bluuebunny/crossref_metadata_2025 huggingface dataset:
Early hospital readmission after kidney transplantation under a public health care system
Authors: Tavares Melissa Gaspar , Cristelli Marina Pontello , Ivani de Paula Mayara , Viana Laila , Felipe Claudia Rosso , Proença Henrique , Aguiar Wilson , Wagner Santos Daniel , Tedesco‐Silva Junior Hélio , Medina Pestana Jose Osmar
Published: December 2018

Early hospital readmission (EHR) is associated with increased mortality after kidney transplantation. This is influenced by population demographics and the comprehensiveness of the healthcare system. We investigated the incidence and risk factors associated with EHR and 1‐year patient and graft survivals.

Methods

We included all recipients of kidney transplant between 2011 and 2012. We excluded recipients younger than 18 years, retransplants and who died or lost the graft during the index hospital admission.

Results

Among 1175 recipients, the incidence of EHR was 26.6%. The main reasons for EHR were infection (67%), surgical complications (14%), and metabolic disturbances (11%). Independent risk factors associated with EHR were recipient age (OR = 1.95, 95% CI 1.46‐2.63, P < 0.001), CMV serology negative (OR = 2.2, 95% CI 1.31‐3.65, P = 0.003), use of rabbit anti‐thymocyte globulin (OR = 2.06, 95% CI 1.33‐3.13, P < 0.001), treatment for acute rejection during index hospitalization (OR = 1.68, 95% CI 1.15‐2.47, P = 0.008), and length of stay (OR = 1.72, 95% CI 1.18‐2.5, P = 0.005). Patient (88.8% vs 97.6%, P < 0.001) and death‐censored graft (97.4% vs 99.0%, P < 0.001) survivals were inferior comparing patients with and without EHR.

Conclusion

EHR was independently associated with mortality (OR 4.01, 95% CI 2.13‐7.54, P < 0.001), but its incidence and causes are directly related to the local characteristics of the population and healthcare system.
The ACCOuNT Consortium: A Model for the Discovery, Translation, and Implementation of Precision Medicine in African Americans
Authors: Friedman Paula N. , Shaazuddin Mohammed , Gong Li , Grossman Robert L. , Harralson Arthur F. , Klein Teri E. , Lee Norman H. , Miller Doriane C. , Nutescu Edith A. , O'Brien Travis J. , O'Donnell Peter H. , O'Leary Kevin J. , Tuck Matthew , Meltzer David O. , Perera Minoli A.
Published: December 2018

The majority of pharmacogenomic (PGx) studies have been conducted on European ancestry populations, thereby excluding minority populations and impeding the discovery and translation of African American–specific genetic variation into precision medicine. Without accounting for variants found in African Americans, clinical recommendations based solely on genetic biomarkers found in European populations could result in misclassification of drug response in African American patients. To address these challenges, we formed the Transdisciplinary Collaborative Center (TCC), African American Cardiovascular Pharmacogenetic Consortium (ACCOuNT), to discover novel genetic variants in African Americans related to clinically actionable cardiovascular phenotypes and to incorporate African American–specific sequence variations into clinical recommendations at the point of care. The TCC consists of two research projects focused on discovery and translation of genetic findings and four cores that support the projects. In addition, the largest repository of PGx information on African Americans is being established as well as lasting infrastructure that can be utilized to spur continued research in this understudied population.
Endoscopic ultrasound‐guided tissue acquisition: Can fork and crown cut the tissue?
Authors: Iwashita Takuji , Yasuda Ichiro , Shimizu Masahito
Published: December 2018

This Editorial refers to the article by J. Y. Bang, p 197‐202 of this issue.
Effects of saxagliptin on adipose tissue inflammation and vascular function in overweight and obese people: a placebo‐controlled study
Authors: Koska J. , Osredkar T. , D'Souza K. , Sands M. , Sinha S. , Zhang W. , Meyer C. , Reaven P. D.
Published: December 2018

Aims

To test the effect of the dipeptidyl peptidase‐4 inhibitor saxagliptin on adipose tissue inflammation and microvascular function, and whole‐body postprandial endothelial function.

Methods

A randomized, double‐blind, placebo‐controlled, parallel study was conducted between June 2013 and November 2016 in 44 overweight or obese people without diabetes (saxagliptin, n=28; placebo, n=16). Subcutaneous abdominal adipose tissue biopsies, a 4‐h fat‐enriched meal test and peripheral arterial tonometry for measurement of endothelial function were performed at baseline and after 6 weeks of treatment with saxagliptin (5 mg/day) or matching placebo.

Results

Forty participants were analysed (saxagliptin, n=26; placebo, n=14). Secretion of interleukin‐8 from adipose tissue explants was reduced after saxagliptin (median fold‐change from baseline: 0.8 saxagliptin vs 3.3 placebo; P=0.02). Adipose tissue expression of thioredoxin‐inhibitory protein (TxNIP) was lower after saxagliptin (0.75 vs 1.0; P=0.02), while there were no significant differences in adipose tissue secretion of interleukin‐1b, interleukin‐6 or macrophage chemoattractant protein 1 (MCP‐1), adipose tissue macrophage content, adipose tissue mRNA levels of mcp1, cd36, cd68, il6, il8, txnip and adpq, and activation of adipose tissue inflammatory pathways [extracellular signal‐regulated kinase, c‐Jun N‐terminal kinase (JNK) and nuclear factor‐κB (NF‐ κB)] or insulin‐induced vasodilation of adipose tissue arterioles. Postprandial plasma glucose was slightly lower (by an estimated 0.3 mmol/l; P=0.01), while postprandial insulin, triglyceride levels and endothelial function were unchanged after saxagliptin.

Conclusions

The effect of saxagliptin on adipose tissue inflammation was relatively modest, with many inflammatory markers unchanged. We also found no evidence that saxagliptin therapy improved adipose tissue arteriole vasodilation or postprandial endothelial function.
Correlation between PSA kinetics and PSMA‐PET in prostate cancer restaging: A meta‐analysis
Authors: Pereira Mestre Ricardo , Treglia Giorgio , Ferrari Matteo , Pascale Mariarosa , Mazzara Calogero , Azinwi Ngwa Che , Llado’ Anna , Stathis Anastasios , Giovanella Luca , Roggero Enrico
Published: December 2018

Background

Serum prostate‐specific antigen (PSA) may predict the risk of positive positron emission tomography/computed tomography with radiolabelled prostate‐specific membrane antigen (PSMA‐PET/CT) in patients with biochemical recurrent prostate cancer (BRPCa). However, to date, there are no clear data regarding the correlation between PSA kinetics and PSMA‐PET findings. We performed a systematic review and meta‐analysis to provide evidence‐based data in this setting.

Methods

A comprehensive literature search of studies published through October 2018 in PubMed/MEDLINE, EMBASE and Cochrane library databases was performed. A meta‐analysis to establish the detection rate (DR) of PSMA‐PET using different cut‐off values of PSA doubling time (PSAdt) and a pooled analysis to establish whether shorter PSAdt may predict positive PSMA‐PET results was performed in patients with BRPCa.

Results

Twelve articles were included in the systematic review, and eight articles (including about 1400 patients) were selected for the meta‐analysis. The pooled DR including 95% confidence intervals (95%CI) of PSMA‐PET in restaging prostate cancer (PCa) patients was 72% (95%CI:60%‐82%), increasing to 83% (95%CI:75%‐90%) when PSAdt was ≤6 months and decreasing to 60% (95%CI:37%‐80%) when PSAdt was >6 months, without a statistical significant difference. PSAdt ≤6 months may predict the positive result of PSMA‐PET (pooled odds ratio: 3.22; 95%CI:1.17‐8.88). Statistical heterogeneity among the included studies was found.

Conclusions

PSA kinetics, and in particular shorter PSAdt, may be predictor of PSMA‐PET positivity in patients with BRPCa. Further larger studies in this setting are warranted.
Does oil substitute for patriarchy?
Authors: Simmons Joel W.
Published: December 2018

Critics of Ross's (American Political Science Review, 102, 2008, 107) gendered resource curse thesis argue that culture trumps oil wealth as a determinant of female labor force participation (FLFP). Here, I argue that, while cultural attributes do indeed affect the female labor supply, oil wealth reduces the demand for female labor by hurting the export‐oriented industries that employ female labor intensively. By reducing the demand for female labor in this way, oil wealth undermines the positive effect of gender egalitarianism onFLFP. Thus, oil curses women. Using data from the World Values Survey and the World Bank, I find support for the argument.
Role of extracellular reactive sulfur metabolites on microbial Se(0) dissolution
Authors: Goff Jennifer , Terry Lee , Mal Joyabrata , Schilling Kathrin , Pallud Céline , Yee Nathan
Published: December 2018

The dissolution of elemental selenium [Se(0)] during chemical weathering is an important step in the global selenium cycle. While microorganisms have been shown to play a key role in selenium dissolution in soils, the mechanisms of microbial selenium solubilization are poorly understood. In this study, we isolated aBacillusspecies, designated as strainJG17, that exhibited the ability to dissolve Se(0) under oxic conditions and neutralpH. Growth ofJG17 in a defined medium resulted in the production and accumulation of extracellular compounds that mediated Se(0) dissolution. Analysis of the spent medium revealed the presence of extracellular sulfite, sulfide, and thiosulfate. Abiotic Se(0) dissolution experiments with concentrations of sulfite, sulfide, and thiosulfate relevant to our system showed similar extents of selenium solubilization as the spent medium. Together, these results indicate that the solubilization of Se(0) byJG17 occurs via the release of extracellular inorganic sulfur compounds followed by chemical dissolution of Se(0) by the reactive sulfur metabolites. Our findings suggest that the production of reactive sulfur metabolites by soil microorganisms and the formation of soluble selenosulfur complexes can promote selenium mobilization during chemical weathering.
Quantifying multiple pressure interactions affecting populations of a recreationally and commercially important freshwater fish
Authors: Gutowsky Lee F. G. , Giacomini Henrique C. , de Kerckhove Derrick T. , Mackereth Rob , McCormick Darren , Chu Cindy
Published: December 2018

The expanding human global footprint and growing demand for freshwater have placed tremendous stress on inland aquatic ecosystems. Aichi Target 10 of the Convention on Biological Diversity aims to minimize anthropogenic pressures affecting vulnerable ecosystems, and pressure interactions are increasingly being incorporated into environmental management and climate change adaptation strategies. In this study, we explore how climate change, overfishing, forest disturbance, and invasive species pressures interact to affect inland lake walleye (Sander vitreus) populations. Walleye support subsistence, recreational, and commercial fisheries and are one of most sought‐after freshwater fish species in North America. Using data from 444 lakes situated across an area of 475 000 km2in Ontario, Canada, we apply a novel statistical tool, R‐INLA, to determine how walleye biomass deficit (carrying capacity—observed biomass) is impacted by multiple pressures. Individually, angling activity and the presence of invasive zebra mussels (Dreissena polymorpha) were positively related to biomass deficits. In combination, zebra mussel presence interacted negatively and antagonistically with angling activity and percentage decrease in watershed mature forest cover. Velocity of climate change in growing degree days above 5°C and decrease in mature forest cover interacted to negatively affect walleye populations. Our study demonstrates how multiple pressure evaluations can be conducted for hundreds of populations to identify influential pressures and vulnerable ecosystems. Understanding pressure interactions is necessary to guide management and climate change adaptation strategies, and achieve global biodiversity targets.
Exploring the emergence of a biojet fuel supply chain in Brazil: An agent‐based modeling approach
Authors: Moncada Jorge A. , Verstegen Judith A. , Posada John A. , Junginger Martin , Lukszo Zofia , Faaij André , Weijnen Margot
Published: December 2018

The aviation industry accounts for more than 2% of global CO2 emissions. Biojet fuel is expected to make an essential contribution to the decarbonization of the aviation sector. Brazil is seen as a key player in developing sustainable aviation biofuels owing to its long‐standing experience with biofuels. Nevertheless, a clear understanding of what policies may be conducive to the emergence of a biojet fuel supply chain is lacking. We extended a spatially explicit agent‐based model to explore the emergence of a biojet fuel supply chain from the existing sugarcane–ethanol supply chain. The model accounts for new policies (feed‐in tariff and capital investment subsidy) and new considerations into the decision making about production and investment in processing capacity. We found that in a tax‐free gasoline regime, a feed‐in tariff above 3 R$/L stimulates the production of biojet fuel. At higher levels of gasoline taxation (i.e., 2.46 R$/L), however, any feed‐in tariff is insufficient to ensure the production of biojet fuel. Thus, at these levels of gasoline taxation, it is needed to introduce regulations on the production of biojet fuel to ensure its production. Given the current debate about the future direction of the biofuel policy in Brazil, we recommend further research into the effect of market mechanisms based on greenhouse gas emissions on the emergence of a Brazilian biojet fuel supply chain.
A semiquantitative grading scale for frontal and vertex of androgenetic alopecia
Authors: Nie Jin , Hou Wei
Published: December 2018

Background

Depending on the severity and region of baldness, numerous researchers proposed different classifications of alopecia. However, these previous classifications have some limitations. The study aimed to establish a semiquantitative grading scale for frontal and vertex androgenetic alopecia (AGA) in both males and females.

Methods

Standardized pictures from 1,602 AGA cases were obtained. Three sets of reference photographs with different alopecia extents from scale 0 to 5 were developed with detailed description. The photographs covered the vertex, frontal of men, and vertex + frontal (V+F) area of the scalp of women. Hair density and the ratio of vellus and terminal hairs in the alopecia area were quantitatively measured by DermDOC® dermoscopy. Hair coverage rate of alopecia area was calculated by Photoshop software. Multirater consensus method was used to test the reliability and validity of the alopecia scale.

Results

Fleiss–Kappa coefficients of the three sets of reference photographs for interobserver analysis reached 0.81–0.89. The overall Kendall's coefficients for intraobserver assessment totaled 0.934–0.963.

Conclusion

This new grading scale is a more sensitive and objective quantitative grading scale for alopecia and treatment response compared with the existing classification.
Revisiting aqueous alkaline silicates as precursors for sol‐gel optical coatings
Authors: Jaffrès Anaël , Boudot Mickaël , Chevalier Sylvain , Mohammedi Rabei , Maron Sébastien , Devys Lucie , Gacoin Thierry
Published: December 2018

Alkaline silicates are well‐known soluble silica derivatives already widely used for industrial purposes. Nevertheless, their applications for the elaboration of functional optical coatings have largely been discarded by the sol‐gel community who mainly focused on alkoxide precursors. The objective of this work is to reconsider the alkaline silicates sol‐gel chemistry, targeting optical coatings of a few hundreds of nanometers. The structures of Li+, Na+, and K+ silicate coatings are discussed on the basis of spectroscopic characterizations. We show that a simple washing process allows a postdeposition removal of most alkaline ions, thus preventing the efflorescence effect and improving the aqueous stability of the films. Finally, several examples are shown for the application of alkaline silicates in the elaboration of functional optical coatings following conventional sol‐gel chemistry.
Transparent niobate glass‐ceramics for optical limiting
Authors: Shi Zhuo , Dong Ningning , Zhang Dingfeng , Jiang Xiaofang , Du Guanxin , Lv Shichao , Chen Jiejie , Wang Jun , Zhou Shifeng
Published: December 2018

The construction of nonlinear optical materials featuring asymmetric transmission of light is of great technological importance for various applications, including optical switching and optical power limiting. A significant challenge is the scalable fabrication of material candidates with good photochemical stability, high optical transmittance, and excellent optical limiting performance. Here, we present a nanocrystallization avenue for constructing hybrid optical limiting materials that exhibit ultrafast and robust optical limiting performance. The experimental results show that the controllable relaxation of a niobate glass may lead to the clustering of Nb‐O units and contracting of the bandgap. It results in the notable improvement in nonlinear optical properties, including the enhanced saturation irradiance (380 GW/cm2), doubly increased nonlinear coefficient, and decreased limiting threshold (200 GW/cm2). Our results suggest a promising material that exhibits promising applications for protecting eyes and sensitive components from laser‐induced damage.
Dielectric relaxation properties of [001]c‐, [011]c‐, and [111]c‐oriented 0.24PIN‐0.47PMN‐0.29PT single crystals
Authors: Qi Xudong , Sun Enwei , Li Kai , Li Shiyang , Zhang Rui , Yang Bin , Cao Wenwu
Published: December 2018

The dielectric relaxation properties and freezing behavior of polar nanoregions (PNRs) of 0.24Pb(In1/2Nb1/2)O3‐0.47Pb(Mg1/3Nb2/3)O3‐0.29PbTiO3 single crystals have been studied. The Burns temperature TB, permittivity maximum temperature Tm, and freezing temperature Tf were determined, respectively. It was found that the temperature‐dependent dielectric constant can be well described by the Lorenz‐type relationship in the ergodic phase due to the existence of PNRs. The diffuseness factor δ is >30 and is basically not dependent on crystal orientation. The frequency dependence of Tm obeys the Vogel‐Fulcher relationship. The residual effect of the poling electric field disappears and the remnant polarization has a sharp decrease near the freezing temperature Tf.
Stabilizing temperature‐capacitance dependence of (Sr, Pb, Bi)TiO3‐Bi4Ti3O12 solutions for energy storage
Authors: Wang Debin , Liu Jingsong , Zeng Mengshi , Zhang Chunmei , Li Huiqin , Yu Hongtao , Yuan Ying , Zhang Shuren
Published: December 2018

(1‐x)Sr0.7Pb0.15Bi0.1TiO3‐xBi4Ti3O12 ((1‐x)SPBT‐xBIT, x = 0‐0.125) bulk ceramics were developed and calcined via the solid‐state method, aimed at the application of pulsed power capacitors. The phase structures, temperature stability, hysteresis loop, and discharge properties were systematically investigated. Considering both the temperature stability and dielectric properties, 0.925SPBT‐0.075BIT bulk ceramics with a capacitance variation satisfying the X7R specification were developed for pulsed power capacitors. The energy storage density was 0.252 J/cm3, and the ceramics showed high temperature stability at 80 kV/cm. The discharge current waveforms of the 0.925SPBT‐0.075BIT ceramics were recorded. A high discharge power density of approximately 1.01 × 108 W/kg with an 8 Ω load resistor and short discharge period of 84 ns were achieved at 50 kV/cm. The good temperature stability properties and high power density show that the 0.925SPBT‐0.075BIT ceramics are well suited for pulsed power capacitors with a wide temperature range.
Temperature‐driven wear behavior of Si3N4‐based ceramic reinforced by in situ formed TiC0.3N0.7 particles
Authors: Liu Jiongjie , Yang Jun , Zhu Shengyu , Cheng Jun , Yu Yuan , Qiao Zhuhui , Liu Weimin
Published: December 2018

Si3N4 as a structural ceramic is desirable for applications in spacecraft, transportation, and energy, but its poor high‐temperature properties still do not satisfy the actual requirements. Here, a TiC0.3N0.7 reinforced Si3N4 ceramic is successfully designed and fabricated via the high‐temperature nitridation of TiCx. It is found that TiC0.3N0.7 grains with the size of 1‐2 μm are uniformly dispersed in the Si3N4 matrix and show a firm bond with substrate. Compared with pure Si3N4, the doping of harder TiCN phase can effectively improve ceramic's hardness and fracture toughness at a certain temperature. Importantly, the ceramic material displays extraordinary wear resistance across a wide temperature range (eg, the wear rate of TiC0.3N0.7 containing Si3N4 over 63 times and 178 times better than pure Si3N4 at 600 and 900°C, respectively). More broadly, a correlation between wear mechanism and temperature is established, and the result shows that the mechanical strength and tribochemical oxidation as two key factors determine the wear behavior of the material. These results developed here can provide a springboard for preparation and optimization of multiphase ceramics that serve under high‐temperature conditions.
Single‐center experience of the FIRM technique to ablate paroxysmal and persistent atrial fibrillation
Authors: Henley Patrick , Foreman Jason R. , Padanilam Benzy J. , Nair Girish V. , Olson Jeff A. , Joshi Sandeep , Aziz Zaid , Foster Todd , Prystowsky Eric N.
Published: December 2018

Introduction

Focal impulse and rotor modulation (FIRM)‐guided ablation has had mixed results of published success, and most studies have had a follow‐up for a year or less. We aimed to study a consecutive group of patients followed for at least 1.5 years, subgrouped into those with an initial FIRM ablation and those with a previous, failed ablation who now received a FIRM guided one, to evaluate for success in each group and factors that might affect success.

Methods

Of 181 patients, 167 were available for analysis. Group 1 (n = 122) had a first or primary ablation (paroxysmal atrial fibrillation [PAF] 51; persistent atrial fibrillation [PeAF] 71) and group 2 (n = 45) had a redo ablation (PAF 18; PeAF 27). All patients were done under general anesthesia. FIRM mapping was done in the right atrium first and then the left, and only rotors consistently seen on multiple epochs were ablated, using 15 to 30 W. Rotor ablation was discontinued when remapping showed elimination of rotational activity at the site. Wide area catheter ablation was done for pulmonary vein isolation (PVI). Routine follow‐up was at 3, 6, and 12 months of the first year, with a Holter monitor at 6 months, and then every 6 months thereafter. Event recorders were given to patients with potential arrhythmic symptoms.

Results

Mean follow‐up was 16 months. Nearly 40% of patients had obstructive sleep apnea; mean body mass index was 32; and average left atrial size was 39.7 mm and 46.2 mm for PAF and PeAF patients, respectively. Freedom from atrial arrhythmia recurrence was: in group 1 patients, 82.4% for PAF and 67.6% for PeAF patients; in group 2 patients, 83.3% for PAF, but only 40.7% for PeAF patients. Comparing outcomes for the first 10 patients studied to the next 20 or more done by three operators showed no difference, suggesting no learning curve affecting the ablation results. Furthermore, the univariate analysis did not show any demographic factor to have an independent significance for ablation success or failure. Spontaneous termination during rotor ablation occurred in 76.8% of PAF and 27.6% of PeAF patients but did not affect the long‐term outcomes for maintenance of sinus rhythm.

Conclusions

FIRM‐guided atrial ablation plus PVI in our patient population resulted in good success from a recurrence of atrial arrhythmias in patients undergoing an initial ablation procedure. For those with persistent AF undergoing a second procedure now using FIRM guidance plus PVI, the results are lower. Further research is needed to define better the appropriate population for FIRM‐guided ablation and the degree of ablation needed for success in these patients.
Analysis of reported cases of left main coronary artery injury during catheter ablation: In search of a pattern
Authors: Klaudel Jacek , Trenkner Wojciech , Glaza Michal , Miekus Pawel
Published: December 2018

Introduction

Left main coronary artery (LMCA) injury is a rare but potentially fatal complication of catheter ablation. Due to LMCA large perfusion area, its occlusion is usually a dramatic event.

Methods and Results

Reports of LMCA injury complicating catheter ablations from 1987 to 2018 were searched in electronic databases. Twenty‐two cases of serious LMCA damage have been identified. Additionally, four reports of direct mechanical trauma involving major LMCA branches induced by inadvertent catheter insertion have been studied. Typically 86% LMCA injury presented as an acute/subacute complication of retrograde ablation in left ventricle/left ventricular outflow tract or aortic cusps. In at least 86% of patients with an in‐hospital presentation, the LMCA trauma manifested dramatically as a life‐threatening arrhythmia, cardiogenic shock, or severe hypotension requiring vasopressors. In‐hospital mortality rate was 32%. Direct stenting has been found to be the most successful strategy.

Conclusion

LMCA injury, even if initially asymptomatic with normal angiographic appearance, may cause delayed flow deterioration, requiring prolonged monitoring and extended follow‐up. Special caution should be given to the prevention whereas survival depends on prompt detection and treatment.
Microbiological, physico‐chemical, and shelf life characteristics of land snail (Achantina fulica) subjected to various preservative treatments
Authors: Onwubuche K. , Efiuvwevwere B. J. O. , Eruteya O. C.
Published: December 2018

Reared and wild land snail (Achantina fulica) samples were subjected to various preservative treatments including potassium aluminium sulfate (PAS, 1% wt/vol), sodium chloride (NaCl, 1% wt/vol) and lime juice filtrate (LJF, 10% vol/vol) and investigated for microbial, physico‐chemical, and shelf life characteristics during ambient temperature storage. Five bacterial genera occurred in wild while three in reared. Total viable counts of 4.15 and 4.60 log10 cfu/g were observed in reared and wild control samples on Day 0 respectively but decreased to 3.72 and 4.08 log10 cfu/g for samples treated with LJF and PAS respectively on Day 3. Changes in pH of samples were marginal. Significant (p < .05) decrease in sensory attributes occurred in all samples and became unacceptable after Day 3 except LJF preserved samples that remained acceptable till Day 9. Thus, LJF as a novel preservative is recommended for shelf life extension of both reared and wild land snails.

Practical applications

The results of this study indicate the practical method of preserving reared and wild land snail (Achantina fulica) to extend its shelf life using lime juice filtrate which is readily available and storage at ambient temperature (30 ± 2 °C) due to erratic power supply. This approach is to encourage median‐capacity industries and small‐medium enterprises to have access to simple technology especially in developing countries to enhance food security and food safety.
What matters in disclosures of key audit matters: Evidence from Europe
Authors: Pinto Inês , Morais Ana Isabel
Published: December 2018

New regulation in the European Union has introduced the mandatory disclosure of key audit matters (KAMs) to audit reports. The EU has identified KAMs as significant risks, significant transactions or events, or significant judgments by auditors. This paper aims to determine the factors that influence the number of KAMs that auditors disclose in the main European countries under the new regulation. We predict that the litigation risk, reputation loss, auditor–client relationship, precision of accounting standards, and the effect of regulators and supervisors’ activities affect the number of KAMs that auditors disclose. The sample consists of firms on the FTSE 100, CAC 40, or AEX 25 that have disclosed KAMs at the 2016 fiscal year‐end. In line with our hypotheses, the findings show that a higher number of business segments (complexity) and more precise accounting standards lead to the disclosure of a higher number of KAMs. Contrary to our expectations, the results indicate that a positive association exists between the audit fee and the number of KAMs disclosed. As audit fees can be related to higher client risk, this finding could indicate that litigation risk dominates any auditor–client dependence. Further, although auditors often view their audits of banks as complex, the findings show a negative association between banks and the number of disclosed KAMs. This evidence may be related to the fact that financial institutions are in a highly regulated and supervised industry that reduces the need to disclose the KAMs.
Activation of the rat hypothalamic supramammillary nucleus by food anticipation, food restriction or ghrelin administration
Authors: Le May Marie V. , Hume Catherine , Sabatier Nancy , Schéle Erik , Bake Tina , Bergström Ulrika , Menzies John , Dickson Suzanne L.
Published: December 2018

The circulating orexigenic hormone ghrelin targets many brain areas involved in feeding control and signals via a dedicated receptor, the growth hormone secretagogue receptor 1A. One unexplored target area for ghrelin is the supramammillary nucleus (SuM), a hypothalamic area involved in motivation and reinforcement and also recently linked to metabolic control. Given that ghrelin binds to the SuM, we explored whether SuM cells respond to ghrelin and/or are activated when endogenous ghrelin levels are elevated. We found that peripheral ghrelin injection activates SuM cells in rats, reflected by an increase in the number of cells expressing c‐Fos protein in this area, as welll as by the predominantly excitatory response of single SuM cells recorded in in vivo electrophysiological studies. Further c‐Fos mapping studies reveal that this area is also activated in rats in situations when circulating ghrelin levels are known to be elevated: in food‐restricted rats anticipating the consumption of food and in fed rats anticipating the consumption of an energy‐dense food. We also show that intra‐SuM injection of ghrelin induces a feeding response in rats suggesting that, if peripheral ghrelin is able to access the SuM, it may have direct effects on this brain region. Collectively, our data demonstrate that the SuM is activated when peripheral ghrelin levels are high, further supporting the emerging role for this brain area in metabolic and feeding control.
What is the optimal site and biopsy technique for the diagnosis of oral mucosal autoimmune blistering disease?
Authors: Gilvetti Ciro , Collyer Jeremy , Gulati Aakshay , Barrett Andrew William
Published: December 2018

Background

The aim of this study was to determine which biopsy method produces the best diagnostic yield in patients presenting with autoimmune blistering diseases (AIBDs) of the oral mucosa.

Methods

This was a retrospective audit of patients who were biopsied at least once for a suspected AIBD of the oral mucosa. The type (incisional or punch) and site of biopsies were recorded in conjunction with case notes, electronic records and histopathological reports in order to calculate sensitivity, specificity and the method of biopsy which produced the superior diagnostic yield.

Results

A total of 125 biopsy samples from 66 patients were identified and reviewed. A diagnosis of AIBD was established in 49 (74%) patients. The chi‐square test showed there was a statistically significantly higher (P = 0.0016) diagnostic yield using the punch biopsy technique compared to the scalpel method. The gingiva was the best biopsy site in terms of achieving a definitive diagnosis (P = 0.0001) regardless of the biopsy method used.

Conclusions

A punch biopsy is more likely than scalpel biopsy to obtain a definitive diagnosis in patients presenting with a suspected oral AIBD. The gingiva is the optimal site to sample.
Focal epilepsy with fear‐related behavior as primary presentation in Boerboel dogs
Authors: Stassen Quirine E. M. , Grinwis Guy C. M. , van Rhijn Nieke C. , Beukers Martjin , Verhoeven‐Duif Nanda M. , Leegwater Peter A. J.
Published: December 2018

Background

Focal seizures with fear as a primary ictal manifestation, their diagnostic challenges, and impact on quality of life are well described in human medicine. Reports focusing on ictal fear‐like behavior in animals are scarce.

Objective

To describe the clinical and histopathological characteristics of a novel focal epilepsy in Boerboel dogs.

Animals

Five client‐owned Boerboel littermates presented for evaluation of sudden episodes of severe fear‐related behavior.

Methods

Clinical examination, complete blood cell count, routine blood biochemistry, and urinalysis were performed in all dogs. Magnetic resonance imaging (MRI) scans of the brain were performed in 3 affected Boerboels. In addition, in 2 affected Boerboels, metabolic screening, cerebrospinal fluid (CSF) analysis, and necropsy were performed.

Results

Onset of signs was 3 months of age in all affected Boerboels. All Boerboels howled loudly, had an extremely fearful facial expression and trembled during seizures. All affected Boerboels also had autonomic or motor signs. Results of laboratory investigations, diagnostic imaging, and metabolic screening were generally unremarkable. Histopathology showed moderate numbers of single large vacuoles in the perikaryon of neurons throughout the brain, specifically in the deeper cerebral cortical regions. Family history, pedigree analysis, and the homogenous phenotype were suggestive of autosomal recessive inheritance.

Conclusions and Clinical Importance

The observed paroxysmal fear‐related behavior represents a newly recognized hereditary focal epilepsy in dogs with distinctive clinical and histopathologic features. Veterinarians should be aware that sudden episodes of unusual behavior can represent focal epilepsy.
Tick‐defense grooming patterns of two sympatric Tibetan ungulates
Authors: Yang Le , Luo Yunchao , Tan Ming , Jiang Zhigang , Li Zhongqiu , Mooring Michael
Published: December 2018

Grooming is an important behavioral defense against tick infestation for ungulates. The ‘programmed grooming model' explains the endogenous regulation of tick‐defense grooming and predicts different inter‐ and intra‐specific grooming patterns owing to the body size principle. Here, we studied the summer grooming behaviors of two sympatric Tibetan ungulates, to explore whether or not body size principle works inter‐ and intra‐specifically. The ungulates were sexually and body‐size dimorphic Tibetan antelopes (Pantholops hodgsonii) with body weight of c. 33 kg and sexually dimorphic but body‐size monomorphic Tibetan gazelle (Procapra picticaudata) with body weight of c. 14 kg. Group size was also included in our negative binominal regression model to determine whether or not the ungulates groomed more or less with the increasing group size. Results showed that large Tibetan antelopes groomed much less than small Tibetan gazelles inter‐specifically. Intra‐specifically, sex–age significantly affects the grooming rate of Tibetan antelopes. The largest adult males groomed the least, whereas the smallest fawns groomed the most. However, this sex–age effect is not found in Tibetan gazelle: males and females groomed similarly. These findings indicate that body size principle is fully supported inter‐ and intra‐specifically. Positive group size effect on grooming is observed in Tibetan gazelle, suggesting that released vigilance time from group size effect is probably transferred to grooming. From a conservation point of view, we suggest further studies on the testosterone effect on grooming patterns during the rut as well as on tick biology on the plateau.
Does a trade‐off between fertility and predation risk explain social evolution in baboons?
Authors: Dunbar R. I. M. , Mac Carron P.
Published: December 2018

The distribution of group sizes in woodland baboons forms a pair of demographic oscillators that trade fertility off against predation risk. Fertility rates, however, set an upper limit on group size of around 90–95 animals. Despite this, two species of baboons (hamadryas and gelada) have groups that significantly exceed this limit, suggesting that these two species have been able to break through this fertility constraint. We suggest that they have done so by adopting a form of social substructuring that uses males as ‘hired guns’ to minimize the stresses of living in the unusually large groups required by high predation risk habitats.
Using camera traps to investigate spatial co‐occurrence between exotic predators and native prey species: a case study from northeastern Madagascar
Authors: Murphy A. , Kelly M. J. , Karpanty S. M. , Andrianjakarivelo V. , Farris Z. J.
Published: December 2018

The presence of exotic predators in ecosystems across the world is a leading driver of native species’ declines. Exotic predators largely influence native species through predation and harassment, which may cause native species to avoid them spatially. We used a camera trap dataset from seven sites in Madagascar's largest protected area complex to investigate spatial co‐occurrence patterns between three exotic predators (free‐ranging domestic dogs Canis familiaris and cats Felis silvestris, and small Indian civet Viverricula indica) and native ground‐dwelling forest birds (n = 5) and small mammals (n = 4). We created 216 two‐species occupancy models for 27 exotic predator‐native species pairings to examine how habitat, exotic predator presence or both, influenced each native species’ occupancy and/or detection. We found that native bird and small mammal occupancy and/or detection were strongly related to an exotic predator's presence 52% of the time (i.e. 14 of 27 exotic predator‐native species pairings). Six of the 14 species pairings (i.e. 43%) had non‐independent co‐occurrence patterns, four of which were habitat‐mediated. The effect of exotic predator presence on native species’ detection was largely negative, depressing native species’ detection in seven out of 12 instances (i.e. 58% of the time). The small Indian civet and free‐ranging cats each strongly influenced the occupancy and/or detection of six species for a combined impact on seven native species, while domestic dogs strongly influenced two species. By including habitat covariates in two‐species occupancy models, we gained deeper insight into the effect exotic predator presence has on native species’ distribution. We also note that the strong effect of exotic predator presence on our ability to detect native species can hinder the ability of researchers to provide accurate parameter estimates. We recommend future research into the synergistic effects that habitat degradation and exotic species presence has on native species.
Psychosocial dimensions of human milk sharing
Authors: Schafer Ellen J. , Ashida Sato , Palmquist Aunchalee E.L.
Published: December 2018

Breastfeeding is critical to maternal and infant health. Psychosocial factors are associated with lactation outcomes, and perinatal mood disorders (PMDs) are often linked with breastfeeding difficulties and early, unexpected weaning. Parents may utilize human milk sharing to ensure their infant receives human milk when breastfeeding requires supplementation or is not possible, but this practice carries health risks and is often stigmatized. Milk sharing recipient mothers may be particularly vulnerable to PMDs associated with breastfeeding difficulties. The study objective was to explore factors associated with emotional responses to a parent's decision to feed their infant with shared human milk. An online cross‐sectional survey of 205 milk sharing recipients was analysed with linear regression. Controlling for participants' education and breastfeeding difficulties, higher perceived social stigma was associated with more negative emotional responses (p < .01). Receiving strong spousal/partner support for milk sharing (p < .001) and screening donors regarding the health of their nursling(s) (p < .05) were associated with more positive emotional responses. Social stigmatization of milk sharing may negatively influence emotional responses among recipient mothers. Based on these results, it can be recommended that health professionals screen breastfeeding mothers with lactation difficulties for emotional distress that may lead to PMDs and provide evidence‐based information about milk sharing in a nonstigmatizing way. Health professionals may support informed decision‐making for infant feeding practices, including human milk sharing, by providing information on milk sharing risks and risk mitigation, developing evidence‐based practices and guidelines that facilitate safe milk sharing, and directing families to available resources for psychosocial support.
Historical demography of four gecko species specializing in boulder cave habitat: Implications in the evolutionary dead end hypothesis and conservation
Authors: Nguyen Hung N. , Lu Chia‐Wei , Chu Jui‐Hua , Grismer Larry Lee , Hung Chih‐Ming , Lin Si‐Min
Published: December 2018

Specialization in narrow ecological niches may not only help species to survive in competitive or unique environments but also contribute to their extermination over evolutionary time. Although the “evolutionary dead end” hypothesis has long been debated, empirical evidence from species with detailed information on niche specialization and evolutionary history remains rare. Here we use a group of four closely related Cnemaspis gecko species that depend highly on granite boulder caves in the Mekong Delta to investigate the potential impact of ecological specialization on their evolution and population dynamics. Isolated by unsuitable floodplain habitats, these boulder‐dwelling geckos are among the most narrowly distributed Squamata in the world. We applied several coalescence‐based approaches combined with the RAD‐seq technique to estimate their divergence times, gene flow and demographic fluctuations during the speciation and population differentiation processes. Our results reveal long‐term population shrinkage in the four geckos and limited gene flow during their divergence. The results suggest that the erosion and fragmentation of the granite boulder hills have greatly impacted population divergence and declines. The habitat specialization of these geckos has led to fine‐scaled speciation in these granite rocky hills; in contrast, specialization might also have pushed these species toward the edge of extinction. Our study also emphasizes the conservation urgency of these vulnerable, cave‐dependent geckos.
Antigenic variation in the Lyme spirochete: detailed functional assessment of recombinational switching at vlsE in the JD1 strain of Borrelia burgdorferi
Authors: Verhey Theodore B. , Castellanos Mildred , Chaconas George
Published: December 2018

Borrelia burgdorferi is a causative agent of Lyme disease and establishes long‐term infection in mammalian hosts. Persistence is promoted by the VlsE antigenic variation system, which generates combinatorial diversity of VlsE through unidirectional, segmental gene conversion from an array of silent cassettes. Here we explore the variants generated by the vls system of strain JD1, which has divergent sequence and structural elements from the type strain B31, the only B. burgdorferi strain in which recombinational switching at vlsE has been studied in detail. We first completed the sequencing of the vls region in JD1, uncovering a previously unreported 114 bp inverted repeat sequence upstream of vlsE. A five‐week infection of WT and SCID mice was used for PacBio long read sequencing along with our recently developed VAST pipeline to analyze recombinational switching at vlsE from 40,000 sequences comprising 226,000 inferred recombination events. We show that antigenic variation in B31 and JD1 is highly similar, despite the lack of 17 bp direct repeats in JD1, a somewhat different arrangement of the silent cassettes, divergent inverted repeat sequences and general divergence in the vls sequences. We also present data that strongly suggest that dimerization is required for in vivo functionality of VlsE.
The educational programs for extrapyramidal disease and spinocerebellar degeneration patients and their families
Authors: Oki Takeshi , Sugawara Naohiko , Haruta Hiroyuki , Takanashi Jyunichi
Published: December 2018

Background

Extrapyramidal disease and spinocerebellar degeneration patients and their families have less information about their diseases, which deteriorate the quality of life of these patients and increase the burdens on their families.

Aim

We designed our study for the purpose of improving the quality of life of these patients and decreasing the burdens on their families by giving enough information to them.

Methods

We conducted educational programs for these patients and their families, consisting of lectures on the symptoms and courses of the diseases, rehabilitation, social support, dysarthria, and dysphagia. To evaluate the efficacy of our programs, we administered the 36‐Item Short‐Form Health Survey to the patients and the Zarit Burden Interview to their families both before and after these programs.

Results

Thirty‐three patients joined our programs with their families. Of these, 22 had Parkinson's disease, four had progressive supranuclear palsy, four had multiple system atrophy, two had spinocerebellar degeneration, and one had undiagnosed parkinsonism. The Physical Component Summary, the Mental Component Summary, the Role‐social Component Summary scores of the 36‐Item Short‐Form Health Survey, and the scores of the Zarit Burden Interview before and after the programs were 33.4 and 87.7, 55.5 and 48.5, 30.6 and 30.8, and, 19.7 and 19.1, respectively. There was no significant difference in Zarit Burden Interview and the 36‐Item Short‐Form Health Survey other than the subscales of physical functioning and vitality.

Conclusions

Our programs could not improve the quality of life of the patients and could not also reduce the burdens on their families.