bluuebunny/crossref_metadata_2025 huggingface dataset:
Family Communication Patterns, Inoculation Theory, and Adolescent Substance‐Abuse Prevention: Harnessing Post‐Inoculation Talk and Family Communication Environments to Spread Positive Influence
Authors: Compton Josh , Craig Elizabeth A.
Published: May 2019

Inoculation theory offers a robust way to combat substance abuse among children. The theory can guide a messaging strategy that prepares for challenges before they are fully experienced. We argue that inoculation as a messaging strategy could be made even more robust by harnessing family communication patterns and post‐inoculation talk to lead to more, and better, parent–child dialogue. We build on the literature on inoculation and family communication patterns to offer four propositions to guide future work in this area, including the efficacy of inoculating parents against tendencies to avoid conversations about substance abuse with their children and the likelihood of inoculation‐based messages leading to continuing talk in families.
Effects of smoking on the association of human leukocyte antigen with ulcerative colitis
Authors: Lee Ho‐Su , Kim Kihyun , Jung Seulgi , Hong Myunghee , Kim Byoung Mok , Yoo Dae‐sung , Moon Jung Won , Baek Jiwon , Hwang Sung Wook , Park Sang Hyoung , Yang Suk‐Kyun , Han Buhm , Song Kyuyoung , Ye Byong Duk
Published: May 2019

Background and Aim

Tobacco smoking is a risk factor for gastrointestinal disorders, causing mucosal damage and impairing immune responses. However, smoking has been found to be protective against ulcerative colitis (UC). Human leukocyte antigen (HLA) is a major susceptibility locus for UC, and HLA‐DRB1*15:02 has the strongest effect in Asians. This study investigated the effects of smoking on the association between HLA and UC.

Methods

The study enrolled 882 patients with UC, including 526 never, 151 current, and 205 former smokers, and 3091 healthy controls, including 2124 never, 502 current, and 465 former smokers. Smoking‐stratified analyses of HLA data were performed using a case–control approach.

Results

In a case–control approach, HLA‐DRB1*15:02 was associated with UC in never smokers (ORnever smokers = 3.20, Pnever smokers = 7.88 × 10−23) but not in current or former smokers (Pcurrent smokers = 0.72 and Pformer smokers = 0.33, respectively). In current smokers, HLA‐DQB1*06 was associated with UC (ORcurrent smokers = 2.59, Pcurrent smokers = 6.39 × 10−12). No variants reached genome‐wide significance in former smokers.

Conclusions

An association between UC and HLA‐DRB1*15:02 was limited to never smokers. Our findings highlight that tobacco smoking modifies the effects of HLA on the risk of UC.
Association of TRAP1 with infliximab‐induced mucosal healing in Crohn's disease
Authors: Park Sang Hyoung , Hong Myunghee , Lee Ho‐Su , Ye Byong Duk , Hwang Sung Wook , Jung Seulgi , Baek Jiwon , Moon Jung Won , Kim Byoung Mok , Oh Seak Hee , Kim Kyung Mo , Lee Inchul , Im Chang‐Nim , Liu Jianjun , McGovern Dermot P B , Yang Suk‐Kyun , Song Kyuyoung
Published: May 2019

Background and Aim

Anti‐tumor necrosis factor (TNF) agents, such as infliximab (IFX), have been increasingly used to induce and maintain disease remission in patients with Crohn's disease (CD). Despite a considerable non‐response rate, little is known about the genetic predictors of response to anti‐TNF therapy in CD. Our aim in this study was to investigate the genetic factors associated with response to anti‐TNF therapy in patients with CD.

Methods

We performed a two‐stage genome‐wide association study (GWAS) to identify loci influencing the response to IFX among Korean patients with CD, comprising 42 good responders with mucosal healing and 70 non‐responders. The achievement of mucosal healing was assessed by endoscopy and imaging. The functional significance of TRAP1 (TNF receptor associated protein 1) was examined using dextran sodium sulfate‐induced colitis model in TRAP1 transgenic mice.

Results

The GWAS identified rs2158962, an intronic single nucleotide polymorphism (SNP) of TRAP1, significantly associated with mucosal healing (odds ratio = 4.94; Pcombined = 1.35 × 10−7). In the dextran sodium sulfate‐induced acute colitis, TRAP1 transgenic mice showed a better response to IFX than the wild‐type mice.

Conclusions

The TRAP1 gene is associated with mucosal healing in CD patients following IFX therapy. Identifying the genetic predictors of mucosal healing to anti‐TNF therapy can prevent patients from exposure to ineffective therapies.
miR‐873‐5p inhibits the progression of colon cancer via repression of tumor suppressor candidate 3/AKT signaling
Authors: Zhu Yufeng , Zhang Xiaojian , Qi Ming , Zhang Yong , Ding Feng
Published: May 2019

Background and Aim

We previously discovered that tumor suppressor candidate 3 (TUSC3) was overexpressed and predicted worse prognosis in colon cancer patients. However, the mechanisms of upregulation of TUSC3 in colon cancer remained unclear.

Methods

MiR‐873‐5p was predicted and identified as the regulator of TUSC3 via online programs and luciferase reporter assays. The roles of miR‐873‐5p in regulating colon cancer cell proliferation, colony formation, and invasion were evaluated in vitro. Animal studies were performed to investigate the effects of miR‐873‐5p on proliferation and lung metastasis. Moreover, the miR‐873‐5p/TUSC3 related signaling pathway and the prognostic value of combining miR‐873‐5p and TUSC3 for colon cancer patients were also explored.

Results

Here, we identified miR‐873‐5p as a novel regulator of TUSC3 in colon cancer. Functionally, ectopic expression or silencing of miR‐873‐5p, respectively, inhibited or promoted colon cancer cells proliferation, colony formation, and invasion, as well as prevented or enhanced the metastasis of colon cancer cells in vitro and in vivo.

Molecularly, miR‐873‐5p functioned as a tumor suppressor by inhibiting the TUSC3/AKT pathway. Overexpression or silencing of TUSC3 could partially reverse the effects of the overexpression or repression of miR‐873‐5p on colon cancer progression caused by activation of the AKT pathway. Clinically, low miR‐873‐5p expression predicted poor survival in colon cancer patients, especially combined with high TUSC3 expression.

Conclusions

We identified miR‐873‐5p as a tumor suppressor, which acts by directly repressing TUSC3 in colon cancer.
Urinary trypsinogen‐2 level and local complications of acute pancreatitis
Authors: Wu Hsing‐Chien , Wang Hsiu‐Po , Chen Chieh‐Chang , Wu Chien‐Hsien , Liu Ting‐Hsu , Wang Chih‐Hsien , Shih Ling‐Na , Liao Wei‐Chih
Published: May 2019

Background and Aim

Local complications of acute pancreatitis (AP) carry risks of morbidity/mortality. This study aimed to assess whether urinary trypsinogen‐2 levels and Bedside Index for Severity in Acute Pancreatitis (BISAP) score on admission predicted subsequent local complications.

Methods

One hundred and forty‐four consecutive patients with AP were prospectively followed till 6 months after discharge. Urinary trypsinogen‐2 levels were measured within 24 h of admission. Local complications (acute peripancreatic fluid collection, acute necrotic collection, pseudocyst, and walled‐off necrosis) were diagnosed by abdominal computed tomography. Cut‐off for trypsinogen‐2 level was assessed using receiver operating characteristic curve, and predictors of local complications were analyzed by logistic regression.

Results

Thirty‐seven (25.7%) patients developed local complications. Urinary trypsinogen‐2 levels were significantly higher in patients with local complications compared with those without local complications (median [interquartile range], 3210 [620–9764.4] μg/L vs 627.3 [72.3–5895] μg/L, P = 0.006). Urinary trypsinogen‐2 significantly outperformed BISAP score in predicting local complications (area under the receiver operating characteristic curve 0.65 [95% CI: 0.55–0.75] vs 0.48 [95% CI: 0.38–0.58], P = 0.005). At the optimal cut‐off of 500 μg/L, the sensitivity, specificity, positive predictive value, and negative predictive value of trypsinogen‐2 level were 78.4%, 45.8%, 33.3%, and 86.0%, respectively. Urinary trypsinogen‐2 level > 500 μg/L was an independent predictor of local complications (adjusted odds ratio, 3.72; 95% CI: 1.42–9.76; P = 0.007). By contrast, BISAP score ≥ 3 and pleural effusion predicted organ failure but not local complications.

Conclusion

In a prospective cohort, urinary trypsinogen‐2 level > 500 μg/L independently predicted local complications of AP.
Longitudinal Relationship Between Frailty and Cognition in Patients 50 Years and Older with Breast Cancer
Authors: Magnuson Allison , Lei Lianlian , Gilmore Nikesha , Kleckner Amber S. , Lin Feng V. , Ferguson Robert , Hurria Arti , Wittink Marsha N. , Esparaz Benjamin T. , Giguere Jeffrey K. , Misleh Jamal , Bautista Javier , Mohile Supriya G. , Janelsins Michelle C.
Published: May 2019

OBJECTIVES

To evaluate relationships between frailty and cognition longitudinally in adults 50 years and older with breast cancer receiving chemotherapy.

DESIGN

Secondary analysis of a prospective longitudinal observational study.

SETTING

University of Rochester NCI Community Oncology Research Program community oncology clinics.

PARTICIPANTS

Patients with breast cancer age 50 and older receiving adjuvant/neoadjuvant chemotherapy (n = 376) and age‐matched controls without cancer (n = 234).

MEASUREMENTS

Frailty was assessed using a modified frailty score from self‐reported assessments (weakness, exhaustion, physical activity, and gait speed). Cognition was assessed by patient report (Functional Assessment of Cancer Therapy‐Cognition [FACT‐Cog]) and objective measures. Frailty and cognition were measured at three time points (prechemotherapy [A1], postchemotherapy [A2], and 6 months postchemotherapy [A3]; similar time interval for controls). Linear regression models evaluated associations between frailty and cognition adjusting for covariates.

RESULTS

The average age was 59 years (standard deviation = 6.4 y). At baseline, patients with cancer had a higher mean frailty score (1.21 vs .73; P < .001) and lower mean FACT‐Cog score (158.4 vs 167.3; P < .001) compared with controls. Objective cognitive measures were not statistically different. Longitudinal decline in FACT‐Cog between A1 and A2 (P < .05) and between A1 and A3 (P < .01) was associated with increased frailty score in patients compared with controls. Longitudinal worsening in Controlled Oral Word Association (P < .05) and Trail‐Making Test (P < .01) were associated with an increase in frailty between A1 and A2 in patients compared with controls; longitudinal decline in the Delayed Match to Sample test was associated with an increase in frailty between A1 and A3 (P < .05) in patients compared with controls. This finding remained significant for a subset analysis of those aged 65 and older.

CONCLUSION

In patients with breast cancer aged 50 and older, longitudinal decline in FACT‐Cog and objective measures of attention and memory were associated with increased frailty during treatment and up to 6 months posttreatment. Overall, our study suggests cognition and frailty are both important factors to assess in breast cancer patients. J Am Geriatr Soc 67:928–936, 2019.
Expanding Therapeutic Options for Older Adults: Case‐Based Updates in Breast and Lung Cancer
Authors: Magnuson Allison , Elias Rawad , Koll Thuy
Published: May 2019

Oncology care has become increasingly complex, with a dramatic increase in the number of available therapy options. Many newly developed medications have novel mechanisms of action and include targeted therapies and immunotherapy options. These agents typically have unique side effects that differ from more traditional cytotoxic chemotherapy regimens. Older adults represent the majority of patients with cancer and it is important for geriatricians and primary care providers for older adults to have a general understanding of newer agents and novel therapies, in order to aid in decision‐making and supportive care strategies during oncology treatment. This review provides a case‐based approach to discussing emerging therapeutic treatment options, including targeted therapies and immune‐based therapies, in two common malignancies affecting older adults. Incorporation of available evidence of specific novel therapies in older adult populations is discussed. J Am Geriatr Soc 67:1012–1019, 2019.
Effects of a Home‐based Exercise Program on Anxiety and Mood Disturbances in Older Adults with Cancer Receiving Chemotherapy
Authors: Loh Kah Poh , Kleckner Ian R. , Lin Po‐Ju , Mohile Supriya G. , Canin Beverly E. , Flannery Marie A. , Fung Chunkit , Dunne Richard F. , Bautista Javier , Culakova Eva , Kleckner Amber S. , Peppone Luke J. , Janelsins Michelle , McHugh Colin , Conlin Alison , Cho Jonathan K. , Kasbari Sameer , Esparaz Benjamin T. , Kuebler J. Philip , Mustian Karen M.
Published: May 2019

BACKGROUND/OBJECTIVE

Exercise interventions improve anxiety and mood disturbances in patients with cancer. However, studies are limited in older adults with cancer. We assessed the effects of exercise on anxiety, mood, and social and emotional well‐being in older patients with cancer during their first 6 weeks of chemotherapy.

DESIGN

Exploratory secondary analysis of a randomized controlled trial (RCT).

SETTING

Community oncology practices.

PARTICIPANTS

Older patients (aged 60 years or older) undergoing chemotherapy (N = 252).

INTERVENTION

Patients were randomized to Exercise for Cancer Patients (EXCAP) or usual care (control) for the first 6 weeks of chemotherapy. EXCAP is a home‐based, low‐ to moderate‐intensity progressive walking and resistance training program.

MEASUREMENTS

Analysis of covariance, with study arm as the factor, baseline value as the covariate, and study arm × baseline interaction, was used to evaluate arm effects on postintervention anxiety (State Trait Anxiety Inventory [STAI]), mood (Profile of Mood States [POMS]), and social and emotional well‐being (Functional Assessment of Cancer Therapy–General subscales) after 6 weeks.

RESULTS

Median age was 67 years; 77% had breast cancer. Statistically significant group differences were observed in the STAI score (P = .001), POMS score (P = .022), social well‐being (P = .002), and emotional well‐being (P = .048). For each outcome, EXCAP patients with worse baseline scores had larger improvements at 6 weeks; these improvements were clinically significant for STAI score and social well‐being.

CONCLUSIONS

Among older cancer patients receiving chemotherapy, a 6‐week structured exercise program improved anxiety and mood, especially among those participants with worse baseline symptoms. Additional RCTs are needed to confirm these findings and evaluate the appropriate exercise prescription for managing anxiety, mood, and well‐being in this patient population. J Am Geriatr Soc 67:1005–1011, 2019.
Malnourished adults’ receipt of hospital discharge nutrition care instructions: a pilot study
Authors: Brooks M. , Vest M. T. , Shapero M. , Papas M.
Published: May 2019

Background

Malnutrition remains an important yet under‐recognised problem among hospitalised adults. Although interventions exist aiming to improve nutritional status beyond hospitalisation, few studies examine how often and what type of nutrition care instructions are given at discharge. The present study sought to review nutrition‐focused discharge care provided to malnourished adults.

Methods

We reviewed the electronic medical record for discharge nutrition care instructions provided to adult patients identified by dietitians as malnourished over a 4‐month period.

Results

Seventy‐six eligible patients were identified during the study period. More than half of malnutrition cases (64.5%) were attributed to chronic illness. According to electronic medical record documentation, 6.6% received discharge instructions to consume oral nutrition supplements and 30.3% received new or changed prescriptions for vitamins/noncaloric supplements. Almost half of patients (47.4%) received general diet instructions that did not address malnutrition and 44.8% received inappropriate instructions to limit caloric intake.

Conclusions

A majority of malnourished adult patients receive inappropriate or inadequate nutrition care instructions at the time of discharge. Clinician education and redesign of nutrition care options in the electronic medical record may improve the provision of post‐discharge nutrition care instructions.
Examination of Alzheimer's disease by a combination of electrostatic force and mechanical measurement
Authors: ZHAO W. , CUI W. , XU S. , CHEONG L.‐Z. , SHEN C.
Published: May 2019

Alzheimer's disease (AD) is the most common dementia and neurodegenerative disorder disease in central nervous system, and threatens the people's health seriously. But till now there are no effective ways to diagnose and treat AD. Herein, the differences between charge propagation, surface morphology, and Young's modulus of the hippocampus, in healthy and AD mice have been investigated using advanced modes of Atomic Force Microscopy (AFM). The ability of charge transfer in AD samples has decreased compared with healthy samples. There are compact layered structures in hippocampus from healthy sample, whereas there are no obvious layered structures in hippocampus from AD sample. The Young's modulus of hippocampus from AD sample is about half of that from healthy sample. The results demonstrate that AFM will be helpful in the further study of the functions of hippocampus and pathogeny of AD.

Lay Description

Alzheimer's disease is the most common cause of dementia, a neurodegenerative disease which especially affects elderly people, threatens people's health seriously. The pathological features of AD are senile plaques, neurofibrillary tangles, and cerebral atrophy. The main clinical symptoms of AD are progressive memory impairment, cognitive dysfunction, and loss of language skills, as there are disorder in limbic and cortices. The morbidity rate increases with age and is currently at 5% and 20% among people older than 65 and 85, respectively. Thus AD has a heavy socioeconomic burden, especially in an aging society. So far, there are no effective therapeutic clinical treatments, and no effective means and methods to test and diagnose early stage AD. This means that further studies are essential to gain a deeper, fundamental understanding of the pathogenesis of AD.

In this work, the surface morphology, electrical and mechanical properties of the hippocampi from healthy and AD mice have been investigated by Atomic Force Microscopy (AFM) at nanometre scale for the first time. The hippocampi from healthy mice are composed of compact layered structures, whereas there are no obvious characteristic features in the hippocampi from AD mice. The electrical properties of hippocampus slices were studied by the Electrostatic Force Microscopy (EFM) mode of AFM. The charge propagation ability of axons from AD mice has decreased dramatically compared to that of healthy mice. After charge injection (injection voltage was +10 V) the charge density was 2.3 × 105 C μm–2 in healthy samples, which was larger than that from the AD samples (1.0 × 105 C μm–2). The Young's modulus of hippocampi from healthy and AD mice were 104.0 and 40.1 kPa, respectively, as revealed by the quantitative nanomechanical mapping (QNM) mode of AFM. It indicates that when AD occurs, the Young's modulus will be lower than the healthy sample. These observations and experimental approaches will be useful in future studies of the pathogeny of AD.
The Impact of Automated Reminders on Credit Outcomes: Results from an Experimental Pilot Program
Authors: Roll Stephen P. , Moulton Stephanie
Published: May 2019

This study evaluates the impact of an automated reminder program designed to help credit counseling consumers manage their payment obligations and financial goals. Credit counseling consumers were randomly assigned to receive reminders linked to their financial goals and payment obligations for one year after an initial credit counseling session. We find that consumers offered reminders were 21% less likely than the control to experience severe (60+ day) payment delinquencies and were 12% less likely to experience a 30+ day delinquency. At the same time, these consumers saw a 10.5 point increase in credit scores relative to the control group. There were no significant impacts on total credit card balances or installment debt levels. This analysis provides promising evidence that automated reminders can provide an important complement to traditional credit counseling when it comes to improving consumers' credit profiles and does so at a fairly low cost.
“The Langue d'Oc Is Bringing People Together”: Debating the Place of Regional Languages in France
Authors: Connor Janet E.
Published: May 2019

France is well known for its strong standard language ideologies, based in the idea that equality among citizens depends on the universality of a standard national language. In this context, a recent push to allow bilingual signage in French and regional languages may seem surprising. This article analyzes recent public debates in France surrounding the use and value of regional languages. These debates reached a climax after a local administrative council banned bilingual signs in French and Occitan in a town on the Mediterranean coast. I argue that these debates are an instance of the negotiation of new understandings of the relation between regional languages and place. First, the debates reinforced the connection between regional languages as entire codes and sets of practices that are authentically linked to the French territory. Second, the debates worked to rescale regional languages to no longer belong just to speakers and their descendants, but as universally owned by the nation as a whole. This kind of universal value was founded on perceived authenticity of regional languages. By renegotiating the place of regional languages within the French nation, they became a form of “safe” diversity to be celebrated and promoted instead of feared.
Resting State Functional Connectivity of the Supplementary Motor Area to Motor and Language Networks in Patients with Brain Tumors
Authors: Bathla Girish , Gene Madeleine N. , Peck Kyung K. , Jenabi Mehrnaz , Tabar Viviane , Holodny Andrei I.
Published: May 2019

BACKGROUND AND PURPOSE

We examined the resting‐state functional connectivity (RSFC) of the supplementary motor area (SMA) in brain tumor patients. We compared the SMA subdivisions (pre‐SMA, SMA proper, central SMA) in terms of RSFC projected from each region to the motor gyrus and language areas.

METHODS

We retrospectively identified 14 brain tumor patients who underwent task‐based and resting‐state fMRI, and who completed motor and language paradigms that activated the SMA proper and pre‐SMA, respectively. Regions of interest (ROIs) obtained from task‐based fMRI were generated in both areas and the central SMA to produce RSFC maps. Degree of RSFC was measured from each subdivision to the motor gyrus and Broca's area (BA).

RESULTS

All patients showed RSFC between the pre‐SMA and language centers and between the SMA proper and motor gyrus. Thirteen of 14 patients showed RSFC from the central SMA to both motor and language areas. There was no significant difference between subdivisions in degree of RSFC to BA (pre‐SMA, r = .801; central SMA, r = .803; SMA proper; r = .760). The pre‐SMA showed significantly less RSFC to the motor gyrus (r = .732) compared to the central SMA (r = .842) and SMA proper (r = .883) (P = .016, P = .001, respectively).

CONCLUSIONS

The region between the pre‐SMA and SMA proper produces reliable RSFC to the motor gyrus and language areas in brain tumor patients. This study is the first to examine RSFC of the central SMA in this population. Consequently, our results provide further validation to previous studies, supporting the existence of a central SMA with connectivity to both motor and language networks.
Manufacturing of Metal Frameworks for Full‐Arch Dental Restoration on Implants: A Comparison between Milling and a Novel Hybrid Technology
Authors: Ciocca Leonardo , Meneghello Roberto , Savio Gianpaolo , Scheda Lorenzo , Monaco Carlo , Gatto Maria Rosaria , Micarelli Costanza , Baldissara Paolo
Published: May 2019

Purpose

To determine the trueness and precision of frameworks manufactured with a selective laser melting/milling hybrid technique (SLM/m) and conventional milling by comparing the implant‐platform/framework interface with those of the original computer‐aided design (CAD).

Materials and Methods

Using a virtual 6‐implant‐supported full‐arch framework CAD drawing, 27 titanium replicas were manufactured by 3 independent manufacturing centers (n = 9/center) using a hybrid SLM/m technology (labs 1 and 2) or the conventional milling technique (lab 3). Using an opto‐mechanical coordinate measuring machine, the frameworks’ misfit distribution and patterns were analyzed, and the position error between paired platform positions within each framework was evaluated to calculate the misfit tendency for each group. A multilevel analysis using a mixed‐effects model was conducted (α = 0.05). The trueness was evaluated as the dimensional difference from the original, while the precision as the dimensional difference from a repeated scan.

Results

The 3 dimensional misfits differed significantly among the 3 groups, with the milled group exhibiting the least accurate outcome (p = 0.005). The mean 3D positioning errors ranged from 8 to 16 µm and from 9 to 22 µm for the SLM/m technique (labs 1 and 2, respectively), and from 20 to 35 µm for conventional milling (lab 3). Regarding the misfit distribution pattern, the misfit increased with the distance between paired platform positions in all groups.

Conclusions

All groups had 3D misfits well within the error limits reported in the literature. The 3D misfits of new hybrid (SLM/milling) and conventional (milling) procedures differed significantly among them, with the milling technique the less accurate and precise. The largest errors in all groups were found between the most distant implants, resulting in a correlation between the framework span and the inaccuracies.
High incidence of respiratory disease in Australian infants despite low rate of maternal cigarette smoking
Authors: Gray Lawrence E K , Ponsonby Anne‐Louise , Lin Tiffany X , O'Hely Martin , Collier Fiona , Ranganathan Sarath , Sly Peter D , Pezic Angela , Tang Mimi L K , Burgner David , Vuillermin Peter
Published: May 2019

Aim

The burden of wheezing illnesses in Australian infants has not been documented since the success of initiatives to reduce maternal cigarette smoking. We aimed to determine the incidence of wheeze and related health‐care utilisation during the first year of life among a contemporary Australian birth cohort.

Methods

A birth cohort of 1074 infants was assembled between 2010 and 2013. Parents completed questionnaires periodically. Several non‐exclusive infant respiratory disease phenotypes were defined, including any wheeze, wheeze with shortness of breath and recurrent wheeze. Skin prick testing was performed to determine atopic wheeze. Health‐care utilisation for respiratory disease was determined from questionnaires and hospital medical records.

Results

Retention to 1 year was 840/1074 (83%). The incidence of any wheeze was 51.8% (95% confidence interval (CI) 48.3–55.2%), wheeze with shortness of breath 20.6% (95% CI 17.9–23.5), recurrent wheeze 19.4% (95% CI 16.8–22.2) and atopic wheeze 6% (95% CI 4.6–7.8). Respiratory illness resulted in primary health‐care utilisation in 82.2% (95% CI 79.3–84.8) of participants and hospital presentation in 8.8% (95% CI 7.2–10.6). Maternal smoking during pregnancy was uncommon (15.7%) and was not associated with wheeze or health resource utilisation. Male gender, familial atopy and asthma and smaller household size were associated with a higher incidence of wheeze.

Conclusions

The incidence of wheezing illness among Australian infants remains high despite relatively low rates of maternal smoking during pregnancy. The majority of the health‐care burden is borne by primary health‐care services. Further research is required to inform novel prevention strategies.
Simultaneous determination of 19 mycotoxins in lotus seed using a multimycotoxin UFLC-MS/MS method
Authors: Wei Fang , Liu Xiaofei , Liao Xiaofang , Shi Linchun , Zhang Shuwei , Lu Jinghua , Zhou Lidong , Kong Weijun
Published: May 2019

Objectives

In relevance to the internal components and improper environmental conditions, lotus seeds are susceptible to fungal contamination and mycotoxins residue, leading to harmful impacts on the quality and safety, as well as their pharmaceutical efficacy and clinical use. It is necessary and urgent to assess various mycotoxins residue in lotus seeds. This study aimed to develop a sensitive method for accurate assessment of multimycotoxin residues in lotus seeds.

Methods

A simple and reliable modified ultrasonication-assisted extraction, QuEChERS purification based ultrafast liquid chromatography tandem mass spectrometry (UFLC-MS/MS) method was successfully developed for ultrasensitive determination of 19 multiclass mycotoxins in starch-rich lotus seeds. Four extraction modes and three clean-up sorbents for improving the recoveries of mycotoxins were optimized. Limits of detection (LODs) and quantification, linearity, precision, accuracy, and matrix effect were studied for method validation. For simultaneous qualitation and quantification, the 19 chemically diversified mycotoxins were well separated on a CAPCELL CORE C18 column (100 mm × 2.1 mm, 2.7 μm) and detected in positive/negative electrospray ionization mode within 7 min.

Key findings

The validated method exhibited satisfactory linearity (r > 0.995), ultragood selectivity (LODs of 0.1–15.0 μg/kg), excellent precision (RSDs <13.0%) and convincing accuracy (recoveries between 79.4% and 131.6% with RSDs <14.4%). Matrix effect, between 54.5% and 113.6%, appeared especially for aflatoxins B1 and B2, deoxynivalenol and T-2 toxins. Matrix-matched curve-based quantification showed that 26 (57.8%) out of 45 lotus seed samples were contaminated with one or more mycotoxins, and ochratoxin A, aflatoxin B2, aflatoxin B1 and citrinin were the most prevalent mycotoxins.

Conclusions

This study reports for the first time the incidence of a wide range of 19 mycotoxins in lotus seeds and the proposed method will get broad application for more trace components in other complex matrices.
Stunting trajectories from post‐infancy to adolescence in Ethiopia, India, Peru, and Vietnam
Authors: Gausman Jewel , Kim Rockli , Subramanian S.V.
Published: May 2019

Many interventions focus on preventing stunting in the first 1,000 days of life. We take a broader perspective on childhood growth to assess the proportions of children who suffer persistent stunting, recover, and falter and become newly stunted between birth and adolescence. We use longitudinal data collected on 7,128 children in Ethiopia, India, Peru, and Vietnam. Data were collected in five survey waves between the ages of 1 to 15 years. We use descriptive and graphical approaches to compare the trajectories of children first stunted by age 1, first stunted by age 5, and those remained not stunted until age 5. On average, 29.6% of children were first stunted by age 1, 12.9% of children were first stunted by the age 5, and 68.7% of children were not stunted at either age 1 or age 5. A larger percentage of children stunted by age 1 remained stunted at age 15 (40.7%) compared with those who were first stunted by age 5 (32.3%); 33.7% of children first stunted by age 1 and 31.1% of children first stunted by age 5 go on to recover, but then falter during later childhood. 13.1% of children who were not stunted at age 1 or age 5 become newly stunted between the ages of 8 and 15. Our results show that children both become stunted and recover from stunting into adolescence. More attention should be paid to interventions to support healthy growth throughout childhood.
Genomic evidence of genetic variation with pleiotropic effects on caterpillar fitness and plant traits in a model legume
Authors: Gompert Zachariah , Brady Megan , Chalyavi Farzaneh , Saley Tara C. , Philbin Casey S. , Tucker Matthew J. , Forister Matthew L. , Lucas Lauren K.
Published: May 2019

Plant–insect interactions are ubiquitous, and have been studied intensely because of their relevance to damage and pollination in agricultural plants, and to the ecology and evolution of biodiversity. Variation within species can affect the outcome of these interactions. Specific genes and chemicals that mediate these interactions have been identified, but genome‐ or metabolome‐scale studies might be necessary to better understand the ecological and evolutionary consequences of intraspecific variation for plant–insect interactions. Here, we present such a study. Specifically, we assess the consequences of genome‐wide genetic variation in the model plant Medicago truncatula for Lycaeides melissa caterpillar growth and survival (larval performance). Using a rearing experiment and a whole‐genome SNP data set (>5 million SNPs), we found that polygenic variation in M. truncatula explains 9%–41% of the observed variation in caterpillar growth and survival. Genetic correlations among caterpillar performance and other plant traits, including structural defences and some anonymous chemical features, suggest that multiple M. truncatula alleles have pleiotropic effects on plant traits and caterpillar performance (or that substantial linkage disequilibrium exists among distinct loci affecting subsets of these traits). A moderate proportion of the genetic effect of M. truncatula alleles on L. melissa performance can be explained by the effect of these alleles on the plant traits we measured, especially leaf toughness. Taken together, our results show that intraspecific genetic variation in M. truncatula has a substantial effect on the successful development of L. melissa caterpillars (i.e., on a plant–insect interaction), and further point toward traits potentially mediating this genetic effect.
Rich pictures: a companion method for qualitative research in medical education
Authors: Cristancho Sayra M , Helmich Esther
Published: May 2019

Context

Within the social sciences, researchers increasingly build on visual methods to explore complex phenomena and understand how people experience and give meaning to this complexity. Amongst the variety of visual methods available, rich pictures are beginning to gain traction in health professions education (HPE) research.

Approach

A rich picture is a pictorial representation of a particular situation, including what happened, who was involved, how people felt, how people acted, how people behaved, and what external pressures they acted upon. Rich pictures expand our perspective; they may highlight connections, illuminate the big picture and reveal unexpected emotions. Although new methods bring excitement to the field, it is our responsibility to also be cautious and insightful about their limitations. Rich pictures are a method in evolution in HPE research, with many unknowns about what is possible and what is optimal.

Purpose

In the current paper, we aim to map out the background, describe the process and share some reflective insights of using rich pictures as a data collection method.
Dynamic headway control for high‐frequency bus line based on speed guidance and intersection signal adjustment
Authors: Bie Yiming , Xiong Xinyu , Yan Yadan , Qu Xiaobo
Published: May 2019

To prevent bus bunching, a dynamic headway control method in the V2I (vehicle to infrastructure) environment for a high‐frequency route with bus lane is developed. Bus operating speed guidance on the mid‐blocks and intersection signal adjustment are two main strategies in the proposed method. A forecasting model of bus travel time under the dynamic control method is developed. The objective function is set up by taking into account differences between actual bus headways and dispatching headways, and the scaling ratios of intersection cycle lengths. The optimization model is solved using genetic algorithm. The proposed method is applied to a real bus route in Meihekou city, China, and compared with the current control plan as well as holding strategy. Results show that the proposed method can reduce bus headway deviations in all investigating periods; negative impacts on cars can be limited by setting reasonable values for the parameters.
How to do things with modals
Authors: Mandelkern Matthew
Published: May 2019

According to a prominent line of thought, epistemic possibility claims do not communicate propositions; instead, they are proposals to leave certain possibilities open. This idea is at the heart of recent arguments that, to make sense of the dynamics of epistemic modality, we must reject the contextualist account of conversational dynamics, on which the fundamental role of assertions—including “might”‐claims—is to communicate information. I argue, on the contrary, that we can capture the dynamics of epistemic modality within the contextualist framework by taking the content of “might”‐claims to be determined by the prospective common attitudes of the conversants.
The Consubstantial Otherness of God: Divine Simplicity and the Trinity in Hans Urs von Balthasar
Authors: Martin Jennifer Newsome
Published: May 2019

Martin explores divine simplicity according to the twentieth‐century Catholic theologian Hans Urs von Balthasar. She grants that Balthasar does not provide a traditional presentation of the attribute of divine simplicity. In his doctrine of the Trinity, Balthasar emphasizes such themes as distance, “hiatus,” and infinite difference, none of which seems to promise a robust doctrine of divine simplicity. Indeed, some have suggested that Balthasar's Trinitarian theology does not allow for traditional claims about divine simplicity. Martin argues, however, that one finds in Balthasar's Trinitarian theology the doctrine of divine simplicity, assumed as an internalized starting point and rooted in his understanding of the analogia entis. This can be seen, for example, in his various engagements with Aquinas as well as with contemporary thinkers such as Gustav Siewerth and Erich Przywara. Likewise, when addressing the issue of whether the Trinitarian Persons can be “counted” according to our normal understanding of number, he insists with Evagrius that God is simple. In the same context, he similarly draws upon Plotinus, Basil of Caesarea, Gregory of Nyssa, Gregory Nazianzen, Tertullian, Ambrose, and Aquinas. Martin therefore gives particular attention to the Theo‐Logic and to Balthasar's affirmation in his Trinitarian theology of the points that the divine Persons are fully God, the divine attributes are identical with each other in God, and the distinction of Persons has to do not with three parts of God but with opposed subsistent relations.
Mould‐reactive T cells for the diagnosis of invasive mould infection—A prospective study
Authors: Steinbach Angela , Cornely Oliver A. , Wisplinghoff Hilmar , Schauss Astrid C. , Vehreschild Joerg J. , Rybniker Jan , Hamprecht Axel , Richter Anne , Bacher Petra , Scheffold Alexander , Koehler Philipp
Published: May 2019

Invasive mould infections (IMI) in immunocompromised patients are difficult to diagnose. Early and targeted treatment is paramount, but minimally invasive tests reliably identifying pathogens are lacking. We previously showed that monitoring pathogen‐specific CD4+T cells in peripheral blood using upregulation of induced CD154 positive lymphocytes can be used to diagnose acute IMI. Here, we validate our findings in an independent patient cohort. We stimulated peripheral blood cells from at‐risk patients with Aspergillus spp. and Mucorales lysates and quantitated mould‐reactive CD4/CD69/CD154 positive lymphocytes via flow cytometry. Mould‐reactive lymphocytes were quantitated in 115 at‐risk patients. In 38 (33%) patients, the test was not evaluable, mainly due to low T cell counts or non‐reactive positive control. Test results were evaluable in 77 (67%) patients. Of these, four patients (5%) had proven IMI and elevated mould‐reactive T cell signals. Of 73 (95%) patients without proven IMI, 59 (81%) had mould‐reactive T cell signals within normal range. Fourteen (19%) patients without confirmed IMI showed elevated T cell signals and 11 of those received antifungal treatment. The mould‐reactive lymphocyte assay identified presence of IMI with a sensitivity of 100% and specificity of 81%. The mould‐reactive lymphocyte assay correctly identified all patients with proven IMI. Assay applicability is limited by low T cell counts during bone marrow suppression. The assay has the potential to support diagnosis of invasive mould infection to facilitate tailored treatment even when biopsies are contraindicated or cultures remain negative.
Platelet mitochondrial DNA methylation: Markers of cardiovascular disease predisposition in overweight and obese individuals
Authors: Byun H.‐M.
Published: May 2019

Obesity‐related non‐communicable diseases are global health issues. More than 50% of men and women are overweight or obese in the UK, which is associated with increased risk of cardiovascular disease (CVD) among other non‐communicable diseases. Early detection of the risk of CVD development within high‐risk groups is urgently needed to reduce the burden of this disease. Several mechanisms underlie the increased risk of CVD in overweight and obese individuals, yet non‐invasive molecular markers for risk prediction are not readily available. With the support of funding from the British Nutrition Foundation Drummond Pump Priming Award, we examined platelet mitochondrial DNA methylation in overweight and obese participants at baseline in relation to future CVD incidence. In this article, the findings from the project supported by the British Nutrition Foundation and future directions are described.
Nondisjunction and unequal spindle organization accompany the drive of Aegilops speltoides B chromosomes
Authors: Wu DanDan , Ruban Alevtina , Fuchs Jörg , Macas Jiri , Novák Petr , Vaio Magdalena , Zhou YongHong , Houben Andreas
Published: May 2019

B chromosomes (Bs) are supernumerary chromosomes, which are often preferentially inherited. When transmission rates of chromosomes are higher than 0.5, not obeying the Mendelian law of equal segregation, the resulting transmission advantage is collectively referred to as ‘chromosome drive’.

Here we analysed the drive mechanism of Aegilops speltoides Bs.

The repeat AesTR‐183 of A. speltoides Bs, which also can be detected on the Bs of Aegilops mutica and rye, was used to track Bs during pollen development. Nondisjunction of CENH3‐positive, tubulin interacting B sister chromatids and an asymmetric spindle during first pollen grain mitosis are key for the accumulation process. A quantitative flow cytometric approach revealed that, independent of the number of Bs present in the mother plant, Bs accumulate in the generative nuclei to > 93%. Nine out of 11 tested (peri)centromeric repeats were shared by A and B chromosomes.

Our findings provide new insights into the process of chromosome drive. Quantitative flow cytometry is a useful and reliable method to study the drive frequency of Bs. Nondisjunction and unequal spindle organization accompany during first pollen mitosis the drive of A. speltoides Bs. The prerequisites for the drive process seems to be common in Poaceae.
Whistle‐blowing in the digital era: motives, issues and recommendations
Authors: Lam Helen , Harcourt Mark
Published: May 2019

With the ever‐increasing popularity of social media, whistle‐blowing, which generally refers to the disclosure of organisational wrongdoing, has entered a new era. Whistle‐blowing via virtual platforms has transformed not just the channel of disclosure, but also the associated motives, processes and outcomes. The impact on the whistle‐blower, the organisation and the public can often be accelerated and is seen as being more significant than traditional whistle‐blowing through internal means or external dedicated authorities or journalists. Yet systematic research on this changing phenomenon is just emerging, and regulation (e.g. for rewards, safeguards or protection) is lagging behind. In this paper, we specifically examine the impetus, as well as the benefits and drawbacks, of using online channels such as social media, blogging or websites, for whistle‐blowing by both employees and non‐employees, taking into consideration recent case law and development. A number of recommendations are proposed for virtual whistle‐blowers, organisations and governments.
Obesity and male hypogonadism: Tales of a vicious cycle
Authors: Carrageta David F. , Oliveira Pedro F. , Alves Marco G. , Monteiro Mariana P.
Published: May 2019

Obesity prevalence, particularly in children and young adults, is perilously increasing worldwide foreseeing serious negative health impacts in the future to come. Obesity is linked to impaired male gonadal function and is currently a major cause of hypogonadism. Besides signs and symptoms directly derived from decreased circulating testosterone levels, males with obesity also present poor fertility outcomes, further evidencing the parallelism between obesity and male reproductive function. In addition, males with androgen deficiency also exhibit increased fat accumulation and reduced muscle and mineral bone mass. Thus, compelling evidence highlights a vicious cycle where male hypogonadism can lead to increased adiposity, while obesity can be a cause for male hypogonadism. On the opposite direction, sustained weight loss can attain amelioration of male gonadal function. In this scenario, a thorough evaluation of gonadal function in men with obesity is crucial to dissect the causes from the consequences in order to target clinical interventions towards maximized improvement of reproductive health. This review will address the causes and consequences of the bidirectional relationship between obesity and hypogonadism, highlighting the implicit male reproductive repercussions.
Frequency of CIED remote monitoring: A quality improvement follow‐up study
Authors: Dechert Brynn E. , Bradley David J. , Serwer Gerald A. , Dick Macdonald , LaPage Martin J.
Published: May 2019

Background

Based on the findings of a prior study of CIED (Cardiac Implantable Electrical Device) remote monitoring (RM) frequency at the same center, the University of Michigan Congenital Heart Center (UMCHC) instituted a quality improvement (QI) change to reduce the frequency of routine CIED RM from every 2 months to every 3 months. The objective of this study is to determine the impact of this QI initiative to reduce workload without compromising patient care.

Methods

This is a single‐center, retrospective cohort study of all UMCHC patients with CIEDs followed via Medtronic CareLink CIED remote monitoring system from July 2015 to June 2017, after the QI change in 2014. The primary outcome was success of transition to new monitoring schedule. Secondary outcomes included complications, incidence of actionable events (AES), patient compliance, and change in workload. Outcomes were compared to the prior study.

Results

There were 325 patients (mean age was 24  ±  14 years) included, of who 293 (90%) completely transitioned to the new RM schedule. During the study period, 96 transmissions included AES (4% of total), of which 50 (52%) were asymptomatic and discovered on routine monitoring. No patient experienced a complication attributable to decreased RM frequency. The mean number of interrogations decreased by 1.6 per patient over the 2‐year period compared to prior study.

Conclusions

This study demonstrated successful implementation of a QI initiative to reduce CIED monitoring frequency at a single center with no patient adverse events. The intervention reduced workload and potentially improved patient compliance with routine RM.