bluuebunny/crossref_metadata_2025 huggingface dataset:
Language‐in‐Use Living under Militarisation and Insecurity: How Securitisation Discourse Wounds Trinidad
Authors: Kerrigan Dylan
Published: April 2018

En este artículo se contextualizan los datos de la entrevista de un proyecto de investigación en marcha sobre la militarización de la vida cotidiana en Trinidad, y se explora discursivamente el lenguaje en uso para proporcionar una visión de las experiencias cotidianas de (in) seguridad en St. Barbs, Laventille. Demuestra cómo el lenguaje puede estar implicado en la justificación, el apoyo y la aceptación de vivir en condiciones de militarización e inseguridad. El artículo sugiere que las ideologías, los discursos y las visiones del mundo mediadas masivamente en Trinidad producen y reproducen dentro y por medio del lenguaje una hegemonía cultural que está implicada en la aceptación ritual de una cultura de militarización, hiper‐masculinidad e inseguridad. Basándose en los conceptos de drama social y actuación cultural de Victor Turner, esta creciente aceptación implica el consentimiento individual de definiciones de la vida cotidiana que oscurecen las narrativas sociales del racismo histórico, la pobreza estructural y la desventaja acumulativa, y las reemplaza por la creación neoliberal de mitos culpando a la personalidad, la psicología y la moral dudosa de los problemas sociales y la inseguridad. [Caribbean, Trinidad y Tobago, antropologia, colonialismo, discurso, politica, postcolonial]
PDGFRA mRNA overexpression is associated with regional metastasis and reduced survival in oral squamous cell carcinoma
Authors: Ong Hui Shan , Gokavarapu Sandhya , Tian Zhen , Li Jiang , Xu Qin , Zhang Chen Ping , Cao Wei
Published: April 2018

Background

Platelet‐derived growth factor alpha (PDGFRA) is a gene encoding tyrosine kinase receptor and both EGFR and PDGFRA activate tyrosine kinases. The implication of PGFRA in many cancers and its prognostic significance irrespective to EGFR status in spinal chordoma, gliomas, and uterine cancers have shown a need for its investigation in oral squamous cell carcinoma (OSCC). We investigated the prognostic value of PDGFRA mRNA expression in OSCC.

Patients and methods

The study was conducted in the department of oral maxillofacial surgery‐head and neck oncology, at a tertiary hospital. The data on PDGFRA mRNA expression and immunohistochemical staining status in primary OSCC patients treated for curative surgery from 2010 to 2012 were analyzed. Univariate and multivariate analyses were performed with other cofactors for survival.

Results

A total of 114 consecutive patients with primary OSCC who received treatment were studied. Thirty‐one patients died of the disease. Strong PDGFRA immunohistochemical staining and high expression of PDGFRA mRNA were associated with positive pN status (P < .001), disease‐free survival (P < .001), and overall survival (P < .001) in multivariate cox regression when all other factors such as pN status and histological grading were analyzed. Kaplan‐Meier analysis revealed that the 2‐year survival and 3‐year survival of patients with PDGFRA mRNA low expression were 96.83%. However, 2‐year survival for PDGFRA mRNA high expression level was 59.64%, which decreased to 45.57% by 3‐years.

Conclusion

PDGFRA overexpression in oral SCC, in respect to strong PDGFRA immunohistochemical staining and high PDGFRA mRNA expression, was positively associated with regional metastasis and reduced patient survival.
Love and Dating Patterns for Same‐ and Both‐Gender Attracted Adolescents Across Europe
Authors: Költő András , Young Honor , Burke Lorraine , Moreau Nathalie , Cosma Alina , Magnusson Josefine , Windlin Béat , Reis Marta , Saewyc Elizabeth M. , Godeau Emmanuelle , Gabhainn Saoirse Nic
Published: April 2018

Sexual orientation is a multidimensional phenomenon, which includes identity, behavior, and attraction. The attraction component, however, is less studied than the other two. In this article, we present the development of a two‐item measure to identify adolescents who prefer same‐ and both‐gender partners for love and dating. The questions were administered to nationally representative samples of 15‐year‐old adolescents in eight European countries and regions participating in the Health Behaviour in School‐aged Children (HBSC) cross‐national study. The distribution of attraction, as operationalized by preference for the gender of love and dating partners, was similar across countries. These questions offer an alternative or supplementary approach to identify same‐ and both‐gender attracted youth, without administering questions related to sexual identity.
Absence of a moderating effect of parent health literacy on Early Head Start enrollment and dental use
Authors: Burgette Jacqueline M. , Preisser John S. , Weinberger Morris , King Rebecca S. , Lee Jessica Y. , Rozier R. Gary
Published: April 2018

Objectives

To examine the moderating effect of parents' health literacy (HL) on the effectiveness of North Carolina Early Head Start (EHS) in improving children's dental use.

Methods

Parents of 479 children enrolled in EHS and 699 Medicaid‐matched parent–child dyads were interviewed at baseline when children were approximately 10 months old and 24 months later. We used in‐person computer‐assisted, structured interviews to collect information on sociodemographic characteristics, dental use, and administer the Short Assessment of Health Literacy – Spanish and English (SAHL‐S&E). This quasi‐experimental study tested whether the interaction effect between EHS and parents' HL was associated with dental use. Logit (any use) and marginalized zero‐inflated negative binomial count models (number of dental visits) included random effects to account for clustering and controlled for baseline dental use, dental need, survey language, and a propensity score covariate.

Results

Nineteen percent of parents in EHS had low literacy compared to 12 percent of parents in the non‐EHS group (P < 0.01). The interaction term between EHS and parent's HL was not significant in the adjusted logit model (ratio of aORs 0.98, 95 percent CI: 0.43‐2.20) or the adjusted count model (ratio of aRRs 0.88, 95 percent CI: 0.72‐1.09).

Conclusions

Parents in EHS had a higher prevalence of low HL compared to non‐EHS parents. Parents' HL did not moderate the relationship between EHS and child dental use, suggesting that EHS results in similar improvements in dental use regardless of parent's HL levels.
The mind–body problem and social science: Motivating a quantum social theory
Authors: Wendt Alexander
Published: April 2018

This comment addresses some of the critiques of “Quantum Mind and Social Science” by the other contributors, with special reference to the challenge that the mind‐body problem poses to conventional, classical thinking about social science. A quantum social ontology transcends those challenges, and in the process could transform social scientific thinking across the board. As an example the essay concludes with a consideration of the physics of social structure.
Safety and immunogenicity of HBAI20 Hepatitis B vaccine in healthy naïve and nonresponding adults
Authors: Koc Ö. M. , Savelkoul P. H. M. , van Loo I. H. M. , Peeters A. , Oude Lashof A. M. L.
Published: April 2018

Approximately 5% of the healthy adult population respond inadequately to the commercial recombinant hepatitis B vaccines. As the recombinant vaccines all have an aluminium‐based adjuvant, we tried to enhance the immune response by adding a cytokine‐based adjuvant. This new adjuvant AI20, containing 20 μg recombinant human IL‐2 attached to 20 μg aluminium hydroxide, was added to HBVaxPro©‐10 μg (HBAI20). In a double‐blind randomized controlled trial (RCT), 24 naïve subjects were randomized to receive either HBAI20 or commercial HBVaxPro©‐10 μg vaccine. In an open‐label study, 10 nonresponders received HBAI20 vaccine. All participants received 3 vaccinations (0, 1 and 6 months). In the RCT, the occurrence of any adverse events or severe events was similar between the trial arms. At month 7, all naïve participants were seroprotected; moreover, 92% in the HBAI20 group had protective antibodies 10 days after the second vaccination vs 58% in the HBVaxPro©‐10 μg group, P = .16. In the open‐label study, no serious adverse events were noted. The HBAI20 vaccine was able to elicit protective anti‐HBs titres in 90% of nonresponders, 1 month after the third vaccination. According to these results, the new HBAI20 vaccine seems safe, well‐tolerated and may promote more rapid protection against hepatitis B infection.
Aiming for elimination: Outcomes of a consultation pathway supporting regional general practitioners to prescribe direct‐acting antiviral therapy for hepatitis C
Authors: Wade A. J. , McCormack A. , Roder C. , McDonald K. , Davies M. , Scott N. , Wardrop M. , Athan E. , Hellard M. E.
Published: April 2018

To increase access to treatment, the Australian government enabled general practitioners (GPs) to prescribe direct‐acting antivirals (DAAs) to treat hepatitis C virus (HCV)—in consultation with a specialist if inexperienced in HCV management. This study describes the establishment and outcomes of a remote consultation pathway supporting GPs to treat HCV. Key stakeholders from primary and tertiary healthcare services in the Barwon South Western region developed and implemented an HCV remote consultation pathway. Pharmaceutical Benefits Schedule prescription data were used to evaluate GP DAA prescription 12 months pre‐and post‐ pathway implementation. A retrospective review of patients referred for remote consultation for 12 months post‐ pathway inception was undertaken to determine the care cascade. HCV treatment initiation by GPs increased after implementation of the remote consultation pathway. In the 12‐month study period, 74 GPs referred 169 people for remote consultation; 114 (67%) were approved for GP DAA treatment; 48 (28%) were referred for specialist assessment. In total, 119 (71%) patients commenced DAA; 69 were eligible for SVR12 assessment. Post‐treatment HCV RNA data were available for 52 (75%) people; 37 achieved SVR12; 15 achieved SVR ranging from week 5 to 11 post‐treatment. No treatment failure was detected. Collaborative development and implementation of a remote consultation pathway has engaged regional GPs in managing HCV. Follow‐up post‐treatment could be improved; however, no treatment failure has been documented. To eliminate HCV as a public health threat, it is vital that specialists support GPs to prescribe DAA.
Hepatitis B virus infection in Taiwan: The role of NTCP rs2296651 variant in relation to sex
Authors: Nfor O. N. , Wu M.‐F. , Debnath T. , Lee C.‐T. , Lee W. , Liu W.‐H. , Tantoh D. M. , Hsu S.‐Y. , Liaw Y.‐P.
Published: April 2018

Sodium taurocholate cotransporting polypeptide (NTCP) is a functional receptor for hepatitis B virus (HBV) infection. NTCP rs2296651 is believed to be an Asian‐specific variant responsible for HBV susceptibility. We investigated the relationship between rs2296651 and HBV infection in Taiwan based on stratification by gender and menopausal status. We recruited 10 017 Taiwan Biobank participants aged 30‐70 years with complete genetic data and sociodemographic information. Gender‐stratified multivariate logistic regression models were used to determine the relationship between NTCP variant and HBV infection. Among individuals with HBV infection, the genotype frequencies of GG, AG and AA in women were 0.85, 0.15 and 0 while those in men were 0.82, 0.18 and 0, respectively. The multivariate‐adjusted odds ratios (OR) of HBV infection were 0.77 (95% CI 0.59‐0.10) in women and 0.98 (95% CI 0.79‐1.20) in men. The adjusted OR was 0.87 (CI 0.63‐1.19) in premenopausal and 0.59 (0.36‐0.97) in postmenopausal women. We found that genetic variation in the HBV receptor gene (NTCP) was significantly associated with a decreased risk of HBV infection in Taiwanese women.
Precore G1896A mutation is associated with reduced rates of HBsAg seroclearance in treated HIV hepatitis B virus co‐infected patients from Western Africa
Authors: Boyd A. , Moh R. , Maylin S. , Abdou Chekaraou M. , Mahjoub N. , Gabillard D. , Anglaret X. , Eholié S. P. , Delaugerre C. , Danel C. , Zoulim F. , Lacombe K. ,   for the ANRS 12240 VarBVA study
Published: April 2018

The nucleotide substitution G1896A on the precore (pc) region has been implicated in virological and serological responses during treatment in hepatitis B virus (HBV)‐infected patients. Whether this mutation affects the therapeutic course of HIV‐HBV co‐infected patients, especially from Western Africa, is unknown. In this prospective cohort study, 86 antiretroviral (ARV)‐naïve HIV‐HBV co‐infected patients from Côte d'Ivoire, initiating ARV‐treatment containing lamivudine (n = 53) or tenofovir (n = 33), had available baseline pc sequences. Association of the pcG1896A mutation with time to undetectable HBV‐DNA, hepatitis B “e” antigen (HBeAg) seroclearance (in HBeAg‐positive patients), and hepatitis B surface antigen (HBsAg) seroclearance was evaluated using Cox proportional hazards regression. At ARV‐initiation, median HBV‐DNA was 6.04 log10 copies/mL (IQR = 3.70‐7.93) with 97.7% harbouring HBV genotype E. Baseline pcG1896A mutation was identified in 51 (59.3%) patients, who were more commonly HBeAg‐negative (P < .001) and had basal core promotor A1762T/G1764A mutations (P < .001). Patients were followed for a median 36 months (IQR = 24‐36). Cumulative proportion of undetectable HBV‐DNA was significantly higher in patients with baseline mutation (pcG1896A = 86.6% vs no pcG1896A = 66.9%, P = .04), but not after adjusting for baseline HBV‐DNA levels and anti‐HBV agent (P = .2). No difference in cumulative proportion of HBeAg seroclearance was observed between mutation groups (pcG1896A = 57.1% vs no pcG1896A = 54.3%, P = .7). Significantly higher cumulative proportion of HBsAg seroclearance was observed in patients without this mutation (pcG1896A = 0% vs no pcG1896A = 36.9%, P < .001), even after adjusting for baseline HBsAg quantification and anti‐HBV agent (P < .001). In conclusion, lacking the pcG1896A mutation before ARV initiation appeared to increase HBsAg seroclearance rates during treatment. The therapeutic implications of this mutation need further exploration in this setting.
Serum NGAL can act as an early renal safety biomarker during long‐term nucleos(t)ide analogue antiviral therapy in chronic hepatitis B
Authors: Carey I. , Byrne R. , Childs K. , Horner M. , Bruce M. , Wang B. , Dusheiko G. , Agarwal K.
Published: April 2018

Tubular renal toxicity is a side‐effect of long‐term therapy with nucleos(t)ide analogue(s) (NA) in chronic hepatitis B (CHB). There are no established surrogate markers in plasma of early NA‐related toxicity. Neutrophil gelatinase‐associated lipocalin (NGAL) is a protein produced by tubular cells following renal damage. We aimed therefore to retrospectively compare conventional renal markers (estimated glomerular filtration rates (eGFR) and urinary protein/creatinine ratio uPCR) with a sensitive biomarker (NGAL) in CHB patients on long‐term NA therapy and assess the ability of new markers to predict NA‐related renal toxicity (new onset of nonalbumin proteinuria). A total of 192 naïve CHB patients (median age 41 years, 78% males, 25% HBeAg+, 35% cirrhosis) were NA treated for at least 5 years (median 8.34 years, range 5.54‐11.1 years). The eGFR and uPCR were compared at baseline and last clinical visit with serum NGAL concentrations measured by ELISA at same time‐points and assessed according to the presence/absence of nonalbumin proteinuria at last visit. While baseline and last visit eGFR were similar (median:78 vs 84 mL/min), serum NGAL concentrations increased during therapy (median:9.4 vs 16.4 ng/mL, P < .05). The proportion of patients with proteinuria (uPCR > 15) increased between baseline and last visit (4.6% vs 21.4%, P < .05), with 30 (16%) patients having de novo nonalbumin proteinuria at last visit. High baseline NGAL concentrations were exclusive to patients with de novo nonalbumin proteinuria (median:31.7 vs 7.8 ng/mL, P < .01) and baseline NGAL levels >25 mg/mL were predictive of nonalbumin proteinuria at last visit (AUROC = 0.813). In conclusion, serum NGAL can act as a surrogate marker of early renal injury (de novo nonalbumin proteinuria) in CHB on long‐term NA therapy.
Early development of de novo hepatocellular carcinoma after direct‐acting agent therapy: Comparison with pegylated interferon‐based therapy in chronic hepatitis C patients
Authors: Yoo S. H. , Kwon J. H. , Nam S. W. , Kim H. Y. , Kim C. W. , You C. R. , Choi S. W. , Cho S. H. , Han J.‐Y. , Song D. S. , Chang U. I. , Yang J. M. , Lee H. L. , Lee S. W. , Han N. I. , Kim S.‐H. , Song M. J. , Hwang S. , Sung P. S. , Jang J. W. , Bae S. H. , Choi J. Y. , Yoon S. K.
Published: April 2018

Patients with chronic hepatitis C who achieve a sustained viral response after pegylated interferon therapy have a reduced risk of hepatocellular carcinoma, but the risk after treatment with direct‐acting antivirals is unclear. We compared the rates of early development of hepatocellular carcinoma after direct‐acting antivirals and after pegylated interferon therapy. We retrospectively analysed 785 patients with chronic hepatitis C who had no history of hepatocellular carcinoma (211 treated with pegylated interferon, 574 with direct‐acting antivirals) and were followed up for at least 24 weeks after antiviral treatment. De novo hepatocellular carcinoma developed in 6 of 574 patients receiving direct‐acting antivirals and in 1 of 211 patients receiving pegylated interferon. The cumulative incidence of early hepatocellular carcinoma development did not differ between the treatment groups either for the whole cohort (1.05% vs 0.47%, P = .298) or for those patients with Child‐Pugh Class A cirrhosis (3.73% vs 2.94%, P = .827). Multivariate analysis indicated that alpha‐fetoprotein level >9.5 ng/mL at the time of end‐of‐treatment response was the only independent risk factor for early development of hepatocellular carcinoma in all patients (P < .0001, hazard ratio 176.174, 95% confidence interval 10.768‐2882.473) and in patients treated with direct‐acting agents (P < .0001, hazard ratio 128.402, 95% confidence interval 8.417‐1958.680). In conclusion, the rate of early development of hepatocellular carcinoma did not differ between patients treated with pegylated interferon and those treated with direct‐acting antivirals and was associated with the serum alpha‐fetoprotein level at the time of end‐of‐treatment response.
Clinical findings and diagnostic procedures in 270 small ruminants with obstructive urolithiasis
Authors: Riedi Anna‐Katharina , Knubben‐Schweizer Gabriela , Meylan Mireille
Published: April 2018

Background

Details of the clinical signs of obstructive urolithiasis in male small ruminants have not been documented in a large population.

Objective

To describe the clinical presentation and diagnostic procedures in a large group of small ruminants with urolithiasis.

Animals

Two hundred and seventy small ruminants (158 sheep and 112 goats).

Methods

Retrospective study of 270 cases identified based on clinical records.

Results

81.2% affected goats were castrated and 91.7% sheep were intact males; 65.5% of the animals had been sick ≤2 days before referral. Common abnormalities included dysuria (93.6%), indigestion (84.4%), reduced general state of health (79.5%), signs of pain (73%), increased heart and respiratory rates (53.6% and 39.1%), and azotemia (89.4%). Blood urea nitrogen (BUN) and creatinine concentrations were strongly correlated (r2 = 0.81). Hypochloremia (52.2%), hyponatremia (43.3%), hypophosphatemia (52.4%), and abnormal potassium concentrations (26.2% hypokalemia and 24.5% hyperkalemia) were the most common serum electrolyte imbalances. Packed cell volume (PCV), plasma proteins, potassium, BUN, and creatinine concentrations were significantly increased in animals with uroperitoneum. Ultrasonography allowed for confirmation of diagnosis in 83.9% of the cases (135/161 with sufficient available information), uroliths were visible on 34 of 56 plain radiographs.

Conclusions and Clinical Importance

Our study confirmed that clinical and ultrasonographic examinations are sufficient to diagnose urolithiasis. Clinical signs can be divided into an early stage with discrete unspecific clinical signs, a painful stage with frequent straining, expression of pain and moderately reduced general condition, and an advanced stage with a markedly reduced general condition and eventually recumbency.
Revisiting the first report of temperature‐dependent sex determination in a vertebrate, the African redhead agama
Authors: Steele A. L. , Wibbels T. , Warner D. A.
Published: April 2018

Vertebrates display a wide variety of sex‐determining mechanisms (SDMs). IdentifyingSDMs for different taxa is important for understanding the origins and phylogenetic history of sex‐determining mechanisms. Temperature‐dependent sex determination (TSD) is found in several vertebrate and invertebrate species, and has been studied most extensively in reptiles. The initial discovery ofTSDwas in a lizard, the African redhead agama (Agama agama), over 50 years ago. The original study ofA. agamaused only two incubation temperature treatments and had a small sample size, thus it could not fully characterize the pattern ofTSDin this species. The goal of this study is to revisit this research to better characterize the pattern ofTSD. We also assessed the effect of fluctuating incubation temperatures on offspring sex ratio to provide insight into how variation in offspring sex ratio is produced under natural conditions. After incubating eggs across six constant temperature treatments, we demonstrated that females are produced at relatively cool temperatures and males at warmer temperatures (30°C); fluctuating thermal regimes showed this same pattern. However, some females are again produced at even warmer temperatures, resulting in relatively balanced sex ratios toward the end of the sex‐determining reaction norm. Though the shape of the sex‐determining reaction norm shown here is unusual, it shows some similarities to that of other agamid lizards. Future studies that explore the diversity ofTSDreaction norms and underlying physiological mechanisms will provide new insights into the evolution ofTSD.
Shorter hepatitis B immunoglobulin administration is not associated to hepatitis B virus recurrence when receiving combined prophylaxis after liver transplantation
Authors: Lens Sabela , García‐Eliz María , Fernández Inmaculada , Castells Lluis , Bonacci Martin , Mas Antoni , Crespo Gonzalo , Buti María , Prieto Martín , Forns Xavier
Published: April 2018

Background & Aims

The combination of hepatitis B immunoglobulin and a nucleos(t)ide analogues has markedly reduced the rate of hepatitis B virus recurrence after liver transplantation; however, the optimal duration of hepatitis B immunoglobulin has not been clarified. This lack of consensus perpetuates the use of different strategies. The aim of this study was to evaluate the risk factors associated to hepatitis B virus recurrence after liver transplantation in a large cohort of patients under different hepatitis B immunoglobulin regimens.

Methods

Retrospective multicentre analysis of hepatitis B virus‐related liver transplantation recipients receiving combined prophylaxis (hepatitis B immunoglobulin + nucleos(t)ide analogues). The strategy of short‐term hepatitis B immunoglobulin was compared to lifelong administration. Hepatitis B virus recurrence was defined as positive HBsAg after liver transplantation.

Results

Three hundred and thirty‐eight patients were analysed. After a median follow‐up period of 72 months, 37 patients (11%) developed hepatitis B virus recurrence. Hepatocellular carcinoma recurrence and lamivudine resistance after liver transplantation were the only factors independently associated to hepatitis B virus recurrence (HR 5.4 [2.3‐12] and 9.3 [4.2‐20] respectively P < .001). HBsAg reappearance after hepatitis B virus recurrence was transient (16 patients), persistent (15) or alternant (6). The hepatitis B immunoglobulin regimen did not have an impact on the rate or evolution of hepatitis B virus recurrence. Overall, patient survival was good and not influenced by hepatitis B virus recurrence (82% at 5 years). Fulminant liver failure, hepatitis C coinfection or hepatocellular carcinoma at liver transplantation were independent risk factors for lower survival.

Conclusions

Liver transplantation is an effective treatment for hepatitis B virus‐related liver disease. Since the introduction of combined prophylaxis the rate of hepatitis B virus recurrence is very low. However, lifelong hepatitis B immunoglobulin administration does not seem necessary to reduce hepatitis B virus recurrence.
Hepatitis E seroprevalence in the Americas: A systematic review and meta‐analysis
Authors: Horvatits Thomas , Ozga Ann‐Kathrin , Westhölter Dirk , Hartl Johannes , Manthey Carolin F. , Lütgehetmann Marc , Rauch Geraldine , Kriston Levente , Lohse Ansgar W. , Bendall Richard , Wedemeyer Heiner , Dalton Harry R. , Pischke Sven
Published: April 2018

Background & Aims

While hepatitis E virus infections are a relevant topic in Europe, knowledge about epidemiology of hepatitis E virus infections in the USA and Latin America is still limited. Aim of this study was to estimate anti‐hepatitis E virus IgG seroprevalence in the Americas and to assess whether low socioeconomic status is associated with hepatitis E virus exposure.

Methods

We performed a systematic review and meta‐analysis. Literature search was performed in PubMed for articles published 01/1994‐12/2016. Prevalence was estimated using a mixed‐effects model and reported in line with PRISMA reporting guidelines.

Results

Seroprevalence was significantly higher in the USA than in Latin America, independently of assay, patient cohort, methodological quality or study year (OR: 1.82 (1.06‐3.08), P = .03). Patients in the USA had a more than doubled estimated seroprevalence (up to 9%, confidence interval 5%‐15.6%) than those in Brazil (up to 4.2%, confidence interval 2.4%‐7.1%; OR: 2.27 (1.25‐4.13); P = .007) and Mixed Caribbean (up to 1%, OR: 8.33 (1.15‐81.61); P = .04). A comparison with published data from Europe demonstrated that anti‐hepatitis E virus seroprevalence in the USA and Europe did not differ significantly (OR: 1.33 (0.81‐2.19), P = .25), while rate in South America was significantly lower than that in Europe (OR: 0.67 (0.45‐0.98), P = .04).

Conclusions

Hepatitis E virus is common in the USA. Surprisingly, the risk of hepatitis E virus exposure was low in many South American countries. Seroprevalence did not differ significantly between Europe and the USA. Hence, hepatitis E virus is not limited to countries with low sanitary standards, and a higher socioeconomic status does not protect populations from hepatitis E virus exposure.
A Nonballasted Rail Track Slab Crack Identification Method Using a Level‐Set‐Based Active Contour Model
Authors: Ai Chengbo , Qiu Shi , Xu Guiyang , Zhang Allen , Wang Kelvin C.P.
Published: April 2018

The nonballasted rail tracks have been extensively applied in the new high‐speed railway system development in China, that is, the China Railway Track System (CRTS). However, many defects have been identified during the operation of the CRTS, among which concrete slab crack is recognized as one of the most common, yet critical defects that require accurate identification and timely maintenance attention. Because of the unique outlook of the cracks in nonballasted rail track slabs captured in the survey imagery, direct adaptations of the existing crack extraction methods show dramatically degraded performance. A new automatic crack identification method is developed in this study by employing a region‐based active contour framework with the intensity cluster energy. The proposed method embodies three major contributions, including (1) a heavy penalization energy component that could effectively avoid both under‐ and overevolutions; (2) a multiphase level‐set function that effectively evolves the contours generated with different intensity clusters; and (3) a two‐step implementation of the framework that significantly improves the efficiency. The experimental test evaluates the performance of the proposed method using the data collected on high‐speed rail tracks in Hebei Province, China. The proposed method accurately identifies more than 93.0% of digitized cracks in different crack patterns and challenging backgrounds using a data set consisting of 1,500 synthetic images and 150 actual images. In addition, it shows promising performance in comparison with other popular state‐of‐the‐art crack detection algorithms in terms of accuracy and computational efficiency. The proposed method has demonstrated the promising capacity to support a reliable and efficient nonballasted rail track crack identification and to facilitate the subsequent maintenance cost‐effectively.
Increased flexibility in the use of exogenous lipoic acid by Staphylococcus aureus
Authors: Laczkovich Irina , Teoh Wei Ping , Flury Sarah , Grayczyk James P. , Zorzoli Azul , Alonzo Francis
Published: April 2018

Lipoic acid is a cofactor required for intermediary metabolism that is either synthesized de novo or acquired from environmental sources. The bacterial pathogen Staphylococcus aureus encodes enzymes required for de novo biosynthesis, but also encodes two ligases, LplA1 and LplA2, that are sufficient for lipoic acid salvage during infection. S. aureus also encodes two H proteins, GcvH of the glycine cleavage system and the homologous GcvH‐L encoded in an operon with LplA2. GcvH is a recognized conduit for lipoyl transfer to α‐ketoacid dehydrogenase E2 subunits, while the function of GcvH‐L remains unclear. The potential to produce two ligases and two H proteins is an unusual characteristic of S. aureus that is unlike most other Gram positive Firmicutes and might allude to an expanded pathway of lipoic acid acquisition in this microorganism. Here, we demonstrate that LplA1 and LplA2 facilitate lipoic acid salvage by differentially targeting lipoyl domain‐containing proteins; LplA1 targets H proteins and LplA2 targets α‐ketoacid dehydrogenase E2 subunits. Furthermore, GcvH and GcvH‐L both facilitate lipoyl relay to E2 subunits. Altogether, these studies identify an expanded mode of lipoic acid salvage used by S. aureus and more broadly underscore the importance of bacterial adaptations when faced with nutritional limitation.
Heat shock transcription factor 3 regulates plant immune response through modulation of salicylic acid accumulation and signalling in cassava
Authors: Wei Yunxie , Liu Guoyin , Chang Yanli , He Chaozu , Shi Haitao
Published: April 2018

As the terminal components of signal transduction, heat stress transcription factors (Hsfs) mediate the activation of multiple genes responsive to various stresses. However, the information and functional analysis are very limited in non‐model plants, especially in cassava (Manihot esculenta), one of the most important crops in tropical areas. In this study, 32 MeHsfs were identified from the cassava genome; the evolutionary tree, gene structures and motifs were also analysed. Gene expression analysis found that MeHsfs were commonly regulated by Xanthomonas axonopodis pv. manihotis (Xam). Amongst these MeHsfs, MeHsf3 was specifically located in the cell nucleus and showed transcriptionally activated activity on heat stress elements (HSEs). Through transient expression in Nicotiana benthamiana leaves and virus‐induced gene silencing (VIGS) in cassava, we identified the essential role of MeHsf3 in plant disease resistance, by regulating the transcripts of Enhanced Disease Susceptibility 1 (EDS1) and pathogen‐related gene 4 (PR4). Notably, as regulators of defence susceptibility, MeEDS1 and MePR4 were identified as direct targets of MeHsf3. Moreover, the disease sensitivity of MeHsf3‐ and MeEDS1‐silenced plants could be restored by exogenous salicylic acid (SA) treatment. Taken together, this study highlights the involvement of MeHsf3 in defence resistance through the transcriptional activation of MeEDS1 and MePR4.
Towards the automated identification of Chrysomya blow flies from wing images
Authors: Macleod N. , Hall M. J. R. , Wardhana A. H.
Published: April 2018

The Old World screwworm fly (OWSF), Chrysomya bezziana (Diptera: Calliphoridae), is an important agent of traumatic myiasis and, as such, a major human and animal health problem. In the implementation of OWSF control operations, it is important to determine the geographical origins of such disease‐causing species in order to establish whether they derive from endemic or invading populations. Gross morphological and molecular studies have demonstrated the existence of two distinct lineages of this species, one African and the other Asian. Wing morphometry is known to be of substantial assistance in identifying the geographical origin of individuals because it provides diagnostic markers that complement molecular diagnostics. However, placement of the landmarks used in traditional geometric morphometric analysis can be time‐consuming and subject to error caused by operator subjectivity. Here we report results of an image‐based approach to geometric morphometric analysis for delivering wing‐based identifications. Our results indicate that this approach can produce identifications that are practically indistinguishable from more traditional landmark‐based results. In addition, we demonstrate that the direct analysis of digital wing images can be used to discriminate between three Chrysomya species of veterinary and forensic importance and between C. bezziana genders.
Transcription factor WRKY22 promotes aluminum tolerance via activation of OsFRDL4 expression and enhancement of citrate secretion in rice (Oryza sativa)
Authors: Li Ge Zi , Wang Zhan Qi , Yokosho Kengo , Ding Bing , Fan Wei , Gong Qiao Qiao , Li Gui Xin , Wu Yun Rong , Yang Jian Li , Ma Jian Feng , Zheng Shao Jian
Published: April 2018

Whilst WRKY transcription factors are known to be involved in diverse plant responses to biotic stresses, their involvement in abiotic stress tolerance is poorly understood. OsFRDL4, encoding a citrate transporter, has been reported to be regulated by ALUMINUM (Al) RESISTANCE TRANSCRIPTION FACTOR 1 (ART1) in rice, but whether it is also regulated by other transcription factors is unknown.

We define the role of OsWRKY22 in response to Al stress in rice by using mutation and transgenic complementation assays, and characterize the regulation of OsFRDL4 by OsWRKY22 via yeas one‐hybrid, electrophoretic mobility shift assay and ChIP‐quantitative PCR.

We demonstrate that loss of OsWRKY22 function conferred by the oswrky22 T‐DNA insertion allele causes enhanced sensitivity to Al stress, and a reduction in Al‐induced citrate secretion. We next show that OsWRKY22 is localized in the nucleus, functions as a transcriptional activator and is able to bind to the promoter of OsFRDL4 via W‐box elements. Finally, we find that both OsFRDL4 expression and Al‐induced citrate secretion are significantly lower in art1 oswrky22 double mutants than in the respective single mutants.

We conclude that OsWRKY22 promotes Al‐induced increases in OsFRDL4 expression, thus enhancing Al‐induced citrate secretion and Al tolerance in rice.
Perioperative hematoma with subcutaneous ICD implantation: Impact of anticoagulation and antiplatelet therapies
Authors: Sheldon Seth H. , Cunnane Ryan , Lavu Madhav , Parikh Valay , Atkins Donita , Reddy Yeruva Madhu , Berenbom Loren D. , Emert Martin P. , Pimentel Rhea , Dendi Raghuveer , Lakkireddy Dhanunjaya R.
Published: April 2018

Background

The safety of perioperative anticoagulation (AC) and antiplatelet (AP) therapy with subcutaneous implantable cardioverter‐defibrillator (S‐ICD) implantation is unknown. The purpose of this study was to identify the risk factors associated with hematoma complicating S‐ICD implantation.

Methods

Records were retrospectively reviewed from 200 consecutive patients undergoing S‐ICD implantation at two academic medical centers. A hematoma was defined as a device site blood accumulation requiring surgical evacuation, extended hospital stay, or transfusion.

Results

Among 200 patients undergoing S‐ICD implantation (age 49 ± 17 years, 67% men), 10 patients (5%) had a hematoma, which required evacuation in six patients (3%). Warfarin was bridged or uninterrupted in 12 and 13 patients, respectively (6% and 6.5%). Four of 12 patients with warfarin and bridging AC (33%) and two of 13 patients with uninterrupted warfarin (15%) developed a hematoma. Neither of the two patients with uninterrupted DOAC had a hematoma. No patients on interrupted AC without bridging (n = 26, 13 with warfarin, 13 with DOAC) developed a hematoma. A hematoma was also more likely with the use of clopidogrel (n = 4/10 vs 10/190, 40% vs 5.3%, P < 0.0001) in combination with aspirin in 12/14 patients. Any bridging AC (odds ratio [OR] 10.3, 1.8–60.8, P = 0.01), clopidogrel (OR 10.0, 1.7–57.7, P = 0.01), and uninterrupted warfarin without bridging (OR 11.1, 1.7–74.3, P = 0.013) were independently associated with hematoma formation.

Conclusion

AC and/or AP therapy with clopidogrel appears to increase the risk for hematoma following S‐ICD implantation. Interruption of AC without bridging should be considered when it is an acceptable risk to hold AC.
Use of digoxin in atrial fibrillation: One step further in the mortality controversy from the AFFIRM study
Authors: Charnigo Richard , Khairy Paul , Guo Jing , Shohoudi Azadeh , Elayi Claude S.
Published: April 2018

Background

Whether there is a causal association between digoxin and mortality among patients with atrial fibrillation (AF), with or without congestive heart failure (HF), has been controversial; in particular, two prior analyses of data from the Atrial Fibrillation Follow‐up Investigation of Rhythm Management (AFFIRM) trial have yielded conflicting results. We sought to investigate how digoxin impacts mortality, in the full AFFIRM cohort and for various subgroups, by applying marginal structural modeling (MSM) to AFFIRM data.

Methods

MSM is a newer statistical approach, which estimates causal association in the absence of randomization. MSM more effectively accounts for time‐varying treatment and mitigates potential biases, in contrast to the two statistical approaches used in prior analyses of the AFFIRM data.

Results

Among 4,060 patients in AFFIRM, 660 (16.3%) died during follow‐up. Digoxin was associated with significantly higher mortality in the full cohort (estimated hazard ratio [HR] 1.33, 95% confidence interval [CI] 1.11–1.60, P  =  0.002) and in 3,121 patients without HF (HR 1.36, 95% CI 1.07–1.72, P  =  0.011). There was a trend toward higher mortality with digoxin in 939 patients with HF (HR 1.29, 95% CI 0.96–1.72, P  =  0.090). Associations were nonsignificant in 463 patients with HF and left ventricular ejection fraction (EF) ≥40% and in 155 patients with EF ≤30%.

Conclusions

Digoxin is associated with significantly increased mortality among AFFIRM patients collectively, as determined by MSM statistical methodology. However, the impact of digoxin among AFFIRM patients with coexisting HF is inconclusive.
The impact of oral food challenges for food allergy on quality of life: A systematic review
Authors: Kansen Hannah M. , Le Thuy‐My , Meijer Yolanda , Flokstra‐de Blok Bertine M. J. , Welsing Paco M. J. , van der Ent Cornelis K. , Knulst André C. , van Erp Francine C.
Published: April 2018

Background

Food allergy significantly impairs health‐related quality of life (HRQL). Currently, it is still unknown whether diagnostic interventions for food allergy improve HRQL. We aim to assess the impact of diagnostic interventions for food allergy on HRQL.

Methods

A systematic search was performed in MEDLINE, Embase, Cochrane Library, and CINAHL focused on patients with a (suspected) food allergy who underwent diagnostic interventions (ie, skin prick test, specific IgE, or oral food challenges [OFC]) and in whom HRQL was assessed. The mean difference between HRQL before and after the diagnostic intervention was calculated. A minimal clinically important difference of 0.5 was considered clinically relevant for the food allergy quality of life questionnaire.

Results

Seven of 1465 original identified publications were included in which the impact of an OFC on HRQL was investigated (total patients n = 1370). No other diagnostic interventions were investigated. Food allergy‐specific parent‐reported HRQL improved significantly after an OFC irrespective of the outcome in children with a suspected food allergy in two publications. The change was considered clinically relevant in one of two publications. In addition, parent‐reported HRQL improved after an OFC to assess the eliciting dose in children with a confirmed food allergy. The parental burden was significantly reduced after an OFC to assess resolution of food allergy. A meta‐analysis could not be performed due to the limited numbers of, and considerable heterogeneity between, eligible publications.

Conclusion

An OFC is associated with an improved food allergy‐specific HRQL and a reduced parental burden of food allergy.
Constructing Treatment Decision Rules Based on Scalar and Functional Predictors when Moderators of Treatment Effect are Unknown
Authors: Ciarleglio Adam , Petkova Eva , Ogden Todd , Tarpey Thaddeus
Published: April 2018

Treatment response heterogeneity poses serious challenges for selecting treatment for many diseases. To understand this heterogeneity better and to help in determining the best patient-specific treatments for a given disease, many clinical trials are collecting large amounts of patient level data before administering treatment in the hope that some of these data can be used to identify moderators of treatment effect. These data can range from simple scalar values to complex functional data such as curves or images. Combining these various types of baseline data to discover ‘biosignatures’ of treatment response is crucial for advancing precision medicine. Motivated by the problem of selecting optimal treatment for subjects with depression based on clinical and neuroimaging data, we present an approach that both identifies covariates associated with differential treatment effect and estimates a treatment decision rule based on these covariates. We focus on settings where there is a potentially large collection of candidate biomarkers consisting of both scalar and functional data. The validity of the approach proposed is justified via extensive simulation experiments and illustrated by using data from a placebo-controlled clinical trial investigating antidepressant treatment response in subjects with depression.
Spatially Balanced Sampling of Continuous Populations
Authors: Grafström Anton , Matei Alina
Published: April 2018

When sampling from a continuous population (or distribution), we often want a rather small sample due to some cost attached to processing the sample or to collecting information in the field. Moreover, a probability sample that allows for design‐based statistical inference is often desired. Given these requirements, we want to reduce the sampling variance of the Horvitz–Thompson estimator as much as possible. To achieve this, we introduce different approaches to using the local pivotal method for selecting well‐spread samples from multidimensional continuous populations. The results of a simulation study clearly indicate that we succeed in selecting spatially balanced samples and improve the efficiency of the Horvitz–Thompson estimator.
Patient blood management and the importance of the Transfusion Practitioner role to embed this into practice
Authors: Bielby L. , Moss R. L.
Published: April 2018

Patient blood management (PBM) is a widely established international initiative, with a multidisciplinary approach to reduce transfusion. The Transfusion Practitioner1 (TP) role is well embedded in the United Kingdom (UK) and Australia. The value of the TP in changing both culture and practice to implement an all‐inclusive PBM approach to care will be discussed. The TP role was born from both a safety and haemovigilance culture, where the greatest identified risk to the patient undergoing a transfusion was human error. From this initial trigger for improved safety, the TP role has evolved to a multifaceted, highly specialised role, involved in both PBM and transfusion processes. As the transfusion paradigm shifted from product to patient, the TP role evolved to include PBM, with an emphasis on the patients and the impact transfusion has on them. A multidisciplinary team is required to drive both PBM and transfusion; the TP is recognised as a critical link in the multidisciplinary team. They are seen as a driving force for change, bridging the gap between the laboratory and clinical arenas. The TP plays a vital role in helping establish and embed PBM that improves patient and safety outcomes.
Patient blood management: how is implementation going?: A report comparing the 2015 survey with the 2013 survey of PBM in England
Authors: Sherliker L. , Pendry K. , Hockley B.
Published: April 2018

Background

Patient blood management (PBM) is an evidence‐based approach to optimising the care of patients who might need transfusion. In 2013, all NHS Trusts in England were surveyed about their readiness to implement PBM. National PBM recommendations were launched in 2014.

Aims

The aim of this study was to determine progress of PBM initiatives.

Methods/Materials

A survey was constructed by staff in hospitals and NHS Blood and Transplant (NHSBT). An online questionnaire was sent to all NHS Trusts in England (N = 149) in November 2015.

Results

Improvements in 2015:

Education/training in transfusion: 80–100% from 60–90% in 2013

Provision of information relating to consent for transfusion: 98% from 65% in 2013 (P = <0·001)

The management of anaemia: elective general surgery management, 66% from 41% in 2013 (P = <0·001)

Transfusion alternatives: Tranexamic use in surgery, 92% from 71% in 2013 (P = <0·001)

Laboratory staff empowered to challenge transfusion requests, 95% from 65% in 2013 (P = 0·001)

Further work required:

Electronic systems to support requesting (e.g. mandatory recording of diagnosis: 47% from 48% in 2013 (P = 0·85), incorporation of standardised requesting codes: 27% from 33% in 2013 (P = 0·24)

Appropriate use of components: in 2015, only 42% had a lower red cell transfusion thresholds policy in non‐bleeding patients

Conclusions

The results provided information to support the development of local and national work plans. It is hoped that the collaborative work across NHS Blood and Transplant (NHSBT), the National Blood Transfusion Committee (NBTC) and NHS Trusts will continue to drive the PBM agenda to support best practice in this field.
Interaction of maternal environment and allelic differences in seed vigour genes determines seed performance in Brassica oleracea
Authors: Awan Sajjad , Footitt Steven , Finch‐Savage William E.
Published: April 2018

Seed vigour is a key trait essential for the production of sustainable and profitable crops. The genetic basis of variation in seed vigour has recently been determined in Brassica oleracea, but the relative importance of the interaction with parental environment is unknown. We produced seeds under a range of maternal environments, including global warming scenarios. Lines were compared that had the same genetic background, but different alleles (for high and low vigour) at the quantitative trait loci responsible for determining seed vigour by altering abscisic acid (ABA) content and sensitivity. We found a consistent effect of beneficial alleles across production environments; however, environmental stress during production also had a large impact that enhanced the genetic difference in seed performance, measured as germination speed, resistance to controlled deterioration and induction of secondary dormancy. Environmental interaction with allelic differences in key genes that determine ABA content and sensitivity develops a continuity in performance from rapid germination through to failure to complete germination, and increasing depths of seed dormancy. The genetic–environmental interaction revealed provides a robust mechanism of bet‐hedging to minimize environmental risk during subsequent germination, and this could have facilitated the rapid change in seed behaviour (reduced dormancy and rapid germination) observed during crop domestication.