bluuebunny/crossref_metadata_2025 huggingface dataset:
Institutional Arrangements and Government Audit Independence in China
Authors: Xiao Jason Zezhong , Yang Suchang , Zhang Xinmin , Firth Michael
Published: August 2016

China has adopted an executive‐dominated government audit system (GAS), which is frequently criticized for lacking independence. Through a questionnaire survey and interviews, we investigate whether and how the reporting/control requirements of the GAS (hereafter, the institutional arrangements) result in a lack of government audit independence in China and how this affects budget supervision by the People's Congress. We contribute field evidence to support the prediction that an executive‐dominated GAS lacks independence and transparency, which in turn is detrimental to the wider accountability regime. However, the specific level of independence varies according to the types and levels of government audit. Our findings enrich the government audit literature, enhance our understanding of the relationship between institutional arrangements and audit independence in a transition economy, and serve as a call for institutional reform relating to the Chinese GAS.
The response of meiofauna and microphytobenthos to engineering effects of fiddler crabs on a subtropical intertidal sandflat
Authors: Citadin Monica , Costa Tânia Marcia , Netto Sérgio A.
Published: August 2016

Fiddler crabs are key bioturbators on tidal flats. During their intense bioturbation process, they manipulate large amounts of sediment, altering the physical state of existing materials. We investigated whether different types of sediment bioturbation produced by fiddler crabs modulate meiofaunal assemblages and microphytobenthic content. We hypothesized that sedimentary structures produced by burrowing (the burrow itself and the excavation pellets) and feeding (feeding pellets) generate different microenvironments compared with areas without apparent signs of fiddler crab disturbance, affecting both meiofauna and microphytobenthos, independent of the sampling period. Our results indicate that the engineering effects of burrow construction and maintenance and the engineering effects of fiddler crab foraging modulate meiofaunal assemblages in different ways. Overall, meiofauna from burrows and excavation pellets was more abundant and diverse than at control sites, whereas feeding pellets contained poor meiofaunal assemblages. By contrast, only foraging effects were detected on microphytobenthos; independent of the sampling period, Chl a and phaeopigment content were higher in the feeding pellets, but similar among burrows, excavation pellets and control sites. The present study demonstrates that the different engineering effects of fiddler crabs are an important source of habitat heterogeneity and a structuring agent of meiofaunal assemblages on subtropical tidal flats.
A Comparison of Market Integration in Nineteenth‐Century China and Japan
Authors: Yao Ke , Zheng Xiao‐Ping
Published: August 2016

This paper performs a cointegration analysis using an Error Correction Model (ECM) on annual rice prices to measure and compare market integration in China and Japan during the nineteenth century. We find markets in Japan were more integrated than in China at both the regional and national levels during the period. Moreover, market integration in Japan improved during industrialisation. These findings support the view that a well‐integrated market is a cause as well as a result of economic growth.
Metabolism and cold tolerance of Chinese white pine beetle Dendroctonus armandi (Coleoptera: Curculionidae: Scolytinae) during the overwintering period
Authors: Wang Juan , Gao Guanqun , Zhang Ranran , Dai Lulu , Chen Hui
Published: August 2016

Cold hardiness becomes a crucial strategy because temperature change often leads to fluctuations in insect abundance.

The present study investigated the relationship between cold‐tolerance ability in overwintering Chinese white pine beetle Dendroctonus armandi Tsai and Li larvae and physiological body indices aiming to determine the possible overwintering strategy from September 2013 to May 2014.

Supercooling points (SCP) differed significantly across months, showing a precipitous drop in December 2013 and January 2014. The maximum monthly mean supercooling point was −1.7 ± 0.4 °C (15 September 2013) and the minimum monthly mean was −7.5 ± 0.2 °C (15 January 2014). The SCP tended to decrease as the ambient temperature decreased until January, before increasing until the end of the winter.

Glycerol, sorbitol and trehalose contents showed a significant negative correlation with the SCP.

The latter results indicate that the cold tolerance ability of the larvae is enhanced by exposure to 4.0 °C.

Dendroctonus armandi larvae decreased their mortality at −8.0 °C after cold acclimation at 4.0 °C for 24 h.
Progestin suppressed inflammation and cell viability of tumor necrosis factor‐α‐stimulated endometriotic stromal cells
Authors: Grandi Giovanni , Mueller Michael , Bersinger Nick , Papadia Andrea , Nirgianakis Konstatinos , Cagnacci Angelo , McKinnon Brett
Published: August 2016

Problem

Endometriosis is an estrogen‐dependent inflammatory disease. Progestins are a first‐line treatment for endometriosis via activation of pituitary progesterone receptors and suppression of systemic estrogen: a less than optimal treatment. Increasing evidence is beginning to show that progestins may also influence local endometriotic cells, which may contribute to their clinical efficacy.

Method of study

Endometrial stromal cells (ESC) isolated from women with endometriosis were cultured with TNF‐α to simulate an inflammatory environment. ESC were treated with the progestins, medroxyprogesterone acetate (MPA), norethisterone acetate (NETA), or dienogest (DNG) and cytokine mRNA production, protein secretion, and cell viability measured.

Results

DNG, NETA, and MPA suppressed the secretion of interleukin (IL)‐6, IL‐8, and monocyte chemotactic protein (MCP)‐1 from ESC. DNG and NETA only reduced the TNF‐α‐stimulated mRNA production. All three progestins suppressed TNF‐α‐stimulated ESC proliferation.

Conclusion

Progestins may influence endometriotic stromal cells altering the inflammatory microenvironment and their clinical efficacy.
Long‐term survival following open repair of ruptured abdominal aortic aneurysm
Authors: Englund Raymond , Katib Nedal
Published: August 2016

Background

Long‐term results for patients being managed for ruptured compared to elective abdominal aortic aneurysms (AAA) are unclear. We hypothesize that patients who survive 30 days or more following repair of ruptured AAA (RAAA) performed by open technique have a life expectancy no different to those patients surviving 30 days or more following elective AAA repair, or compared to a general age‐matched population.

Methods

Between 1987 and December 2014, 620 consecutive patients were treated by the principal author for aortic aneurysmal disease. Two subgroups were selected from this population, elective open abdominal repair (215) and RAAA open repair (105). Comparable age‐matched life curves with the general population were used from the Australian Bureau of Statistics for each patient according to gender, age and date of presentation. Statistical comparison was by Kaplan–Meier survival analysis.

Results

Both the open and RAAA groups were well matched for age and sex. There was no statistical difference between RAAA survival and an age‐matched population P = 0.23, or was there any difference between open repair and an age‐matched population, P = 0.1. Survival curves for RAAA and open repair were similar, P = 0.98. For elective open repair 1‐, 5‐, 10‐, 15‐ and 20‐year survival was 93.6, 71.2, 40, 17 and 2% respectively. Corresponding results for RAAA were 92.5, 74, 36.7, 13.5 and 5% respectively.

Conclusion

Open AAA repair for RAAA or elective aneurysm treatment restores predicted life expectancy for those patients surviving 30 days or more and is therefore a durable method of treatment for this condition.
Validation of the Leuven Postprandial Distress Scale, a questionnaire for symptom assessment in the functional dyspepsia/postprandial distress syndrome
Authors: Carbone F. , Vandenberghe A. , Holvoet L. , Vanuytsel T. , Van Oudenhove L. , Jones M. , Tack J.
Published: August 2016

Background

A validated patient‐reported outcome instrument is lacking for the functional dyspepsia/postprandial distress syndrome.

Aim

To validate the Leuven Postprandial Distress Scale (LPDS).

Methods

The LPDS diary, comprising eight symptoms with verbal descriptors rated for severity (0–4), was derived from focus groups and cognitive debriefing. It was used in a 2‐week run‐in, 8‐week double‐blind placebo‐controlled trial of itopride 100 mg t.d.s. Results in 60 patients, with concealed treatment allocation, were used to analyse LPDS content validity, consistency, reliability and responsiveness. Patients also filled out Patient Assessment of Gastrointestinal Symptoms (PAGI‐SYM), Nepean Dyspepsia Index, overall treatment evaluation and overall symptom severity questionnaires. Construct validity was evaluated by known‐group analyses and by correlating LPDS with these additional questionnaires. Minimum Clinically Important Difference was determined from threshold changes in anchor questionnaires.

Results

Symptom patterns and factor analysis identified three cardinal symptoms of postprandial distress syndrome (early satiation, postprandial fullness, upper abdominal bloating), whose mean intensities generate weekly LPDS scores. Known‐groups analysis showed large‐effect‐size differences in LPDS scores (Cohen's d = 2.16). Strong correlations (r > 0.57) between LPDS scores and relevant anchors at baseline indicate good convergent validity. Internal consistency of LPDS was good (α > 0.85) with high inter‐item correlations (0.67–0.76), and test–retest reliability (r = 0.85). Changes in LPDS scores were highly convergent with changes in overall treatment evaluation, overall symptom severity and PAGI‐SYM (r > 0.52). minimum clinically important difference analysis generated thresholds of 0.4‐0.6.

Conclusions

The Leuven Postprandial Distress Scale, which is supported by the European Medicines Agency, is a sensitive and reliable patient‐reported outcome instrument to assess symptoms in the functional dyspepsia/postprandial distress syndrome.
Editorial introduction: Revisiting Denis Cosgrove and Peter Jackson's ‘New directions in cultural geography’
Authors: Kraftl Peter
Published: August 2016

This editorial introduction provides an overview of this ‘Classics Revisited’ section. The section focuses on a seminal paper by Denis Cosgrove and Peter Jackson (Area, 19, 95–101) that sought to bring social and cultural geographies into greater and more productive dialogue, in particular around ideas of landscape, resistance and social difference. This introductory piece explains the rationale behind choosing this paper as an Area ‘Classic’, provides an overview of the key arguments of the original articles and briefly summarises the five reflective pieces that follow.
Timely geographies: ‘New directions in cultural geography’ revisited
Authors: Wylie John
Published: August 2016

In this commentary I focus on the timing and timeliness of Cosgrove and Jackson's () ‘New directions’ piece (Area, 19, 95–101). The discussion is structured in two parts. First, I consider the coincidence (or not) between the emergence of new cultural geography and the establishment of official measurements of research quality in UK Higher Education – an issue flagged for me by the contents of the Area issue in which ‘New directions’ appears. Second, the piece's timeliness resides in its nearly one‐off rapprochement between social‐ethnographic and historical‐interpretative traditions in cultural geography. Beyond the rich and evident legacies of new cultural geography, my commentary concludes by noting again the comparative lack of attention paid today to the concept of ‘culture’.
Laparoscopic radical lymph node dissection for advanced colon cancer close to the hepatic flexure
Authors: Uematsu Dai , Akiyama Gaku , Sugihara Takehiko , Magishi Akiko , Yamaguchi Takuya , Sano Takayuki
Published: August 2016

Introduction

Complete mesocolic excision is currently recognized as a standard procedure for colon cancer. Gastroepiploic, infrapyloric, and superficial pancreatic head lymph node metastases in the gastrocolic ligament have been reported for colon cancer close to the hepatic flexure. We sought to investigate metastases in the gastrocolic ligament in colon cancer close to the hepatic flexure.

Methods

This was a single‐center retrospective study. All patients with T2 or deeper invasive colon cancer in the relevant tumor location who underwent laparoscopic right hemicolectomy or extended right hemicolectomy at our institution between 1 April 2011 and 31 March 2015 were included.

Results

Lymph node dissection in the gastrocolic ligament was performed in 35 cases. Complications occurred in 11 patients (31%) and were grades I and II according to the Clavien–Dindo classification. Lymph node metastases in the gastrocolic ligament were found in only three patients (9%). Each metastasis was larger than 9 mm.

Conclusions

Metastases in the gastrocolic ligament occurred in 9% of patients with T2 or deeper invasive colon cancer close to the hepatic flexure. Laparoscopy was feasible and useful during gastrocolic ligament resection. This study included a small sample and lacked an extended follow‐up. Further studies are needed to determine the clinical relevance of this finding, particularly in terms of recurrence and long‐term survival.
Does tablet formulation alone improve adherence and persistence: a comparison of ezetimibe fixed dose combination versus ezetimibe separate pill combination?
Authors: Bartlett Louise E. , Pratt Nicole , Roughead Elizabeth E.
Published: August 2016

Aims

The aim of this study was to compare adherence and persistence in patients who add ezetimibe to statin therapy as a separate pill combination (SPC) or fixed dose combination (FDC).

Method

This is a retrospective cohort study of prescription data conducted in an Australian health dataset. Two cohorts were identified: those dispensed statins and subsequently ezetimibe as either SPC or FDC. We compared adherence to combination therapy using the medication possession ratio (MPR), multivariate linear and logistic regression. Persistence to initial combination medicines and any lipid‐lowering therapies were analysed using Kaplan Meyer survival and Cox proportional hazards models.

Results

A total of 3651 people initiated ezetimibe SPC and 5740 ezetimibe FDC. There was no significant difference in adherence with mean MPRs: ezetimibe SPC = 0.99 (95% confidence interval 0.98–1.01) and FDC = 0.97 (95% CI 0.95–0.99). One year persistence rates to initial combination medicines were ezetimibe SPC 49.1% vs. FDC 62.4%; hazard ratio (HR) = 1.81 (95% CI 1.76–1.90). However, persistence to any lipid‐lowering therapy was higher in those initiating ezetimibe SPC = 84.9% vs. FDC = 76%; HR = 0.62 (95% CI 0.55–0.72). One year persistence rates to any two lipid‐lowering medicines were similar: ezetimibe SPC 65.2% and FDC 65%.

Conclusion

In this study FDCs have little impact on either adherence or persistence to combination lipid‐lowering therapy in people who have been taking statins. The benefit of higher persistence to FDCs in first episode of treatment with initial medicines is debatable as persistence to dual therapy was similar in both cohorts.
Laparoscopic retroperitoneal partial nephrectomy using an ergonomic chair: demonstration of technique and matched‐pair analysis
Authors: Rassweiler Jens J. , Klein Jan , Tschada Alexandra , Gözen Ali Serdar
Published: August 2016

Objectives

To present the technique and long‐term results of retroperitoneal laparoscopic partial nephrectomy (LPN), focusing on the impact of an ergonomic platform.

Patients and Methods

Between January 2000 and May 2016, 287 patients (193 men, 94 women) underwent LPN performed by four surgeons. The median (range) patient age was 59 (19–85) years, tumour size 3.1 (1–9) cm and PADUA score 7.3 (6–12). Access was retroperitoneal in 235 cases (82%). Since October 2010, we have used the ETHOS™ chair (ETHOS™, Seattle, WA, USA) during excision of the tumour in 130 patients (45.3%). A total of 51 tumours (17.7%) were excised without ischaemia and 226 (78.7%) under warm ischaemia, with clamping of the renal artery using an enucleo‐resection technique. We suture the resection bed and perform renorrhaphy using a barbed‐suture pre‐loaded with absorbable LAPRA‐TY™ clips (Ethicon, Somerville, NJ, USA). The impact of the ETHOS chair was examined using a matched‐pair analysis (66 with ETHOS chair vs 67 without ETHOS chair).

Results

The median (range) operating time was 146 (60–325) min, the median (range) estimated blood loss was 99 (10–3 000) mL and the mean (range) warm ischaemia time (WIT) was 17.1 (7–47) min. Histology showed 240 (83.6%) renal cell carcinomas (RCCs) and 46 (15.9%) benign tumours. The cumulative overall disease‐free survival rate after a median (range) follow‐up of 84 (3–155) months was 100% for 203 pT1 RCCs and local recurrence was observed in one patient (0.4%), who was managed by radical nephrectomy. There were two conversions (0.7%) to open surgery, both to hand‐assisted laparoscopy. Perirenal haematoma was observed in 13 patients (4.5%). A total of 20 patients (6.9%) required transfusions (2–11 units). We observed five urine leaks (1.7%) requiring prolonged drainage. The median (range) length of hospital stay was 5 (3–24) days. Three patients developed arteriovenous fistulas, which were successfully occluded by superselective embolization (1.0%). Use of the ETHOS chair resulted in shorter operating time (134.7 vs 168.5 min; P = 0.04), including WIT (13.1 vs 15.9 min; P = 0.01), and a lower complication rate (15 vs 29.8%; P = 0.02).

Conclusions

Laparoscopic partial nephrectomy is technically difficult but oncologically effective. Standardization and simplification of endoscopic suturing using the ETHOS chair significantly improved the outcomes of the surgical procedure.
Ice‐margin and meltwater dynamics during the mid‐Holocene in the Kangerlussuaq area of west Greenland
Authors: Carrivick Jonathan L. , Yde Jacob , Russell Andrew J. , Quincey Duncan J. , Ingeman‐Nielsen Thomas , Mallalieu Joseph
Published: August 2016

Land‐terminating parts of the west Greenland ice sheet have exhibited highly dynamic meltwater regimes over the last few decades including episodes of extremely intense runoff driven by ice surface ablation, ponding of meltwater in an increasing number and size of lakes, and sudden outburst floods, or ‘jökulhlaups’, from these lakes. However, whether this meltwater runoff regime is unusual in a Holocene context has not been questioned. This study assembled high‐resolution topographical data, geological and landcover data, and produced a glacial geomorphological map covering ~1200 km2. Digital analysis of the landforms reveals a mid‐Holocene land‐terminating ice margin that was predominantly cold‐based. This ice margin underwent sustained active retreat but with multiple minor advances. Over c. 1000 years meltwater runoff became impounded within numerous and extensive proglacial lakes and there were temporary connections between some of these lakes via spillways. The ice‐dams of some of these lakes had several quasi‐stable thicknesses. Meltwater was apparently predominantly from supraglacial sources although some distributary palaeochannel networks and some larger bedrock palaeochannels most likely relate to mid‐Holocene subglacial hydrology. In comparison to the geomorphological record at other Northern Hemisphere ice‐sheet margins the depositional landforms in this study area are few in number and variety and small in scale, most likely due to a restricted sediment supply. They include perched fans and deltas and perched braidplain terraces. Overall, meltwater sourcing, routing and the proglacial runoff regime during the mid‐Holocene in this land‐terminating part of the ice sheet was spatiotemporally variable, but in a manner very similar to that of the present day.
Improvement of islet graft function using liraglutide is correlated with its anti‐inflammatory properties
Authors: Langlois A , Dal S , Vivot K , Mura C , Seyfritz E , Bietiger W , Dollinger C , Peronet C , Maillard E , Pinget M , Jeandidier N , Sigrist S
Published: August 2016

Background and Purpose

Liraglutide improves the metabolic control of diabetic animals after islet transplantation. However, the mechanisms underlying this effect remain unknown. The objective of this study was to evaluate the anti‐inflammatory and anti‐oxidative properties of liraglutide on rat pancreatic islets in vitro and in vivo.

Experimental Approach

In vitro, rat islets were incubated with 10 μmol·L−1 liraglutide for 12 and 24 h. Islet viability functionality was assessed. The anti‐inflammatory properties of liraglutide were evaluated by measuring CCL2, IL‐6 and IL‐10 secretion and macrophage chemotaxis. The anti‐oxidative effect of liraglutide was evaluated by measuring intracellular ROS and the total anti‐oxidative capacity. In vivo, 1000 islets were cultured for 24 h with or without liraglutide and then transplanted into the liver of streptozotocin‐induced diabetic Lewis rats with or without injections of liraglutide. Effects of liraglutide on metabolic control were evaluated for 1 month.

Key Results

Islet viability and function were preserved and enhanced with liraglutide treatment. Liraglutide decreased CCL2 and IL‐6 secretion and macrophage activation after 12 h of culture, while IL‐10 secretion was unchanged. However, intracellular levels of ROS were increased with liraglutide treatment at 12 h. This result was correlated with an increase of anti‐oxidative capacity. In vivo, liraglutide decreased macrophage infiltration and reduced fasting blood glucose in transplanted rats.

Conclusions and Implications

The beneficial effects of liraglutide on pancreatic islets appear to be linked to its anti‐inflammatory and anti‐oxidative properties. These findings indicated that analogues of glucagon‐like peptide‐1 could be used to improve graft survival.
Peripheral blood T cell subset characteristics of multiple sclerosis in remission phase correlate with annualized relapse rates
Authors: Song Zi‐Ye , Nakamura Yuri , Yamasaki Ryo , Kawano Yuji , Shinoda Koji , Guzailiayi Maimaitijiang , Masaki Katsuhisa , Yamaguchi Hiroo , Matsushita Takuya , Kira Jun‐ichi
Published: August 2016

Objective

A large number of disease‐modifying drugs are available for multiple sclerosis (MS); however, there is no established biomarker to predict long‐term disease severity and future relapses in MS. We aimed to clarify the alterations in peripheral blood T cell subsets that are associated with MS relapse and disease severity, according to cytokine production profiles in the remission phase.

Methods

Blood samples collected from 29 relapsing–remitting MS patients in the remission phase and 21 healthy controls (HC) were analyzed for various cytokine‐producing T cell subsets by flow cytometry.

Results

MS patients in the remission phase had significantly higher percentages of interleukin (IL)‐17+CD4+ T cells, IL‐4+CD4+ T cells, IL‐9+CD4+ T cells, interferon‐γ+CD8+ T cells and IL‐4+CD8+ T cells than HC (P = 0.047, P = 0.007, P = 0.026, P = 0.015 and P = 0.007, respectively). In MS, the percentages of IL‐9+CD4+ T cells, IL‐9+CD8+ T cells and IFN‐γ+IL‐17+CD8+ T cells showed a significant positive correlation with annualized relapse rates (ARR) (P = 0.011, r = 0.47, P = 0.007, r = 0.49 and P = 0.044, r = 0.38, respectively).

Conclusions

In the remission phase of MS, both anti‐inflammatory cytokine‐producing T cells and pro‐inflammatory cytokine‐producing T cells are increased; however, only the percentages of pro‐inflammatory cytokine‐producing T cells, such as IL‐9‐producing CD4+ T cells, IL‐9‐producing CD8+ T cells and IFN‐γ‐ and IL‐17‐producing CD8+ T cells, correlate with ARR. These pro‐inflammatory cytokine‐producing T cells in the remission phase might be candidate biomarkers for future relapses in MS patients.
Cutaneous histoplasmosis with prominent parasitization of epidermal keratinocytes: report of a case
Authors: Honarpisheh Hedieh H. , Curry Jonathan L. , Richards Kristen , Nagarajan Priyadharsini , Aung Phyu P. , Torres‐Cabala Carlos A. , Ivan Doina , Drucker Carol R. , Cartun Richard , Prieto Victor G. , Tetzlaff Michael T.
Published: August 2016

Disseminated histoplasmosis most commonly occurs in immunosuppressed individuals and involves the skin in approximately 6% of patients. Cutaneous histoplasmosis with an intraepithelial‐predominant distribution has not been described.

A 47‐year‐old man was admitted to our institution with fever and vancomycin‐resistant enterococcal bacteremia. He had been diagnosed with T‐cell prolymphocytic leukemia 4 years earlier and had undergone matched‐unrelated‐donor stem cell transplant 2 years earlier; on admission, he had relapsed disease. His medical history was significant for disseminated histoplasmosis 6 months before admission, controlled with multiple antifungal regimens. During this final hospitalization, the patient developed multiple 2–5 mm erythematous papules, a hemorrhagic crust across the chest, shoulders, forearms, dorsal aspect of the fingers, abdomen and thighs. Skin biopsy revealed clusters of oval yeast forms mostly confined to the cytoplasm of keratinocytes and within the stratum corneum; scattered organisms were present in the underlying superficial dermis without any significant associated inflammatory infiltrate. Special stains and immunohistochemical studies confirmed these to be Histoplasma organisms.

We highlight this previously unrecognized pattern of cutaneous histoplasmosis to ensure its prompt recognition and appropriate antifungal therapy.
Value of adding GNAS testing to pancreatic cyst fluid KRAS and carcinoembryonic antigen analysis for the diagnosis of intraductal papillary mucinous neoplasms
Authors: Kadayifci Abdurrahman , Atar Mustafa , Wang Jessica L. , Forcione David G. , Casey Brenna W. , Pitman Martha B. , Brugge William R.
Published: August 2016

Background and Aim

Molecular analysis of pancreatic cyst fluid (PCF) has been proposed as a novel method for differentiating pancreatic cystic lesions (PCL). The present study aimed to investigate the value of GNAS testing when added to KRAS and carcinoembryonic antigen (CEA) testing of PCF for the diagnosis of intraductal papillary mucinous neoplasms (IPMN).

Methods

Prospectively collected endoscopic ultrasonography fine‐needle aspiration (EUS‐FNA) data were analyzed retrospectively for GNAS and KRAS mutations and CEA results. IPMN were histologically confirmed or supported by imaging and EUS‐FNA findings (KRAS, CEA, cytology). Performance characteristics of GNAS added to KRAS and CEA for the diagnosis of IPMN were calculated.

Results

The study population consisted of 197 patients with cyst fluid test results. Cysts were histologically classified in 33 patients and by clinical criteria in 164 patients. The IPMN group included 108 patients and the non‐IPMN group included 89 patients. GNAS was positive in 51 patients (47.2%) with IPMN. Forty‐two of these patients (82.3%) also had a KRAS mutation. Adding GNAS to KRAS increased the diagnostic accuracy from 76.6% to 79.1% (P > 0.05). Adding GNAS to CEA increased the diagnostic accuracy from 66.4% to 80.7 % (P < 0.05), but did not achieve a diagnostic superiority to KRAS testing alone (80.7% vs 76.6%, P > 0.05). The diagnostic accuracy of the triple combination was significantly better than all single tests (P < 0.05).

Conclusion

GNAS mutation is a highly specific test for IPMN. When GNAS testing is added to CEA and KRAS, a significantly greater overall accuracy (86.2%) is achieved.
Calcified amorphous tumor of the heart in a hemodialysis patient
Authors: Takeuchi Tetsushiro , Dohi Kaoru , Sato Yuichi , Kanemitsu Shinji , Sugiura Saki , Uchida Katsunori , Yamada Norikazu , Takeuchi Misao , Shiraishi Taizo , Shimpo Hideto , Ito Masaaki
Published: August 2016

We report a case of calcified amorphous tumor (CAT) of the heart in a 60‐year‐old Japanese man on hemodialysis. Because the masses in the mitral annulus developed during two‐year echocardiographic follow‐up, he underwent surgical resection with mitral valve replacement. Histological examination showed that the tumor contained multiple calcified nodules, which confirmed the diagnosis of CAT. This case report reinforces the need to deeply and periodically investigate for cardiac involvement of CAT in all patients on hemodialysis.
Diel migration pattern of Atlantic salmon (Salmo salar) and sea trout (Salmo trutta) smolts: an assessment of environmental cues
Authors: Haraldstad Tormod , Kroglund Frode , Kristensen Torstein , Jonsson Bror , Haugen Thrond O.
Published: August 2016

The timing of smolt migration is a key phenological trait with profound implications for individual survival during both river descent and the subsequent sea sojourn of anadromous fish. We studied relationships between the time of smolt migration, water temperature and light intensity for Atlantic salmon (Salmo salar) and sea trout (Salmo trutta). During 2006–2012, migrating smolts descending the southern Norway River Storelva were caught in a rotary screw trap located at the river mouth. The date of 50% cumulative smolt descent correlated significantly with the date when the river temperature exceeded 8°C for both Atlantic salmon and sea trout smolts. In 2010, smolts of both species were passive integrated transponder (PIT)‐tagged, and the diel timing of their migration was precisely documented. The degree of night migration decreased in both species as the river temperature rose, and at temperatures above 12–13°C, more smolts migrated during day than during night. A multinomial model was fitted for estimating temperature and species effects on probabilities of migration during night, daytime, dusk and dawn. Atlantic salmon smolts preferred migrating under lower light intensities than sea trout smolts during early, but not late spring when both species migrated during bright daylight. In accordance with the early‐season tendency to migrate at night, Atlantic salmon smolts migrated more during darker hours of the day than sea trout. In both species, smaller smolts migrated under dark conditions than during light conditions. Most of the findings on thermal, light and temporal effects on the observed smolt migration pattern can be explained as adaptations to predation avoidance.
Haematogenous septic arthritis in foals: Short‐ and long‐term outcome and analysis of factors affecting prognosis
Authors: Wright L. , Ekstrøm C. T. , Kristoffersen M. , Lindegaard C.
Published: August 2016

Synovial sepsis represents a major cause of morbidity and mortality in foals; however, there are no studies focusing on foals particularly at risk during the first 2 months of life. Our objective was to analyse outcome in foals aged <2 months with haematogenous septic arthritis and to identify prognostic factors and compare the effects of two different lavage procedures on outcome. Sixty foals with synovial sepsis were used for our retrospective study in which medical records, online data and telephone interviews were utilised to analyse prognostic factors, and determine short‐ and long‐term survival and athletic performance of foals treated at Evidensia Equine Specialist Hospital, Helsingborg, between 2008 and 2014. Overall survival to discharge was 80% (48/60). Time to long‐term follow‐up ranged from 6 months to 6.5 years. Forty/60 (67%) horses survived long‐term. Four/8 (50%) of the nonsurvivors at long‐term follow‐up had been subjected to euthanasia due to sequelae of joint sepsis. Of the long‐term survivors, 37/40 (92.5%) achieved athletic soundness. Overall long‐term outcome for athletic soundness was 37/60 (62%). Prognostic factors based on historical, clinical or laboratory data, or the use of through‐and‐through needle lavage compared to endoscopic lavage as the first procedure, could not be identified. The present study demonstrates a more favourable prognosis than previously reported, with 80% of foals with synovial sepsis surviving to discharge, and approximately 60% achieving athletic soundness. However, the study was limited by a small population size, which may account for the failure to verify statistically significant prognostic factors.
Analysing hypoglycin A, methylenecyclopropylacetic acid conjugates and acylcarnitines in blood to confirm the diagnosis and improve our understanding of atypical myopathy
Authors: Votion D.‐M.
Published: August 2016

Owing to recent methodological validation studies, we have now the opportunity to determine hypoglycin A, methylenecyclopropylacetic acid–carnitine and acylcarnitines concentrations in equine serum. These analytes are essential to confirm the diagnosis of atypical myopathy but also to improve our understanding of the pathophysiology of the disease. In particular, they might help elucidate why some horses seem more resistant to hypoglycin A poisoning.
The Role of Relational Instability on Individual and Partner Outcomes Following Couple Relationship Education Participation
Authors: McGill Julianne , Adler‐Baeder Francesca , Bradford Angela B. , Kerpelman Jennifer , Ketring Scott A. , Sollie Donna
Published: August 2016

Some scholars have suggested that distressed populations may benefit more from couple and relationship education (CRE) than do their nondistressed counterparts. We examined this hypothesis using actor–partner interdependence models to explore the relationship between baseline relational instability and change for individuals and their partners (379 couples; 758 individuals) who participated in a CRE program for 6 to 8 weeks. Findings indicated that a higher level of relational instability on the part of women was associated with greater positive change in depressive symptoms. Furthermore, respondents' and partners' baseline relational instability moderated the change in women's couple quality, such that women reported greater positive change in relationship quality when reporting higher instability and higher relationship quality before CRE participation, and when their partners reported higher instability and lower quality before CRE participation. Men appear to benefit from CRE participation regardless of baseline relational instability. Suggestions for researchers and facilitators are discussed.
Older Adult Descriptions of Living Apart Together
Authors: Benson Jacquelyn J. , Coleman Marilyn
Published: August 2016

Much can be learned about the nature and meaning of close relationships by studying language use. This qualitative study explores the process of defining relationships and choosing partner reference terms among an understudied population—living apart together (LAT) couples in older adulthood. Twenty‐five men and women aged 60 years and older were interviewed about their LAT relationships. Grounded theory analyses demonstrated that participants chose terms by trial and error through a process of meaning making. Terms associated with youth culture (e.g., girlfriend, boyfriend) were spurned, although they were commonly used for lack of age‐appropriate alternatives. Participants defined LAT by drawing contrasts to dating and marital relationships. Practical implications and future directions for research are discussed.
Contribution of organic toxicants to multiple stress in river ecosystems
Authors: Schäfer Ralf B. , Kühn Bernhard , Malaj Egina , König Anne , Gergs René
Published: August 2016

River ecosystems are threatened by multiple stressors, including habitat degradation, pollution and invasive species. However, freshwater ecologists have largely disregarded the contribution of toxicants to stress in rivers, whereas ecotoxicologists have primarily examined toxicant effects in artificial systems. As a result, there is a paucity of information on the co‐occurrence of organic toxicants with other stressors and on the relative importance of toxicants for overall ecological risk in rivers.

We used monitoring data for German rivers to analyse the individual and joint occurrence of four stressors: habitat degradation, invasive species, nutrient pollution and organic toxicants. All stressors were examined for ecological risks in terms of whether they exceeded low‐ and high‐risk thresholds derived from published studies and regulatory thresholds.

Nutrients and habitat degradation exceeded low and high risk thresholds at c. 85% of the sites and invasive species and organic toxicants at c. 50% of the sites. At least one stressor exceeded thresholds at all sites for which data on all four stressors were available. Toxicity showed weak positive correlations with nutrients and habitat degradation (0.2 < Spearman's ρ < 0.34, 0.009 < P < 0.08). The risks of ecological effects arising from habitat degradation and invasive species were higher in lowland rivers, particularly for invasive species.

Our assessment shows that organic toxicants contribute notably to risks of ecological effects in rivers, to a similar extent as invasive species, although habitat degradation and nutrients are the dominant stressors. Exposure to multiple stressors is the typical situation prevailing in rivers. Consequently, mitigation measures focusing on individual stressors may not be effective at reducing ecological risks. This suggests that integrating concepts and data from freshwater ecology and ecotoxicology is essential to meet the challenge of managing multiple stressors in river ecosystems.
Effects of replacing timothy silage by alsike clover silage on performance, carcass traits and meat quality of finishing Aberdeen Angus and Nordic Red bulls
Authors: Huuskonen A. , Pesonen M. , Honkavaara M.
Published: August 2016

The objective of the study was to determine the effects of silage plant species and cattle breed on performance and meat quality of finishing bulls. A feeding experiment was conducted using thirty Aberdeen Angus (AA) and thirty Nordic Red (NR) bulls. Both breeds were randomly allotted to three experimental diets. The composition (g kg−1 dry matter) of the diets was as follows: (i) timothy silage (TS) (650) and barley (350); (ii) TS (325), alsike clover silage (AS) (325) and barley (350); and (iii) AS (650) and barley (350). The bulls were fed a total mixed ration ad libitum. Replacing TS by AS did not affect dry‐matter intake, growth, carcass conformation or meat quality traits of the bulls, but carcass fat score tended to decrease when replacing TS by AS (P = 0·07). The AA bulls grew faster and had better feed conversion and superior carcass conformation compared with the NR bulls (P < 0·001). The loin of the AA bulls had lower shear force value and was given higher scores in sensory analyses compared with the NR bulls (P < 0·01). The experiment demonstrated that replacing TS by AS in the diet of finishing bulls had minor effects on performance or meat quality.
Methylotrophic yeast, lactic acid bacteria and glycerine as additives for sugarcane silage
Authors: Carvalho B. F. , Ávila C. L. S. , Pereira M. N. , Schwan R. F.
Published: August 2016

The ensiling of sugarcane results in high dry‐matter (DM) loss, but the addition of glycerine may compensate for the loss during ensiling. Methanol is the most undesirable contaminant of crude glycerine destined for animal feeding. The aim of this study was to evaluate the ability of the yeast strain Pichia methanolica NCYC 1381 to reduce the methanol concentration in sugarcane silage inoculated with Lactobacillus hilgardii CCMA 0170 + glycerine. A randomized design consisted of four dose rates of glycerine (0, 4, 8 and 12% of fresh forage), three periods of silage fermentation (11, 34 and 68 d) and three combinations of microbial additives [L. hilgardii (LH), L. hilgardii plus P. methanolica (LH + PM) and without microbial additive (WI)]. The DM of the fresh sugarcane was 275 g kg−1. The linear reduction in neutral detergent fibre caused by glycerine inclusion was probably due to a dilution effect. The LH treatment increased the concentrations of the succinic, acetic and propionic acids, and 1,2‐propanediol, and reduced the yeast population. The LH + PM treatment increased DM loss of sugarcane silage with 12% glycerine and L. hilgardii CCMA 0170 (6·1 log cfu g−1 of FM) reduced the DM loss when compared to the silage without additives. Under the conditions of the experiment, the P. methanolica treatment did not reduce the methanol concentration in silage.
The boundaries of transnationalism: the case of assisted voluntary return migrants
Authors: LIETAERT INE , BROEKAERT ERIC , DERLUYN ILSE
Published: August 2016

Few studies on transnationalism have focused on migrants who return to their country of origin with insufficient resources and limited mobility. This study sheds light on the transnational connections of those who went back to Georgia and Armenia from Belgium on a voluntary assisted return and reintegration programme. Using Boccagni's (2012) analytical framework, we reveal the returnees' interpersonal, institutional and symbolic transnational ties. Although these ties were often limited and had little effect on their daily lives, and although the migrants' desire to participate in the transnational field rarely matched their ability to do so, they nonetheless attached great value to them symbolically and emotionally. Our findings question current conceptualizations of transnationalism and the focus on the home country as the sole context in which transnational ties should have an impact. We believe that there is a need to pay greater attention to the subjective and symbolic dimensions of the return–transnationalism field, including the relationship between integration and return migration policies.
How and why should we engage parents as co‐researchers in health research? A scoping review of current practices
Authors: Shen Shuoqi , Doyle‐Thomas Krissy A.R. , Beesley Lori , Karmali Amir , Williams Laura , Tanel Nadia , McPherson Amy C.
Published: August 2016

Background

The importance of engaging parents in health research as co‐researchers is gaining growing recognition. While a number of benefits of involving parents as co‐researchers have been proposed, guidelines on exactly how effective engagement can be achieved are lacking. The objectives of this scoping review were to (i) synthesize current evidence on engaging parents as co‐researchers in health research; (ii) identify the potential benefits and challenges of engaging parent co‐researchers; and (iii) identify gaps in the literature.

Methods

A scoping literature review was conducted using established methodology. Four research databases and one large grey literature database were searched, in addition to hand‐searching relevant journals. Articles meeting specific inclusion criteria were retrieved and data extracted. Common characteristics were identified and summarized.

Results

Ten articles were included in the review, assessed as having low‐to‐moderate quality. Parent co‐researchers were engaged in the planning, design, data collection, analysis and dissemination aspects of research. Structural enablers included reimbursement and childcare. Benefits of engaging parent co‐researchers included enhancing the relevance of research to the target population, maximizing research participation and parent empowerment. Challenges included resource usage, wide‐ranging experiences, lack of role clarity and power differences between parent co‐researchers and researchers. Evaluation of parent co‐researcher engagement was heterogeneous and lacked rigour.

Conclusions

A robust evidence base is currently lacking in how to effectively engage parent co‐researchers. However, the review offers some insights into specific components that may form the basis of future research to inform the development of best practice guidelines.
Oral health impact of halitosis in Chinese adults
Authors: Lu H‐X , Chen X‐L , Wong MCM , Zhu C , Ye W
Published: August 2016

Objectives

To compare differences in oral health‐related quality of life (OHRQoL) between halitosis and non‐halitosis patients and to explore relationships between halitosis and OHRQoL.

Methods

Patients who visited the halitosis clinic at the Ninth People's Hospital and were diagnosed with halitosis were included in the halitosis group. The control group consisted of patients without halitosis. All participants were assessed for halitosis (volatile sulphur compound measurements with a portable sulphide monitor, Oral Chroma and organoleptic tests), underwent a clinical oral examination (dental caries status and periodontal condition) and completed a questionnaire. Oral health‐related quality of life was measured using the Oral Health Impact Profile (OHIP‐14, Chinese version).

Results

A total of 204 patients (102 halitosis and 102 controls) were included. The halitosis group had significantly higher OHIP‐14 scores (severity) than the control group (15.7 versus 7.9, P < 0.001). The mean number of items with negative impact (extent) was significantly different between the halitosis and control groups (1.8 versus 0.3, P < 0.001). Around 56% of participants in the halitosis group reported at least one item with ‘fairly often’ or ‘very often’ (prevalence), while 21% did so in the control group (P < 0.001). In halitosis patients, the most commonly reported negative impacts were within the domains of ‘psychological discomfort’ and ‘psychological disability’.

Conclusions

Oral health‐related quality of life status was significantly poorer in halitosis patients than in non‐halitosis patients. Halitosis patients may experience some degree of psychological discomfort and disability.
The efficacy of video monitoring‐supported student self‐evaluation of dental explorer skills in dental hygiene education
Authors: Tano R , Takaku S , Ozaki T
Published: August 2016

Objective

The objective of this study was to investigate whether having dental hygiene students monitor video recordings of their dental explorer skills is an effective means of proper self‐evaluation in dental hygiene education.

Methods

The study participants comprised students of a dental hygiene training school who had completed a module on explorer skills using models, and a dental hygiene instructor who was in charge of lessons. Questions regarding ‘posture’, ‘grip’, ‘finger rest’ and ‘operation’ were set to evaluate explorer skills. Participants rated each item on a two‐point scale: ‘competent (1)’ or ‘not competent (0)’. The total score was calculated for each evaluation item in evaluations by students with and without video monitoring, and in evaluations by the instructor with video monitoring. Mean scores for students with and without video monitoring were compared using a t‐test, while intraclass correlation coefficients were found by reliability analysis of student and instructor evaluations.

Results

A total of 37 students and one instructor were subject to analysis. The mean score for evaluations with and without video monitoring differed significantly for posture (P < 0.0001), finger rest (P = 0.0006) and operation (P < 0.0001). The intraclass correlation coefficient between students and instructors for evaluations with video monitoring ranged from 0.90 to 0.97 for the four evaluation items.

Conclusion

The results of this study suggested that having students monitor video recordings of their own explorer skills may be an effective means of proper self‐evaluation in specialized basic education using models.