bluuebunny/crossref_metadata_2025 huggingface dataset:
IQGAP2 acts as a tumor suppressor in breast cancer and its reduced expression promotes cancer growth and metastasis by MEK/ERK signalling pathways
Authors: Kumar Dinesh , Hassan Md. Khurshidul , Pattanaik Niharika , Mohapatra Nachiketa , Dixit Manjusha
Published: May 2019

IQGAP2 is a member of IQGAPs scaffolding protein family. It has been reported as a tumor suppressor in various cancers, as well as, an oncogene in some cancers, suggesting organ specific role. Need to identify therapeutic targets which function in ER/PR independent way, prompted us to explore role of IQGAP2 in molecular mechanism in breast cancer, which was completely unknown. In vitro studies in estrogen receptor positive breast cancer cell line (MCF7) showed that low IQGAP2 expression results in increased cell proliferation, migration and invasion of cells whereas an opposite effect was observed with ectopic expression of IQGAP2. Triple negative breast cancer cell line (MDA-MB-468), with IQGAP2 depletion showed similar effect, supporting its role in ER/PR independent manner. Furthermore, we found that reduced IQGAP2 expression induces the expression of EMT markers; twist and N-cadherin and decreases the expression of MET marker, E-cadherin via the MEK/ERK pathway but not via AKT pathway. Validation of findings in patients showed a reduced IQGAP2 expression in breast cancer tissues compared to normal tissue. Patients with low levels of IQGAP2 showed correlation with higher tumor stage. Our results suggest that IQGAP2 acts as a tumor suppressor and its down regulation results in cell growth, cell invasion and EMT through the MEK/ERK signalling pathways and it hence may be a potential therapeutic target in breast cancer.
Presence of a family history and excessive pressure on the first toe pad during walking in female subjects with pincer nails
Authors: Makino Koji , Ogawa Youichi , Kanagawa Takaiki , Matsuzawa Miyuki , Yamamoto Saori , Yamada Kazuki , Shimada Shinji , Kawamura Tatsuyoshi , Terada Hidetsugu
Published: May 2019

Pincer nails (PN) are defined as a transverse overcurvature of the nail plate. Although there have been advancements in therapeutic approaches, the precise underlying mechanisms for the development of PN are still not fully understood. Currently, PN are assumed to develop due to lack of upward mechanical force on the toes. We developed a novel wireless device to observe detailed gait motion. We analyzed trends of gait motion in healthy individuals without PN, healthy individuals with PN without a family history of PN, and healthy individuals with PN and a family history of PN. We found that a family history of PN is an independent risk factor for PN, irrespective of gait motion. Moreover, healthy individuals with PN but without a family history of PN exhibit strong and concentrated pressure on the first toe pad during walking. In sum, a family history of PN and excess upward mechanical forces on the first toe pad during walking may be risk factors for the development of PN.
A test of trophic and functional island biogeography theory with the avifauna of a continental archipelago
Authors: Ross Samuel R. P.‐J. , Friedman Nicholas R. , Janicki Julia , Economo Evan P.
Published: May 2019

The classical MacArthur–Wilson theory of island biogeography (TIB) emphasizes the role of island area and isolation in determining island biotas, but is neutral with respect to species differences that could affect community assembly and persistence. Recent extensions of island biogeography theory address how functional differences among species may lead to non‐random community assembly processes and different diversity–area scaling patterns. First, the trophic TIB considers how diversity scaling varies across trophic position in a community, with species at higher trophic levels being most strongly influenced by island area. Second, further extensions have predicted how trait distributions, and hence functional diversity, should scale with area. Trait‐based theory predicts richness‐corrected functional diversity should be low on small islands but converge to null on larger islands. Conversely, competitive assembly predicts high diversity on small islands converging to null with increasing size.

However, despite mounting interest in diversity–area relationships across different dimensions of diversity, these predictions derived from theory have not been extensively tested across taxa and island systems.

Here, we develop and test predictions of the trophic TIB and extensions to functional traits, by examining the diversity–area relationship across multiple trophic ranks and dimensions of avian biodiversity in the Ryūkyū archipelago of Japan.

We find evidence for a positive species– and phylogenetic diversity–area relationship, but functional diversity was not strongly affected by island area. Counter to the trophic TIB, we found no differences in the slopes of species–area relationships among trophic ranks, although slopes varied among trophic guilds at the same rank. We revealed differential assembly of trophic ranks, with evidence of trait‐based assembly of intermediate predators but otherwise neutral community assembly.

Our results suggest that niche space differs among trophic guilds of birds, but that differences are mostly not predicted by current extensions of island biogeography theory. While predicted patterns do not fit the empirical data well in this case, the development of such theory provides a useful framework to analyse island patterns from new perspectives. The application of empirical datasets such as ours should help provide a basis for developing further iterations of island biogeography theory.
Negative frequency‐dependent foraging behaviour in a generalist herbivore (Alces alces) and its stabilizing influence on food web dynamics
Authors: Hoy Sarah R. , Vucetich John A. , Liu Rongsong , DeAngelis Don L. , Peterson Rolf O. , Vucetich Leah M. , Henderson John J.
Published: May 2019

Resource selection is widely appreciated to be context‐dependent and shaped by both biological and abiotic factors. However, few studies have empirically assessed the extent to which selective foraging behaviour is dynamic and varies in response to environmental conditions for free‐ranging animal populations.

Here, we assessed the extent that forage selection fluctuated in response to different environmental conditions for a free‐ranging herbivore, moose (Alces alces), in Isle Royale National Park, over a 10‐year period. More precisely, we assessed how moose selection for coniferous versus deciduous forage in winter varied between geographic regions and in relation to (a) the relative frequency of forage types in the environment (e.g. frequency‐dependent foraging behaviour), (b) moose abundance, (c) predation rate (by grey wolves) and (d) snow depth. These factors are potentially important for their influence on the energetics of foraging. We also built a series of food‐chain models to assess the influence of dynamic foraging strategies on the stability of food webs.

Our analysis indicates that moose exhibited negative frequency dependence, by selectively exploiting rare resources. Frequency‐dependent foraging was further mediated by density‐dependent processes, which are likely to be predation, moose abundance or some combination of both. In particular, frequency dependence was weaker in years when predation risk was high (i.e. when the ratio of moose to wolves was relatively low). Selection for conifers was also slightly weaker during deep snow years.

The food‐chain analysis indicates that the type of frequency‐dependent foraging strategy exhibited by herbivores had important consequences for the stability of ecological communities. In particular, the dynamic foraging strategy that we observed in the empirical analysis (i.e. negative frequency dependence being mediated by density‐dependent processes) was associated with more stable food web dynamics compared to fixed foraging strategies.

The results of this study indicated that forage selection is a complex ecological process, varying in response to both biological (predation and moose density) and abiotic factors (snow depth) and over relatively small spatial scales (between regions). This study also provides a useful framework for assessing the influence of other aspects of foraging behaviour on the stability of food web dynamics.
Using medico‐legal claims for quality improvement in maternity care: application and revision of an NHSLA coding taxonomy
Authors: Nowotny BM , Basnayake S , Lorenz K , Hall J , Ruddock S , Fennessy G , Cox E , Hodges R , Loh E , Wallace EM
Published: May 2019

Objective

To validate the NHSLA maternity claims taxonomy at the level of a single maternity service and assess its ability to direct quality improvement.

Design

Qualitative descriptive study.

Setting

Medico‐legal claims between 1 January 2000 and 31 December 2016 from a maternity service in metropolitan Melbourne, Australia.

Population

All obstetric claims and incident notifications occurring within the date range were included for analysis.

Methods

De‐identified claims and notifications data were derived from the files of the insurer of Victorian public health services. Data included claim date, incident date and summary, and claim cost. All reported issues were coded using the NHSLA taxonomy and the lead issue identified.

Main outcome measures

Rate of claims and notifications, relative frequency of issues, a revised taxonomy.

Results

A combined total of 265 claims and incidents were reported during the 6 years. Of these 59 were excluded, leaving 198 medico‐legal events for analysis (1.66 events/1000 births). The costs for all claims was $46.7 million. The most common claim issues were related to management of labour (n = 63, $17.7 million), cardiotocographic interpretation (n = 43, $24.4 million), and stillbirth (n = 35, $656,750). The original NHSLA classification was not sufficiently detailed to inform care improvement programmes. A revised taxonomy and coding flowchart is presented.

Conclusions

Systematic analysis of obstetric medico‐legal claims data can potentially be used to inform quality and safety improvement.

Tweetable abstract

New taxonomy to target health improvement from maternity claims based on NHSLA Ten Years of Maternity Claims.
The effect of different sampling and recall periods in the CAHPS Clinician & Group (CG‐CAHPS) survey
Authors: Hargraves J. Lee , Cosenza Carol , Elliott Marc N. , Cleary Paul D.
Published: May 2019

Objective

To examine the effect of changing the sampling and reference periods for the CAHPS® Clinician & Group Survey from 12 to 6 months.

Data Sources/Study Setting

Adult patients with a visit in the last 12 months to New England community health centers.

Study Design

We randomly assigned patients to receive a survey with either a 12‐ or 6‐month recall period.

Data Collection/Extraction Methods

Questionnaires were mailed to patients, with a second questionnaire mailed to nonrespondents, followed by six attempts to complete a telephone interview.

Principal Findings

If the sampling criterion was a visit in the last 6 months, 9 percent of those with a visit in the last 12 months would not have been surveyed. A total of 1837 patients completed 6‐month surveys (44.9 percent response rate); 588 completed 12‐month surveys (46.0 percent response rate). Shortening the reference from 12 to 6 months reduced the proportion of respondents reporting a blood test, X‐ray, or other tests. Adjusting for respondent characteristics, the most positive response was selected more often on the 6‐month survey for 12 out of 13 questions, and three of these differences were statistically significant (P < 0.05).

Conclusions

Surveys using a 6‐month recall period may yield slightly higher scores than surveys with a 12‐month recall period.
The effects of a schizophrenia pay‐for‐performance program on patient outcomes in Taiwan
Authors: Chen Tsung‐Tai , Yang Jing‐Jung , Hsueh Ya‐seng (Arthur) , Wang Vinchi
Published: May 2019

Objective

To examine the effects of a schizophrenia pay‐for‐performance (P4P) program on the health outcomes of patients in Taiwan.

Data Sources

Seven years (2007‐2013) of data from the National Health Insurance Administration (NHIA) databases were examined.

Study Design

P4P patients included those who were treated at participating facilities and consecutively included in the regular group (classified by the NHIA). Non‐P4P patients were treated at nonparticipating facilities and never included in the regular group. The caliper matching method and a generalized estimating equation were used to estimate difference‐in‐differences models (baseline year 2009) and examine the short‐ and long‐term effects of the P4P program on adverse outcomes.

Principal Findings

The schizophrenia P4P program was associated with decreases in unscheduled outpatient visits (OR: 0.69, P < 0.001) and compulsory admissions (incidence rate ratio: 0.33, P < 0.05). However, this program was not associated with decreases in other outcomes including emergency department visits for any disease, admissions to an acute psychiatric ward, and readmission within 6 months.

Conclusions

Although the disease management component of the P4P program can be beneficial for compulsory admissions, more sophisticated activities, such as health promotion targeting disadvantaged patients, could be implemented to reduce the occurrence of complicated adverse outcomes.
The effect of Medicaid waivers on ameliorating racial/ethnic disparities among children with autism
Authors: LaClair Michelle , Mandell David S. , Dick Andrew W. , Iskandarani Khaled , Stein Bradley D. , Leslie Douglas L.
Published: May 2019

Objective

To examine the effects of Medicaid Home and Community‐based Services (HCBS) waivers on reducing racial/ethnic disparities in unmet need for services among families of children with autism spectrum disorder (ASD).

Data Sources

Data from the 2003, 2007, and 2011 waves of the National Survey of Children's Health and the 2005 and 2010 waves of the National Survey of Children with Special Health Care Needs were used. Data on waiver characteristics were collected from source materials that were submitted in support of each state's waiver application. Waiver characteristics were combined to create a single waiver generosity variable.

Study Design

Quasi‐difference‐in‐difference‐in‐difference models were used to determine the effect of waiver generosity on racial/ethnic disparities in unmet need among children with ASD.

Principal Findings

Increased waiver generosity was associated with significantly reduced odds of having unmet need for black children with ASD compared with white children with ASD. Unmet needs among black children with ASD were roughly cut in half, a 13 percentage point decrease, with the implementation of an average generosity waiver. No significant differences were seen for Hispanic ethnicity.

Conclusion

These findings suggest that Medicaid HCBS waivers have the potential to ameliorate disparities in unmet need among children with ASD. Future policy development should focus on replicating the most effective characteristics of these waivers.
MicroRNA‐2738 regulates gene expression in the sex determination pathway in Bombyx mori
Authors: Liu Zu‐Lian , Xu Jun , Ling Lin , Yang De‐Hong , Chen Shu‐Qing , Huang Yong‐Ping
Published: May 2019

MicroRNAs (miRNAs) are a class of short, non‐coding transcripts that bind to 3′‐untranslated regions to trigger messenger RNA degradation or translational inhibition. Here we explored how miRNAs regulate sex determination in Bombyx mori, a lepidopteran model insect. Genes known to be involved in sex determination, BmPSI, Bmdsx, and BmMasc, are predicted targets of the species‐specific miR‐2738. Using a dual luciferase reporter assay in HEK293T cells, we confirmed that miR‐2738 suppressed transcription of BmPSI, Bmdsx, and BmMasc. The levels of BmPSI and BmMasc were significantly down‐regulated in B. mori miR‐2738 overexpression. In contrast, the genetic disruption of miR‐2738 using the clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR‐associated protein 9 transgenic system increased the levels of BmPSI and BmMasc transcripts, whereas splicing of Bmdsx was unaltered by miR‐2738 depletion or overexpression. Taken together, this study implicates miR‐2738 as a minor regulator of sex determination genes in the silkworm.
Expression of multidrug transporter P‐glycoprotein in Pichia pastoris affects the host's methanol metabolism
Authors: Liu Wan‐cang , Zhou Fei , Xia Di , Shiloach Joseph
Published: May 2019

Pichia pastoris KM71H (MutS) is an efficient producer of hard‐to‐express proteins such as the membrane protein P‐glycoprotein (Pgp), an ATP‐powered efflux pump which is expressed properly, but at very low concentration, using the conventional induction strategy. Evaluation of different induction strategies indicated that it was possible to increase Pgp expression by inducing the culture with 20% media containing 2.5% methanol. By quantifying methanol, formaldehyde, hydrogen peroxide and formate, and by measuring alcohol oxidase, catalase, formaldehyde dehydrogenase, formate dehydrogenase, malate dehydrogenase, isocitrate dehydrogenase and α‐ketoglutarate dehydrogenases, it was possible to correlate Pgp expression to the induction strategy. Inducing the culture by adding methanol with fresh media was associated with decreases in formaldehyde and hydrogen peroxide, and increases in formaldehyde dehydrogenase, formate dehydrogenase, isocitrate dehydrogenase and α‐ketoglutarate dehydrogenases. At these conditions, Pgp expression was 1400‐fold higher, an indication that Pgp expression is affected by increases in formaldehyde and hydrogen peroxide. It is possible that Pgp is responsible for this behaviour, since the increased metabolite concentrations and decreased enzymatic activities were not observed when parental Pichia was subjected to the same growth conditions. This report adds information on methanol metabolism during expression of Pgp from P. pastoris MutS strain and suggests an expression procedure for hard‐to‐express proteins from P. pastoris.
18F‐FDG PET/CT imaging: A supplementary understanding of pulmonary sclerosing pneumocytoma
Authors: Xu Jie , Dong Youwen , Yin Guotao , Jiang Wei , Yang Zhen , Xu Wengui , Zhu Lei
Published: May 2019

Background

We sought to investigate the clinical features and 18F‐FDG PET/CT characteristics of pulmonary sclerosing pneumocytoma (PSP).

Methods

We retrospectively reviewed and comparatively analyzed 18F‐FDG PET/CT imaging results of 22 patients with diagnosed PSP in our hospital from November 2009 to September 2015.

Results

The SUVmax in tumors was positively correlated with tumor size in typical PSPs (R = 0.806, R2 = 0.650, P = 0.001); however, the SUVmax in tumors had no significant correlation with tumor size of atypical PSPs (R = 0.479, R2 = 0.229, P = 0.162), and the degree of correlation between them attenuated when atypical PSPs were included (R = 0.518, R2 = 0.268, P = 0.011). A majority (90%) of atypical PSPs were found in males. Symptomatic patients showed a higher SUVmax than the asymptomatic group (5.68 ± 3.63 vs. 2.76 ± 1.18, respectively, P = 0.002).

Conclusion

Tumor size and clinical features may be associated with increased FDG uptake in PSPs. Morphological differences may affect the correlation between tumor size and SUVmax in PSPs. The atypical form of PSP may be more common in men.
The role of health, experience, and educational attainment in agricultural production: Evidence from smallholders in Burkina Faso
Authors: Wouterse Fleur , Badiane Ousmane
Published: May 2019

We apply parametric and nonparametric methods to data from smallholders in Burkina Faso and assess the role that human capital characteristics play in the agricultural production process. Our results point to the technology‐changing nature of health, education, and experience. However, effects are rather heterogeneous. The productivity elasticity of health is much larger for households in the lowest landholding quintiles, while returns to experience are larger for households in the upper quintile. In terms of policy implications, our results suggest that productivity can be stimulated through the allocation of expenditure to social services that enhance certain types of human capital. Interventions aimed at improving the health status of households with smaller landholdings could have particularly strong welfare effects.
Review: Sex‐Based Differences in Treatment Outcomes for Persons With Opioid Use Disorder
Authors: Huhn Andrew S. , Berry Meredith S. , Dunn Kelly E.
Published: May 2019

Background and Objectives

In order to address the current opioid crisis, research on treatment outcomes for persons with opioid use disorder (OUD) should account for biological factors that could influence individual treatment response. Women and men might have clinically meaningful differences in their experience in OUD treatment and might also have unique challenges in achieving successful, long‐term recovery. This review summarizes and synthesizes the current literature on sex‐based differences in OUD treatment outcomes.

Methods

Relevant literature was identified via automated and manual searches using the terms “opioid treatment outcome sex [or gender] differences” and “opiate treatment outcome sex [or gender] differences.” Search methodology was consistent with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA), and were conducted within the PubMed electronic database during March and April of 2018.

Results

The initial PubMed search yielded 241 manuscripts and 31 original research articles that met inclusion/exclusion criteria were synthesized in this review. Several important trends emerged, including findings that women are more likely than men to present to treatment with co‐occurring mental health conditions such as depression, and that women might respond particularly well to buprenorphine maintenance.

Discussion and Conclusions

While much of the literature on this topic is subject to potential cohort effects, interventions that address co‐occurring mental health conditions and psychosocial stress might improve treatment outcomes for women with OUD.

Scientific Significance

Funding agencies and researchers should focus attention toward human laboratory studies and clinical trials that are prospectively designed to assess sex‐based differences in OUD recovery. (Am J Addict 2019;28:246–261)
The association between antiphospholipid antibodies and late fetal loss: A systematic review and meta‐analysis
Authors: Xu Jinfeng , Chen Daijuan , Duan Xia , Li Li , Tang Yuxin , Peng Bing
Published: May 2019

Introduction

Antiphospholipid syndrome is a chronic autoimmune disease with a high prevalence in females. Published data have identified that antiphospholipid antibodies (APLA) of antiphospholipid syndrome are risk factors for poor pregnancy outcomes, such as recurrent spontaneous abortion, intrauterine growth restriction and preeclampsia. However, the association between APLA and late fetal loss is not fully understood and remains controversial. The aim of this study is to identify and analyze the recent publications to better understand the association between APLA and late fetal loss.

Material and methods

The literature was searched on 31 January 2019 using Ovid, Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) to evaluate the association between APLA and late fetal loss, with articles published before January 2019, according to the PRISMA statement. Without imposing regional restrictions, referenced articles were selected. Quality assessment was conducted independently by two reviewers, based on the Newcastle‐Ottawa scale. For the meta‐analysis, we used odds ratios (random effects model). The between‐study heterogeneity was assessed by Q test. Publication bias was assessed by funnel plots.

Results

Nineteen studies (with 10 265 cases) were included in the final analysis. The odds ratio (OR) for the late fetal loss with lupus anticoagulant was 5.02 (95% confidence interval [CI] 2.14‐7.89). Seven included studies reported that lupus anticoagulant had a statistically significant association with late fetal loss. The results did not show a statistically significant association between anticardiolipin antibodies and late fetal loss. The pooled odds ratio for the association of anticardiolipin antibodies with late fetal loss was 3.47 (95% CI 0.68‐6.26). However, we did find the relation between anticardiolipin antibodies and late fetal loss among cohort studies (OR 2.27, 95% CI 1.20‐3.44). Anti‐beta2 glycoprotein 1 antibodies (β2GP1) showed a significant association with late fetal loss (OR 3.13, 95% CI 0.75‐5.50).

Conclusions

Lupus anticoagulant is strongly associated with late fetal loss in antiphospholipid syndrome patients. However, the association between anticardiolipin antibodies and late fetal loss is inconsistent. There are currently insufficient data to support a significant relation between β2GP1 and late fetal loss.
A Varying-Coefficient Generalized Odds Rate Model With Time-Varying Exposure: An Application to Fitness and Cardiovascular Disease Mortality
Authors: Zhou Jie , Zhang Jiajia , Mclain Alexander C. , Lu Wenbin , Sui Xuemei , Hardin James W.
Published: May 2019

Varying-coefficient models have become a common tool to determine whether and how the association between an exposure and an outcome changes over a continuous measure. These models are complicated when the exposure itself is time-varying and subjected to measurement error. For example, it is well known that longitudinal physical fitness has an impact on cardiovascular disease (CVD) mortality. It is not known, however, how the effect of longitudinal physical fitness on CVD mortality varies with age. In this paper, we propose a varying-coefficient generalized odds rate model that allows flexible estimation of age-modified effects of longitudinal physical fitness on CVD mortality. In our model, the longitudinal physical fitness is measured with error and modeled using a mixed-effects model, and its associated age-varying coefficient function is represented by cubic B-splines. An expectation-maximization algorithm is developed to estimate the parameters in the joint models of longitudinal physical fitness and CVD mortality. A modified pseudoadaptive Gaussian-Hermite quadrature method is adopted to compute the integrals with respect to random effects involved in the E-step. The performance of the proposed method is evaluated through extensive simulation studies and is further illustrated with an application to cohort data from the Aerobic Center Longitudinal Study.
Muscle and Fascia Simulation with Extended Position Based Dynamics
Authors: Romeo M. , Monteagudo C. , Sánchez‐Quirós D.
Published: May 2019

Recent research on muscle and fascia simulation for visual effects relies on numerical methods such as the finite element method or finite volume method. These approaches produce realistic results, but require high computational time and are complex to set up. On the other hand, position‐based dynamics offers a fast and controllable solution to simulate surfaces and volumes, but there is no literature on how to implement constraints that could be used to realistically simulate muscles and fascia for digital creatures with this method. In this paper, we extend the current state‐of‐the‐art in Position‐Based Dynamics to efficiently compute realistic skeletal muscle and superficial fascia simulation. In particular, we embed muscle fibres in the solver by adding an anisotropic component to the distance constraints between mesh points and apply overpressure to realistically model muscle volume changes under contraction. In addition, we also define a modified distance constraint for the fascia that allows compression and enables the user to scale the constraint's original distance to gain elastic potential at rest. Finally, we propose a modification of the extended position‐based dynamics algorithm to properly compute different sets of constraints and describe other details for proper simulation of character's muscle and fascia dynamics.
Depot buprenorphine injections for opioid use disorder: Patient information needs and preferences
Authors: Neale Joanne , Tompkins Charlotte N. E. , Strang John
Published: May 2019

Introduction and Aims

There has been significant recent investment in new medications for opioid use disorder, including buprenorphine depot injections. Patients and professionals need good quality, independent information on medications to help them make informed treatment decisions. This paper aims to understand patients’ information needs and preferences in relation to buprenorphine depot injections.

Design and Methods

Semi‐structured qualitative interviews were conducted with 36 people using opioids (26 men, 10 women; 24–63 years). Twelve participants were currently prescribed daily oral methadone; 12 were currently prescribed daily oral buprenorphine; and 12 were using heroin and not in treatment. Interviews were transcribed, coded and analysed via Iterative Categorisation.

Results

Participants asked many questions about depot buprenorphine injections. These related to: (i) medication purpose and availability; (ii) pharmacology; (iii) evidence base and effectiveness; (iv) safety and side effects; (v) administration and dosing; and (vi) reducing and ending treatment. Additionally, participants expressed their information preferences in terms of (i) ‘format’ and (ii) ‘source’. Specifically, they wanted printed, verbal and electronic materials provided by people in authority, particularly patients who had already had the medication.

Discussion and Conclusions

All potential patients should be offered accessible information on depot buprenorphine to enable them to consider their options and participate meaningfully in treatment decision making. We recommend that further qualitative research is undertaken to produce informative video material that describes patient experiences of receiving depot buprenorphine. This should help to balance biomedical knowledge with lay knowledge, so facilitating more informed discussions when decisions about depot buprenorphine treatment are made.
Do New Zealand sexual minorities engage in more hazardous drinking than non‐sexual minorities?
Authors: Surace Anthony , Riordan Benjamin C. , Winter Taylor
Published: May 2019

Introduction and Aims

Research has shown that sexual minorities (SMs) throughout the world display more alcohol use related problems than non‐SMs. To date, however, this research has not been replicated in New Zealand. The aim of the current study is to determine whether SMs in New Zealand drink more hazardously than non‐SMs.

Design and Methods

Secondary data analyses were performed using data from the 2015/16 and 2016/17 New Zealand Health Survey.

Results

Using a Bayesian logistic regression model we tested whether SM status predicted hazardous alcohol consumption. We found that SMs were 2.2 times (95% HDI [1.7–2.7]) more likely to drink hazardously than non‐SMs, but this effect was largely driven by sexual minority women (SMW).

Discussion and Conclusion

New Zealand SMs engaged in more hazardous drinking than non‐SMs, an effect driven by SMW. A potential reason for these findings could be that, despite New Zealand's relative acceptance of SMs, structural/social discrimination may persist and have a disproportionate effect on women. More research is needed to determine what factors, such as stigma/discrimination, impact SMs’ alcohol use in New Zealand.
Adding ecological and evolutionary processes to restoration biodiversity offset models using neutral theory
Authors: Buschke Falko T. , Sinclair Samuel P.
Published: May 2019

Aim

Biodiversity offsets are being implemented or planned across all continents and biogeographical realms. Due to their popularity, new offset projects have developed faster than empirical evidence of their ecological effectiveness, so policy has been informed by quantitative models. However, these models have yet to incorporate ecological and evolutionary processes, which vary globally. Here we use the unified neutral theory of biodiversity to integrate speciation and dispersal into models of restoration biodiversity offsets.

Location

A simulated one‐dimensional circular landscape.

Methods

We designed a simulation framework based on neutral theory that allowed us to compare restoration biodiversity offsets under various scenarios of speciation, dispersal and offset implementation: no offsets, passive restoration and translocation. This approach allowed us to evaluate time series of multiple metrics of biodiversity (richness, evenness and community similarity) at different spatial scales (patch and landscape), which were then compared using model‐based recursive partitioning.

Results

The choice of offset implementation was the main determinant of successful offset outcomes; translocation consistently had the best outcomes. Passive restoration only improved offset outcomes for systems with high speciation rates. Speciation and dispersal mainly played a secondary role in offset outcomes, with dispersal only affecting offset outcomes at landscape scales. Outcomes also varied across different metrics of biodiversity, with species richness and evenness showing opposing trajectories for some scenarios.

Main conclusions

Although ecological and evolutionary processes affect biodiversity offset outcomes, the type of offset implementation remains the most important determinant of offset success. This emphasizes the development—and effective implementation—of robust offset policies and guidelines that include active translocation and demand more than just passive restoration.
In the dental implant era, why do we still bother saving teeth?
Authors: Clark Danielle , Levin Liran
Published: May 2019

Teeth are vital sensory organs that contribute to our daily activities of living. Unfortunately, teeth can be lost for several reasons including trauma, caries, and periodontal disease. Although dental trauma injuries and caries are more frequently encountered in a younger population, tooth loss because of periodontal disease occurs in the older population. In the dental implant era, the trend sometimes seems to be to extract compromised teeth and replace them with dental implants. However, the long‐term prognosis of teeth might not be comparable with the prognosis of dental implants. Complications, failures, and diseases such as peri‐implantitis are not uncommon, and, despite popular belief, implants are not 99% successful. Other treatment options that aim to save compromised or diseased teeth such as endodontic treatment, periodontal treatment, intentional replantation, and autotransplantation should be considered on an individual basis. These treatments have competing success rates to dental implants but, more importantly, retain the natural tooth in the dentition for a longer period of time. These options are important to discuss in detail during treatment planning with patients in order to clarify any misconceptions about teeth and dental implants. In the event a tooth does have to be extracted, procedures such as decoronation and orthodontic extrusion might be useful to preserve hard and soft tissues for future dental implant placement. Regardless of the treatment modality, it is critical that strict maintenance and follow‐up protocols are implemented and that treatment planning is ethically responsible and evidence based.
Prospective evaluation of minimal residual disease monitoring to predict prognosis of adult patients with Ph‐negative acute lymphoblastic leukemia
Authors: Nagafuji Koji , Miyamoto Toshihiro , Eto Tetsuya , Ogawa Ryosuke , Okumura Hirokazu , Takase Ken , Kawano Noriaki , Miyazaki Yasuhiko , Fujisaki Tomoaki , Wake Atsushi , Ohno Yuju , Kurokawa Toshiro , Kamimura Tomohiko , Takamatsu Yasushi , Yokota Shouhei , Akashi Koichi
Published: May 2019

Objective

We investigated whether minimal residual disease (MRD) status in adult patients with Philadelphia chromosome (Ph)‐negative acute lymphoblastic leukemia (ALL) is useful for decision on clinical indications for allogeneic hematopoietic stem cell transplantation (HSCT).

Methods

We prospectively monitored MRD after induction and consolidation therapy in adult patients with Ph‐negative ALL.

Results

Among 103 adult ALL patients enrolled, 59 were Ph‐negative, and MRD status was assessed in 51 patients. The probability of 3‐year overall survival (OS) and disease‐free survival (DFS) was 69% (95%CI 54‐80) and 50% (95%CI 36‐63), respectively. Patients who were MRD‐negative after induction therapy (n = 15) had a significantly better 3‐year DFS compared with those who were MRD‐positive (n = 30; 73% vs 41%, P = 0.018). Patients who were MRD‐positive after induction but became MRD‐negative after consolidation chemotherapy C in the first course (n = 11) showed a significantly worse 3‐year DFS compared with patients who were MRD‐negative after induction chemotherapy A in the first course (45% vs 73%, P = 0.025).

Conclusions

These results indicate that DFS of about 70% can be expected in MRD‐negative patients after induction therapy, and the patients did not benefit from HSCT in 1CR. This study was registered with the UMIN Clinical Trials Registry (UMIN‐CTR), number UMIN000001519.
Soil microbiome mediates positive plant diversity‐productivity relationships in late successional grassland species
Authors: Wang Guangzhou , Schultz Peggy , Tipton Alice , Zhang Junling , Zhang Fusuo , Bever James D.
Published: May 2019

Which processes drive the productivity benefits of biodiversity remain a critical, but unanswered question in ecology. We tested whether the soil microbiome mediates the diversity‐productivity relationships among late successional plant species. We found that productivity increased with plant richness in diverse soil communities, but not with low‐diversity mixtures of arbuscular mycorrhizal fungi or in pasteurised soils. Diversity‐interaction modelling revealed that pairwise interactions among species best explained the positive diversity‐productivity relationships, and that transgressive overyielding resulting from positive complementarity was only observed with the late successional soil microbiome, which was both the most diverse and exhibited the strongest community differentiation among plant species. We found evidence that both dilution/suppression from host‐specific pathogens and microbiome‐mediated resource partitioning contributed to positive diversity‐productivity relationships and overyielding. Our results suggest that re‐establishment of a diverse, late successional soil microbiome may be critical to the restoration of the functional benefits of plant diversity following anthropogenic disturbance.
Clinical spectrum of glutamic acid decarboxylase antibodies in a Taiwanese population
Authors: Kuo Y.‐C. , Lin C.‐H.
Published: May 2019

Background and purpose

High levels of autoantibodies against glutamic acid decarboxylase (GAD‐abs) are associated with stiff‐person syndrome (SPS). However, the full clinical spectrum associated withGAD‐abs in Asians is unclear. The clinical and immunological features of patients positive forGAD‐abs were reviewed in a large Taiwanese series.

Methods

Retrospective case series and immunological investigations were conducted between July 2007 and July 2017 at a tertiary referral centre in Taiwan. Amongst 361 patients withGAD‐ab reactivity, 185 with detailed clinical records were included.

Results

Twenty‐seven patients (14.59%), with a mean age at assessment of 54.8 ± 13.9 years, presented with neurological symptoms. The major neurological presentations (meanGAD‐ab concentrations) wereSPS(n = 9, 33.3%; 135.45 ± 27.84 U/ml), cerebellar ataxia (n = 3, 11.1%; 95.61 ± 49.63 U/ml), encephalopathy (n = 2, 7.4%; 51.8 ± 49.64 U/ml) and epilepsy (n = 1, 3.7%; 83.3 U/ml). Notably, eight patients fulfilling the clinical diagnosis of multiple system atrophy had relatively lowerGAD‐ab concentrations (2.57 ± 0.82 U/ml), which has not been reported previously. There was no correlation between disease severity andGAD‐ab concentration. Patients presenting with comorbid endocrinopathies (n = 15, 55.5%) had higherGAD‐ab concentrations than those without endocrinopathies (n = 12, 44.4%; 104.45 ± 22.51 U/ml vs. 34.08 ± 21.83 U/ml,P = 0.04). Of 158 patients (85.4%) without a neurological presentation, 133 had type 1 diabetes mellitus and 20 had diabetes of other aetiologies (type 2 or gestational diabetes mellitus, or diabetes secondary to pancreatitis); the remaining four patients had pure thyroid disorders.

Conclusions

A clinical and immunological evaluation of East Asian patients positive forGAD‐abs is presented and a different clinical spectrum of anti‐GADsyndrome is identified compared to Caucasians.
Clinical efficacy of bronchodilators in equine asthma: Looking for minimal important difference
Authors: Calzetta L. , Crupi R. , Roncada P. , Pistocchini E. , di Cave D. , Rossi I. , Cito G. , Jacobson G. A. , Britti D.
Published: May 2019

Background

Airway obstruction is the main trait of severe equine asthma that affects respiratory function and elicits detrimental effects on clinical presentation. Only few and underpowered clinical studies have investigated the impact of improvement in lung function induced by bronchodilators on the clinical signs of asthma‐affected horses.

Objectives

To identify the minimal important difference (MID) in lung function elicited by bronchodilator leading to a meaningful improvement in clinical signs.

Study design

Pairwise meta‐analysis and meta‐regression analysis.

Methods

Literature searches were performed for studies that investigated the effect of bronchodilator therapy on lung function and clinical condition of asthmatic horses. The relationship between the change in lung function variables and clinical score was analysed via random‐effect meta‐regression. One‐point change of the Improved clinically Detectable Equine Asthma Scoring System (IDEASS) score was used to identify the MID.

Results

A significant (P<0.05) relationship was found between the changes in IDEASS score and maximum change in transpulmonary pressure (ΔPplmax) or pulmonary resistance (RL). Since only the model resulting for RLpassed through the origin (Y‐intercept when X = 0: −0.31, 95% CI −0.75 to 0.14), this variable was used to identify the MID correlated with a meaningful improvement in clinical signs. The resulting MID value was a change in RLof 0.63 cm H2O/L/s (95% CI 0.33–0.94), representing the slope of meta‐regression model (high quality of evidence).

Main limitations

No long‐term studies investigated the effect of bronchodilator agents on both lung function and clinical signs in asthmatic horses.

Conclusions

In conclusion, bronchodilator pharmacotherapy in equine asthma elicits clinically meaningful effect when RLincreases ≥1 cm H2O/L/s, a value indicating the MID. Assessing the MID based on change in RLmay improve the quality of evidence and the scientific impact of future clinical trials as it extends beyond the simple, and limiting, evaluation of statistical significance.
Flow‐mediated predator–prey dynamics influence fish populations in a tropical river
Authors: Turschwell Mischa P. , Stewart‐Koster Ben , King Alison J. , Pusey Brad , Crook David , Boone Edward , Douglas Michael , Allsop Quentin , Jackson Sue , Kennard Mark J.
Published: May 2019

Predator–prey interactions are an inherently local‐scale phenomenon, but the intensity of these interactions can be mediated by abiotic conditions that can exert a multi‐scaled influence through space and time. Understanding how multi‐scale abiotic factors may influence local‐scale biotic processes has proven challenging; however, the hierarchical nature of riverine flow regimes makes these environments an ideal setting to test how predator–prey relationships may vary with multi‐scaled flow variation.

We developed a series of Bayesian hierarchical models to explore how predator–prey relationships between barramundiLates calcariferand their prey may be influenced by multi‐scaled flow variables in the Daly River, northern Australia.

We found that spatio‐temporal variation in barramundi abundance was strongly related to both antecedent flow and the abundance of prey fishes (predictiver2 = 0.57), and that barramundi abundance is more likely to be influenced by bottom‐up, rather than top‐down predator–prey dynamics. We also found that the strength and direction of these relationships varied across the catchment and between seasons. We found stronger, positive relationships between barramundi abundance and prey abundance in the most downstream sites with higher mean annual flows, compared to upstream sites.

These results indicate that the abundance of predatory fishes can be related to both recent abiotic (flow) conditions and the abundance of prey (biotic conditions), and provides strong support for the importance of bottom‐up trophic dynamics. Management of iconic predators such as barramundi should therefore consider both flow management and other key factors such as habitat maintenance to support their prey.
Spleen stiffness by 2‐D shear wave elastography is the most accurate predictor of high‐risk esophagogastric varices in children with biliary atresia
Authors: Yokoyama Shinya , Ishigami Masatoshi , Honda Takashi , Kuzuya Teiji , Ishizu Yoji , Ito Takanori , Hirooka Yoshiki , Tanaka Yujiro , Tainaka Takahisa , Shirota Chiyoe , Chiba Kosuke , Uchida Hiroo , Fujishiro Mitsuhiro
Published: May 2019

Aim

Esophagogastric variceal hemorrhage is a cause of poor prognosis in patients with biliary atresia (BA). To prevent variceal hemorrhage, simple and reliable screening methods for high‐risk esophagogastric varices (HR‐EGV) are needed. We evaluated the efficacy of liver stiffness (LS) and spleen stiffness (SS) as measured by 2‐D shear wave elastography (2D‐SWE), which was reported to be more accurate than transient elastography, for detecting HR‐EGV in children with BA.

Methods

Thirty‐four children with BA were enrolled. Both LS and SS were measured by 2D‐SWE. The presence of large esophageal varices or esophageal varices of any size with red wale marking and/or the presence of gastric varices along the cardia were defined as HR‐EGV. Clinical data were collected and previously reported prediction indices for varices were calculated.

Results

Liver stiffness and SS were obtained from all patients. Fourteen patients showed HR‐EGV. Significantly different variables between patients with and without HR‐EGV were as follows: spleen diameter (116 mm vs. 95 mm), clinical prediction rule (104.7 vs. 124.7), King's variceal prediction score (78.8 vs. 99.4), aspartic aminotransferase‐to‐platelet ratio index (2.03 vs. 0.98), LS (2.63 m/s vs. 1.87 m/s), and SS (4.44 m/s vs. 3.69 m/s). The highest area under the receiver operating characteristic curve for detecting HR‐EGV was that for SS (0.900), and the cut‐off SS of 4.12 m/s yielded 92.9% sensitivity and 90% specificity. The intraclass correlation coefficient for intra‐observer reproducibility was 0.828.

Conclusions

Spleen stiffness from 2D‐SWE offered the most accurate predictor of HR‐EGV in BA children.