bluuebunny/crossref_metadata_2025 huggingface dataset:
LEAPing through the looking glass: secondary analysis of the effect of skin test size and age of introduction on peanut tolerance after early peanut introduction
Authors: Greenhawt M. , Fleischer D. M. , Chan E. S. , Venter C. , Stukus D. , Gupta R. , Spergel J. M.
Published: November 2016

Background

In the Learning Early About Peanut Allergy (LEAP) study, early peanut introduction in high‐risk 4‐ to 11‐month‐olds was associated with a significantly decreased risk of developing peanut allergy. However, the influences of key baseline high‐risk factors on peanut tolerance are poorly understood.

Methods

Secondary analysis was conducted on the publically available LEAP dataset, exploring relationships between peanut tolerance, baseline peanut/egg sensitization, eczema severity/duration, age of introduction, gender, and race.

Results

A multiple logistic regression model predicting odds of successful oral food challenge (OFC) at 60 months noted higher odds with early introduction (OR 9.2, P < 0.001, 95% CI 4.2–20.3), white race (OR 2.1, P = 0.04, 95% CI 1.1–3.9), and advancing age (OR 4.8, P = 0.04, 95% CI 1.1–20.8). Odds of peanut tolerance were lower with increasing peanut wheal size (OR 0.58, P < 0.001, 95% CI 0.46–0.74), increased baseline SCORAD score (OR 0.98, P = 0.04, 95% CI 0.97–1), and increased kUA/l of egg serum IgE (sIgE) (OR 0.99, P = 0.04, 95% CI 0.98–1). The probability of peanut tolerance in the early introduction group was 83% vs 43% in the avoidance group with SPT wheal of <4 mm. The probability of a successful OFC was significantly higher with peanut introduction between 6 and 11 months than at 4–6 months. Increasing eczema severity had limited impact on the probability of peanut tolerance in the early introduction arm.

Conclusion

Increasing peanut wheal size predicted peanut tolerance only in the avoidance arm. Peanut introduction between 6 and 11 months of age was associated with the highest rates of peanut tolerance, questioning the ‘urgency’ of introduction before 6 months.
Bayesian (mean) most powerful tests
Authors: Zhang Jin
Published: November 2016

A fundamental theorem in hypothesis testing is the Neyman‐Pearson (N‐P) lemma, which creates the most powerful test of simple hypotheses. In this article, we establish Bayesian framework of hypothesis testing, and extend the Neyman‐Pearson lemma to create the Bayesian most powerful test of general hypotheses, thus providing optimality theory to determine thresholds of Bayes factors. Unlike conventional Bayes tests, the proposed Bayesian test is able to control the type I error.
The evolutionary and clinical implications of the uneven distribution of the frequency of the inherited haemoglobin variants over short geographical distances
Authors: Premawardhena Anuja , Allen Angela , Piel Fred , Fisher Chris , Perera Laxman , Rodrigo Rexan , Goonathilaka Gayan , Ramees Lebbe , Peto Tim , Olivieri Nancy , Weatherall David
Published: November 2016

Studies of the frequency of heterozygous carriers for common inherited diseases of haemoglobin in over 7500 adolescent children in 25 districts in Sri Lanka have disclosed a highly significant variation over very short geographical distances. A further analysis of these findings, including their relationship to the past frequency and distribution of malaria, climatic variation, altitude, ethnic origin and consanguinity rates, have provided evidence regarding the evolutionary basis for the variable distribution of these conditions over short distances. It is likely that the complex interplay between malaria and the environment, together with related ethnic and social issues, exists in many countries across the tropical belt. Hence, these observations emphasise the importance of micromapping heterozygote distributions in high‐frequency countries in order to define their true burden and the facilities required for the prevention and management of the homozygous and compound heterozygous disorders that result from their interaction.
The response of bird feeding guilds to forest fragmentation reveals conservation strategies for a critically endangered African eco‐region
Authors: Olivier Pieter I. , van Aarde Rudi J.
Published: November 2016

South African coastal forests form part of two critically endangered eco‐regions and harbor an extinction debt. Remaining fragments are small, isolated, and embedded within a range of human land‐use types. In this study, we ask: how should we invest conservation resources if we want to restore this landscape and prevent predicted extinctions? To answer this question, we use path analyses to determine the direct and indirect effects of forest area, forest connectivity, and matrix land‐use types on species richness within five bird feeding guilds. We found that forest connectivity had a significant direct effect on insectivores—fragments that were more connected had more species of insectivores than those that were isolated. Moreover, forest area had a significant indirect effect on insectivores that was mediated through tree species richness. Larger fragments had more species of trees, which led to more species of insectivores. Fragment area, connectivity, matrix land‐use type, and tree species richness had no significant effects on the species richness of frugivores, nectarivores, granivores, or generalist feeders. To conserve insectivores in coastal forests, conservation efforts should focus on maximizing fragment connectivity across the landscape, but also protect the tree community within fragments from degradation. This can be achieved by including matrix habitats that adjoin forest fragments within forest conservation and restoration plans. Natural matrix habitats can increase connectivity, provide supplementary resources, buffer fragments from degradation, and could play an important role in safeguarding diversity and preventing extinctions in this threatened human‐modified landscape.
Canopy soil greenhouse gas dynamics in response to indirect fertilization across an elevation gradient of tropical montane forests
Authors: Matson Amanda L. , Corre Marife D. , Veldkamp Edzo
Published: November 2016

Canopy soils can significantly contribute to aboveground labile biomass, especially in tropical montane forests. Whether they also contribute to the exchange of greenhouse gases is unknown. To examine the importance of canopy soils to tropical forest‐soil greenhouse gas exchange, we quantified gas fluxes from canopy soil cores along an elevation gradient with 4 yr of nutrient addition to the forest floor. Canopy soil contributed 5–12 percent of combined (canopy + forest floor) soil CO2 emissions but CH4 and N2O fluxes were low. At 2000 m, phosphorus decreased CO2 emissions (>40%) and nitrogen slightly increased CH4 uptake and N2O emissions. Our results show that canopy soils may contribute significantly to combined soil greenhouse gas fluxes in montane regions with high accumulations of canopy soil. We also show that changes in fluxes could occur with chronic nutrient deposition.
Fusion of Ssm6a with a protein scaffold retains selectivity on NaV1.7 and improves its therapeutic potential against chronic pain
Authors: Wang Chuan , Shan Bin , Wang Qiong , Xu Qunyuan , Zhang Hailin , Lei Huimeng
Published: November 2016

Voltage‐gated sodium channel NaV1.7 serves as an attractive target for chronic pain treatment. Several venom peptides were found to selectively inhibit NaV1.7 but with intrinsic problems. Among them, Ssm6a, a recently discovered centipede venom peptide, shows the greatest selectivity against NaV1.7, but dissociates from the target too fast and loses bioactivity in synthetic forms. As a disulfide‐rich venom peptide, it is difficult to optimize Ssm6a by artificial mutagenesis and produce the peptide with common industrial manufacturing methods. Here, we developed a novel protein scaffold fusion strategy to address these concerns. Instead of directly mutating Ssm6a, we genetically fused Ssm6a with a protein scaffold engineered from human muscle fatty acid‐binding protein. The resultant fusion protein, SP‐TOX, maintained the selectivity and potency of Ssm6a upon NaV1.7 but dissociated from target at least 10 times more slowly. SP‐TOX dramatically reduced inflammatory pain in a rat model through DRG‐targeted delivery. Importantly, SP‐TOX can be expressed cytosolically in Escherichia coli and purified in a cost‐effective way. In summary, our study provided the first example of cytosolically expressed fusion protein with high potency and selectivity on NaV1.7. Our protein scaffold fusion approach may have its broad application in optimizing disulfide‐rich venom peptides for therapeutic usage.
FDG PET-CT imaging of therapeutic response in granulomatous lymphocytic interstitial lung disease (GLILD) in common variable immunodeficiency (CVID)
Authors: Jolles S , Carne E , Brouns M , El-Shanawany T , Williams P , Marshall C , Fielding P
Published: November 2016

Common variable immunodeficiency (CVID) is the most common severe adult primary immunodeficiency and is characterized by a failure to produce antibodies leading to recurrent predominantly sinopulmonary infections. Improvements in the prevention and treatment of infection with immunoglobulin replacement and antibiotics have resulted in malignancy, autoimmune, inflammatory and lymphoproliferative disorders emerging as major clinical challenges in the management of patients who have CVID. In a proportion of CVID patients, inflammation manifests as granulomas that frequently involve the lungs, lymph nodes, spleen and liver and may affect almost any organ. Granulomatous lymphocytic interstitial lung disease (GLILD) is associated with a worse outcome. Its underlying pathogenic mechanisms are poorly understood and there is limited evidence to inform how best to monitor, treat or select patients to treat. We describe the use of combined 2-[(18)F]-fluoro-2-deoxy-d-glucose positron emission tomography and computed tomography (FDG PET-CT) scanning for the assessment and monitoring of response to treatment in a patient with GLILD. This enabled a synergistic combination of functional and anatomical imaging in GLILD and demonstrated a widespread and high level of metabolic activity in the lungs and lymph nodes. Following treatment with rituximab and mycophenolate there was almost complete resolution of the previously identified high metabolic activity alongside significant normalization in lymph node size and lung architecture. The results support the view that GLILD represents one facet of a multi-systemic metabolically highly active lymphoproliferative disorder and suggests potential utility of this imaging modality in this subset of patients with CVID.
Is it time to reconsider lobectomy in low‐risk paediatric thyroid cancer?
Authors: Kluijfhout Wouter P. , Pasternak Jesse D. , van der Kaay Danielle , Vriens Menno R. , Propst Evan J. , Wasserman Jonathan D.
Published: November 2016

Objective

Current guidelines recommend total thyroidectomy for nearly all children with well‐differentiated thyroid cancer (WDTC). These guidelines, however, derive from older data accrued prior to current high‐resolution imaging. We speculate that there is a subpopulation of children who may be adequately treated with lobectomy.

Design

Retrospective analysis of prospectively maintained database.

Patients

Seventy‐three children with WDTC treated between 2004 and 2015.

Measurements

We applied two different risk‐stratification criteria to this population. First, we determined the number of patients meeting American Thyroid Association (ATA) ‘low‐risk’ criteria, defined as disease grossly confined to the thyroid with either N0/Nx or incidental microscopic N1a disease. Second, we defined a set of ‘very‐low‐risk’ histopathological criteria, comprising unifocal tumours ≤4 cm without predefined high‐risk factors, and determined the proportion of patients that met these criteria.

Results

Twenty‐seven (37%) males and 46 (63%) females were included in this study, with a mean age of 13·4 years. Ipsilateral‐ and contralateral multifocality were identified in 27 (37·0%) and 19 (26·0%) of specimens. Thirty‐seven (51%) patients had lymph node metastasis (N1a = 18/N1b = 19). Pre‐operative ultrasound identified all cases with clinically significant nodal disease. Of the 73 patients, 39 (53·4%) met ATA low‐risk criteria and 16 (21·9%) met ‘very‐low‐risk’ criteria. All ‘very‐low‐risk’ patients demonstrated excellent response to initial therapy without persistence/recurrence after a mean follow‐up of 36·4 months.

Conclusions

Ultrasound and histopathology identify a substantial population that may be candidates for lobectomy, avoiding the risks and potential medical and psychosocial morbidity associated with total thyroidectomy. We propose a clinical framework to stimulate discussion of lobectomy as an option for low‐risk patients.
Presumed tuberculous uveitis in non‐endemic country for tuberculosis: case series from a New Zealand tertiary uveitis clinic
Authors: Ng Ken K , Nisbet Mitzi , Damato Erika M , Sims Joanne L
Published: November 2016

Abstract

Background

To describe the clinical spectrum of presumed tuberculous (TB) uveitis in a developed, non‐endemic country of high immigrant population.

Design

Retrospective review of a consecutive case series.

Participants

All 39 patients diagnosed with presumed TB uveitis at the tertiary uveitis service in Auckland from 2007 to 2014.

Methods

Clinical chart review.

Main Outcome Measures

Patient demographics, risk factors, ophthalmic manifestations, management and outcome.

Results

The median age was 37 years (interquartile range [IQR] 31–52) and 56% were female. The majority (97%) were born outside of New Zealand, and 77% had no TB‐related history. Radiological abnormalities consistent with TB were evident in seven patients, including three who had culture positive pulmonary disease. Anterior uveitis was diagnosed in ten patients (26%), anterior and intermediate uveitis in eight (21%), posterior uveitis in 13 (33%) and panuveitis in eight (21%). Sixteen (41%) had retinal vasculitis, and five (13%) had multifocal serpiginoid choroiditis. Common complications included cataract (51%), ocular hypertension (36%), broad posterior synechiae (33%) and cystoid macular oedema (28%). Anti‐TB treatment was initiated in 30 patients (76%). All but three patients completed the intended course of six to 12 months. Following anti‐TB treatment, 67% remained in remission for at least 12 months, and all but two patients successfully stopped systemic steroids. The median initial and final visual acuity was 6/9 (IQR 6/6–6/18) and 6/6 (IQR 6/6–6/9), respectively.

Conclusions

Despite a wide range of ocular presentations and complications, our cohort demonstrated good remission rate and visual prognosis following anti‐TB treatment in carefully selected patients.
‘Not a good person’: family stigma of mental illness from the perspectives of young siblings
Authors: Liegghio Maria
Published: November 2016

The purpose of this paper is to critically examine family stigma as one form of the stigma of mental illness in child and youth mental health. Presented are the outcomes of a thematic content analysis of in‐depth, semi‐structured interviews conducted with seven (n = 7) young siblings, ages 13 to 21 years old, with a brother or sister identified as having a mental‐health issue. The focus of the interviews was on the ways the siblings experienced their other sibling's mental health and how those experiences shaped their sense of self and family. From the analysis, young siblings had predominately negative experiences, struggled with making sense of their brother or sister and the family as ‘flawed’ against the mental illness as ‘bad’ and experienced considerable family stress and overt family stigma. Current practice theories fail to consider the complexity of these factors and, in doing so, fail to adequately explain the nature and extent to which stigmatization occurs for immediate family members. The importance of peer support and understanding stigma in social work practice with children and their families is discussed.
Stepping through the door – exploring low‐threshold services in Norwegian family centres
Authors: Bulling Ingunn Skjesol
Published: November 2016

Public policies encourage the service system to work in new ways to promote health and increase social equality. This paper presents four categories that show the character of the low‐threshold services in Norwegian family centres from the professionals' and parents' perspectives, focusing on accessibility and participation: easy access, low level of bureaucracy, collaborative competences and inclusive arena. This paper is based on an inductive study in three municipalities that have chosen to establish family centres as interdisciplinary co‐located services that aim to offer low‐threshold services for children and their families. Data were generated through a fieldwork, and participatory observation and interviews were the main source of data. The methodological framework for the analysis was grounded theory, in which the data generation and analysis interchanged throughout the study, and theoretical sampling set the focus for the fieldwork. Exploring the actor's perspective highlighted both strengths and challenges with the low‐threshold services in the family centres. The four elements presented emphasize that the value of these low‐threshold services are not found in one single hallmark; rather, the value depends on an interaction between different elements that must be addressed when establishing, evaluating and developing low‐threshold services in family centres.
Contact sensitization to limonene and linalool hydroperoxides in Spain: a GEIDAC* prospective study
Authors: Deza Gustavo , García‐Bravo Begoña , Silvestre Juan F. , Pastor‐Nieto Maria A. , González‐Pérez Ricardo , Heras‐Mendaza Felipe , Mercader Pedro , Fernández‐Redondo Virginia , Niklasson Bo , Giménez‐Arnau Ana M. ,   GEIDAC
Published: November 2016

Background

Limonene and linalool are common fragrance terpenes widely used in cosmetic, household and hygiene products. Their primary oxidation products formed after air exposure, the hydroperoxides, have been recognized as important contact haptens.

Objectives

To investigate the prevalence of contact allergy to hydroperoxides of limonene (Lim‐OOHs) and hydroperoxides of linalool (Lin‐OOHs) in Spain, and to define the optimal concentration for screening in consecutive patients.

Methods

Three different concentrations of Lim‐OOHs (0.1%, 0.2% and 0.3% pet.) and Lin‐OOHs (0.25%, 0.5% and 1.0% pet.) were simultaneously tested in 3639 consecutive patients at 22 departments of dermatology in Spain.

Results

Lim‐OOHs at 0.1%, 0.2% and 0.3% yielded positive patch test reactions in 1.4%, 3.4% and 5.1% of the tested patients, respectively; and Lin‐OOHs at 0.25%, 0.5% and 1.0% yielded positive reactions in 1.3%, 2.9% and 4.9% of the tested patients, respectively. Few irritant (1.5–1.9%) and doubtful reactions (0.4–0.5%) to both terpene hydroperoxides were registered at the highest concentrations tested.

Conclusions

Lim‐OOHs and Lin‐OOHs can be considered as common causes of contact allergy, and their inclusion in an extended baseline patch test series therefore seems to be appropriate. The patch test preparations of Lim‐OOHs 0.3% pet. and Lin‐OOHs 1.0% pet. are useful tools for screening of contact sensitization.
Measuring changes of manual ability with ABILHAND‐Kids following intensive training for children with unilateral cerebral palsy
Authors: Bleyenheuft Yannick , Gordon Andrew M , Rameckers Eugène , Thonnard Jean‐Louis , Arnould Carlyne
Published: November 2016

Aim

ABILHAND‐Kids is a parent‐reported questionnaire measuring manual ability in children with cerebral palsy (CP). Its psychometric properties have been established, with the exception of responsiveness, which is examined here.

Method

In this cohort study, 98 children (46 males, 52 females; range 6–19y, mean 11y, standard deviation [SD] 3.3y) with unilateral CP underwent three assessments of upper extremity function: at baseline (T1); after 80 to 90 hours of intensive training (T2); and at follow‐up (T3). The responsiveness was analyzed using global, group (based on age and on Manual Ability Classification System [MACS] level), and individual approaches during two time periods (T1–T2 and T2–T3). Effect size was used to quantify magnitude of changes.

Results

The global approach showed significant improvements between T1 and T2 (p<0.001) but not between T2 and T3 (p=0.222). In the group analyses, effect size and SRM demonstrated large changes in younger children (6–12y, n=52, mean change=1.06 logit, effect size >0.8) and small changes in the older children (13–19y, n=46, mean change=0.71 logit, effect size >0.4). Children in MACS level II demonstrated larger changes than children in MACS level I or III.

Interpretation

The ABILHAND‐Kids exhibited responsiveness in detecting changes after intensive training. Therefore, this scale is potentially useful in assessing the functional status of children with unilateral CP in clinical trials.
Effects of DPP‐4 inhibitor linagliptin and GLP‐1 receptor agonist liraglutide on physiological response to hypoglycaemia in Japanese subjects with type 2 diabetes: A randomized, open‐label, 2‐arm parallel comparative, exploratory trial
Authors: Yabe Daisuke , Eto Takashi , Shiramoto Masanari , Irie Shin , Murotani Kenta , Seino Yusuke , Kuwata Hitoshi , Kurose Takeshi , Seino Susumu , Ahrén Bo , Seino Yutaka
Published: November 2016

Dipeptidyl peptidase‐4 (DPP‐4) inhibitors reduce the risk of hypoglycaemia, possibly through augmentation of glucose‐dependent insulinotropic polypeptide (GIP) action, but not that of glucagon‐like peptide‐1 (GLP‐1) on glucagon secretion. To examine this model in Japanese individuals with type 2 diabetes (T2D), the effects of the DPP‐4 inhibitor linagliptin on glucagon and other counter‐regulatory hormone responses to hypoglycaemia were evaluated and compared with those of the GLP‐1 receptor agonist liraglutide in a multi‐centre, randomized, open‐label, 2‐arm parallel comparative, exploratory trial. Three‐step hypoglycaemic clamp glucose tests preceded by meal tolerance tests were performed before and after 2‐week treatment with the drugs. Glucagon levels were increased during the hypoglycaemic clamp test at 2.5 mmol/L. This increase was similar in the linagliptin and liraglutide groups, both before and after the 2‐week treatment. Changes in other counter‐regulatory hormones (ie, growth hormone, cortisol, epinephrine and norepinephrine) were also similar between the groups, but were suppressed substantially after 2‐week treatment compared to baseline. In conclusion, we confirmed that the glucagon response to hypoglycaemia was not affected by linagliptin or liraglutide treatment in Japanese individuals with T2D.
Fatigue behaviour of 16Mo3 steel at elevated temperatures under uniaxial as well as biaxial‐planar loading
Authors: Kulawinski D , Hoffmann M , Weidner A , Lippmann T , Lamprecht G , Henkel S , Biermann H
Published: November 2016

The isothermal fatigue behaviour of the ferritic steel 16Mo3 was investigated at 200 and 500 °C under uniaxial and biaxial‐planar loading. Furthermore, thermo‐mechanical fatigue behaviour under uniaxial loading was characterized under in‐phase (IP) and out‐of‐phase (OP) conditions between 200 and 500 °C. The fatigue lives of uniaxial and biaxial loading are in a good agreement to each other by using the distortion energy hypothesis according to von Mises. Under IP and OP thermo‐mechanical loading, nearly the same lifetimes were determined. They agree well with those of the isothermal tests at 500 °C. A recently developed fatigue lifetime model was applied on all tests and shows an excellent agreement within a scatter of two.
Fishing operations and adaptive strategies of small‐scale fishers: insights for fisheries management in data‐poor situations
Authors: Saldaña A. , Salas S. , Arce‐Ibarra A. M. , Torres‐Irineo E.
Published: November 2016

Small‐scale fisheries' management is complex given its multigear, multispecies nature; despite this, fishing effort has usually been controlled by nominal units, ignoring changes in effective fishing effort. This study aimed to understand the adaptive strategies of small‐scale fishers in San Felipe, Yucatan, Mexico through an analysis of their fishing operations. Minor changes in trip numbers among three seasons were observed, but increases in fishing time, depth and travel costs from one season to another at the operational level were found. It was also evident that high value species at the beginning of the season were gradually replaced by low‐value finfish as the season progresses. The results provide insights for new adaptive management strategies according to fisher's adaptive responses. For instance, using boats or fishing trips as fishing effort units in Yucatan may not be the most appropriated unit for management, as fishers adapt their strategies at different levels.
Regulation of behaviour by the nuclear receptor TLX
Authors: O'Leary J. D. , O'Leary O. F. , Cryan J. F. , Nolan Y. M.
Published: November 2016

The orphan nuclear receptor Tlx (Nr2e1) is a key regulator of both embryonic and adult hippocampal neurogenesis. Several different mouse models have been developed which target Tlx in vivo including spontaneous deletion models (from birth) and targeted and conditional knockouts. Although some conflicting findings have been reported, for the most part studies have demonstrated that Tlx is important in regulating processes that underlie neurogenesis, spatial learning, anxiety‐like behaviour and interestingly, aggression. More recent data have demonstrated that disrupting Tlx during early life induces hyperactivity and that Tlx plays a role in emotional regulation. Moreover, there are sex‐ and age‐related differences in some behaviours in Tlx knockout mice during adolescence and adulthood. Here, we discuss the role of Tlx in motor‐, cognitive‐, aggressive‐ and anxiety‐related behaviours during adolescence and adulthood. We examine current evidence which provides insight into Tlx during neurodevelopment, and offer our thoughts on the function of Tlx in brain and behaviour. We further hypothesize that Tlx is a key target in understanding the emergence of neurobiological disorders during adolescence and early adulthood.
French women's representations and experiences of the post‐treatment management of breast cancer and their perception of the general practitioner's role in follow‐up care: A qualitative study
Authors: Laporte Catherine , Vaure Julie , Bottet Anne , Eschalier Bénédicte , Raineau Clémentine , Pezet Denis , Vorilhon Philippe
Published: November 2016

Background

In France, the Cancer Plan II 2009‐2013 was launched to improve post‐cancer management and promote greater involvement of general practitioners (GPs) in follow‐up care.

Objectives

We investigated how women experienced the post‐treatment management of breast cancer and perceived the role of the GP in follow‐up care.

Design

We conducted a qualitative study based on semi‐structured interviews with women with breast cancer in remission. The interviews were transcribed and analysed in accordance with the principles of thematic analysis.

Setting and participants

We interviewed 21 patients aged between 30 and 86. Eighteen breast cancer survivors were recruited from GP practices and five from a patients’ association.

Results

Four themes emerged from the thematic analysis: that breast cancer is a life‐changing event; how patients managed the effects of treatment; how patients viewed the future; and patients’ expectations of their GP.

Discussion and conclusion

French survivors of breast cancer perceived the physical changes caused by their illness to impact their womanhood, leading to difficulties with sexual relations, a diminished sense of self and fears for the future. They felt abandoned at the end of treatment and desired support. They appreciated the ease of contacting their GP but considered follow‐up care outside their remit. They agreed to be followed up by their GP, provided that they co‐operated closely with a cancer specialist. This is in accordance with the French Cancer Plan II 2009‐2013, which recommends greater involvement of GPs in a monitoring protocol shared with cancer specialists.
Benefits and tensions in delivering public health in community pharmacies – a qualitative study of healthy living pharmacy staff champions
Authors: Cooper Richard J , Tsoneva Jo
Published: November 2016

Objective

Healthy Living Pharmacies (HLP) were introduced in the United Kingdom (UK) in a further attempt to deliver public health benefits in community pharmacy settings. Central to the initiative are staff trained as Healthy Living Champions (HLC) and this study sought to explore HLC perceptions of positive and negative aspect of their work and the wider scheme.

Methods

A qualitative study was undertaken with a purposive sample of HLCs working in pathfinder HCPs in the Sheffield area in 2014. Participants were recruited by email to either a focus group (n = 7) held at a training event or later semi-structured one-to-one interviews in pharmacies (n = 6). Four stages of interpretative phenomenological analysis were used to code and identify themes.

Key findings

Four main themes emerged relating to the positive workforce development impact HLPs had upon HLCs themselves and on perceived customer and patient engagement and benefits. Tensions were identified with existing commercial business demands and negative views overall of the pharmacy setting with a perceived lack of not only integration with other services but also awareness among the public and health care staff. HLCs felt empowered and more confident in initiating conversation about health issues with patients, but identified barriers relating to workload, a lack of time to perform their role, isolation, tensions with non-HLC staff and logistical barriers such as poor Internet access.

Conclusions

Delivering public health activities through the HLC role in UK pharmacies is associated with several perceived benefits for different stakeholders, but may be threatened by well recognised barriers in UK pharmacies related to the commercial setting.
Identifying fallacious arguments in a qualitative study of antipsychotic prescribing in dementia
Authors: Donyai Parastou
Published: November 2016

Background

Dementia can result in cognitive, noncognitive and behavioural symptoms which are difficult to manage. Formal guidelines for the care and management of dementia in the UK state that antipsychotics should only be prescribed where fully justified. This is because inappropriate use, particularly problematic in care-home settings, can produce severe side effects including death. The aim of this study was to explore the use of fallacious arguments in professionals’ deliberations about antipsychotic prescribing in dementia in care-home settings. Fallacious arguments have the potential to become unremarkable discourses that construct and validate practices which are counter to guidelines.

Methods

This qualitative study involved interviews with 28 care-home managers and health professionals involved in caring for patients with dementia. Potentially fallacious arguments were identified using qualitative content analysis and a coding framework constructed from existing explanatory models of fallacious reasoning.

Key findings

Fallacious arguments were identified in a range of explanations and reasons that participants gave for in answer to questions about initiating, reducing doses of and stopping antipsychotics in dementia. The dominant fallacy was false dichotomy. Appeal to popularity, tradition, consequence, emotion, or fear, and the slippery slope argument was also identified.

Conclusions

Fallacious arguments were often formulated to present convincing cases whereby prescribing antipsychotics or maintaining existing doses (versus not starting medication or reducing the dose, for example) appeared as the only acceptable decision but this is not always the case. The findings could help health professionals to recognise and mitigate the effect of logic-based errors in decisions about the prescribing of antipsychotics in dementia.
Lived experience of involuntary transport under mental health legislation
Authors: Bradbury Joanne , Hutchinson Marie , Hurley John , Stasa Helen
Published: November 2016

Police have historically been responsible for transporting people during a mental health crisis in Australia. A major change to the New South Wales (NSW) Mental Health Act (MHA) in 2007 expanded the range of coercive transportation agencies to include NSW Ambulance (paramedics) and NSW Health (mental health nurses). Anecdotal reports, however, describe a lack of clarity around how these changes should be implemented in practice. This research aims to explore this lack of clarity through qualitative analysis of interviews with people with the lived experience of involuntary transport under the MHA. Sixteen interviews were conducted; most (n = 14) interviews in northern NSW regions: six with people who had been transported (consumers), four with carers, and six with service providers (two police, one paramedic, and three mental health nurses). For consumers and carers, the police response was often perceived as too intense, particularly if the person was not violent. Carers were often conflicted by having to call for emergency intervention. Service providers were frustrated by a lack of a coordinated interagency response, resourcing issues, delays at emergency departments, and lack of adequate training. A central theme across all groups was the importance of communication styles. As one participant (consumer) said: ‘Everybody needs a lesson in kindness’. All groups agreed that high‐risk situations necessitate police involvement. However, invocation of the MHA during a high‐risk situation is fraught with stress and difficulties, leaving little room for empathetic communications. Effective and diverse, evidence‐based, early intervention strategies – both consensual and non‐consensual – are necessary to reduce the requirement for police involvement in mental health transports.
Estimating the Cost of Capital Using Stock Prices and Near‐term Earnings Forecasts
Authors: Easton Peter
Published: November 2016

Earnings‐based valuation models, although long used by finance practitioners, have become increasingly popular among finance academics as well. Among the most important reasons for academics' increased acceptance of earnings‐based valuation is the well‐documented claim that earnings over a short (three‐ to four‐year) forecast horizon tend to capture a large fraction—as much as 80%—of today's value, much more than is captured by near‐term forecasts of free cash flow, the measure long advocated by finance theorists as the basis for DCF valuation.

But most important for the purposes of this article, the recognition that such a large percentage of the current values of many public companies is captured within a short forecast horizon has led to a large academic literature that uses earnings‐based valuation models together with current stock prices to “back out” estimates of the companies' implied expected rates of return and costs of equity capital. The effectiveness and precision of such reverse engineering depend on the reliability of the forecasts both within a finite forecast horizon and beyond. And although the models tested in academic work, which are based on large samples of forecasts and hard‐to‐verify assumptions about earnings beyond the forecast horizon, often do not appear to provide useful estimates, the author argues that such reverse engineering of the valuation models should become straightforward and workable once reliable forecasts of earnings are obtained—say, from the corporate (or investment) analysts who are familiar with the operations of the companies they work for (or cover).
Do Investment Banks Have Incentives to Help Clients Make Value‐Creating Acquisitions?
Authors: McConnell John J. , Sibilkov Valeriy
Published: November 2016

Many have long suspected that investment banks, when advising corporate clients on potential acquisitions, have strong incentives just to “get the deal done” with little if any motive for urging clients to walk away from “bad” deals. The incentive to complete deals comes from compensation arrangements in which the bulk of the bankers' fees depend upon completion of the deals. Several earlier studies have provided support for this suspicion by reporting findings that show banks' market shares of advisory services depending mainly on two variables—their previous market shares and their deal completion rate—with little if any connection to the value created (or destroyed) for their clients' shareholders.

In their recently published study, the authors revisit that relationship and reach a number of different conclusions: (1) advisors in acquisitions that create more value for clients are more likely to be chosen for future deals; (2) the changes in bankers' advisory market shares are strongly related to the value created for prior clients; and (3) the changes in banks' market values are positively correlated with the value created for their acquirer clients.

In sum, the findings suggest that banks have significant market‐related incentives to advise their clients to pursue value‐creating acquisitions and to avoid deals likely to reduce their market values.
Reexamining Phylloscopus trochiloides complex as a ring species: a refugial counter‐hypothesis
Authors: Peterson A. Townsend , Anamza Tashitso
Published: November 2016

The idea of ring species has been viewed as a demonstration of the potential for species‐level differentiation produced by isolation by distance in otherwise continuous populations. Although the concept is attractive, the list of empirical examples has narrowed significantly as detailed studies have been carried out. One of the few examples still cited among birds is the warbler species complex Phylloscopus trochiloides, which comprises P. trochiloides sensu stricto, P. plumbeitarsus, and P. nitidus. The ring comprises a series of populations surrounding the Tibetan Plateau in which a species‐level break is apparent at the north end of the ring. Although recent theoretical treatments have indicated that such differentiation is possible in theory, recent genomic analyses indicated multiple differentiated populations around the ring unlikely to have resulted from isolation by distance. Here, we complement the genomic studies to date with paleodistributional projections of ecological niche models that provide further evidence for multiple, isolated refugia around the ring during and since the Late Pleistocene. As such, this group should not be interpreted as exemplifying an isolation‐by‐distance mechanism of speciation, and should no longer be considered as a ring species: genomic and geographic evidence coincide in indicating that its differentiation took place in allopatry.
Preparation for flight: pre‐fledging exercise time is correlated with growth and fledging age in burrow‐nesting seabirds
Authors: Yoda Ken , Shiozaki Tatsuya , Shirai Masaki , Matsumoto Sakiko , Yamamoto Maki
Published: November 2016

Chicks of many burrow‐nesting seabirds are known to repeatedly emerge from their nests (these trips being termed ‘excursions’) and exercise their wings prior to fledging, but this behavior is poorly documented in the literature, and thus the relationship between growth and exercise remains unclear. Here, we used infrared video cameras placed in front of streaked shearwater Calonectris leucomelas nests during the chick‐emergence period to examine correlations between chick excursions and parameters known to be important for juvenile survival after fledging. In addition, we also attached acceleration‐temperature loggers to several chicks in order to evaluate the relationship between excursion time and time spent exercising the wing muscles (i.e. flapping). Chicks that undertook longer excursions exhibited more rapid increases in wing length and larger body masses at fledging, and also fledged earlier. Correlations between fitness‐related parameters and excursion time indicate that excursions during the emergence period might offer insights into the various relationships between growth and behavior and/or the mechanisms underlying offspring survival following fledging.
EU Member States at the UN: A Case of Europeanization Arrested?
Authors: Smith Karen E.
Published: November 2016

This article addresses two questions about the EU's and EU Member States' diplomacy in the UN General Assembly's Third Committee and the Human Rights Council: have EU Member States been more, or less, active outside the framework of EU co‐ordination since the entry into force of the Lisbon Treaty? Has EU activity increased? The findings are that EU Member States have been increasingly active at the Human Rights Council and have increasingly worked with other states outside of the EU, while the level of EU activity has remained largely the same. In the Third Committee, Member States speak more than the EU but neither the EU nor Member States have been sponsoring more resolutions. Europeanization is ‘arrested’ in these cases, as Member States are reluctant to push for more EU activity because both the internal intergovernmental decision‐making system and external context discourage it.
Effect of carbohydrate counting using bolus calculators on glycemic control in type 1 diabetes patients during continuous subcutaneous insulin infusion
Authors: Yamada Eijiro , Okada Shuichi , Nakajima Yasuyo , Bastie Claire C , Tagaya Yuko , Osaki Aya , Shimoda Yoko , Shibusawa Ryo , Saito Tsugumichi , Ozawa Atsushi , Yamada Masanobu
Published: November 2016

The present study examined the long‐term efficacy of insulin pump therapy for type 1 diabetes patients when carried out using carbohydrate counting with bolus calculators for 1 year. A total of 22 type 1 diabetes patients who had just started continuous subcutaneous insulin infusion were examined and divided into two groups: one that was educated about carbohydrate counting using bolus calculators (n = 14); and another that did not use bolus calculators (n = 8). After 1 year, the hemoglobin A1c levels of the patient group that used bolus calculators decreased persistently and significantly (P = 0.0297), whereas those of the other group did not. The bodyweight, total daily dose of insulin and bolus percentage of both groups did not change. Carbohydrate counting using bolus calculators is necessary to achieve optimal and persistent glycemic control in patients undergoing continuous subcutaneous insulin infusion.
A method to characterize the roughness of 2‐D line features: recrystallization boundaries
Authors: SUN J. , ZHANG Y.B. , DAHL A.B. , CONRADSEN K. , JUUL JENSEN D.
Published: November 2016

A method is presented, which allows quantification of the roughness of nonplanar boundaries of objects for which the neutral plane is not known. The method provides quantitative descriptions of both the local and global characteristics. How the method can be used to estimate the sizes of rough features and local curvatures is also presented. The potential of the method is illustrated by quantification of the roughness of two recrystallization boundaries in a pure Al specimen characterized by scanning electron microscopy.
Role of a heterotrimeric G‐protein, Gi2, in the corticogenesis: possible involvement in periventricular nodular heterotopia and intellectual disability
Authors: Hamada Nanako , Negishi Yutaka , Mizuno Makoto , Miya Fuyuki , Hattori Ayako , Okamoto Nobuhiko , Kato Mitsuhiro , Tsunoda Tatsuhiko , Yamasaki Mami , Kanemura Yonehiro , Kosaki Kenjiro , Tabata Hidenori , Saitoh Shinji , Nagata Koh‐ichi
Published: November 2016

We analyzed the role of a heterotrimeric G‐protein, Gi2, in the development of the cerebral cortex. Acute knockdown of the α‐subunit (Gαi2) with in utero electroporation caused delayed radial migration of excitatory neurons during corticogenesis, perhaps because of impaired morphology. The migration phenotype was rescued by an RNAi‐resistant version of Gαi2. On the other hand, silencing of Gαi2 did not affect axon elongation, dendritic arbor formation or neurogenesis at ventricular zone in vivo. When behavior analyses were conducted with acute Gαi2‐knockdown mice, they showed defects in social interaction, novelty recognition and active avoidance learning as well as increased anxiety. Subsequently, using whole‐exome sequencing analysis, we identified a de novo heterozygous missense mutation (c.680C>T; p.Ala227Val) in the GNAI2 gene encoding Gαi2 in an individual with periventricular nodular heterotopia and intellectual disability. Collectively, the phenotypes in the knockdown experiments suggest a role of Gαi2 in the brain development, and impairment of its function might cause defects in neuronal functions which lead to neurodevelopmental disorders.

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Vagal nerve endings in visceral pleura and triangular ligaments of the rat lung
Authors: Wang Feng‐Bin , Liao Yi‐Han , Wang Yao‐Chen
Published: November 2016

The inner thoracic cavity is lined by the parietal pleura, and the lung lobes are covered by the visceral pleura. The parietal and visceral plurae form the pleural cavity that has negative pressure within to enable normal respiration. The lung tissues are bilaterally innervated by vagal and spinal nerves, including sensory and motor components. This complicated innervation pattern has made it difficult to discern the vagal vs. spinal processes in the pulmonary visceral pleura. With and without vagotomy, we identified vagal nerve fibres and endings distributed extensively in the visceral pleura (‘P’‐type nerve endings) and triangular ligaments (‘L’‐type nerve endings) by injecting wheat germ agglutinin‐horseradish peroxidase as a tracer into the nucleus of solitary tract or nodose ganglion of male Sprague–Dawley rats. We found the hilar and non‐hilar vagal pulmonary pleural innervation pathways. In the hilar pathway, vagal sub‐branches enter the hilum and follow the pleural sheet to give off the terminal arborizations. In the non‐hilar pathway, vagal sub‐branches run caudally along the oesophagus and either directly enter the ventral‐middle‐mediastinal left lobe or follow the triangular ligaments to enter the left and inferior lobe. Both vagi innervate: (i) the superior, middle and accessory lobes on the ventral surfaces that face the heart; (ii) the dorsal‐rostral superior lobe; (iii) the dorsal‐caudal left lobe; and (iv) the left triangular ligament. Innervated only by the left vagus is: (i) the ventral‐rostral and dorsal‐rostral left lobe via the hilar pathway; (ii) the ventral‐middle‐mediastinal left lobe and the dorsal accessory lobe that face the left lobe via the non‐hilar pathway; and (iii) the ventral‐rostral inferior lobe that faces the heart. Innervated only by the right vagus, via the non‐hilar pathway, is: (i) the inferior (ventral and dorsal) and left (ventral only) lobe in the area near the triangular ligament; (ii) the dorsal‐middle‐mediastinal left lobe; and (iii) the right triangular ligament. Other regions innervated with unknown vagal pathways include: (i) the middle lobe that faces the superior and inferior lobe; (ii) the rostral‐mediastinal inferior lobe that faces the middle lobe; and (iii) the ventral accessory lobe that faces the diaphragm. Our study demonstrated that most areas that face the dorsal thoracic cavity have no vagal innervation, whereas the interlobar and heart‐facing areas are bilaterally or unilaterally innervated with a left‐rostral vs. right‐caudal lateralized innervation pattern. This innervation pattern may account for the fact that the respiratory regulation in rats has a lateralized right‐side dominant pattern.