bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic review with meta‐analysis: association between acetaminophen and nonsteroidal anti‐inflammatory drugs (NSAIDs) and risk of Crohn's disease and ulcerative colitis exacerbation
Authors: Moninuola O. O. , Milligan W. , Lochhead P. , Khalili H.
Published: April 2018

Background

Unlike acetaminophen, nonsteroidal anti‐inflammatory drugs (NSAIDs) have generally been thought to be associated with increased risk of IBD exacerbation.

Aim

To carry out a systematic review and meta‐analysis of previous studies examining the association between acetaminophen and NSAIDs including cyclooxygenase (COX‐2) inhibitors use, and risk of Crohn's disease (CD) and ulcerative colitis (UC) exacerbation.

Methods

We identified published manuscripts and abstracts through 1 March 2017 by systematic search of Medline, Embase, Cochrane and other trial registries. Quality assessment was done using Newcastle‐Ottawa scale and random‐effect meta‐analysis using pooled relative risks (RRs) and 95% CIs were calculated.

Results

Eighteen publications between years 1983 and 2016 were identified. For the meta‐analysis, pooled RRs of disease exacerbation with NSAIDs use were (1.42, 95% CI, 0.65‐3.09), I2 = 60.3% for CD, and (1.52, 95% CI, 0.87‐2.63), I2 = 56.1% for UC. The corresponding values for acetaminophen use were (1.40, 95% CI, 0.96‐2.04), I2 = 45.6% for UC, and (1.56, 95% CI, 1.22‐1.99), I2 = 0.0% for IBD. Sensitivity analyses limited to studies with low risk of bias showed a significantly increased risk of CD exacerbation (1.53, 95% CI, 1.08‐2.16) but not UC (0.94, 95% CI, 0.36‐2.42) with NSAIDs use.

Conclusions

Contrary to generally accepted belief, we did not find a consistent association between NSAIDs use and risk of CD and UC exacerbation. There was also no consistent evidence for association with acetaminophen although further studies are needed.
Does Nuclear Uncertainty Threaten Financial Markets? The Attention Paid to North Korean Nuclear Threats and Its Impact on South Korea's Financial Markets
Authors: Huh In , Pyun Ju Hyun
Published: April 2018

We explore how investor attention paid to dangerous nuclear tests influences financial market outcomes. To measure the attention paid to North Korean nuclear threats, we introduce a weekly Google search volume index for keywords on North Korean nuclear events. Using a time‐varying structural vector autoregression model with block exogeneity restrictions, we find that investor attention paid to nuclear threats has heterogeneous effects on South Korea's stock prices across industries and over time: attention on only the first nuclear test was negatively related to the stock price index, which vanished thereafter. Moreover, the investor attention paid to the nuclear risk reduced stock prices, especially in the banking industry, during the entire sample period.
Classification of European and Mediterranean coastal dune vegetation
Authors: Marcenò Corrado , Guarino Riccardo , Loidi Javier , Herrera Mercedes , Isermann Maike , Knollová Ilona , Tichý Lubomír , Tzonev Rossen T. , Acosta Alicia Teresa Rosario , FitzPatrick Úna , Iakushenko Dmytro , Janssen John A. M. , Jiménez‐Alfaro Borja , Kącki Zygmunt , Keizer‐Sedláková Iva , Kolomiychuk Vitaliy , Rodwell John S. , Schaminée Joop H. J. , Šilc Urban , Chytrý Milan
Published: April 2018

Aims

Although many phytosociological studies have provided detailed local and regional descriptions of coastal dune vegetation, a unified classification of this vegetation in Europe and the Mediterranean Basin has been missing. Our aim is to produce a formalized classification of this vegetation and to identify the main factors driving its plant species composition at a continental scale.

Location

Atlantic and Baltic coasts of Europe, Mediterranean Basin and the Black Sea region.

Methods

We compiled a database of 30,759 plots of coastal vegetation, which were resampled to reduce unbalanced sampling effort, obtaining a data set of 11,769 plots. We classified these plots with TWINSPAN, interpreted the resulting clusters and used them for developing formal definitions of phytosociological alliances of coastal dune vegetation, which were included in an expert system for automatic vegetation classification. We related the alliances to climatic factors and described their biogeographic features and their position in the coastal vegetation zonation. We examined and visualized the floristic relationships among these alliances by means of DCA ordination.

Results

We defined 18 alliances of coastal dune vegetation, including the newly described Centaureo cuneifoliae‐Verbascion pinnatifidi from the Aegean region. The main factors underlying the differentiation of these alliances were biogeographic and macroclimatic contrasts between the Atlantic–Baltic, Mediterranean and Black Sea regions, along with ecological differences between shifting and stable dunes. The main difference in species composition was between the Atlantic–Baltic and Mediterranean–Black Sea regions. Within the former region, the main difference was driven by the different ecological conditions between shifting and stable dunes, whereas within the latter, the main difference was biogeographic between the Mediterranean and the Black Sea.

Conclusions

The first formal classification of the European coastal dune vegetation was established, accompanied by an expert system containing the formal definitions of alliances, which can be applied to new data sets. The new classification system critically revised the previous concepts and integrated them into a consistent framework, which reflects the main gradients in species composition driven by biogeographic influences, macroclimate and the position of the sites in the coast–inland zonation of the dune systems. A revision of the class concept used in EuroVegChecklist is also proposed.
Large differences in neonatal drug use between NICUs are common practice: time for consensus?
Authors: Flint Robert B. , van Beek Floor , Andriessen Peter , Zimmermann Luc J. , Liem Kian D. , Reiss Irwin K.M. , de Groot Ronald , Tibboel Dick , Burger David M. , Simons Sinno H.P. ,   DINO Research group
Published: April 2018

Aims

Evidence for drug use in newborns is sparse, which may cause large differences in drug prescriptions. We aimed to investigate the differences between neonatal intensive care units (NICUs) in the Netherlands in currently prescribed drugs.

Methods

This multicentre study included neonates admitted during 12 months to four different NICUs. Drugs were classified in accordance with the Anatomical Therapeutic Chemical (ATC) classification system and assessed for on/off‐label status in relation to neonatal age. The treatment protocols for four common indications for drug use were compared: pain, intubation, convulsions and hypotension.

Results

A total of 1491 neonates (GA range 23+6–42+2 weeks) were included with a total of 32 182 patient days, 181 different drugs and 10 895 prescriptions of which 23% was off‐label in relation to neonatal age. Overall, anti‐infective drugs were most frequently used with a total of 3161 prescriptions, of which 4% was off‐label in relation to neonatal age. Nervous system drugs included 2500 prescriptions of which 31% was off‐label in relation to neonatal age. Nervous system drugs, blood and blood forming organs, and cardiovascular drugs showed the largest differences between NICUs with ranges of 919–2278, 554–1465, and 238–952 total prescriptions per 1000 patients per ATC class, respectively.

Conclusions

We showed that drug use varies widely in neonatal clinical practice. The drug classes with the highest proportion of off‐label drugs in relation to neonatal age showed the largest differences between NICUs, i.e. cardiovascular and nervous system drugs. Drug research in neonates should receive high priority to guarantee safe and appropriate medicines and optimal treatment.
Pharmacokinetics of efavirenz in patients on antituberculosis treatment in high human immunodeficiency virus and tuberculosis burden countries: A systematic review
Authors: Atwine Daniel , Bonnet Maryline , Taburet Anne‐Marie
Published: April 2018

Aims

Efavirenz (EFV) and rifampicin–isoniazid (RH) are cornerstone drugs in human immunodeficiency virus (HIV)–tuberculosis (TB) coinfection treatment but with complex drug interactions, efficacy and safety challenges. We reviewed recent data on EFV and RH interaction in TB/HIV high‐burden countries.

Methods

We conducted a systematic review of studies conducted in the high TB/HIV‐burden countries between 1990 and 2016 on EFV pharmacokinetics during RH coadministration in coinfected patients. Two reviewers conducted article screening and data collection.

Results

Of 119 records retrieved, 22 were included (two conducted in children), reporting either EFV mid‐dose or pre‐dose concentrations. In 19 studies, median or mean concentrations of RH range between 1000 and 4000 ng ml–1, the so‐called therapeutic range. The proportion of patients with subtherapeutic concentration of RH ranged between 3.1 and 72.2%, in 12 studies including one conducted in children. The proportion of patients with supratherapeutic concentration ranged from 19.6 to 48.0% in six adult studies and one child study. Five of eight studies reported virological suppression >80%. The association between any grade hepatic and central nervous system adverse effects with EFV/RH interaction was demonstrated in two and three studies, respectively. The frequency of the CYP2B6 516G > T polymorphism ranged from 10 to 28% and was associated with higher plasma EFV concentrations, irrespective of ethnicity.

Conclusions

Anti‐TB drug coadministration minimally affect the EFV exposure, efficacy and safety among TB‐HIV coinfected African and Asian patients. This supports the current 600 mg EFV dosing when coadministered with anti‐TB drugs.
Proximal hypospadias treated with a transverse preputial island tube: long‐term functional, sexual, and cosmetic outcomes
Authors: Rynja Sybren P. , de Jong Tom P.V.M. , Bosch J.L.H. Ruud , de Kort Laetitia M.O.
Published: April 2018

Objective

To study long‐term urinary and sexual function, and cosmetic outcomes in adult patients who underwent single‐stage transverse preputial island tube (TPIT) for proximal hypospadias repair in childhood. Long‐term data on outcomes of patients with proximal hypospadias with severe coexisting curvature and insufficient urethral plate are scarce, but are necessary to decide which repair technique is most beneficial.

Patients, Subjects and Methods

Patients with proximal hypospadias operated with TPIT (TPIT Group) were compared to patients with distal hypospadias repair (Distal Group) and to a control group of male medical students (Control Group). Participants completed the International Prostate Symptom Score, the International Index of Erectile Function (IIEF‐15), additional non‐validated questions, and performed uroflowmetry. Cosmesis was assessed in the patients with hypospadias using the Pediatric Penile Perception Score (PPPS); stretched penile length was also measured.

Results

Of the 121 eligible patients with hypospadias, 54 with either TPIT or distal hypospadias repairs participated. The TPIT Group comprised 12 patients (median age of 20.0 years) and the Distal Group comprised 42 patients (median age of 19.6 years). The complication rates were similar, at 8 of the 12 patients in the TPIT Group vs 26/42 (62%) in the Distal Group (P = 0.76). Urinary outcomes were similar in the TPIT, Distal, and the Control (comprised of 148 medical students with a median age of 21.0 years) groups. The TPIT Group had a lower maximum urinary flow rate compared to the Control Group, at 24.1 vs 28.6 mL/s (P < 0.05). IIEF‐15 scores were similar in the TPIT, Distal and Control groups, except for ‘Orgasmic Function’ (7.5 vs 10.0 vs 10.0, respectively; P < 0.01). Although the TPIT Group had a smaller penile length compared to the Distal Group (10.1 vs 12.9 cm, P < 0.01), PPPS outcomes were similar.

Conclusion

In these TPIT patients, long‐term urinary, sexual and cosmetic outcomes were similar to those in patients with distal hypospadias repairs and controls.
Abdominal Aortic Aneurysms Presenting as Renal Colic
Authors: ECKFORD S. D. , GILLATT D. A.
Published: April 2018

In a 6‐year period, 9 patients were referred by their General Practitioners to the urology unit with a clinical diagnosis of renal colic but were subsequently found to have leaking abdominal aortic aneurysms (AAA). In all cases of loin pain, especially in the elderly patient, the possibility of a leaking abdominal aneurysm must be considered. If no intrinsic urological cause for the pain is found or patterns suggestive of ureteric obstruction are seen on urography, ultrasound examination of the aorta‐iliac vessels should be performed. Magnetic resonance imaging (MRI) and computed tomography (CT) scans may be useful adjuncts to this investigation.
Psychological Aspects of Female Urinary Incontinence in General Practice
Authors: LAGRO-JANSSEN A. L. M. , DEBRUYNE F. M. J. , VAN WEEL C.
Published: April 2018

The aim of this study was to determine whether urge incontinence was associated with a higher prevalence of psychological symptoms than other types of incontinence. The psychological aspects of 110 women presenting with urinary incontinence in general practice were assessed by means of standardised questionnaires and medical history‐taking. The results showed no difference in psychological characteristics between patients with urge incontinence and those with other types of incontinence. These findings were contrary to the conclusions of almost all other studies based on populations selected for specialist care.

It was concluded that in general practice the psychological approach to urinary incontinence depends more on the individual needs of the patient than specifically on the type of incontinence.
Does Residual Urine Predispose to Urinary Tract Infection?
Authors: HAMPSON S. J. , NOBLE J. G. , RICKARDS D. , MILROY E. J. G.
Published: April 2018

The relationship between the presence of post‐micturition residual urine and urinary tract infection is unclear. We have performed a retrospective analysis of 342 studies on bladder emptying and compared the incidence of bacterial infection and pyuria in patients with residual urinary volumes of more or less than 100 ml. In patients with a residual volume > 100 ml 49/219 studies showed evidence of pyuria and 28/198 studies of patients whose residual urine was less than 100 ml showed evidence of infection. In cases where the residuals were > 100 m133/123 had evidence of pyuria and 19/109 infection. There was no significant increase in the rate of infection in patients with large residual urinary volumes, suggesting that there is no definite correlation between post‐micturition residues and urinary tract infection.
High Resolution Ultrasonography in the Diagnosis of Simple Intratesticular Cysts
Authors: HÖBARTH K. , KRATZIK CH.
Published: April 2018

Simple intratesticular cysts are a rare condition. High resolution sonography permits unequivocal sonographic differentiation between intratesticular cysts and neoplastic lesions with a cystic appearance, so that conservative treatment seems justified. Seventeen patients with sonographically diagnosed intraparenchymal testicular cysts were followed up for an average of 29 months. No increase in size or change in echo pattern was found and surgical intervention was therefore not indicated.
Prevalence and measurement of anterior loop of the mandibular canal using CBCT: A cross sectional study
Authors: J Pradeep Christopher , Marimuthu Thenaruvi , C Krithika , Devadoss Poorna , Kumar Santhosh M.
Published: April 2018

Background

Anterior loop of the mental nerve is a very important anatomic landmark in implant placement and anterior mandibular osteotomies.

Purpose

Two‐dimensional imaging techniques are not competent enough to locate and measure the mental nerve loop in majority of the cases. Any injury to this loop results in pain/paresthesia/numbness in the region supplied by the mental nerve. The aim of this study is to analyze the prevalence and measure the length of the loop using cone beam computerized tomography (CBCT) and calculate the average length and prevalence so that a safe margin can be given while placing the implants or the osteotomy cuts in the premolar region.

Materials and Methods

A cross‐sectional study was done using CBCT images of 85 patients taken for impaction surgery. The length of the loop was measured in mm using standardized lines drawn along specific anatomic landmarks.

Results

In our study 11.76% of patients had anterior loop in their mental nerve. Mean length of the mental nerve loop was calculated and found to be 2.79 mm.

Conclusion

A margin of 4 mm anterior to the mental foramen should be safe to avoid any damage to the mental nerve loop bundle in majority of the cases where the loop is present.
Altered lactate metabolism in Huntington's disease is dependent on GLUT3 expression
Authors: Solís‐Maldonado Macarena , Miró María Paz , Acuña Aníbal I. , Covarrubias‐Pinto Adriana , Loaiza Anitsi , Mayorga Gonzalo , Beltrán Felipe A. , Cepeda Carlos , Levine Michael S. , Concha Ilona I. , Bátiz Luis Federico , Carrasco Mónica A. , Castro Maite A.
Published: April 2018

Aims

Huntington's disease (HD) is a neurodegenerative disorder characterized by progressive abnormalities in cognitive function, mental state, and motor control. HD is characterized by a failure in brain energy metabolism. It has been proposed that monocarboxylates, such as lactate, support brain activity. During neuronal synaptic activity, ascorbic acid released from glial cells stimulates lactate and inhibits glucose transport. The aim of this study was to evaluate the expression and function of monocarboxylate transporters (MCTs) in two HD models.

Methods

Using immunofluorescence, qPCR, and Western blot analyses, we explored mRNA and protein levels of MCTs in the striatum of R6/2 animals and HdhQ7/111 cells. We also evaluated MCT function in HdhQ7/111 cells using radioactive tracers and the fluorescent lactate sensor Laconic.

Results

We found no significant differences in the mRNA or protein levels of neuronal MCTs. Functional analyses revealed that neuronal MCT2 had a high catalytic efficiency in HD cells. Ascorbic acid did not stimulate lactate uptake in HD cells. Ascorbic acid was also unable to inhibit glucose transport in HD cells because they exhibit decreased expression of the neuronal glucose transporter GLUT3.

Conclusion

We demonstrate that stimulation of lactate uptake by ascorbic acid is a consequence of inhibiting glucose transport. Supporting this, lactate transport stimulation by ascorbic acid in HD cells was completely restored by overexpressing GLUT3. Therefore, alterations in GLUT3 expression could be responsible for inefficient use of lactate in HD neurons, contributing to the metabolic failure observed in HD.
Disrupted striatal neuron inputs and outputs in Huntington's disease
Authors: Reiner Anton , Deng Yun‐Ping
Published: April 2018

Huntington's disease (HD) is a hereditary progressive neurodegenerative disorder caused by a CAG repeat expansion in the gene coding for the protein huntingtin, resulting in a pathogenic expansion of the polyglutamine tract in the N‐terminus of this protein. The HD pathology resulting from the mutation is most prominent in the striatal part of the basal ganglia, and progressive differential dysfunction and loss of striatal projection neurons and interneurons account for the progression of motor deficits seen in this disease. The present review summarizes current understanding regarding the progression in striatal neuron dysfunction and loss, based on studies both in human HD victims and in genetic mouse models of HD. We review evidence on early loss of inputs to striatum from cortex and thalamus, which may be the basis of the mild premanifest bradykinesia in HD, as well as on the subsequent loss of indirect pathway striatal projection neurons and their outputs to the external pallidal segment, which appears to be the basis of the chorea seen in early symptomatic HD. Later loss of direct pathway striatal projection neurons and their output to the internal pallidal segment account for the severe akinesia seen late in HD. Loss of parvalbuminergic striatal interneurons may contribute to the late dystonia and rigidity.
Oral juvenile xanthogranuloma in a child: Clinical, histological and immunohistochemical profile of a rare entity
Authors: Sánchez‐Romero Celeste , Cuenca Arriaga Ana Isabel , Paes de Almeida Oslei , Gutiérrez Cortés Evangelina
Published: April 2018

Juvenile xanthogranuloma (JXG) is a non‐Langerhans cell histiocytosis (non‐LCH) affecting normolipemic infants and children most frequently in the first year of life, often showing spontaneous regression within 3 to 6 years. Classic JXG is characterized by a yellowish asymptomatic papule or nodule, often located in the skin of the head, neck and upper trunk. Oral JXG has been reported, but is rare. Histologically, JXG is composed mainly of an infiltrate of macrophages with a variable degree of lipidization (foamy macrophages), and (most of the time) scattered Touton‐type giant cells. Because of the rarity of oral lesions and possible variations in the clinical and histological presentation, the correct diagnosis can be challenging, requiring a careful clinical and histopathological evaluation with adjuvant immunohistochemical studies. Our review of the English‐language literature disclosed 33 cases of oral JXG, including this case report. The purpose of this study is to present a new case of this uncommon entity as well as to review and discuss its main clinicopathologic features and immunohistochemical findings.
Forty‐nine cases of acute lymphoblastic leukaemia/lymphoma in pleural and pericardial effusions: A cytological‐histological correlation
Authors: Li J. , Zhang W. , Wang W. , Jiang Y. , Zhao S. , Liu W. , Li G. , Liu N. , Li Q. , Su X.
Published: April 2018

Introduction

Acute lymphoblastic leukaemia/lymphoma (ALL/LBL) is an aggressive entity of precursor lymphoid neoplasm and may cause malignant serous effusion (SE). The current study aimed to analyse the characteristics of SE cytology of ALL/LBL including cytomorphology, immunophenotyping, clonality and evaluate the effectiveness of SE cytology as a diagnostic method for ALL/LBL.

Methods

SE specimens with final diagnosis of ALL/LBL from 2006 to 2016 were reviewed for clinical data, cytomorphological features and ancillary studies. Cytodiagnoses were compared with histodiagnoses, and the discordant cases were analysed.

Results

A total of 49 specimens including 47 pleural fluids and 2 pericardial fluids from 49 patients were evaluated. Cytomorphology revealed lymphoblasts varied from small size with scant cytoplasm, condensed nuclear chromatin and indistinct nucleoli to large size with dispersed nuclear chromatin and multiple variably prominent nucleoli. Nuclear clefts and hand mirror‐shaped blasts were demonstrated. The positive rates of CD99 and terminal deoxynucleotidyl transferase were 90.9% and 81.6%, respectively. Both monoclonal immunoglobulin (Ig)H and T‐cell receptor‐γ gene rearrangements were demonstrated in 1 of 3 cases. Monoclonal T‐cell receptor‐γ gene rearrangement was found in 10 of 11 cases. Monoclonal IgH and/or Ig? gene rearrangements were revealed in 2 of 3 cases. Cytodiagnoses included 4 ALL/LBL, 3 B‐ALL/LBL and 42 T‐ALL/LBL. Histodiagnoses were available in 24 cases including 2 ALL/LBL, 2 B‐ALL/LBL and 20 T‐ALL/LBL. The concordance rates of cytological‐histological diagnoses were 66.7%, 0% and 95.2% in the three categories, respectively. There were 3 cases with discrepancies of cell lineages.

Conclusions

SE cytological evaluation is a reliable and effective method for the diagnosis of ALL/LBL.
Differentiated cervical intraepithelial neoplasia‐associated invasive cervical squamous cell carcinoma as a source of major cytopathological and surgical pathological discrepancy in Papanicolaou smear screening tests
Authors: Mai K. T.
Published: April 2018

Introduction

Differentiated cervical intraepithelial neoplasia (dCIN) analogous to differentiated squamous intraepithelial neoplasia of the vulva is characterised by the proliferation of atypical cells limited to the basal/parabasal layers. Exfoliative cytology of dCIN has not been investigated.

Methods and Results

A 46‐year‐old woman, with a history of normal Papanicolaou (Pap) smear up to 2 years prior to the occurrence of postcoital vaginal bleeding had two consecutive Pap smears, which only revealed atypical squamous cells of unknown significance (ASCUS). The subsequent cervical biopsy revealed dCIN. The cone biopsy showed the invasive cervical squamous cell carcinoma (ICC) that developed from the overlying dCIN. Review of 32 consecutive cases of ICC revealed a second case of dCIN‐associated ICC (Group 1) preceded by ASCUS suspicious for high‐grade neoplastic cells. In both cases, the ASCUS were keratinised atypical cells without koilocytosis. In addition, there were another seven cases showing focal dCIN associated with extensive usual CIN (Group 2). In comparison with the remaining 24 cases with usual CIN (Group 3), Group 2 lesions occurred in younger patients (mean ages of 36 ± 3 vs 47 ± 9 years) and were associated with shorter intervals after the last normal Pap smears. Pap smears in Group 2 occasionally consisted only of ASCUS cells.

Conclusions

dCIN may occur in the cervix and accounts for a short interval of normal Pap smears and false negative or low‐grade Pap smears in ICC.
Rehydration before wet fixation in conventional body fluid cytology – An 18‐year experience
Authors: Hsu C.‐Y. , Chen T.‐C. , Chang C.‐B. , Liu Y.‐C. , Lin T.‐R.
Published: April 2018

Purpose

In conventional cytology, preparation of a specimen by wet fixation for Papanicolaou stain is potentially subject to dry effect or cell loss which may make cytologic interpretation difficult or even impossible. We have been routinely making an additional smear for rehydration with normal saline (rehydration method) before wet fixation to overcome the above shortcomings.

Methods

We reviewed malignant pleural effusion and ascites 15 cases each in our cytology laboratory over the past 1 year. Four slides of each specimen were made. Two were air‐dried for Liu's stain (a Romanowsky stain) and the other two were wet‐fixed for Papanicolaou stain. The air‐dried smears were also served as retained cellularity control. One of the two wet‐fixed smears was processed as a control of preservation of nuclear detail whereas the other one stayed air‐dried for 10 minutes and then covered with normal saline (rehydration method) for 80 seconds before wet fixation.

Results

There was minor cell loss (P = .032). The cells appeared larger with good preservation of nuclear detail (P < .0001 by two‐sided Wilcoxon rank sum test) but no red blood cells retained on the slide after rehydration.

Conclusion

The rehydration method can effectively minimise cell loss, enlarge and preserve the cytological features of malignant cells with haemolysis. This method is simple, practical and good for cytological screening for tumour cells and interpretation especially in a bloody smear. We recommend that the rehydration method be part of traditional cytopreparatory work of wet fixation for Papanicolaou stain in conventional body fluid cytology.
Hyperleukocytosis is associated with distinct genetic alterations and is an independent poor‐risk factor in de novo acute myeloid leukemia patients
Authors: Tien Feng‐Ming , Hou Hsin‐An , Tsai Cheng‐Hong , Tang Jih‐Luh , Chen Chien‐Yuan , Kuo Yuan‐Yeh , Li Chi‐Cheng , Lin Chien‐Ting , Yao Ming , Huang Shang‐Yi , Ko Bor‐Sheng , Hsu Szu‐Chun , Wu Shang‐Ju , Tsay Woei , Tseng Mei‐Hsuan , Liu Ming‐Chih , Liu Chia‐Wen , Lin Liang‐In , Chou Wen‐Chien , Tien Hwei‐Fang
Published: April 2018

Objectives

Acute myeloid leukemia (AML) with hyperleukocytosis (HL) is intuitively thought as a unique group with dismal prognosis. However, comprehensive studies regarding the genetic landscape and clinical outcome in this group of patients are limited.

Methods

A total of 693 newly diagnosed de novo non‐M3 AML patients were consecutively enrolled. We compared relevant mutations in 20 genes between AML patients with or without HL and exposed their prognostic implications.

Results

Hyperleukocytosis, defined as initial white blood cell counts above 50 000/μL, occurred in 28.9% of AML patients. HL patients had higher incidences of FLT3‐ITD, NPM1, DNMT3A, CEBPA, and TET2 mutations. Multivariate analysis demonstrated that HL was an independent poor prognostic factor for overall survival and disease‐free survival in total patients, those with intermediate‐risk cytogenetics and normal karyotype irrespective of genetic alterations. Intriguingly, HL predicted poor survival in CEBPA double mutated, NPM1 + /FLT3‐ITD‐ and NPM1‐/FLT3‐ITD‐ patients. Further, HL patients who received allogeneic hematopoietic stem cell transplantation (allo‐HSCT) in first complete remission (CR) had a significantly longer overall survival and disease‐free survival than those without allo‐HSCT.

Conclusions

Hyperleukocytosis is an independent poor prognostic factor irrespective of cytogenetics and mutation status. Allo‐HSCT in first CR seems to ameliorate the poor prognostic impact of HL.
Credit Ratings and Managerial Voluntary Disclosures
Authors: He Guanming
Published: April 2018

This study investigates whether managers influence credit ratings via voluntary disclosures. I find that firms near a rating change have a higher incidence of a disclosure regarding product and business expansion (PBE) plans. This finding is more evident for firms that are subject to lower proprietary costs of disclosures, which implies that managers do trade off both the benefits and costs of the disclosures. I find no evidence that firms close to a rating change selectively release good news or suppress bad news on PBE. Overall, my results suggest that firms generally exhibit a credible commitment to maintaining disclosure transparency for a desired credit rating.
Phenological sensitivity to climate change is higher in resident than in migrant bird populations among European cavity breeders
Authors: Samplonius Jelmer M. , Bartošová Lenka , Burgess Malcolm D. , Bushuev Andrey V. , Eeva Tapio , Ivankina Elena V. , Kerimov Anvar B. , Krams Indrikis , Laaksonen Toni , Mägi Marko , Mänd Raivo , Potti Jaime , Török János , Trnka Miroslav , Visser Marcel E. , Zang Herwig , Both Christiaan
Published: April 2018

Many organisms adjust their reproductive phenology in response to climate change, but phenological sensitivity to temperature may vary between species. For example, resident and migratory birds have vastly different annual cycles, which can cause differential temperature sensitivity at the breeding grounds, and may affect competitive dynamics. Currently, however, adjustment to climate change in resident and migratory birds have been studied separately or at relatively small geographical scales with varying time series durations and methodologies. Here, we studied differential effects of temperature on resident and migratory birds using the mean egg laying initiation dates from 10 European nest box schemes between 1991 and 2015 that had data on at least one resident tit species and at least one migratory flycatcher species. We found that both tits and flycatchers advanced laying in response to spring warming, but resident tit populations advanced more strongly in relation to temperature increases than migratory flycatchers. These different temperature responses have already led to a divergence in laying dates between tits and flycatchers of on average 0.94 days per decade over the current study period. Interestingly, this divergence was stronger at lower latitudes where the interval between tit and flycatcher phenology is smaller and winter conditions can be considered more favorable for resident birds. This could indicate that phenological adjustment to climate change by flycatchers is increasingly hampered by competition with resident species. Indeed, we found that tit laying date had an additional effect on flycatcher laying date after controlling for temperature, and this effect was strongest in areas with the shortest interval between both species groups. Combined, our results suggest that the differential effect of climate change on species groups with overlapping breeding ecology affects the phenological interval between them, potentially affecting interspecific interactions.
Seed production in grassland species: Morpho‐biological determinants in a species‐rich semi‐natural grassland
Authors: Scotton M.
Published: April 2018

Studying the seed production of herbaceous species can help to conserve grassland habitats and re‐create new high‐value grassland surfaces. Studies on grassland seed production have focused mainly on individual species and traits, without characterizing their relative importance at the plant community level. The aim of this study was to investigate the entire seed production process of the main species in a temperate grassland. Fertile shoots (FS) of twenty‐nine grasses and forbs were collected over 4 years and analysed for sixteen traits that determine inflorescence size, seed production and seed quality. The per cent viability played a predominant role in determining the total production of viable seeds. Forbs showed a range of reproductive strategies, including variable distribution of flowers among growth periods, number of inflorescences per FS and relationship between seed size and FS density in the grassland. The flower production for grasses was concentrated in the first growth period, but this limitation was mitigated by a higher seed dormancy. The number of viable seeds per FS and seed size were important components of the reproductive strategy of forbs, with heavy‐seeded species being characterised by high individual densities in the community, but producing few seeds per FS. Light‐seeded species showed an opposite pattern. The results suggest that when using seeds from semi‐natural grasslands for ecological restoration, special attention should be paid to the seed amount, germinability and viability of forbs, as they seem to depend more on seed reproduction and have a lower ovule to seed transformation efficiency.
Impact of salt reduction in meals consumed during hemodialysis sessions on interdialytic weight gain and hemodynamic stability
Authors: Colson Arthur , Brinkley Anita , Braconnier Philippe , Ammor Nadia , Burnier Michel , Pruijm Menno
Published: April 2018

Introduction: Patients on hemodialysis (HD) are advised to limit daily water‐ and salt intake to reduce interdialytic weight gain (IDWG). To counterbalance protein‐losses, protein‐rich meals are sometimes provided during HD sessions, but their salt content is not always taken into account. The aim of this study was to assess the influence of a lower salt content of meals provided during HD sessions on IDWG, blood pressure (BP), and hemodynamic stability during dialysis.

Methods: This monocentric, interventional study was proposed to all the patients treated with three weekly HD sessions. The first two months of the study (high salt period), the patients continued to receive one sandwich containing 2.4 g of salt per session. Then, we reduced its salt content from 2.4 to 1.4 g, and patients received this “low‐salt sandwich” at each dialysis session for four months. The mean values of IDWG, BP, and dry weight of the first two months were compared with those collected during the low salt periods (2–6 months).

Findings: Forty out of 76 patients who initially agreed to participate were free of hospitalization, transplantation, and transfer to another center or death during the study period and were included in the final analysis (35% women). Median age was 63 years (range 28–90), 22.5% had a residual diuresis > 0.5 L/day. IDWG baseline decreased from 2.17 ± 0.98 to 2.03 ± 1 kg (P = 0.001) two months and to 2.09 ± 1.01 kg (P = 0.009) four months after we had lowered the salt content of the sandwich. The number of symptomatic intradialytic hypotension was also reduced (6.1% vs., respectively, 3.2% and 3.3% of HD sessions; P = 0.004).

Discussion: IDWG was reduced and hemodynamic stability improved after the reduction of the salt content of perdialytic meals. This suggests that salt consumed during HD matters and might influence salt and water intake outside the dialysis unit.
Comparison between open and pharmacomechanical repair of acutely thrombosed arteriovenous hemodialysis fistulae within a decade
Authors: Regus Susanne , Almási‐Sperling Veronika , Rother Ulrich , Meyer Alexander , Schmid Axel , Uder Michael , Lang Werner
Published: April 2018

Introduction: Different declotting techniques are available for acutely thrombosed arteriovenous hemodialysis fistulae (AVF). The aim of this single‐center study was to compare immediate and follow‐up results between surgical repair and a modified interventional lyse‐and‐wait technique characterized by prolonged local reaction times of recombinant tissue‐plasminogen activator (rtPA).

Materials and Methods: We retrospectively analyzed medical records of 110 consecutively treated patients between the years 2003 and 2013. All patients were on hemodialysis (HD) and suffered from an acutely thrombosed AVF. The treatment standards changed in the course of time, wherefore we compared 2 groups: the open repair (OR) (N = 50) and the endovascular repair (ER) group (N = 60).

Findings: We found no significant differences in success rates (OR 92%/ER 96.7%; P = 0.28), immediate failures (IFs) (OR 8%/ER 10%; P = 0.71), and temporary catheter placements (TCPs) (OR 10%/ER 6.7%; P = 0.52). Furthermore, there were no differences in cumulative primary patency rates (P = 0.42) and secondary patency rates (P = 0.97).The infection rate was significantly increased after OR (8%) compared to ER (0%); P = 0.026. The hospital stay in days was shorter after ER (5.2 ±2.8) vs. OR (9.0 ± 3.5); P < 0.001.

Conclusion: The modified lyse‐and‐wait technique with prolonged local reaction times is a successful alternative to surgical repair for acutely thrombosed AVF. Clear benefits are less infections and significant shorter hospital stays after ER. However, OR remains the preferred treatment for aneurysms and anastomotic stenoses.
Young consumers in the digital era: The selfie effect
Authors: Berg Lisbet
Published: April 2018

This article investigates a mechanism named the selfie effect. By their frequent sharing of selfies on social media, perhaps displaying their cool new fashions or newly acquired tattoos, young people—unintentionally—help providers to promote their products and services, and thereby contribute to the commercial pressure. The existence of a selfie effect builds on hypotheses originating from a pilot interview study concerning how young adults master the consumer role. In this article, the existence of a selfie effect is investigated in a nationally representative web survey with 1,707 respondents aged 16–60, living in Norway. While 59% of the teenagers said they were posting selfies weekly or more often, only 2% among those in their fifties did. The multivariate quantitative analyses support the idea that teenagers and young adults, frequently online, become vulnerable in the consumer role. Particularly posting selfies and following bloggers increase consumer detriment and overconsumption.
Levodopa‐carbidopa intestinal gel: is the naso‐jejunal phase a redundant convention?
Authors: Vijiaratnam Nirosen , Hewer Sarah , Varley Sue , Paul Eldho , Bertram Kelly L. , Lee Will , Ligtermoet Matthew , Williams David R.
Published: April 2018

Levodopa‐carbidopa intestinal gel (LCIG) is an effective treatment for Parkinson disease. Initiating therapy involves an initial naso‐jejunal (NJ) titration phase. The NJ phase is prolonged with significant morbidity. The aim of this study is to assess the impact of proceeding without the NJ phase on resource utilisation and the outcomes of patients. Twenty‐five patients were started on LCIG using the patients existing levodopa equivalent dose (LED). We recorded change in LED, length of hospital stay, readmission rates and use of outpatient services and clinical outcomes within 6 months. The median length of stay was 4.5 days. Patients had four outpatient clinic reviews and 2.5 community nurse contacts within 6 months. There was no significant change in daily LED on discharge (P = 0.56). There were significant improvements in all Unified Parkinson Disease Rating Scale subscores (P < 0.05), the Freezing of Gait scale (P < 0.01) and Parkinson Disease Quality Of Life 39 score (P < 0.01). Initiating LCIG without the NJ phase resulted in short admissions, a minimal outpatient burden and no significant requirement for dose titration while producing good clinical outcomes.
The potential economic value of influenza vaccination for healthcare workers in The Netherlands
Authors: Meijboom Marjan J. , Riphagen‐Dalhuisen Josien , Hak Eelko
Published: April 2018

Background

Despite the clinical evidence, influenza vaccination coverage of healthcare workers remains low. To assess the health economic value of implementing an influenza immunization program among healthcare workers (HCW) in University Medical Centers (UMCs) in the Netherlands, a cost‐benefit model was developed using a societal perspective.

Methods/Patients

The model was based on a trial performed among all UMCs in the Netherlands that included both hospital staff and patients admitted to the pediatrics and internal medicine departments. The model structure and parameters estimates were based on the trial and complemented with literature research, and the impact of uncertainty explored with sensitivity analyses.

Results

In a base‐case scenario without vaccine coverage, influenza‐related annual costs were estimated at € 410 815 for an average UMC with 8000 HCWs and an average occupancy during the influenza period of 6000 hospitalized patients. Of these costs, 82% attributed to the HCWs and 18% were patient‐related. With a vaccination coverage of 15.47%, the societal program’s savings were € 2861 which corresponds to a saving of € 270.53 per extended hospitalization. Univariate sensitivity analyses show that the results are most sensitive to changes in the model parameters vaccine effectiveness in reducing influenza‐like illness (ILI) and the vaccination‐related costs.

Conclusion

In addition to the decreased burden of patient morbidity among hospitalized patients, the effects of the hospital immunization program slightly outweigh the economic investments. These outcomes may support healthcare policymakers’ recommendations about the influenza vaccination program for healthcare workers.
Towards an adequate and sustainable replacement rate in defined benefit pension systems: The case of Spain
Authors: Alonso Fernández Juan José , Devesa Carpio José Enrique , Devesa Carpio Mar , Domínguez Fabián Inmaculada , Encinas Goenechea Borja , Meneu Gaya Robert
Published: April 2018

The main objective of this article is to determine, based on internal data, replacement rates for a defined benefit pension system, with two aims: the adequacy of pensions – measured in terms of the expenditure of retirees – and the sustainability of the system. For this purpose two instruments are used: the internal rate of return, and techniques based on systems of notional accounts. These figures, derived from internal data, will serve, by comparison with the replacement rate of the system, to assess whether the system tends more towards adequacy or sustainability. The system studied is that of Spain.
Linking taxation and social protection: Evidence on redistribution and poverty reduction in Ethiopia
Authors: Hirvonen Kalle , Mascagni Giulia , Roelen Keetie
Published: April 2018

Although redistribution results from the simultaneous effects of taxes and transfers, analyses of their distributional effects in low‐income countries have largely been undertaken from singular perspectives. This article jointly assesses the distributional effect of taxes and transfers (through social protection) using Ethiopia as a case study. We find that Ethiopia's flagship social protection programme is more effective than income taxation in achieving poverty reduction, while neither policy achieves a sizeable reduction in overall inequality. We also find that Ethiopia does not currently have the capacity to close the poverty gap or to fully fund its main safety net programme using domestic income sources alone.
A Tribute to Our Founding Father, Professor Bernard J. “Bud” LaLonde
Authors: Goldsby Thomas J. , Zinn Walter
Published: April 2018

This editorial pays tribute to the founding editor of the Journal of Business Logistics, Professor Bernard J. “Bud” LaLonde, who passed away recently. Professor LaLonde's influence on the field—and the individuals that compose it—is immeasurable. We reflect on his career, achievements, and motivations for creating JBL. Further, we attempt to build on his proud legacy with an introduction of articles featured in the current issue.
Commentary: The neonatal brain and the challenge of imaging biomarkers, reflections on Batalle et al. (2018)
Authors: Gilmore John H.
Published: April 2018

This review by Batalle et al. comes at an important time in the field as neonatal imaging has matured to a point that important questions can now be asked in a more definitive way. Identifying imaging biosmarkers that reflect the prenatal and early childhood origins of cognitive ability, behavior, and risk for neuropsychiatric disorders is now possible, and this commentary offers suggestions for addressing some of the challenges that lie ahead.
Commentary: A time to reap and a time to sow: reducing the adolescent suicide rate now and in the future: commentary on Cha et al. (2018)
Authors: Brent David
Published: April 2018

Cha and colleagues have provided an erudite, lucid, and comprehensive survey of where research on adolescent suicide has been, and where it should go. Their paper provides a broad global picture of the descriptive epidemiology of adolescent suicide, describes environmental, psychological, social, and biological processes likely to be associated with suicidal risk, reviews extant approaches to the management of adolescent suicidal behavior, and makes recommendations for future research. This editorial will expand on some of their recommendations, and also remind readers, that, regardless of how much we still need to learn, we do possess knowledge that, if applied now, could help to reduce the adolescent suicide rate in the near term.
Feasibility of a Health‐Utility Approach to Quantifying Noneconomic Losses from Personal Injury
Authors: Carvalho Natalie , Fish David , Grant Genevieve M. , Salomon Joshua A. , Studdert David M.
Published: April 2018

There is wide agreement that existing approaches to valuing noneconomic losses from personal injury lack coherence. “Health‐utility” measurement—an approach developed in health economics for valuing health outcomes in public health and medicine—holds considerable promise for bringing greater rationality and consistency to assessments of injury‐related noneconomic loss. However, the feasibility of creating utility measures that are suitable for use in personal injury compensation has not been demonstrated. This study takes that step. We surveyed more than 4,100 members of the general public in Australia to assess people's preferences for a variety of nonfatal “health states.” The health states were selected to reflect harms commonly seen in claims to compensation schemes for transport and workplace accidents. We then followed established methods for transforming the survey responses into a “severity weight” for each health state. We show how these severity weights can be used to define tiers in a schedule for guiding noneconomic damages determinations. We also discuss the strengths and limitations of the approach, and consider implementation challenges.