bluuebunny/crossref_metadata_2025 huggingface dataset:
Intramedullary nailing with supplemental plate and screw fixation of long bones of patients with osteogenesis imperfecta: operative technique and preliminary results
Authors: Franzone Jeanne M. , Kruse Richard W.
Published: November 2016

Although intramedullary fixation is the standard form of surgical fixation of the long bones of children with osteogenesis imperfecta (OI), it remains fraught with complications. Implant breakage, implant cut out, long bone fracture, nonunion, and rod bending have all been described as complications of intramedullary long bone fixation in children with OI. Supplemental fixation techniques represent an attempt to decrease these risks of surgical implant failure of intramedullary devices. A supplemental plate and screw construct at a fracture or an osteotomy site in addition to an intramedullary device in the long bone segment is one such form of supplemental fixation. The aim of this study is to describe the surgical technique and early results of plate and screw fixation used to supplement intramedullary fixation in a subset of our OI patient population. This is a retrospective review and report on 14 long bone segments of 11 children with OI who have undergone intramedullary fixation as well as supplemental fixation at osteotomy or fracture sites with a plate and screw construct. The long bone segments treated with intramedullary fixation and a supplemental plate and screw construct included 11 femurs, two tibias, and one humerus. Intramedullary devices included a combination of telescoping and nontelescoping implants. The mean follow-up duration was 10 months. All 14 long bone segments have gone on to radiographic union. The average time to union was 8.8 weeks (range: 6.5–17 weeks). In 11 of the long bone segments, the supplemental plate fixation was applied to the site of a fracture or osteotomy. In one case, supplemental plate fixation was applied to the site of a nonunion (distal humerus nonunion). We describe various options of this surgical technique and early results. Although further follow-up and investigation will provide further insight into long-term outcomes, supplemental plate and screw fixation is a valuable and versatile option for this challenging patient population.
The Kinematics and Spondylosis of the Lumbar Spine Vary Depending on the Levels of Motion Segments in Individuals With Low Back Pain
Authors: Basques Bryce A. , Espinoza Orías Alejandro A. , Shifflett Grant D. , Fice Michael P. , Andersson Gunnar B. , An Howard S. , Inoue Nozomu
Published: November 2016

Study Design.

A prospective cohort study.

Objective.

The aim of this study was to identify associations of spondylotic and kinematic changes with low back pain (LBP).

Summary of Background Data.

The ability to characterize and differentiate the biomechanics of both the symptomatic and asymptomatic lumbar spine is crucial to alleviate the sparse literature on the association of lumbar spine biomechanics and LBP.

Methods.

Lumbar dynamic plain radiographs (flexion-extension), dynamic computed tomography (CT) scanning (axial rotation, disc height), and magnetic resonance imaging (MRI, disc and facet degeneration grades) were obtained for each subject. These parameters were compared between symptomatic and control groups using Student t test and multivariate logistic regression, which controlled for patient age and sex and identified spinal parameters that were independently associated with symptomatic LBP. Disc grade and mean segmental motion by level were tested by one-way analysis of variance (ANOVA).

Results.

Ninety-nine volunteers (64 asymptomatic/35 LBP) were prospectively recruited. Mean age was 37.3 ± 10.1 years and 55% were male. LBP showed association with increased L5/S1 translation [odds ratio (OR) 1.63 per mm, P = 0.005], decreased flexion-extension motion at L1/L2 (OR 0.87 per degree, P = 0.036), L2/L3 (OR 0.88 per degree, P = 0.036), and L4/L5 (OR 0.87 per degree, P = 0.020), increased axial rotation at L4/L5 (OR 2.11 per degree, P = 0.032), decreased disc height at L3/L4 (OR 0.52 per mm, P = 0.008) and L4/L5 (OR 0.37 per mm, p < 0.001), increased disc grade at all levels (ORs 2.01–12.33 per grade, P = 0.001–0.026), and increased facet grade at L4/L5 (OR 4.99 per grade, P = 0.001) and L5/S1 (OR 3.52 per grade, P = 0.004). Significant associations were found between disc grade and kinematic parameters (flexion-extension motion, axial rotation, and translation) at L4/L5 (P = 0.001) and L5/S1 (P < 0.001), but not at other levels (P > 0.05).

Conclusion.

In symptomatic individuals, L4/L5 and L5/S1 levels were affected by spondylosis and kinematic changes. This study clarifies the relationships between kinematic alterations and LBP, mostly observed at the above-mentioned segments.

Level of Evidence: N/A
Factors associated with the lack of access to cervical cancer screening test results in the Brazilian unified health system network in the municipality of Rio de Janeiro
Authors: Martins Luís Felipe L. , Almeida Liz Maria de , Szklo André S. , Szklo Moyses , Thuler Luiz Claudio S. , Enes Maria de Fátima G. , Pinheiro Rejane S. , Coeli Cláudia M.
Published: November 2016

Papanicolaou test screening remains an effective approach for the control of cervical cancer. However, for successful control of the disease, patients need to have access to the test results and complete the treatment. The aim of this study was to investigate the factors associated with lack of access to results from the most recent Papanicolaou test in women living in the municipality of Rio de Janeiro who used the Brazilian Unified Health System. Overall prevalence of lack of access to test results was 18.4%. Access to test results was lower for younger women of Black race/skin color origin, those who had difficulties in making an appointment, those who received no information about when to pick up the test results, and those who evaluated the assistance provided by the health professional who collected the Papanicolaou test. Issues related to the organization and infrastructure of the health unit were the most frequently reported cause by the interviewees. The Brazilian Unified Health Service should improve its knowledge of users and service conditions to prevent interruption of the screening flow.
Investigation of the Effects of a Nursing Information System by Using the Technology Acceptance Model
Authors: Hsu Hung-Hsiou , Wu Ya-Hui
Published: November 2016

The purposes of this study are to investigate the effectiveness of implementing a nursing information system and to discuss several issues affecting its successful deployment from the perspectives of nurses, the major users of the system. The methodology was based on the theory of the technology acceptance model. This study adopted a cross-sectional study method to survey and collect data. In total, 167 questionnaires were distributed to subjects. Approximately 94.6%, or 158 valid questionnaires, were collected. The data were analyzed using SPSS and PLS software.

The data analysis indicated that the factors that most significantly influenced the willingness of nurses to use the nursing information system were their degrees of satisfaction with the system and their perceptions of its usefulness. A nursing information system that can provide functions that are useful and convenient and that facilitate the avoidance of tedious repetitive writing and improve the quality of provided care can encourage nurse satisfaction with the system and thus stimulate their interest in using it for their work. The ease of use of the system can also affect the willingness of nurses to use it.
Successful Treatment of Pyoderma Gangrenosum after Augmentation Mastopexy Using Vacuum Therapy
Authors: Soncini Julio Alberto , Grassi Salles Alessandra , Frizzo Neto Juvenal Antonio , Gemperli Rolf
Published: November 2016

Background:

Pyoderma gangrenosum (PG) is a rare, severe, destructive neutrophilic dermatosis characterized by a progressive, necrotizing process after skin injury. Its cause is still unknown, and diagnosis represents a challenge when ulcers are seen after surgery. Bacterial infection is not found in the wounds. Patients exhibit “pathergy” with the appearance of new lesions after local trauma such as surgical procedures, debridements, and wound care, suggesting altered inflammatory response. The objective of this study was to review the literature and report a case of PG that was satisfactorily treated with vacuum therapy (vacuum-assisted closure [VAC]).

Case Report:

A 19-year-old healthy patient presented with skin ulceration 4 days after augmentation mastopexy, progressing to extensive necrosis. On the eighth day, she underwent debridement and implant removal. Two days later, the necrotic process was again evident and progressed, resulting in a significant increase in wound size, with each wound reaching 20 × 25 cm. Intense and diffuse neutrophilic exudate and areas of necrosis were present. Systemic corticosteroids and VAC under general anesthesia were initiated 5 days after the second surgery. From the fourth VAC session, some adherence between the mammary gland and pectoral muscles was visible, so deep sutures avoiding the dermis were placed to direct wound closure.

Conclusions:

PG is a life-threatening complication with devastating outcomes. Early diagnosis is critical. Although some reported cases needed up to 2 years for wound closure, in this case, VAC therapy allowed the patient to be discharged after only 42 days and permitted wound closure without the need for skin grafts.
The Clinical Diagnostic Utility of Electrophysiological Techniques in Assessment of Patients With Disorders of Consciousness Following Acquired Brain Injury: A Systematic Review
Authors: Hauger S. L. , Schanke A.-K. , Andersson S. , Chatelle C. , Schnakers C. , Løvstad M.
Published: November 2016

Objective:

To investigate the diagnostic utility of electrophysiological recordings during active cognitive tasks in detecting residual cognitive capacities in patients with disorders of consciousness (DoC) after severe acquired brain injury.

Design:

Systematic review of empirical research in MEDLINE, Embase, PsycINFO, and Cochrane from January 2002 to March 2016.

Main Measures:

Data extracted included sample size, type of electrophysiological technique and task design, rate of cognitive responders, false negatives and positives, and excluded subjects from the study analysis. The Quality Assessment of Diagnostic Accuracy Studies–2 (QUADAS-2) was used for quality appraisal of the retrieved literature.

Results:

Twenty-four studies examining electrophysiological signs of command-following in patients with DoC were identified. Sensitivity rates in healthy controls demonstrated variable accuracy across the studies, ranging from 71% to 100%. In patients with DoC, specificity and sensitivity rates varied in the included studies, ranging from 0% to 100%. Pronounced heterogeneity was found between studies regarding methodological approaches, task design, and procedures of analysis, rendering comparison between studies challenging.

Conclusion:

We are still far from establishing precise recommendations for standardized electrophysiological diagnostic procedures in DoC, but electrophysiological methods may add supplemental diagnostic information of covert cognition in some patients with DoC.
Inducible nitric oxide synthase (NOS2) knockout mice as a model of trichotillomania
Authors: Casarotto PC , Biojone C , Montezuma K , Cunha FQ , Joca SRL , Castren E , Guimaraes FS
Published: November 2016

Trichotillomania (TTM) is an impulse control disorder characterized by repetitive hair pulling/trimming. Barbering behavior (BB) has been observed in laboratory animals and proposed as TTM model. The neurobiological basis of TTM is not clear, but it seems to involve striatal hyperactivity parallel to hypoactivation of prefrontal cortex. In this study we observed that knockout mice to the inducible isoform of nitric oxide synthase (NOS2) exhibit exacerbated BB following the 4th week of age, as well as increased repetitive movements compared to wild-type mice (WT). These behaviors are associated to decreased levels of NMDA receptor subunit (NR1) in prefrontal cortex, while an increase was observed in striatum of NOS2KO compared to WT. Striatal neurons from NOS2KO also exhibited increased number of branches compared to WT. The repeated treatment with clomipramine, a clinically approved drug to treat TTM in humans, or memantine, an antagonist of NMDA receptors, as well as partial rescue of NOS2 expression in haploinsufficient animals, attenuated the expression of BB. The silencing of NOS2 expression reduced the MAP2 (microtubule-associated protein 2) levels in activity-induced differentiated PC12 cells. Our data led us to propose that NOS2 regulates the neuronal maturation of the inhibitory afferent pathways to striatum during neurodevelopment, and such inadequate inhibition of striatal motor programs might be associated to the observed phenotype.
How lizards fly: A novel type of wing in animals
Authors: Dehling J. Maximilian
Published: November 2016

Flying lizards of the genusDracoare famous for their gliding ability, using an aerofoil formed by winglike patagial membranes and supported by elongated thoracic ribs. It has remained unknown, however, how the lizards manoeuvre during flight. Here, I show that the patagium is deliberately grasped and controlled by the forelimbs while airborne. This type of composite wing is unique inasmuch as the lift-generating and the controlling units are formed independently by different parts of the body and are connected to each other only for the duration of the flight. The major advantage for the lizards is that the forelimbs keep their entire movement range and functionality for climbing and running when they are not used as the controlling unit of the wing. These findings not only shed a new light on the flight ofDracolizards but also have implications for the interpretation of gliding performance in fossil species.
Optimizing complex phenotypes through model-guided multiplex genome engineering
Authors: Kuznetsov Gleb , Goodman Daniel B. , Filsinger Gabriel T. , Landon Matthieu , Rohland Nadin , Aach John , Lajoie Marc J. , Church George M.
Published: November 2016

Optimization of complex phenotypes in engineered microbial strains has traditionally been accomplished by laboratory evolution. However, only a subset of the resulting mutations may affect the phenotype of interest and many others may have unintended effects. Multiplexed genome editing can complement evolutionary approaches by creating diverse combinations of targeted changes, but in both cases it remains challenging to identify which alleles influence the desired phenotype. We present a method for identifying a minimal set of genomic modifications that optimizes a complex phenotype by combining iterative cycles of multiplex genome engineering and predictive modeling. We applied our method to the 63-codonE. colistrain C321.ΔA, which has 676 mutations relative to its wild-type ancestor, and identified six single nucleotide mutations that together recover 59% of the fitness defect exhibited by the strain. The resulting optimized strain, C321.DA.opt, is an improved chassis for production of proteins containing non-standard amino acids. Our data reveal how multiple cycles of multiplex automated genome engineering (MAGE) and inexpensive sequencing can generate rich genotypic and phenotypic diversity that can be combined with linear regression techniques to quantify individual allelic effects. While laboratory evolution relies on enrichment as a proxy for allelic effect, our model-guided approach is less susceptible than enrichment to bias from population dynamics and recombination efficiency. We also show that the method can identify beneficialde novomutations that arise adventitiously. Beyond improving the fitness of C321, ΔA, our work provides a proof-of-principle for high-throughput quantification of individual allelic effects which can be used with any method for generating targeted genotypic diversity.
A mixture of sparse coding models explaining properties of face neurons related to holistic and parts-based processing
Authors: Hosoya Haruo , Hyvärinen Aapo
Published: November 2016

Experimental studies have revealed evidence of both parts-based and holistic representations of objects and faces in the primate visual system. However, it is still a mystery how such seemingly contradictory types of processing can coexist within a single system. Here, we propose a novel theory called mixture of sparse coding models, inspired by the formation of category-specific subregions in the inferotemporal (IT) cortex. We developed a hierarchical network that constructed a mixture of two sparse coding submodels on top of a simple Gabor analysis. The submodels were each trained with face or non-face object images, which resulted in separate representations of facial parts and object parts. Importantly, evoked neural activities were modeled by Bayesian inference, which had a top-down explaining-away effect that enabled recognition of an individual part to depend strongly on the category of the whole input. We show that this explaining-away effect was indeed crucial for the units in the face submodel to exhibit significant selectivity to face images over object images in a similar way to actual face-selective neurons in the macaque IT cortex. Furthermore, the model explained, qualitatively and quantitatively, several tuning properties to facial features found in the middle patch of face processing in IT as documented by Freiwald, Tsao, and Livingstone (2009). These included, in particular, tuning to only a small number of facial features that were often related to geometrically large parts like face outline and hair, preference and anti-preference of extreme facial features (e.g., very large/small inter-eye distance), and reduction of the gain of feature tuning for partial face stimuli compared to whole face stimuli. Thus, we hypothesize that the coding principle of facial features in the middle patch of face processing in the macaque IT cortex may be closely related to mixture of sparse coding models.
De novotranscriptome characterization of a sterilizing trematode parasite (Microphallussp.) from two species of New Zealand snails
Authors: Bankers Laura , Neiman Maurine
Published: November 2016

Snail-borne trematodes represent a large, diverse, and evolutionarily, ecologically, and medically important group of parasites, often imposing strong selection on their hosts and causing host morbidity and mortality. Even so, there are very few genomic and transcriptomic resources available for this important animal group. We help to fill this gap by providing transcriptome resources from trematode metacercariae infecting two congeneric snail species,Potamopyrgus antipodarumandP.estuarinus. This genus of New Zealand snails has gained prominence in large part through the development of P. antipodarum and its sterilizing trematode parasiteMicrophallus livelyiinto a textbook model for host-parasite coevolutionary interactions in nature. By contrast, the interactions betweenMicrophallustrematodes andP. estuarinus, an estuary-inhabiting species closely related to the freshwaterP. antipodarum, are relatively unstudied. Here, we provide the first annotated transcriptome assemblies fromMicrophallusisolated fromP.antipodarumandP.estuarinus. We also use these transcriptomes to produce genomic resources that will be broadly useful to those interested in host-parasite coevolution, local adaption, and molecular evolution and phylogenetics of this and other snail-trematode systems. Analyses of the twoMicrophallustranscriptomes revealed that the two trematode isolates are more genetically differentiated from one another than areM. livelyiinfecting different populations ofP. antipodarum, suggesting that theMicrophallusinfectingP.estuarinusrepresent a distinct lineage. We also provide a promising set of candidate genes likely involved in parasitic infection and response to salinity stress.
Crystal structure ofcatena-poly[diammonium [di-μ-oxalato-cuprate(II)]]
Authors: Dickie Diane A. , Kemp Richard A.
Published: November 2016

The structure of the title compound, {(NH4)2[Cu(C2O4)2]}n, at 100 K has monoclinic (P21/c) symmetry with the CuIIatom on an inversion center. The compound has a polymeric structure due to long Cu...O interactions which create [Cu(C2O4)2] chains along theaaxis. The structure also displays intermolecular N—H...O hydrogen bonding, which links these chains into a three-dimensional network.
Bring Your Own Devices classroom
Authors: Adhikari Janak , Mathrani Anuradha , Scogings Chris
Published: November 2016

Purpose

Over the past few years, technology-mediated learning has established itself as a valuable pathway towards learners’ academic and social development. However, within the adoption stages of information and communications technology-enabled education, further questions have been raised in terms of equity of information literacy and learning outcomes. For the past three years, the authors have been working with one of the earliest secondary schools in New Zealand to introduce a Bring Your Own Device (BYOD) policy. In this paper, the authors present the findings of a longitudinal investigation into the BYOD project, which offers new insights into the digital divide issues in the context of evolving teaching and learning practices across three levels, namely, digital access, digital capability and digital outcome.

Design/methodology/approach

This study is an empirically grounded longitudinal case research conducted over a three-year period in one secondary school in New Zealand. This research has included a number of methods, including surveys, interviews and classroom observations, to gather qualitative data from various stakeholders (teachers, students and parents).

Findings

The findings from the study of the BYOD project inform of digital divide issues in the context of evolving teaching and learning practices across formal and informal spaces. The authors explored how the BYOD policy has influenced existing divides in the learning process across three levels, namely, digital access, digital capability and digital outcome. The result sheds light on key issues affecting the learning process to contextualise factors in the three-level digital divide for the BYOD technology adoption process in classroom settings.

Research limitations/implications

The study presents findings from an ongoing investigation of one secondary school, an early adopter of the BYOD policy. While the authors have followed the school for three years, more in-depth studies on how teaching and learning practices are evolving across formal and informal spaces will be further qualified in the next stages of data collection.

Originality/value

The study contributes to new knowledge on how digital inclusion can be supported beyond mere access to meaningful use of technology to reinforce student learning and their overall skill development.
Do consumers dig it all? The interplay of digital and print formats in media
Authors: Krishen Anjala S. , Kachen Sheen , Kraussman Michael , Haniff Zeenath
Published: November 2016

Purpose

This study aims to explore consumers’ motivations in the adoption of either print or digital forms of media, given the fluctuation of trends and attitudes in magazine consumption in the USA. This paper utilizes cognitive lock-in and the power law of practice to further the understanding of digital adoption through an interdisciplinary lens.

Design/methodology/approach

In this study, initially, five focus group sessions, including 53 qualifying non-student participants randomly placed into groups of 10 or 11, were held. Next, a 2 × 2 between-subjects quasi-experiment, using 163 undergraduate students at a large public university, was conducted.

Findings

The findings show that although the digital medium is considered less expensive, more convenient and more environmentally friendly, the print medium is regarded as more familiar, personal and visual. Further, whether the media type is a book or a magazine, consumers report higher perceived value, hedonic value and attitude toward print versus digital media.

Practical implications

The potential to digitally attract and lock-in consumers in the media industry has immense implications. Individuals consume media because of fashion marketing, personal space and advertisements, among other reasons.

Originality/value

This paper contributes to existing research by uncovering qualitative and quantitative insights into media consumption through a multilayered analysis of focus group participants and a quantitative experiment. The findings indicate that both the power law of practice theory and cognitive lock-in are plausible explanations for the choice of print over digital media format.
Brave new World of Warcraft: a conceptual framework for active escapism
Authors: Kuo Andrew , Lutz Richard J. , Hiler Jacob L.
Published: November 2016

Purpose

This paper aims to investigate the phenomenon of active escapism – a unique form of experiential consumption that engages fantasy and role-play as a means of coping. In contrast with passive forms of escapism, whereby consumers act as observers (e.g. watching a movie), active escapism provides consumers with the opportunity to directly interact with mediated realities, whether constructed in a virtual space (e.g. a video game) or the real world.

Design/methodology/approach

Within the context of video game consumption, a conceptual framework for active escapism comprised antecedents, processes and consequences is established through literature review, depth interviews and naturalistic inquiry.

Findings

The findings suggest that active escapism functions as a coping mechanism when consumers are confronted with external stressors that threaten either their sense of identity or control. While other forms of emotion-focused coping relieve stress through psychological avoidance (i.e. refocusing of attention away from stressors), active escapism provides the benefits of affirmation and empowerment through projective fantasy (i.e. role-play) and presence (i.e. immersion into a mediated reality).

Originality/value

The conceptual framework established by this analysis gives insight into the structure of active escapism as a theoretical construct, providing a foundation for future research. Managerial implications for consumer escapism (e.g. branded in-game content) are discussed.
Accessing the Urban Commons Through the Mediation of Information: The Eliana Silva Occupation, Belo Horizonte, Brazil
Authors: Morado Nascimento Denise
Published: November 2016

This essay demonstrates how mediations (called Dialogues) between the University of Belo Horizonte and the residents of the Eliana Silva Occupation in that city have secured not only the right to urban land and constitutional rights that have been historically violated in Brazil, but also the right to that which is of common interest. The essay speaks to Michael Hardt and Antonio Negri's contention that what is common goes far beyond the provision of public services. This starting point allows us to see that urban occupations are politically empowered, to the extent that poor people consciously violate the Brazilian law governing the right of possession and ownership over urban land through creative and cooperative actions that are undertaken and extended across networks. This essay will focus on the centrality of the struggle to build a common communication platform serving to nourish social ties and sociability among those social actors who share the same human deprivation—lack of access to what should be widely available to all citizens. On the theoretical side, the essay takes Pierre Bourdieu, Bruno Latour and Milton Santos as its guides to understanding how social actors act in the struggle for socio‐spatial coexistence and urbanity.
Clinical and genetic association, radiological findings and response to biological therapy in seven children from Qatar with non‐bacterial osteomyelitis
Authors: Moussa Taha , Bhat Venkatraman , Kini Vishwanatha , Fathalla Basil M.
Published: November 2016

Aim

We aim to report the clinical manifestations, genetic testing results, magnetic resonance imaging (MRI) findings and biologics used in the management of non‐bacterial osteomyelitis in our center.

Methods

We conducted a retrospective review of medical records. A previously proposed classification was implemented as follows: chronic recurrent multifocal osteomyelitis (CRMO), chronic non‐bacterial osteomyelitis (CNBO) and acute non‐bacterial osteomyelitis.

Results

Four females and three males with a median age at presentation of 6 years (6 months–14 years) presented with arthralgia (7/7), back pain (4/7), arthritis (4/7) and bone pain (2/7). Six patients had CRMO and one patient had CNBO. Genetic testing revealed an apparent homozygote p.S734L LPIN2 mutation in two siblings, a heterozygote p.M694V MEFV mutation in one patient with familial Mediterranean fever and heterozygote p.Q219H PSTPIPI variant of unknown significance in one patient. The most common lesions on MRI involved the tibia (6/7), talar bones (5/7), fibula (4/7) and sacroiliac joints (4/7). Three patients received infliximab. Two are in remission after 2 and 5 years, and the third was advanced after 5 years to canakinumab. Two other patients received canakinumab first. One patient with Majeed syndrome and dyserythropoietic anemia exhibited evidence of improvement, and one had partial improvement and was then treated with infliximab.

Conclusion

Non‐bacterial osteomyelitis may coexist with other autoinflammatory diseases. MRI remains a favorable diagnostic tool and genetic testing may have a limited role in selected cases. Infliximab and canakinumab are associated with variable outcomes, and 6‐week or less dosing intervals for both medications may be more effective.
Occurrence of nausea, vomiting and diarrhoea reported as adverse events in clinical trials studying glucagon‐like peptide‐1 receptor agonists: A systematic analysis of published clinical trials
Authors: Bettge Karolin , Kahle Melanie , Abd El Aziz Mirna S. , Meier Juris J. , Nauck Michael A.
Published: November 2016

Aim

GLP‐1 receptor agonists (RAs) may cause nausea, vomiting or diarrhoea. The aim of this study was to assess the risk of adverse events (AEs) with GLP‐1 RAs and their relation to dose, background medication and duration of action.

Research design and methods

The PubMed database was searched and 32 clinical trials with GLP‐1 RAs (phase 3) were selected. We performed a systematic analysis and compared the proportion of patients reporting nausea, vomiting or diarrhoea, for different doses and glucose‐lowering background medications, and relative to a reference compound within the subclasses of short‐ (exenatide b.i.d.) and long‐acting (liraglutide) GLP‐1 RAs, calculating the relative risks ± 95% confidence intervals.

Results

The risk of nausea was dose‐dependent for long‐acting (P = .0063) and across all GLP‐1 RAs (P = .0017), and a similar trend was observed for vomiting (P = .23). Diarrhoea was dose‐dependent (P = .031). Background treatment with metformin was associated with more nausea (P = .04) and vomiting (P = .0009). Compared to exenatide b.i.d., there was less nausea and diarrhoea with lixisenatide. Compared to liraglutide, there was a similar risk associated with dulaglutide, and less with exenatide q.w. and albiglutide. Long‐acting GLP‐1 RAs were associated with less nausea and vomiting, but with more diarrhoea than short‐acting agents.

Conclusions

GLP‐1 RAs are associated with gastrointestinal AEs that are related to dose and background medications (especially metformin) and may vary in a compound‐specific manner. Long‐acting agents are associated with less nausea and vomiting but with more diarrhoea.
Ecology shapes metabolic and life history scalings in termites
Authors: PEQUENO PEDRO A. C. L. , BACCARO FABRICIO B. , SOUZA JORGE L. P. , FRANKLIN ELIZABETH
Published: November 2016

1. Metabolic rate (B) is a fundamental property of organisms, and scales with body mass (M) as B = αMβ. There has been much debate on whether scaling parameters should be viewed as constants or variables. However, there is increasing evidence that ecological differentiation can affect both α and β.

2. In colonial organisms such as social insects, individual metabolism is integrated at the colony level. Theory and data suggest that whole‐colony metabolism partly reflects individual‐level metabolic and life‐history scalings, but whether these have been affected by ecological diversification is little known.

3. Here, this issue was addressed using termites. Data from the literature were assembled to assess the interspecific scalings of individual metabolic rate with individual mass, and of individual mass with colony mass. Concurrently, it was tested whether such scalings were affected by two key ecological traits: lifestyle and diet.

4. Individual‐level metabolic scaling was affected by diet, with β = 1.02 in wood feeders and 0.60 in soil feeders. However, there was no difference in α. Further, individual mass scaled to the 0.25 power with colony mass, but forager species had larger colonies and smaller individuals relative to wood‐dwelling, sedentary ones, thus producing a grade shift.

5. Our results show that ecological diversification has affected fundamental metabolic and life‐history scalings in termites. Thus, theory on the energetics and evolution of colonial life should account for this variability.
Equine viral arteritis: A respiratory and reproductive disease of significant economic importance to the equine industry
Authors: Balasuriya U. B. R. , Carossino M. , Timoney P. J.
Published: November 2016

Equine arteritis virus is the causative agent of equine viral arteritis, a respiratory and reproductive disease that affects the members of the familyEquidae. The virus was first isolated from the lung of an aborted fetus after an extensive outbreak of respiratory disease and abortion on a Standardbred breeding farm near Bucyrus, Ohio, in 1953. Since then, periodic outbreaks of equine viral arteritis have been reported in a number of countries around the world. This disease may result in significant economic loss to the equine industry due to the occurrence of abortion in pregnant mares, neonatal mortality, and establishment of the carrier state in stallions. This article provides an extensive review on equine arteritis virus, epidemiology, disease, pathogenesis, and prevention and control measures.
Development of fatigue cracks from mechanically machined scratches on 2024‐T351 aluminium alloy—Part II: finite element analysis and prediction method
Authors: Cini A , Irving P E
Published: November 2016

A prediction method to evaluate the effect of scratch geometry on fatigue life of aluminium structures containing scribe marks was developed on the basis of the experimental results described in Part I of this paper. Finite element calculations were performed on scribed samples to investigate the local stress around scribes. Elastic and elastic‐plastic stress and strain distributions at the scribe root were computed under monotonic and cyclic tensile and bending loads evaluating the driving force behind initiation and propagation from scribes. Scribe shape, size and cladding regulated stress and strain distributions in the neighbourhood of scribe roots. Fatigue life of tested scribed samples was divided into initiation life, defined as the cycles spent to develop a 50 µm deep crack at scribe roots, and the remaining propagation life up to failure. Striation counting measurements were used to calculate propagation lives by integrating linear elastic da/dN versus ΔK curves. Only up to a maximum of 38% of total fatigue life was spent to propagate an initial 50 µm deep crack from scribe roots. The theory of critical distances was successfully applied to predict initiation lives of scribed samples from elastic stress distributions. A plastic correction was also suggested, in the frame of the theory of critical distances, to correlate initiation lives of clad and unclad specimens.
Effects of intraspecific hybridisation between two hatchery‐reared strains of Atlantic salmon, Salmo salar, on juvenile survival and fitness‐related traits
Authors: Audet C. L. , Wilson C. C. , Pitcher T. E.
Published: November 2016

Intraspecific hybridisation may result in hybrid offspring exhibiting superior (heterosis) or inferior (outbreeding depression) fitness relative to their parental populations. As both have been demonstrated in salmonids, consequences of interbreeding between divergent populations are relevant to their conservation. Atlantic salmon Salmo salar L. were extirpated from Lake Ontario by the late 19th Century due to anthropogenic causes. Multiple allopatric populations of hatchery‐reared Atlantic salmon are being stocked in an effort to re‐establish a self‐sustaining population. This study evaluated whether interbreeding between Sebago Lake (Maine) and LaHave River (Nova Scotia) individuals will result in heterosis or outbreeding depression in juveniles. This was accomplished through full‐factorial 2 × 2 mating crosses between the strains and comparing multiple fitness‐related traits between the cross types. Hybrid juveniles displayed no signs of outbreeding depression nor heterosis. Further studies on comparative fitness of backcross and F2 hybrids are recommended to assess potential consequences for this and similar restoration efforts.
Higher rates of neuropsychiatric adverse events leading to dolutegravir discontinuation in women and older patients
Authors: Hoffmann C , Welz T , Sabranski M , Kolb M , Wolf E , Stellbrink H‐J , Wyen C
Published: November 2016

Objectives

Dolutegravir (DTG), a second‐generation integrase strand transfer inhibitor (INSTI), is now among the most frequently used antiretroviral agents. However, recent reports have raised concerns about potential neurotoxicity.

Methods

We performed a retrospective analysis of a cohort of HIV‐infected patients who had initiated an INSTI in two large German out‐patient clinics between 2007 and 2016. We compared discontinuation rates because of adverse events (AEs) within 2 years of starting treatment with dolutegravir, raltegravir or elvitegravir/cobicistat. We also evaluated factors associated with dolutegravir discontinuation.

Results

A total of 1950 INSTI‐based therapies were initiated in 1704 patients eligible for analysis within the observation period. The estimated rates of any AE and of neuropsychiatric AEs leading to discontinuation within 12 months were 7.6% and 5.6%, respectively, for dolutegravir (n = 985), 7.6% and 0.7%, respectively, for elvitegravir (n = 287), and 3.3% and 1.9%, respectively, for raltegravir (n = 678). Neuropsychiatric AEs leading to dolutegravir discontinuation were observed more frequently in women [hazard ratio (HR) 2.64; 95% confidence interval (CI) 1.23–5.65; P = 0.012], in patients older than 60 years (HR: 2.86; 95% CI: 1.42–5.77; P = 0.003) and in human leucocyte antigen (HLA)‐B*5701‐negative patients who initiated abacavir at the same time (HR: 2.42; 95% CI: 1.38–4.24; P = 0.002).

Conclusions

In this large cohort, the rate of discontinuation of dolutegravir because of neuropsychiatric adverse events was significantly higher than for other INSTIs, at almost 6% within 12 months. Despite the limitations of this retrospective study, the almost three‐fold higher discontinuation rates observed amongst women and older patients underscore the need for further investigation, especially in patient populations usually underrepresented in clinical trials.
An audit of coagulation screening in patients presenting to the emergency department for potential stroke thrombolysis
Authors: Thorne Katie , McNaughton Harry , Weatherall Mark
Published: November 2016

Aim

To assess time to coagulation screening results in patients presenting for potential stroke thrombolysis.

Methods

A retrospective cohort study of patients was assessed for thrombolysis for stroke at Wellington Hospital between January and June 2014. We assessed time from presentation to receipt of laboratory specimen, processing time and total time from presentation to result availability and whether times differed by receipt time.

Results

During the audit period, 97 unique patients, and 99 clinical episodes, were assessed for stroke thrombolysis; 20 patients received thrombolysis. In 11of 99 (11%) episodes, no coagulation sample was sent. Sample was unsuitable for processing in 16 episodes (18%), and in four, a further specimen was sent. Median (interquartile range) time from presentation to the emergency department to laboratory report during working hours (n = 55) was 61 (53–77) min and out of hours (n = 33) 64 (50–90) min; Hodges‐Lehmann estimator (95% CI) of location shift −1 (−11 to 8) min, P = 0.90. No difference in reporting times was seen whether patients received thrombolysis or not. Seven patients were prescribed warfarin, and one had an international normalised ratio (INR) of 1.7 and was thrombolysed. INR in the other six patients ranged between 1.9 and 3.4. Two patients using dabigatran had prolonged thrombin times and so were not thrombolysed.

Conclusion

A high proportion of laboratory specimens was unsuitable for testing, and overall samples took an unacceptably long time to process. Point‐of‐care testing may potentially allow quicker decisions regarding whether thrombolysis is contraindicated but is likely to affect only a small proportion of patients.
Arrival and onset of breeding of three passerine birds in eastern Finland tracks climatic variation and phenology of insects
Authors: Valtonen Anu , Latja Raimo , Leinonen Reima , Pöysä Hannu
Published: November 2016

Anthropogenic climate change poses a challenge to the annual cycles of migratory birds. It has become urgent to understand whether migratory birds are able to advance their spring phenology when the climate is warming and whether they are able to adjust these phenological phases to the spring phenology in their breeding areas. In this work, we studied long‐term trends in first arrival and onset of breeding for three passerine birds in eastern Finland; the pied flycatcher Ficedula hypoleuca, the common redstart Phoenicurus phoenicurus and the great tit Parus major. The pied flycatcher and the common redstart are long‐distance migrants while the great tit is a partial migrant in Finland. We asked what environmental variables best explain the first arrival or onset of breeding, if there is evidence of ‘thermal delay’ (long‐term increase in the accumulated temperatures) at arrival or onset of breeding and if the interannual variation in the onset of breeding correlates with variation in spring phenology of local insects. We found that the pied flycatcher and the common redstart had advanced their first arrival (explained by increased temperatures at the migration route), but we found no long‐term change in the onset of breeding (explained by local temperatures). Also, the onset of breeding of the great tit is tracking local temperatures. We found no or only weak evidence of thermal delay at arrival or onset of breeding for any of the species. The onsets of breeding for the pied flycatcher and the great tit are also closely tracking the spring phenology of the local insects. The stable or increasing population sizes of all three species in Finland could be a result from their ability to effectively track climatic and environmental variation.
Opportunity costs influence food selection and giving‐up density of dabbling ducks
Authors: Hagy Heath M. , Stafford Joshua D. , Smith Randolph V. , Yetter Aaron P. , Hine Christopher S. , Horath Michelle M. , Whelan Christopher J.
Published: November 2016

The interaction of animals with their food can yield insights into habitat characteristics, such as perceived predation risk and relative quality. We deployed experimental foraging patches in wetlands used by migrating dabbling ducks Anas spp. in the central Illinois River Valley to estimate variation in seed removal and giving‐up density (GUD; i.e. density of food remaining in patches following abandonment) with respect to seed density, seed size, seed depth in the substrate, substrate firmness, perceived predation risk, and an energetic profitability threshold (i.e. critical food density). Seed depth and the density of naturally‐occurring seeds outside of experimental plots affected seed removal and GUD in experimental patches more than perceived predation risk, seed density, seed size or substrate firmness. The greatest seed removal and lowest GUDs in experimental patches occurred when food resources in alternative foraging locations outside of plots (i.e. opportunity costs) appeared to be near or below a critical food density (i.e. 119–181 kg ha–1). Giving‐up densities varied substantially from a critical food density across a range of food densities in alternative foraging locations suggesting that fixed GUDs should not be used as surrogates for critical food densities in energetic carrying capacity models. Foraging and resting rates in and near experimental foraging patches did not reflect patterns of seed removal and were poor predictors of GUD and foraging habitat quality. Our results demonstrated the usefulness of GUDs as indicators of habitat quality for subsurface, benthic foragers relative to other available foraging patches and suggested that food may be limited for dabbling ducks during spring migration in some years in the midwestern USA.
Do surveillance intervals in patients with more than five adenomas at index colonoscopy be shorter than those in patients with three to four adenomas? A Korean Association for the Study of Intestinal Disease study
Authors: Park Soo‐Kyung , Song Young Seok , Jung Yoon Suk , Kim Won Hee , Soo Eun Chang , Ko Bong Min , Seo Geom Seog , Cha Jae Myung , Park Jae Jun , Mo Moon Chang , Jung Yunho , Jeon Seong Ran , Park Dong Il
Published: November 2016

Background and Aim

There is controversy about the surveillance interval after colonoscopy when 5–10 adenomas have been found on index colonoscopy. This study aimed to investigate the risk of colorectal neoplasm (CRN) according to the number of adenomas at index colonoscopy.

Methods

A retrospective, multicenter study was conducted at 10 university hospitals in Korea. We included 1394 patients with ≥ 3 adenomas at index colonoscopy. The risk of advanced CRN was compared according to the number of adenomas (intermediate risk group, 3–4 small adenomas or at least one ≥ 10 mm, and high risk group, ≥ 5 small adenomas or ≥ 3 at least one ≥ 10 mm).

Results

Overall, 164 (11.8%) developed an advanced CRN after a mean of 4.0 years from baseline colonoscopy. The 3‐year and 5‐year risk of advanced CRN was 2.1% (95% CI 2.09–2.11) and 14.4% (95% CI 14.36–14.44) in intermediate risk group and 3.2% (95% CI 3.19–3.21) and 23.3% (95% CI 19.15–19.25) in high risk group (P = 0.01). Having ≥ 5 adenomas (OR = 1.57, 95% CI 1.11–2.23, P = 0.01) detected at index colonoscopy was a significant risk factor for developing advanced CRN.

Conclusions

Although risk of advanced CRN in patients with 5–10 adenomas was significantly higher than that in patients with 3–4 adenomas, the cumulative risk at 3 years was low at 3.2%. Thus, we suggest that a 3‐year surveillance interval might be appropriate for the patients with 5–10 adenomas, and further prospective studies are needed to investigate whether more intensive surveillance is needed in this group.