bluuebunny/crossref_metadata_2025 huggingface dataset:
The Boundary of Smallholder Producers’ Cooperatives: A Conceptual and Empirical Analysis
Authors: Tadesse Getaw , Abate Gashaw T. , Ergano Kebebe
Published: November 2018

In this study we explain the concepts, determinants and imperatives of boundary in smallholder producers’ cooperatives both conceptually and empirically. The conceptual framework indicates the importance of the type of goods (being a club good or not) and range of activities that a cooperative provides to its members in defining a competitive boundary. Using unique organisational and market level data from Ethiopia, we then test empirically whether the observed (weak) performance of producers’ cooperatives in Africa is explained by their organisational boundary – the type and range of goods or services they provide to members. The empirical results confirm that the competitiveness of producers’ cooperatives is significantly correlated with the type and number of services – i.e. cooperatives that provide club goods and a limited range of services are found to be more competitive. The results also suggest that a considerable number of cooperatives in Ethiopia engage in markets where they do not have competitive advantage. Overall, we demonstrate the importance of properly defining a viable boundary – proper selection of services (or markets) and limiting the range of services – for improving the competitiveness of membership‐based producer cooperatives in Africa.
Diversity and distribution of Klebsiella capsules in Escherichia coli
Authors: Nanayakkara Buddhie S. , O'Brien Claire L. , Gordon David M.
Published: November 2018

E. coli strains responsible for elevated counts (blooms) in freshwater reservoirs in Australia carry a capsule originating from Klebsiella. The occurrence of Klebsiella capsules in E. coli was about 7% overall and 23 different capsule types were detected. Capsules were observed in strains from phylogroups A, B1 and C, but were absent from phylogroup B2, D, E and F strains. In general, few A, B1 or C lineages were capsule‐positive, but when a lineage was encapsulated multiple different capsule types were present. All Klebsiella capsule‐positive strains were of serogroups O8, O9 and O89. Regardless of the phylogroup, O9 strains were more likely to be capsule‐positive than O8 strains. Given the sequence similarity, it appears that both the capsule region and the O‐antigen gene region are transferred to E. coli from Klebsiella as a single block via horizontal gene transfer events. Pan genome analysis indicated that there were only modest differences between encapsulated and non‐encapsulated strains belonging to phylogroup A. The possession of a Klebsiella capsule, but not the type of capsule, is likely a key determinant of the bloom status of a strain.
Tau‐induced nuclear envelope invagination causes a toxic accumulation of mRNA in Drosophila
Authors: Cornelison Garrett L. , Levy Simon A. , Jenson Tyler , Frost Bess
Published: November 2018

The nucleus is a spherical dual‐membrane bound organelle that encapsulates genomic DNA. In eukaryotes, messenger RNAs (mRNA) are transcribed in the nucleus and transported through nuclear pores into the cytoplasm for translation into protein. In certain cell types and pathological conditions, nuclei harbor tubular invaginations of the nuclear envelope known as the “nucleoplasmic reticulum.” Nucleoplasmic reticulum expansion has recently been established as a mediator of neurodegeneration in tauopathies, including Alzheimer's disease. While the presence of pore‐lined, cytoplasm‐filled, nuclear envelope invaginations has been proposed to facilitate the rapid export of RNAs from the nucleus to the cytoplasm, the functional significance of nuclear envelope invaginations in regard to RNA export in any disorder is currently unknown. Here, we report that polyadenylated RNAs accumulate within and adjacent to tau‐induced nuclear envelope invaginations in a Drosophila model of tauopathy. Genetic or pharmacologic inhibition of RNA export machinery reduces accumulation of polyadenylated RNA within and adjacent to nuclear envelope invaginations and reduces tau‐induced neuronal death. These data are the first to point toward a possible role for RNA export through nuclear envelope invaginations in the pathogenesis of a neurodegenerative disorder and suggest that nucleocytoplasmic transport machinery may serve as a possible novel class of therapeutic targets for the treatment of tauopathies.
Carbon monoxide attenuates amyloidogenesis via down‐regulation of NF‐κB‐mediated BACE1 gene expression
Authors: Kim Hyo Jeong , Joe Yeonsoo , Chen Yingqing , Park Gyu Hwan , Kim Uh‐Hyun , Chung Hun Taeg
Published: November 2018

Amyloid‐β (Aβ) peptides, the major constituent of plaques, are generated by sequential proteolytic cleavage of the amyloid precursor protein (APP) via β‐secretase (BACE1) and the γ‐secretase complex. It has been proposed that the abnormal secretion and accumulation of Aβ are the initial causative events in the development of Alzheimer's disease (AD). Drugs modulating this pathway could be used for AD treatment. Previous studies indicated that carbon monoxide (CO), a product of heme oxygenase (HO)‐1, protects against Aβ‐induced toxicity and promotes neuroprotection. However, the mechanism underlying the mitigative effect of CO on Aβ levels and BACE1 expression is unclear. Here, we show that CO modulates cleavage of APP and Aβ production by decreasing BACE1 expression in vivo and in vitro. CO reduces Aβ levels and improves memory deficits in AD transgenic mice. The regulation of BACE1 expression by CO is dependent on nuclear factor‐kappa B (NF‐κB). Consistent with the negative role of SIRT1 in the NF‐κB activity, CO fails to evoke significant decrease in BACE1 expression in the presence of the SIRT1 inhibitor. Furthermore, CO attenuates elevation of BACE1 level in brains of 3xTg‐AD mouse model as well as mice fed high‐fat, high‐cholesterol diets. CO reduces the NF‐κB‐mediated transcription of BACE1 induced by the cholesterol oxidation product 27‐hydroxycholesterol or hydrogen peroxide. These data suggest that CO reduces the NF‐κB‐mediated BACE1 transcription and consequently decreases Aβ production. Our study provides novel mechanisms by which CO reduces BACE1 expression and Aβ production and may be an effective agent for AD treatment.
Efficacy of erbium glass laser in the treatment of Old World cutaneous leishmaniasis: A case series
Authors: Mashayekhi Goyonlo Vahid , Karrabi Mahboubeh , Kiafar Bita
Published: November 2018

Background

Treatment of cutaneous leishmaniasis remains a challenge; new physical treatment modalities including laser systems are of interest in the treatment of localized lesions.

Method

Fourteen patients (10 females) with 20 lesions of Old World cutaneous leishmaniasis underwent weekly treatments of 1540 nm erbium glass fractional laser (Palomar) using 10 mm spot size hand piece in four passes of 50–70 mJ/cm2 fluence and 10 ms pulse duration.

Results

Twelve lesions were available for assessment: six (50%) improved at 6 weeks and eleven lesions (91.7%) at 12 weeks. There were no recurrences at 6‐ and 12‐month follow‐ups.

Conclusion

Erbium glass fractional laser may be an alternative treatment for localized cases of Old World cutaneous leishmaniasis.
The use of pre‐caesarean prophylactic intra‐arterial balloon catheters for suspected placenta accreta
Authors: Frank Wolf Maya , Singer‐Jordan Jonathan , Shnaider Oleg , Aiob Ala , Sgayer Inshirah , Bornstein Jacob
Published: November 2018

Introduction

The incidence of placenta accreta (PA) has markedly increased in the United States, from 1/30 000 in 1950 to 1/731 deliveries in 2011. Although placenta praevia after prior caesarean sections (CS) is the most important risk factor for PA, other risk factors make up 1–5% of PA occurrences. At our referral hospital, we use the pre‐caesarean prophylactic balloon catheter with or without post‐surgery embolisation in a hybrid room. Here, we evaluate the role of prior CS and placenta praevia on the outcome of this procedure.

Materials and Methods

This retrospective cohort analysis included 61 women during the years 2004–2016 with sonographic suspicion of PA who underwent balloon catheterisation prior to CS.

Results

Eleven women had no previous CS (18%). Mean previous CS rate was 1.85. Six women (9.8%) had previous dilatation and curettage (D&C); 36.4% of women with no previous CS had previous D&C compared with 4% of women with previous CS (P = 0.008). Placenta praevia was sonographically diagnosed in 55 women (90.2%). There was a higher rate of caesarean hysterectomy in women with previous CS than in those without (32% vs 0%, P = 0.052) but no significant difference in blood product requirements (45.5% vs 66%, P = 0.303). There was no significant difference in hysterectomy rate, blood transfusion or surgery duration between women with and without placenta praevia (P = 0.648, 0.594, 0.995, respectively).

Conclusion

Previous CS rather than placenta praevia is a strong indicator of hysterectomy in cases of PA. Different risk factors for PA do not affect blood transfusion rates or surgery duration.
Conventional or minimized cardiopulmonary bypass support during coronary artery bypass grafting? – An analysis by means of perfusion and body mass index
Authors: Provaznik Zdenek , Unterbuchner Christoph , Philipp Alois , Foltan Maik , Creutzenberg Marcus , Schopka Simon , Camboni Daniele , Schmid Christof , Floerchinger Bernhard
Published: November 2018

The use of minimized cardiopulmonary bypass support to reduce the side effects of extracorporeal circulation is still contradictorily discussed. This study compares perfusion operated by conventional (CCPB) and minimized (MCPB) cardiopulmonary bypass support during coronary artery bypass grafting (CABG). This study includes the data of 5164 patients treated at our department between 2004 and 2014. Tissue perfusion during cardiopulmonary bypass support and cardiac arrest was assessed by means of body mass index, hemodilution, blood pressure with corresponding pump flow and venous oxygen saturation, serum lactate, and serum pH. Hemodilution was more pronounced after CCPB: hemoglobin had dropped to 4.47 ± 0.142 g/dL after CCPB and to 2.77 ± 0.148 g/dL after MCPB (P = 0.0022). Despite the higher pump flow in conventional circuits (4.86–4.95 L/min vs. 4.1–4.18 L/min), mean blood pressure was higher during minimized bypass support (53 ± 10 vs. 56 ± 13 mm Hg [aortic clamping], 57 ± 9 vs. 61 ± 12 mm Hg [34°C], 55 ± 9 vs.59 ± 11 mm Hg [aortic clamp removal], P < 0.0001) at all time points. Venous oxygen saturation remained on comparable levels of >70% during both conventional and minimized cardiopulmonary bypass support. The increase in serum lactate was more pronounced after CCPB (8.98 ± 1.28 vs. 3.66 ± 1.25 mg/dL, P = 0.0079), corresponding to a decrease in serum pH to acidotic levels (7.33 ± 0.06 vs. 7.35 ± 0.06, P < 0.0001). These effects were evident in all BMI ranges. Minimized cardiopulmonary bypass support provides efficient perfusion in all BMI ranges and is thus equivalent to conventional circuits.
Systematic review: efficacy and safety of switching patients between reference and biosimilar infliximab
Authors: Feagan Brian G. , Lam Gordon , Ma Christopher , Lichtenstein Gary R.
Published: November 2018

Background

Biosimilar versions of widely prescribed drugs, including the tumour‐necrosis factor antagonist infliximab, are becoming increasingly available. As biosimilars are not identical copies of reference products, evidence may be required to demonstrate that switching between a reference biologic and biosimilars is safe and efficacious. To establish interchangeability, US Food and Drug Administration guidance states that studies must demonstrate that biosimilars remain equivalent or non‐inferior to a reference product after multiple switches between products.

Aims

To investigate the evidence evaluating the safety and efficacy of switching between reference and biosimilar infliximab in patients with inflammatory disorders, including Crohn's disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and plaque psoriasis.

Methods

Published studies presenting data on switching between reference and biosimilar infliximab were identified by searching the MEDLINE database. Congress abstracts were identified by searching the EMBASE database and manually searching abstracts from relevant congresses.

Results

A total of 113 journal articles and 149 abstracts were found. Of these, 70 were considered relevant and included in this analysis. Most of the publications were uncontrolled, observational studies. Data from six randomised, controlled trials were identified. In general, the evidence revealed no clinically important efficacy or safety signals associated with switching.

Conclusions

While available data have not identified significant risks associated with a single switch between reference and biosimilar infliximab, the studies available currently report on only single switches and were mostly observational studies lacking control arms. Additional data are needed to explore potential switching risks in various populations and scenarios.
Successful single‐stage laparoscopic surgery using a preoperative self‐expanding metallic stent in patients with obstructive colorectal cancer
Authors: Hosono Masayoshi , Matsuda Takeru , Yamashita Kimihiro , Hasegawa Hiroshi , Yamamoto Masashi , Kanaji Shingo , Oshikiri Taro , Nakamura Tetsu , Sumi Yasuo , Suzuki Satoshi , Kakeji Yoshihiro
Published: November 2018

Introduction

Although a self‐expanding metallic stent (SEMS) or a transnasal or transanal decompression tube is sometimes used as a bridge to surgery in patients with obstructive colorectal cancer, the optimal decompression procedure to achieve successful laparoscopic surgery remains unclear.

Methods

Forty‐two patients with obstructive colorectal cancer who were preoperatively decompressed by using SEMS (the SEMS group, n = 20) or a decompression tube (the DT group, n = 22) between January 2010 and February 2017 were included in this retrospective study.

Results

In the SEMS group, 20 patients (100%) were able to eat and 17 patients (85%) were able to undergo total colonoscopy preoperatively, but no patients could do so in the DT group (P < 0.01 and P < 0.01, respectively). The serum albumin level increased in the time between admission and just before surgery in five patients in the SEMS groups (25%), whereas it decreased in all patients in the DT group (P = 0.037). Laparoscopic surgery was performed more frequently in the SEMS groups (19 patients, 95%) than in the DT group (13 patients, 59.1%) (P = 0.018). Primary anastomosis without stoma was also achieved more frequently in the SEMS groups (19 patients, 95%) than in the DT group (15 patients, 68.2%) (P = 0.047). Anastomotic leakage did not occur in the SEMS group, but it did occur in one patient in the DT group. The recurrence‐free survival rate did not differ between the groups (median follow‐up period: 21 months).

Conclusion

In patients with obstructive colorectal cancer, SEMS appears to be more effective than a decompression tube as a preoperative treatment to achieve successful laparoscopic resection without stoma.
Football in Mexico: ‘A Paradise for Foreigners’?
Authors: BREWSTER KEITH , BREWSTER CLAIRE
Published: November 2018

This article traces the development of Mexican football from its inception to the successful hosting of two World Cup finals. We place our analysis within a post‐revolutionary context that exalted the virtues of self‐discipline that sport could contribute towards the patriotic endeavour of ‘improving the race’. We argue that the character of the post‐revolutionary state, in which a symbiotic relationship between public and private endeavours was encouraged, was reflected in the distinct way in which football developed in Mexico. Furthermore, it also influenced the way in which sporting culture contributed to the Mexican migrant experience in the United States.
Antioquia's Regional Narratives and the Challenges of Professional Football in Medellín during the 1950s and 1960s
Authors: BOLIVAR‐RAMIREZ INGRID J.
Published: November 2018

This article examines the challenges sportswriters and footballers faced in Antioquia (Colombia) during the 1950s and 1960s when trying to make of professional football a legitimate job and spectacle. Because in Colombia neither the nation‐state nor collective actors participated directly in professional football and the tournament involved teams from several regions, the history of these challenges illuminates the varying political and cultural conditions under which professional football developed, reveals footballers' agency to promote the sport, and demonstrates that professional football became a field in which different actors contested and forged regional narratives.
The influences of age, gender and geometric pattern of visual image on the verticality perception: A subjective visual vertical (SVV) study among Malaysian adults
Authors: Zakaria Mohd Normani , Salim Rosdan , Tahir Adnan , Zainun Zuraida , Mohd Sakeri Nurul Syarida
Published: November 2018

Objectives

Subjective visual vertical (SVV) is a simple, quick and reliable test for measuring utricular function. The literature on the effects of fundamental demographic variables such as age and gender on SVV is inconclusive and should be supported by research with larger samples. The aim of the present study was to determine the influences of age, gender and geometric pattern of visual image on SVV among healthy adults.

Study Design

This study employed a repeated measures design.

Settings

Otorhinolaryngology Clinic, Hospital Universiti Sains Malaysia, Malaysia.

Participants

Eligible Malaysian adults (N = 187, aged 21‐75 years) were recruited and categorised into young (N = 60), middle‐aged (N = 66) and older (N = 61) groups. Most of them were Malay, and 51.3% were men.

Main Outcome Measures

Subjective visual vertical angles (in degrees) were determined from each participant in a static upright condition using a computerised SVV device. They were asked to indicate their verticality perception for three types of visual images (solid line, dotted line and arrow pattern).

Results

Three‐way mixed ANOVA revealed insignificant influences of age and gender on SVV results (P > 0.05). In contrast, mean SVV angles were significantly higher for the arrow pattern than for other visual images (P = 0.004).

Conclusion

While the insignificant influences of age and gender on static SVV are further ascertained with larger samples, the perception of verticality is less accurate when aligning a more geometrically complex visual image (ie, arrow pattern). Further SVV research on vestibular‐disordered patients is beneficial, particularly to verify the normative data obtained with this complex visual image.
Design of skin islands for a myocutaneous serratus anterior free flap—An anatomical study and clinical implication for pharyngeal reconstruction after laryngopharyngectomy
Authors: Janik Stefan J. , Paraszti István , Hirtler Lena , Seemann Rudolf , Traxler Hannes , Weninger Wolfgang , Erovic Boban M.
Published: November 2018

Objectives

The main purpose of this study was to evaluate flap size and flap design of skin islands in myocutaneous serratus anterior free flaps (SAFFs) in fresh cadavers and to further investigate whether myocutaneous SAFFs are suitable flaps for pharyngeal reconstruction after laryngopharyngectomy.

Methods

Dissection and injection of methylene blue were performed in 20 hemithoraces of 13 fresh cadavers to evaluate flap size and location of skin islands. Based on these pre‐clinical data, we performed pharyngeal reconstruction with myocutaneous SAFF in five patients after laryngopharyngectomy.

Results

Perfused skin paddles were found in all specimens with a mean size of perfused skin islands of 85.6 ± 49.8 cm2. Lengths and widths of skin islands ranged from 10‐21 cm and 6‐20.5 cm respectively. Flap size did not significantly differ between males and females (P = 0.998), left compared to right hemithoraces (P = 0.468) and between paired specimens (P = 0.915). All skin islands were found within the upper 29.3%‐51.7% of hemithorax (calculated from axilla to costal arch), and between latissimus dorsi muscle posteriorly and anterior axillary line anteriorly. Accordingly, myocutaneous SAFFs were used for pharyngeal reconstruction after laryngopharyngectomy in five patients with advanced hypopharyngeal carcinomas. Three patients had uneventful courses, while one patient developed immediate intraoperative flap loss and another patient developed partial necrosis of SAFF on postoperative day 7.

Conclusion

Skin islands of SAFF have reliable blood supply, which allow harvest of large myocutaneous SAFFs that can be used also for pharyngeal reconstruction after laryngopharyngectomy.
Decreased serum neuregulin 4 levels associated with non‐alcoholic fatty liver disease in children with obesity
Authors: Wang Ran , Yang Fan , Qing Li , Huang Rong , Liu Qianqi , Li Xiaonan
Published: November 2018

Neuregulin 4 (Nrg4), a newly identified adipokine secreted by brown adipose tissue, is hypothesised to play a crucial role in metabolism. The present study aimed to evaluate the association between serum Nrg4 levels and non‐alcoholic fatty liver disease (NAFLD) in children with obesity in China. A total of 123 children with obesity were included in this study. Anthropometric and biochemical parameters were measured in all subjects. NAFLD was diagnosed using ultrasonography. The serum levels of Nrg4, leptin and adiponectin were measured by enzyme‐linked immunosorbent assay. NAFLD was identified in 58 children with obesity (47.2%). Serum Nrg4 levels were significantly lower in the NAFLD group (2.24 [1.20, 3.22] ng/mL) than in the control group (5.50 [2.45, 10.85] ng/mL) (p < 0.001). Serum Nrg4 levels were negatively correlated with most of the anthropometric and biochemical parameters (p < 0.05) but were positively correlated with high‐density lipoprotein cholesterol (p < 0.05). In multiple stepwise regression analyses, serum Nrg4 levels were independently related with WHtR (β = −2.009, p = 0.048) and homeostasis model assessment of insulin resistance (β = −0.524, p = 0.005). Furthermore, a multivariable logistic regression analysis of NAFLD prediction by Nrg4 revealed an odds ratio of 0.129 (95% confidence interval: 0.028–0.587, p < 0.01). The receiver operating characteristic curve analysis of the diagnostic value of using serum Nrg4 levels to differentiate NAFLD in children with obesity showed that the area under the curve was 0.723; the cutoff for serum Nrg4 levels to have diagnostic value for predicting NAFLD in children with obesity was 3.39 ng/mL. Elevated Nrg4 is associated with a decreased risk of NAFLD in children with obesity.
Treatment of anal fissure: a survey of surgical practice in Australia and New Zealand
Authors: Siddiqui J. , Fowler G. E. , Zahid A. , Brown K. , Young C. J.
Published: November 2018

Aim

The aim was to determine whether or not the clinical management of anal fissure in Australia and New Zealand accords with published guidelines.

Methods

A comprehensive survey based on common clinical scenarios was distributed to 206 colorectal surgeons in Australia and New Zealand.

Results

The response rate was 44% (91 surgeons). For 19 topic areas, only seven (37%) reached consensus (defined as > 70% majority opinion). Of these, six (86%) agreed with guideline recommendations. Twelve (63%) topic areas demonstrated community equipoise (defined as less than or equal to 70% majority opinion), of which five (42%) agreed with guideline recommendations and seven (58%) disagreed with guidelines. Of the seven topics that disagreed with guidelines, three were based on moderate quality evidence (first line management of acute anal fissure in a young patient, fissure healing and faecal incontinence rates following anocutaneous flap) and four were based on low quality evidence (length of sphincter division during a lateral sphincterotomy in women, management of chronic low‐pressure anal fissures postpartum, fissure healing rate following anoplasty with botulinum toxin or sphincterotomy and faecal incontinence rates following repeat sphincterotomy for recurrence). Consensus and/or agreement with guidelines were more prevalent in management when medical therapy failed.

Conclusion

While areas of consensus mostly agreed with guideline recommendations, there remain many areas of community equipoise which warrant further research.
CD8‐positive pseudolymphoma in lues maligna and human immunodeficiency virus with monoclonal T‐cell receptor‐beta rearrangement
Authors: Mitteldorf Christina , Plumbaum Heidi , Zutt Markus , Schön Michael P. , Kaune Kjell M.
Published: November 2018

A 42‐year‐old Caucasian man suffered from disseminated plaques and ulcerated nodules for 6 weeks. He had weight loss and generalized lymphadenopathy. Underlying diseases were not known up till then. Based on a skin biopsy, the diagnosis of CD8‐positive cutaneous T‐cell lymphoma, type mycosis fungoides was made in a pathological reference center for lymphoma. A reproducible T‐cell receptor (TCR)‐beta rearrangement was detectable. Before starting therapy, a new biopsy was taken and the previous diagnosis was re‐evaluated taking clinical images and symptoms into account. Based on both, the diagnosis of a CD8+ pseudolymphoma in lues maligna and human immunodeficiency virus was made. We highlight histopathologic clues for the correct diagnosis, and we emphasize the indispensability of clinical‐pathological correlation. Furthermore, we discuss the differential diagnosis of CD8+ lymphoproliferative disorders.
Development of hand function during the first year of life in children with unilateral cerebral palsy
Authors: Sakzewski Leanne , Sicola Elisa , Verhage Cornelia H , Sgandurra Giuseppina , Eliasson Ann‐Christin
Published: November 2018

Aim

To identify developmental trajectories of hand function in infants aged 3 months to 12 months with unilateral cerebral palsy (CP).

Method

Infants at high risk of unilateral CP were recruited from 3 months of age from follow‐up programmes and clinics in Sweden, the Netherlands, Italy, and Australia. Measurements on the Hand Assessment for Infants (HAI) were completed until 12 months of age. Group‐based trajectory modelling was used to identify subgroups of infants with similar trajectories of development. Multinomial logistic regression determined associations between demographic variables and trajectory membership.

Results

Ninety‐seven infants (52 males, 45 females; median gestational age 38wks [interquartile range 30–40wks]) were included. Infants were assessed between two and seven times (mean 4, SD 1.2) with a total of 387 observations. A three‐group trajectory model identified a ‘low‐functioning group’ (n=45: 46%), ‘moderate‐functioning group’ (n=30: 31%), and ‘high‐functioning group’ (n=22: 23%). Mean posterior probabilities (0.91–0.96) and odds of correct classification (26.3–33.2) indicated good model fit. Type of brain lesion, sex, side of hemiplegia, country, gestational age, and access to intensive intervention were not associated with group membership.

Interpretation

Three trajectories of hand function development for infants with unilateral CP were identified and indicate some greater distinctions between groups with increasing age. The HAI is a valuable measure, capturing development of hand function of infants with unilateral CP over time.

What this paper adds

Three distinct developmental trajectories of hand function in infants with unilateral cerebral palsy were identified.

A low‐functioning group made little progress in development of hand function in the first year of life.

The degree of impairment on the impaired hand at 6 months of age is highly associated with trajectory membership.

Infants with all types of brain lesion were represented across each trajectory group.
Influence of mildly and moderately elevated pulmonary artery systolic pressure on post‐renal transplantation survival and graft function
Authors: Wang Stephani C. , Garcia Rachel , Torosoff Mikhail , Fein Steven A. , Ashar Ata , Chandolias Nikolaos , Conti David , Lyubarova Radmila
Published: November 2018

Background

Severe pulmonary hypertension (PH) has been associated with decreased post–kidney transplant survival and increased rate of long‐term cardiovascular complications. Despite a high prevalence of PH in patients with end‐stage renal disease, data on post‐transplant renal allograft survival in recipients with pre‐existing mild‐to‐moderate PH are limited.

Methods

The single‐center retrospective study cohort consisted of 192 consecutive (2008–2015) renal transplant recipients with documented pretransplantation transthoracic echocardiogram (TTE) pulmonary artery systolic pressure (PASP). Mean age was 50.9 ± 12.4 years, 36.5% were females, and 81.25% were Caucasians.

Results

Elevated PASP ≥ 37 mm Hg was present in 51 patients. Elevated PASP was more common in patients with decreased <50% left ventricular ejection fraction (13.73% vs 3.55%, P = 0.010); otherwise, there were no significant differences in baseline demographic (age, ethnicity, gender, and donor status) and clinical parameters between patients with normal and elevated PASP. Four‐year mortality (5.7%) was not significantly affected by elevated PASP. However, elevated PASP was associated with significantly decreased estimated glomerular filtration rate (eGFR) at 1 year (52.26 vs 60.13 mL/min, P = 0.019) and 2 years (51.04 vs 60.28 mL/min, P = 0.006) post‐transplant.

Conclusion

Mild and moderately elevated pre–kidney transplant PASP does not affect 4‐year post‐transplant mortality or graft loss. However, elevated pretransplant PASP is significantly associated with decreased 1 year and 2 years post‐transplant eGFR. Preoperative echocardiographic evaluation for PH may be useful in predicting the probability of short‐term renal graft and long‐term graft dysfunction in these patients.
Institutions for the taking: property rights and the settlement of the Cape Colony, 1652–1750
Authors: Dye Alan , La Croix Sumner
Published: November 2018

We examine the formation of property rights in land during the early settlement by the Dutch of the Cape Colony at the southern tip of Africa. After its founding in 1652 as a provisioning outpost for ships of the Dutch East India Company (VOC), the colonial government promoted settlement initially by granting land with well‐specified and enforced property rights in restricted zones near Cape Town. By 1714 it transitioned to accommodate rapidly expanding settlement by creating a weaker form of property rights, the loan farm, which was imprecisely defined and had limited government enforcement. We develop a profit‐maximizing monopsony model to explain the VOC's choice to transition from the better‐specified land grant to the less well‐specified loan farm. We conclude that the decline in the population size and ability of the Khoikhoi, the Cape's original inhabitants, to organize effective resistance to the Dutch invasion was critical to the transition, as it lowered the costs of private enforcement of settlers’ territorial claims. The choice of property rights thus enabled and encouraged the rapid taking by European settlers of the western Cape of Africa for the expansion of the Dutch colony's pastoral economy.
Local adaptation primes cold‐edge populations for range expansion but not warming‐induced range shifts
Authors: Hargreaves Anna L. , Eckert Christopher G.
Published: November 2018

According to theory, edge populations may be poised to expand species’ ranges if they are locally adapted to extreme conditions, or ill‐suited to colonise beyond‐range habitat if their offspring are genetically and competitively inferior. We tested these contrasting predictions by transplanting low‐, mid‐, and high‐elevation (edge) populations of an annual plant throughout and above its elevational distribution. Seed from poor‐quality edge habitat (one of two transects) had inferior emergence, but edge seeds also had adaptive phenology (both transects). High‐elevation plants flowered earlier, required less heat accumulation to mature seed, and so achieved higher lifetime fitness at and above the range edge. Experimental warming improved fitness above the range, but eliminated the advantage of local cold‐edge populations, supporting recent models in which cold‐adapted edge populations do not facilitate warming‐induced range shifts. The highest above‐range fitness was achieved by a ‘super edge phenotype’ from a neighbouring mountain, suggesting key adaptations exist regionally even if absent from local edge populations.
When the “U” is not Inverted: Trajectories of Expressed Emotional Arousal Predict Relationship Satisfaction
Authors: Fischer Melanie S. , Baucom Brian R. W. , Baucom Donald H. , Sheng Elisa , Atkins David C. , Hahlweg Kurt
Published: November 2018

Maladaptive emotional reactivity and dysfunctional communication during couple conflict are both destructive to couple functioning, and observational research has elucidated how conflict escalates. However, much of the evidence is based on measures that combine content (i.e., what was said) and the emotion with which it was said, which are then examined using sequential analyses. Despite the general presumptions about underlying emotional reactivity and escalation in negative emotions as part of relationship distress and deterioration, little empirical data are available that directly examine these continuous shifts in emotions. The current study examined concurrent and longitudinal associations between relationship satisfaction and trajectories of change in vocally expressed emotional arousal during couple conflict in 62 couples who participated in a relationship education program. Contrary to expectations and patterns found in distressed couples, trajectories followed a U‐shape rather than an inverted U‐shape curve, with steeper and more persistent decreases in emotional arousal predicting more stable relationship satisfaction over time. In addition, there were within‐couple effects. These results suggest that early signs for relationship deterioration may be less in the form of overt escalation as would be seen in distressed couples. Instead, couples who subsequently deteriorate more are less effective in calming emotional arousal. They also are less able to remain at lower emotional arousal. It is possible that the more pronounced escalation toward the end of the conversation in more at‐risk couples is a precursor of the greater escalation patterns seen in distressed couples; this should be examined empirically. Limitations and implications are discussed.
Scurvy in a hemodialysis patient. Rare or ignored?
Authors: Panchal Sarju , Schneider Christine , Malhotra Kunal
Published: November 2018

Chronic kidney disease and dialysis brings with it a plethora of complications, including malnutrition. Strict dietary restrictions in hemodialysis (HD) patients further complicate the picture as it increases the risk of deficiency of micronutrients, specifically water‐soluble vitamins. Today, there is a lack of concrete guidelines concerning recommendations on vitamin supplementation in HD patients. This lack of data is partly due to our incomplete understanding of handling of vitamins in a uremic state. There is a dire need for more data on the impact of dialysis and uremic state on water‐soluble vitamins to facilitate appropriate preventative supplementation. We present a case of scurvy in a HD patient that will contribute toward the understanding of vitamin status in HD. We hope it will aid in screening HD patients for vitamin C deficiency and individualizing supplementation of vitamin C.
High‐risk symptoms do not predict gastric cancer precursors
Authors: Da Ben , Jani Niraj , Gupta Nikhil , Jayaram Preeth , Kankotia Ravi , Yao Yu Chung , Dinis‐Ribeiro Mario , Buxbaum James
Published: November 2018

Background & Study Aims

Gastric intestinal metaplasia (GIM) is the most common precursor of gastric cancer. Our aim is to determine if presenting symptoms predict gastric cancer precursor lesions in a high‐risk population.

Patient and Methods

Consecutive unique patients evaluated by endoscopy for upper gastrointestinal symptoms at the Los Angeles County Hospital between 2010 and 2014 were evaluated. Presenting symptoms were classified as low‐ or high‐risk depending on the procedure indication as coded using the Clinical Outcomes Research Initiative (CORI) system. Endoscopy and histology results were used to classify findings as benign, GIM, high‐risk GIM, or malignant. The primary outcome was the proportion of patients with premalignant or malignant gastric findings who had high‐risk clinical indications for endoscopy relative to those with benign results.

Results

A total of 3699 patients underwent endoscopy to evaluate upper gastrointestinal symptoms. There were 373 (10.1%) patients with GIM of which 278 had high‐risk GIM. One hundred and sixty (4.3%) patients were diagnosed with gastric cancer. High‐risk indications for upper endoscopy predicted gastric cancer (OR 1.8 [95% CI 1.3‐2.6]) but not GIM (OR 1.0 [0.8‐1.3]) or high‐risk GIM (OR 0.9 [0.7‐1.2]). Hispanic or Asian patients and patients >50 years old were more likely to have GIM, high‐risk GIM, and cancer.

Conclusions

Performance of upper endoscopy for high‐risk indications is inadequate to detect GIM and marginal for malignancy. At risk patients should undergo upper endoscopy for both low‐ and high‐risk symptoms. Screening certain populations deserve additional study and may, in fact, be cost‐effective.
A systematic review to assess the methodological quality of studies on measurement properties for caries risk assessment tools for young children
Authors: Christian Bradley , Armstrong Rebecca , Calache Hanny , Carpenter Lauren , Gibbs Lisa , Gussy Mark
Published: November 2018

Background

At present, there are numerous caries risk assessment tools (CRATs) being promoted for disease management. The evidence to inform CRAT selection however is unclear.

Aim

This review aimed to assess the strength of evidence to inform the selection of CRATs for children ages 6 years and less.

Design

MEDLINE was the principal search database for this review. Other key databases, the reference lists of included articles, known cariology literature and experts were also consulted. Peer‐reviewed papers describing CRATs and their development methodology were included. The Consensus‐based Standards for the selection of health Measurement Instruments (COSMIN) checklist guided the quality assessment. The reporting of the key measurement properties (reliability, validity, and responsiveness) informed the quality assessment.

Results

The search resulted in 10 papers, reporting on eight different CRATs. The identified CRATs were as follows: Caries Management By Risk Assessment (CAMBRA), Cariogram, National University of Singapore CRAT (NUS‐CRAT), MySmileBuddy, Dundee Caries Risk Assessment Model, University of North Carolina Risk Assessment Models, University of Michigan paediatric dental clinic caries risk assessment sheet, and American Academy of paediatric Dentistry (AAPD) CRAT. Common across all CRATs was the lack of information to determine the levels of evidence for the measurement properties of reliability and construct validity. Studies on tools that were assessed as having strong evidence for content validity identified the relevant risk factors for caries in the population being studied, before developing and testing their respective CRATs.

Conclusions

The evidence to inform the selection of current CRATs for children is mostly yet to be established. Overall, the NUS‐CRAT studies reported the most information to inform the assessment of its measurement properties, and as a result, this tool attained a higher quality rating than other CRATs studied.
Y‐chromosome haplotype analysis revealing multiple paternal origins in swamp buffaloes of China and Southeast Asia
Authors: Wang Shaoqiang , Xia Xiaoting , Zhang Tao , Sun Ting , Dang Ruihua , Huang Yongzhen , Lan Xianyong , Chen Hong , Lei Chuzhao
Published: November 2018

To further probe into the paternal origins and domestication area of swamp buffaloes, we examined Y‐chromosome diversity of 482 bulls representing 22 populations from China and Southeast Asia. A total of 40 bovine Y‐chromosome‐specific microsatellite (Y‐STR) markers were screened in this study. The results showed that seven Y‐STR markers (UMN2405, UMN0504, UMN0103, UMN1307, BC1.2, UMN0304 and INRA008) were specific and polymorphic in male swamp buffaloes, which can define 9 Y‐haplotypes corresponding to four Y‐haplogroups (Y1, Y2, Y3 and Y4). Haplogroup Y1 was predominant (83.4%) in all swamp buffalo populations, indicating haplogroup Y1 was the major domestication event of swamp buffalo. In addition, the abundant genetic background and backbone of haplogroup Y1 suggested Yangtze Valley as the major domestication area of swamp buffalo. Interestingly, haplogroup Y4 was only confined in Hainan Island which was more ancient than other haplogroups. We hypothesized that haplogroup Y4 was the descendants of the wild Asian buffalo trapped on Hainan Island in prehistoric glacier period and preserved by later introgression into domesticated cows after the domestication. In conclusion, our findings revealed four divergent paternal origins in swamp buffaloes based on Y‐STR markers.
A comparison between modified and conventional surgical techniques for surgical lip repositioning in the management of the gummy smile
Authors: Alammar Asmaa , Heshmeh Omar , Mounajjed Radek , Goodson Michaela , Hamadah Omar
Published: November 2018

Aim

The aim of this study was to evaluate and compare conventional and modified lip repositioning surgical techniques used for management of gummy smile involving hyperactive lip elevator muscles.

Methods and Materials.

A prospective study was conducted between April 2016 and May 2017. Twenty two adult patients aged 18‐38 years with gummy smile ranging from 4 to 6 mm because of soft tissue disorders were included in the study. All patients were treated in the oral and maxillofacial department at Damascus University. The sample was divided into two groups of 11 patients. The first group was treated by the conventional standard technique, and the second group treated by a modified study technique. The amount of gingival display in full smile was evaluated in both groups following each intervention.

Results

Both groups exhibited a statistically significant reduction in the measurement of gummy smile at month 1 and 6 postoperatively (P < .05), but there was no significant difference in gingival display at 3 months in either group postoperatively (P > .05). The recent study showed a significant difference in gingival display between 3 and 6 months postoperatively in group 1, but no significant difference in group 2.

Conclusion

This study showed that the modified technique utilized in treating gummy smile has less relapse after surgery, shows excellent cosmesis and compared to the conventional technique, greater sustainability.

Clinical significance

The recent increase in demand for an esthetic smile has led to the development a modification of conventional lip repositioning for correcting gummy smile by myotomy of lip elevator muscles. This modified technique offers less relapse and greater stability post‐operatively than the conventional technique.
New Zealand rickettsia‐like organism (NZ‐RLO) and Tenacibaculum maritimum: Distribution and phylogeny in farmed Chinook salmon (Oncorhynchus tshawytscha)
Authors: Brosnahan Cara L. , Munday John S. , Ha Hye Jeong , Preece Mark , Jones John B.
Published: November 2018

A total of 777 fish from three growing regions of New Zealand Chinook salmon farms comprising of five sites were tested. Quantitative PCR was used to determine the distribution of New Zealand rickettsia‐like organism and Tenacibaculum maritimum. Genetic information from these bacteria were then compared with strains reported worldwide. Using this information, suggested associations of pathogens with clinically affected fish were made. NZ‐RLO was detected in two of the three regions, and T. maritimum was detected in all regions. Three strains of NZ‐RLO were identified during this study. Based on analysis of the ITS rRNA gene, NZ‐RLO1 appears to be part of an Australasian grouping sharing high similarity with the Tasmanian RLO, NZ‐RLO2 was shown to be the same as an Irish strain, and NZ‐RLO3 was shown be closely related to two strains from Chile. Based on multi‐locus sequence typing, the New Zealand T. maritimum was the same as Australian strains. NZ‐RLOs were detected more frequently in fish with skin ulcers than fish without skin ulcers. While additional research is required to investigate the pathogenicity of these organisms, this is the first time that NZ‐RLOs have been associated with the development of clinical infections in farmed Chinook salmon.
Persistent amnion‐chorion membrane separation
Authors: Gerson Kristin D. , Modest Anna M. , Hecht Jonathan L. , Young Brett C.
Published: November 2018

Aim

Fetal membranes are composed of the amnion and chorion, which fuse during the early second trimester. Persistent separation confers increased risk of adverse perinatal outcomes. This study characterizes sonographic and placental findings associated with persistent amnion‐chorion (AC) membrane separation.

Methods

This is a case series of 23 patients carrying singleton pregnancies with persistent AC membrane separation after 16 weeks’ gestation diagnosed by ultrasound from 2010 to 2016 at our institution. Twenty placentas were available for analysis.

Results

Obstetrical complications occurred in 13 (56.5%) cases; two (8.7%) cases resulted in intrauterine fetal demise. Fetal malformations were reported in eight (34.8%) cases. Four (17.4%) neonates were small‐for‐gestational age (SGA; <10th percentile). Placental size measured ≤10th percentile for gestational age in eight (40%) cases. Placental cord insertion was marginal or velamentous in eight (34.8%) cases. Maternal and/or fetal placental perfusion abnormalities occurred in 11 (55%) cases.

Conclusion

AC membrane separation is associated with adverse obstetrical outcomes, placental abnormalities, including marginal and velamentous cord insertion, placental growth restriction and placental perfusion defects. This membrane complication is associated with increased incidence of fetal malformations in the absence of identifiable genetic etiologies.
Patterns and costs of health‐care utilisation in Australian children: The first 5 years
Authors: Hayes Alison J , Brown Victoria , Tan Eng Joo , Chevalier Anna , D’Souza Mario , Rissel Chris , Baur Louise A , Wen Li Ming , Moodie Marj L
Published: November 2018

Aim

To describe patterns of health‐care utilisation and costs of a cohort of Australian children in the first 5 years of life and to investigate demographic factors associated with high health‐care utilisation.

Methods

This was a secondary data analysis of prospectively linked health‐care utilisation data, including primary and secondary health‐care consults, hospitalisations and emergency. The subjects were 350 children from a disadvantaged area of Sydney. Outcomes were the frequency and cost of all health‐care consults from birth to 5 years of age. Multivariable logistic regression examined the odds of being a high health‐care user in relation to child and family characteristics.

Results

Children had more health‐care consults and higher annual health‐care costs in the first 2 years of life (mean 12 health‐care visits per year, mean cost Australian dollars (AUD) 1400 per child) than in the next 3 years (8 visits per year, AUD 900 per child). Primary care consults formed 86% of all health‐care encounters but only contributed to 30% of the total costs. Factors positively associated with frequent use of health care in the first 2 years of life included being male, mother not married/de facto and annual household income of less than AUD 40000. Frequent users mostly accessed primary care services. There was no association between demographic factors and frequent use of health care in years 3–5 of life.

Conclusions

Children from low‐income or single‐parent families may require additional support services during the first 2 years of life. Maintaining or increasing access to free or very low‐cost primary health‐care services for disadvantaged families will promote equity in health.