bluuebunny/crossref_metadata_2025 huggingface dataset:
Extensive land cover change across Arctic–Boreal Northwestern North America from disturbance and climate forcing
Authors: Wang Jonathan A. , Sulla‐Menashe Damien , Woodcock Curtis E. , Sonnentag Oliver , Keeling Ralph F. , Friedl Mark A.
Published: August 2019

A multitude of disturbance agents, such as wildfires, land use, and climate‐driven expansion of woody shrubs, is transforming the distribution of plant functional types across Arctic–Boreal ecosystems, which has significant implications for interactions and feedbacks between terrestrial ecosystems and climate in the northern high‐latitude. However, because the spatial resolution of existing land cover datasets is too coarse, large‐scale land cover changes in the Arctic–Boreal region (ABR) have been poorly characterized. Here, we use 31 years (1984–2014) of moderate spatial resolution (30 m) satellite imagery over a region spanning 4.7 × 106 km2 in Alaska and northwestern Canada to characterize regional‐scale ABR land cover changes. We find that 13.6 ± 1.3% of the domain has changed, primarily via two major modes of transformation: (a) simultaneous disturbance‐driven decreases in Evergreen Forest area (−14.7 ± 3.0% relative to 1984) and increases in Deciduous Forest area (+14.8 ± 5.2%) in the Boreal biome; and (b) climate‐driven expansion of Herbaceous and Shrub vegetation (+7.4 ± 2.0%) in the Arctic biome. By using time series of 30 m imagery, we characterize dynamics in forest and shrub cover occurring at relatively short spatial scales (hundreds of meters) due to fires, harvest, and climate‐induced growth that are not observable in coarse spatial resolution (e.g., 500 m or greater pixel size) imagery. Wildfires caused most of Evergreen Forest Loss and Evergreen Forest Gain and substantial areas of Deciduous Forest Gain. Extensive shifts in the distribution of plant functional types at multiple spatial scales are consistent with observations of increased atmospheric CO2 seasonality and ecosystem productivity at northern high‐latitudes and signal continental‐scale shifts in the structure and function of northern high‐latitude ecosystems in response to climate change.
DMPP reduced nitrification, but not annual N2O emissions from mineral fertilizer applied to oilseed rape on a sandy loam soil
Authors: Thers Henrik , Petersen Søren O. , Elsgaard Lars
Published: August 2019

Direct field emissions of nitrous oxide (N2O) may determine whether biodiesel from oilseed rape (Brassica napus L.) fulfills the EU requirement of at least 50% reduction of greenhouse gas emissions as compared to fossil diesel. However, only few studies have documented fertilizer N emission factors (EF) and mitigation options for N2O emissions from oilseed rape cropping systems. We conducted a field experiment with three N levels (0, 171, and 217 kg/ha), where the N fertilizer was applied as ammonium sulfate nitrate with or without the nitrification inhibitor 3,4‐dimethylpyrazole phosphate (DMPP). N2O fluxes were measured using static chambers technique and soil samples were analyzed for water and mineral N content during a monitoring period of 368 days. The DMPP treatments showed a significantly increased level of ammonium () for up to 18 weeks after spring fertilization as compared to the treatments without DMPP. However, this difference did not result in a corresponding decrease in soil content, and no differences in cumulative N2O emissions were found between any fertilized treatments with or without DMPP (mean, 1.26 kg N2O‐N ha−1 year−1). More field experiments are needed to clarify whether DMPP‐coated mineral fertilizers could mitigate N2O emissions under different weather conditions, for example, under conditions where fertilization events concurred with rainfall events increasing water‐filled pore space to the assumed 60% threshold for denitrification. Emission factors for mineral N fertilizer were 0.28%–0.36% with a mean of 0.32% across the fertilized treatments. These data concur with recent European studies suggesting that the EF for mineral N fertilizers in oilseed rape cropping systems may typically be lower than the default IPCC value of 1%. Further studies are needed to consolidate an EF for oilseed rape under temperate conditions, which will be determining for the sustainability of Northern European oilseed rape cultivation for biodiesel.
Quality of life in cognitively impaired older adults
Authors: Bonfiglio Viviana , Umegaki Hiroyuki , Kuzuya Masafumi
Published: August 2019

Aim

Quality of life (QOL) in older adults can be affected by many factors, such as dementia, sarcopenia and frailty. This study sought to identify factors that can lead to global deterioration in QOL among older outpatients, including factors stated in caregiver reports. This study also evaluated the discrepancy between QOL ratings reported by the patients and those by their family or professional caregivers.

Methods

The sample comprised 141 patients with a Mini‐Mental State Examination score ≥20 and a Clinical Dementia Rating of 0.5–1, indicating mild cognitive impairment to mild dementia. QOL was assessed using both components of the EQ‐5D scale, namely, the index score and visual analog scale. In addition, cognitive, neuropsychological, nutritional and physical function tests were carried out, and body measurements were taken.

Results

Patients’ self‐reported QOL was significantly associated with basic activities of daily living, Mini Nutritional Assessment score and Geriatric Depression Scale‐15. QOL rated by caregivers was significantly associated with basic activities of daily living. EQ‐5D index scores reported by caregivers were lower than those reported by patients. Furthermore, patients achieved a better score for self‐care, usual activities, pain/discomfort and anxiety/depression than those assigned by caregivers.

Conclusions

As far as the patient's ratings are concerned, the presence of depressive symptoms and a worse nutritional status were indicative of lower QOL, whereas a better functional status was associated with a higher QOL. For caregivers, however, the most relevant factor negatively affecting QOL was basic activities of daily living. Geriatr Gerontol Int 2019; 19: 999–1005.
Nutritional status of children and adolescents with haemophilia in Basra, Iraq
Authors: Abdulaziz Jaafar Sadek , Hassan Meaad Kadhum
Published: August 2019

Introduction

Patients with haemophilia are at increased risk of being overweight or obese, which in turn may have a profound effect on morbidity and quality of life.

Aims

To assess the nutritional status of paediatric patients with haemophilia and identify possible risk factors that may adversely affect their nutritional status.

Methods

A case‐control study was performed on 63 haemophilia patients and 135 control subjects aged 5‐18 years. For all participants, weight, height and body mass index Z (BMIZ) score were assessed. Physical activity (PA) was assessed using the International Physical Activity Questionnaire and the Children's Physical Activity Questionnaire for participants ≥15 years and 5‐14 years old, respectively.

Results

The frequency of overweight and obesity was 36.29% among the control group compared with 23.81% among patients, while thinness was higher in patients with haemophilia (19.05%) compared with 9.63% in the control group,P = .042. Low PA was reported in 22.73% of haemophilia patients aged 5‐14 years compared with 2.06% in the control group,P < .001. However, no difference in PA was reported among participants aged ≥15 years. There were no significant differences in the frequency of nutritional problems among patients with respect to age, type of haemophilia, disease severity and hepatitis C seropositivity. Regression analysis revealed a negative association between paternal educational level and high BMIZ in patients ≥15 years,P = .028.

Conclusions

Paediatric patients seem to have lower BMIZ than the control group. In addition, most of the studied factors were not found to predict either high or low BMIZ among studied patients.
Sintering of porous alumina using an alumina slurry containing aluminum and polysiloxane
Authors: Kita Ken'ichiro , Kondo Naoki
Published: August 2019

We herein describe the sintering of a slurry containing alumina, aluminum, and polysiloxane. After sintering, porous alumina was obtained with an increased bulk density but without any remarkable change in volume. In addition, necking was found to occur between the alumina and aluminum particles due to the formation of an aluminum silicate layer by polysiloxane upon sintering at 800°C, and this necking resulted in volume expansion upon further heating. Furthermore, the bulk density of the sample increased due to aluminum filling the spaces between particles during aluminum oxidation when sintering at temperatures ≥1200°C.
The phosphatase activity of soluble epoxide hydrolase regulates ATP‐binding cassette transporter‐A1‐dependent cholesterol efflux
Authors: Lien Chih‐Chan , Chen Chia‐Hui , Lee Yeng‐Ming , Guo Bei‐Chia , Cheng Li‐Ching , Pan Ching‐Chien , Shyue Song‐Kun , Lee Tzong‐Shyuan
Published: August 2019

The contribution of soluble epoxide hydrolase (sEH) to atherosclerosis has been well defined. However, less is understood about the role of sEH and its underlying mechanism in the cholesterol metabolism of macrophages. The expression of sEH protein was increased in atherosclerotic aortas of apolipoprotein E‐deficient mice, primarily in macrophage foam cells. Oxidized low‐density lipoprotein (oxLDL) increased sEH expression in macrophages. Genetic deletion of sEH (sEH−/−) in macrophages markedly exacerbated oxLDL‐induced lipid accumulation and decreased the expression of ATP‐binding cassette transporters‐A1 (ABCA1) and apolipoprotein AI‐dependent cholesterol efflux following oxLDL treatment. The down‐regulation of ABCA1 in sEH−/− macrophages was due to an increase in the turnover rate of ABCA1 protein but not in mRNA transcription. Inhibition of phosphatase activity, but not hydrolase activity, of sEH decreased ABCA1 expression and cholesterol efflux following oxLDL challenge, which resulted in increased cholesterol accumulation. Additionally, oxLDL increased the phosphatase activity, promoted the sEH‐ABCA1 complex formation and decreased the phosphorylated level of ABCA1 at threonine residues. Overexpression of phosphatase domain of sEH abrogated the oxLDL‐induced ABCA1 phosphorylation and further increased ABCA1 expression and cholesterol efflux, leading to the attenuation of oxLDL‐induced cholesterol accumulation. Our findings suggest that the phosphatase domain of sEH plays a crucial role in the cholesterol metabolism of macrophages.
Cold‐inducible protein RBM3 mediates hypothermic neuroprotection against neurotoxin rotenone via inhibition on MAPK signalling
Authors: Yang Hai‐Jie , Zhuang Rui‐Juan , Li Yuan‐Bo , Li Tian , Yuan Xin , Lei Bing‐Bing , Xie Yun‐Fei , Wang Mian
Published: August 2019

Mild hypothermia and its key product, cold‐inducible protein RBM3, possess robust neuroprotective effects against various neurotoxins. However, we previously showed that mild hypothermia fails to attenuate the neurotoxicity from MPP+, one of typical neurotoxins related to the increasing risk of Parkinson disease (PD). To better understand the role of mild hypothermia and RBM3 in PD progression, another known PD‐related neurotoxin, rotenone (ROT) was utilized in this study. Using immunoblotting, cell viability assays and TUNEL staining, we revealed that mild hypothermia (32°C) significantly reduced the apoptosis induced by ROT in human neuroblastoma SH‐SY5Y cells, when compared to normothermia (37°C). Meanwhile, the overexpression of RBM3 in SH‐SY5Y cells mimicked the neuroprotective effects of mild hypothermia on ROT‐induced cytotoxicity. Upon ROT stimulation, MAPK signalling like p38, JNK and ERK, and AMPK and GSK‐3β signalling were activated. When RBM3 was overexpressed, only the activation of p38, JNK and ERK signalling was inhibited, leaving AMPK and GSK‐3β signalling unaffected. Similarly, mild hypothermia also inhibited the activation of MAPKs induced by ROT. Lastly, it was demonstrated that the MAPK (especially p38 and ERK) inhibition by their individual inhibitors significantly decreased the neurotoxicity of ROT in SH‐SY5Y cells. In conclusion, these data demonstrate that RBM3 mediates mild hypothermia‐related neuroprotection against ROT by inhibiting the MAPK signalling of p38, JNK and ERK.
DIFFERENTIAL RISK‐TAKING IMPLICATIONS OF PERFORMANCE INCENTIVES FROM STOCK AND STOCK OPTION HOLDINGS
Authors: Savaşer Tanseli , Şişli‐Ciamarra Elif
Published: August 2019

We study the risk‐taking implications of managerial pay‐for‐performance incentives (delta) arising from stock and stock options separately in the United States between 1992 and 2017. The current literature assumes that each unit of delta has an equal incentive effect on firm performance. Instead, we show that the risk‐reducing effect of performance incentives is more pronounced for executives whose delta comes mostly from stock holdings relative to option holdings. Accordingly, we propose a new measure that takes into account the magnitude of delta from option holdings relative to delta from stock holdings (source ratio). Our results show that risk taking increases as this ratio increases.
Cost‐Related Medication Nonadherence Among Older Adults: Findings From a Nationally Representative Sample
Authors: Chung Green C. , Marottoli Richard A. , Cooney Leo M. , Rhee Taeho Greg
Published: August 2019

OBJECTIVES

To estimate the rate of and risk factors associated with cost‐related medication nonadherence among older adults.

DESIGN

Cross‐sectional analysis of the 2017 National Health Interview Survey (NHIS).

SETTING

Nationally representative health interview survey in the United States.

PARTICIPANTS

Survey respondents, aged 65 years or older (n = 5701 unweighted) in the 2017 wave of the NHIS.

MEASUREMENTS

Self‐reported, cost‐related medication nonadherence (due to cost: skip dose, reduce dose, or delay or not fill a prescription) and actions taken due to cost‐related medication nonadherence (ask for lower‐cost prescription, use alternative therapy, or buy medications from another country) were quantified. We used a series of multivariable logistic regression analyses to identify factors associated with cost‐related medication nonadherence. We also reported analyses by chronic disease subgroups.

RESULTS

In 2017, 408 (6.8%) of 5901 older adults, representative of 2.7 million older adults nationally, reported cost‐related medication nonadherence. Among those with cost‐related medication nonadherence, 44.2% asked a physician for lower‐cost medications, 11.5% used alternative therapies, and 5.3% bought prescription drugs outside the United States to save money. Correlates independently associated with a higher likelihood of cost‐related medication nonadherence included: younger age, female sex, lower socioeconomic levels (eg, low income and uninsured), mental distress, functional limitations, multimorbidities, and obesity (P < .05 for all). Similar patterns were found in subgroup analyses.

CONCLUSION

Cost‐related medication nonadherence among older adults is increasingly common, with several potentially modifiable risk factors identified. Interventions, such as medication therapy management, may be needed to reduce cost‐related medication nonadherence in older adults. J Am Geriatr Soc 67:2463–2473, 2019
Medication Nonadherence as a Complex Health Behavior: There Is More to It Than Just Missed Doses
Authors: Easthall Claire
Published: August 2019

This editorial comments on the article by Chung et al.
Nocturnal Excretion in Healthy Older Women and Rationale for a Safer Approach to Sleep Disruption
Authors: Tyagi Shachi , Perera Subashan , Clarkson Becky D. , Tadic Stasa D. , Resnick Neil M.
Published: August 2019

OBJECTIVES

Insomnia, especially difficulty maintaining sleep, is prevalent among older adults and increases the incidence of falls and fractures. Moreover, the drugs used to treat it exacerbate the risk. Yet current therapies fail to address one of its most common causes in older adults: nocturia and its primary contributor, nocturnal polyuria (NP), especially among the majority of individuals without lower urinary tract symptoms (LUTS). Therefore, we examined the factors associated with nocturia in two groups of such older women and the impact of nocturia on sleep.

DESIGN

Secondary analysis of two observational studies of bladder function in carefully evaluated healthy older women.

SETTING

Academic medical center.

PARTICIPANTS

A total of 39 women without LUTS who had adequate fluid intake (ie, >1200 mL urine output/24 h recorded on their diary), normal videourodynamic testing, and normal daytime frequency (≤7 voids).

MEASUREMENTS

Voided volumes and sleep duration obtained from subjects’ 3‐day voiding diary, and sleep quality from the Center for Epidemiologic Studies Depression Scale. Nighttime excretion of more than 33% of 24‐hour urine volume was considered NP.

RESULTS

Overall, 21 of these healthy subjects (54%) awakened at least once nightly to void, and 19 (90%) of them had NP. Compared with those without nocturia, participants with nocturia had shorter duration of the first uninterrupted sleep period (182 ± 100 vs 250 ± 60 min; P = .03), and they reported worse sleep quality. Two factors contributed independently to nocturia: (1) a larger proportion of 24‐hour urine output at night (43.4 ± 7.4% vs 25.4 ± 5.5%; P = <.001) and (2) smaller bladder capacity (484 ± 157 mL vs 608 ± 167 mL; P = .02).

CONCLUSIONS

Nocturia, NP, and reduced bladder capacity are very common even in healthy older women without LUTS and are associated with impaired sleep. Thus applying currently available modalities to address both NP and reduced bladder capacity may effectively treat sleep disruption without incurring the complications of sedative‐hypnotics. J Am Geriatr Soc 67:2610–2614, 2019
Concurrent and predictive validity of the Mini Nutritional Assessment Short‐Form and the Geriatric Nutritional Risk Index in older stroke rehabilitation patients
Authors: Nishioka S. , Omagari K. , Nishioka E. , Mori N. , Taketani Y. , Kayashita J.
Published: August 2019

Background

Malnutrition may worsen clinical outcomes in stroke patients. Few malnutrition screening tools have been validated in the rehabilitation setting. The present study aimed to assess the concurrent and predictive validity of two malnutrition screening tools.

Methods

We retrospectively collected scores for the Mini Nutritional Assessment Short‐Form (MNA‐SF) and the Geriatric Nutritional Risk Index (GNRI) in consecutive stroke patients aged ≥65 years in a rehabilitation hospital. Concurrent validity was confirmed against the European Society for Clinical Nutrition and Metabolism diagnostic criteria for malnutrition (ESPEN‐DCM). Malnutrition risk within the ESPEN‐DCM process was assessed using the Malnutrition Universal Screening Tool. Cut‐off values with maximum Youden index, and with sensitivity (Se) >90% and specificity (Sp) >50%, were defined as appropriate for identification and screening of malnutrition, respectively. The Functional Independence Measure and discharge destination were used to explore predictive validity.

Results

Overall, 420 patients were analysed. Of these, we included 125 patients in the malnutrition group and 295 in the non‐malnutrition group based on the ESPEN‐DCM. Cut‐off values for the identification and screening of malnutrition were 5 (Se: 0.78; Sp: 0.85) and 7 (Se: 0.96; Sp: 0.57) for the MNA‐SF; 92 (Se: 0.74; Sp: 0.84) and 98 (Se: 0.93; Sp: 0.50) for the GNRI, respectively. The GNRI predicted discharge to acute care hospital, whereas the MNA‐SF did not predict all outcome measures.

Conclusions

The MNA‐SF and the GNRI have a fair concurrent validity in stroke patients, although lower cut‐off values than currently used were required for the MNA‐SF. The GNRI exhibits good predictive validity for discharge destination.
Cutaneous necrotic lesion: A wonderful delay adverse effect of interferon beta‐1b injection for multiple sclerosis treatment
Authors: Mozafari Nikoo , Saffaei Ali , Alizadeh Mohammad , Shabani Minoosh
Published: August 2019

Multiple sclerosis (MS) is a chronic and inflammatory autoimmune disease. These patients may manifest severe inflammatory cutaneous reactions after using interferon beta‐1b. This article describes a 55‐year‐old man with severe injection site reactions after 10 years administration of interferon beta‐1b. The biopsy specimens revealed skin and subcutaneous tissue necrosis. Histologic evaluation revealed nonspecific inflammatory reactions with no evidence of vasculitis or granulomatous reactions. Based on clinical and pathological findings, the diagnosis of skin and soft tissue necrosis due to interferon injection was given. The injection of interferon beta‐1b in the affected areas was stopped, and the patient's clinical condition improved by wound care. This report is aimed to increase awareness about severe adverse skin reactions, which may infrequently occur with subcutaneous interferon beta‐1b injection after several years. Early diagnosis of this reaction can help to prevent associated complications.
Survey of the desire to have children and engage in sexual activity after trachelectomy among young Japanese women with early‐stage cervical cancer
Authors: Yahata Hideaki , Sonoda Kenzo , Okugawa Kaoru , Yagi Hiroshi , Ohgami Tatsuhiro , Yasunaga Masafumi , Onoyama Ichiro , Kaneki Eisuke , Asanoma Kazuo , Kato Kiyoko
Published: August 2019

Aim

To evaluate how the desire to have children and engage in sexual activity change after trachelectomy in Japanese women with early‐stage cervical cancer who strongly desired to have children before surgery.

Methods

Desire to have children, coital pain, fear of sexual intercourse, sexual activity frequency and libido were assessed in cervical cancer patients who received follow‐up after trachelectomy. An anonymous questionnaire survey was conducted via informed consent.

Results

Of the 151 patients who underwent trachelectomy at Kyushu University Hospital between 2005 and 2015, 46 patients were evaluated; the response rate was 30%. The desire to have children disappeared in 13 of 46 (28%) patients, and 14 (30%) patients experienced increased coital pain. Moreover, 19 (41%) patients experienced fear of sexual intercourse, and sexual frequency decreased in 24 (52%) patients.

Conclusion

Trachelectomy is an important fertility‐sparing surgical method; however, this study revealed loss of the desire to have children and/or to engage in sexual activity in some patients after surgery. Counseling about these issues is important and should be addressed.
Relationship between Radiographic Misfit and Clinical Outcomes in Immediately Loaded Complete‐Arch Fixed Implant‐Supported Prostheses in Edentulous Patients
Authors: Slauch Robert W. , Bidra Avinash S. , Wolfinger Glenn J. , Kuo Chia‐Ling
Published: August 2019

Purpose

To examine if an uncorrected radiographically detected immediate postoperative misfit (implant level or abutment level) in immediately loaded conversion prosthesis plays a significant role in early implant or prosthesis failure. In addition, clinical characteristics related to type of arch, implant position, type of implant, implant orientation, type of connection, and type of surgery were analyzed relative to their relationship to early implant or prosthesis failure.

Materials and Methods

Immediate postoperative and subsequent follow‐up panoramic radiographs of 425 arches with immediately loaded complete‐arch fixed implant‐supported prostheses were screened in a retrospective analysis. Implants with misfit and nonmisfit within a given arch were summarized separately with respect to each clinical characteristic and the difference between misfit and nonmisfit groups was tested using a mixed‐effects logistic regression model with a patient‐specific random intercept. A p‐value <0.05 was determined to be statistically significant.

Results

A total of 2025 implants from 311 patients were identified in the 425 arches that were screened for radiographic misfit. A total of 48 implants with misfit were found within 33 arches (23 patients) for a 2.4% prevalence rate. Among the misfit implants, two failures were documented during the healing phase for an early implant survival rate of 95.8%. Five conversion prostheses with misfit fractured during the healing phase for early prosthesis survival rate of 84.8%. None of the clinical variables analyzed were significantly associated with the misfit status (p < 0.05).

Conclusions

The results from this retrospective study showed that misfit in immediately loaded complete‐arch fixed implant‐supported prostheses may not play a detrimental role in the implant survival but may affect survival of the conversion prostheses.
Development of a paediatric central venous access device database: A retrospective cohort study of practice evolution and risk factors for device failure
Authors: Kleidon Tricia M , Rickard Claire M , Schults Jessica A , Mihala Gabor , McBride Craig A , Rudkin John , Chaseling Brett , Ullman Amanda J
Published: August 2019

Aim

To describe practice evolution, complications and risk factors for multiple insertion attempts and device failure in paediatric central venous access devices (CVADs).

Methods

A paediatric retrospective cohort study using prospectively collected data from CVAD database 2012–2014. Data included were patient (i.e. age, condition), insertion (i.e. indication, device, technique) and removal (complications, dwell). Descriptive statistics and incidence rates were calculated per calendar year and compared. Risk factors for multiple insertion attempts and failure were explored with logistic regression and cox regression, respectively.

Results

A total of 1308 CVADs were observed over 273 467 catheter‐days in 863 patients. Multiple insertion attempts remained static (14%) and significantly associated with non‐haematological oncology (odds ratio 2.19; 95% confidence interval (CI) 1.08–4.43), respiratory (3.71; 1.10–12.5), gastroenterology (4.18; 1.66–10.5) and other (difficult intravenous access) (2.74; 1.27–5.92). CVAD failure decreased from 35% (2012) to 25% (2014), incidence rate from 1.50 (95% CI 1.25–1.80) to 1.28 (1.06–1.54) per 1000 catheter‐days. Peripherally inserted CVAD failure was significantly associated with lower body weight (per kilogram decrease, hazard ratio (HR) 1.02; 95% CI 1.00–1.03), cephalic vein (1.62; 1.05–2.62), difficult access (1.92; 1.02–3.73), sub‐optimal tip placement (1.69; 1.06–2.69) and gastroenterology diagnosis (2.27; 1.05–4.90). Centrally placed CVAD failure was significantly associated with younger age (per year, HR 1.04; 95% CI 1.00–1.07), tunnelled device (3.38; 2.41–4.73) and gastroenterology diagnosis (1.70; 1.06–2.73).

Conclusions

While advancement in CVAD practices improved overall CVAD insertion and failure outcomes, further improvements and innovation are necessary to ensure improved vessel health and preservation for children requiring CVAD.
Incidence, predictors and prognosis of genotype 4 hepatitis E related liver failure: A tertiary nested case‐control study
Authors: Wang Yijin , Liu Hongyang , Liu Shuhong , Yang Changshuang , Jiang Yiyun , Wang Shan , Liu Aixia , Peppelenbosch Maikel P. , Kamar Nassim , Pan Qiuwei , Zhao Jingmin
Published: August 2019

Background/Aims

Hepatitis E virus (HEV) infection has been recognized an important insult of acute or acute‐on‐chronic liver failure (A(C)LF). This study aimed to identify the incidence, predictors and outcomes of A(C)LF in patients with hepatitis E.

Methods

All patients diagnosed of hepatitis E between 2012 and 2018 in the tertiary hospital were retrospectively and consecutively analysed. Patients with hepatitis E who developed A(C)LF were enrolled as cases (HEV‐LF) and controls were randomly selected from those who did not develop liver failure with 1:3 ratio in the same cohort.

Results

Eight hundred and nine patients were diagnosed with hepatitis E, among which 80 were identified with HEV‐related liver failure (HEV‐LF) with HEV as the solely acute aetiology of A(C)LF. Sequencing of HEV genome showed genotype (GT) 4 strains in all available serum samples. Hepatitis E patients with cirrhosis underwent higher risk to develop liver failure, compared to non‐cirrhotic patients. Hydrothorax, respiratory infections, lower γ‐glutamyl transferase, higher lactate dehydrogenase and alpha‐foetoprotein were found to be independent predictors of A(C)LF in patients with hepatitis E. The 28‐day and 90‐day mortality for HEV‐LF was 12.86% and 30.36% respectively. Renal injury and lower triglyceride were independent factors associated with 28‐day mortality. Lower alanine aminotransferase and higher International normalized ratio were independent predictors of 90‐day mortality.

Conclusions

Patients with GT4 hepatitis E are at high risk to develop A(C)LF. Different CLD status impacted the incidence of HEV‐LF distinctively. The identified variables shall help to identify HEV patients with high risk for developing liver failure and the risk for death.
Biology and significance of alpha‐fetoprotein in hepatocellular carcinoma
Authors: Galle Peter R. , Foerster Friedrich , Kudo Masatoshi , Chan Stephen L. , Llovet Josep M. , Qin Shukui , Schelman William R. , Chintharlapalli Sudhakar , Abada Paolo B. , Sherman Morris , Zhu Andrew X.
Published: August 2019

Hepatocellular carcinoma (HCC) is one of the most common causes of cancer‐related deaths globally due, in part, to the majority of patients being diagnosed with intermediate or advanced stage disease. Our increased understanding of the heterogeneous molecular pathogenesis of HCC has led to significant developments in novel targeted therapies. Despite these advances, there remains a high unmet need for new treatment options. HCC is a complex disease with multiple pathogenic mechanisms caused by a variety of risk factors, making it difficult to characterize with a single biomarker. In fact, numerous biomarkers have been studied in HCC, but alpha‐fetoprotein (AFP) remains the most widely used and accepted serum marker since its discovery over 60 years ago. This review summarizes the most relevant studies associated with the regulation of AFP at the gene and protein levels; the pathophysiology of AFP as a pro‐proliferative protein; and the correlation of AFP with molecular HCC subclasses, the vascular endothelial growth factor pathway and angiogenesis. Also described are the historical and current uses of AFP for screening and surveillance, diagnosis, its utility as a prognostic and predictive biomarker and its role as a tumour antigen in HCC. Taken together, these data demonstrate the relevance of AFP for patients with HCC and identify several remaining questions that will benefit from future research.
Plasma N‐terminal propeptide of type III procollagen accurately predicts liver fibrosis severity in children with non‐alcoholic fatty liver disease
Authors: Mosca Antonella , Comparcola Donatella , Romito Ilaria , Mantovani Alessandro , Nobili Valerio , Byrne Christopher D. , Alisi Anna , Targher Giovanni
Published: August 2019

Background & Aims

We examined the diagnostic performance of plasma N‐terminal propeptide of type III procollagen (PIIINP) levels, aspartate aminotransferase to platelet ratio index (APRI) and Fibrosis‐4 (FIB‐4) score for predicting non‐alcoholic steatohepatitis (NASH) and liver fibrosis stage in children/adolescents with non‐alcoholic fatty liver disease (NAFLD).

Methods

We enrolled 204 children/adolescents with biopsy‐proven NAFLD at the "Bambino Gesù" Children's Hospital. We measured plasma PIIINP levels using a commercially available enzyme‐linked immunosorbent assay kit and calculated APRI and FIB‐4 scores using standard methods.

Results

Children with NASH had higher plasma PIIINP levels, APRI and FIB‐4 scores compared with those without NASH (all P < .001). However, PIIINP levels had much better diagnostic performance and accuracy than APRI and FIB‐4 scores for predicting liver fibrosis stage. PIIINP levels correlated with the total NAFLD activity score (NAS) and its constituent components (P < .0001). The risk of either NASH or F ≥ 2 fibrosis progressively increased with increasing PIIINP levels (P < .0001), independent of age, gender, adiposity measures, insulin resistance, NAS score and the patatin‐like phospholipase domain‐containing protein‐3 rs738409 polymorphism. For every 3.6 ng/mL increase in PIIINP levels, the likelihood of having F ≥ 2 fibrosis increased by ~14‐fold (adjusted‐odds ratio 14.1, 95% CI 5.50‐35.8, P < .0001) after adjustment for the aforementioned risk factors. The area under the receiver operating characteristics curve was 0.921 (95% CI 0.87‐0.97) for F ≥ 2 fibrosis, and 0.993 (95% CI 0.98‐1.0) for F3 fibrosis respectively.

Conclusions

Unlike APRI and FIB‐4 scores, plasma PIIINP levels are a promising, non‐invasive biomarker for diagnosing liver fibrosis stage in children/adolescents with biopsy‐proven NAFLD.
The Mouth‐Gut‐Brain model: An interdisciplinary approach to facilitate reformulation of reduced fat products
Authors: Yeomans M. R. , Zhou X. , Wilde P. , Thomas A. , Linter B. , Beri A. , Lovegrove J. A. , Williams C. M. , Methven L.
Published: August 2019

The food industry faces the difficult challenge of reformulating many of their products to meet increasingly stringent targets to reduce energy density by adjusting fat and sugar levels. However, reducing fat in products raises multiple risks for consumer satisfaction because of the consequent effects on both the multimodal sensory experience of the product and the extent to which satiety post‐ingestion meets expected satiety. Recognising that this complex problem requires an interdisciplinary approach, the Mouth‐Gut‐Brain project brought together academic expertise in food and sensory science, the psychology of appetite and the biophysics of food microstructure, with the support of seven industry partners, to develop novel, innovative approaches to enable successful reformulation of fat in a snack context. The project recognised the multifaceted nature of fat perception, and how it affects the psychological and physiological responses to consumption and ingestion. The outcomes of the research programme, comprising the characterisation of sensory and satiety responses of volunteers in the context of two novel fat‐reduced snack products, will be published over the next year and will help inform future novel approaches to fat reduction.
Phenomenology as a political position within maternity care
Authors: Thomson Gill , Crowther Susan
Published: August 2019

In this article, the authors use the context of childbirth to consider the power that is endemic in certain forms of evidence within maternity care research. First, there is consideration of how the current evidence hierarchy and experimental‐based studies are the gold standard to determine and direct women's maternity experiences, although this can be at the detriment of care and irrespective of women's needs. This is followed by a critique of how the predominant means to assess women's experiences via satisfaction surveys is of limited utility, offering impartial and restricted insights to assess the quality of care provision. A counter position of hermeneutic phenomenology as research method is then described. This approach offers an alternative perspective by penetrating the taken‐for‐granted ordinariness of an event (such as childbirth) to elicit rich emic meanings. Whilst all approaches to understanding maternity care have a place, depending on the question(s) being asked, the contribution of phenomenology is how it can uncover a depth of contextual understanding into what matters to women and to inform and transform care delivery.
IgE binding to linear epitopes of Ara h 2 in peanut allergic preschool children undergoing oral Immunotherapy
Authors: Dreskin Stephen C. , Germinaro Matthew , Reinhold Dominik , Chen Xueni , Vickery Brian P. , Kulis Michael , Burks A. Wesley , Negi Surendra S. , Braun Werner , Chambliss Jeffery M. , Eglite Spodra , McNulty Caitlin M. G.
Published: August 2019

Background

For patients with peanut allergy, there are currently no methods to predict who will develop sustained unresponsiveness (SU) after oral immunotherapy (OIT).

Objective

Assess IgE binding to peanut (PN), Ara h 2, and specific linear epitopes of Ara h 2 as predictors of the important clinical parameters: eliciting dose threshold and attainment of SU following OIT.

Methods

Samples and clinical data were collected from children undergoing OIT. PN‐ and Ara h 2‐sIgE were quantified by ImmunoCAP®. IgE binding to linear peptides of Ara h 2 and Ara h 6 was measured with peptide microarrays.

Results

Values of PN‐sIgE correlated with eliciting dose (P = .001) and with a higher likelihood of achieving SU (P < .0001), but these relationships were lost at higher values for PN‐sIgE (≥14 kIU for eliciting dose and ≥35 kIU/L for SU). In subjects with PN‐sIgE ≥ 14 kIU/L, binding of IgE to epitopes 5 and 6 of Ara h 2 was associated with a lower eliciting dose at baseline challenge (P < .001; Pc < .02). In subjects with PN‐sIgE ≥ 35 kIU/L, a combined model of IgE binding to epitopes 1, 5 and 6 with PN‐sIgE was highly predictive of attainment of SU (AUC of 0.86; P = .0067).

Conclusion

In young patients with peanut allergy, measurement of PN‐sIgE and IgE binding to specific linear epitopes of Ara h 2 in baseline samples may allow stratification of patients regarding sensitivity to challenge and outcome of OIT.
Real fasting times and incidence of pulmonary aspiration in children: Results of a German prospective multicenter observational study
Authors: Beck Christiane E. , Rudolp Diana , Becke‐Jakob Karin , Schindler Ehrenfried , Etspüler Alexander , Trapp Almut , Fink Gordon , Müller‐Lobeck Lutz , Röher Katharina , Genähr Arka , Eich Christoph , Sümpelmann Robert
Published: August 2019

Background

Prolonged fasting before anesthesia is still common in children. Shortened fasting times may improve the metabolic and hemodynamic condition during induction of anesthesia and the perioperative experience for parents and children and simplify perioperative management. As a consequence, some centers in Germany have reduced fasting requirements, but the national guidelines are still unchanged.

Aims

This prospective multicenter observational study was initiated by the Scientific Working Group for Pediatric Anesthesia of the German Society of Anesthesiology and Intensive Care Medicine to evaluate real fasting times and the incidence of pulmonary aspiration before a possible revision of national fasting guidelines.

Methods

After the Ethics Committee's approval, at least 3000 children were planned to be enrolled for this analysis. Patient demographics, real fasting times, anesthetic and surgical procedures and occurrence of regurgitation or pulmonary aspiration were documented using a standardized case report form. Results were presented as median [interquartile range] (range) or incidence (percentage).

Results

At ten pediatric centers, 3324 children were included between October 2018 and May 2019. The real fasting times for large meals were 14 [12.2‐15.6] (0.5‐24) hours, for light meals 9 [5.6‐13.3] (0.25‐28.3) hours, for formula milk 5.8 [4.5‐7.4] (0.9‐24) hours, for breast milk 4.8 [4.2‐6.3] (1.3‐25.3) hours and for clear fluids 2.7 [1.5‐6] (0.03‐22.8) hours. Prolonged fasting (deviation from guideline >2 hours) was reported for large meals in 88.3%, for light meals in 54.7%, for formula milk in 44.4%, for breast milk in 25.8% and for clear fluids in 34.2%. Eleven cases (0.33%) of regurgitation, four cases (0.12%) of suspected pulmonary aspiration and two cases (0.06%) of confirmed pulmonary aspiration were reported; all of them could be extubated after the end of the procedure and recovered without any incidents.

Conclusion

This study shows that prolonged fasting is still common in pediatric anesthesia in Germany that pulmonary aspiration with postoperative respiratory distress is rare and that improvements to current local fasting regimens and national fasting guidelines are urgently needed.
Why the Confucians had no concept of race (Part I): The antiessentialist cultural understanding of self
Authors: Xiang Shuchen
Published: August 2019

This paper argues that Confucianism had an antiessentialist conception of selfhood. This understanding of self means that they did not have, and could not have had, a concept of “race” in the sense that one's essence determines one's becoming. In the Confucian canon, the embodiment of cultural norms/performance of culturally appropriate actions defines one's human‐ness. This account of human agency in becoming human can be seen in the Confucian explanation of moral failure. This assumption of human agency also means that the Confucian understanding of hierarchy is social as opposed to ontological and that differences between peoples are understood to be a result of culture–custom variation.
Effects of sucrose supplementation and generation on life‐history traits of Bracon cephi and Bracon lissogaster, parasitoids of the wheat stem sawfly
Authors: Reis Dayane A. , Hofland Megan L. , Peterson Robert K. D. , Weaver David K.
Published: August 2019

Knowledge of the life‐history traits that influence the reproductive success of parasitoids could provide useful information to enhance their effectiveness as biological control agents. The wheat stem sawfly Cephus cinctus Norton (Hymenoptera: Cephidae) is a major pest of wheat in the Northern Great Plains of North America. The bivoltine, sympatric and specialist parasitoids Bracon cephi (Gahan) and Bracon lissogaster Muesebeck (Hymenoptera: Braconidae) are the only species known to attack C. cinctus in wheat. In the present study, we quantify the body size, longevity, egg load and egg volume of B. cephi and B. lissogaster aiming to test whether these life‐history traits differ among adult females developing from overwintering and summer generation larvae. We also investigate the effect of sucrose supplementation on the same reproductive parameters. The results obtained show no differences between life‐history traits of B. cephi developing from the overwintering and summer generations. By contrast, the egg load of B. lissogaster is significantly different between generations, with overwintered females producing 1.2‐fold more eggs than summer individuals. Sucrose feeding has a strong positive effect on life‐history traits of both parasitoid species and generations. The longevity of sucrose‐fed females of B. cephi is increased three‐fold, whereas the survival of B. lissogaster is increased almost nine‐fold. Females of B. cephi treated with sucrose have four‐fold more mature eggs, whereas the egg load of B. lissogaster is increased 1.15‐ to 1.25‐fold with sugar feeding. Only B. cephi females increase egg volume with sucrose. The present study provides valuable insights on the life‐history and nutritional requirements of these two important parasitoid species.
Trade liberalization, consumption shifting and pollution: Evidence from Mexico's used vehicle imports
Authors: Chen Liang , Garcia‐Medina B. Cecilia , Wan Rui
Published: August 2019

This paper develops a model of used vehicle trade between the United States and Mexico, countries with different environmental regulations regarding vehicle emissions. We demonstrate that the United States, with its strict environmental regulations, has a motive to export used vehicles to Mexico, which impacts air pollution emissions from vehicle driving in Mexico. Using unique data on the import and registration of vehicles in Mexico after NAFTA, we find that Mexico's used vehicle imports reduce pollution emissions generated from vehicle driving mainly because of the technique effect, that is, model–age‐comparable vehicles imported from the United States emit less than those originally operated in Mexico.
Physical activity during pregnancy and intelligence in sons; A cohort study
Authors: Jochumsen Sara , Henriksen Tine Brink , Lindhard Morten Søndergaard , Hegaard Hanne Kristine , Rode Line
Published: August 2019

The purpose was to examine the association between exercise during pregnancy and intelligence score in offspring. We analyzed data from 4008 women from the Aarhus Birth Cohort, Aarhus University Hospital, Denmark, recruited during pregnancy from July 1989 to November 1991 and their sons who were registered at conscription at 17‐20 years of age. The women gave information by self‐administered questionnaires during the first trimester including leisure‐time physical activity and weekly hours of sport. This information was linked to the sons’ measures of intelligence by Børge Priens test scores from the Danish Conscription Registry. Only sons were included since very few women register at conscription in Denmark. The main outcome measure was the Børge Priens test score as a continuous variable and with a low score defined as <10% of the population score. Analyses were adjusted for maternal body mass index, years in school, and smoking. Sons of women with light and moderate to heavy leisure‐time physical activity had lower risk of having a low intelligence score compared with sons of women with sedentary activity: adjusted odds ratio (aOR) 0.66 (95% CI 0.49;0.88) and 0.46 (95% CI 0.23;0.93), respectively. Furthermore, sons of women engaged in sports had lower risk of a low intelligence score: aOR 0.50 (95% CI 0.30; 0.83) for 1‐2 h/wk and 0.62 (95% CI 0.35; 1.10) for ≥3 h/wk compared with no weekly sports activity. In conclusion, a higher level of physical activity during pregnancy was associated with a lower risk of low intelligence score in early adulthood in sons.
Comparing income poverty gap and deprivation on social acceptance: A mediation model with interpersonal communication and social support
Authors: Zhang Yin , Wong Hung , Chen Ji‐Kang , Tang Vera M. Y.
Published: August 2019

In many developed countries or regions, wide income disparities increase the difficulty in reducing poverty. In their day‐to‐day lives, poor people often feel less accepted by the society. The failures in communicating with social groups and receiving social support lead to negative consequences on individual well‐being and higher level of social exclusion. Based on the debate upon alternative approaches to conceptualizing and operationalizing poverty, this study attempts to verify a mediation model with data from a household survey (N= 1,202) in Hong Kong. The results of structural equation modelling reveal that deprivation is a more powerful indicator than income poverty for specifying the negative relations of poverty with interpersonal communication, social support, and social acceptance; the negative impact of deprivation on social acceptance can be reduced by two significant mediators of interpersonal communication and social support. The results are discussed in terms of directions for future research and policy and welfare intervention.
Implementation of traction constraints in Bragg‐edge neutron transmission strain tomography
Authors: Hendriks Johannes , Gregg Alex , Wensrich Chris , Wills Adrian
Published: August 2019

Several recent methods for tomographic reconstruction of stress and strain fields from Bragg‐edge neutron strain images have been proposed in the literature. This paper presents an extension of a previously demonstrated approach based on Gaussian process regression that enforces equilibrium in the method. This extension incorporates knowledge of boundary conditions, primarily boundary tractions, into the reconstruction process. This is shown to increase the rate of convergence and is more tolerant of systematic errors that may be present in experimental measurements. An exact expression for a central calculation in this method is also provided which avoids the need for the approximation scheme that was previously used. Convergence of this method for simulated data is compared to existing approaches and a reconstruction from experimental data is provided. Validation of the results to conventional constant wavelength strain measurements and comparison to prior methods show a significant improvement.