bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive validity of verbal and non‐verbal communication and mother–child turn‐taking at 12 months on language outcomes at 24 and 36 months in a cohort of infants experiencing adversity: a preliminary study
Authors: Smith Jodie , Eadie Tricia , Levickis Penny , Bretherton Lesley , Goldfeld Sharon
Published: July 2018

Background

Parent‐reported measures of early communication have limitations for use with infants experiencing adversity. Observational measures of early non‐verbal and verbal communicative behaviours and mother–child turn‐taking may provide a complementary method of capturing early communication skills for these children.

Aims

To explore the predictive validity of verbal and non‐verbal behaviours and mother–child conversational turn‐taking (fluency and connectedness) at child age 12 months in relation to language measures at 24 and 36 months in a cohort of infants experiencing adversity.

Methods & Procedures

Pregnant women experiencing adversity were recruited from maternity hospitals in Australia. At 12 months, 190 infants were videoed during mother–child free‐play. Verbal and non‐verbal communicative behaviours and fluency and connectedness were measured from the 12‐month videos. Predictive validity of 12‐month behaviours was calculated in relation to mean length of utterance and number of unique words at 24 months and Clinical Evaluation of Language Fundamentals Preschool—Second Edition (CELF‐P2) Core Language scores at 36 months.

Outcomes & Results

All 12‐month behaviours had adequate specificity but poor sensitivity when compared with other predictive validity studies using published early language measures. However, in adjusted regression models, fluency and connectedness and verbal behaviours at 12 months predicted unique words at 24 months. Fluency and connectedness also predicted CELF‐P2 scores at 36 months.

Conclusions & Implications

Findings reconfirm the difficulty in early identification of children at risk of later language difficulties. All 12‐month measures were more accurate at identifying those children who will have better language than those children who will not. As fluency and connectedness was the only measure to predict 24‐ and 36‐month language in adjusted regression models, it may be an important factor to consider when measuring early language skills for infants experiencing adversity. Future research could combine observational measures of early communication and fluency and connectedness with other predictors of language to try to increase prediction accuracy.
Genetic risk for squamous cell carcinoma of the nictitating membrane parallels that of the limbus in Haflinger horses
Authors: Singer‐Berk M. , Knickelbein K. E. , Vig S. , Liu J. , Bentley E. , Nunnery C. , Reilly C. , Dwyer A. , Drögemüller C. , Unger L. , Gerber V. , Lassaline M. , Bellone R. R.
Published: July 2018

Squamous cell carcinoma (SCC) is the most common cancer affecting the equine eye, with a higher incidence documented in Haflinger horses. Recently, a missense variant in the genedamage specificDNAbinding protein 2(DDB2, p.Thr338Met) onECA12 was identified as a risk factor for the development of limbalSCCin Haflinger horses.SCCalso occurs on the nictitating membrane; therefore, investigating the role of this missense variant in nictitating membraneSCCis warranted. In this study, a common ancestor was identified among Haflinger horses affected with limbalSCCor with nictitating membraneSCC, thus supporting a recessive risk factor for the development of cancer at both ocular locations. Analysis of genotype data from Haflinger horses with and without nictitating membraneSCCrevealed that the same region onECA12 associated with limbalSCCwas also associated with nictitating membraneSCC(P < 2.04 × 10−5). Fine mapping of this locus using 25 cases and 49 controls supported the hypothesis thatDDB2:c.1013C>T, p.Thr338Met, is a risk factor for nictitating membraneSCC, as 88% of our cases were homozygous for this variant and no other polymorphism was more strongly associated (P = 4.13 × 10−14). These data indicate that the genetic risk is the same for the development of both limbal and nictitating membraneSCCin Haflinger horses and validates utilization of genetic testing of theDDB2variant for both clinical management and the guidance of mating decisions.
Do the contour feathers of Cisticolae exhibit adaptations to annual rainfall in their habitats?
Authors: le Roux Klem Jana , Bouwman Hindrik , Rijke Arie M.
Published: July 2018

Birds of the genus Cisticola occur over most of Southern Africa in varying habitats ranging from low to high altitudes and wet to dry areas causing species to have unique distributions. In order to determine if Cisticolas have evolved species‐specific water repellency and resistance to water penetration compatible with their habitats, we have measured the barb diameter and spacing of abdominal, breast and throat feathers of six cisticola species and related the results to mean annual rainfall and altitudes in five different locations. Water repellency was not significantly associated with altitude or maximum mean summer temperatures. However, water repellency increased markedly with annual rainfall in the 550 to 600 mm/year range for abdominal and breast feathers, but not for throat feathers. This increase was evident both among species occurring at multiple sites and among different species occurring at single sites. However, the two species occurring at the wettest sites showed low water repellency, but increased resistance to water penetration. These findings suggest that water repellency and resistance to water penetration are part of the evolutionary forces that shape the microstructure of Cisticola contour feathers.
Management of acute appendicitis in an acute surgical unit: a cost analysis
Authors: Wang Edward , Jootun Ravish , Foster Amanda
Published: July 2018

Background

The acute surgical unit (ASU) model of acute general surgery care offers efficient patient assessment, improved clinical outcomes and has been demonstrated to be cost‐efficient. Despite this, the management of acute appendicitis in our ASU was found to be highly cost‐negative. This study sought to identify the drivers of increased cost.

Methods

A retrospective cost analysis of all patients with uncomplicated acute appendicitis in 2016 was undertaken to investigate the drivers of increased cost. The patient‐level costing approach was used to assign cost to patients.

Results

The ASU management of uncomplicated appendicitis was found to have made a net loss of $625 000 in 2016. This study identified that the three largest cost drivers in appendicitis care were hospital overheads, bed day length of admission cost and operating theatre costs. Radiology, pathology and pharmacy costs did not affect total cost significantly.

Conclusion

Two key targets for improvement were identified. First, reduced theatre turnaround times will allow more efficient theatre utilization. Second, improved after‐hours and weekend theatre availability will reduce preoperative waiting time‐related cost.
Retinal perfusion changes in radiation retinopathy
Authors: Rose Kalpana , Krema Hatem , Durairaj Priya , Dangboon Wantanee , Chavez Yael , Kulasekara Susith I. , Hudson Christopher
Published: July 2018

Purpose

To investigate retinal blood flow and oxygen saturation changes in patients diagnosed with retinopathy following plaque radiation treatment to treat choroidal melanoma.

Methods

Eight patients (mean age 55.75 years, SD 12.58 years) who have developed unilateral ischaemic radiation‐related retinopathy as confirmed by wide‐field fluorescein angiography were recruited for the study. The fellow eye with no other ocular or retinal pathology was used as control. Both eyes underwent measurement of total retinal blood flow (TRBF) and retinal blood oxygen saturation using prototype methodologies of Doppler Spectral Domain Optical Coherence Tomography (OCT) and Hyperspectral Retinal Camera, respectively.

Results

The average TRBF in the retinopathy eye was significantly lower compared to the fellow eye (33.48 ± 12.73 μl/min versus 50.37 ± 15.26 μl/min; p = 0.013). The arteriolar oxygen saturation (SaO2) and venular oxygen saturation (SvO2) were higher in the retinopathy eye compared to the fellow eye (101.11 ± 4.26%, versus 94.45 ± 5.79%; p = 0.008) and (62.96 ± 11.05% versus 51.24 ± 6.88%, p = 0.051), respectively.

Conclusion

The ionizing radiation seems to have an impact on the TRBF, SaO2 and SvO2, clinically presenting similar to a rapidly developing diabetic retinopathy. The results show an altered retinal vascular physiology in patients with radiation‐related retinopathy.
Letter: vedolizumab drug levels in cord and maternal blood in women with inflammatory bowel disease—authors’ reply
Authors: Mahadevan U. , Vermeire S. , Lasch K. , Abhyankar B. , Bhayat F. , Blake A. , Dubinsky M.
Published: July 2018

Linked Content

This article is linked to Mahadevan et al and Julsgaard et al papers. To view these articles visit https://doi.org/10.1111/apt.13960 and https://doi.org/10.1111/apt.14837.
Hepatic steatosis is highly prevalent across the paediatric age spectrum, including in pre‐school age children
Authors: Dhaliwal J. , Chavhan G. B. , Lurz E. , Shalabi A. , Yuen N. , Williams B. , Martincevic I. , Amirabadi A. , Wales P. W. , Lee W. , Ling S. C. , Mouzaki M.
Published: July 2018

Background

The prevalence of non‐alcoholic fatty liver disease (NAFLD) in children is 8% in the general population, and 34% in the context of obesity. There is a paucity of data on the prevalence of hepatic steatosis in healthy children in Ontario.

Aims

To determine the prevalence of hepatic steatosis using abdominal computed tomography (CT) scans in a cohort of previously healthy children across the paediatric age spectrum in Ontario, Canada, and to determine any association between measures of abdominal adiposity and hepatic steatosis.

Methods

Retrospective review of the SickKids Trauma Database from 2004‐2015. Previously healthy children ages 1‐17 years having undergone an abdominalCTscan as a part of routine trauma assessment were included, and those with an intra‐abdominal injury excluded. Steatosis was defined as a difference between liver and spleen attenuation ≤‐25HU. The percentage of the total area occupied by abdominal subcutaneous adipose and visceral adipose tissue was measured. Anthropometrics and baseline demographics were collected.

Results

A total of 503 (51% male) children with mean (±SD) age 9.5 ± 4.5 years and weightz‐score of 0.37 ± 1.05 were studied. Seventy‐seven (15%, 95%CI[12%‐18%]) had hepatic steatosis; no differences found between sexes or across age quartiles. The abdominal subcutaneous adipose tissue area was greater in those with hepatic steatosis compared to those without (32% [22‐42] vs 24% [17‐36],P = 0.003). The visceral adipose tissue area was significantly greater in older children ≥9.8 years with hepatic steatosis (7.7% [5.1‐10] vs 6.6% (4.9‐8.5),P = 0.04).

Conclusion

Hepatic steatosis was highly prevalent in previously healthy children in Ontario, including children of pre‐school age. We found an association between hepatic steatosis and abdominal subcutaneous adipose tissue, and in older children with visceral adipose tissue.
What does empathy sound like in social work communication? A mixed‐methods study of empathy in child protection social work practice
Authors: Lynch Amy , Newlands Fiona , Forrester Donald
Published: July 2018

It is widely accepted that empathy is important for social work practice, yet there are multiple dimensions of empathy and comparatively few studies of empathy as a component of social work skill. To date, published studies have been quantitative, and as a result, we know little about how social workers demonstrate empathy in practice or what skilled empathic practice in child and family social work might sound like. This study contributes to the development of understanding of empathy as a social work skill through a mixed‐methods analysis of 110 audio recordings of meetings in a child protection service between workers and parents, applying a coding framework for analysis. Findings indicate that workers who demonstrate higher levels of empathy skill use more open questions and reflections in their communication with parents. Further, they demonstrate curiosity about and make efforts to understand parents' often difficult experiences, including a focus on emotions. That the majority of workers were found not to demonstrate a high level of empathy skill presents concerns to be considered by the social work profession. A deeper understanding of empathy presents an opportunity for an increased focus in organizations to enable workers to demonstrate empathy towards families they work with.
Variations in the management of significant polyps and early colorectal cancer: results from a multicentre observational study of 383 patients
Authors: Dattani M. , Crane S. , Battersby N. J. , Di Fabio F. , Saunders B. P. , Dolwani S. , Rutter M. D. , Moran B. J. ,   the SPECC study group
Published: July 2018

Aim

The concept of significant polyps and early colorectal cancer (SPECC) encompasses complex polyps not amenable to routine snare polypectomy or where malignancy cannot be excluded. Surgical resection (SR) offers definitive treatment, but is overtreatment for the majority which are benign and amenable to less invasive endoscopic resection (ER). The aim of this study was to investigate variations in the management and outcomes of significant colorectal polyps.

Method

This was a retrospective observational study of significant colorectal polyps, defined as nonpedunculated lesions of ≥ 20 mm size, diagnosed across nine UK hospitals in 2014. Inclusion criteria were endoscopically or histologically benign polyps at biopsy.

Results

A total of 383 patients were treated by primary ER (87.2%) or SR (12.8%). Overall, 108/383 (28%) polyps were detected in the Bowel Cancer Screening Programme (BCSP). Primary SR was associated with a significantly longer length of stay and major complications (P < 0.01). Of the ER polyps, 290/334 (86.8%) patients were treated without undergoing surgery. The commonest indication for secondary surgery was unexpected polyp cancer, and of these cases 60% had no residual cancer in the specimen. Incidence of unexpected cancer was 10.7% (n = 41) and was similar between ER and SR groups (P = 0.11). On multivariate analysis, a polyp size of > 30 mm and non‐BCSP status were independent risk factors for primary SR [OR 2.51 (95% CI 1.08–5.82), P = 0.03].

Conclusion

ER is safe and feasible for treating significant colorectal polyps. Robust accreditation within the BCSP has led to improvements in management, with lower rates of SR compared with non‐BCSP patients. Standardization, training in polyp assessment and treatment within a multidisciplinary team may help to select appropriate treatment strategies and improve outcomes.
Effect of microgravity on proliferation and differentiation of embryonic stem cells in an automated culturing system during the TZ‐1 space mission
Authors: Lei Xiaohua , Cao Yujing , Zhang Ying , Qian Jingjing , Zhao Qian , Liu Fangwu , Zhang Tao , Zhou Jiaxi , Gu Ying , Xia Guoliang , Duan Enkui
Published: July 2018

Objective

Despite a great number of studies analysing the effects of microgravity on stem cell proliferation and differentiation, few of them have focused on real‐time imaging estimates in space. Herein, we utilized the TZ‐1 cargo spacecraft, automatic cell culture equipment and live cell imaging techniques to examine the effects of real microgravity on the proliferation and differentiation of mouse embryonic stem cells (mESCs).

Materials and methods

Oct4‐GFP, Brachyury‐GFP mESC and Oct4‐GFP mESC‐derived EBs were used as experimental samples in the TZ‐1 spaceflight mission. These samples were seeded into chambers, cultured in an automatic cell culture device and were transported into space during the TZ‐1 mission. Over 15 days of spaceflight, bright field and fluorescent images of cell growth were taken in micrography, and the medium was changed every day. Real‐time image data were transferred to the ground for analysis.

Results

Space microgravity maintains stemness and long‐term survival of mESCs, promising 3D aggregate formation. Although microgravity did not significantly prevent the migration of EBs on the ECM substrate, it did prevent terminal differentiation of cells.

Conclusions

This study demonstrates that space microgravity might play a potential role in supporting 3D cell growth and maintenance of stemness in embryonic stem cells, while it may negatively affect terminal differentiation.
Basic skin care in atopic dermatitis – new and established treatment options
Authors: Chylla Ricarda , Schnopp Christina , Volz Thomas
Published: July 2018

Basic skin care (basic therapy) is a mainstay in the treatment of atopic dermatitis, irrespective of disease severity and current disease activity. Consistent application of basic skin care plays a key role in restoring skin barrier function and reducing xerosis as well as pruritus. Moreover, it has been shown that concurrent basic therapy has steroid‐sparing effects in acute disease flares. In long‐term atopic dermatitis management, the use of basic skin care is associated with prolonged recurrence‐free intervals. Recent studies have also demonstrated that early initiation of basic skin therapy has protective effects in infants at risk of developing atopic dermatitis. The present review addresses these topics with a focus on established treatments and new developments.
Highlighting declines of cold‐demanding plant species in lowlands under climate warming
Authors: Kuhn Emilien , Gégout Jean‐Claude
Published: July 2018

High rates of species extinction have been predicted for the next century as a consequence of climate change. Although species range shifts have been widely reported, evidence of changes in species frequency linked to recent climate change is scarce. Moreover, studies have mainly focused on mountainous ecosystems and species. There is thus a clear lack of understanding of the recent changes in species frequencies linked to climate change across their whole range. Using a large forest vegetation‐plot database, we investigated changes in cold and warm‐demanding forest plant species frequencies between the periods 1914–1987 and 1997–2013 in French lowlands and highlands. Changes in frequencies were assessed for 185 lowland (warm‐demanding), 135 sub‐montane (intermediate) and 104 montane (cold‐demanding) forest plant species. Observed changes were compared to predicted changes derived from species distribution model predictions. The frequency of montane and sub‐montane species strongly declined, whereas the frequency of lowland species remained steady in lowland areas. In highlands, the frequency of lowland, sub‐montane and montane species increased, remained steady and decreased, respectively. Predicted and observed trends of changes in the frequency of forest plant species were in agreement. These results clearly show that cold‐demanding species are currently declining in lowlands that correspond to their warm range margins, whereas warm‐demanding species are expanding in highlands that correspond to their cold range margins. These trends can be seen as early signs of future regional extinction and reshuffling of the spatial presence of species due to climate warming.
Custom‐made facemask as a coadjuvant in the postoperative treatment of sport‐related facial trauma: Case report
Authors: Antunes Leonardo Santos , Torres Ariane Ferraz Corrêa , Ferreira Gustavo , Prado Roberto , Coto Neide Pena , Antunes Lívia Azeredo Alves
Published: July 2018

Maxillofacial injuries are a regular consequence of sport activities that can force athletes to take a long time off from training and competitions. One way to decrease the time that the athlete needs to get back to his or her training exercises after surgery is to use a custom facemask as a coadjuvant in the postoperative recovery phase. This case report describes the case of a 16‐year‐old male athlete who suffered facial trauma (orbitozygomatic fractures) during a soccer game. After surgery, a facemask was used during the postoperative phase. He returned to his regular physical activities only 3 weeks after surgery. This simple and very efficient procedure is a good option for athletes who suffer facial injuries.
Feasting on terrestrial organic matter: Dining in a dark lake changes microbial decomposition
Authors: Fitch Amelia , Orland Chloe , Willer David , Emilson Erik J. S. , Tanentzap Andrew J.
Published: July 2018

Boreal lakes are major components of the global carbon cycle, partly because of sediment‐bound heterotrophic microorganisms that decompose within‐lake and terrestrially derived organic matter (t‐OM). The ability for sediment bacteria to break down and alter t‐OM may depend on environmental characteristics and community composition. However, the connection between these two potential drivers of decomposition is poorly understood. We tested how bacterial activity changed along experimental gradients in the quality and quantity of t‐OM inputs into littoral sediments of two small boreal lakes, a dark and a clear lake, and measured the abundance of operational taxonomic units and functional genes to identify mechanisms underlying bacterial responses. We found that bacterial production (BP) decreased across lakes with aromatic dissolved organic matter (DOM) in sediment pore water, but the process underlying this pattern differed between lakes. Bacteria in the dark lake invested in the energetically costly production of extracellular enzymes as aromatic DOM increased in availability in the sediments. By contrast, bacteria in the clear lake may have lacked the nutrients and/or genetic potential to degrade aromatic DOM and instead mineralized photo‐degraded OM into CO2. The two lakes differed in community composition, with concentrations of dissolved organic carbon and pH differentiating microbial assemblages. Furthermore, functional genes relating to t‐OM degradation were relatively higher in the dark lake. Our results suggest that future changes in t‐OM inputs to lake sediments will have different effects on carbon cycling depending on the potential for photo‐degradation of OM and composition of resident bacterial communities.
Impact of breast cancer grade discordance on prediction of outcome
Authors: Rakha Emad A , Aleskandarany Mohammed A , Toss Michael S , Mongan Nigel P , ElSayed Maysa E , Green Andrew R , Ellis Ian O , Dalton Les W
Published: July 2018

Aims

Histological grade is an independent prognostic variable in breast cancer (BC). Previous concordance studies of BC grade have reported moderate levels of agreement; a typical finding in morphological assessment of biological variables. This study aimed to investigate the impact of discordance on the prognostic value of grade and to identify the best reporting approach in borderline cases.

Methods and results

A large (n = 1675) well‐characterised annotated cohort of BC, originally graded in routine practice using glass slides, was re‐graded twice by an expert breast pathologist using virtual microscopy with a 3‐month washout period. Outcome was assessed using breast cancer‐specific and distant metastasis‐free survival (median follow‐up = 135 months). Fifty‐eight per cent of the cases showed absolute agreement in the three separate grading sessions, whereas grades 1/2 and 2/3 discordance were observed in 21% and 21%, respectively. Absolute intra‐observer agreement using virtual microscopy was observed in 77% of the cases, whereas 13% and 10% showed grades 1/2 and 2/3 discordance, respectively. Despite the concordance, outcome analysis revealed significant associations between tumour grade and patients’ outcome in the three grading sessions. Grades 1/2 and 2/3 discordant cases showed intermediate survival between grades 1 and 2 tumours and grades 2 and 3 tumours, respectively. Grades 1/2 discordant cases showed a worse outcome when compared with grade 1 tumours (P = 0.008) but no statistical difference was identified when compared with grade 2 tumours. Similarly, grades 2/3 discordant cases showed a significant difference from grade 2 tumours (P < 0.001), but no statistical difference was identified when compared with grade 3 tumours.

Conclusions

Breast cancer grade discordance is probably a reflection of biologically, and hence morphologically, borderline tumours. Cases with borderline features for grade are more likely to behave similarly to the higher‐grade category. Repeating histological grade of borderline cases or double reporting may improve correlation with outcome.
Structural and optical study of Fe3+‐doped Al2O3 nanocrystals prepared by new sol gel precursors
Authors: Khodadadi Abolfazl , Farahmandjou Majid , Yaghoubi Mojtaba , Amani Ali Reza
Published: July 2018

Pure and Fe‐doped Al2O3 nanoparticles (NPs) were synthesized with different iron doping percentage of 1, 3, and 5 mol% employing sol gel technique with AlCl3, FeCl3 as well as ethylene glycol (EG) and Polyvinylpyrrolidone (PVP) stabilizers as precursors. The XRD results indicated that the hexagonal structure of Fe/Al2O3 nanocomposite with alpha phase was formed by the substitution of Fe3+ ions in the alumina network. The sizes of the NPs obtained for the pure samples and doped samples at percentage dopant of 5% were 35 and 28 nm, respectively. The results of FTIR optical analysis showed the vibrational bond at the wavelength of 448 cm−1, indicating the Al‐O band in the sample. The UV‐DRS analysis showed that the energy band gap for the pure NPs was 4 eV, but with increase in iron dopant up to 5%, it decreased to 3.42 eV. In addition, the results of photoluminescence (PL) analysis demonstrated that with increase in doping percentage, the PL intensity diminished. VSM magnetic analysis showed that with increase in iron dopant, the ferromagnetic state emerged in the NPs at saturation magnetism of 0.136 emu/g. Finally, photocatalytic experimental results demonstrated that 5% Fe‐doped Al2O3 NPs effectively degrade MB approximately 53%.
The role of birth weight on the causal pathway to child and adolescent ADHD symptomatology: a population‐based twin differences longitudinal design
Authors: Lim Kai Xiang , Liu Chao‐Yu , Schoeler Tabea , Cecil Charlotte A.M. , Barker Edward D. , Viding Essi , Greven Corina U. , Pingault Jean‐Baptiste
Published: July 2018

Background

Available evidence points towards lower birth weight as a risk factor for the development of attention deficit/hyperactivity disorder (ADHD) symptoms. We probed the causal nature of this putative effect of birth weight on ADHD symptoms using the twin differences design, which accounts for genetic and shared environmental confounds.

Method

In a large population‐based twin sample – 3,499 monozygotic (MZ) and 6,698 dizygotic (DZ) pairs – parents, teachers or twins rated the twins’ ADHD symptoms at nine assessment waves (2–16 years). We implemented the twin differences design, which completely accounts for shared environmental and genetic confounding in MZ twins. We tested whether: (a) the lighter‐born twins had elevated ADHD symptoms compared to the heavier‐born twins, by regressing within‐pair differences of ADHD symptoms on within‐pair differences of birth weight among MZ twins; (b) the effect of birth weight on ADHD was moderated by gender, gestational age and low birth weight; (c) this effect changed with age at ADHD assessment using adapted latent growth curve models; and (d) results differed for inattention and hyperactivity/impulsivity.

Results

Birth weight significantly predicted ADHD symptoms from early childhood to late adolescence. The lighter‐born twin had more ADHD symptoms than the heavier‐born cotwin among MZ twins across assessment waves and raters. No moderation effect was detected. The magnitude of the effect of birth weight decreased significantly across time for hyperactivity/impulsivity, but the decrease failed to reach significance for inattention. Estimates for inattention were significantly larger than for hyperactivity/impulsivity at each time point, implying stronger effect of birth weight on inattention symptoms.

Conclusions

Our findings provide stringent evidence for environmental effect of lower birth weight on the causal pathway to elevated ADHD symptoms. Effect of birth weight persists across a 14‐year period from childhood into late adolescence, in particular for inattention symptoms.
ALIGNed on adherence: subanalysis of adherence in immune‐mediated inflammatory diseases in the DACH region of the global ALIGN study
Authors: Kolios A.G.A. , Hueber A.J. , Michetti P. , Mrowietz U. , Mustak‐Blagusz M. , Sator P.‐G. , Reinshagen M. , Wilsmann‐Theis D. , Gomis‐Kleindienst S. , Luckey U. , Rössler A. , Schiefke I.
Published: July 2018

Background

Non‐adherence to medication is a challenging problem in daily clinical practice.

Objective

To assess reasons for non‐adherence in patients with chronic immune‐mediated inflammatory diseases (IMIDs) in a direct comparison including evaluation of treatment necessity and concerns.

Methods

ALIGN was a non‐interventional, multicountry, multicentre, self‐administered, cross‐sectional, epidemiologic survey study. Here, we investigate the German, Austrian and Swiss (DACH) cohort. Six hundred thirty‐one patients with different IMIDs (rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, plaque psoriasis, Crohn's disease and ulcerative colitis) under systemic therapies were evaluated concerning adherence, beliefs of necessity and concerns towards treatment in patients with IMIDs.

Results

The DACH cohort had significantly different levels of adherence depending on the IMID (P < 0.05) and the type of therapy (P < 0.05). Based on the significant influence of concerns on treatment adherence (P < 0.05) and the high belief of treatment necessity, patients could be classified in four attitudinal segments, which were unequally distributed throughout various IMIDs. High concerns had a significant influence on non‐adherence, whereas necessity did not. Older age, female sex, TNFi mono‐, conventional combination and TNFi combination therapy are positively associated with adherence.

Conclusions

In the DACH region, patients are less concerned about medication and believe in the necessity of treatment. Therefore, we suggest adapting the communication in the various patient groups.
Lymph node ratio is an independent prognostic factor for rectal cancer after neoadjuvant therapy: A meta‐analysis
Authors: Jin Chengwu , Deng Xiangbing , Li Yan , He Wanbin , Yang Xuyang , Liu Jian
Published: July 2018

Objective

With neoadjuvant therapy increasingly used in advanced rectal cancer, the lymph node ratio (LNR) has been strongly considered to indicate cancer‐specific survival in recent years, and a comprehensive evaluation of a large number of studies is deficient. The objective of our study is to pool enough eligible studies to assess the relationship between LNR and prognosis of advanced rectal cancer after neoadjuvant therapy.

Methods

A systematic search was done in the PubMed and EmBase databases (through 1 March 2017) that reported LNR in colorectal cancer after neoadjuvant therapy. The first two authors independently conducted the study selection and data extraction. All statistical analyses were conducted using STATA 13.0 (College Station, Texas).

Results

Thirteen studies with 4023 participants were included in the meta‐analysis, and all were published after 2011. A high LNR was assessed to be a predictor of poor overall survival in rectal cancer after neoadjuvant therapy (HR: 2.94, 95% CI:1.97 to 3.91, P < 0.001). Similarly, a high LNR was related to poor disease‐free survival (HR: 2.83, 95% CI: 1.82 to 3.85, P < 0.001). With respect to recurrence, the HRs of 3.25, 1.93, and 2.11 also showed a strong relationship between high LNR and poor local, distant, and total recurrences.

Conclusions

Our present study demonstrates that a high LNR can predict poor survival in advanced rectal cancer. We suggest well‐designed clinical trials to prospectively assess LNR as an independent predictor of rectal cancer survival.
Combination of microwave endometrial ablation and postoperative dienogest administration is effective for treating symptomatic adenomyosis
Authors: Ota Kuniaki , Takahashi Toshifumi , Shiraishi Satoru , Mizunuma Hideki
Published: July 2018

Aim

Menorrhagia and dysmenorrhea are common symptoms. Uterine adenomyosis is one of the causes of menorrhagia and dysmenorrhea. These symptoms often decrease the quality of life in women. Microwave endometrial ablation (MEA) is a recently developed procedure that enables endometrial ablation. Dienogest has long been used to suppress endometrium development and reduce adenomyosis‐related dysmenorrhea. However, some cases could be resistant to dienogest. In this study, we evaluated the efficacy of a combination of MEA and postoperative dienogest in reducing adenomyosis‐related dysmenorrhea and menorrhagia.

Methods

Ten patients with hormone treatment‐resistant symptomatic adenomyosis underwent MEA and were administered oral dienogest after the procedure. The primary endpoints were reduction in pain recurrence and anemia. The secondary endpoint was a change in the adenomyosis lesion and its symptomatic recurrence.

Results

Statistically significant improvements were seen in the visual analog scale score and hemoglobin levels in women post‐treatment. The difference in myometrial thickness pre‐ and post‐MEA was statistically significant. There were no cases of symptomatic recurrence.

Conclusion

The combination of MEA and postoperative dienogest is useful for treating uterine adenomyosis with menorrhagia and dysmenorrhea.
What growth sounds like: Redemption, self‐improvement, and eudaimonic growth across different life narratives in relation to well‐being
Authors: Bauer Jack J. , Graham Laura E. , Lauber Elissa A. , Lynch Bridget P.
Published: July 2018

Objective

We disentangled three growth‐relevant concepts (redemption, self‐improvement, and eudaimonic growth) in personal narratives of high, low, and turning points and tested their relations to well‐being.

Method

In two studies, participants (Study 1n = 111, Study 2n = 206; overall ages 17–83, 56% women, 75% white) wrote narratives of high points, low points, and turning points. Researchers coded each narrative forredemption sequences(i.e., affectively valenced changes in life from bad to good),self‐improvement sequences(i.e., affectively valenced changes in oneself for the better), andthemes of eudaimonic growth(i.e., values or motives for cultivating meaningful activities or relationships, helping others, or wisdom). Participants also self‐reported well‐being.

Results

Redemption sequences in low points predicted higher well‐being but in high points predicted lower well‐being. Self‐improvement sequences and growth themes each predicted higher well‐being in each life event (and interacted in high points). Growth themes consistently mediated predicted relations between both redemption and self‐improvement sequences and well‐being. Findings held when controlling for global narrative affect, self‐reported growth motivation, and big‐five traits.

Conclusions

Thematic motives for eudaimonic growth were more closely tied to well‐being than were affective evaluations of either changes from bad to good (redemption) or one's becoming better (self‐improvement).
Losses (and Gains) from Health Reform for Non‐Medicaid Uninsureds
Authors: Pauly Mark , Leive Adam , Harrington Scott
Published: July 2018

This article examines how the Affordable Care Act (ACA) would change financial resources for and transfers to the previously uninsured if they were to purchase coverage in the ACA insurance exchanges (marketplaces) in 2014. The results suggest that the law provides gains to some, relative to their spending in the pre‐ACA period, particularly those in poor health and with very low incomes, but it also potentially imposes financial losses on many, again compared to their experience when uninsured. We estimate changes in expected payments—defined as premiums plus expected out‐of‐pocket costs—from purchasing coverage and paying cost sharing post‐ACA, relative to expected out‐of‐pocket payments when being uninsured pre‐ACA, across population subgroups characterized by income, age, and health status. We also estimate changes in expected transfers to the previously uninsured under alternative assumptions on how much health care spending increases after the ACA.
Incidence and spontaneous clearance of hepatitis C virus (HCV) in people who inject drugs at the Stockholm Needle Exchange—Importance for HCV elimination
Authors: Kåberg Martin , Navér Georg , Hammarberg Anders , Weiland Ola
Published: July 2018

The major transmission route for hepatitis C virus (HCV) is through sharing of unsterile injection equipment among people who inject drugs (PWID). The WHO strategy for HCV elimination by 2030 proposes increased efforts to treat PWID populations that drive the HCV epidemic. Among participants in the Stockholm needle exchange programme (NEP), the HCV prevalence is 60%. We aimed to study HCV incidence, spontaneous HCV clearance rate, and predictors associated with new HCV infections and reinfections in NEP participants. All 2320 patients enrolled in the programme between 8 April 2013 and 23 September 2016 were tested for HCV at baseline, and responded to a questionnaire regarding sociodemographic data and injection risk behaviour. Tests for HCV were repeated at an interval of 3‐6 months. The anti‐HCV prevalence in the NEP participants at baseline was 77%, and the prevalence of HCV RNA was 57%. 24% of the anti‐HCV positive were HCV RNA negative with a spontaneously cleared HCV infection. The overall HCV incidence rate was 22/100 PY. The HCV incidence rate in the HCV naive group was 26/100 PY, and in the spontaneously cleared group 19/100. Although there were no significant differences in becoming HCV infected between the two groups (31% vs 29%), the rate of spontaneous HCV clearance was significantly lower in the HCV naive group, 20% vs 44%, (P < 0.05). A high HCV incidence rate was noted among the PWID indicating that treatment needs to be scaled up in conjunction with harm reduction measures to achieve HCV elimination goals set by WHO. This includes high coverage needle exchange programmes and effective addiction treatment for substance users, including opiate substitution treatment.
CTL‐associated and NK cell‐associated immune responses induce different HBV DNA reduction patterns in chronic hepatitis B patients
Authors: Nomura Motonobu , Tsuge Masataka , Uchida Takuro , Hiraga Nobuhiko , Kurihara Mio , Tsushima Ken , Fujino Hatsue , Nakahara Takashi , Murakami Eisuke , Abe‐Chayama Hiromi , Kawaoka Tomokazu , Miki Daiki , Hiramatsu Akira , Imamura Michio , Kawakami Yoshiiku , Aikata Hiroshi , Ochi Hidenori , Zhang Yizhou , Makokha Grace Naswa , Hayes Clair Nelson , Tanaka Shinji , Chayama Kazuaki
Published: July 2018

The activation of hepatitis B virus (HBV)‐related hepatitis is associated with both natural killer (NK) cells and cytotoxic T lymphocytes (CTLs). We analyzed the association between the immune response and changes in the proportion of Pre‐S deletion variants. We quantified Pre‐S deleted HBV (HBV‐del) and wild‐type HBV (HBV‐wt) DNA levels in sera obtained from HBV‐infected mice and chronic hepatitis B patients. In chronic hepatitis B patients, the HBV‐del proportion usually increased during or after ALT elevation but did not occur during all ALT elevations. To clarify this difference in the immunological responses, we performed in vivo analyses using HBV‐infected human hepatocyte chimeric mice. Although HBV‐del proportions did not change in mice with NK cell‐associated hepatitis or in mice treated with entecavir, the proportions sharply increased in mice with CTL‐associated hepatitis. Furthermore, the number of patients in which HBV‐del proportions were greater than 5% was significantly higher in chronic hepatitis B patients than in asymptomatic carriers (P = 0.023). We identified associations between virological response in chronic hepatitis B patients and two different immune responses. The proportion of HBV‐del variants could be a useful biomarker for distinguishing between chronic hepatitis and asymptomatic carriers.
Cost‐effectiveness and health‐related outcomes of screening for hepatitis C in Korean population
Authors: Kim Kyung‐Ah , Chung Wankyo , Choi Hwa Young , Ki Moran , Jang Eun Sun , Jeong Sook‐Hyang
Published: July 2018

Background/Aim

In the era of direct‐acting antivirals (DAA), active screening for hidden hepatitis C virus (HCV) infection is important for HCV elimination. This study estimated the cost‐effectiveness and health‐related outcomes of HCV screening and DAA treatment of a targeted population in Korea, where anti‐HCV prevalence was 0.6% in 2015.

Methods

A Markov model simulating the natural history of HCV infection was used to examine the cost‐effectiveness of two strategies: no screening vs screening and DAA treatment. Screening was performed by integration of the anti‐HCV test into the National Health Examination Program. From a healthcare system's perspective, the cost‐utility and the impact on HCV‐related health events of one‐time anti‐HCV screening and DAA treatment in Korean population aged 40‐65 years was analysed with a lifetime horizon.

Results

The HCV screening and DAA treatment strategy increased quality‐adjusted life years (QALY) by 0.0015 at a cost of $11.27 resulting in an incremental cost‐effectiveness ratio (ICER) of $7435 per QALY gained compared with no screening. The probability of the screening strategy to be cost‐effective was 98.8% at a willingness‐to‐pay of $27 205. Deterministic sensitivity analyses revealed the ICERs were from $4602 to $12 588 and sensitive to screening costs, discount rates and treatment acceptability. Moreover, it can prevent 32 HCV‐related deaths, 19 hepatocellular carcinomas and 15 decompensated cirrhosis per 100 000 screened persons.

Conclusions

A one‐time HCV screening and DAA treatment of a Korean population aged 40‐65 years would be highly cost‐effective, and significantly reduce the HCV‐related morbidity and mortality compared with no screening.
Testing the light:nutrient hypothesis: Insights into biofilm structure and function using metatranscriptomics
Authors: Veach Allison M. , Griffiths Natalie A.
Published: July 2018

Aquatic biofilms are hotspots of biogeochemical activity due to concentrated microbial biomass (Battin, Kaplan, Newbold, & Hansen, ). However, biofilms are often considered a single entity when their role in biogeochemical transformations is assessed, even though these biofilms harbour functionally diverse microbial communities (Battin, Besemer, Bengtsson, Romani, & Packmann, ; Veach, Stegen, Brown, Dodds, & Jumpponen, ). Often overlooked are the biotic interactions among biofilm components that can affect ecosystem‐scale processes such as primary production and nutrient cycling. These interactions are likely to be especially important under resource limitation. Light is a primary resource mediating algal photosynthesis and both phototrophic and heterotrophic production due to bacterial reliance on C‐rich algal exudates (Cole, ). However, current understanding of function–structure linkages in streams has yet to unravel the relative degree of these microbial feedbacks under resource availability gradients. In this issue of Molecular Ecology, Bengtsson, Wagner, Schwab, Urich, and Battin () studied stream biofilm responses to light availability to understand its impact across three domains of life. By integrating biogeochemical rate estimation and metatranscriptomics within a microcosm experiment, they were able to link primary production and nutrient uptake rates to algal and bacterial metabolic processes and specify what taxa contributed to gene expression. Under low light, diatoms and cyanobacteria upregulated photosynthetic machinery and diatom‐specific chloroplast rRNA suggesting heightened transcriptional activity under light limitation to maintain phototrophic energy demands. Under high light, heterotrophic bacteria upregulated mRNAs related to phosphorous (P) metabolism while biofilm P uptake increased indicating high bacterial‐specific P demand when algal biomass was high. Together, these results indicate that biogeochemical function is mediated by complex microbial interactions across trophic levels.
High School Spanish Students and Foreign Language Reading Anxiety: Déjà vu All Over Again All Over Again
Authors: SPARKS RICHARD L. , LUEBBERS JULIE , CASTAÑEDA MARTHA , PATTON JON
Published: July 2018

A unique anxiety for foreign language (L2) learning has been hypothesized to explain students’ problems with language learning. However, L2 anxiety instruments have been challenged on the grounds that they reflect students’ language learning ability and/or perceptions of their language learning skills. In this study, 266 U.S. high school students were administered measures of first language (L1) skills, L2 aptitude, and L2 achievement and followed through 2–3 years of Spanish courses. In 1st‐year Spanish, they were administered the Foreign Language Reading Anxiety Scale (FLRAS), divided into 3 anxiety groups, and compared on the L1 and L2 measures. Findings showed that the Low Anxiety group scored significantly higher than the High Anxiety group on all L1 and L2 measures, and significantly higher than the Average Anxiety group on most L1 and L2 measures at the end of 1st‐ and 2nd‐year Spanish. Students who completed 3rd‐year Spanish displayed either low or average anxiety on the FLRAS. Results revealed negative correlations between the FLRAS and all L1 and L2 measures. Correlations between the FLRAS and the L2 achievement measures increased over time. Findings show that the FLRAS is unlikely to be measuring anxiety for language learning but more likely to be a proxy for students’ levels of L1 skill, L2 aptitude, and L2 achievement.
Plant carbon metabolism and climate change: elevated CO2 and temperature impacts on photosynthesis, photorespiration and respiration
Authors: Dusenge Mirindi Eric , Duarte André Galvao , Way Danielle A.
Published: July 2018

Contents

Summary
32

I.
The importance of plant carbon metabolism for climate change
32

II.
Rising atmospheric CO2 and carbon metabolism
33

III.
Rising temperatures and carbon metabolism
37

IV.
Thermal acclimation responses of carbon metabolic processes can be best understood when studied together
38

V.
Will elevated CO2 offset warming‐induced changes in carbon metabolism?
40

VI.
No plant is an island: water and nutrient limitations define plant responses to climate drivers
41

VII.
Conclusions
42

Acknowledgements
42

References
42

Appendix A1
48

Plant carbon metabolism is impacted by rising CO2 concentrations and temperatures, but also feeds back onto the climate system to help determine the trajectory of future climate change. Here we review how photosynthesis, photorespiration and respiration are affected by increasing atmospheric CO2 concentrations and climate warming, both separately and in combination. We also compile data from the literature on plants grown at multiple temperatures, focusing on net CO2 assimilation rates and leaf dark respiration rates measured at the growth temperature (Agrowth and Rgrowth, respectively). Our analyses show that the ratio of Agrowth to Rgrowth is generally homeostatic across a wide range of species and growth temperatures, and that species that have reduced Agrowth at higher growth temperatures also tend to have reduced Rgrowth, while species that show stimulations in Agrowth under warming tend to have higher Rgrowth in the hotter environment. These results highlight the need to study these physiological processes together to better predict how vegetation carbon metabolism will respond to climate change.