bluuebunny/crossref_metadata_2025 huggingface dataset:
Chemical composition of unripe banana peels and pulps flours and its effects on blood glucose of rats
Authors: de Angelis-Pereira Michel Cardoso , Barcelos Maria de Fátima Piccolo , Pereira Rafaela Corrêa , Pereira Juciane de Abreu Ribeiro , de Sousa Raimundo Vicente
Published: July 2016

Purpose

Flours obtained from pulps and peels of unripe banana were evaluated regarding their chemical composition and glycemic responses in rats. Moreover, this study aims to propose a new assay to measure glycemic responses using animals.

Design/methodology/approach

Proximal composition, total dietary fiber and its insoluble and soluble fractions, mineral content and tannins were evaluated. Glycemic responses were measured using albino Wistar rats (seven animals/group).

Findings

Flours from pulp and peel of unripe banana presented high content of carbohydrates and minerals. Moreover, flour from peel was rich in insoluble fiber, whereas flour from pulp had adequate proportion of insoluble and soluble fractions. Consumption of banana flours from peel and pulp did not affect fasting blood glucose of normoglycemic rats. Flour from pulp, when consumed in concentrations of 10 and 15 per cent of the diet, significantly stimulated lower glycemic responses in the animals.

Originality/value

Results presented in this study disclose unripe banana flour as an interesting food source, which may be indicated for preventing some types of diseases, such as diabetes, obesity and dyslipidemia. Moreover, the glycemic index assay using animals promoted accurate answers, as the diets were standardized, unlike studies with humans, which do not control variations related to omission and distortion of information regarding food intake.
The estimation of spectra from time‐frequency transforms for use in attenuation studies
Authors: Beckwith James , Clark Roger , Hodgson Linda
Published: July 2016

We introduce the signal dependent time–frequency distribution, which is a time–frequency distribution that allows the user to optimize the tradeoff between joint time–frequency resolution and suppression of transform artefacts. The signal‐dependent time–frequency distribution, as well as the short‐time Fourier transform, Stockwell transform, and the Fourier transform are analysed for their ability to estimate the spectrum of a known wavelet used in a tuning wedge model. Next, the signal‐dependent time–frequency distribution, and fixed‐ and variable‐window transforms are used to estimate spectra from a zero‐offset synthetic seismogram. Attenuation is estimated from the associated spectral ratio curves, and the accuracy of the results is compared. The synthetic consisted of six pairs of strong reflections, based on real well‐log data, with a modeled intrinsic attenuation value of 1000/Q = 20. The signal‐dependent time–frequency distribution was the only time–frequency transform found to produce spectra that estimated consistent attenuation values, with an average of 1000/Q = 26±2; results from the fixed‐ and variable‐window transforms were 24±17 and 39±10, respectively. Finally, all three time–frequency transforms were used in a pre‐stack attenuation estimation method (the pre‐stack Q inversion algorithm) applied to a gather from a North Sea seismic dataset, to estimate attenuation between nine different strong reflections. In this case, the signal‐dependent time‐frequency distribution produced spectra more consistent with the constant‐Q model of attenuation assumed in the pre‐stack attenuation estimation algorithm: the average L1 residuals of the spectral ratio surfaces from the theoretical constant‐Q expectation for the signal‐dependent time‐frequency distribution, short‐time Fourier transform, and Stockwell transform were 0.12, 0.21, and 0.33, respectively. Based on the results shown, the signal‐dependent time‐frequency distribution is a time–frequency distribution that can provide more accurate and precise estimations of the amplitude spectrum of a reflection, due to a higher attainable time–frequency resolution.
EFT‐C's understanding of couple distress: an overview of evidence from couple and emotion research
Authors: Vanhee Gaëlle , Lemmens Gilbert M. D. , Moors Agnes , Hinnekens Céline , Verhofstadt Lesley L.
Published: July 2016

Despite the growing body of research on Emotionally Focused Couple Therapy (EFT‐C), less research attention has been paid to the validity of EFT‐C's description of the relationship dynamics that characterize distressed couples. The current theoretical paper provides a narrative review of evidence from existing emotion and couple research for EFT‐C's assumptions on the origin of relationship distress (according to Johnson and to Greenberg and Goldman). Our findings lead to three conclusions: first, the general assumptions outlined by EFT‐Cs on need frustration, emotional responses, and interaction patterns are largely supported by the couple and emotion literature. Second, less straightforward evidence was found for the specific elaborations of these principles made by EFT‐Cs. Third, a lack of systematic research on EFT‐C's assumptions hampers strong conclusions. We suggest future research on this issue with attention toward current insights in the emotion and couple literature.

Practitioner points

Evidence supports EFT‐C's basic assumptions that partners’ unmet needs lead to relationship distress and negative emotions, which give rise to negative interaction cycles between partners

Direct empirical evidence is available for attachment‐related assumptions, whereas assumptions on identity and attraction/liking needs have been less investigated

Some of EFT‐C's more specific assumptions need to be more systematically researched
Journalists’ Evaluation of the South Korean Government's Crisis Management in the Cheonan Incident
Authors: Cho SeungHo , Hong Sook‐Yeong
Published: July 2016

The purpose of this study was to examine how journalists judge and react to the withholding of information by the government during a national crisis. This article analyses the case of the sinking of the Cheonan, which killed four South Korean marines and sparked extreme tension throughout the Korean peninsula. For this research, in‐depth interviews were conducted with journalists who reported on the Cheonan incident. All participants (11 journalists) believed that the South Korean government withheld information about the cause of the Cheonan sinking for a period of time. Half of the journalists did not agree with the governmental restrictive information policy, while the other half accepted this as the government acting in the best interest of national security in a crisis situation.
Modelling catch per unit effort of the Black Volta near the Bui dam in Ghana
Authors: Alhassan Elliot H. , Ofori‐Danson Patrick K. , Nunoo Francis K. E.
Published: July 2016

The chlorophyll a concentration and water level of the Black Volta near the Bui dam were studied in relation to fish production as measured by catch per unit effort (CPUE) between February 2011 and December 2012. The primary objective was to develop a simple linear regression model for predicting CPUE levels. The mean estimated CPUE for 2011 and 2012 was lower (6.23 kg canoe−1 day−1) in the postwet season than in the dry season (10.86 kg canoe−1 day−1) with a mean of 7.95 kg canoe−1 day−1. Hence, the dry season was the most important season for fish catches in the study area. Predictor variables that significantly explained CPUE levels were chlorophyll a (positive correlation) and water level (negative correlation) (P = 0.0002). The model was validated with independent data from the same Black Volta in 2011 and 2012. This model, CPUE = (0.062 × chlorophyll a) − (0.456 × water level) + 3.363, explained 91% CPUE variability. Independent validation indicated that the model had the potential to predict CPUE (as a measure of fish production) in the Black Volta near the Bui dam. Hence, the model is also a valuable tool to predict future trends in the CPUE levels of the Black Volta.
Species richness and evenness respond to diverging land‐use patterns – a cross‐border study of dry tropical woodlands in southern Africa
Authors: Revermann Rasmus , Wallenfang Johannes , Oldeland Jens , Finckh Manfred
Published: July 2016

Cross‐border studies offer unique situations to study the impact of different land‐use regimes on ecosystems. Along the Angolan and Namibian border formed by the Okavango River, the environmental conditions and traditional land‐use practises are the same on either side of the river. However, decades of civil war in Angola led to a stagnant development while political stability in Namibia fostered a recent socio‐economic transformation. We investigated the impact of spatially diffuse land use on plant diversity of the dry tropical woodlands covering the vast, sandy hinterlands of the river. As accessibility is the major factor governing land use, we used distance to road as a proxy for land‐use intensity. Based on 58 vegetation plots sized 20 m × 50 m, we showed that species richness increased with distance to road in Angola while in Namibia it remained constant on a lower level. Evenness showed an inverse pattern to species richness and Shannon diversity index showed no response. Analysing diversity patterns according to life forms revealed that these patterns are primarily driven by woody species. The study showed that spatially diffuse land use has a measurable effect on plant diversity and illustrates that roads act as vectors of change.
Use of mistletoes by the Grey Go‐away‐bird (Corythaixoides concolor, Musophagidae) in a semi‐arid savannah, south‐west Zimbabwe
Authors: Ndagurwa Hilton G. T. , Nyawo Elizabeth , Muvengwi Justice
Published: July 2016

Mistletoes are preferred nesting sites for many bird species in a range of habitats. However, no studies have examined the use of mistletoes by nesting birds in the semi‐arid savannah. We studied nesting in mistletoe and its role in determining nesting success in the Grey Go‐away‐bird in south‐west Zimbabwe. We modelled the effects of mistletoe, mistletoe abundance, nest microclimate, concealment and nest height on daily survival rates (DSR) using program MARK. A constant survival model was best fitted for the Grey Go‐away‐bird suggesting a constant nest survival rate across the nesting period. Mistletoe nests had lower DSR than nests placed elsewhere in the canopy. Mistletoe abundance and nest height had a positive association with DSR whereas visibility distance, microclimate and concealment were negatively associated with DSR. Overall, survival for nests in mistletoe was 22.1% compared with 90.5% for nests in other substrates over the 50‐day nesting period. In conclusion, the low nest survival in mistletoe suggests either that the factors used to select mistletoe as nest sites by these birds are poor predictors of nest success or that nesting in mistletoe may be maladaptive.
Seasonality affects leaf nutrient and condensed tannin concentration in southern African savannah browse
Authors: Naumann Harley D. , Cooper Caitlyn E. , Muir James P.
Published: July 2016

Trees that maintain some leaves throughout dry seasons become important ruminant browse depending on nutritive and antinutritive values. Leaves from seven tree species that maintained some leaves during the dry season were collected during dry and wet seasons and analysed for nutritive and antinutritive values. Neutral detergent fibre of leaves was either not different or less (P ≤ 0.05) during the dry season as compared to the wet season depending on species. Acid detergent fibre was either not different or greater (P ≤ 0.05) during the dry season as compared to the wet season. Crude protein and condensed tannins (CT) were either not different or less (P ≤ 0.05) during the dry season than during the wet season for the seven species. The biological activity (protein‐binding ability; PB) of the CT was highly species specific and was either not different between seasons, more bioactive during the wet season, or more bioactive during the dry season depending on the species. Based on combinations of low fibre, high protein and potentially beneficial levels of bioactive CT, Senegalia caffra, Vachellia karoo and Searsia lancea may be the most promising dry‐season browse of the species studied.
Avian species diversity in different habitat types in and around North Nandi Forest, Kenya
Authors: Bett Mark Cheruiyot , Muchai Muchane , Waweru Catherine
Published: July 2016

Forest fragmentation and degradation leads to formation of modified habitats whose ability to support existing avifaunal diversity is still largely unknown. Bird diversity in indigenous forest, disturbed forest, plantation forest and farmlands adjacent to North Nandi Forest reserve was studied between January 2015 and June 2015. The distribution of bird feeding guilds in these habitat patches was also evaluated. Birds were surveyed using point counts, timed species counts and line transects and classified into six feeding guilds. A total of 3,232 individual birds of 151 species were recorded in the four habitats. Significant difference on bird abundance across the four habitats (F = 15.141, P ≤ 0.05, df = 3, 1121) was noted. Shannon–Weiner diversity index H′ for bird community ranged from 3.06 for plantation forest to 4.05 for disturbed forest showing a relatively diverse bird community. Insectivores (F = 3.090, P ≤ 0.05, df = 3, 297) dominated the foraging species assemblage in all the habitats significantly. Linear regression analysis revealed a strong linear relationship on bird species richness and abundance with vegetation variables (P < 0.01 in all cases). The results indicate that disturbed forest and indigenous forest support high bird species richness than plantation forest and farmlands. However, high bird abundance was observed in farmlands and plantation forest as opposed to indigenous forest and disturbed forest as they provide dispersal routes over a short distance and are important for creating corridors between primary forests.
Night and day: evaluating transect methodologies to monitor duikers in the Dzanga‐Sangha Protected Areas, Central African Republic
Authors: Jost Robinson Carolyn A , Zollner Patrick A , Kpanou Jean Bosco
Published: July 2016

Across the Congo Basin, human hunting pressure poses the biggest threat to small‐ and medium‐bodied forest ungulates (genusPhilantombaandCephalophus, commonly known as duikers). The exploitation of these species has cascading effects on larger ecosystem processes, as well as on human subsistence practices. This study compares encounter rates and estimated population densities of duiker species, specificallyPhilantomba monticola(blue duiker) in the Dzanga‐Sangha Protected Areas (APDS), Central African Republic (CAR). Data were collected using direct observations of individual animals during diurnal (135 km) and nocturnal (150 km) transects in theAPDS, with abundance estimates produced usingDISTANCEsoftware. Transect data demonstrate that within hunted forests similar toAPDS, nocturnal rather than diurnal transects yield more individual observations of ungulates. Despite hunting pressure in the region, estimates presented forAPDSsuggest some of the highest density estimates reported for blue duikers in western and central Africa (58.6 blue duikers per km2). This study directly contributes current regional data on the status of duiker populations atAPDSand in the larger Sangha Trinational Landscape (TNS,UNESCO). More broadly, we highlight the potential importance of nocturnal transect data to the development of adaptive management regimes in hunted forests.
Climate Change Impacts on Faidherbia albida (Delile) A. Chev. Distribution in Dry Lands of Ethiopia
Authors: Noulèkoun Florent , Chude Stella , Zenebe Amanuel , Birhane Emiru
Published: July 2016

Given recent and projected climate change, the study of adaptation and mitigation strategies which involve ecologically and economically important plant species is urgently needed. Faidherbia albida (Delile) A. Chev. is a species of both economic and ecological importance. We use 229 locational records gathered in the dry highlands of Ethiopia, nineteen environmental variables and the modelling program MaxEnt to model both the present and possible future distributions of this species. To model future distributions, we used two emission scenarios (Representative Concentration Pathways 2.6 and 8.5) for two time slices (2050 and 2070). Mean temperature of wettest quarter was the major factor which determines the species' potential distribution. Suitable habitat for F. albida under the current climatic conditions is the mid‐highlands. However, its future distributions would shift upwards in elevation and will likely lead to some decrease in suitable areas, especially towards the end of the century. At the same time, however, other areas would become suitable for colonization, so that, overall, the species does not appear to face a significant reduction in distribution within our study region. Future studies should consider the possible effects of climate extremes, further environmental factors and of evolutionary adaptation of the species to new conditions.
Label‐ and Level‐Invariant Graphical Log‐Linear Models
Authors: Ramírez‐Aldana Ricardo , Eslava‐Gómez Guillermina
Published: July 2016

We introduce two types of graphical log‐linear models: label‐ and level‐invariant models for triangle‐free graphs. These models generalise symmetry concepts in graphical log‐linear models and provide a tool with which to model symmetry in the discrete case. A label‐invariant model is category‐invariant and is preserved after permuting some of the vertices according to transformations that maintain the graph, whereas a level‐invariant model equates expected frequencies according to a given set of permutations. These new models can both be seen as instances of a new type of graphical log‐linear model termed the restricted graphical log‐linear model, or RGLL, in which equality restrictions on subsets of main effects and first‐order interactions are imposed. Their likelihood equations and graphical representation can be obtained from those derived for the RGLL models.
Impact of ischaemia time on renal function after partial nephrectomy: a systematic review
Authors: Rod Xavier , Peyronnet Benoit , Seisen Thomas , Pradere Benjamin , Gomez Florie D. , Verhoest Grégory , Vaessen Christophe , De La Taille Alexandre , Bensalah Karim , Roupret Morgan
Published: July 2016

Objective

To assess the impact of ischaemia on renal function after partial nephrectomy (PN).

Materials and methods

A literature review was performed according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) criteria. In January 2015, the Medline and Embase databases were systematically searched using the protocol (‘warm ischemia’[mesh] OR ‘warm ischemia’[ti]) AND (‘nephrectomy’[mesh] OR ‘partial nephrectomy’[ti]). An updated search was performed in December 2015. Only studies based on a solitary kidney model or on a two‐kidney model but with assessment of split renal function were included in this review.

Results

Of the 1119 studies identified, 969 abstracts were screened after duplicates were removed: 29 articles were finally included in this review, including nine studies that focused on patients with a solitary kidney. None of the nine studies adjusting for the amount of preserved parenchyma found a negative impact of warm ischaemia time on postoperative renal function, unless this was extended beyond a 25‐min threshold. The quality and the quantity of preserved parenchyma appeared to be the main contributors to postoperative renal function.

Conclusion

Currently, no evidence supports that limited ischaemia time (i.e. ≤25 min) has a higher risk of reducing renal function after PN compared to a ‘zero ischaemia’ technique. Several recent studies have suggested that prolonged warm ischaemia (>25–30 min) could cause an irreversible ischaemic insult to the surgically treated kidney.
Germline genetic variation in JAK2 as a prognostic marker in castration‐resistant prostate cancer
Authors: Zhang Ben Y. , Riska Shaun M. , Mahoney Douglas W. , Costello Brian A. , Kohli Rhea , Quevedo Jorge F. , Cerhan James R. , Kohli Manish
Published: July 2016

Objectives

To evaluate the prognostic significance of germline variation in candidate genes in patients with castration‐resistant prostate cancer (CRPC).

Methods

Germline DNA was extracted from peripheral blood mononuclear cells of patients with CRPC enrolled in a clinically annotated registry. Fourteen candidate genes implicated in either initiation or progression of prostate cancer were tagged using single nucleotide polymorphisms (SNPs) from HapMap with a minor allele frequency of >5%. The primary endpoint was overall survival (OS), defined as time from development of CRPC to death. Principal component analysis was used for gene levels tests of significance. For SNP‐level results the per allele hazard ratios (HRs) and 95% confidence intervals (CIs) under the additive allele model were estimated using Cox regression, adjusted for age at CRPC and Gleason score (GS).

Results

A total of 240 patients with CRPC were genotyped (14 genes; 84 SNPs). The median (range) age of the cohort was 69 (43–93) years. The GS distribution was 55% with GS ≥8, 32% with GS = 7 and 13% with GS <7 or unknown. The median (interquartile range) time from castration resistance to death for the cohort was 2.67 (1.6–4.07) years (144 deaths). At the gene level, a single gene, JAK2 was associated with OS (P < 0.01), and 11 of 18 JAK2 SNPs were individually associated with OS after adjustment for age and GS. A multivariate model consisting of age, GS, rs2149556 (HR 0.67; 95% CI 0.38–1.18) and rs4372063 (HR 2.17; 95% CI 1.25–3.76) was constructed to predict survival in patients with CRPC (concordance of 0.69, P < 3.2 × 10−9).

Conclusions

Germline variation in the JAK2 gene was associated with survival in patients with CRPC and warrants further validation as a potential prognostic biomarker.
Ground crickets singing in volcanic warm “islets” in snowy winter: Their seasonal life cycles, photoperiodic responses and origin
Authors: Masaki Sinzo , Soma Masayuki , Ubukata Hidenori , Katakura Haruo , Ichihashi Rie , He Zhuqing , Ichijô Nobuaki , Kobayashi Norio , Takeda Makio
Published: July 2016

The ground cricketDianemobius nigrofasciatusoverwinters as an egg in Japan, being univoltine in Hokkaido and northern Honshu and bivoltine farther south. In Hokkaido, however, this cricket is heard singing in winter in several fumarolic fields covered with moss and grasses locally known as “bokke”. In such warm “islets” the adult density was high in early summer and again in autumn, indicating that the cricket is bivoltine in contrast to the univoltine life cycle outside thebokkehabitats in Hokkaido. Eggs laid by females collected at regular intervals from abokkehabitat showed a clear seasonal cycle of diapause incidence. At 26°C, thebokkestrains produced non‐diapause eggs under long days and diapause eggs under short days as in the southern bivoltine populations, although the critical day‐length was longer than in the south. Several strains derived from non‐bokkehabitats in Hokkaido and northern Honshu produced high percentages of diapause eggs under long days as well as short days as expected for the univoltine life cycle. Winter adults singing inbokkehabitats could be either survivors of the autumn generation or individuals derived from eggs laid in autumn and then matured in response to the high soil temperature. In the laboratory, the proportion of egg diapause in short days was decreased by selection only for several generations. Phylogenetic trees ofbokkeand non‐bokkepopulations, based on both the nucleotide sequence of the mitochondrialCOIgene and four allozyme loci, suggest thatbokkepopulations have not been isolated from non‐bokkepopulations for an evolutionarily significant time.
Automatic Schaeffer's gestures recognition system
Authors: Gomez‐Donoso Francisco , Cazorla Miguel , Garcia‐Garcia Alberto , Garcia‐Rodriguez Jose
Published: July 2016

Schaeffer's sign language consists of a reduced set of gestures designed to help children with autism or cognitive learning disabilities to develop adequate communication skills. Our automatic recognition system for Schaeffer's gesture language uses the information provided by an RGB‐D camera to capture body motion and recognize gestures using dynamic time warping combined with k‐nearest neighbors methods. The learning process is reinforced by the interaction with the proposed system that accelerates learning itself thus helping both children and educators. To demonstrate the validity of the system, a set of qualitative experiments with children were carried out. As a result, a system which is able to recognize a subset of 11 gestures of Schaeffer's sign language online was achieved.
ENPP1 processes protein ADP‐ribosylation in vitro
Authors: Palazzo Luca , Daniels Casey M. , Nettleship Joanne E. , Rahman Nahid , McPherson Robert Lyle , Ong Shao‐En , Kato Kazuki , Nureki Osamu , Leung Anthony K. L. , Ahel Ivan
Published: July 2016

ADP‐ribosylation is a conserved post‐translational protein modification that plays a role in all major cellular processes, particularly DNA repair, transcription, translation, stress response and cell death. Hence, dysregulation of ADP‐ribosylation is linked to the physiopathology of several human diseases including cancers, diabetes and neurodegenerative disorders. Protein ADP‐ribosylation can be reversed by the macrodomain‐containing proteins PARG, TARG1, MacroD1 and MacroD2, which hydrolyse the ester bond known to link proteins to ADP‐ribose as well as consecutive ADP‐ribose subunits; targeting this bond can thus result in the complete removal of the protein modification or the conversion of poly(ADP‐ribose) to mono(ADP‐ribose). Recently, proteins containing the NUDIX domain – namely human NUDT16 and bacterial RppH – have been shown to process in vitro protein ADP‐ribosylation through an alternative mechanism, converting it into protein‐conjugated ribose‐5′‐phosphate (R5P, also known as pR). Though this protein modification was recently identified in mammalian tissues, its physiological relevance and the mechanism of generating protein phosphoribosylation are currently unknown. Here, we identified ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) as the first known mammalian enzyme lacking a NUDIX domain to generate pR from ADP‐ribose on modified proteins in vitro. Thus, our data show that at least two enzyme families – Nudix and ENPP/NPP – are able to metabolize protein‐conjugated ADP‐ribose to pR in vitro, suggesting that pR exists and may be conserved from bacteria to mammals. We also demonstrate the utility of ENPP1 for converting protein‐conjugated mono(ADP‐ribose) and poly(ADP‐ribose) into mass spectrometry‐friendly pR tags, thus facilitating the identification of ADP‐ribosylation sites.
Rare coagulation disorders: fibrinogen, factor VII and factor XIII
Authors: de Moerloose P. , Schved J.‐F. , Nugent D.
Published: July 2016

Rare coagulation disorders (RCDs) include the inherited deficiencies of fibrinogen, factor (F) II, FV, combined FV and VIII, FVII, FX, combined FVII and X, FXI, FXIII and combined congenital deficiency of vitamin K‐dependent factors (VKCFDs). Despite their rarity, a deep comprehension of all these disorders is essential to really understand haemostasis. Indeed, even if they share some common features each RCD has some particularity which makes it unique. In this review, we focus on three disorders: fibrinogen, FVII and FXIII.
Rethinking events in the haemostatic process: role of factor V and TFPI
Authors: Camire R. M.
Published: July 2016

Regulatory mechanisms responsible for limiting blood clot formation are critical for maintaining normal haemostasis. Dysregulation can lead to bleeding (e.g. haemophilia) or thrombosis. New findings showing that tissue factor pathway inhibitor‐alpha (TFPIα) binds coagulation factor V(a) and inhibits prothrombinase assembly highlights that our understanding of the initiation of coagulation is evolving. Work over the past decade on the biochemistry of FV activation has laid the groundwork for deciphering the mechanistic bases that may underpin how TFPIα mediates these anticoagulant effects. Collectively, these new findings are re‐shaping our thinking about how coagulation is initiated at the site of injury. These ideas could have important clinical implications and help identify new ways to bias the coagulation response for the treatment of haemophilia and other disorders of the haemostatic process.
Alternative therapies for the management of inhibitors
Authors: Shima M. , Lillicrap D. , Kruse‐Jarres R.
Published: July 2016

The development of inhibitors to factor VIII (FVIII) or factor IX (FIX) remains a major treatment complication encountered in the treatment of haemophilia. Not all patients with even the same severity and genotype develop inhibitors suggesting an underlying mechanism of tolerance against FVIII‐ or FIX‐related immunity. One mechanism may be central tolerance observed in patients in whom the FVIII mutation enables some production of the protein. The other is a peripheral tolerance mechanism which may be evident in patients with null mutation. Recently, recombinant porcine FVIII (rpFVIII, Obixur, OBI‐1, BAX801) has been developed for the haemostatic treatment of both congenital haemophilia with inhibitor (CHAWI) and acquired haemophilia A (AHA). In 28 subjects with AHA with life‐/limb‐threatening bleeding, rpFVIII reduced or stopped bleeding in all patients within 24 h. The cross‐reactivity of anti‐human FVIII antibodies to rpFVIII remains around 30–50%. Recently, new therapeutics based on the quite novel concepts have been developed and clinical studies are ongoing. These are humanized asymmetric antibody mimicking FVIIIa function by maintaining a suitable interaction between FIXa and FX (Emicizumab, ACE910), and small interfering RNAs (siRNA, ALN‐AT3) suppress liver production of AT through post‐transcriptional gene silencing and a humanized anti‐TFPI monoclonal antibody (Concizumab). Their main advantages are longer half‐life, subcutaneous applicability and efficacy irrespective of the presence of inhibitors which will make it easier to initiate more effective treatment especially early childhood.
Haemophilia treatment in 2030
Authors: Berntorp E.
Published: July 2016

Introduction

Looking into the future is difficult and sometimes hazardous. A reliable look into haemophilia treatment in 2030 should be based on history and contemporary progress as well as dilemmas. Today, the issue of inhibitors overshadows the entire haemophilia community together with lack of treatment for large parts of the world's persons with haemophilia.

Aims

The aim of this paper was to provide a perspective on haemophilia treatment in 2030 and its provenance.

Methods

Literature review on history, treatment of haemophilia today as well as of emerging therapies give a base for the author's opinion on haemophilia treatment in 2030.

Results

Development of haemophilia treatment has virtually exploded during the last decade and a number of new clotting factor concentrates and alternative approaches are in the pipeline.

Conclusion

The collection of treatment resources that we can see on the horizon gives hope that each person with haemophilia will get the care needed in 2030. The products used will be directed by individual needs and tailored to regional and local situations.
Extended half‐life clotting factor concentrates: results from published clinical trials
Authors: Young G. , Mahlangu J. N.
Published: July 2016

Extended half‐life clotting factor concentrates have been recently introduced into the armamentarium of treatments for patients with haemophilia A and B. In general, the data from published studies have demonstrated these products to be safe with no inhibitors reported in previously treated patients and efficacious with the advantage of a longer half‐life allowing for less frequent intravenous infusions of factor. This enhanced convenience has led to some patients not previously on prophylaxis to begin prophylaxis while for others, especially children, has led to the ability to provide prophylaxis with reduced use of central venous catheters. The extended half‐life factor IX products are now allowing patients to dose every 1–2 weeks while maintaining higher trough levels while the extended half‐life factor VIII products have reduced the frequency of administration for patients on prophylaxis to as infrequent as once per week for some patients and to twice per week for all patients including younger children. It is important to note that data from previously untreated patients have not been published yet and the incidence for inhibitors in this patient population is as of yet unknown. The era of extended half‐life clotting factor products has begun and the challenge for the haemophilia community will be how to best integrate these products into haemophilia clinical practice.
How much information about the benefits of medicines is included in patient leaflets in the European Union? – A survey
Authors: Dickinson Rebecca , Raynor David K , Knapp Peter , MacDonald Jan
Published: July 2016

Introduction

Patient information leaflets (PILs) are required with all licensed medicines throughout the European Union (EU) and they must include information about all side effects and their likelihood. This has led to criticism of a lack of balance, with little information included about potential benefits. Recent European Medicines Agency guidance proposed the inclusion of benefit information, and this study examined the current prevalence and type of such information in PILs in the EU.

Methods

A survey and content analysis of the English translation of PILs in the EUwas carried out. Random quota sampling was used on the most frequently dispensed (n = 50) and newly licensed medicines (n = 50) in 2011/2. Leaflets were searched for benefit information meeting predefined criteria, and data synthesised and categorised into 10 categories.

Results

Eighty-five (85%) leaflets described how the medicine works, with 45 providing information about the rationale for treatment (more commonly for newly licensed (32/50) than most commonly dispensed medicines (13/50; P < 0.001). Nearly half (47) did not describe whether the medicine was curative, symptomatic or preventative. The terms used to communicate uncertainty were imprecise (such as ‘may help’). None communicated numerical benefit information.

Conclusion

Current PILs do not appropriately communicate information about benefit. At the basic level, around a half did not include information about treatment rationale or whether the treatment was to treat symptoms, curative or preventative. However, for true informed decision making, patients need quantitative information about benefits and none of the leaflets provided this.
Young onset dementia
Authors: Draper B. , Withall A.
Published: July 2016

Young onset dementia (YOD), where symptoms of dementia have an onset before the age of 65, has become more prominent due to the population increase from the Baby Boomer generation. This clinical perspective examines key issues in the assessment, diagnosis and management of YOD. Challenges in the assessment and diagnosis of YOD are partly due to the diverse range of types of YOD, where degenerative dementias are less common and secondary dementias more common than in late onset dementia. Early symptoms are broad and include depression, behavioural change, neurological disorders, systemic disorders and mild cognitive impairment (MCI). Perceived diagnostic delay may result in frustration and distress in people with YOD and their families. Chronic depression and MCI are associated with longer time to diagnosis, and in these situations, clinicians need to establish appropriate review processes and communicate clearly. A diagnosis of YOD may have marked consequences for a younger person, including early retirement, financial impacts and the psychological challenge of coming to grips with cognitive decline. Partners, children and other supporters often have unmet needs, feel burdened by care and are at high risk of physical and emotional consequences. Concerns about the heritability of dementia may add to family distress. Recent community service developments in Australia for YOD are outlined and the challenges of residential care described.
Client and parent feedback on a Youth Mental Health Service: The importance of family inclusive practice and working with client preferences
Authors: Coates Dominiek
Published: July 2016

In mental health settings, feedback from clients and carers is central to service evaluation, development and delivery. Increasingly, client and carer feedback is considered an integral part of service planning, and recognized as a critical element of the provision of recovery oriented service. This paper outlines the findings of a qualitative evaluation of a Youth Mental Health (YMH) service from the perspective of discharged clients and their parents. The service researcher conducted telephone interviews with 39 parents of discharged clients, and 17 young people themselves. Participants reported positive or mixed experiences with the service. In addition to more generic positive statements about the service, analysis identified two key themes: the importance of ‘family inclusive practice’ and the importance of ‘working with client preferences’. Young people and their parents want to be actively engaged in treatment and have their treatment preferences considered in treatment planning. Participants expressed the importance of “a good fit” between the client and the worker in terms of the clinician's gender, personality and treatment style/modality. While for some participants these themes were raised in the context of service strengths, others identified them as limitations or opportunities for service improvement. The extent to which clients and their parents felt engaged and heard by their allocated clinician is critical to their satisfaction or dissatisfaction with the service, depending on their unique experience. As an outcome of this evaluation, a range of service improvement strategies have been recommended.
Topical glycopyrrolate reduces axillary hyperhidrosis
Authors: Baker D.M.
Published: July 2016

Introduction

Oral anti‐cholinergic medications reduce generalized hyperhidrosis, but the effectiveness of topical anticholinergic solutions on axillary hyperhidrosis is unclear. This study determines the initial effectiveness of 1% and 2% topical glycopyrrolate spray and compares this with Botulinum toxin type A injections for the management of axillary hyperhidrosis.

Methods

In a non‐randomized, consecutive patient, prospective questionnaire, treatment comparison study, 40 patients with axillary hyperhidrosis were allocated to one of four study groups (10 patients to each group): (a) 1% glycopyrrolate spray, (b) 2% glycopyrrolate spray, (c) subcutaneous Botulinum toxin type A injections, (d) no treatment. Clinical outcomes were measured by comparing a prospectively administered questionnaire, completed both pre‐treatment and 6 weeks after starting treatment. Forty healthy volunteers without axillary hyperhidrosis completed the same questionnaire.

Results

The three treatment groups showed a significant (P < 0.05) improvement in their hyperhidrosis scores following treatment. The degree of improvement was less for the 1% glycopyrrolate group when compared with the Botulinum toxin type A group (P < 0.05), but there was no difference in treatment outcomes between the 2% glycopyrrolate and Botulinum toxin type A groups. No treatment group experienced reduced hyperhidrosis to a level similar to those without hyperhidrosis. Patients in both, the 2% glycopyrrolate and Botulinum toxin type A groups reported a significant improvement in axillary hyperhidrosis symptoms. These included reduction in psychologically precipitating factors (e.g. public speaking) and axillary hyperhidrosis‐specific physical effects (e.g. limitation of clothing choice).

Conclusions

Topical glycopyrrolate spray could provide a further treatment modality to manage axillary hyperhidrosis.
Beard infantile hemangioma and subglottic involvement: are median pattern and telangiectatic aspect the clue?
Authors: Piram M. , Hadj‐Rabia S. , Boccara O. , Couloigner V. , Hamel‐Teillac D. , Bodemer C.
Published: July 2016

Background

Identification of patient at risk of subglottic infantile hemangioma (IH) is challenging because subglottic IH can grow fast and cause airway obstruction with a fatal course.

Objective

To refine the cutaneous IH pattern at risk of subglottic IH.

Methods

Prospective and retrospective review of patients with cutaneous IH involving the beard area. IHs were classified in the bilateral pattern group (BH) or in the unilateral pattern group (UH). Infantile hemangioma topography, subtype (telangiectatic or tuberous), ear, nose and throat (ENT) manifestations and subglottic involvement were recorded.

Results

Thirty‐one patients (21 BH and 10 UH) were included during a 20‐year span. Nineteen patients (16 BH and 3 UH) had subglottic hemangioma. BH and UH group overlap on the median pattern (tongue, gum, lips, chin and neck). Median pattern, particularly the neck area and telangiectatic subtype of IH were significantly associated with subglottic involvement.

Conclusion

Patients presenting with telangiectatic beard IH localized on the median area need early ENT exploration. They should be treated before respiratory symptoms occur.
A position statement on the management of patients with pityriasis rosea
Authors: Chuh A. , Zawar V. , Sciallis G. , Kempf W.
Published: July 2016

Many clinical trials have been conducted on the treatment of pityriasis rosea (PR). Our aim was to establish a position statement for the management of adults with PR based on the best available evidence. We searched PubMed for all reports on randomized controlled trials for the treatment of PR published in the past 30 years. We retrieved 14 articles reporting randomized controlled trials, and found five which met our quality requirements for in‐depth analyses. Erythromycin was found in a well‐conducted triple‐blind study to cast significant impacts on clinical outcomes. However, adverse gastrointestinal effects were fairly common. Another well‐conducted study on azithromycin reported no significant benefit. It was reported in three well‐conducted studies on oral acyclovir in low dose (400 mg three times daily for 7 days or 400 mg five times daily for 7 days) and high dose (800 mg five times daily for 7 days), that acyclovir is effective in attaining rash regression and lessening the pruritus. When compared against each other, the high‐dose regimen demonstrated no benefit over the low‐dose regimens. Our statement comprises the follows: (i) The diagnosis of PR should be ascertained; (ii) The patients should be assessed for rash severity and impacts on quality of life; (iii) PR is a self‐limiting disease, and most patients do not necessitate any treatment; (iv) For patients necessitating active treatment, oral acyclovir as 400 mg three times daily for 7 days can be considered; (v) Attention should be given to adverse effects and contraindications of acyclovir; (vi) When PR occurs in early pregnancy, oral antiviral therapy could be considered after consulting experienced clinicians; (vii) Inadequate information exists in the use of acyclovir to treatment PR in children and breastfeeding women; and (viii) Treating PR is an off‐label use of acyclovir, and this has to be discussed with experienced colleagues and the patients.
Effects of adult emergence timing on susceptibility and fitness of Cry3Bb1‐resistant western corn rootworms
Authors: Wangila D. S. , Meinke L. J.
Published: July 2016

Field‐evolved resistance by the western corn rootworm (WCR), Diabrotica virgifera virgifera LeConte to the Cry3Bb1 trait expressed in maize, has been documented in areas of Nebraska USA. Currently, only limited information is available on life‐history traits of Cry3Bb1‐resistant field populations. Therefore, the Gassmann on‐plant bioassay was used to investigate the potential variability among four Cry3Bb1‐resistant WCR field collections made in 2011–2012 by focusing on the key parameters: larval survival, developmental stage and weight with specific emphasis on the impact of adult emergence timing on these parameters in subsequent progeny. Key results: In three of four collections, the susceptibility of larval progeny from adults that emerged early or late within a generation from Cry3Bb1 plants was similar. Each of the three collections exhibited complete resistance; that is, survival on Cry3Bb1 plants was greater or equal to survival on non‐Bt isoline plants. Bioassays from an additional field collection from one site 2 years (2013) after the original collection (2011) (both from Cry3Bb1 maize) indicated that resistance to Cry3Bb1 was maintained over time at the site despite Bt trait rotation in 2012. In general, comparative WCR life‐history parameter data from Cry3Bb1 and isoline maize indicate that fitness of field collections exhibiting complete resistance was similar on each hybrid. The mean proportion of larvae in third instar and mean weight of larvae recovered in bioassays from progeny of early‐ and late‐emerged adults was not significantly affected by emergence period. This suggests that delays in development and associated mean adult emergence commonly observed in populations that are susceptible to Cry3Bb1 may become smaller as populations become resistant to Cry3Bb1. Results from this article will inform Cry3Bb1 resistance mitigation efforts and contribute to the development of sustainable WCR management programmes.
Cryopreservation of Atlantic salmonSalmo salarsperm: effects on sperm physiology
Authors: Figueroa E. , Valdebenito I. , Merino O. , Ubilla A. , Risopatrón J. , Farias J. G.
Published: July 2016

The objective of this study was to determine the effect of freezing on the function in Atlantic salmonSalmo salarspermatozoa. The semen was frozen in Cortland's medium + 1.3Mdimethyl sulphoxide + 0.3Mglucose + 2% bovine serum albumin (final concentration) in a ratio of 1:3 (semen:cryoprotectant) as the treatment (T) and fresh semen as the control (F). Straws of 0·5 ml of sperm suspension were frozen in 4 cm ofN2L. They were thawed in a thermoregulated bath (40° C). After thawing, the percentage of spermatozoa with fragmentedDNA[transferasedUTP(deoxyuridine triphosphate) nick‐end labelling (TUNEL)], plasma membrane integrity (SYBR‐14/PI) and mitochondrial membrane potential (ΔΨMMit,JC‐1) were evaluated by flow cytometry and motility was evaluated by optical microscope under stroboscopic light. The fertilization rates of the control and treatment semen were tested at a sperm density of 1·5 × 107spermatozoa oocyte−1, by observation of the first cleavages after 16 h incubation at 10° C. In the cryopreserved semen (T), the mean ± s.d.DNAfragmentation was 4·8 ± 2·5%; plasma membrane integrity 75·2 ± 6·3%; mitochondrial membrane potential 51·7 ± 3·6%; motility 58·5 ± 5·3%; curved line velocity (VCL) 61·2 ± 17·4 µm s−1; average‐path velocity (VAP) 50·1 ± 17·3 µm s−1; straight‐line velocity (VSL) 59·1 ± 18·4 µm s−1; fertilization rate 81·6 ± 1·9%. There were significant differences in the plasma membrane integrity, mitochondrial membrane potential, motility, fertilization rate, VCL, VAPand VSLcompared with the controls (P < 0·05). Also the mitochondrial membrane potential correlated with motility, fertilization rate,VCLandVSL(r = 0·75;r = 0·59;r = 0·77 andr = 0·79, respectively;P < 0·05); and the fertilization rate correlated withVCLandVSL(r = 0·59 andr = 0·55, respectively).