cause deterioration of the function of the kidneys, retina and peripheral nerves, which are typically regarded as reflecting microvascular disease. The current confusion about the cardiovascular effects of glucose‐lowering drugs may be exacerbated by conceptual uncertainties about the classification of large and small vessel disease in determining the clinical course of diabetes. Physicians should not be falsely reassured by claims that a new treatment appears to have passed a narrowly defined regulatory test. The management of people with diabetes often carries with it the risk of important cardiovascular consequences, even for drugs that do not overtly increase the risk of myocardial infarction or stroke.
Tofogliflozin decreases body fat mass and improves peripheral insulin resistance
Authors: Matsuba Ren , Matsuba Ikuro , Shimokawa Mototsugu , Nagai Yoshio , Tanaka Yasushi
Published: January 2018

The impact of tofogliflozin, a sodium‐glucose co‐transporter‐2 inhibitor, on peripheral glucose uptake in patients with type 2 diabetes mellitus (T2DM) was investigated using the hyperinsulinaemic‐euglycaemic clamp method in a single‐arm, open‐label study. The following variables were compared between before and after tofogliflozin administration for 12 weeks in 16 patients with T2DM who were receiving dipeptidyl peptidase‐4 inhibitor treatment: body weight (BW); blood pressure; glucose metabolism; liver function; lipid profile; and body composition. Peripheral glucose uptake (M value and M/I ratio) was examined by the hyperinsulinaemic‐euglycaemic clamp method. After 12 weeks, there was a significant decrease (P < .001) in glycated haemoglobin, BW, body fat mass and lean body mass. Peripheral glucose uptake, which indicates insulin sensitivity, increased significantly (M value by 0.90 and M/I ratio by 0.49; both P < .05). The change in the M value after 12 weeks of tofogliflozin therapy was correlated with the change in body fat mass (P < .05). Tofogliflozin significantly improved insulin sensitivity and peripheral glucose uptake in patients with T2DM. These improvements were significantly correlated with reduction in body fat mass.
Basal insulin peglispro increases lipid oxidation, metabolic flexibility, thermogenesis and ketone bodies compared to insulin glargine in subjects with type 1 diabetes mellitus
Authors: Porksen Niels K. , Linnebjerg Helle , Lam Eric Chen Quin , Garhyan Parag , Pachori Alok , Pratley Richard E. , Smith Steven R.
Published: January 2018

Aims

When treated with basal insulin peglispro (BIL), patients with type 1 diabetes mellitus (T1DM) exhibit weight loss and lower prandial insulin requirements versus insulin glargine (GL), while total insulin requirements remain similar. One possible explanation is enhanced lipid oxidation and improved ability to switch between glucose and lipid metabolism with BIL. This study compared the effects of BIL and GL on glucose and lipid metabolism in subjects with T1DM.

Materials and Methods

Fifteen subjects with T1DM were enrolled into this open‐label, randomised, crossover study, and received once‐daily stable, individualised, subcutaneous doses of BIL and GL for 4 weeks each. Respiratory quotient (RQ) was measured using whole‐room calorimetry, and energy expenditure (EE) and concentrations of ketone bodies (3‐hydroxybutyrate) and acylcarnitines were assessed.

Results

Mean sleep RQ was lower during the BIL (0.822) than the GL (0.846) treatment period, indicating greater lipid metabolism during the post‐absorptive period with BIL. Increases in carbohydrate oxidation following breakfast were greater during BIL than GL treatment (mean change in RQ following breakfast 0.111 for BIL, 0.063 for GL). Furthermore, BIL treatment increased total daily EE versus GL (2215.9 kcal/d for BIL, 2135.5 kcal/d for GL). Concentrations of ketone bodies and acylcarnitines appeared to be higher following BIL than GL treatment.

Conclusions

BIL increased sleeping fat oxidation, EE, ketone bodies, acylcarnitines and post‐prandial glucose metabolism when switching from conventional insulin, thus, restoring metabolic flexibility and increasing thermogenesis. These changes may explain the previously observed weight loss with BIL versus GL.
Population trends of bycatch species reflect improving status of target species
Authors: Cook Robin M , Heath Michael R
Published: January 2018

Synthesis studies of fish stocks worldwide suggest improving status of mainly target species that are fully assessed. Other analyses, primarily based on catch data alone, but which include a wider range of species as well as bycatch, present a different view. Catch‐only analyses could be more robust if fishery‐independent data were used and discards accounted for. We develop a model that uses only survey biomass at length and landings data to estimate fishing mortality, spawning stock biomass (SSB) and discards. An analysis of species from the North Sea shows the model results compare well with most fully assessed stocks. When applied to bycatch species with limited data, trends in fishing mortality and SSB typically reflect those of the target species. In the last decade, mean fishing mortality rates have tended to decline, while mean SSB has increased. Despite increasing SSB, recent mean recruitment appears to have been lower than previously which may limit future biomass recovery. Species usually associated with more northerly distributions appear to show the greatest effect of weaker recruitment, which may be linked to climate. Estimated discards have tended to decline in magnitude as a result of reduced fishing mortality and associated lower total catches. The model offers a simple way to use both landings and survey data to obtain more detailed population trends for data limited species.
Continuous intravenous vancomycin in children with normal renal function hospitalized in hematology–oncology: prospective validation of a dosing regimen optimizing steady‐state concentration
Authors: Hoegy Delphine , Goutelle Sylvain , Garnier Nathalie , Rénard Cécile , Faure‐Conter Cécile , Bergeron Christophe , Bertrand Yves , Bleyzac Nathalie
Published: January 2018

Continuous intravenous (IV) infusion has been shown to be the best option to administer vancomycin because of its time‐dependent bactericidal activity. Available IV vancomycin dosing guidelines in pediatrics with normal renal function leads to less than 50% of patients achieving a vancomycin serum concentration (Css) in the target range (15–20 mg/L). The primary objective of this study was to prospectively validate an age‐based dosing regimen in pediatric oncology–hematology. The secondary objective was to investigate the influence on Css attainment of different variables. A continuous IV dosing nomogram was built by retrospective study (2000–2010) on Bayesian dosing adjustments performed in 161 patients. This study assessed the prospective validation of this age‐based nomogram and the influence on Css attainment of variables as the gender, underlying disease (oncology or hematology), and hematopoietic stem cell transplantation (HSCT) before receiving vancomycin therapy. A total of 94 patients aged from 4.3 months to 17.9 years old with normal renal function were eligible for the prospective validation. Fifty‐five of those patients (58.5%) achieved the target range of vancomycin Css. There was no significant difference between age groups (P = 0.816) and no influence of gender (P = 0.500). There was a nonsignificant trend to a better target attainment in oncology patients (69.2% vs. hematology 54.4%, P = 0.142) and patients who did not undergo HSCT (63.3% vs. 33.3%, P = 0.031). This study proposed an age‐based nomogram prospectively validated which near 60% of patients of each age class achieving the target range of Css.
Rare long‐distance dispersal of a marine angiosperm across the Pacific Ocean
Authors: Smith Timothy M. , York Paul H. , Broitman Bernardo R. , Thiel Martin , Hays Graeme C. , van Sebille Erik , Putman Nathan F. , Macreadie Peter I. , Sherman Craig D. H.
Published: January 2018

Aim

Long‐distance dispersal (LDD) events occur rarely but play a fundamental role in shaping species biogeography. Lying at the heart of island biogeography theory, LDD relies on unusual events to facilitate colonization of new habitats and range expansion. Despite the importance of LDD, it is inherently difficult to quantify due to the rarity of such events. We estimate the probability of LDD of the seagrass Heterozostera nigricaulis, a common Australian species, across the Pacific Ocean to colonize South America.

Location

Coastal Chile, Australia and the Pacific Ocean.

Methods

Genetic analyses of H. nigricaulis collected from Chile and Australia were used to assess the relationship between the populations and levels of clonality. Ocean surface current models were used to predict the probability of propagules dispersing from south‐east Australia to central Chile and shipping data used to determine the likelihood of anthropogenic dispersal.

Results

Our study infers that the seagrass H. nigricaulis dispersed from Australia across the entire width of the Pacific (c. 14,000 km) to colonize South America on two occasions. Genetic analyses reveal that these events led to two large isolated clones, one of which covers a combined area of 3.47 km2. Oceanographic models estimate the arrival probability of a dispersal propagule within 3 years to be at most 0.00264%. Early shipping provides a potential alternative dispersal vector, yet few ships sailed from SE Australia to Chile prior to the first recording of H. nigricaulis and the lack of more recent and ongoing introductions demonstrate the rarity of such dispersal.

Main conclusions

These findings demonstrate LDD does occur over extreme distances despite very low probabilities. The large number of propagules (100s of millions) produced over 100s of years suggests that the arrival of propagules in Chile was inevitable and confirms the importance of LDD for species distributions and community ecology.
Unions and social media: Prospects for gender inclusion
Authors: Thornthwaite Louise , Balnave Nikola , Barnes Alison
Published: January 2018

The emergence of web 2.0 technologies led to optimistic predictions that social media (SM) might alter traditional gendered patterns of member participation in trade unions. Greene, Hogan, and Grieco and others suggested that the forms of communication and engagement these technologies offered to unions and their members had the potential to foster gender inclusion and contribute to union diversity, arguably central to effective representation. This article reports on a survey of union members’ experiences with and perceptions of their union's SM services, to identify whether there is a gendered dimension to members’ use. The findings indicate that for most union members regardless of gender, more traditional communication channels such as face‐to‐face contact and email remain the preferred means of communication. However, the findings also show that women are just as likely as men, if not more so, to engage with union SM. Given that historically, women largely participated less in union activities than their male counterparts, this broad parity of use by women supports the conclusion that SM has substantial potential to improve women's participation in unions.
An assessment of drinking water contamination with Helicobacter pylori in Lima, Peru
Authors: Boehnke Kevin F. , Brewster Rebecca K. , Sánchez Brisa N. , Valdivieso Manuel , Bussalleu Alejandro , Guevara Magaly , Saenz Claudia Gonzales , Alva Soledad Osorio , Gil Elena , Xi Chuanwu
Published: January 2018

Background

Helicobacter pylori is a gut bacterium that is the primary cause of gastric cancer. H. pylori infection has been consistently associated with lack of access to sanitation and clean drinking water. In this study, we conducted time‐series sampling of drinking water in Lima, Peru, to examine trends of H. pylori contamination and other water characteristics.

Materials and methods

Drinking water samples were collected from a single faucet in Lima's Lince district 5 days per week from June 2015 to May 2016, and pH, temperature, free available chlorine, and conductivity were measured. Quantities of H. pylori in all water samples were measured using quantitative polymerase chain reaction. Relationships between the presence/absence and quantity of H. pylori and water characteristics in the 2015‐2016 period were examined using regression methods accounting for the time‐series design.

Results

Forty‐nine of 241 (20.3%) of drinking water samples were contaminated with H. pylori. Statistical analyses identified no associations between sampling date and the likelihood of contamination with H. pylori. Statistically significant relationships were found between lower temperatures and a lower likelihood of the presence of H. pylori (P < .05), as well as between higher pH and higher quantities of H. pylori (P < .05).

Conclusions

This study has provided evidence of the presence of H. pylori DNA in the drinking water of a single drinking water faucet in the Lince district of Lima. However, no seasonal trends were observed. Further studies are needed to determine the presence of H. pylori in other drinking water sources in other districts in Lima, as well as to determine the viability of H. pylori in these water sources. Such studies would potentially allow for better understanding and estimates of the risk of infection due to exposure to H. pylori in drinking water.
Attitudes towards mental health, mental health research and digital interventions by young adults with type 1 diabetes: A qualitative analysis
Authors: Clarke Janine , Proudfoot Judy , Vatiliotis Veronica , Verge Charles , Holmes‐Walker Deborah J. , Campbell Lesley , Wilhelm Kay , Moravac Catherine , Indu Pillaveetil S. , Bridgett Madeleine
Published: January 2018

Background

Young people with type 1 diabetes are at increased risk of mental disorders. Whereas treatment need is high, difficulty recruiting young people with type 1 diabetes into psychosocial studies complicates development, testing and dissemination of these interventions.

Objective

Interviews with young adults with type 1 diabetes were conducted to examine attitudes towards mental health and mental health research, including barriers and motivators to participation in mental health studies and preferred sources of mental health support. The interviews were audio‐taped, transcribed and evaluated via thematic analysis.

Setting and participants

Young adults with type 1 diabetes were recruited via social media channels of 3 advocacy organizations. A total of 31 young adults (26 females and 5 males) with an average age of 22 years were interviewed between October 2015 and January 2016.

Results

Participants were largely unaware of their increased vulnerability to common mental health problems and knew little about mental health research. Major barriers to participation included perceived stigma and lifestyle issues and low levels of trust in researchers. Opportunities to connect with peers and help others were described as key motivators. Psychological distress was considered normal within the context of diabetes. A need for some level of human contact in receiving psychosocial support was expressed.

Discussion and conclusion

Findings provide valuable insights into the complex dynamics of engaging young adults with type 1 diabetes in mental health studies. Interviewees provided practical suggestions to assist investigation and delivery of psychosocial interventions for this vulnerable group.
The role of ergonomic saddle seats and magnification loupes in the prevention of musculoskeletal disorders. A systematic review
Authors: Plessas A , Bernardes Delgado M
Published: January 2018

Objectives

Musculoskeletal disorders affect a high percentage of dentists, dental hygienists and therapists. Static and awkward working postures are considered as major risk factors. Proper seat selection and use of magnification loupes are promoted for their ergonomic benefits. The aim of this review was to evaluate the existing empirical evidence on the effect of the above interventions on (i) correction of poor posture and (ii) reduction in musculoskeletal pain.

Methods

The review was conducted according to the PRISMA guidelines. The review protocol was registered with PROSPERO (CRD42017058580). The Medline via Ovid, CINHAL via EBSCO, Web of Science, OpenGrey and EThOS electronic databases were searched. Prospective experimental studies were considered for inclusion. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) was used to assess the methodological quality of the included studies.

Results

Eight studies were included in the review. Four investigated the effect of loupes on posture and musculoskeletal pain, 4 the effect of the saddle seats on posture and one of the latter explored the combined effect of magnification and use of saddle seats on posture.

Conclusions

Based on a limited number of studies, the use of ergonomic saddle seats and dental loupes leads to improved working postures. The use of loupes appears to relieve shoulder, arm and hand pain. However, their effect on neck pain is scarce. None of the studies reported on the effect of the saddle seats on musculoskeletal pain. Future well‐powered prospective longitudinal studies are deemed necessary to confirm the conclusions of this review.
Hypopigmented mycosis fungoides: a 20‐case retrospective series
Authors: Amorim Gustavo M. , Niemeyer‐Corbellini Joao P. , Quintella Danielle C. , Cuzzi Tullia , Ramos‐e‐Silva Marcia
Published: January 2018

Background

Hypopigmented mycosis fungoides (hMF) is a rare subtype of mycosis fungoides. The aim of this study was to identify the clinical–epidemiological profile of our patient group and also to provide additional information about treatment responses and prognosis.

Methods

This is a cross‐sectional retrospective observational study, with exploratory analysis. The outcome variables were disease progression and related death.

Results

Twenty patients with hMF were selected from a group of 102 patients diagnosed with MF. There was no gender difference (10 females and 10 males). Mean age at diagnosis was 43.85 years, and most patients had mixed or black skin color. The mean time between the onset of the lesions and the diagnosis was 66.75 months. Patients were equally distributed in stages IA (50%) and IB (50%). Photochemotherapy (psoralen and ultraviolet A) was the predominant therapeutic modality. The mean follow‐up time was 7.25 years. In 10%, disease progression was observed. Death related to the disease occurred in one patient.

Conclusions

The clinical and epidemiological profile of patients with hypopigmented MF found in our sample is in agreement with what is described in the literature, with the exception of the age at diagnosis, higher than expected. Diagnostic delay time, despite long, is also consistent with the medical literature; however, in this sample, we had two cases of disease progression, with death of one patient, despite the treatment, which is extremely important since hypopigmented MF is usually associated with good prognosis.
Predictive factors of biochemical recurrence after radical prostatectomy for high‐risk prostate cancer
Authors: Murata Yukiko , Tatsugami Katsunori , Yoshikawa Masahiro , Hamaguchi Masumitsu , Yamada Shigetomo , Hayakawa Yusuke , Ueda Kouhei , Momosaki Seiya , Sakamoto Naotaka
Published: January 2018

Objective

To identify risk factors of biochemical recurrence after radical prostatectomy in high‐risk patients.

Methods

A total of 191 high‐risk prostate cancer patients according to the D'Amico classification treated with radical prostatectomy at a single institution between April 2000 and December 2013 were enrolled. The pathological evaluation including intraductal carcinoma of prostate was reassessed, and the clinical and pathological risk factors of biochemical recurrence were analyzed.

Results

The median follow up after radical prostatectomy was 49 months. The 5‐year biochemical recurrence‐free survival rate after radical prostatectomy in high‐risk prostate cancer patients was 41.6%. Initial prostate‐specific antigen, pathological Gleason score, seminal vesicle invasion, extraprostatic extension and intraductal carcinoma of the prostate were significantly associated with biochemical recurrence‐free survival. The 5‐year biochemical recurrence‐free survival rates in patients with zero, one, two and three of these risk factors were 92.9%, 70.7%, 38.3% and 28.8%, respectively. In patients with four or more factors, the biochemical recurrence‐free survival rate was 6.1% after 18 months.

Conclusions

In D'Amico high‐risk patients treated with radical prostatectomy, risk factors for biochemical recurrence can be identified. Patients with fewer risk factors have longer biochemical recurrence‐free survival, even among these high‐risk cases.
Layperson's knowledge and perceptions of irritable bowel syndrome as potential barriers to care
Authors: Sherwin LeeAnne B.
Published: January 2018

Aims

The aim of this study was to describe the layperson's knowledge and perceptions regarding the aetiology, pathogenesis, prevalence, medical evaluation, diagnosis and treatment of irritable bowel syndrome.

Background

Diagnosis acceptance and adherence to treatment is influenced by the views of the patient's social networks. Little is known how these networks influence those with irritable bowel syndrome.

Design

Cross‐sectional study of two‐hundred four laypersons, ages 18–80 years without an irritable bowel syndrome diagnosis.

Methods

Data were collected May 2016–March 2017. Laypersons without a diagnosis of IBS self‐reported their knowledge and perceptions about IBS.

Results/findings

Participants were able to identify many symptoms associated with irritable bowel syndrome however held misconceptions regarding the development of irritable bowel syndrome as noted by the endorsement of genetics, environment and diet or alcohol/smoking behaviours as specific causes. Further misconceptions held included the belief that irritable bowel syndrome was associated with an increased risk for the development of colon cancer and inflammatory bowel disease. Contrary to current guidelines, many thought a gastroenterologist was the only person appropriate to diagnose irritable bowel syndrome and objective testing, such as colonoscopy, was necessary to establish a diagnosis.

Conclusion

Laypersons have an understanding of the symptoms associated with IBS; however, hold numerous misconceptions regarding the aetiology, role of the healthcare provider, necessary testing and risks associated with irritable bowel syndrome. These misconceptions are inconsistent with current guidelines and practices. Establishing partnerships and educating social networks in addition to patients may enhance outcomes for those with IBS.
Lower haematocrit, haemoglobin and red blood cell number in zebra finches acclimated to cold compared to thermoneutral temperature
Authors: Niedojadlo Jowita , Bury Agata , Cichoń Mariusz , Sadowska Edyta T. , Bauchinger Ulf
Published: January 2018

Thermoregulation constitutes an important share of the energy budget of endotherms. Elevated thermoregulatory requirements must be met by oxygen supply through the blood, as heat is produced mainly via aerobic processes. In contrast to mammal studies, it remains unclear whether elevated thermoregulatory needs are followed by changes in haematological variables in birds. We investigated haematocrit (HCT), haemoglobin content per volume of blood (HGB), number of red blood cells (RBCcount), and size of the erythrocytes (RBCarea) in zebra finchesTaeniopygia guttataacclimated to either cold or thermoneutral ambient temperatures under laboratory conditions. Seventy‐nine females were maintained for six weeks either in cold (T = +12°C) or thermoneutral (T = +32°C) ambient temperature prior to blood collection. On average, HGB, HCT and RBCcountwere significantly lower by about 10% in cold acclimated compared to thermoneutral acclimated birds. Only RBCareawas not different between the two acclimation temperatures. Mean HCT, one of the most commonly measured haematological variable for example was 53 ± 0.9% (LSM ± SEM) in thermoneutral and 49 ± 0.8 % (LSM ± SEM) in cold acclimated zebra finches. On first sight, the observed lower values for three out of the four determined haematological variables in response to acclimation to cold question oxygen supply to be indeed a limiting factor for heat production. However, higher demands of oxygen supply due to increased thermoregulation in birds may instead require specific optimisation of blood viscosity and modulation by other cardiovascular properties. Nucleated red blood cells in birds may pose different strain on blood viscosity compared to non‐nucleated mammalian erythrocytes and explain the contrasting response in haematological variables to temperature acclimation between birds and mammals.
International evidence on economic policy uncertainty and asymmetric adjustment of audit pricing: Big 4 versus non‐big 4 auditors
Authors: Zhang Min , Xu Haoran , Tong Lijing , Ye Tingting
Published: January 2018

By investigating the association between economic policy uncertainty and audit fees using data from eight countries, this study examines whether and how Big 4 auditors reinforce their advantages over non‐Big 4 auditors through audit pricing. We find that both Big 4 and non‐Big 4 auditors reduce their audit fees when economic policy uncertainty increases. However, while non‐Big 4 auditors adjust audit pricing asymmetrically as economic policy uncertainty changes, i.e., the magnitude of decline in audit fees when economic policy uncertainty increases exceeds the magnitude of rise when economic policy uncertainty decreases, Big 4 auditors regulate their audit pricing in a symmetric manner. Further analyses reveal that: (1) the asymmetric pricing of non‐Big 4 auditors mainly exists in countries where Big 4 auditors have dominant market share, (2) Big 4 auditors provide higher‐quality audits when economic policy uncertainty increases and (3) many firms in better financial condition turn to Big 4 auditors during uncertain years. Our findings suggest that the symmetric audit pricing helps Big 4 auditors maintain a favorable position in the audit market.