bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing the sustainability of chemical vapour polishing of additive manufactured ABS parts using a vacuum chamber
Authors: Pietanza Sergio , Sorgente Donato , Percoco Gianluca
Published: October 2017

Purpose

In this paper, the authors propose an experimental set-up to study the chemical vapour polishing technique confining pure dimethylketone atmosphere at a fixed temperature in a vacuum chamber. The purpose of this paper is to improve conventional vapour treatments lowering the amount of solvent, lowering time and temperature needed and improving the environmental impact of the technique.

Design/methodology/approach

A factorial design of experiments is adopted to understand the effect of the treatment on roughness and on the surface morphology of treated specimens.

Findings

The proposed method improves several aspects of well-known methods based on water–dimethylketone liquid solution such as: no interaction between water and workpiece and higher capability of process management. It also improves several aspects of well-known methods based on vapour, lowering the amount of solvent, time and temperature compared to conventional vapour treatments.

Originality/value

Chemical vapour polishing is a well-known technique for smoothing additive manufactured acrylonitrile butadiene styrene (ABS) parts. Several data and users' experiences are available on the Web about this topic. In recent scientific literature, a few papers are available about this topic, dealing with how process parameters affect the final surface roughness. In the present paper, the authors propose to improve the process performing the process using dimethylketone into a vacuum chamber. The main advantages are the significant reduction of the solvent needed to perform the process and lower time needed to obtain same results as atmospheric pressure treatments.
Outline of guidelines for the management of vasculitis and vascular disorders in Japan, 2016 revised edition
Authors: Ikeda Takaharu , Furukawa Fukumi , Kawakami Tamihiro , Ishiguro Naoko , Uzuki Miwa , Ozaki Shoichi , Katsuoka Kensei , Kono Takeshi , Kawana Seiji , Kodera Masanari , Sawai Takashi , Sawada Yasuyuki , Seishima Mariko , Tanikawa Akiko , Chen Ko‐Ron , Hasegawa Minoru ,   Committee for Guidelines for the Management of Vasculitis and Vascular Disorders of The Japanese Dermatological Association
Published: October 2017

The proposal by the 1994 International Chapel Hill Consensus Conference on the Nomenclature of Systemic Vasculitides (CHCC1994) and by the CHCC2012 markedly influenced the classification and way of considering cutaneous vasculitis. In the proposal by the CHCC1994, hypersensitivity angiitis was defined as an equivalent pathological condition to microscopic polyangiitis or cutaneous leukocytoclastic angiitis (CLA), and it was not adopted as a disease name. However, CLA which was positioned as a type of small‐vessel vasculitis is only a pathological name. In the proposal by the CHCC2012, a new category of single‐organ vasculitis included CLA and cutaneous arteritis. Vasculitis allergica cutis (Ruiter) corresponded to CLA and cutaneous polyarteritis nodosa corresponded to cutaneous arteritis. The Japanese Dermatological Association (JDA) prepared guidelines for the management of vasculitis and vascular disorders in 2008 based on the proposal by the CHCC1994 and their original viewpoint of dermatology. The JDA subsequently revised the 2008 edition guidelines in 2016 following publication of the proposal of the CHCC2012 in Japanese. We presented the outline of the 2016 edition guidelines and propose a treatment algorithm for primary vasculitides based on the evaluation of the cutaneous symptoms for cases suspected as primary cutaneous vasculitides, which integrates the 2008 JDA guideline and CHCC2012 classification. This is the secondary English version of the original Japanese manuscript for the guideline for management of vasculitis and vascular disorders published in the Japanese Journal of Dermatology 127(3); 299–415, 2017.
A comparison of parent and professional perceptions of children with autism spectrum disorder in Portugal
Authors: Reis Helena , Pereira Ana , Almeida Leandro
Published: October 2017

Improving early intervention in Portugal for children with autism spectrum disorder (ASD) requires parents and professionals to collaborate in assessing and planning intervention programmes. This article analyses parental and professional assessments of children with ASD, in the dimensions of social communication, repetitive behaviours and restricted interests, and sensory processing. The study presents contrasting perspectives from professionals and parents from a range of socio‐academic backgrounds. The sample consists of 136 Portuguese children (aged three to six years old) with ASD and involves children, parents and professionals from across the country. All children, at the time, were in preschool and receiving early special education intervention. Parents and professionals used the Assessment Scale for Children with ASD to complete the assessments. The results show that parents rate children's development and learning more positively compared to professionals; and that this difference is more significant in the field of social communication. Further, parents with higher academic qualifications showed statistically significant differences in comparison with professionals in the social communication dimension. These findings are discussed in relation to the literature and some suggestions are made regarding certain practices related to intervention in early childhood.
Implementing cycles of Assess, Plan, Do, Review: a literature review of practitioner perspectives
Authors: Greenwood Jo , Kelly Catherine
Published: October 2017

This article uses a literature review process to explore current literature on Response to Intervention (RtI), an approach to the identification of and provision for students with special educational needs introduced in the USA by the Individuals with Disabilities Education Improvement Act of 2004. Parallels are made between RtI and the graduated approach of successive cycles of Assess, Plan, Do, Review (APDR) outlined in the Special Educational Needs and Disability Code of Practice introduced in England in 2014. Research concerning APDR is scarce, and therefore this review looks to research on RtI to inform current practice. Recurring themes throughout the literature relate to the ongoing professional development and learning for practitioners that is afforded by engagement in RtI, and an awareness that it takes time to accrue the benefits of such an approach. Further research is needed to ascertain the outworking of a reform such as RtI/APDR within the English context.
1,4‐Dioxane‐degrading consortia can be enriched from uncontaminated soils: prevalence of Mycobacterium and soluble di‐iron monooxygenase genes
Authors: He Ya , Mathieu Jacques , da Silva Marcio L.B. , Li Mengyan , Alvarez Pedro J.J.
Published: October 2017

Two bacterial consortia were enriched from uncontaminated soil by virtue of their ability to grow on 1,4‐dioxane (dioxane) as a sole carbon and energy source. Their specific dioxane degradation rates at 30°C, pH = 7 (i.e. 5.7 to 7.1 g‐dioxane per g‐protein per day) were comparable to those of two dioxane‐metabolizing archetypes: Pseudonocardia dioxanivoransCB1190 and Mycobacterium dioxanotrophicusPH‐06. Based on 16S rRNA sequencing, Mycobacterium was the dominant genus. Acetylene inhibition tests suggest that dioxane degradation was mediated by monooxygenases. However, qPCR analyses targeting the tetrahydrofuran/dioxane monooxygenase gene (thmA/dxmA) (which is, to date, the only sequenced dioxane monooxygenase gene) were negative, indicating that other (as yet unknown) catabolic gene(s) were responsible. DNA sequence analyses also showed threefold to sevenfold enrichment of group 5 and group 6 soluble di‐iron monooxygenase (SDIMO) genes relative to the original soil samples. Whereas biodegradation of trace levels of dioxane is a common challenge at contaminated sites, both consortia degraded dioxane at low initial concentrations (300 μg l−1) below detectable levels (5 μg l−1) in bioaugmented microcosms prepared with impacted groundwater. Overall, this work shows that dioxane‐degrading bacteria (and the associated natural attenuation potential) exist even in some uncontaminated soils, and may be enriched to broaden bioaugmentation options for sites experiencing insufficient dioxane catabolic capacity.
Parliamentary Democracy and International Treaties
Authors: Schütze Robert
Published: October 2017

Classic constitutional thought considered the power to conclude international treaties to fall within the executive's exclusive domain. But this nineteenth‐century logic hardly convinces in the twenty‐first century. For the function of international treaties has dramatically shifted from the military to the regulatory domain; and in the wake of this ‘new internationalism’, the traditional divide between ‘internal’ and ‘external’ affairs has increasingly disappeared. Has this enlarged scope of the treaty power also triggered a transformation of its nature; and in particular: has the rise of ‘legislative’ international treaties been compensated by a greater role accorded to parliaments? This article explores this question comparatively by looking at the constitutional law of the United States and the European Union. Within the United States, international treaties were traditionally concluded under a procedure that excluded the House of Representatives; yet with the rise of the Congressional‐Executive‐Agreement in the twentieth century, this democratic deficit has been partially remedied. We find a similar evolution within the context of the European Union, where an increasing ‘parliamentarisation’ of the treaty power has taken place. Yet a democratic deficit here nevertheless also continues to exist.
Democracy under Siege of Authoritarian Liberalism: Remarks on the Crisis of National and Transnational Republicanism in Europe
Authors: Brunkhorst Hauke
Published: October 2017

Modern republicanism must be distinguished sharply from ancient republicanism and modern liberalism. Modern republicanism is strongly restricted in Europe due to the constitutional hegemony of ordo‐ and neoliberalism. Therefore, Europe is running out of democratic alternatives on both, the national and the transnational level. This is a challenge for the entire Western legal tradition. During a lasting period of multiple crises the new prevalence of private over public law became evident, and as a result democracy became façade democracy. However, at the same time technocratic incrementalism no longer is a solution because it destroys the legitimatory basis of European. But is the legitimation crisis a last chance – or is it already the catastrophe?
Prenatal development in greater mouse‐eared bat, Myotis myotis (Borkhausen, 1797) (Chiroptera, Vespertilionidae)
Authors: Paksuz E. P. , Hayretdağ S. , Olgun K.
Published: October 2017

Order Chiroptera is the second largest mammal group after rodents. An understanding of the development of the bats, which is a very special mammal group in terms of their lifestyles, morphology and their ability to fly, is very important because most of the adult anatomical differences characterizing species occur during organogenesis. In this study, developmental stages were determined for Myotis myotis species based on external morphological characteristics from embryos obtained from wild‐caught pregnant females. The developmental stages of M. myotis were comparable with those of other bat species.
Applying the extended theory of planned behaviour to predict Chinese people's non‐remunerated blood donation intention and behaviour: The roles of perceived risk and trust in blood collection agencies
Authors: Chen Liangyong
Published: October 2017

Against the backdrop of critical clinical blood shortage in China in recent years, the present research extends the theory of planned behaviour by incorporating two constructs potentially of importance in influencing non‐remunerated blood donation behaviour, namely perceived risk and individual trust in blood collection agencies to predict Chinese people's non‐remunerated blood donation intention and behaviour. A survey was conducted to measure variables of the theory of planned behaviour, and other variables such as experience of non‐remunerated blood donation, perceived risk and individual trust in blood collection agencies. Data to assess non‐remunerated blood donation behaviour were collected via phone interviews. Results of the path analysis are as follows. Subjective norm, perceived behavioural control and individual trust in blood collection agencies are all positively associated with attitudes toward non‐remunerated blood donation, explaining 46.9% of the variance in this variable. Perceived risk is negatively associated with blood donation intention, while subjective norm and attitudes toward non‐remunerated blood donation are both positively associated with blood donation intention. Together, the three variables account for 28.4% of the variance in donation intention. Both having a positive association with non‐remunerated blood donation behaviour, the combination of blood donation intention and donation experience explains 42.8% of its variance.
Differential relations of grandiose narcissism and vulnerable narcissism to emotion dysregulation: Self‐esteem matters
Authors: Zhang Hui , Luo Yun , Zhao Yimeng , Zhang Runzhu , Wang Zhenhong
Published: October 2017

The present study aims to explore the effects of grandiose and vulnerable narcissism on emotion dysregulation and examine the mediating role of self‐esteem on these associations. Undergraduates (N = 426) completed self‐report measurements on grandiose narcissism, vulnerable narcissism, self‐esteem and emotion dysregulation. Correlation analyses indicated that grandiose narcissism was negatively correlated with emotion dysregulation, while vulnerable narcissism was positively correlated with emotion dysregulation. Moreover, mediational analyses revealed that self‐esteem fully mediated the association between grandiose narcissism and emotion dysregulation, and partially mediated the association between vulnerable narcissism and emotion dysregulation. The present study highlights the importance of self‐esteem and deepens the understanding of the associations between the two forms of narcissism and emotion dysregulation.
Pre‐operative variables including fitness associated with complications after oesophagectomy
Authors: Sinclair R. C. F. , Phillips A. W. , Navidi M. , Griffin S. M. , Snowden C. P.
Published: October 2017

Oesophagectomy is a technically‐demanding operation associated with a high level of morbidity. We analysed the association of pre‐operative variables, including those from cardiopulmonary exercise testing, with complications (logistic regression) and survival and length of stay (Cox regression) after scheduled transthoracic oesophagectomy in 273 adults, in isolation and on multivariate testing (maximum Akaike information criterion). On multivariate analysis, any postoperative complication was associated with ventilatory equivalents for carbon dioxide, odds ratio (95%CI) 1.088 (1.02–1.17), p = 0.018. Cardiorespiratory complications were associated with FEV1 and pre‐operative background survival (in an analogous group without cancer), odds ratios (95%CI) 0.55 (0.37–0.80), p = 0.002 and 0.89 (0.82–0.96), p = 0.004, respectively. Survival was associated with the ratio of expected‐to‐observed ventilatory equivalents for carbon dioxide and predicted postoperative survival, hazard ratios (95%CI) 0.17 (0.03–0.91), p = 0.039 and 0.96 (0.90–1.01), p = 0.076. Length of hospital stay was associated with FVC, hazard ratio (95%CI) 1.38 (1.17–1.63), p < 0.0001.
“We will not perish; we’re going to keep flourishing”: Race, Food Access, and Geographies of Self‐Reliance
Authors: Reese Ashanté M.
Published: October 2017

Drawing from 18 months of ethnographic fieldwork in Washington, DC, this article outlines geographies of self‐reliance; a theoretical framework for understanding black food geographies that are embedded in histories of self‐reliance as a response to structural inequalities. Using a community garden as a case study, I argue that the garden functions as a site for addressing several manifestations of structural violence: racist and classist depictions of low‐income and working class people, joblessness, gentrification, and youth underdevelopment. Drawing on self‐reliance ideologies as well as collective and personal histories, the residents exhibit a form of agency that demonstrates unwavering hope in the sustainability of their shared community. Through this analysis, I show that self‐reliance functions as a mechanism through which residents navigate spatial inequalities.
The emerging core characteristics of Vietnam's political economy
Authors: Fforde Adam
Published: October 2017

This paper offers an understanding of the core drivers of the political economy of the ruling Communist Party in Vietnam. In the absence of political reform, the regime does not possess the powers required by the new conditions of a market economy and an increasingly open society. Designed for Soviet totalitarianism, and without popular support or authority, the formal political institutions are anachronistic and thus limit the range of powers available to the Party. As the regime is thus unable to reliably deploy policy unless it feels threatened, politics becomes a competition over spoils. Thus, if macroeconomic instability actually or potentially threatens the regime, the Politburo gains authority to act, and policy is deployed. Yet, as popular discontent mounts over corruption, favourable treatment of politically connected businesses, public education and health, and other areas not seen as regime‐threatening, the disequilibrium leads to use of the security forces and increasing violence against popular opposition.
The Asian crisis: what did we learn and when did we learn it?
Authors: Grenville Stephen
Published: October 2017

This paper steps back from the detail of the Asian crisis, to ask whether the 1997 crisis advanced our broad understanding of the age‐old problem of economic crises. Some immediate lessons were learned from the failures of the crisis‐response in Indonesia, which was the worst‐affected economy. It is notable, however, how little changed to address the ongoing systemic weaknesses. Three areas of unresolved vulnerability can be identified. First, the sudden stops and reversals of international capital flows. Second, the intrinsic fragility of a financial system that borrows short and lends long. Third, unanchored exchange rates, where the market's price‐discovery can take the rate to levels far from equilibrium, for sustained periods. For more than a decade after the Asian crisis, international capital flows continued to be seen as unambiguously beneficial, with any attempts at capital flow management rejected. At a global level, it was not until the 2008 financial crisis that widespread financial fragility was addressed through tighter regulation and higher capital requirements. On exchange rates, misleading advocacy of corner solutions—either pure floating exchange rates or immutable fixed rates—continued in the face of the real‐world experience that sometimes intervention is needed to maintain an exchange rate close to equilibrium.
Cost analysis of open radical cystectomy versus robot‐assisted radical cystectomy
Authors: Bansal Sukhchain S. , Dogra Tara , Smith Peter W. , Amran Maisarah , Auluck Ishna , Bhambra Maninder , Sura Manraj S. , Rowe Edward , Koupparis Anthony
Published: October 2017

Objectives

To perform a cost analysis comparing the cost of robot‐assisted radical cystectomy (RARC) with open RC (ORC) in a UK tertiary referral centre and to identify the key cost drivers.

Patients and Methods

Data on hospital length of stay (LOS), operative time (OT), transfusion rate, and volume and complication rate were obtained from a prospectively updated institutional database for patients undergoing RARC or ORC. A cost decision tree model was created. Sensitivity analysis was performed to find key drivers of overall cost and to find breakeven points with ORC. Monte Carlo analysis was performed to quantify the variability in the dataset.

Results

One RARC procedure costs £12 449.87, or £12 106.12 if the robot was donated via charitable funds. In comparison, one ORC procedure costs £10 474.54. RARC is 18.9% more expensive than ORC. The key cost drivers were OT, LOS, and the number of cases performed per annum.

Conclusion

High ongoing equipment costs remain a large barrier to the cost of RARC falling. However, minimal improvements in patient quality of life would be required to offset this difference.
GBF1 and Arf1 function in vesicular trafficking, lipid homoeostasis and organelle dynamics
Authors: Kaczmarek Beata , Verbavatz Jean‐Marc , Jackson Catherine L.
Published: October 2017

The ADP‐ribosylation factor (Arf) small G proteins act as molecular switches to coordinate multiple downstream pathways that regulate membrane dynamics. Their activation is spatially and temporally controlled by the guanine nucleotide exchange factors (GEFs). Members of the evolutionarily conserved GBF/Gea family of Arf GEFs are well known for their roles in formation of coat protein complex I (COPI) vesicles, essential for maintaining the structure and function of the Golgi apparatus. However, studies over the past 10 years have found new functions for these GEFs, along with their substrate Arf1, in lipid droplet metabolism, clathrin‐independent endocytosis, signalling at the plasma membrane, mitochondrial dynamics and transport along microtubules. Here, we describe these different functions, focussing in particular on the emerging theme of GFB1 and Arf1 regulation of organelle movement on microtubules.
‘The challenges of sharing information when a young person is experiencing severe emotional difficulties’: implications for schools and CAMHS
Authors: Hart Tania , O'Reilly Michelle
Published: October 2017

Background

Supporting the education of children and young people with complex emotional mental health difficulties requires schools to have knowledge of their needs. Exchanging information about less visible mental health difficulties is, however, known to be complex. Exploring the perceptions of young people experiencing problems can explicate some of this complexity and identify solutions. Yet their views are rarely given credence in this context.

Methods

The findings were derived from a broader qualitative study exploring the school experiences of young people, aged 14–16 years, identified by CAMHS as having severe emotional difficulties. Their parents’ and teachers’ perceptions were also explored. Data were collected via semistructured interviews and analysed using thematic analysis.

Results

Findings demonstrated that young people experiencing emotional difficulties need to feel safe about exchanging private information pertaining to their mental health. Teachers having a basic knowledge of mental health promoted their safety as this ensured confidentiality. Participants reported that CAMHS practitioners needed to be more proactive regarding the practicalities of exchanging information.

Conclusions

Arguably, teachers need to have basic knowledge of mental health and schools need clearer mental health confidentiality guidance. CAMHS also have responsibility in identifying more information exchange mechanisms and young service users and parents can play a part in this.
A double‐edged sword: The world according to Capicua in cancer
Authors: Tanaka Miwa , Yoshimoto Toyoki , Nakamura Takuro
Published: October 2017

CIC/Capicua is an HMG‐box transcription factor that is well conserved during evolution. CIC recognizes the T(G/C)AATG(A/G)A sequence and represses its target genes, such as PEA3 family genes. The receptor tyrosine kinase/RAS/MAPK signals downregulate CIC and relieves CIC's target genes from the transrepressional activity; CIC thus acts as an important downstream molecule of the pathway and as a tumor suppressor. CIC loss‐of‐function mutations are frequently observed in several human neoplasms such as oligodendroglioma, and lung and gastric carcinoma. CIC is also involved in chromosomal translocation‐associated gene fusions in highly aggressive small round cell sarcoma that is biologically and clinically distinct from Ewing sarcoma. In these mutations, PEA3 family genes and other important target genes are upregulated, inducing malignant phenotypes. Downregulation of CIC abrogates the effect of MAPK inhibitors, suggesting its potential role as an important modifier of molecular target therapies for cancer. These data reveal the importance of CIC as a key molecule in signal transduction, carcinogenesis, and developing novel therapies.
Expression level of CXCL7 in peripheral blood cells is a potential biomarker for the diagnosis of renal cell carcinoma
Authors: Kinouchi Toshiro , Uemura Motohide , Wang Cong , Ishizuya Yu , Yamamoto Yoshiyuki , Hayashi Takuji , Matsuzaki Kyosuke , Nakata Wataru , Yoshida Takahiro , Jingushi Kentaro , Kawashima Atsunari , Ujike Takeshi , Nagahara Akira , Fujita Kazutoshi , Imamura Ryoichi , Ueda Yuko , Kitae Kaori , Tsujikawa Kazutake , Nonomura Norio
Published: October 2017

There are no blood biomarkers for the diagnosis of renal cell carcinoma (RCC) in routine clinical use. We focused on the gene expression profile of peripheral blood cells obtained from RCC patients to discover novel biomarkers for RCC diagnosis. Using microarray analysis and quantitative verification, CXCL7 was shown to be significantly upregulated in the peripheral blood cells of RCC patients. Importantly, aberrant CXCL7 expression was confirmed even in peripheral blood cells obtained from early stage (pT1a) RCC patients, and the expression level of CXCL7 in peripheral blood cells was a potential independent biomarker for the diagnosis of RCC by receiver operating characteristic curve analysis (sensitivity, 70.0%; specificity, 64.0%; area under the curve = 0.722; multiple logistic regression analysis: odds ratio, 1.07; 95% confidence interval, 1.03–1.11; P = 0.0004). Moreover, CXCL7 expression in peripheral blood cells significantly decreased after resection of the primary tumor. CXCL7 is more highly expressed in PBMCs than in neutrophils from both healthy controls and RCC patients. Interestingly, CXCL7 expression in PBMCs from healthy volunteers was significantly elevated following coculture with RCC cells compared to those cocultured with normal cells as a control. These results suggest that aberrant CXCL7 expression in peripheral blood cells is induced by RCC cells and may serve as a novel biomarker in the diagnosis of RCC.
Whole genome microarray expression analysis in blood identifies pathways linked to signs and symptoms of a patient with hypercalprotectinaemia and hyperzincaemia
Authors: Isaksson H S , Farkas S A , Müller P , Gustafsson D , Nilsson T K
Published: October 2017

A child, 2 years with the ‘hypercalprotectinaemia with hyperzincaemia’ clinical syndrome, presented with atypical symptoms and signs, notably persistent fever of approximately 38°C, thrombocythaemia of > 700 × 109/l and a predominance of persistent intestinal symptoms. In an effort to find a cure by identifying the dysregulated pathways we analysed whole-genome mRNA expression by the Affymetrix HG U133 Plus 2·0 array in blood on three occasions 3–5 months apart. Major up-regulation was demonstrated for the Janus kinase/signal transducer and activators of transcription (JAK/STAT) pathway including, in particular, CD177, S100A8, S100A9 and S100A12, accounting for the thrombocytosis; a large number of interleukins, their receptors and activators, accounting for the febrile apathic state; and the high mobility group box 1 (HMBG1) gene, possibly accounting for part of the intestinal symptoms. These results show that gene expression array technology may assist the clinician in the diagnostic work-up of individual patients with suspected syndromal states of unknown origin, and the expression data can guide the selection of optimal treatment directed at the identified target pathways.
B cell tolerance to epidermal ribonuclear-associated neo-autoantigenin vivo
Authors: Degn S E , Alicot E , Carroll M C
Published: October 2017

Defining how self-antigens are perceived by the immune system is pivotal to understand how tolerance is maintained under homeostatic conditions. Clinically relevant, natural autoantigens targeted by autoantibodies, in e.g. systemic lupus erythematosus (SLE), commonly have an intrinsic ability to engage not only the B cell receptor (BCR), but also a co-stimulatory pathway in B cells, such as the Toll-like receptor (TLR)-7 pathway. Here we developed a novel mouse model displaying inducible expression of a fluorescent epidermal neo-autoantigen carrying an OT-II T cell epitope, B cell antigen and associated ribonucleic acids capable of stimulating TLR-7. The neo-autoantigen was expressed in skin, but did not drain in intact form into draining lymph nodes, even after ultraviolet B (UVB)-stimulated induction of apoptosis in the basal layer. Adoptively transferred autoreactive B cells were excluded follicularly and perished at the T–B border in the spleen, preventing their recirculation and encounter with antigen peripherally. This transitional check-point was bypassed by crossing the reporter to a BCR knock-in line on a C4-deficient background. Adoptively transferred OT-II T cells homed rapidly into cutaneous lymph nodes and up-regulated CD69. Surprisingly, however, tolerance was not broken, as the T cells subsequently down-regulated activation markers and contracted. Our results highlight how sequestration of intracellular and peripheral antigen, the transitional B cell tolerance check-point and T cell regulation co-operate to maintain immunological tolerance in vivo.
Rethinking the Role of Racial Segregation in the American Foreclosure Crisis
Authors: Latner Jonathan P.
Published: October 2017

Racial segregation is an important factor in understanding the foreclosure crisis, but must be understood to operate in particular and specific ways. The primary, positive impact of segregation on foreclosure risk operates prior to loan origination through the differential access to loan quality by race. Afterward, the impact of segregation is negative. Drawing on a rare dataset of loans that combine loan performance and borrower characteristics, I use a competing risks proportional hazard model to examine the impact of race and racial segregation on risk of foreclosure among borrowers. Results indicate that Black segregation has a large, negative impact on foreclosure risk. Instead, the strongest positive contributor to foreclosure is the negative value of the home relative to the balance of the loan (i.e., “underwater,” as measured by the put option), which is also the mechanism that explains most of the difference in the foreclosure rate by race. The negative impact of racial segregation on foreclosure risk is the result of a mismatch between cities with high levels of segregation and cities with large declines in home prices and related foreclosures.
DOES FISCAL DECENTRALIZATION AFFECT INFRASTRUCTURE QUALITY? AN EXAMINATION OF U.S. STATES
Authors: Escaleras Monica , Calcagno Peter T.
Published: October 2017

A transportation network is vital to an economy. However, the U.S. highway infrastructure suffers from insufficient maintenance creating inefficiencies such as increased travel times and increase in accidents. The means to fund the infrastructure and their maintenance is a point of debate. In this paper, we examine the role of political institutions and decision‐making on the quality of highway infrastructure by focusing on the role of fiscal decentralization. Using generalized linear model estimation on state data from 1992 to 2012, we find evidence that fiscal decentralization improves infrastructure quality. These results are robust to the choice of control variables and method of estimation. (JEL D73, H42, H72)
AN EXAMINATION OF VETERAN HEALTH ACCESS AROUND THE MEDICARE ELIGIBILITY AGE
Authors: Stype Amanda C.
Published: October 2017

Recent news reports suggest that veterans' health care may be inadequate. We use Health and Retirement Study data to compare utilization rates for preventative care by male veterans and nonveterans before and after the near‐universal health coverage at Medicare eligibility. Larger increases in utilization rates for preventative services upon reaching Medicare eligibility at age 65 are associated with less health care adequacy before Medicare eligibility. Results suggest that health care adequacy for male veterans between the ages of 56 and 64 is at least as good as that of nonveterans and may be better. (JEL I14, J14)
Direct immunofluorescence testing in vasculitis—A single institution experience with Henoch‐Schönlein purpura
Authors: Feasel Patrick , Billings Steven D. , Bergfeld Wilma F. , Piliang Melissa P. , Fernandez Anthony P. , Ko Jennifer S.
Published: October 2017

Background

Direct immunofluorescence (DIF) panels (IgG, IgA, IgM, C3 and fibrinogen) are ordered for clinically suspected vasculitis, with frequently negative results.

Methods

Cases submitted for DIF and histology (2010‐2014) with “vasculitis” in the clinical data were examined, and the electronic medical record reviewed for clinical suspicion of Henoch‐Schönlein purpura (HSP). Peri/intravascular IgA was considered positive, other reactants non‐specific and no immunoreactivity negative.

Results

Vasculitis was the given indication for 20% (258/1318) of DIF studies. HSP was clinically suspected in 36% (95/258). In this setting, leukocytoclastic vasculitis (LCV) was common (66%, 63/95) and DIF was positive in 43% (27/63). One hundred percentage of DIF+ had LCV+. In cases without HSP suspicion, 26% (42/163) were LCV+ and <1% DIF+. Of the 258 cases, LCV+ greatly enriched for DIF+ (105/258 LCV+ with 28/105 [27%] DIF+), captured 100% of HSP and included cases with non‐specific DIF/etiologic findings. In LCV cases, DIF positivity was not seen, HSP was not diagnosed and non‐specific DIF findings were common.

Conclusions

LCV is an H&E‐based histopathologic diagnosis that can have positive, negative and non‐specific DIF results that are rarely contributory except in the setting of HSP, where DIF is best utilized with IgA as the sole immunoreactant. H&E‐based triage of DIF orders is recommended.
Quality of life and comorbidities associated with Dravet syndrome severity: a multinational cohort survey
Authors: Lagae Lieven , Brambilla Isabella , Mingorance Ana , Gibson Eddie , Battersby Alysia
Published: October 2017

Aim

To test the hypothesis that higher seizure burden in Dravet syndrome is associated with increased comorbidities and lower quality of life (QoL) in a large cohort of patients with Dravet syndrome and their caregivers in Europe.

Method

An extensive survey of caregivers of patients with Dravet syndrome on experiences of diagnosis, seizure burden, management, social and financial impact, and health services use was administered online in 10 languages.

Results

The survey received 584 unique responses from caregivers of paediatric (83%) and adult (17%) patients with Dravet syndrome (aged <1–48y). Despite broadly following current treatment guidance, less than 10% of patients were seizure free in the previous 3 months. Nearly all (99.6%) patients aged 5 years or older experienced at least one or more motor, speech, learning, or behavioural impairment. High seizure frequency was related to more reports of emergency treatment, comorbidities, and a lower QoL (as measured by the standardized instrument EQ‐5D‐5L). If not diagnosed at the first instance, the majority (83%) of adults, but less than 20% of 6‐ to 11‐year‐olds were diagnosed after 4 or more years.

Interpretation

Patients with Dravet syndrome with the highest current seizure frequency suffer from more comorbidities and have a lower QoL. Therefore, more effective antiepileptic treatments are needed.

What this paper adds

The survey captured about 15% of all patients with Dravet syndrome in Europe.

Less than 10% of patients had current seizure freedom.

Patients with a high current seizure burden have more comorbidities and lower quality of life.
Broad clinical high‐risk mental state (CHARMS): Methodology of a cohort study validating criteria for pluripotent risk
Authors: Hartmann Jessica A. , Nelson Barnaby , Spooner Rachael , Paul Amminger G. , Chanen Andrew , Davey Christopher G. , McHugh Meredith , Ratheesh Aswin , Treen Devi , Yuen Hok Pan , McGorry Patrick D.
Published: October 2017

Aim

The development of the ultra‐high risk (UHR) criteria for psychosis created a new paradigm for the prevention research in psychiatry. Since (1) prevention research faces the challenge of achieving adequate statistical power when focusing on single low‐incidence syndromes and (2) early clinical phenotypes are overlapping and non‐specific, this study broadens the UHR state beyond psychosis as an outcome. The CHARMS (clinical high at‐risk mental state) study aims to prospectively validate a set of trans‐diagnostic criteria to identify help‐seeking young people at risk of developing a range of serious mental illnesses.

Methods

This paper describes the methodology of the CHARMS study, which involves applying the CHARMS criteria to a cohort of help‐seeking young people aged 12 to 25 attending youth mental health services in Melbourne. New referrals meeting the CHARMS criteria are allocated to the CHARMS+ group; referrals not meeting CHARMS threshold are allocated to CHARMS‐ group (control group); referrals meeting criteria for a full‐threshold disorder are excluded. Transition status and clinical and functional outcomes are re‐assessed at 6 and 12 months.

Conclusions

This study will be the first to introduce and validate clinical criteria to identify a broader at‐risk patient population, which may facilitate young people's access to clinical services and early treatment by reducing the reliance on “caseness” defined according to current diagnostic categories being required for service entry. These criteria may introduce a new, trans‐diagnostic approach for understanding risk factors and pathogenic mechanisms that drive the onset of severe mental illness and the next generation of preventive intervention trials.
Rates and predictors of disengagement of patients with first‐episode psychosis from the early intervention service for sychosis service (EASY) covering 15 to 64 years of age in Hong Kong
Authors: Lau Ka Wa , Chan Sherry K.W. , Hui Christy L.M. , Lee Edwin H.M. , Chang Wing Chung , Chong Catherine Shiu‐yin , Lo William Tak‐lam , Chen Eric Y.H.
Published: October 2017

Aim

This study aims at assessing the rate and predictors of disengagement of patients with first‐episode psychosis (FEP) from the early intervention (EI) service in Hong Kong (EASY) that covers age 15 to 64.

Methods

All FEP patients aged 15 to 64 years who were newly registered with the EASY programme of Kowloon West Psychiatric Unit from January to December 2012 were included. Data on socio‐demographic, clinical characteristics and disengagement over 3 years of the EI service were obtained retrospectively through systematic clinical record review. Predictors of 3 different types of disengagement and their rate of occurrence were identified: complete disengagement (type I), disengaged and re‐engaged through hospitalization (type II) and re‐engaged as outpatient (type III).

Results

Among the 277 patients included for analysis, 36 patients (13%) had type I disengagement, 17.2% (N = 21) were of age 15 to 25 and 9.7% (N = 15) were of age 25 to 64. Type II and type III disengagements were 4.3% and 13.4%, respectively. Early‐stage poor drug compliance significantly predicted type I and type II disengagements. History of substance use, suicidal attempts and poor drug compliance predicted type III disengagement. Younger patients had significant earlier disengagement (χ2 = 5.01, df = 1, P = .025).

Conclusion

Results of the current study highlighted the different patterns of disengagement for different age groups and the importance of identifying the high‐risk group at early stage of the illness. With the expansion of EI service for wider age group, studies of the differential needs of patient with different ages would be important to guide the future service development.
Dental students’ and staff perceptions of the impact of learning environment disruption on their learning and teaching experiences
Authors: The A. J. M. , Adam L. , Meldrum A. , Brunton P.
Published: October 2017

Introduction

This project is a qualitative investigation into student and staff experiences of the effect of a major building redevelopment on their Dental School learning and teaching environments. Currently, there is little research exploring the impact of disruptions to the learning environment on students’ learning and staff teaching experiences.

Method

Data were collected in 2016 using an online survey, semi‐structured interviews and focus groups with students and staff. Data were analysed using a general inductive approach.

Results

Four broad themes emerged as follows: (i) students valued having a space for personal and collaborative work within the Dental School; (ii) both staff and students positioned staff contributions to learning experiences above the role of the physical learning environment; (iii) the majority of staff and students not feel that the physical environment limited their clinical training; and (iv) staff and students were able to adapt to the impact of building redevelopment through resilience and organisation.

Discussion

Results of this research have informed the provision of collegial spaces at the School, both as the building redevelopment continues, and in planning for the completed building.
Increasing incidence of primary central nervous system lymphoma but no improvement in survival in Sweden 2000‐2013
Authors: Eloranta Sandra , Brånvall Elsa , Celsing Fredrik , Papworth Karin , Ljungqvist Maria , Enblad Gunilla , Ekström‐Smedby Karin
Published: October 2017

Objectives

This study aims to characterize the epidemiology of immunocompetent Primary central nervous system lymphoma (PCNSL) diagnosed 2000‐2013 in Sweden.

Methods

Cases were identified in the population‐based Swedish Lymphoma Register. Incidence per 100 000 person‐years and 95% confidence intervals (CI) were calculated, and PCNSL‐specific survival was estimated using relative survival. Tests for temporal trends were performed using Poisson regression. Population incidence of all brain tumors was retrieved for comparison.

Results

With 359 identified PCNSL cases (median age 66 years), overall incidence was 0.26 (95% CI: 0.24‐0.29) and the average annual increase 4% (P = .002). The increasing trend was primarily observed among elderly individuals (70+ years). Similarly, an increase in incidence of all brain tumors was noted only among the elderly. There was no significant improvement in relative survival across the study period although, among fit patients (with Eastern Cooperative Oncology Group, EGOC 0), survival plateaued 6 years after diagnosis.

Conclusion

The increasing PCNSL incidence in the elderly was consistent with an increasing incidence of brain tumors of any type and may in part be attributable to improved diagnostics and reporting in this group. New treatment options have not yet translated into general survival improvements in a population‐based setting, although the presence of long‐term survivors among fit patients is encouraging.
The effects on soil aggregation and carbon fixation of different organic amendments for restoring degraded soil in semiarid areas
Authors: Hernandez T. , Hernandez M. C. , Garcia C.
Published: October 2017

The addition of organic wastes as a strategy to restore degraded soil in semiarid regions can increase soil aggregation and carbon fixation. These processes can be affected by both the characteristics of the organic amendments and the soil microbial community structure. This study examines the effect of single additions (150 t ha−1) of different organic residues for soil restoration (fresh and composted sewage sludge, vegetal residue and farmyard manure) on aggregation and carbon (C) retention in a semiarid degraded soil. Changes in the distribution of microbial biomass in soil aggregates were also evaluated. Sewage sludge compost was added at rates of 150 and 300 t ha−1 to determine the effect of the amount applied on the distribution processes. Large macroaggregates (2000–8000 μm), small macroaggregates (250–2000 μm), microaggregates (53–250 μm) and the < 53‐μm soil fraction were obtained, and organic carbon (Corg) concentration was determined in these fractions in addition to the total phospholipid‐derived fatty acids (PLFAs). Both the characteristics of the amendments and the amount applied affected soil aggregation and Corg concentration in the aggregate size classes. The manure and the compost added at 300 t ha−1 contributed to the fixation of stable Corg in soil aggregates to a greater extent than the fresh sludge, vegetal residue or compost added at 150 t ha−1. In all soil fractions, the total concentration of PLFAs was larger in restored soil than in the control soil, and increases depended on the aggregate size class and characteristics of the amendment. The largest microbial abundance occurred in both large and small macroaggregates.

Highlights

Effects of type and amount of amendment on aggregation and C fixation in semiarid soil are elucidated.

We explored distribution of the microbial community in soil aggregates in response to new soil C pools.

Carbon fixation and microbial abundance of aggregates are affected by type and amount of amendment.

Restored and degraded soils differ in terms of the breakdown of new organic matter inputs.