bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing quality fidelity and engagement measures for complex health interventions
Authors: Walton Holly , Spector Aimee , Williamson Morgan , Tombor Ildiko , Michie Susan
Published: November 2019

Objectives

To understand whether interventions are effective, we need to know whether the interventions are delivered as planned (with fidelity) and engaged with. To measure fidelity and engagement effectively, high‐quality measures are needed. We outline a five‐step method which can be used to develop quality measures of fidelity and engagement for complex health interventions. We provide examples from a fidelity study conducted within an evaluation of an intervention aimed to increase independence in dementia.

Methods

We propose five steps that can be systematically used to develop fidelity checklists for researchers, providers, and participants to measure fidelity and engagement. These steps include the following: (1) reviewing previous measures, (2) analysing intervention components and developing a framework outlining the content of the intervention, (3) developing fidelity checklists and coding guidelines, (4) obtaining feedback about the content and wording of checklists and guidelines, and (5) piloting and refining checklists and coding guidelines to assess and improve reliability.

Results

Three fidelity checklists that can be used reliably were developed to measure fidelity of and engagement with, the Promoting Independence in Dementia (PRIDE) intervention. As these measures were designed to be used by researchers, providers, and participants, we developed two versions of the checklists: one for participants and one for researchers and providers.

Conclusions

The five steps that we propose can be used to develop psychometrically robust and implementable measures of fidelity and engagement for complex health interventions that can be used by different target audiences. By considering quality when developing measures, we can be more confident in the interpretation of intervention outcomes drawn from fidelity and engagement studies.

Statement of contribution

What is already known on the subject?

Fidelity and engagement can be measured using a range of methods, such as observation and self‐report.

Studies seldom report psychometric and implementation qualities of fidelity measures.

What does this study add?

A method for developing fidelity and engagement measures for complex health interventions.

Guidance on how to consider quality when developing fidelity and engagement measures.
Rules of engagement: Reactions to internal and external criticism in public debate
Authors: Adelman Levi , Verkuyten Maykel
Published: November 2019

Since 2014, the refugee crisis has launched a political shockwave across Europe, with consequences for the European Union, the Schengen Zone, and national politics. Within this context, we investigated how public statements about the refugee crisis are received. While debate and criticism are hallmarks of a democratic society, research demonstrates that people respond more negatively to criticism about their group from an outsider compared with an insider. But does this reflect a protective bias in favour of one’s own group, or a more principled position against criticism from outsiders independently of one’s own group membership? In three experimental studies, people apply the principle of preferring internal over external criticism, even to the point of penalizing in‐group members who criticized outgroups. This preference for internal over external criticism is guided by perceptions that internal critics are more constructive and more expert than external critics.
The relationship between tax rates and tax revenues in eurozone member countries ‐ exploring the Laffer curve
Authors: Ferreira‐Lopes Alexandra , Martins Luís Filipe , Espanhol Ruben
Published: November 2019

We estimate Laffer Curves for direct and indirect taxes for each Eurozone country, using panel data from 1995 to 2011, by means of Seemingly Unrelated Regression (SUR) models. We choose the three taxes that contribute the most to the government tax revenue: the value added tax (VAT), the corporate income tax (CT), and the labour income tax (LT). From our estimated significant parameters, which have the expected signs according to the Laffer Curve theory, we obtained a maximum/optimal tax rate for VAT for Greece, Portugal, and Slovakia and for the majority of the Eurozone countries for direct taxes. We also take into consideration the business cycle. Many countries do not present differences in regime, and when they do, the optimal tax rate is higher during recessions. Finally, we compare the observed tax rates in 2012 to the estimated optimal tax rates, to assess if the 2012 policy was located at the prohibitive range of the Laffer Curve. Our results are important for the discussions about fiscal discipline and harmonization in the Eurozone, since they exhibit important disparities between countries and taxes. We can see that, especially for CT and LT, there is a strong divide between the values of the optimal maximum tax rates for Eastern European countries and Western European economies. Additionally, the economic and financial conditions of each country also influence the value for the tax rate.
Dietary fat and obesity as modulators of breast cancer risk: Focus on DNA methylation
Authors: Donovan Micah G. , Wren Spencer N. , Cenker Mikia , Selmin Ornella I. , Romagnolo Donato F.
Published: November 2019

Breast cancer (BC) is the most common cancer and second leading cause of cancer mortality in women worldwide. Validated biomarkers enhance efforts for early detection and treatment, which reduce the risk of mortality. Epigenetic signatures have been suggested as good biomarkers for early detection, prognosis and targeted therapy of BC. Here, we highlight studies documenting the modifying effects of dietary fatty acids and obesity on BC biomarkers associated with DNA methylation. We focus our analysis on changes elicited in writers of DNA methylation (i.e., DNA methyltransferases), global DNA methylation and gene‐specific DNA methylation. To provide context, we precede this discussion with a review of the available evidence for an association between BC incidence and both dietary fat consumption and obesity. We also include a review of well‐vetted BC biomarkers related to cytosine‐guanine dinucleotides methylation and how they influence BC risk, prognosis, tumour characteristics and response to treatment.

Linked Articles

This article is part of a themed section on The Pharmacology of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.6/issuetoc
Rethinking economic development
Authors: Nunn Nathan
Published: November 2019

I provide a summary, reflection and assessment of the current state of economic development in both the policy and academic worlds. In terms of development policy, currently, the primary focus is on policy interventions, namely, foreign aid, aimed at fixing the “deficiencies” of developing countries. Academic research also has a similar focus, except with an emphasis in rigorous evaluation of interventions to estimate causal effects. A standard set of versatile quantitative tools is used, e.g., experimental and quasi‐experimental methods, which can be easily applied in a range of settings to estimate the causal effects of policies, which are typically presumed to be similar across contexts. In this article, I take a step back and ask whether the current practices are the best that we can do. Are foreign aid and policy interventions the best options we have for poverty alleviation? What else can be done? Is our current research strategy, characterized by rigorous but a lack of context‐specific analysis, the best method of analysis? Is there a role for other research methods, for a deeper understanding of the local context and for more collaboration with local scholars?
Reconciliation and the Representation of Indigenous Peoples in Introductory Sociology Textbooks
Authors: Carroll Michael P.
Published: November 2019

The Truth and Reconciliation Commission has indicated that education has a central role to play in the reconciliation process. This article assesses how well sociology is doing in this regard by looking at what introductory textbooks say about three topics: (1) residential schools, (2) Indigenous “religion;” and (3) the social construction of Indigenous identities. The findings are mixed. While most textbooks mention the “loss of culture” and the abuse associated with those schools, discussions of intergenerational trauma could be much improved. Discussions of Indigenous religion are still guided by a Western model that has long been regarded as inappropriate to Indigenous cultures. All textbooks ignore the ways in which Indigenous identities are socially constructed and how this is linked to the dramatic growth of the Indigenous population over the last several decades. A concluding section draws upon the work of Indigenous scholars in suggesting ways of decolonizing textbooks.
The Linguistic Continuity of Ontario's Minority Francophone Population: Examining the Relationship between Culture and Linguistic Practices
Authors: Nault Jean‐François
Published: November 2019

Despite decades of policy aimed at the maintenance of Francophone communities in Ontario, the proportion of individuals with French as a mother tongue or who speak French most often at home has steadily declined. Research on language retention has highlighted the importance of sociodemographic and structural factors in understanding minority language practices. However, given the relationship between culture and action, this paper examines how cultural factors contribute to Franco‐Ontarians’ linguistic practices. Results indicate that beyond couple composition and the concentration of minority‐language speakers, cultural factors including identity, cultural consumption, and values play an instrumental role in Franco‐Ontarians’ linguistic continuity. The importance of considering linguistic continuity as part of a “package” of cultural practices is discussed.
Cerebellar ataxia with normal intellect associated with a homozygous truncating variant in CA8
Authors: Richmond Christopher M. , Leventer Richard , Ryan Monique M. , Delatycki Martin B.
Published: November 2019

Biallelic pathogenic variants in CA8 cause cerebellar ataxia, mental retardation and dysequilibrium syndrome 3 (CAMRQ3), a rare form of hereditary ataxia characterised by cerebellar hypoplasia/atrophy, variable intellectual disability and often quadrupedal gait. The few cases reported in the medical literature are all caused by pathogenic homozygous or compound heterozygous missense variants in CA8. We report a 9 year‐old boy with marked gross motor delay, ataxia and progressive cerebellar atrophy with limited bipedal gait, but without intellectual disability. Singleton whole exome sequencing was performed. A novel homozygous truncating variant in CA8 (c.232C>T) with a predicted premature termination codon at position 78 (p.Arg78*) was identified. Both parents and the proband's healthy sister are heterozygous for the variant. This variant is likely pathogenic and the cause of the condition in this child. Functional evidence in the form of a spontaneous mouse model involving homozygous intragenic deletion of the mouse analogue of CA8 with nonsense‐mediated decay and similar clinical features to the proband support pathogenicity. Identification of this truncating variant broadens the genotypic and phenotypic spectrum of CA8‐related cerebellar ataxia.
Incidence and prevalence of peri‐implantitis and peri‐implant mucositis 17 to 23 (18.9) years postimplant placement
Authors: Krebs Mischa , Kesar Nikolina , Begić Amira , von Krockow Nadine , Nentwig Georg‐Hubertus , Weigl Paul
Published: November 2019

Purpose

To evaluate the prevalence of peri‐implantitis (PI) and peri‐implant mucositis (PM) in a long‐term follow‐up with comparison among different PI and PM definitions, and to report on the incidence of PI.

Materials and Methods

In a retrospective clinical study five different PI and PM definitions were applied onto a population with 274 implants 17 to 23 years postimplant placement. Recommendations by the Eighth European Workshop on Periodontology (EWOP) were used as base reference. Clinical and radiological measurements were considered. Risk factors were evaluated in a regression analysis.

Results

After an average observation period of 18.9 years, 40.1% of the implants were diagnosed with PM and 15.0% with PI (Eighth EWOP). PI incidence reached 7.9% on implant level and 13.2% on patient level. Implants diagnosed with PI and progressive bone loss displayed exceptionally vertical bone defect configuration (BDC). Diabetes mellitus, smoking, regular maintenance, or a former periodontal infection did not show significant influence on the prevalence of peri‐implant diseases. Patients with bruxism displayed significantly less PM and PI.

Conclusions

Vertical BDC seems to correspond with active PI, wherefore we estimate such a defining factor of importance. Diagnosis of PM and evaluation of probing pocket depths might be only of descriptive interest as they could lead to false‐positive results.
Odors Can Serve as Landmarks in Human Wayfinding
Authors: Hamburger Kai , Knauff Markus
Published: November 2019

Scientists have shown that many non‐human animals such as ants, dogs, or rats are very good at using smells to find their way through their environments. But are humans also capable of navigating through their environment based on olfactory cues? There is not much research on this topic, a gap that the present research seeks to bridge. We here provide one of the first empirical studies investigating the possibility of using olfactory cues as landmarks in human wayfinding. Forty subjects participated in a piloting study to determine the olfactory material for the main experiment. Then, 24 subjects completed a wayfinding experiment with 12 odors as orientation cues. Our results are astonishing: Participants were rather good at what we call “odor‐based wayfinding.” This indicates that the ability of humans to use olfactory cues for navigation is often underestimated. We discuss two different cognitive explanations and rule out the idea that our results are just an instance of sequential learning. Rather, we argue that humans can enrich their cognitive map of the environment with olfactory landmarks and may use them for wayfinding.
AS1411 aptamer modified carbon dots via polyethylenimine‐assisted strategy for efficient targeted cancer cell imaging
Authors: Kong Tingting , Zhou Ronghui , Zhang Yujun , Hao Liying , Cai Xiaoxiao , Zhu Bofeng
Published: November 2019

Objectives

Carbon dots (CDs), as a fascinating class of fluorescent carbon nanomaterials, have been proven to be powerful tools in the field of bioimaging and biosensing due to their small size, suitable photostability and favourable biocompatibility. However, the cellular uptake of free CDs lacks selectivity and the same negative charges as cell membranes may cause inefficient cell internalization. In this study, an efficient detecting and targeting nanosystem was developed based on the DNA aptamer AS1411 modified CDs with polyethyleneimine (PEI) as connecting bridge.

Materials and methods

Hydrothermally prepared CDs were assembled with positive‐charged PEI, followed by conjugation with AS1411 through electrostatic interaction to form CDs‐PEI‐AS1411 nanocomplexes. The CDs, CDs‐PEI and CDs‐PEI‐AS1411 were characterized by transmission electron microscopy (TEM), fourier transform infrared (FTIR) spectra, UV–vis spectra, zeta potential measurements and capillary electrophoresis characterizations. The cytotoxicity investigation of the CDs‐PEI‐AS1411 and CDs‐PEI in both MCF‐7 and L929 cells was carried out by the CCK‐8 assay. The cellular uptake of the CDs‐PEI‐AS1411 was studied with confocal microscopy and flow cytometry.

Results

The as‐prepared nanosystem possessed good photostability and no obvious cytotoxicity. On the basis of the confocal laser scanning microscope observation and the flow cytometry studies, the cellular uptake of CDs‐PEI‐AS1411 nanosystem in MCF‐7 cells was significantly higher than that of L929 cells, which revealed the highly selective detection ability of nucleolin‐positive cells.

Conclusions

The results of this study indicated that the CDs‐PEI‐AS1411 nanosystem had a potential value in cancer cell targeted imaging.
Continuous‐flow mechanical circulatory support is not associated with early graft failure: An analysis of the International Society for Heart and Lung Transplantation registry
Authors: Clerkin Kevin J. , Mancini Donna M. , Stehlik Josef , Cherikh Wida S. , Lund Lars H.
Published: November 2019

Background

Continuous‐flow mechanical circulatory support (CF‐MCS) is associated with impaired vascular function and increased risk of vasoplegia. One contributing factor to early graft failure (EGF) is severe vasoplegia. We tested the hypothesis that CF‐MCS is associated with increased risk of EGF.

Methods

Adult primary heart transplant recipients in the ISHLT Registry from 2005 to 2013 were stratified into three groups based on pre‐transplant MCS: No MCS (n = 11 748), pulsatile (P)‐MCS (n = 718), and CF‐MCS (n = 3818). EGF was defined as death/retransplantation due to graft failure within 30 days after HT. Comparisons were made using descriptive statistics and associations. EGF was assessed with multivariable Cox proportional hazard regression.

Results

The incidence of EGF within 30 days was similar between groups (No MCS 2.2%, P‐MCS 3.3%, CF‐MCS 2.1%, P = .10). Following multivariable adjustment, the risk of EGF was not statistically different for those with CF‐MCS compared with P‐MCS (HR 0.75, 95% CI 0.46‐1.21, P = .24). The risk of EGF was numerically, but not statistically significantly higher for CF‐MCS compared with No MCS (HR 1.24, 95% CI 0.92‐1.67, P = .16).

Conclusion

CF‐MCS use was not associated with a statistically significant increased risk of EGF resulting in death or retransplantation in the first 30 days after transplant.
Methicillin‐resistant Staphylococcus aureus carriers are vulnerable to bloodstream infection after living donor liver transplantation
Authors: Takemura Yusuke , Hibi Taizo , Shinoda Masahiro , Obara Hideaki , Minagawa Takuya , Kitago Minoru , Yagi Hiroshi , Abe Yuta , Matsubara Kentaro , Oshima Go , Hori Shutaro , Hoshino Ken , Yamada Yohei , Itano Osamu , Takano Yaoko , Kuroda Tatsuo , Hasegawa Naoki , Kitagawa Yuko
Published: November 2019

Background

Bloodstream infection (BSI) is a life‐threatening complication after living donor liver transplantation (LDLT). We aimed to explore the incidence and predisposing factors of BSI at our institution.

Methods

We conducted a retrospective cohort analysis on all consecutive adults with BSI within 6 months after LDLT performed between 2005 and 2016. For antimicrobial prophylaxis, ampicillin/sulbactam, cefotaxime, and micafungin were administered. From 2011, methicillin‐resistant Staphylococcus aureus (MRSA) carriers were decolonized using mupirocin ointment and chlorhexidine gluconate soap. Risk factors for BSI were identified by uni‐ and multivariate logistic regression.

Results

Of a total of 106 LDLTs, 42 recipients (40%) suffered BSI. The BSI group demonstrated significantly higher in‐hospital mortality rates compared with the non‐BSI group (24% vs. 7%, P = .01). We identified MRSA carrier (odds ratio [OR], 19.1; P < .001), ABO incompatibility (OR, 2.9; P = .03), and estimated glomerular filtration rate <30 mL/min/1.73m2 (OR, 15.8; P = .02) as independent risk factors for BSI. Decolonization treatment for MRSA carriers did not reduce the incidence of all‐cause BSI but reduced the frequency of BSI caused by MRSA.

Conclusion

To our knowledge, for the first time, MRSA carriers were revealed to be highly vulnerable to BSI after LDLT.
Dosage Regimens for Meropenem in Children with Pseudomonas Infections Do Not Meet Serum Concentration Targets
Authors: Hassan Hazem E. , Ivaturi Vijay , Gobburu Jogarao , Green Thomas P.
Published: November 2019

There have been literature reports that some recommended meropenem dosage regimens may fail to meet therapeutic targets in some high‐risk children and adults. We evaluated this observation in children using literature studies conducted in infants and children. Observed and, as necessary, simulated data from the literature were combined, yielding a data set of 288 subjects (1 day to ~ 17 years). A population pharmacokinetic model was fit to the data and then used to simulate the recommended dosing regimens and estimate the proportion of subjects achieving recommended target exposures. A two‐compartment model best fit the data with weight, postnatal age, gestational age, and serum creatinine as covariates. The US Food and Drug Administration (FDA)‐approved dosing regimens achieved targets in ~ 90% or more of subjects less than 3 months of age for organisms with minimum inhibitory concentration (MIC)'s of 2 and 4 mg/L; however, only 68.4% and 41.7% of subjects older than 3 months and weighing < 50 kg achieved target exposures for organisms with MIC's of 2 and 4 mg/L, respectively [Correction added on January 23, 2020, after first online publication: "> 3 months" corrected to "less than 3 months".]. Moreover, for subjects weighing more than 50 kg, only 41.3% and 17% achieved these respective targets. Simulation studies were used to explore the impact of changing dose, dosing interval, and infusion duration on the likelihood of achieving therapeutic targets in these groups. Our findings illustrate that current dosing recommendations for children over 3 months of age fail to meet therapeutic targets in an unacceptable fraction of patients. Further investigation is needed to develop new dosing strategies in these patients.
A Network Meta‐Analysis of Efficacy of Different Interventions in the Prevention of Postoperative Intrauterine Adhesions
Authors: Xiong Qian , Zhang Tiansong , Su Shujun
Published: November 2019

This network meta‐analysis was conducted to compare the efficacy of six interventions, including anti‐blocking agents, intrauterine contraceptive devices (IUDs), estrogens, intrauterine balloon, Foley catheter, and amnion graft for the prevention of intrauterine adhesions (IUAs). We searched PubMed, Embase, and Cochrane Library from inception to December 2016. Cohort studies meeting these six interventions in the prevention of IUAs were included. The combination of direct and indirect evidence was conducted to assess the odds ratio (OR) or weighted mean differences and surface under the cumulative ranking curves of the six interventions in the prevention of postoperative IUAs. Finally, 12 eligible cohort studies were included in this network meta‐analysis. The results of this network meta‐analysis demonstrated that during 1 to 2 months after operation, compared with the surgical group, anti‐blocking agent, and estrogens presented with relatively low ratios of postoperative IUAs (OR = 0.30 95% confidence interval (CI) = 0.10–0.67; OR = 0.12, 95% CI = 0.01–0.78, respectively). Compared with IUDs, estrogens exerted comparatively low ratio of postoperative IUAs (OR = 0.10, 95% CI = 0.01–0.90), which indicated that anti‐blocking agent and estrogens had relatively better prevention efficacy. The cluster analysis showed that estrogens had relatively better efficacy in the prevention postoperative IUAs. Overall, our findings support that estrogens had relatively better efficacy in the prevention of postoperative IUAs.
Melanocytic aggregates with unique morphology associated with regression of basal cell carcinoma
Authors: Jackson Christopher R. , Sriharan Aravindhan , Momtahen Shabnam , Seidel Gregory D. , Felty Cameron C. , Ruby Kristen N. , Yan Shaofeng
Published: November 2019

Background

Spontaneous regression of basal cell carcinomas (BCC) is a well‐documented phenomenon. In practice, we have observed melanocytic aggregates associated with BCC at various stages of regression showing unique morphologic features.

Methods

Fourteen cases featuring melanocytic aggregates were retrospectively identified through a pathology database search. Clinical and histopathologic features were systematically evaluated, and additional immunohistochemical studies were performed. Melanocyte density within tumor nodules was compared to a group of control BCCs.

Results

All cases showed BCC at various stages of regression with associated melanocytic aggregates, as highlighted by Melan‐A and SOX10 immunostains. Three of 14 cases (21.4%) had only dermal melanocytic nests, while 11 (78.6%) had both junctional and dermal nests. The melanocytic aggregates all had similar asymmetrical architecture and lacked maturation. The melanocytes were small, uniform, bland, and had minimal cytoplasm. Their nuclei were overlapping and hyperchromatic, and had inconspicuous nucleoli. None of the melanocytic aggregates stained for BRAFV600E by immunohistochemistry. No patient developed a recurrent or metastatic melanocytic lesion (median follow‐up 42 months). Melanocyte density was higher in the case series than in the control BCCs (P = 0.0008).

Conclusion

We described the unique morphology of melanocytic aggregates associated with BCC regression.
917. CORETHROGYNE FILAGINIFOLIA
Authors: Hind Nicholas
Published: November 2019

Corethrogyne filaginifolia (Hook. & Arn.) Nutt. (Compositae: Astereae: Machaerantherinae) is illustrated and described. The full synonymy of this monospecific North American genus is provided together with the location of known type material and relevant comments made where applicable. The Conservation Status of the species is considered LC (Least Concern), as previous listings in California are shown to refer to Corethrogyne filaginifolia (Hook. & Arn.) var. incana (Lindl.) D.R. Morgan & R.L. Hartman, which is now considered a synonym of the rather variable Dieteria canescens (Pursh) Nutt. The taxonomic placement of Diplopappus incanus Lindl. is discussed, and a synonymy has been provided for Dieteria canescens subsp. canescens var. incana (Lindl.) D.R. Morgan & R.L. Hartman, of which it is the basionym. The location of the probable holotype of Diplopappus leucophyllus Lindl. ex DC. is discussed, together with the relevance of material mounted on a Kew sheet.
919. ANTHEMIS MARSCHALLIANA
Authors: Hind Nicholas , Broome Jeremy
Published: November 2019

Anthemis marschalliana Willd. (Compositae: Anthemideae: Anthemidinae) is described and illustrated, a full synonymy provided and its present taxonomic position discussed, especially the choice of this as the current name, and not Archanthemis marschalliana (Willd.) Lo Presti & Oberpr. The type collections of the accepted name and one synonym are compared as both honour the same person, Marschall von Bieberstein. Cultivation requirements are also outlined, with some commentary on the pests that are sometimes an issue. Cultivation and propagation requirements are outlined, and the availability of the species noted.
920. CONSTANCEA NEVINII
Authors: Hind Nicholas , Strange Kit
Published: November 2019

Constancea nevinii (A. Gray) B.G. Baldwin (Compositae: Heliantheae: Baeriinae) is described and illustrated. The distribution of the species in, and a glimpse at the history and endemic flora of, the California Channel Islands (also known as the Santa Barbara Islands), together with the conservation threats posed by feral goats, is outlined. The historically variable Conservation Status is commented on, although the species is no longer considered under threat of extinction. The position of this monotypic genus in the Heliantheae is commented on. Cultivation, propagation, and availability notes are provided. The species is rarely cultivated in the United Kingdom, but clearly widely so in the western States along the Californian coast.
Artificial neural network model to distinguish pleomorphic adenoma from adenoid cystic carcinoma on fine needle aspiration cytology
Authors: Kapatia Gargi , Dey Pranab , Saikia Uma Nahar
Published: November 2019

Background

To differentiate pleomorphic adenoma (PA) and adenoid cystic carcinoma (ACC) on fine needle aspiration cytology (FNAC) is often challenging to cytologists.

Aims

In the present study, we tried to make an artificial neural network (ANN) model from the FNAC smears to differentiate PA from ACC.

Methods

The detailed cytomorphological features were analysed on the FNAC of histopathology proven cases of PA (n = 35) and ACC (n = 33) and enumerated semi‐quantitatively by two independent observers. These data were used to make an ANN model to distinguish PA from ACC on FNAC material. We used neuro‐intelligence software to build the ANN model. The network architecture was 10‐2‐1. The heuristic search engine was applied to have this model. We used backpropagation neural network to teach ANN. At least 500 iterations were done to train the model. The efficacy of this ANN model was assessed with the help of the confusion matrix and receiver operating characteristic curve.

Result

The data were separated automatically by the software as a training set (n = 48), validation set (n = 10) and test set (n = 10). The ANN model was able to differentiate every case (10/10) of PA and ACC in the final test set. The area under the receiver operating characteristic curve was 1.

Conclusion

The currently built ANN model is competent to identify PA and ACC cases on FNAC. Additional parameters and new cases can be incorporated into this open‐ended ANN model to make it more robust.
Is there an increased risk of perinatal mental disorder in women with gestational diabetes? A systematic review and meta‐analysis
Authors: Wilson C. A. , Newham J. , Rankin J. , Ismail K. , Simonoff E. , Reynolds R. M. , Stoll N. , Howard L. M.
Published: November 2019

Aim

Gestational diabetes (GDM) and mental disorder are common perinatal morbidities and are associated with adverse maternal and child outcomes. While there is a relationship between type 2 diabetes and mental disorder, the relationship between GDM and mental disorder has been less studied. We conducted a systematic review and meta‐analysis of the prevalence of mental disorders in women with GDM and their risk for mental disorders compared with women without GDM.

Methods

Published, peer‐reviewed literature measuring prevalence and/or odds of GDM and perinatal mental disorders was reviewed systematically. Risk of bias was assessed using a checklist. Two independent reviewers were involved. Analyses were grouped by stage of peripartum, i.e. antepartum at the time of GDM diagnosis and after diagnosis, and in the postpartum.

Results

Sixty‐two studies were included. There was an increased risk of depressive symptoms in the antenatal period around the time of diagnosis of GDM [odds ratio (OR) 2.08; 95% confidence interval (CI) 1.42, 3.05] and in the postnatal period (OR 1.59; 95% CI 1.26, 2.00).

Conclusions

Given the potential relationship between GDM and perinatal mental disorders, integration of physical and mental healthcare in women experiencing GDM and mental disorders could improve short‐ and long‐term outcomes for women and their children.
Rationale, study design and methodology of the LANDMARC trial: a 3‐year, pan‐India, prospective, longitudinal study to assess management and real‐world outcomes of diabetes mellitus
Authors: Das A. K. , Mithal A. , Kumar K. M. P. , Unnikrishnan A. G. , Kalra S. , Thacker H. , Sethi B. , Ghosh R. , Mathew A. , Chodankar D. , Mohanasundaram S. , Menon S. K. , Trivedi C. , Naqvi M. , Kanade V. , Salvi V. , Chatterjee G. , Rais N. , Wangnoo S. K. , Chowdhury S. , Zargar A. H. , Joshi S.
Published: November 2019

Aim

India contributes towards a large part of the worldwide epidemic of diabetes and its associated complications. However, there are limited longitudinal studies available in India to understand the occurrence of diabetes complications over time. This pan‐India longitudinal study was initiated to assess the real‐world outcomes of diabetes across the country.

Methods

The LANDMARC study is the first prospective, multicentre, longitudinal, observational study investigating a large cohort of people with type 2 diabetes mellitus across India over a period of 3 years. The primary objective of this ongoing study is to determine the proportion of people developing macrovascular diabetes complications over the duration of the study (36 months ± 45 days) distributed over seven visits; the secondary objective is to evaluate microvascular diabetes complications, glycaemic control and time‐to‐treatment adaptation or intensification. Overall, 6300 participants (aged 25–60 years) diagnosed with type 2 diabetes for at least 2 years will be included from 450 centres across India. Data will be recorded for baseline demographics, comorbidities, glycaemic measurements, use of anti‐hyperglycaemic medications and any cardiovascular or other diabetes‐related events occurring during the observational study period.

Conclusions

The LANDMARC study is expected to reveal the trends in complications associated with diabetes, treatment strategies used by physicians, and correlation among treatment, control and complications of diabetes within the Indian context. The findings of this study will help to identify the disease burden, emergence of early‐onset complications and dose titration patterns, and eventually develop person‐centred care and facilitate public health agencies to invest appropriate resources in the management of diabetes. (Trial Registration No: CTRI/2017/05/008452).
Efficacy and safety of MYL‐1501D versus insulin glargine in people with type 1 diabetes mellitus: Results of the INSTRIDE 3 phase 3 switch study
Authors: Blevins Thomas C. , Barve Abhijit , Raiter Yaron , Aubonnet Patrick , Athalye Sandeep , Sun Bin , Muniz Rafael
Published: November 2019

Aims

To assess the efficacy, insulin dose, safety and immunogenicity when people with type 1 diabetes mellitus switched between MYL‐1501D and reference insulin glargine (Lantus®; Sanofi‐Aventis US LLC, Bridgewater, New Jersey).

Materials and methods

Eligible participants from INSTRIDE 1 who completed 52 weeks of reference insulin glargine treatment were randomized 1:1 to the reference sequence (n = 63; reference insulin glargine for 36 weeks) or to the treatment‐switching sequence (n = 64; MYL‐1501D [weeks 0–12], reference insulin glargine [weeks 12–24] and MYL‐1501D [weeks 24–36]). Change in glycated haemoglobin (HbA1c) from baseline to week 36 was the primary efficacy endpoint used to demonstrate equivalence between the two treatment sequences. Secondary endpoints included: change in fasting plasma glucose (FPG), self‐monitored blood glucose (SMBG) and insulin dose; immunogenicity; and adverse events, including hypoglycaemia.

Results

Mean changes in HbA1c (least squares [LS] mean [SE]) from baseline to week 36 were −0.05 (0.032) and −0.06 (0.034) for the treatment‐switching and reference sequences, respectively (LS mean difference 0.01 [95% CI −0.085 to 0.101]). Treatment sequences were comparable in terms of secondary endpoints, including FPG, SMBG and insulin dose, and the safety and immunogenicity profiles of the two sequences were similar.

Conclusions

Switching participants between MYL‐1501D and reference insulin glargine demonstrated equivalent efficacy and similar safety and immunogenicity, showing that people taking reference insulin glargine can safely switch to MYL‐1501D.
Exenatide and dapagliflozin combination improves markers of liver steatosis and fibrosis in patients with type 2 diabetes
Authors: Gastaldelli Amalia , Repetto Enrico , Guja Cristian , Hardy Elise , Han Jenny , Jabbour Serge A. , Ferrannini Ele
Published: November 2019

Aim

To assess the efficacy of exenatide (EXE) once weekly + dapagliflozin once daily (DAPA) versus each drug alone in reducing biomarkers of fatty liver/steatosis and fibrosis in a post hoc analysis of DURATION‐8, a 104‐week study in 695 patients with type 2 diabetes uncontrolled by metformin monotherapy.

Materials and methods

We evaluated the impact of the study treatments on non‐invasive markers of hepatic steatosis (fatty liver index [FLI] and non‐alcoholic fatty liver disease [NAFLD] liver fat score), fibrosis (fibrosis‐4 index [FIB‐4]) and severe fibrosis (NAFLD fibrosis score), along with liver enzymes and insulin resistance, at weeks 28 and 52. All outcomes in this analysis were exploratory, with nominal P values reported.

Results

At week 28, biomarkers of fatty liver/steatosis and fibrosis were reduced from baseline in all treatment groups. At week 28, EXE once weekly + DAPA effects for decrease in FLI were stronger than those of EXE once weekly + placebo (PLB; −2.92, 95% confidence interval [CI] −5.11, −0.73; P = 0.0092) or DAPA+PLB (−2.77 [95% CI −4.93, −0.62]; P = 0.0119), and stronger than those of EXE once weekly + PLB at week 52 (−3.23 [95% CI −5.79, −0.68]; P = 0.0134). FIB‐4 showed reduction versus baseline only in the EXE once weekly + DAPA group at both week 28 (−0.06 [95% CI −0.11, −0.01]; P = 0.0135) and week 52 (−0.05 [95% CI −0.09, −0.004]; P = 0.0308).

Conclusions

The EXE once weekly + DAPA combination showed stronger effects than EXE once weekly + PLB or DAPA + PLB in ameliorating markers of hepatic steatosis and fibrosis in patients with type 2 diabetes. Prospective trials are needed to validate these findings.
Incorporating intraspecific variation into species distribution models improves distribution predictions, but cannot predict species traits for a wide‐spread plant species
Authors: Chardon Nathalie Isabelle , Pironon Samuel , Peterson Megan Lynn , Doak Daniel Forest
Published: November 2019

The most common approach to predicting how species ranges and ecological functions will shift with climate change is to construct correlative species distribution models (SDMs). These models use a species’ climatic distribution to determine currently suitable areas for the species and project its potential distribution under future climate scenarios. A core, rarely tested, assumption of SDMs is that all populations will respond equivalently to climate. Few studies have examined this assumption, and those that have rarely dissect the reasons for intraspecific differences. Focusing on the arctic‐alpine cushion plant Silene acaulis, we compared predictive accuracy from SDMs constructed using the species’ full global distribution with composite predictions from separate SDMs constructed using subpopulations defined either by genetic or habitat differences. This is one of the first studies to compare multiple ways of constructing intraspecific‐level SDMs with a species‐level SDM. We also examine the contested relationship between relative probability of occurrence and species performance or ecological function, testing if SDM output can predict individual performance (plant size) and biotic interactions (facilitation). We found that both genetic‐ and habitat‐informed SDMs are considerably more accurate than a species‐level SDM, and that the genetic model substantially differs from and outperforms the habitat model. While SDMs have been used to infer population performance and possibly even biotic interactions, in our system these relationships were extremely weak. Our results indicate that individual subpopulations may respond differently to climate, although we discuss and explore several alternative explanations for the superior performance of intraspecific‐level SDMs. We emphasize the need to carefully examine how to best define intraspecific‐level SDMs as well as how potential genetic, environmental, or sampling variation within species ranges can critically affect SDM predictions. We urge caution in inferring population performance or biotic interactions from SDM predictions, as these often‐assumed relationships are not supported in our study.
NicheMapR – an R package for biophysical modelling: the ectotherm and Dynamic Energy Budget models
Authors: Kearney Michael R. , Porter Warren P.
Published: November 2019

Mechanistic niche models characterise the fundamental niche of an organism by determining thermodynamic constraints on its heat, water and nutritional budget, and the consequences of this for growth, development and reproduction. They can thus quantify constraints on survival, activity and, ultimately, the vital rates that determine population growth, given a sequence of environmental conditions and the key morphological, physiological and behavioural functional traits.

Here we introduce and document the ectotherm model of NicheMapR, an R package that includes a suite of programs for the mechanistic modelling of heat, water, energy and mass exchange between any kind of ectothermic organism and its environment. The NicheMapR ectotherm model is based on a Fortran program originally developed by Porter, Mitchell and Beckman for predicting core body temperature and evaporative water loss as a function of microclimatic conditions and behavioural thermoregulation. The model includes routines for computing steady state body temperature and evaporative water loss given two extreme microclimates (minimum and maximum shade) as computed by the NicheMapR microclimate model. Behavioural options include posture and colour change, shade‐seeking, panting, climbing and retreating underground.

Here we configure the program to be called from R as part of the NicheMapR package and describe the model in detail including new functionality for modelling whole life‐cycle energy and water budgets using Dynamic Energy Budget theory. We include scripts for core operation of the ectotherm model as well as stand‐alone R scripts for running the DEB model. Example applications are provided in the paper and in the associated vignettes. The integrated microclimate and ectotherm models should provide a strong thermodynamic basis for determining the effects of environmental change on the behaviour, distribution and abundance of ectothermic organisms.
Italian consensus recommendations for a biomarker‐based aetiological diagnosis in mild cognitive impairment patients
Authors: Boccardi M. , Nicolosi V. , Festari C. , Bianchetti A. , Cappa S. , Chiasserini D. , Falini A. , Guerra U.P. , Nobili F. , Padovani A. , Sancesario G. , Morbelli S. , Parnetti L. , Tiraboschi P. , Muscio C. , Perani D. , Pizzini F.B. , Beltramello A. , Salvini Porro G. , Ciaccio M. , Schillaci O. , Trabucchi M. , Tagliavini F. , Frisoni G.B.
Published: November 2019

Background and purpose

Biomarkers support the aetiological diagnosis of neurocognitive disorders in vivo. Incomplete evidence is available to drive clinical decisions; available diagnostic algorithms are generic and not very helpful in clinical practice. The aim was to develop a biomarker‐based diagnostic algorithm for mild cognitive impairment patients, leveraging on knowledge from recognized national experts.

Methods

With a Delphi procedure, experienced clinicians making variable use of biomarkers in clinical practice and representing five Italian scientific societies (neurology – Società Italiana di Neurologia per le Demenze; neuroradiology – Associazione Italiana di Neuroradiologia; biochemistry – Società Italiana di Biochimica Clinica; psychogeriatrics – Associazione Italiana di Psicogeriatria; nuclear medicine – Associazione Italiana di Medicina Nucleare) defined the theoretical framework, relevant literature, the diagnostic issues to be addressed and the diagnostic algorithm. An N–1 majority defined consensus achievement.

Results

The panellists chose the 2011 National Institute on Aging and Alzheimer's Association diagnostic criteria as the reference theoretical framework and defined the algorithm in seven Delphi rounds. The algorithm includes baseline clinical and cognitive assessment, blood examination, and magnetic resonance imaging with exclusionary and inclusionary roles; dopamine transporter single‐photon emission computed tomography (if no/unclear parkinsonism) or metaiodobenzylguanidine cardiac scintigraphy for suspected dementia with Lewy bodies with clear parkinsonism (round VII, votes (yes‐no‐abstained): 3‐1‐1); 18F‐fluorodeoxyglucose positron emission tomography for suspected frontotemporal lobar degeneration and low diagnostic confidence of Alzheimer’s disease (round VII, 4‐0‐1); cerebrospinal fluid for suspected Alzheimer’s disease (round IV, 4‐1‐0); and amyloid positron emission tomography if cerebrospinal fluid was not possible/accepted (round V, 4‐1‐0) or inconclusive (round VI, 5‐0‐0).

Conclusions

These consensus recommendations can guide clinicians in the biomarker‐based aetiological diagnosis of mild cognitive impairment, whilst guidelines cannot be defined with evidence‐to‐decision procedures due to incomplete evidence.
Scalp EEG spikes predict impending epilepsy in TSC infants: A longitudinal observational study
Authors: Wu Joyce Y. , Goyal Monisha , Peters Jurriaan M. , Krueger Darcy , Sahin Mustafa , Northrup Hope , Au Kit S. , O’Kelley Sarah , Williams Marian , Pearson Deborah A. , Hanson Ellen , Byars Anna W. , Krefting Jessica , Beasley Mark , Cutter Gary , Limdi Nita , Bebin E. Martina
Published: November 2019

Objective

To determine if routine electroencephalography (EEG) in seizure‐naive infants with tuberous sclerosis complex (TSC) can predict epilepsy and subsequent neurocognitive outcomes.

Methods

Forty infants 7 months of age or younger and meeting the genetic or clinical diagnostic criteria for tuberous sclerosis were enrolled. Exclusion criteria included prior history of seizures or treatment with antiseizure medications. At each visit, seizure history and 1‐hour awake and asleep video‐EEG, standardized across all sites, were obtained until 2 years of age. Developmental assessments (Mullen and Vineland‐II) were completed at 6, 12, and 24 months of age.

Results

Of 40 infants enrolled (mean age of 82.4 days), 32 completed the study. Two were lost to follow‐up and six were treated with antiepileptic drugs (AEDs) due to electrographic seizures and/or interictal epileptiform discharges (IEDs) on their EEG studies prior to the onset of clinical seizures. Seventeen of the 32 remaining children developed epilepsy at a mean age of 7.5 months (standard deviation [SD] = 4.4). Generalized/focal slowing, hypsarrhythmia, and generalized/focal attenuation were not predictive for the development of clinical seizures. Presence of IEDs had a 77.3% positive predictive value and absence a 70% negative predictive value for developing seizures by 2 years of age. IEDs preceded clinical seizure onset by 3.6 months (mean). Developmental testing showed significant decline, only in infants with ongoing seizures, but not infants who never developed seizures or whose seizures came under control.

Significance

IEDs identify impending epilepsy in the majority (77%) of seizure‐naive infants with TSC. The use of a 1‐hour awake and asleep EEG can be used as a biomarker for ongoing epileptogenesis in most, but not all, infants with TSC. Persistent seizures, but not history of interictal epileptiform activity or history of well‐controlled seizures, correlated with low scores on the Vineland and Mullen tests at 2 years of age.
Managerial incentives for attracting attention
Authors: Gutiérrez María , Papiashvili Nino , Tribó Josep A. , Vazquez Antonio B.
Published: November 2019

This paper studies the mechanisms which motivate managers to engage in cheap talk and attract the market's attention in a credible way. We consider stock split announcements, voluntary earnings forecasts, and press releases issued by firms to the media as proxies for managerial cheap talk. We show that: (a) managerial performance‐related pay contracts incentivize executives to attract attention; (b) analysts increase their coverage of firms following cheap talk; and (c) chief executive officers are punished for attracting attention when market prices do not increase following cheap talk. The results are stronger for firms which are most in need of attention.