bluuebunny/crossref_metadata_2025 huggingface dataset:
The art and science of species delimitation
Authors: Rannala Bruce
Published: February 2016

DNA-based approaches to systematics have changed dramatically during the last two decades with the rise of DNA barcoding methods and newer multi-locus methods for species delimitation. During the last half-decade, partly driven by the new sequencing technologies, the focus has shifted to multi-locus sequence data and the identification of species within the framework of the multi-species coalescent (MSC). In this paper, I discuss model-based Bayesian methods for species delimitation that have been developed in recent years using the MSC. Several approximate methods for species delimitation (and their limitations) are also discussed. Explicit species delimitation models have the advantage of clarifying more precisely what is being delimited and what assumptions we are making in doing so. Moreover, the methods can be very powerful when applied to large multi-locus datasets and thus take full advantage of data generated using today’s technologies.
Novel insights into the historical biogeography of the streak-breasted scimitar babbler complex (Aves: Timaliidae: Pomatorhinus ruficollis complex)
Authors: Reddy Sushma , Nyári Árpád S.
Published: February 2016

The Streak-breasted Scimitar Babblers of the Pomatorhinus ruficollis species complex are found in most of the forested habitats across southern and eastern Asia. The diversification history of this group is obscured by high plumage variation across populations and conflicting genetic signal across loci. We combined genetic and geographic data from several recent studies to investigate how these species diversified across China using both phylogenetic and ecological niche modeling analyses. These two lines of evidence are consistent in showing that two well-sampled species, P. reconditus and P. nigrostellatus, in central and southern China respectively, likely experienced a history of isolation and expansion as suitable habitat contracted during the last interglacial and expanded in patchy extent during the glacial maximum. The genetic analysis showed that populations of P. nigrostellatus on Hainan Island are very similar to the ones in nearby mainland southern China. We recovered two well-supported clades within P. reconditus that were not geographically structured with both containing individuals from the same localities across central China. This phylogenetic result corresponded to the ecological niche models that showed expansion from refugia since the last interglacial. This study illustrates the value of using an integrative approach and detailed geographic sampling to help understand the recent diversification of birds in China.
Passive and active, predator and prey: using acoustics to study interactions between cetaceans and forage fish
Authors: Lawrence Joshua M. , Armstrong Eric , Gordon Jonathan , Lusseau Susan Mærsk , Fernandes Paul G.
Published: February 2016

Fisheries acoustics surveys provide platforms for deploying passive acoustic equipment to detect cetacean vocalizations. Passive acoustic methods are developing as viable alternatives to visual surveys, particularly for small, inconspicuous species such as the harbour porpoise (Phocoena phocoena). Passive acoustic monitoring using a towed hydrophone array was carried out during an acoustic survey of clupeids in the Clyde Sea and surrounding sea lochs to identify spatial relationships between porpoises and their prey. Methods were developed to process passive acoustic data, successfully identifying porpoise echolocation clicks while discriminating them from the transmitted 120-kHz echosounder pulse and its reflections. To date, this has been a confounding factor which has made these survey techniques potentially incompatible. The highest biomass of pelagic fish was detected in the northernmost parts of the survey region, as were the largest number of porpoises. A moving average was used to examine the scale of the relationships identified, and it was found that while porpoises show no significant preferences for pelagic prey numbers at the smallest scales, they do show significant avoidance of larger areas (5+ km) with very low pelagic fish biomass. This study demonstrates that high-frequency passive acoustic monitoring can be used effectively alongside multifrequency fisheries echosounder surveys to provide novel insights into the trophic interactions between these species, and that further work will hopefully prove useful in improving the efficacy of management strategies for harbour porpoises.
Clinical Features of Spontaneous Partial Healing During Mycobacterium ulcerans Infection
Authors: Marion Estelle , Chauty Annick , Kempf Marie , Le Corre Yannick , Delneste Yves , Croue Anne , Marsollier Laurent ,   for the Franco-Beninese Buruli Research Group, Vincent Quentin B. , Abel Laurent , Johnson Christian , Alcaïs Alexandre , Marion Estelle , Marsollier Laurent , Kempf Marie , Saint-André Jean-Paul , Adeye Ambroise , Chauty Annick , Agossadou Didier
Published: February 2016

Background.  Buruli ulcer, caused by Mycobacterium ulcerans, is a necrotizing skin disease leading to extensive cutaneous and subcutaneous destruction and functional limitations. Spontaneous healing in the absence of medical treatment occurs in rare cases, but this has not been well described in the literature.

Methods.  In a retrospective case study in an area of Benin where this disease is highly endemic, we selected 26 Buruli ulcer patients presenting features of spontaneous healing from a cohort of 545 Buruli ulcer patients treated between 2010 and 2013.

Results.  The 26 patients studied had a median age of 13.5 years and were predominantly male (1.4:1). Three groups of patients were defined on the basis of their spontaneous healing characteristics. The first group (12 patients) consisted of patients with an ulcer of more than 1 year′s duration showing signs of healing. The second (13 patients) group contained patients with an active Buruli ulcer lesion some distance away from a first lesion that had healed spontaneously. Finally, the third group contained a single patient displaying complete healing of lesions from a nodule, without treatment and with no relapse.

Conclusions.  We defined several features of spontaneous healing in Buruli ulcer patients and highlighted the difficulties associated with diagnosis and medical management. Delays in consultation contributed to the high proportion of patients with permanent sequelae and a risk of squamous cell carcinoma. Early detection and antibiotic treatment are the best ways to reduce impairments.
Unnecessary Antibiotics for Acute Respiratory Tract Infections: Association With Care Setting and Patient Demographics
Authors: Barlam Tamar F. , Soria-Saucedo Rene , Cabral Howard J. , Kazis Lewis E.
Published: February 2016

Background.  Up to 40% of antibiotics are prescribed unnecessarily for acute respiratory tract infections (ARTIs). We sought to define factors associated with antibiotic overprescribing of ARTIs to inform efforts to improve practice.

Methods.  We conducted a retrospective analysis of ARTI visits between 2006 and 2010 from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. Those surveys provide a representative sample of US visits to community-based physicians and to hospital-based emergency departments (EDs) and outpatient practices. Patient factors (age, sex, race, underlying lung disease, tobacco use, insurance), physician specialty, practice demographics (percentage poverty, median household income, percentage with a Bachelor's Degree, urban-rural status, geographic region), and care setting (ED, hospital, or community-based practice) were evaluated as predictors of antibiotic overprescribing for ARTIs.

Results.  Hospital and community-practice visits had more antibiotic overprescribing than ED visits (odds ratio [OR] = 1.64 and 95% confidence interval [CI], 1.27–2.12 and OR = 1.59 and 95% CI, 1.26–2.01, respectively). Care setting had significant interactions with geographic region and urban and rural location. The quartile with the lowest percentage of college-educated residents had significantly greater overprescribing (adjusted OR = 1.41; 95% CI, 1.07–1.86) than the highest quartile. Current tobacco users were overprescribed more often than nonsmokers (OR = 1.71; 95% CI, 1.38–2.12). Patient age, insurance, and provider specialty were other significant predictors.

Conclusions.  Tobacco use and a lower grouped rate of college education were associated with overprescribing and may reflect poor health literacy. A focus on educating the patient may be an effective approach to stewardship.
Uncommon Tumor, Uncommon Location: A Dermal-Based Spindle Cell/Pleomorphic Lipoma
Authors: Lincoln Mark , Royer Michael
Published: February 2016

Spindle cell/pleomorphic lipoma is an uncommonly encountered benign neoplasm that is usually found in the subcutaneous tissues. Rare cases reported in the literature have an intradermal location. This lesion usually presents as a subcutaneous nodule on the neck, shoulders, or back of middle-aged to elderly males. Although spindle cell and pleomorphic lipoma are currently considered the same entity, they were historically categorized separately. The authors report a case of hyperpigmented papule with an associated subcutaneous nodule on the left cheek of a 56-year-old man, review the literature, and discuss several important diagnostic pitfalls of spindle cell/pleomorphic lipoma.
Colorectal Cancer Screening in a Nationwide High-deductible Health Plan Before and After the Affordable Care Act
Authors: Wharam J. Frank , Zhang Fang , Landon Bruce E. , LeCates Robert , Soumerai Stephen , Ross-Degnan Dennis
Published: February 2016

Background:

Little is known about the effect of the Affordable Care Act’s (ACA) elimination of out-of-pocket costs for preventive services. This policy likely reduced out-of-pocket colonoscopy costs most for high-deductible health plan (HDHP) members.

Objectives:

Determine the ACA’s impact on colorectal cancer screening among HDHP members.

Research Design:

Pre-post with comparison group, constructed before and after the ACA.

Subjects:

We studied 2003–2012 administrative claims data of a large national health insurer. HDHP members had 1 year of low-deductible (≤$500) plan enrollment followed by 1 year of HDHP (≥$1000) enrollment after an employer-mandated switch; HDHP enrollment occurred fully after the ACA for 21,605 members and fully before the ACA for 106,609 members. We propensity score-matched contemporaneous low-deductible (≤$500) control group members to both the before-ACA and after-ACA HDHP groups. We examined the 1-year impact of the HDHP switch separately in the before-ACA and after-ACA study cohorts, then compared these changes to estimate ACA effects.

Measures:

Overall colorectal cancer screening, colonoscopy, and fecal-occult blood testing annual rates.

Results:

Before the ACA, colorectal cancer screening tests declined by 37/10,000 (−71, −4) among HDHP members versus controls; after the ACA, HDHP members experienced a nonsignificant increase in screening [+52/10,000 (−19,124)]. Corresponding changes in colonoscopy were −55/10,000 (−81, −29) before and +20/10,000 (−38, 78) after the ACA. Thus, the ACA was associated with increased colorectal cancer screening rates [+89/10,000 (11, 168); relative: +9.1% (0.5–17.8)] and screening colonoscopies [+75/10,000 (12–139); relative: +16.4% (2.5–30.3)] among HDHP members.

Conclusion:

The ACA was associated with improved colorectal cancer screening among HDHP members.
Paediatric Rome III Criteria–Related Abdominal Pain Is Associated With Helicobacter pylori and Not With Calprotectin
Authors: Sýkora Josef , Huml Michal , Siala Konrad , Pomahačová Renáta , Jehlička Petr , Liška Jiří , Kuntscherová Jana , Schwarz Jan
Published: February 2016

Objectives:

Abdominal pain–related functional gastrointestinal disorders in children include functional dyspepsia, functional abdominal pain, irritable bowel syndrome, and abdominal migraine. We aimed to evaluate a possible association between functional abdominal pain disorders and Helicobacter pylori infection and faecal calprotectin level.

Methods:

Prospective observational study including consecutive children with functional gastrointestinal disorders fulfilling Rome III criteria (cases) and age/sex‐matched healthy controls. H pylori has been detected by biopsy‐based tests and stool‐antigen detection, faecal calprotectin by enzyme‐linked immunosorbent assay.

Results:

A total of 56 cases (27 with functional dyspepsia) and 56 controls were enrolled. H pylori being detected in 17 of 56 cases (30.4%) and 4 of 56 controls (7.1%, odds ratio: 5.7; 95% confidence interval [CI]: 1.8–18.2, P = 0.003). H pylori was detected significantly more frequently in cases with functional dyspepsia (14/27, 51.9% odds ratio: 14.0; 95% CI: 3.9–49.7, P = 0.00001) than in controls and not in cases with other well‐recognized functional gastrointestinal complaints (3/29, 10.3%). The median faecal calprotectin level was similar in cases (7.8 μg/g, 95% CI: 7.8–8.4) including those with gastritis, and controls (9.1 μg/g, 95% CI: 7.8–11.3). Gastritis features were more frequent in H pylori–infected and noninfected cases with functional dyspepsia (27/27, 100%) than in cases with other abdominal functional complaints (15/29, 51.7%, P = 0.007).

Conclusions:

H pylori gastritis and noninfectious gastritis were associated with functional dyspepsia in children referred for abdominal pain–related functional gastrointestinal disorders while faecal calprotectin is not a predictor of gastritis and is similar in children with functional abdominal pain symptoms and in controls.
The Experience of Participation in Suicide Research From the Perspective of Individuals With Bipolar Disorder
Authors: Owen Rebecca , Gooding Patricia , Dempsey Robert , Jones Steven
Published: February 2016

Reasons underlying the elevated prevalence of suicide in bipolar disorder remain underresearched and poorly understood. Participation in suicide-focused research may pose a risk to vulnerable groups, such as those with bipolar disorder. Participants were asked to provide feedback about their experience of participating in a suicide-focused qualitative research interview. The data set was analyzed using inductive thematic analysis. Qualitative themes were (1) talking about suicide was not distressing, (2) negative interview expectations, (3) personal benefits, (4) value of suicide research, (5) interview advice, and (6) talking about suicide was difficult. Suicide-focused research can be conducted with minimal participant distress. Sufficient procedures must be in place, both to identify those at risk of experiencing distress and to efficiently deal with any distress that might occur.
Patient-Ventilator Asynchrony During Assisted Ventilation in Children
Authors: Blokpoel Robert G. T. , Burgerhof Johannes G. M. , Markhorst Dick G. , Kneyber Martin C. J.
Published: February 2016

Objective:

To describe the frequency and type of patient-ventilator asynchrony in mechanically ventilated children by analyzing ventilator flow and pressure signals.

Design:

Prospective observational study.

Setting:

Tertiary PICU in a university hospital.

Patients:

Mechanically ventilated children between 0 and 18 years old and who were able to initiate and maintain spontaneous breathing were eligible for inclusion. Patients with congenital or acquired neuromuscular disorders, those with congenital or acquired central nervous system disorders, and those who were unable to initiate and maintain spontaneous breathing from any other cause were excluded.

Interventions:

None.

Measurements and Main Results:

All patients were ventilated in a time-cycled, pressure-limited mode with flow triggering set at 1.0 L/min by using the Evita XL (Dräger, Lubeck, Germany). Patient-ventilator asynchrony was identified by a random 30-minute continuous recording and an offline analysis of the flow and pressure signals. Patient-ventilator asynchrony was categorized and labeled into four different groups: 1) trigger asynchrony (i.e., insensitive trigger, double triggering, autotriggering, or trigger delay), 2) flow asynchrony, 3) termination asynchrony (i.e., delayed or premature termination), and 4) expiratory asynchrony. Flow and pressure signals were recorded in 45 patients for 30 minutes. A total number of 57,651 breaths were analyzed. Patient-ventilator asynchrony occurred in 19,175 breaths (33%), and it was seen in every patient. Ineffective triggering was the most predominant type of asynchrony (68%), followed by delayed termination (19%), double triggering (4%), and premature termination (3%). Patient-ventilator asynchrony significantly increased with lower levels of peak inspiratory pressure, positive end-expiratory pressure, and set frequency.

Conclusions:

Patient-ventilator asynchrony is extremely common in mechanically ventilated children, and the predominant cause is ineffective triggering.
Inhibitory control of correlated intrinsic variability in cortical networks
Authors: Stringer Carsen , Pachitariu Marius , Okun Michael , Bartho Peter , Harris Kenneth , Latham Peter , Sahani Maneesh , Lesica Nicholas
Published: February 2016

Cortical networks exhibit intrinsic dynamics that drive coordinated, large-scale fluctuations across neuronal populations and create noise correlations that impact sensory coding. To investigate the network-level mechanisms that underlie these dynamics, we developed novel computational techniques to fit a deterministic spiking network model directly to multi-neuron recordings from different species, sensory modalities, and behavioral states. The model generated correlated variability without external noise and accurately reproduced the wide variety of activity patterns in our recordings. Analysis of the model parameters suggested that differences in noise correlations across recordings were due primarily to differences in the strength of feedback inhibition. Further analysis of our recordings confirmed that putative inhibitory neurons were indeed more active during desynchronized cortical states with weak noise correlations. Our results demonstrate that network models with intrinsically-generated variability can accurately reproduce the activity patterns observed in multi-neuron recordings and suggest that inhibition modulates the interactions between intrinsic dynamics and sensory inputs to control the strength of noise correlations.
User password repetitive patterns analysis and visualization
Authors: Yu Xiaoying , Liao Qi
Published: February 2016

Purpose

– Passwords have been designed to protect individual privacy and security and widely used in almost every area of our life. The strength of passwords is therefore critical to the security of our systems. However, due to the explosion of user accounts and increasing complexity of password rules, users are struggling to find ways to make up sufficiently secure yet easy-to-remember passwords. This paper aims to investigate whether there are repetitive patterns when users choose passwords and how such behaviors may affect us to rethink password security policy.

Design/methodology/approach

– The authors develop a model to formalize the password repetitive problem and design efficient algorithms to analyze the repeat patterns. To help security practitioners to analyze patterns, the authors design and implement a lightweight, Web-based visualization tool for interactive exploration of password data.

Findings

– Through case studies on a real-world leaked password data set, the authors demonstrate how the tool can be used to identify various interesting patterns, e.g. shorter substrings of the same type used to make up longer strings, which are then repeated to make up the final passwords, suggesting that the length requirement of password policy does not necessarily increase security.

Originality/value

– The contributions of this study are two-fold. First, the authors formalize the problem of password repetitive patterns by considering both short and long substrings and in both directions, which have not yet been considered in past. Efficient algorithms are developed and implemented that can analyze various repeat patterns quickly even in large data set. Second, the authors design and implement four novel visualization views that are particularly useful for exploration of password repeat patterns, i.e. the character frequency charts view, the short repeat heatmap view, the long repeat parallel coordinates view and the repeat word cloud view.
Marketing in SMEs: a “4Ps” self-branding model
Authors: Resnick Sheilagh Mary , Cheng Ranis , Simpson Mike , Lourenço Fernando
Published: February 2016

Purpose

– The purpose of this paper is to explore the extent to which traditional marketing theory and practice can be applied in small- and medium-sized enterprises (SMEs) and consider how owner-managers perceive their own role in marketing within a small business setting.

Design/methodology/approach

–A qualitative exploratory approach using semi-structured in-depth interviews amongst owner-managers of SMEs in the UK.

Findings

– SME marketing is effective in that it embraces some relevant concepts of traditional marketing, tailors activities to match its customers and adds its own unique attribute of self-branding as bestowed by the SME owner-manager.

Research limitations/implications

– The study was limited to the UK and to a small sample of SMEs and as such the findings are not necessarily generalisable.

Originality/value

– A “4Ps” model for SME self-branding is proposed, which encompasses the attributes of personal branding, (co)production, perseverance and practice.
Credit risk management of Ghanaian listed banks
Authors: Apanga Michelle Ayog-Nying , Appiah Kingsley Opoku , Arthur Joseph
Published: February 2016

Purpose

– The study aims to assess credit risk management practices within financial institutions in Ghana. Specifically, the study compares credit risk management practices of listed banks in Ghana with Basel II (1999).

Design/methodology/approach

– The analysis is based on data gathered from varied sources, namely, use of questionnaires, analysis of internal credit policies and procedure manuals and semi-structured interviews and discussions with credit risk managers of the selected banks in May 2007 and October 2014.

Findings

– Overall, the credit risk management practices within listed banks in Ghana are in line with sound practices. The only dissimilarity, however, is the role of the board of directors in defining acceptable types of loans and maximum maturities for the various types of loans. The listed banks in Ghana are also exposed to credit risks associated with granting both corporate and small business commercial loans and the use of collaterals to mitigate their credit risk exposures.

Practical implications

– Banks in Ghana should consider developing the skills of all their personnel and appropriately motivating those involved in the credit risk management processes to ensure that they carry out this process efficiently.

Originality/value

– Research into credit risk management in the banking industry from the Ghanaian perspective remains scant. This study is, therefore, timely, and its findings are invaluable for the efficient management of credit risk in the banking industry. This study provides policy recommendations which will enhance shareholder value and, in this way, contribute to greater stability in the banking sector in developing countries, in particular.
Mobile payment technologies in retail: a review of potential benefits and risks
Authors: Taylor Emmeline
Published: February 2016

Purpose

– Retailers and suppliers are facing the challenge of reconfiguring systems to accommodate increasingly mobile customers expecting multichannel options supporting quick and secure digital payment. The purpose of this paper is to harness the learning from the implementation of self-checkout and combines it with available information relating to mobile scanning and mobile point-of-sale (MPOS).

Design/methodology/approach

– In review of the literature, the paper provides an overview of different modes of mobile payment systems, and a consideration of some of the benefits that they offer to retailers and their customers. The main focus, drawing upon telephone interviews with retail security professionals in Australia and New Zealand, is on anticipating and mitigating against the potential risks, vulnerabilities and impact on shrinkage.

Findings

– With the market being flooded with software and products, retailers are exposed to a compelling case for mobile payment, but it was found that they are not as cognisant of the potential risks.

Research limitations/implications

– Further research is needed on the different permutations of mobile POS and how it impacts on the customer journey and rates of internal and external theft.

Practical implications

– Suggestions for future empirical research on the risks and vulnerabilities that moving to mobile payment can usher in are provided.

Originality/value

– The paper links research from diverse fields, in particular criminology, to elucidate the potential impact of mobile technologies on retail theft and internal technological and process issues, before offering possible solutions.
Socially interacting or indifferent neighbours? Randomization of movement paths to tease apart social preference and spatial constraints
Authors: Spiegel Orr , Leu Stephan T. , Sih Andrew , Bull C. Michael
Published: February 2016

Understanding how animals interact with their physical and social environment is a major question in ecology, but separating between these factors is often challenging. Observed interaction rates may reflect social behaviour – preferences or avoidance of conspecifics or certain phenotypes. Yet, environmental spatiotemporal heterogeneity also affects individual space use and interaction rates. For instance, clumped and ephemeral resources may force individuals to aggregate independently of sociality.

Proximity‐based social networks (PBSNs) are becoming increasingly popular for studying social structures thanks to the parallel improvement of biotracking technologies and network randomization methods. While current methods focus on swapping individual identities among network nodes or in the data streams that underlies the network (e.g. individuals movement paths), we still need better tools to distinguish between the contribution of sociality and other factors towards those interactions.

We propose a novel method that randomizes path segments among different time stamps within each individual separately (Part I). Temporal randomization of whole path segments (e.g. full days) retains their original spatial structure while decoupling synchronization among individuals. This allows researchers to compare observed dyadic association rates with those expected by chance given explicit space use of the individuals in each dyad.

Further, since environmental changes are commonly much slower than the duration of social interactions, we can differentiate between these two factors (Part II). First, an individual's path is divided into successive time windows (e.g. weeks), and days are randomized within each time window. Then, by exploring how the deviations between randomized and observed networks change as a function of time window length, we can refine our null model to account also for temporal changes in the activity areas.

We used biased‐correlated random walk models to simulate populations of socially indifferent or sociable agents for testing our method for both false‐positive and negative errors. Applying the method to a data set of GPS‐tracked sleepy lizards (Tiliqua rugosa) demonstrated its ability to reveal the social organization in free‐ranging animals while accounting for confounding factors of environmental spatiotemporal heterogeneity. We demonstrate that this method is robust to sampling bias and argue that it is applicable for a wide range of systems and tracking techniques, and can be extended to test for preferential phenotypic assortment within PBSNs.
Country of origin labeling for complex supply chains: the case for labeling the location of different supply chain links
Authors: Bienenfeld Jason M. , Botkins Elizabeth R. , Roe Brian E. , Batte Marvin T.
Published: February 2016

We investigate the value of a country of origin label (COOL) that separately identifies the geographic location of different stages in a food product's supply chain. We estimate the willingness‐to‐pay (WTP) of U.S. consumers for a packaged cereal product where the key grain ingredient may be grown in one country and processed in a second country (multicountry supply chain) and compare it to equivalent products that have both stages located in a single country. We find consumer WTP for products with single‐country and multicountry supply chains are statistically different, meaning that simplifying a multicountry label by listing only the country where the ingredients are grown or only the country where the ingredients are processed can result in different consumer values. We also find that for countries with a poor quality reputation, consumers respond more negatively when that country has the “last touch” than when that country's involvement is limited to upstream supply chain links.
Pulsed dye laser treatment of capillary malformations in infants at 2‐weekly versus 3‐monthly intervals, reducing the need for general anaesthesia
Authors: Swan Bonnie C , Robertson Susan J , Tuxen Alana , Ma Ellen , Yip Leona , Ly Lena , Bingham Linda , Davidson Andrew , Bekhor Philip
Published: February 2016

Capillary malformations (CM) cause significant psychosocial complications. Pulsed dye laser (PDL) treatment at 6–12‐weekly intervals under general anaesthesia (GA) commencing in infants at 6 months of age remains the standard of care in order to achieve maximal improvement prior to school age. The safety of repeated GA in children is controversial. Shortening the time between treatments increases the number that can be delivered prior to 6 months of age, thus reducing the number of subsequent treatments needed under GA. We investigated the safety and effectiveness of more frequent PDL treatment of CM in infancy via a pilot, prospective patient‐controlled study of 10 patients. Using 595 nm (Vbeam) PDL, the entire CM was treated initially, then half the CM randomly allocated to 2‐weekly and half to 3‐monthly intervals for two further treatments. Photographs of the CM taken 3 months after treatment completion were evaluated by an independent, blinded dermatologist. Nine infants completed the study. Three infants (33%) had more improvement on the 2‐weekly treated side and four (44%) had more improvement on the 3‐monthly treated side. Two patients (22%) showed no difference between sides. Treatments were well tolerated without complications. We conclude that 2‐weekly PDL treatments of CM in infants aged under 6 months is effective and well tolerated without adverse effects. Our preliminary data suggest a possible superior efficacy with 3‐monthly treatment intervals; however, larger studies are warranted for stronger evidence. More frequent non‐GA treatment of CM in infants should be further investigated to decrease the risk of repeated GA exposure in young children.
The 12‐month effects of structured lifestyle advice and pelvic floor muscle training for pelvic organ prolapse
Authors: Due Ulla , Brostrøm Søren , Lose Gunnar
Published: February 2016

Introduction

We evaluated the 12‐month effects of adding pelvic floor muscle training to a lifestyle advice program in women with symptomatic pelvic organ prolapse stage II–III and the number of women who had sought further treatment.

Material and methods

This study was a 12‐month follow up of a randomized controlled trial comparing a structured lifestyle advice program alone (lifestyle group) or in combination with pelvic floor muscle training (training and lifestyle group). Both programs consisted of six separate group sessions within 12 weeks.

Results

Data were available from 83 (76%) of the 109 originally included women. At the 12‐month follow up, 34/83 (41%) had not sought further treatment, 13/43 (30%) in the lifestyle group and 21/40 (52%) in the training and lifestyle group, and these could be included for analysis. The lifestyle group had significantly improved bladder symptoms compared with baseline on single‐item analysis (p = 0.01). The training and lifestyle group had significantly improved pelvic organ prolapse symptoms on single‐item analysis (p = 0.02) and of bowel‐related quality of life (p = 0.04). No significant between‐group differences were found in the symptom and quality of life scores. All together 49 women (59%) had sought further treatment, 70% in the lifestyle group, and 48% in the training and lifestyle group (p = 0.05). Twenty‐six in the lifestyle group, and 15 in the training and lifestyle group had sought conservative treatment. Four women in each group had received surgery. More severe anterior prolapse and more bladder symptoms at the 3‐month follow up were significantly associated with having sought further treatment in both groups.

Conclusions

At 12‐month follow up, the effects of adding pelvic floor muscle training to a structured lifestyle advice program were limited.
Randomised clinical trial: alginate (Gaviscon Advance) vs. placebo as add‐on therapy in reflux patients with inadequate response to a once daily proton pump inhibitor
Authors: Reimer C. , Lødrup A. B. , Smith G. , Wilkinson J. , Bytzer P.
Published: February 2016

Background

Many reflux patients remain symptomatic on a standard dose of proton pump inhibitor (PPI). Alginates decrease the number of reflux events by forming a raft on top of the stomach content and thus offer a supplemental mechanism of action to acid suppression.

Aim

To assess the efficacy of an alginate (Gaviscon Advance, Reckitt Benckiser, Slough, UK) on reflux symptoms in patients with persistent symptoms despite once daily PPI.

Methods

This was a multicentre, randomised, placebo‐controlled, 7‐day double‐blind trial preceded by a 7‐day run‐in period. Reflux symptoms were assessed using the Heartburn Reflux Dyspepsia Questionnaire (HRDQ). Based on symptom score during run‐in, eligible patients were randomised to Gaviscon Advance 10 mL four times a day or placebo in addition to a once daily PPI. The primary endpoint was change in HRDQ score post‐treatment compared to baseline.

Results

One hundred and thirty‐six patients were randomised. Change in HRDQ reflux score was significantly greater for Gaviscon Advance (mean: −5.0, s.d.: 4.7) than for placebo (mean: −3.5, s.d.: 5.5) with an LS mean difference of 1.6 [95% CI −3.1 to −0.1], P = 0.03. A decrease in the mean (s.d.) number of nights with symptoms was observed from 3.6 (2.8) to 3.0 (3.0) in the placebo group and from 3.9 (2.8) to 2.2 (2.7) for the Gaviscon Advance group. This reduction was significantly greater in the Gaviscon Advance group than in the placebo group [LS mean difference = −0.9, 95% CI (−1.6 to −0.2), P < 0.01].

Conclusion

In patients with residual reflux symptoms despite PPI treatment, adding an alginate offers additional decrease in the burden of reflux symptoms (EudraCT/IND Number: 2011‐005486‐21).
It is rocket science – why dietary nitrate is hard to ‘beet’! Part II: further mechanisms and therapeutic potential of the nitrate‐nitrite‐NO pathway
Authors: Mills Charlotte Elizabeth , Khatri Jibran , Maskell Perry , Odongerel Chimed , Webb Andrew James
Published: February 2016

Dietary nitrate (found in green leafy vegetables such as rocket and in beetroot) is now recognized to be an important source of nitric oxide, via the nitrate‐nitrite‐NO pathway. Dietary nitrate confers several cardiovascular beneficial effects on blood pressure, platelets, endothelial function, mitochondrial efficiency and exercise. Having described key twists and turns in the elucidation of the pathway and the underlying mechanisms in Part I, we explore the more recent developments which have served to confirm mechanisms, extend our understanding, and discover new properties and potential therapeutic uses of the pathway in Part II. Even the established dependency on low oxygen states for bioactivation of nitrite has recently been challenged. Dietary nitrate appears to be an important component of ‘healthy diets’, such as the DASH diet to lower blood pressure and the Mediterranean diet, with its potential to lower cardiovascular risk, possibly through beneficial interactions with a range of other constituents. The World Cancer Research Foundation report strong evidence for vegetables including spinach and lettuce (high nitrate‐containing) decreasing cancer risk (mouth, pharynx, larynx, oesophagus and stomach), summarized in a ‘Nitrate‐Cancer Risk Veg‐Table’. The European Space Agency recommends that beetroot, lettuce, spinach and rocket (high‐nitrate vegetables) are grown to provide food for long‐term space missions. Nitrate, an ancient component of rocket fuel, could support sustainable crops for healthy humans.
Estimation and Testing for Multiple Regulation of Multivariate Mixed Outcomes
Authors: Agniel Denis , Liao Katherine P. , Cai Tianxi
Published: February 2016

Considerable interest has recently been focused on studying multiple phenotypes simultaneously in both epidemiological and genomic studies, either to capture the multidimensionality of complex disorders or to understand shared etiology of related disorders. We seek to identify multiple regulators or predictors that are associated with multiple outcomes when these outcomes may be measured on very different scales or composed of a mixture of continuous, binary, and not-fully observed elements. We first propose an estimation technique to put all effects on similar scales, and we induce sparsity on the estimated effects. We provide standard asymptotic results for this estimator and show that resampling can be used to quantify uncertainty in finite samples. We finally provide a multiple testing procedure which can be geared specifically to the types of multiple regulators of interest, and we establish that, under standard regularity conditions, the familywise error rate will approach 0 as sample size diverges. Simulation results indicate that our approach can improve over unregularized methods both in reducing bias in estimation and improving power for testing.
Meta-Analysis Framework for Exact Inferences with Application to the Analysis of Rare Events
Authors: Yang Guang , Liu Dungang , Wang Junyuan , Xie Min-ge
Published: February 2016

The usefulness of meta-analysis has been recognized in the evaluation of drug safety, as a single trial usually yields few adverse events and offers limited information. For rare events, conventional meta-analysis methods may yield an invalid inference, as they often rely on large sample theories and require empirical corrections for zero events. These problems motivate research in developing exact methods, including Tian et al.'s method of combining confidence intervals (2009, Biostatistics, 10, 275–281) and Liu et al.'s method of combining p-value functions (2014, JASA, 109, 1450–1465). This article shows that these two exact methods can be unified under the framework of combining confidence distributions (CDs). Furthermore, we show that the CD method generalizes Tian et al.'s method in several aspects. Given that the CD framework also subsumes the Mantel–Haenszel and Peto methods, we conclude that the CD method offers a general framework for meta-analysis of rare events. We illustrate the CD framework using two real data sets collected for the safety analysis of diabetes drugs.
Survival Impact Index and Ultrahigh-Dimensional Model-Free Screening with Survival Outcomes
Authors: Li Jialiang , Zheng Qi , Peng Limin , Huang Zhipeng
Published: February 2016

Motivated by ultrahigh-dimensional biomarkers screening studies, we propose a model-free screening approach tailored to censored lifetime outcomes. Our proposal is built upon the introduction of a new measure, survival impact index (SII). By its design, SII sensibly captures the overall influence of a covariate on the outcome distribution, and can be estimated with familiar nonparametric procedures that do not require smoothing and are readily adaptable to handle lifetime outcomes under various censoring and truncation mechanisms. We provide large sample distributional results that facilitate the inference on SII in classical multivariate settings. More importantly, we investigate SII as an effective screener for ultrahigh-dimensional data, not relying on rigid regression model assumptions for real applications. We establish the sure screening property of the proposed SII-based screener. Extensive numerical studies are carried out to assess the performance of our method compared with other existing screening methods. A lung cancer microarray data is analyzed to demonstrate the practical utility of our proposals.
Physical abuse, psychological abuse and neglect: Evidence of alcohol‐related harm to children in five states of India
Authors: Esser Marissa B. , Rao Girish N. , Gururaj Gopalkrishna , Murthy Pratima , Jayarajan Deepak , Sethu Lakshmanan , Jernigan David H. , Benegal Vivek ,   Collaborators Group on Epidemiological Study of Patterns and Consequences of Alcohol Misuse in India
Published: February 2016

Introduction and Aims

In India, alcohol consumption per capita has increased in recent years, and child maltreatment is highly prevalent. We assess alcohol‐related harms to children, including physical abuse, psychological abuse and neglect, and correlates for men reporting these harms.

Design and Methods

We analysed data from household interviews collected in a cross‐sectional, case–control study in five Indian states (n = 5026). Data were collected from October 2011 to May 2012. Using multilevel mixed‐effects logistic regression, we examined male adult's reports of five types of alcohol‐related harm to children (respondents were not necessarily the perpetrators of the harms) and respondents' drinking patterns and socio‐demographic characteristics associated with the reporting of these harms.

Results

In this sample, 43.2% of the men reported at least one alcohol‐related harm to children in the past year; among them, 61.6% reported multiple. Among all men, 15.7% reported that a child experienced physical abuse from adults' drinking. Adjusting for respondents' drinking pattern and socio‐demographics, multilevel mixed‐effects logistic regression showed that living in a rural area was associated with greater odds of reporting alcohol‐related physical abuse, psychological harm and neglect to children. Compared with past‐year abstainers, both non‐heavy episodic and heavy episodic drinkers had significantly greater odds of reporting these harms. We found significant differences in the reporting of harms by location.

Discussion and Conclusions

This study suggests that adults' drinking is associated with physical and psychological abuse and neglect to children. Greater use of evidence‐based alcohol policy interventions may help reduce alcohol‐related harms to children in India. [Esser MB, Rao GN, Gururaj G, Murthy P, Jayarajan D, Sethu L, Jernigan DH, Benegal V, Collaborators Group on Epidemiological Study of Patterns and Consequences of Alcohol Misuse in India. Physical abuse, psychological abuse and neglect: Evidence of alcohol‐related harm to children in five states of India. Drug Alcohol Rev 2016;35:530–538]
Morphological variation in salamanders and their potential response to climate change
Authors: Ficetola Gentile Francesco , Colleoni Emiliano , Renaud Julien , Scali Stefano , Padoa‐Schioppa Emilio , Thuiller Wilfried
Published: February 2016

Despite the recognition that some species might quickly adapt to new conditions under climate change, demonstrating and predicting such a fundamental response is challenging. Morphological variations in response to climate may be caused by evolutionary changes or phenotypic plasticity, or both, but teasing apart these processes is difficult. Here, we built on the number of thoracic vertebrae (NTV) in ectothermic vertebrates, a known genetically based feature, to establish a link with body size and evaluate how climate change might affect the future morphological response of this group of species. First, we show that in old‐world salamanders, NTV variation is strongly related to changes in body size. Secondly, using 22 salamander species as a case study, we found support for relationships between the spatial variation in selected bioclimatic variables and NTV for most of species. For 44% of species, precipitation and aridity were the predominant drivers of geographical variation of the NTV. Temperature features were dominant for 31% of species, while for 19% temperature and precipitation played a comparable role. This two‐step analysis demonstrates that ectothermic vertebrates may evolve in response to climate change by modifying the number of thoracic vertebrae. These findings allow to develop scenarios for potential morphological evolution under future climate change and to identify areas and species in which the most marked evolutionary responses are expected. Resistance to climate change estimated from species distribution models was positively related to present‐day species morphological response, suggesting that the ability of morphological evolution may play a role for species’ persistence under climate change. The possibility that present‐day capacity for local adaptation might help the resistance response to climate change can be integrated into analyses of the impact of global changes and should also be considered when planning management actions favouring species persistence.
Awareness and Knowledge of Child and Adolescent Risky Behaviors: A Parent's Perspective
Authors: Ahern Nancy R. , Kemppainen Jeanne , Thacker Paige
Published: February 2016

PROBLEM

Adolescence is a developmental stage marked by risk‐taking and limited comprehension of dangers of risky behaviors. Previous research has focused on adolescents’ perspective of risk with little evidence on parents’ knowledge regarding risk.

METHODS

This qualitative study examined parental knowledge and perspectives of child/teen risk behaviors associated with salvia, sexting, inhalant use/abuse, and self/participant‐assisted choking. A sample of 30 parents of children/teens aged 10–17 completed a self‐administered survey based on Flanagan's critical incident technique.

FINDINGS

Data were analyzed according to Flanagan's guidelines. Two advanced practice nurses determined category reliability with 95% agreement. The survey yielded five categories of parental responses to potential risky behaviors in their child/teen including the following: talking to my children, setting up consequences, confronting the child, seeking help, and talking to others. Although the majority of the parents were aware of newer behaviors, less than one half of the participants reported discussing risks with their child/teen. One third reported that their child knew a friend who was thinking about/tried sexting. One quarter of parents reported that they were not monitoring their child/teen's media use.

CONCLUSIONS

Study findings provide important implications for developing an evidence‐based education intervention to improve parents’ awareness, knowledge, and identification of risk behaviors in their children/teens.