bluuebunny/crossref_metadata_2025 huggingface dataset:
Engagement and observation: a review of local policies in England and Wales
Authors: Ashmore Russell
Published: May 2020

Purpose

The purpose of this paper is to report on the content of local policies on engagement and observation written by National Health Service (NHS) organisations in England and Wales.

Design/methodology/approach

Engagement and observation policies were obtained from all (n = 61) NHS mental health trusts in England and health boards in Wales via a Freedom of Information Act 2000 request. Data were analysed using content analysis.

Findings

All organisations had a specific policy referring to either “observation and engagement” or “observation”. The policies varied considerably in quality, length, breadth and depth of the information provided. Significant variations existed in the terminology used to describe the different types of enhanced observation. Inconsistencies were also noted between organisations regarding: which members of the clinical team could initiate, increase, decrease and terminate observation; who could undertake the intervention (for example students); and the reasons for using it. Finally, despite rhetoric to the contrary, the emphasis of policies was on observation and not engagement.

Research limitations/implications

This research has demonstrated the value of examining local policies for identifying inconsistencies in guidance given to practitioners on the implementation of engagement and observation. Further research should be undertaken to explore the impact of local policies on practice.

Practical implications

Local policies remain variable in content and quality and do not reflect contemporary research. There is a need to produce evidence-based national standards that organisations are required to comply with.

Originality/value

To the best of the author’s knowledge, this is the first research in 20 years examining the local policy framework for the implementation of engagement and observation.
Conceptual ambiguity hinders measurement and management of ecosystem disservices
Authors: Saunders Manu E.
Published: May 2020

The term ‘ecosystem disservices’ is used to refer to ecological costs that humans experience from nature. Managing ecosystems to protect ecosystem function and minimize costs to human well‐being is a global imperative.

Like ecosystem services, disservices are outcomes of ecological processes and interactions. They are supplied concurrently with ecosystem services, not as isolated outcomes of ecosystem function. Therefore, accurate measurement of disservices must identify the ecological interactions contributing to the disservice, as well as any associated services. Despite regular calls for increased rigour around measuring services and disservices, conceptual and methodological ambiguities dominate the ecosystem disservices literature.

A systematic literature review revealed 85 studies that aimed to explicitly identify or measure ecosystem disservices. Only 13 studies met both essential criteria for an empirical assessment of disservices: identification of the ecological interactions supplying the disservice and identification of associations between services and disservices.

Most empirical studies identify ecosystem disservices based on subjective opinions or proxy data, and rarely acknowledge how disservices are related to services within the system. Some identify the presence of unwanted organisms, management costs, minor nuisances and personal aversions as ecosystem disservices.

Synthesis and applications. Disservices are supplied concurrently with ecosystem services and human perceptions do not always accurately represent ecological costs in social–ecological systems. Hence, knowledge of the ecological interactions underlying perceived and actual disservices is vital for evidence‐informed decision‐making that sustains biodiversity and human well‐being.
Air care: an ‘aerography’ of breath, buildings and bugs in the cystic fibrosis clinic
Authors: Brown Nik , Buse Chrissy , Lewis Alan , Martin Daryl , Nettleton Sarah
Published: May 2020

With significant relevance to the Covid‐19 pandemic, this paper contributes to emerging ‘aerographic’ research on the socio‐materialities of air and breath, based on an in‐depth empirical study of three hospital‐based lung infection clinics treating people with cystic fibrosis. We begin by outlining the changing place of atmosphere in hospital design from the pre‐antibiotic period and into the present. We then turn to the first of three aerographic themes where air becomes a matter of grasping and visualising otherwise invisible airborne infections. This includes imagining patients located within bodily spheres or ‘cloud bodies’, conceptually anchored in Irigaray's thoughts on the ‘forgetting of the air’ and Sloterdijk's immunitary ‘spherology’ of the body. Our second theme explores the material politics of air, air conditioning, window design and the way competing ‘air regimes’ come into conflict with each other at the interface of buildings, bodies and the biotic. Our final theme attends to the ‘cost of air’, the aero‐economic problem of atmospheric scarcity within modern high‐rise, deep‐density healthcare architectures.
The symbol in the body: the un‐doing of a dissociation through Embodied Active Imagination in Jungian analysis
Authors: Fleischer Karin
Published: May 2020

Jung understood dissociation as a natural state of the psyche, capable of turning defensive through development. Based on this premise, and its conception on the equivalence between psyche and matter, the present work describes the un‐doing of a dissociation expressed through a chronic enterocolitis disorder. When the symbol remains closer to the body and its most instinctive manifestations, we need to descend to that level in order to let the vertical axis connection be gradually restored through the therapeutic relationship – the horizontal axis. In other words, this un‐doing requires that patient and analyst follow the unconscious path proposed by symbolic expressions that gradually emerge through the patient’s body and active imagination. Movement is our most primitive and fundamental experience. Many authors (Stern, Panksepp, Gallese) have agreed that, in addition to being first in terms of development, movement continues to have primacy over any other experience throughout life. This means that emotions, bodily concepts and, later, speech, evolve from a somatic basis. In the light of such neuroscientific findings, Jung’s vision of the correspondence of psyche and matter will be revisited in order to portray how the analytic bond provides a context for the re‐establishment of the linking/creative function of the archetype, and allows the restoring of the ego‐Self axis connection by including non‐verbal approaches, such as body‐based active imagination, also known as Authentic Movement. Authentic Movement is an amplification of Jung’s active imagination method that enables a dialogue between the ego and the diverse configurations of the unconscious. When such dialogue is grounded in the body, there is an easier access to the affective dimension stored in implicit memory. That which was relived through the body can gradually be remembered, and affects hitherto rejected, find other symbolic ways of being expressed and contained in the analytic vas.
Modeling unobserved heterogeneity in hedonic price models
Authors: Francke Marc , Van de Minne Alex
Published: May 2020

This paper studies unobserved heterogeneity in hedonic price models, arising from missing property and locational characteristics. Specifically, commercial real estate is very heterogeneous, and data on detailed property characteristics are often lacking. We show that adding mutually independent property random effects to a hedonic price model results in more precise out‐of‐sample price predictions, both for commercial multifamily housing in Los Angeles and owner‐occupied single‐family housing in Heemstede, the Netherlands. The standard hedonic price model does not take advantage of the fact that some properties sell more than once. We subsequently show that adding spatial random effects leads to an additional increase in prediction accuracy. The increase is highest for properties without prior sales.
Dietary habits and risk of hepatocellular carcinoma among hepatitis B surface antigen carriers: A prospective cohort study in China
Authors: Yu Cheng Xiao , Chen Yong Sheng , Ge Zi Jun , Zhang Yong Hui , Xu Xin , Tian Ting , Wen Yang , Zhu Jian , Song Ci , Chen Jian Guo , Hu Zhi Bin
Published: May 2020

Objective

In this prospective cohort study, we aimed to evaluate the association between dietary habits and the risk of developing hepatocellular carcinoma (HCC) in hepatitis B surface antigen (HBsAg)‐positive carriers in Qidong, an hepatitis B virus (HBV)‐epidemic area in China.

Methods

A total of 3199 HBsAg carriers aged 30‐70 years in a prospective cohort in Qidong, China from 2007 to 2011 were included in the study. At baseline, all participants self‐reported their dietary habits in a questionnaire interview. A follow‐up check‐up was performed every 6 months to identify HCC cases until November 2017. Cox’s regression analysis and an interaction analysis were performed to estimate the relative risks of HCC in terms of baseline diet.

Results

Among 3199 HBsAg‐positive participants, 270 developed HCC (143.86/100 000 person‐years [PYs]). Compared with participants who rarely consume garlic, the risk of HCC in those who consumed it ≥ once per week decreased along with the increase in frequency (HR = 1.00, 0.90 and 0.62 in those who consumed it rarely vs those who consumed it 1‐6 times per week and ≥ 7 times per week, respectively). This study found a synergistic effect between garlic and tea consumption on the risk of HCC (P = 0.039 for a multiplicative interaction).

Conclusions

HBsAg carriers should improve their diet. Regular consumption of garlic and tea drinking may reduce the HCC incidence in HBsAg carriers.
Metabolic modulation during intestinal fibrosis
Authors: Bos Simon , Laukens Debby
Published: May 2020

Intestinal fibrosis is one of the biggest challenges in the therapeutic management of inflammatory bowel diseases (IBD). Patients with Crohn's disease, in particular, suffer from fibrotic complications, which are manifested by the clinical stenosis of the bowel. Although fibrosis is caused by recurrent episodes of inflammation and wound healing, current therapies for IBD do not seem to reduce the incidence of stenosis, suggesting that inflammation‐independent mechanisms also contribute to intestinal fibrogenesis. The lack of anti‐fibrotic therapies for IBD and the huge burden this complication places on patients has prompted us to redirect inflammation research toward understanding the mechanisms that drive gut fibrosis. Based on data from other fibroproliferative diseases, metabolic modifications are increasingly recognized as pathogenic processes that may generate new therapeutic opportunities. These metabolic alterations result from a switch in the cellular metabolism of activated fibroblasts, which are the key mediator cells of fibrosis. Here, we review the metabolic changes associated with fibrotic disease and summarize the evidence of a metabolic shift during intestinal fibrosis.
Role of non‐inflammatory factors in intestinal fibrosis
Authors: Zhao Jin Fang , Ling Fang Mei , Li Jun Rong , Chen Yi Dong , Huang Liang , Zhu Liang Ru
Published: May 2020

Intestinal fibrosis is a common complication of inflammatory bowel disease (IBD), resulting in strictures and ultimately obstruction, which is a significant clinical problem. Fibrosis is mainly triggered by local chronic inflammation and occurs when excessive extracellular matrix deposition is caused by activated mesenchymal cells. Despite the advance of anti‐inflammatory therapies in IBD, the incidence and preventive strategies of intestinal fibrosis and strictures in IBD have not significantly changed over time. This shows that inflammation is necessary for fibrosis, but it does not necessarily affect the fibrotic progression. This review summarizes current knowledge about the non‐inflammatory mechanisms implicated in the gut fibrotic process of IBD, which may pave the way for new mechanisms and anti‐fibrotic therapies.
Treatment with or without bevacizumab as a first‐line and maintenance therapy for advanced non‐squamous non‐small cell lung cancer: A retrospective study
Authors: Jun Ni , Hanping Wang , Xiaoyan Si , Yan Xu , Mengzhao Wang , Xiaotong Zhang , Li Zhang
Published: May 2020

Background

Pemetrexed and bevacizumab as monotherapies, or in combination, have been approved for maintenance therapy following platinum‐based induction in patients with advanced nonsquamous non‐small cell lung cancer (NSCLC). The differences in the benefits of bevacizumab for treatment during early or late NSCLC have not yet been characterized.

Methods

We retrospectively analyzed data from 35 patients with advanced naïve NSCLC who had received pemetrexed/platinum with or without bevacizumab followed by maintenance therapy with pemetrexed alone or pemetrexed plus bevacizumab. The data were analyzed using the Kaplan‐Meier method and Cox regression adjusted for risk factors. Patients were grouped according to treatment conditions. Group A received pemetrexed plus platinum followed by pemetrexed alone (Pem‐Pt/Pem). Group B received pemetrexed plus platinum followed by pemetrexed and bevacizumab (Group B; Pem‐Pt/Pem + Bev). Group C received pemetrexed, platinum, and bevacizumab during induction therapy, and pemetrexed as maintenance therapy (Group C; Pem‐Pt + Bev/Pem + Bev). We assessed the significance of introduction of bevacizumab at different stages of treatment.

Results

A total of 13 (37.1%) patients were included in Group A, nine patients (25.7%) were included in Group B, and 13 patients (37.1%) were included in Group C. Among the 35 patients, 69.2% were male, and the median age was 59 years (range 40–75). The median progression‐free survival (PFS) was 7.7 months (231 days, range 134–410 days) in Group A, 9.3 months (280 days, range 84–565 days) in Group B, and 8.0 months (241 days, range 108–665 days) in Group C. The median PFS was not significantly different among the three groups (P = 0.233). Similarly, bevacizumab did not significantly affect PFS (P = 0.630).

Conclusions

The addition of bevacizumab into induction chemotherapy or maintenance therapy provided limited benefits to PFS in our study, but previous studies suggested that bevacizumab may improve disease control. In that way, we presume that early use of bevacizumab may provide a greater benefit.
Pre‐operative transthoracic echocardiography in ambulatory surgery—A cross‐sectional study
Authors: Stenberg Ylva , Lindelöf Linnea , Hultin Magnus , Myrberg Tomi
Published: May 2020

Background

Cardiac disease and aberrations in central volume status are risk factors for perioperative complications, and should be identified prior to surgery. This study investigated the benefit of transthoracic echocardiography (TTE) for pre‐operative identification of cardiac disease and hypovolemia in ambulatory surgery.

Methods

Ninety‐six patients, with a mean age of 63.5 ± 12.2 years and body mass index of 27.0 ± 4.3 kg/m2, scheduled for ambulatory surgery (breast, thyroid, and minor gastrointestinal), were consecutively enrolled in this prospective observational study. Pre‐operative comprehensive TTE was performed in order to assess heart failure (HF), asymptomatic left ventricular dysfunction, valvular disease, and aberrations in central volume status.

Results

Pre‐operative TTE identified a total of 28 cases of HF, 13 cases of HF with reduced or moderately reduced, ejection fraction (EF), and 15 cases of HF with preserved EF. Furthermore, 46 cases of asymptomatic left ventricular (LV) dysfunction were identified. 44/96 patients were hypovolemic, 16 of whom in severe hypovolemia. Seven cases of previously unknown obstructive valvular or myocardial disease and six cases of right ventricular systolic dysfunction were identified. A total of 24% (23/96) were classified as potential critical hemodynamic findings. The number needed (NNT) to treat for pre‐operative TTE in order to find one critical finding was 4.2.

Conclusion

In this ambulatory surgical cohort, a high prevalence of pre‐operative LV dysfunction and aberrations in volume status was observed. The results demonstrate that pre‐operative TTE contributed valuable hemodynamic information. The standard pre‐operative assessment for this cohort might need to be revised.
The risk of post‐operative myocardial injury after major emergency abdominal surgery: A retrospective cohort study
Authors: Ekeloef Sarah , Bjerrum Ellen , Kristiansen Puk , Wahlstrøm Kirsten , Burcharth Jakob , Gögenur Ismail
Published: May 2020

Background

The aim was to examine the risk of post‐operative myocardial injury after major emergency abdominal surgery and identify pre‐ and intra‐operative risk factors of post‐operative myocardial injury. Moreover, the study aimed to examine the association between post‐operative myocardial injury and clinical outcomes.

Methods

This was a retrospective cohort study including patients undergoing major emergency abdominal surgery from February 2017 to January 2019. Troponin I was assessed on post‐operative days 1‐3. Post‐operative myocardial injury was defined as a cardiac troponin I ≥ 45 ng per litre. Post‐operative clinical outcomes included in‐hospital myocardial infarction, in‐hospital major adverse cardiovascular events, reoperation, admission to the intensive care unit, lengths of stay, 30‐ and 90‐day all‐cause mortality.

Results

98 out of 401 patients (24.4%) sustained a post‐operative myocardial injury within the third post‐operative day. Increasing age was an independent risk factor of post‐operative myocardial injury (age per 10 years adjusted odds ratio 2.2 [95% CI 1.7‐2.9], P < .0001). Patients with post‐operative myocardial injury had an increased risk of major adverse cardiovascular events, a higher admission rate to the intensive care unit, a longer median post‐operative length of stay and a higher 30‐ and 90‐day all‐cause mortality compared with patients without myocardial injury.

Conclusion

One in four patients suffered a post‐operative myocardial injury within the third post‐operative day. Post‐operative myocardial injury was a risk factor of adverse cardiac and non‐cardiac clinical outcomes. Troponin monitoring could potentially improve the post‐operative risk stratification in this cohort of high‐risk surgical patients.
Australian contribution to global otolaryngology research: 2008–2018
Authors: Seah Yi Gim Jolyn , Bonnici Aliyah , Carney A. Simon
Published: May 2020

Background

Obtaining research funding in Otolaryngology – Head and Neck Surgery (ORL‐HNS) can be challenging. In this paper, an analysis of research output in ORL‐HNS in Australia and worldwide between 2008 and 2018 was conducted and then adjusted for the number of specialist surgeons in each country.

Methods

Scopus by Elsevier was used to measure research output of Ear, Nose and Throat (ENT) surgeons in Australia between 2008 and 2018. Each individual's career and 10‐year h‐index was identified and then repeated with self‐citations excluded. Total and 10‐year citations were also recorded. The top 15 countries in terms of research output in ORL‐HNS were also ranked based on the number of ENT articles published in the 10‐year period, and then adjusted by the number of actively practicing ENT surgeons per country.

Results

Between 2008 and 2018, Australia published 1510 articles out of a total global output of 48 613 papers in ORL‐HNS with the top 10 authors having an h‐index placing them within the world's top 100. Whilst the USA made the greatest total contribution with 12 912 publications, when adjusted for the number of specialist ORL‐HNS clinicians in each country, Australia, Canada and India in order topped the rankings.

Conclusion

Australia has established itself as a research leader in the global field of ORL‐HNS, publishing more articles per surgeon than any other country between 2008 and 2018. The Australian ORL‐HNS Academic Surgeons also rank highly on an individual basis when compared to global peers.
Transanal total mesorectal excision the Gold Coast experience: learning curve and comparison to traditional technique
Authors: Cooper Michelle , Kim Jason , Shin Brian Ng Hung , Ng Shu Kay , Lu Cu‐Tai , Nolan Gregory , Von Papen Michael
Published: May 2020

Background

Laparoscopic and open techniques in rectal cancer are well‐published, however, technical challenges remain for mid to low rectal cancer resections in the narrow pelvis. Transanal total mesorectal excision (taTME) has been pioneered to potentially circumvent these challenges. The aims of this study were to evaluate the learning curve associated with our first cases of taTME as well as compare outcomes to that of conventionally performed rectal resections.

Methods

This was a single‐centre retrospective study with data collated from all elective resections by the colorectal unit from 2015 to 2017. Primary outcome was completeness of total mesorectal excision and secondary outcomes were intra‐ and post‐operative morbidity and mortality.

Results

A total of 43 patients were identified. Of which, 20 underwent taTME. Mesorectal completeness was obtained in only 47.4% in the taTME group compared to 78.3% in the anterior resection group (p = 0.115). 5.9% of patients in our taTME group had positive circumferential resection margin compared to nil in the anterior resection. Conversion rates were greater in the taTME group (15% versus 0%; 0.028). Operative time, length of stay and clavien IV and V complications were greater in the taTME group.

Conclusion

This study highlights the difficulty in introducing a novel technique given the learning curve. Our results would expect to improve with increased caseload.
Feasibility study of an online modifiable Enhanced Recovery After Surgery protocol with specific focus on opioid avoidance
Authors: Ceuppens Charlotte , Dudi‐Venkata Nagendra N. , Lee Yanni D. , Beh Yong Z. , Bedrikovetski Sergei , Thomas Michelle L. , Kroon Hidde M. , Sammour Tarik
Published: May 2020

Background

The high and increasing rate of opioid use is a serious issue in the Western world affecting the population's physical and mental health. In most cases, opioid dependency starts with prescriptions by medical professionals, so efforts aimed at reducing in‐hospital opioid use should result in less long‐term dependency. The aim of the current study was to evaluate the feasibility of implementing an opioid‐scarce protocol as part of a new online modifiable Enhanced Recovery After Surgery (mERAS) programme.

Methods

A single‐centre retrospective study was conducted comparing a cohort treated under the new opioid‐scarce mERAS protocol (n = 96; May 2018–Nov 2018) to those treated under the original ERAS protocol (n = 84; November 2017–April 2018). The primary outcome was the quantity and duration of opioid use.

Results

Fewer patients used fentanyl via intravenous patient‐controlled analgesia in the mERAS group (54% versus 70%; P = 0.03). The mERAS group was also less likely to use oral oxycodone (80% versus 99%; P < 0.0001) and for a shorter duration (median 3 versus 5 days; P = 0.0002). More local anaesthetic transversus abdominis plane catheters were used in the mERAS group (34% versus 6% in the control group; P < 0.0001).

Conclusion

Opioid use can be significantly reduced after elective colorectal surgery by employing an opioid‐scarce ERAS protocol. Further data is required to confirm the clinical benefits of this approach.
Long‐term outcomes of oesophagogastric devascularization and splenectomy in patients with portal hypertension and liver cirrhosis
Authors: Yang Lingpeng , Zhang Zifei , Zheng Jinli , Kong Junjie , Yang Xianwei , Wang Wentao
Published: May 2020

Background

Research about the long‐term outcomes of oesophagogastric devascularization and splenectomy (OGDS) to treat portal hypertension (PH) is scarce. This study aimed to evaluate the safety and long‐term treatment efficacy of OGDS, especially in elderly patients.

Methods

During 2010–2016, open splenectomy and oesophagogastric devascularization (OSOD) and laparoscopic splenectomy and oesophagogastric devascularization were performed in 124 (group A) and 29 (group C) patients diagnosed with PH and liver cirrhosis, respectively. All patients aged less than 65 years. Besides, 39 patients aged 65 years or older undergoing open splenectomy and oesophagogastric devascularization were classified into group B. All clinical data were retrospectively analysed.

Results

Compared with group A, patients in group C had longer operative time, less blood loss and shorter post‐operative hospitalization time. However, for perioperative data, there was no significant difference between group A and group B. During post‐operative follow‐up, compared with pre‐operative condition, all haematology and liver function parameters significantly changed, except for alanine aminotransferase. For post‐operative complications, only the portal vein system thrombosis rate was significantly higher in group C than group A. No significant difference was found in the overall survival rate among three groups, when non‐variceal‐rebleeding‐related deaths were excluded.

Conclusion

OGDS remains safe and effective to treat PH secondary to liver cirrhosis and it can be performed successfully in elderly patients and achieve a curative effect that is not inferior to young patients.
Positive detection of SARS‐CoV‐2 combined HSV1 and HHV6B virus nucleic acid in tear and conjunctival secretions of a non‐conjunctivitis COVID‐19 patient with obstruction of common lacrimal duct
Authors: Hu Yaguang , Chen Tianyan , Liu Miaomiao , Zhang Li , Wang Fang , Zhao Shuo , Liu Hui , Xia Han , Wang Yawen , Li Li
Published: May 2020

Background

The current outbreak of COVID‐19 has spread rapidly all over the world. Respiratory droplets and contaction with infected patients are the two major transmission routes. However, the value of tear virus nucleic acid is still not clear. We dynamic detected the SARS‐CoV‐2 in eye sample of one COVID‐19 patient with obstruction of common lacrimal ducts.

Methods

Besides the routine examination, nasopharyngeal and eye swab were continuously measured by polymerase chain reaction assay and next‐generation sequencing (NGS). Gene detection was performed for drug use guidance, and flow cytometry was performed to analyse the lymphocyte subsets.

Results

Nasopharyngeal swabs were positive for 22 days, but eye swabs were still continuously positive for 2 weeks after nasopharyngeal swabs turned negative. The low level of lymphocyte and the high level IL‐6 lasted for almost 4 weeks, then became near normal. Next‐generation sequencing (NGS) confirmed the existing of SARS‐CoV‐2, HSV1 and HHV6B virus nucleic acid. The gene detection for drug use guidance showed the genetic locus ABCB1 (3435T>C) rs1045642 belonged to type CC and it mean the efficiency of lopinavir–ritonavir would be significantly decreased. The flow cytometry of lymphocyte subsets showed PD‐1+ CD95+ cells was accounting for 94.8% in CD3+ CD8+ T subset and for 94.8% in CD3+ TCRγδ+ T subset.

Conclusions

As obstruction of common lacrimal duct, positively detection in one eye for 2 weeks more after nasopharyngeal swab became negative. More eye swabs should be collected from COVID‐19 patients, especially from those immunocompromised, those with eye symptoms and those had a history of ocular diseases.
Editorial: increasing IBD prevalence and its complications in the context of the COVID‐19 pandemic
Authors: Benson‐Pope Samantha Jane , Gearry Richard B.
Published: May 2020

LINKED CONTENT

This article is linked to King et al papers. To view these articles, visit https://doi.org/10.1111/apt.15701 and https://doi.org/10.1111/apt.15769.
Randomised clinical trial: linaclotide vs placebo—a study of bi‐directional gut and brain axis
Authors: Rao Satish S.C. , Xiang Xuelian , Yan Yun , Rattanakovit Kulthep , Patcharatrakul Tanisa , Parr Rachael , Ayyala Deepak , Sharma Amol
Published: May 2020

Background

Linaclotide, a guanylate cyclase C agonist relieves irritable bowel syndrome with predominant constipation (IBS‐C) symptoms, but how it improves pain in humans is unknown.

Aims

To investigate the effects of linaclotide and placebo on the afferent and efferent gut‐brain‐gut signalling in IBS‐C patients, in a randomised clinical trial.

Methods

Patients with IBS‐C (Rome III) and rectal hypersensitivity were randomised (2:1) to receive linaclotide (290 µg) or placebo for 10 weeks and undergo bi‐directional gut and brain axis assessment using anorectal electrical stimulations and transcranial/transspinal‐anorectal magnetic stimulations. Rectal sensations were examined by balloon distention. Assessments included abdominal pain, bowel symptoms and quality of life (QOL) scores. Primary outcomes were latencies of recto‐cortical and cortico‐rectal evoked potentials.

Results

Thirty‐nine patients participated; 26 received linaclotide and 13 received placebo. Rectal cortical evoked potentials latencies (milliseconds) were significantly prolonged with linaclotide compared to baseline (P1:Δ 19 ± 6, P < 0.005; N1:Δ 20 ± 7, P < 0.02) but not with placebo (P1:Δ 3 ± 5; N1:Δ 4.7 ± 5,P = 0.3) or between groups. The efferent cortico‐anorectal and spino‐anorectal latencies were unchanged. The maximum tolerable rectal volume (cc) increased significantly with linaclotide compared to baseline (P < 0.001) and placebo (Δ 29 ± 10 vs 4 ± 20, (P < 0.03). Abdominal pain decreased (P < 0.001) with linaclotide but not between groups. Complete spontaneous bowel movement frequency increased (P < 0.001), and IBS‐QOL scores improved (P = 0.01) with linaclotide compared to baseline and placebo. There was no difference in overall responders between linaclotide and placebo (54% vs 23%, P = 0.13).

Conclusions

Linaclotide prolongs afferent gut‐brain signalling from baseline but both afferent and efferent signalling were unaffected compared to placebo. Linaclotide significantly improves rectal hypersensitivity, IBS‐C symptoms and QOL compared to placebo. These mechanisms may explain the effects of linaclotide on pain relief in IBS‐C patients.

ClinicalTrials.Gov: Registered at Clinical trials.gov no NCT02078323.
Letter: does vitamin D have a potential role against COVID‐19? Authors' reply
Authors: Tian Yuan , Rong Long
Published: May 2020

LINKED CONTENT

This article is linked to Tian et al and Kumar et al papers. To view these articles, visit https://doi.org/10.1111/apt.15731 and https://doi.org/10.1111/apt.15801.
Letter: low population mortality from COVID‐19 in countries south of latitude 35 degrees North supports vitamin D as a factor determining severity
Authors: Mansur Jose L.
Published: May 2020

LINKED CONTENT

This article is linked to Rhodes et al papers. To view these articles, visit https://doi.org/10.1111/apt.15777 and https://doi.org/10.1111/apt.15823.
Cooperation of firms yielding industrial clusters
Authors: Nie Pu‐yan , Wang Chan , Lin Li‐kui
Published: May 2020

Industrial clusters, exceedingly popular all over the world, play a significant role in economics, and it is very important to further capture them. This paper addresses the formation of industrial clusters with evolutionary game theory techniques. According to evolutionary game theory techniques, cooperation conditions for two firms in two different industries are characterised. Actually, if the evolutionary stable strategy (ESS) is the corporation, an industrial cluster is yielded. We therefore outline the conditions to possibly cooperate in two industries, which give rise to an industrial cluster. This implies the planning practice to encourage the cooperation to establish industrial clusters.
Robot‐assisted intracorporeal orthotopic bladder substitution after radical cystectomy: perioperative morbidity and oncological outcomes – a single‐institution experience
Authors: Hosseini Abolfazl , Mortezavi Ashkan , Sjöberg Siri , Laurin Oscar , Adding Christofer , Collins Justin , Wiklund Peter N.
Published: May 2020

Objective

To report a single‐institution experience with totally intracorporeal neobladder urinary diversion (UD) after robot‐assisted laparoscopic radical cystectomy (RARC).

Patients and methods

A total of 158 patients underwent totally intracorporeal neobladder UD after RARC between 2003 and 2016. Patient demographics, intraoperative and pathological data, 30‐ and 90‐day perioperative mortality and complications were recorded. Complications were classified according to the modified Clavien–Dindo classification. The 5‐year overall (OS) and cancer‐specific survival (CSS) rates were estimated by Kaplan–Meier plots.

Results

Most of the patients were male (84%) and had clinical T Stage ≤2 (87%). The mean operation time was 359 (SD ±98) min, with a median (range) estimated blood loss of 300 (50–2200) mL. Most of the men (86%) received a nerve‐sparing procedure and 38% of the females an organ‐sparing approach. A lymph node dissection was performed in 156 (99%) patients, with a median (range) yield of 23 (7–48) nodes. Conversion to open surgery occurred in five patients (3%). We recorded negative margins in 156 patients (99%). The median (range) follow‐up was 34 (1–170) months, with 30‐ and 90‐day mortality rates of 0%. Clavien–Dindo Grade III–IV complications occurred in 29 of 158 (18%) patients at 30‐days and in eight of 158 (5%) between 30–90 days, resulting into a 90‐day overall high‐grade complication rate of 23%. The unadjusted estimated 5‐years recurrence‐free survival, CSS and OS rates were 70%, 72%, and 71%, respectively.

Conclusion

In our present series the complication and oncological results were similar to open RC series, suggesting that RARC followed by totally intracorporeal neobladder UD is a safe and feasible alternative.
Interplay of eustatic, tectonic and autogenic controls on a Late Devonian carbonate platform, northern Canning Basin, Australia
Authors: Ferguson Ian J. , Da Silva Anne‐Christine , Chow Nancy , George Annette D.
Published: May 2020

Frasnian reef complexes along the northern margin of the Canning Basin in northwestern Australia evolved during rifting of the Fitzroy Trough. Geological investigations of the Frasnian Hull platform, which developed on an active tilted fault‐block, reveal significant lateral and vertical facies variations superimposed on prominent metre‐scale cyclicity. This study uses numerical analyses of facies and magnetic susceptibility data from three measured sections along the Hull platform to test whether a tectonic signal can be distinguished from eustatic and other signals.

Geostatistical analysis of facies variations reveals an exponential distribution of thin (<3 m) facies, characteristic of stochastic depositional processes. Thick subtidal facies predominate in the Guppy Hills (GH) and southeastern Hull Range (SHR) sections near the hangingwall margin, and thick shallow‐subtidal to intertidal facies dominate the Horse Springs drillcore (HD 14) section near the footwall margin. Power and wavelet spectral analyses indicate a strong periodic component; Average Spectral Misfit and spectral optimisation methods confirm the presence of Milankovitch eccentricity signals and suggest the presence of obliquity and precession signals. However, the results also expose strong temporal and spatial variation providing evidence for tectonic control. Spectral analyses show strongest periodicity is recorded in short intervals that are not correlated across the platform and provide evidence of variations in sedimentation rate and hiatuses. Time series for the neighbouring GH and SHR sections show no overall statistical correlation, and Markov analysis indicates weakly ordered vertical facies transitions that do not correlate across the platform. Subtidal to intertidal facies data from HD 14 core suggest that at least 35% of the section is absent, almost obscuring the Milankovitch signal. The results indicate a complex set of controls on deposition on the Hull platform with local tectonic effects having produced spatio‐temporal moderation of the underlying eustatic signals and autogenic processes adding a localised stochastic response.
Large‐scale connectivity of fluvio‐deltaic stratigraphy: Inferences from simulated accommodation‐to‐supply cycles and automated extraction of chronosomes
Authors: Karamitopoulos Pantelis , Weltje Gert J. , Dalman Rory A. F.
Published: May 2020

Multiscale simulation of fluvio‐deltaic stratigraphy was used to quantify the elements of the geometry and architectural arrangement of sub‐seismic‐scale fluvial‐to‐shelf sedimentary segments. We conducted numerical experiments of fluvio‐deltaic system evolution by simulating the accommodation‐to‐sediment‐supply (A/S) cycles of varying wavelength and amplitude with the objective to produce synthetic 3‐D stratigraphic records. Post‐processing routines were developed in order to investigate delta lobe architecture in relation to channel‐network evolution throughout A/S cycles, estimate net sediment accumulation rates in 3‐D space, and extract chronostratigraphically constrained lithosomes (or chronosomes) to quantify large‐scale connectivity, that is, the spatial distribution of high net‐to‐gross lithologies. Chronosomes formed under the conditions of channel‐belt aggradation are separated by laterally continuous abandonment surfaces associated with major avulsions and delta‐lobe switches. Chronosomes corresponding to periods in which sea level drops below the inherited shelf break, that is, the youngest portions of the late falling stage systems tract (FSST), form in the virtual absence of major avulsions, owing to the incision in their upstream parts, and thus display purely degradational architecture. Detailed investigation of chronosomes within the late FSST showed that their spatial continuity may be disrupted by higher‐frequency A/S cycles to produce “stranded” sand‐rich bodies encased in shales. Chronosomes formed during early and late falling stage (FSST) demonstrate the highest large‐scale connectivity in their proximal and distal areas, respectively. Lower‐amplitude base level changes, representative of greenhouse periods during which the shelf break is not exposed, increase the magnitude of delta‐lobe switching and favour the development of system‐wide abandonment surfaces, whose expression in real‐world stratigraphy is likely to reflect the intertwined effects of high‐frequency allogenic forcing and differential subsidence.
High expression of CXCL14 is a biomarker of lung adenocarcinoma with micropapillary pattern
Authors: Sata Yuki , Nakajima Takahiro , Fukuyo Masaki , Matsusaka Keisuke , Hata Atsushi , Morimoto Junichi , Rahmutulla Bahityar , Ito Yuki , Suzuki Hidemi , Yoshino Ichiro , Kaneda Atsushi
Published: May 2020

Lung adenocarcinoma with micropapillary pattern (MPP) has an aggressive malignant behavior. Limited resection should be avoided because of its high recurrence rate. If adenocarcinoma with MPP is diagnosed preoperatively, the selection of proper treatment is possible. To explore a preoperative biomarker for diagnosing MPP, we undertook RNA sequencing analysis of 25 clinical samples as the training set, including 6 MPP, 16 other adenocarcinoma subtypes, and 3 normal lung tissues. Unsupervised hierarchical clustering analysis suggested a presence of subgroup with MPP showing different gene expression phenotype. We extracted differentially expressed genes with high expression levels in MPP samples, and chose VSIG1, CXCL14, and BAMBI as candidate biomarkers for MPP. Reverse transcription‐quantitative PCR analysis confirmed a significantly higher expression of VSIG1 (P = .03) and CXCL14 (P = .02) in MPP than others. In a validation set of 4 MPP and 4 non‐MPP samples, CXCL14 expression was validated to be significantly higher in MPP than in non‐MPP (P = .04). Comparing a total of 10 MPP and 20 non‐MPP samples, the area under the curve of CXCL14 to distinguish MPP from others was 0.89. The threshold value was 0.0116, corresponding to sensitivity 80% and specificity 90%. In immunostaining of CXCL14, the staining score was significantly higher in MPP cases than others, where not only the MPP component but also other components showed heterogeneous staining in adenocarcinoma tissues with MPP. Moreover, a higher staining score of CXCL14 was significantly associated with poorer prognosis in all patients (P = .01) or within cases in stage I‐III (P = .01). In summary, we identified CXCL14 as a possible diagnostic biomarker of MPP.
IGF‐I in cord blood is predictive of final height in monozygotic twins with intra‐twin birth weight differences
Authors: Kasner Charlotte , Schulte Sandra , Schreiner Felix , Fimmers Rolf , Stoffel‐Wagner Birgit , Bartmann Peter , Woelfle Joachim , Gohlke Bettina
Published: May 2020

Objective

Adverse prenatal conditions can exert a long‐lasting impact on growth up to final height (FH). Due to different prenatal nutrient availability, monozygotic twin pairs with discordant birth weight (bw) provide an excellent model to examine the impact of genes and environment and to analyse the predictive value of bw, birth length (bl) and cord blood (cb) concentration of IGF‐I on FH.

Patients and Methods

Twenty eight monozygotic twin pairs with intra‐twin bw‐/bl‐differences were studied at birth and longitudinally until FH. Intra‐twin bw difference >1 SDS was defined “discordant” (n = 10 pairs). IGF‐I was analysed in cord blood in all twins. Intra‐twin differences (∆) in bw, bl and cord blood IGF‐I were correlated with ∆FH.

Results

Throughout growth and up until FH intra‐twin length/height differences remained for all but two (26/28) twins and for all (10/10) discordant twins. In the discordant group, a highly significant intra‐twin difference for FH‐SDS was found with a mean intra‐twin Δheight‐ SDS of 1.23 (range, 0.29‐2.34). This corresponds to a mean Δintra‐twin difference at FH of 7.9 cm (3.1 inch; range, 2‐15 cm [0.79‐5.9 inch]). Correlation coefficients were calculated to identify factors predicting FH: ∆bw (r = .678; P = .0005), ∆bl (r = .333; P = .0002) and ∆IGF‐I in cb (r = .418; P = .0023). Interaction terms showed that IGF‐I is an additional factor to the auxological data, leading to an improvement of the ∆FH modelling.

Conclusion

Prenatal environment leading to bw‐/bl‐ and cbIGF‐I differences in monozygotic twins had a long‐lasting impact on growth until FH. Both, anthropometric data at birth and cbIGF‐I are predictive of FH.
Bricks, Documents and Pipes: Material Politics and Urban Development in Niamey, Niger
Authors: Körling Gabriella
Published: May 2020

In this article I explore the ways in which material things—bricks, documents, pipes, and utility poles—mediate everyday life and politics in informal neighborhoods in Niamey, the capital of Niger. I argue that informal neighborhoods are key sites where the material becomes political. Created “from below,” these neighborhoods are literally constructed brick by brick through the gradual division of land plots, the incremental construction and improvement of houses, the negotiation of connections to the water and electricity networks, and attempts at securing public service provision. These material transformations are central to residents’ quest for legitimation in a context of insecure land tenure (rights). I pay particular attention to the ways in which these material transformations are mediated by social and political relations involving both state and non‐state actors (including the traditional chieftaincy, NGOs, public and private companies, and the municipality). In sum, the analysis of material transformations and interventions in informal neighborhoods elucidates the important role of infrastructure and other material things in shaping urban landscapes and in mediating political subjectivities in Niamey.
DIY Verticality: The Politics of Materiality in Luanda
Authors: Gastrow Claudia
Published: May 2020

A growing body of work has highlighted the centrality of verticality to the making of contemporary urbanism, pushing scholars to begin conceptualising inequality, politics, and planning as multi‐scalar in nature. This paper builds off these interventions to argue that verticality should be understood as a fragile and unstable achievement, a fragility heightened when the oft‐taken for granted workings of the state and private sector, which enable the appearance of verticality as a seamless achievement, fail. Drawing on research conducted in Luanda, Angola, this paper explores how residents, planners, and real estate developers discuss the difficulties of maintaining the experience, materiality, and imaginations of verticality as embodied in the architectural form of the high‐rise. The paper shows that in the context of ongoing urban decay and the seeming abnegation of most state responsibility for provision, urban residents are forced to engage in the production of a DIY verticality—constantly patching and repairing buildings to keep them viable, actions which in turn pull them into relationships of privatized belonging with the city. As such, the paper argues that the material politics of the high‐rise in Luanda both highlights the fragility at the heart of verticality as well as the shifting forms of privatized belonging immanent to this fragility.
Consuming Citizenship: Prepaid Meters and the Politics of Technology in Mumbai
Authors: Anand Nikhil
Published: May 2020

In November 2007, the Additional Municipal Commissioner of Mumbai announced Sujal Mumbai—a new program to upgrade the city’s water infrastructure. Amongst several initiatives was a proposal to connect new settlements to water lines regulated by prepaid meters. In this paper I focus on the surprising and unexpected appearance of the prepaid water meter in Mumbai to make two arguments. First, I argue that based on the particular technopolitical history of Mumbai’s water infrastructure, the neoliberal technology that was the prepaid meter represented not a withdrawal, but an extension of state services in the city. Second, I argue for an attention to the accreted and relational politics produced by infrastructural assemblages. The politics of technical devices or infrastructure are not discrete and singular, nor are these contained by the meter. Instead, the political effects of the meter are plural, and emerge from the relations between the meter and the accreted materials, histories, and rationalities already embedded and at work in infrastructural systems.
An ecological framework for contextualizing carnivore–livestock conflict
Authors: Wilkinson Christine E. , McInturff Alex , Miller Jennifer R. B. , Yovovich Veronica , Gaynor Kaitlyn M. , Calhoun Kendall , Karandikar Harshad , Martin Jeff Vance , Parker‐Shames Phoebe , Shawler Avery , Van Scoyoc Amy , Brashares Justin S.
Published: May 2020

Carnivore predation on livestock is a complex management and policy challenge, yet it is also intrinsically an ecological interaction between predators and prey. Human–wildlife interactions occur in socioecological systems in which human and environmental processes are closely linked. However, underlying human–wildlife conflict and key to unpacking its complexity are concrete and identifiable ecological mechanisms that lead to predation events. To better understand how ecological theory accords with interactions between wild predators and domestic prey, we developed a framework to describe ecological drivers of predation on livestock. We based this framework on foundational ecological theory and current research on interactions between predators and domestic prey. We used this framework to examine ecological mechanisms (e.g., density‐mediated effects, behaviorally mediated effects, and optimal foraging theory) through which specific management interventions operate, and we analyzed the ecological determinants of failure and success of management interventions in 3 case studies: snow leopards (Panthera uncia), wolves (Canis lupus), and cougars (Puma concolor). The varied, context‐dependent successes and failures of the management interventions in these case studies demonstrated the utility of using an ecological framework to ground research and management of carnivore–livestock conflict. Mitigation of human–wildlife conflict appears to require an understanding of how fundamental ecological theories work within domestic predator–prey systems.