bluuebunny/crossref_metadata_2025 huggingface dataset:
Survival is negatively related to basal metabolic rate in tropical Andean birds
Authors: Scholer Micah N. , Arcese Peter , Puterman Martin L. , Londoño Gustavo A. , Jankowski Jill E.
Published: May 2019

Life‐history theory postulates that physiological traits, such as energy metabolism, can be understood in terms of allocation trade‐offs between self‐maintenance and reproduction over an organism's life span, and data show that metabolic intensity and survival vary inversely with latitude, with tropical birds exhibiting a “slow” pace of life relative to temperature species. However, tropical regions harbour strong environmental gradients of their own, and it remains to be shown whether similar life‐history trade‐offs between metabolism and longevity are reflected among tropical birds of the same latitude.

We estimated apparent annual survival in 37 species of tropical passerine birds along an elevational gradient (400–3,000 m) in Peru to test whether variation in survival was influenced by basal metabolic rate (BMR; estimated at the same sites), elevation or both factors. We used path analysis to test our prediction that survival would decline as BMR increased, while accounting for the potential direct effects of elevation on survival due to differences in predation pressure or environmental conditions as well as potential indirect effects of elevation on BMR via temperature and the costs of thermoregulation.

Higher BMR in tropical passerine birds predicted lower apparent survival, regardless of the elevation at which species occurred. In addition, elevation had a direct negative effect on apparent survival, perhaps due to harsher abiotic conditions, low site fidelity or both at high elevations.

We provide evidence of a link between metabolic rate and longevity previously undescribed in populations of free‐living birds. Our results illustrate that tropical montane species may be characterized by a unique suite of traits in their pace of life, in which BMR does not differ from lowland birds, but survival does.

A plain language summary is available for this article.
Fifty Aureobasidium pullulans genomes reveal a recombining polyextremotolerant generalist
Authors: Gostinčar Cene , Turk Martina , Zajc Janja , Gunde‐Cimerman Nina
Published: May 2019

The black yeast Aureobasidium pullulans is a textbook example of a generalistic and ubiquitous fungus thriving in a wide variety of environments. To investigate whether A. pullulans is a true generalist, or alternatively, whether part of its versatility can be attributed to intraspecific specialization masked by cryptic diversification undetectable by traditional phylogenetic analyses, we sequenced and analysed the genomes of 50 strains of A. pullulans from different habitats and geographic locations. No population structure was observed in the sequenced strains. Decay of linkage disequilibrium over shorter physical distances (<100 bp) than in many sexually reproducing fungi indicates a high level of recombination in the species. A homothallic mating locus was found in all of the sequenced genomes. Aureobasidium pullulans appears to have a homogeneous population genetics structure, which is best explained by good dispersal and high levels of recombination. This means that A. pullulans is a true generalist that can inhabit different habitats without substantial specialization to any of these habitats at the genomic level. Furthermore, in the future, the high level of A. pullulans recombination can be exploited for the identification of genomic loci that are involved in the many biotechnologically useful traits of this black yeast.
Alternate instruments to manage the capital flow conundrum: A study of selected Asian economies
Authors: Sengupta Rajeswari , Sen Gupta Abhijit
Published: May 2019

Capital inflows to and outflows from emerging market economies (EME) have increased significantly since 2000. This rapid increase, accompanied by a sharp rise in volatility, has amplified the complexity of macroeconomic management in EME. While foreign capital provides additional financing for productive investment and offers avenues for risk diversification, unbridled flows exacerbate financial and macroeconomic instability. In this paper, we focus on the experience of six emerging Asian economies (EAE) in dealing with capital flows. Using quarterly data, we identify the waves of capital flows experienced by these EAE and the efficacy of the various policy measures taken. The policy choices include negotiating the trilemma (i.e. balancing the need for monetary policy autonomy, exchange rate flexibility and capital account openness), as per the demands of the macroeconomic situation. The paper also analyses the extent to which intervention in the foreign exchange market and imposition of short‐term capital flow management measures have aided countries to negotiate the trilemma. The efficacy of these responses have been varied across countries, implying that a judicious mix of these measures, along with improvement in financial and institutional development, is required to effectively counter the vagaries of capital flows.
Do terrorist attacks feed populist Eurosceptics? Evidence from two comparative quasi‐experiments
Authors: LARSEN ERIK GAHNER , CUTTS DAVID , GOODWIN MATTHEW J.
Published: May 2019

Over recent years, Europe has experienced a series of Islamic terrorist attacks. In this article, conflicting theoretical expectations are derived on whether such attacks increase populist Euroscepticism in the form of anti‐immigration, anti‐refugee and anti‐European Union sentiment. Empirically, plausible exogenous variation in the exposure to the 2016 Berlin attack is exploited in two nationally representative surveys covering multiple European countries. No evidence is found for a populist response to the terrorist attack in any of the surveyed countries. On the contrary, people in Germany became more positive towards the EU in the wake of the Berlin attack. Moreover, little evidence is found that ideology shaped the response to the attack. The findings suggest that terrorist attacks are not met by an immediate public populist response.
Late‐life time‐restricted feeding and exercise differentially alter healthspan in obesity
Authors: Schafer Marissa J. , Mazula Daniel L. , Brown Ashley K. , White Thomas A. , Atkinson Elizabeth , Pearsall Vesselina M. , Aversa Zaira , Verzosa Grace C. , Smith Leslie A. , Matveyenko Aleksey , Miller Jordan D. , LeBrasseur Nathan K.
Published: May 2019

Aging and obesity increase multimorbidity and disability risk, and determining interventions for reversing healthspan decline is a critical public health priority. Exercise and time‐restricted feeding (TRF) benefit multiple health parameters when initiated in early life, but their efficacy and safety when initiated at older ages are uncertain. Here, we tested the effects of exercise versus TRF in diet‐induced obese, aged mice from 20 to 24 months of age. We characterized healthspan across key domains: body composition, physical, metabolic, and cardiovascular function, activity of daily living (ADL) behavior, and pathology. We demonstrate that both exercise and TRF improved aspects of body composition. Exercise uniquely benefited physical function, and TRF uniquely benefited metabolism, ADL behavior, and circulating indicators of liver pathology. No adverse outcomes were observed in exercised mice, but in contrast, lean mass and cardiovascular maladaptations were observed following TRF. Through a composite index of benefits and risks, we conclude the net healthspan benefits afforded by exercise are more favorable than those of TRF. Extrapolating to obese older adults, exercise is a safe and effective option for healthspan improvement, but additional comprehensive studies are warranted before recommending TRF.
Association between the BHMT gene rs3733890 polymorphism and the efficacy of oral folate therapy in patients with hyperhomocysteinemia
Authors: Ren Bingnan , Tian Dandan , Wang Lianke , Han Han , Wang Wenhua , Tian Huizi , Yue Limin , Zhang Weidong
Published: May 2019

Oral folate is currently the most common treatment for hyperhomocysteinemia (HHcy), which seriously threatens human health, but its efficacy is unsatisfactory. Betaine‐homocysteine methyltransferase (BHMT) is a key enzyme that regulates Hcy metabolism. We investigated the association between the BHMT rs3733890 and the efficacy of oral folate therapy for HHcy in the Chinese Han population and analysed the effects of gene–environmental interactions on the efficacy. Blood samples were collected from 1071 eligible patients at baseline, and these individuals received subsequent folate treatment for 90 days. A total of 638 patients included in the final analysis were grouped into the treatment success group or the treatment failure group based on posttreatment Hcy levels. Hcy concentrations were measured by fluorescence polarization immunoassay. Time‐of‐flight mass spectrometry (MassArray system) was used to assess the genotype of BHMT rs3733890. Stratified analyses based on additive models and generalized multifactor dimensionality reduction were used to explore gene–environmental interactions. The genotype distribution presented distinct differences in the two groups. The mutant genotype and allele had significantly increased risk of treatment failure (p < 0.05). Furthermore, synergistic effects of the BHMT rs3733890 polymorphism with environmental risk factors (smoking, drinking, past history) on the efficacy of therapy were also found. However, future, large well‐designed studies, as well as mechanistic studies, are still needed to validate our findings.
Causes of death in long‐term bladder cancer survivors: A population‐based study
Authors: Kong Jianqiu , Diao Xiayao , Diao Feiyu , Fan Xinxiang , Zheng Junjiong , Yan Dong , Huang Jian , Qin Haide , Lin Tianxin
Published: May 2019

Background

Long‐term (> 5 years) bladder cancer survivors represent a distinct subgroup of bladder cancer patients and information about the causes of death in this subgroup is limited. The aim of this study was to review the causes of death in long‐term bladder cancer survivors.

Method

The Surveillance, epidemiology and end results (SEER) database was used to analyze the causes of death of long‐term bladder cancer survivors. Patients' characteristics and survival outcomes were reported for the entire cohort in our study. Kaplan–Meier analysis and Cox proportional hazard model for survival analysis.

Results

A total of 147 781 bladder cancer patients with >5 years survival were identified. This cohort included 81 843 patients surviving 5–10 years and 65 938 patients surviving >10 years. Among the patients who survived 5–10 years, 6.9% died because of primary bladder cancer, 11.0% due to cardiac disease and 7.7% due to nonmalignant pulmonary disease. Among patients surviving >10 years, 3.1% died because of primary bladder cancer, 8.6% due to cardiac disease and 5.8% due to nonmalignant pulmonary disease. On multivariate analysis, factors associated with longer cardiac disease‐specific survival among long‐term bladder cancer survivors include younger age at diagnosis（<40 years; vs. 40–69 years, P = 0.030 or >69 years, P < 0.001), married status (vs. single status, P < 0.001), white race (vs. African American race, P = 0.002), male (vs. female, P < 0.001), grade I (vs. grade III, P = 0.003 or grade IV, P < 0.001).

Conclusion

The probability of death from primary bladder cancer is still important among various causes of death even 20 years after being diagnosed with bladder cancer. Furthermore, cardiopulmonary causes contributed to a considerable proportion of deaths in long‐term bladder cancer survivors.
Tracheo–bronchial adenoid cystic carcinoma: A retrospective study
Authors: Ning Ye , He Wenxin , Bian Dongliang , Xie Dong , Jiang Gening
Published: May 2019

Objectives

Adenoid cystic carcinoma (ACC) of the trachea and bronchus is rare, representing 1% of all respiratory tract cancers. We presented our experiences in treating tracheal–bronchial ACC and the results of long‐term surveillance.

Methods

We conducted a retrospective study of treating tracheo–bronchial ACC. From 2009 to 2014, 42 patients presented to our department. All of them received surgical resection and adjunctive therapy.

Results

R0 resections were achieved in 33 patients, whereas 15 patients whose lesions spread outside the tracheo–bronchial lumens. Nine patients had R1 resections followed by radiation and chemotherapy. The 5 year survival rate of R1 resection group showed no difference compared to the R0 resection group, but the 5 year disease‐free survival rate showed difference in extra‐lumenal invasion (ELI) and non‐ELI group (P = 0.0357 < 0.05), although no difference was seen in the overall survival rate in these two groups.

Conclusions

ACC of the trachea and bronchus is a rare and low‐to‐moderate grade malignant tumor. When the R0 resection is over risky or may cause mortal complication, the R1 resection with adjunctive therapy is acceptable for patients to obtain a promising prognosis, whereas pathological ELI is an adverse prognostic indicator.
Pathological and therapeutic aspects of matrix metalloproteinases: Implications in osteosarcoma
Authors: Tang Huayan , Tang Zhaohui , Jiang Yongjun , Wei Weisheng , Lu Jian
Published: May 2019

Osteosarcoma (OS) is one of the most common malignant bone tumors in children and adolescents, and the eighth leading form of childhood cancer. Matrix metalloproteinases (MMPs) are proteolytic enzymes implicated in certain cancers including OS. In this review, we discuss the mechanism of actions of MMPs in progression of OS, and the therapeutic use of MMPs inhibitors in the treatment of OS with subsequent clinical studies and future management. The expression of MMPs is upregulated in cancer cells by a variety of cytokines and growth factors, and upregulation of MMPs induces degradation of the extracellular matrix that contributes to cell proliferation by releasing growth factors. MMPs promote the detachment and migration of endothelial cells, cross the basement membrane as well as invade the surrounding lymphatic vessels and causes cancer metastasis. The use of selective MMP inhibitors with limited side effects might be promising therapeutic strategy in the treatment of OS. More clinical trials are necessary to evaluate the role of selective MMPs inhibitors in the prevention and treatment of OS along with their assessment of toxicity.
Anti‐angiogenic therapies for gastric cancer
Authors: Hironaka Shuichi
Published: May 2019

Tumor angiogenesis plays an important role in cancer cell proliferation and metastasis. In gastric cancer, among the numerous clinical trials investigating various anti‐angiogenic therapies, such as antivascular endothelial growth factor (VEGF) or anti‐VEGF receptor (VEGFR)‐2 monoclonal antibodies, VEGF‐Trap and VEGFR tyrosine kinase inhibitors, the anti‐VEGFR‐2 antibody ramucirumab was shown to prolong overall survival not only as a single agent but also in combination with paclitaxel as a second‐line chemotherapy. Additionally, apatinib, a selective VEGFR‐2 tyrosine kinase inhibitor, prolonged survival as a third‐line or later treatment option in patients with advanced gastric cancer. Preliminary results of studies investigating ramucirumab plus immune checkpoint inhibitors in gastric cancer were encouraging, and further investigations are ongoing. In China, apatinib in combination with cytotoxic agents is being investigated for systemic chemotherapy or maintenance therapy as an earlier treatment option. The clinical activity in gastric cancer of the multikinase inhibitor regorafenib was suggested in a randomized phase II study. A global phase III trial comparing regorafenib with placebo is currently ongoing. Further studies of anti‐angiogenic therapy combined with not only chemotherapy but also immune checkpoint inhibitors are also being pursued, providing hope for improved survival in patients with gastric cancer.
Immediations and rhythms of speculative design: Implications for value in design‐based research
Authors: Ehret Christian , Ehret Lea , Low Bronwen , Čiklovan Luka
Published: May 2019

This paper presents data from the first six‐months of an ongoing speculative design project in which youth and researchers co‐created a videogame club, and later an eSports team, in an urban youth centre in Montréal, Québec. It describes how process philosophy informed researchers’ approach to speculative design, allowing youth and researchers to co‐compose a sense of value for the club and the potentials for what they could do together through the club. This speculative process is contrasted with structuralist approaches to design‐based research in education, which can overly or pre‐determine value and mechanisms of social change, with or without the collaboration of youth and communities.
Evaluation and in vivo efficacy study of pyrano[3,2‐c]quinoline analogues as TNF‐α inhibitors
Authors: Upadhyay Kuldip D. , Dodia Narsinh M. , Khunt Rupesh C. , Chaniara Ravi S. , Shah Anamik K.
Published: May 2019

A series of pyrano[3,2 c]quinoline was evaluated for its in vivo efficacy as TNF‐α inhibitor using LPS, phosphodiesterase (PDE)‐4, and CIA assays in different mice/rat models. The synthesis was performed using one‐pot multicomponent condensation between 2,4‐dihydroxy‐1‐methylquinoline, malononitrile, and diverse un(substituted) aromatic aldehydes. In vivo efficacy of the title compounds was evaluated using LPS assay in BALB/c mice, PDE4 inhibition in ketamine–xylazine‐induced anesthetize SD rats, and CIA assay was performed in DBA/1J mice as per the standard literature protocols. The outcome of the study revealed that compound 4v was found to be most promising candidate of the series. It was efficacious with 48.8 ± 13.0% inhibition of TNF‐α release at 100 mg/kg p.o., in the LPS assay in Balb/c mice model. It was effective in PDE4 assay in ketamine–xylazine‐induced anesthetize SD rats with duration of 38.3 ± 4.5 min for reversal of anesthetic effect and also showed significant inhibition of PDE4 in salbutamol treated U937 cell assay. It was also abolished TNF‐α induced phosphorylation and degradation of IκBα. Ultimately, its effect on CIA‐related bone and cartilage damage was found statistically similar to Enbrel.
Forty Years Development of China's Outward Foreign Direct Investment: Retrospect and the Challenges Ahead
Authors: Wang Bijun , Gao Kailin
Published: May 2019

Outward foreign direct investment (OFDI) has increasingly become an important method for China to integrate into the world economy. This paper comprehensively reviews and analyzes policy development and the changing pattern of China's OFDI over the past 40 years. We divide the development into “restricted” (1978–1999), “relaxed” (2000–2016) and “regulated” (2017 onwards) stages. This paper also reviews literature on the impact of Chinese OFDI on China and host countries. Despite its generally positive effects, large‐scale and unbalanced OFDI activities have alarmed Chinese policymakers. Both developing and developed host countries have expressed their concern over national security and the misbehavior of some Chinese overseas enterprises. Therefore, greater supervision and adjustment from quantity to quality growth is necessary for the future development of China's OFDI.
Policy Analysis and Development Evaluation of Digital Trade: An International Comparison
Authors: Ma Shuzhong , Guo Jiwen , Zhang Hongsheng
Published: May 2019

As an extension of traditional trade, digital trade is a new type of trade in the era of the digital economy. In this paper, we first analyze the digital trade‐related strategies of eight leading economies through word clouds and dissect China's digital trade‐related policies using the word frequency method by sorting through the digital trade‐related policy documents of 26 economies and Chinese provinces. We then evaluate the status quo of digital trade development in 111 countries and Chinese provinces by building a digital trade index system to determine the development environment and market potential. The results show that all countries attach great importance to digital technology, data and government guidance in the development of digital trade. The results also reveal that “development,” “service” and “construction” are the three most frequently used words in various Chinese documents. The overall level of China's digital trade is at the global vanguard, but is characterized by uneven regional development. In the era of digital trade, traditional international trade theory is also in urgent need of breakthroughs and innovation.
Survival of Helicoverpa armigera larvae on and Bt toxin expression in various parts of transgenic Bt cotton (Bollgard II) plants
Authors: Bahar Md Habibullah , Stanley John , Backhouse David , Mensah Robert , Del Socorro Alice , Gregg Peter
Published: May 2019

There is no conclusive evidence that Helicoverpa spp. (Lepidoptera: Noctuidae) in Australia have evolved significant levels of resistance to Bollgard II® cotton (which expresses two Bt toxin genes, cry1Ac and cry2Ab). However, there is evidence of surviving larvae on Bollgard II cotton in the field. The distribution and survival of early‐instar Helicoverpa armigera (Hübner) (Lepidoptera: Noctuidae) larvae were examined on whole Bollgard II and non‐Bt cotton plants in greenhouse bioassays. The expression of Cry toxins in various parts of Bollgard II plants was compared to the survival of larvae in those locations. Only 1% of larvae survived after 6 days on greenhouse‐grown Bollgard II plants compared to 31% on non‐Bt cotton plants. Overall, and across all time intervals, more larvae survived on reproductive parts (squares, flowers, and bolls) than on vegetative parts (leaves, stems, and petioles) on Bollgard II plants. The concentration of Cry1Ac toxin did not differ between plant structures, whereas Cry2Ab toxin differed significantly, but there was no relationship between the level of expression and the location of larvae. This study provides no evidence that lower expression of Cry toxins in the reproductive parts of plants explains the survival of H. armigera larvae on Bollgard II cotton.
Survival costs of reproduction are mediated by parasite infection in wild Soay sheep
Authors: Leivesley Jessica A. , Bussière Luc F. , Pemberton Josephine M. , Pilkington Jill G. , Wilson Kenneth , Hayward Adam D.
Published: May 2019

A trade‐off between current and future fitness potentially explains variation in life‐history strategies. A proposed mechanism behind this is parasite‐mediated reproductive costs: individuals that allocate more resources to reproduction have fewer to allocate to defence against parasites, reducing future fitness. We examined how reproduction influenced faecal egg counts (FEC) of strongyle nematodes using data collected between 1989 and 2008 from a wild population of Soay sheep in the St. Kilda archipelago, Scotland (741 individuals). Increased reproduction was associated with increased FEC during the lambing season: females that gave birth, and particularly those that weaned a lamb, had higher FEC than females that failed to reproduce. Structural equation modelling revealed future reproductive costs: a positive effect of reproduction on spring FEC and a negative effect on summer body weight were negatively associated with overwinter survival. Overall, we provide evidence that parasite resistance and body weight are important mediators of survival costs of reproduction.
Pharmacological outcomes in teenagers with newly diagnosed epilepsy: A 30‐year cohort study
Authors: Alsfouk Bshra A. , Alsfouk Aisha A. , Chen Zhibin , Kwan Patrick , Brodie Martin J.
Published: May 2019

Objective

To evaluate the long‐term pharmacological outcomes in teenagers with different epilepsies.

Method

This study included teenagers aged 13‐19 years at treatment initiation who were newly treated with antiepileptic drugs (AEDs) at the epilepsy unit of the Western Infirmary in Glasgow, Scotland, between 1 September 1982 and 30 September 2012. Patients were prospectively followed until 30 April 2016, or death, with at least a 2‐year follow‐up.

Results

A total of 332 adolescent patients (53% female; median age 16 years; 54% with generalized epilepsy) were included. At the end of the study, 221 patients (67%) were seizure‐free. A higher seizure‐free rate was observed in those with generalized compared to focal epilepsy (72% versus 60%, P = 0.01). During the study, 108 patients had relapses after periods of being seizure‐free, most commonly due to poor adherence to AEDs (49%, n = 53/108). AED withdrawal was associated with a high risk of seizure recurrence (70%, n = 26/37), but 56% (n = 61/108) of relapsed patients became seizure‐free again by the end of the study, with only 9% (n = 31/332) meeting the International League Against Epilepsy (ILAE) definition of pharmacoresistance during follow‐up. Of the 221 seizure‐free patients, 83% achieved this on monotherapy. There was no significant difference in efficacy rate between new and standard AED monotherapy (74% versus 77%, P = 0.66). The overall poor tolerability rate of AEDs was 21% (n = 69/332). Among the different new and standard AEDs used as initial monotherapy, lamotrigine was associated with the lowest rate of adverse effects (12%, n = 15/124), while topiramate was associated with the highest rate (56%, n = 5/9).

Significance

Teenagers with epilepsy showed good seizure control, particularly those with generalized epilepsy. However, relapse was common and there was high risk of seizure recurrence after treatment withdrawal. Most patients were controlled on monotherapy. As the efficacy of AEDs was comparable, tolerability can be a primary consideration for AED selection in this population.
A decision tree to determine fitness to drive in epilepsy: Results of a pilot in two Australian states
Authors: Somerville Ernest R. ,   the Driving Committee of the Epilepsy Society of Australia
Published: May 2019

Objective

Certification by treating physicians of fitness to drive in people with epilepsy creates a conflict of interest that may result in unsafe decisions, damage the doctor‐patient relationship, expose the physician to legal liability and prevent optimal treatment. Ideally, the treating physician should provide objective clinical information to the driver licensing authority (DLA), which then determines fitness or otherwise. However, DLAs in Australia do not employ medical staff and the national standards are complex. Fitness is determined by the treating physician, according to published national standards. The purpose of this study was to determine the feasibility of using a decision tree to determine fitness, according to the Australian standards.

Methods

A decision tree was constructed to use clinical data to determine whether a patient met the national standard to drive a private motorcar, failed to meet it or required further assessment. A form was designed to collect the necessary clinical data from the treating physician. A computerized version of the decision tree was then used in a pilot in two Australian states in parallel with the existing certification system. Four hundred thirty‐nine drivers with declared epilepsy and their treating physicians were invited to participate when their annual driver licence review was due.

Results

Two hundred fifty‐three (58%) forms were returned. All patients were considered fit to drive by their physician. Seventy‐six percent had not had a seizure for over two years. In 88.1%, there was agreement between the decision tree and treating physician, with 3.6% identified by the decision tree as requiring review. Although considered fit by their physician, 6.3% did not meet the national standard to drive.

Significance

The decision tree model is a practical alternative to fitness certification by treating physicians. This Australian pilot can serve as a model for applying objective standards to driving assessments in other jurisdictions, using local driving standards. It has the potential to improve road safety by avoiding the negative effects of certification by treating physicians and can cope with complex standards. It is now in use in two states of Australia.
Climate change, biological invasions, and the shifting distribution of Mediterranean fishes: A large‐scale survey based on local ecological knowledge
Authors: Azzurro Ernesto , Sbragaglia Valerio , Cerri Jacopo , Bariche Michel , Bolognini Luca , Ben Souissi Jamila , Busoni Giulio , Coco Salvatore , Chryssanthi Antoniadou , Fanelli Emanuela , Ghanem Raouia , Garrabou Joaquim , Gianni Fabrizio , Grati Fabio , Kolitari Jerina , Letterio Guglielmo , Lipej Lovrenc , Mazzoldi Carlotta , Milone Nicoletta , Pannacciulli Federica , Pešić Ana , Samuel‐Rhoads Yanna , Saponari Luca , Tomanic Jovana , Eda Topçu Nur , Vargiu Giovanni , Moschella Paula
Published: May 2019

Climate change and biological invasions are rapidly reshuffling species distribution, restructuring the biological communities of many ecosystems worldwide. Tracking these transformations in the marine environment is crucial, but our understanding of climate change effects and invasive species dynamics is often hampered by the practical challenge of surveying large geographical areas. Here, we focus on the Mediterranean Sea, a hot spot for climate change and biological invasions to investigate recent spatiotemporal changes in fish abundances and distribution. To this end, we accessed the local ecological knowledge (LEK) of small‐scale and recreational fishers, reconstructing the dynamics of fish perceived as “new” or increasing in different fishing areas. Over 500 fishers across 95 locations and nine different countries were interviewed, and semiquantitative information on yearly changes in species abundance was collected. Overall, 75 species were mentioned by the respondents, mostly warm‐adapted species of both native and exotic origin. Respondents belonging to the same biogeographic sectors described coherent spatial and temporal patterns, and gradients along latitudinal and longitudinal axes were revealed. This information provides a more complete understanding of the shifting distribution of Mediterranean fishes and it also demonstrates that adequately structured LEK methodology might be applied successfully beyond the local scale, across national borders and jurisdictions. Acknowledging this potential through macroregional coordination could pave the way for future large‐scale aggregations of individual observations, increasing our potential for integrated monitoring and conservation planning at the regional or even global level. This might help local communities to better understand, manage, and adapt to the ongoing biotic transformations driven by climate change and biological invaders.
Effectiveness and safety of furazolidone‐containing quadruple regimens in patients with Helicobacter pylori infection in real‐world practice
Authors: Song Conghua , Qian Xing , Zhu Yin , Shu Xu , Song Yanping , Xiong Zhijuan , Ye Jianfang , Yu Tao , Ding Ling , Wang Hui , Lu Nonghua , Xie Yong
Published: May 2019

Background & Aims

The eradication rate of Helicobacter pylori (H pylori) has decreased largely because of the antibiotic resistance. We aimed to evaluate the effectiveness and safety of furazolidone‐containing quadruple regimens for H pylori eradication.

Methods

This was an observational study of furazolidone‐containing quadruple regimens for H pylori infection in real‐world settings. Data sets were collected from the medical records and telephone interviews of patients referred to a specialist clinic for suspected H pylori reinfection from January 1, 2015, to January 1, 2018, at the First Affiliated Hospital of Nanchang University. Main outcome measures were the eradication rate and adverse reactions during medication.

Results

Among 584 patients with H pylori infection that met the inclusion criteria, 561 (96.1%) were treated for the first time, 19 (3.3%) had one, and 4 (0.5%) had two or more prior to furazolidone‐containing quadruple regimens. The eradication rates for 10‐day and 14‐day regimens were 93.7% (95% CI: 91.5%‐95.9%) vs 98.2% (95% CI: 95.6%‐99.3%), respectively (P = 0.098). Adverse drug reactions occurred in 8.2% (48/584) with abdominal discomfort being the most common symptom. Overall adverse events with 10‐day regimens were lower than 14‐day regimens (6.1% vs 17.4%, P < 0.001). Logistic regression analysis indicated that poor adherence (adjusted odds ratio [AOR] = 46.5, 95% CI: 9.7‐222.4) was correlated with failed eradication. Adverse drug reactions during medication were related to smoking and tobacco status, alcohol intake history, regimens combined with tetracycline, and poor adherence (all P < 0.05).

Conclusions

Furazolidone‐containing quadruple regimens proved both safe and highly effective in a real‐world setting.
DNA flow cytometric and interobserver study of crypt cell atypia in inflammatory bowel disease
Authors: Wen Kwun Wah , Umetsu Sarah E , Goldblum John R , Gill Ryan M , Kim Grace E , Joseph Nancy M , Rabinovitch Peter S , Kakar Sanjay , Lauwers Gregory Y , Choi Won‐Tak
Published: May 2019

Aims

The pathological features and diagnostic reliability of crypt cell atypia (CCA) arising in inflammatory bowel disease (IBD) and its clinical significance are unknown.

Methods and results

DNA flow cytometry (FCM) was performed on 14 colon biopsies of CCA from seven IBD patients (male‐to‐female ratio, 5:2; mean age, 53 years; mean IBD duration, 15 years) using paraffin‐embedded tissue. Seven gastrointestinal pathologists were asked to diagnose each biopsy as negative for dysplasia (NEG), indefinite for dysplasia (IND), low‐grade dysplasia (LGD) or high‐grade dysplasia (HGD) by morphology alone, then again with knowledge of FCM results. Aneuploidy was detected in all 14 biopsies, and five of eight biopsies (63%) also showed strong and diffuse nuclear staining for p53 in the areas of CCA. Six (86%) patients developed HGD (n = 5) or adenocarcinoma (n = 1) in the same colonic segment where CCA had been diagnosed within a mean follow‐up time of 27 months. No follow‐up information was available in the remaining one patient. When diagnoses were grouped as NEG or ‘atypical’ (including IND, LGD or HGD), the overall agreement rate of 76% (kappa = 0.51) based on morphology alone improved to 90% (kappa = 0.81) with knowledge of FCM results. Even when categorised as NEG or dysplasia (LGD or HGD) with each of the IND diagnoses reclassified into three categories (NEG, LGD or HGD) based on the degree of suspicion for dysplasia, the overall agreement rate of 63% (kappa = 0.25) based on morphology alone improved to 73% (kappa = 0.46) with knowledge of FCM results. However, when grouped as NEG, LGD or HGD, the overall agreement rate was less than 40% (kappa < 0.09) regardless of knowledge of FCM results.

Conclusions

The presence of aneuploidy, p53 positivity and development of HGD or adenocarcinoma on follow‐up indicate that CCA likely represents a dysplastic lesion (at least LGD) and is a histological marker of neoplastic progression. Although the grading of CCA, largely based on cytological abnormalities, is subject to significant interobserver variability, CCA can be histologically identified and should lead to a recommendation of increased endoscopic surveillance, especially if aneuploidy is detected.
Bone marrow findings in metastatic melanoma, including role of BRAF immunohistochemistry
Authors: Corean Jessica L. E. , George Tracy I. , Patel Jay L. , Li K. David
Published: May 2019

Introduction

We describe peripheral blood smear, bone marrow morphology, histopathology, immunohistochemistry, including BRAF V600E, and molecular testing results of patients with metastatic melanoma to the bone marrow.

Methods

We performed a retrospective review for patients with metastatic melanoma to the bone marrow at our institution. Bone marrow morphology, histology, immunophenotyping, and cytogenetic/molecular genetic testing were reviewed, and BRAF V600E immunohistochemistry was performed. Results were compared to the literature.

Results

We identified four patients with metastatic melanoma to the bone marrow presenting with at least one cytopenia. Two of the four patients had leukoerythroblastosis, with three patients having atypical cells on bone marrow aspirate/touch preparation, and all patients had aggregates of atypical cells on biopsy. Immunohistochemistry for S100, Melan A, and HMB45 confirmed the diagnosis in all patients, and BRAF V600E immunohistochemistry was detected in two of four patients, which correlated with molecular testing findings. Review of the literature found 27 total patients, with normocytic anemia and leukoerythroblastosis as common peripheral blood smear findings.

Conclusions

Features including cytopenias (typically anemia), leukoerythroblastosis, and morphology of cohesive, large atypical cells in aspirate and biopsy, and immunohistochemical expression for S100, Melan A, and HMB45 were present in patients with metastatic melanoma. BRAF V600E immunohistochemistry is useful as a surrogate marker of molecular results. Regardless of clinical history, at the time of the bone marrow biopsies, hematologic malignancies are in the main differential diagnosis and very rarely included metastatic melanoma, likely due to the under‐recognized metastatic potential of melanoma to the bone marrow.
Post‐stroke sleep disturbances and rehabilitation outcomes: a prospective cohort study
Authors: Iddagoda Mayura T. , Inderjeeth Charles A. , Chan Kien , Raymond Warren D.
Published: May 2019

Background

Poor sleep is common after stroke, and data regarding its effect on rehabilitation outcomes are limited. Controversial evidence was found concerning the effect of sedatives on improving sleep quality in poor sleepers after stroke.

Aim

To assess the prevalence of poor sleep in post‐stroke patients and its effect on rehabilitation outcomes.

Method

A total of 104 stroke patients from two major stroke rehabilitation units in Western Australia was enrolled. Sleep quality was assessed using the Pittsburgh Sleep Quality Indexes at baseline and after stroke. The main outcome measures were Functional Independence Measure (FIM) change and length of stay (LOS). Sedative use during this period was also recorded.

Results

A total of 29.8% post‐stroke patients suffered from poor sleep. There was no relationship between poor sleep and the stroke characteristics, such as severity, side and type, or demographics, such as age and gender. Poor sleep quality was inversely associated with rehabilitation outcomes measured by FIM (Rs. −0.317, P = 0.005). However, there was no significant association between sleep quality and LOS (P = 0.763). Sedatives were used in 18.2% of patients but had no impact on sleep quality or rehabilitation outcomes.

Conclusion

This research supported that poor sleep was frequent after stroke and had negative effects on rehabilitation outcomes. Use of sedatives was of limited benefit to improve sleep quality, and further studies are required to search for strategies to improve sleep problems after stroke.
Impact of supplemental private health insurance on dialysis and outcomes
Authors: Sriravindrarajah Arunan , Kotwal Sradha S. , Sen Shaundeep , McDonald Stephen , Jardine Meg , Cass Alan , Gallagher Martin
Published: May 2019

Background

The influence of health insurance systems on the treatment of end‐stage kidney disease (ESKD) patients ispoorly understood.

Aim

We investigated how supplemental private health insurance (PHI) coverage impacted ESKD treatment modalitiesand patient outcomes.

The influence of health insurance systems on the treatment of end‐stage kidney disease (ESKD) patients is poorly understood. We investigated how supplemental private health insurance (PHI) coverage impacted ESKD treatment modalities and patient outcomes.

Methods

All adult patients commencing ESKD treatment in New South Wales, Australia from 2000 to 2010 were identified using the Australia and New Zealand Dialysis and Transplant Registry. Data were linked to the state hospitalisation dataset to obtain insurance status, allowing the comparisons of mortality, ESKD treatment modality and health service utilisation between privately insured and public patients.

Results

The cohort of 5737 patients included 38% (n = 2152) with PHI. At 1 year after ESKD treatment initiation, PHI patients had lower mortality (hazard ratio 0.84, 95% confidence interval (CI) 0.74–0.95, P = 0.01), were more likely to be receiving home haemodialysis (HD) (odds ratio (OR) 1.38, 95% CI 1.01–1.89, P = 0.04), to have been transplanted (OR 1.75, 95% CI 1.25–2.46, P = 0.001) and used fewer hospital days (incidence rate ratio 0.85, 95% CI 0.74–0.96, P = 0.01). After adjustment, PHI patients were more likely to initiate ESKD treatment with facility‐based HD (OR 1.22, 95% CI 1.01–1.46, P = 0.03) but were less likely to be started on peritoneal dialysis (OR 0.81, 95% CI 0.67–0.98, P = 0.03).

Conclusion

Our findings suggest that supplemental PHI in Australia is associated with lower‐risk ESKD treatment attributes and improved health outcomes. A greater understanding of the treatment pathways that deliver these outcomes may inform treatment for the broader ESKD treatment population.
The Process, Challenges and Opportunities of Developing a Curriculum in a Creative and Therapeutic Arts Undergraduate Degree Programme
Authors: Pickard Beth
Published: May 2019

This article reflects upon the process, the challenges and the opportunities realised in the recent revalidation activity of an undergraduate degree programme in Creative and Therapeutic Arts (CTA) in the UK. The premise of the revalidation activity and the historical context of the course are briefly encapsulated, before engaging with theoretical frameworks at the forefront of contemporary Participatory Arts practice. This includes an initial focus on the relevance of Critical Disability Studies to Participatory Arts education, followed by exploration of the contrasting approaches of Socially Engaged Art practice, Inclusive Arts practice, Participatory Arts practice, Arts in Health and Arts Therapies. The challenge of defining a diverse practice which draws from such contrasting perspectives is further explored in relation to the challenge of working on the boundary between artistic and therapeutic practice. Geographical context is considered, drawing from the Welsh evidence base to inform culturally relevant provision. Curriculum design is reviewed in relation to experiential learning and inclusive practice literature, as well as relevant higher education policies. Upon briefly summarising the revalidated curriculum, a critical discussion around the future of the training and the discipline more broadly is developed, considering the contribution of the critical review and focus groups facilitated as part of this revalidation activity. It is hoped that this discussion will further nurture and challenge educators, students and practitioners in this exciting area of evolving, contemporary practice.
How parents describe the positive aspects of parenting their child who has intellectual disabilities: A systematic review and narrative synthesis
Authors: Beighton Carole , Wills Jane
Published: May 2019

Background

Identifying what parents describe to be positive about parenting their child who has intellectual disabilities is important for professional practice and how parents can be supported over a lifespan.

Methods

Studies in which parents describe the positive aspects of parenting their child with intellectual disabilities were identified via electronic databases searches and analysed in a narrative synthesis.

Results

Twenty‐two studies were included. Consistent themes emerged relating to positive change, increased personal strength, growth and development largely related to parental intrapersonal orientation. Several studies emphasized that the presence of growth or positive change does not imply the absence of distress.

Conclusions

Positive aspects are not consistently defined and measured differently across studies. Consistent themes are described variously attributed to theories relating to coping, adaptation or growth following adversity; however, no single theoretical framework emerged. Factors likely to predict a parent's ability to identify positive aspects are inconclusive.
Incidence of early pulmonary vein reconnections using different energy sources for pulmonary vein isolation: Multielectrode phased radiofrequency vs second‐generation cryoballoon
Authors: Wieczorek Marcus , Tajtaraghi Sharam , Sassani Kiarash , Hoeltgen Reinhard
Published: May 2019

Objective

To determine and compare the incidence of early recurrence of conduction after pulmonary vein isolation (PVI) using two different ablation technologies: phased radiofrequency by a multipolar ablation catheter (PVAC) and cryo‐ablation by a second‐generation cryoballoon (CB).

Methods and Results

Two hundred patients (pts) with atrial fibrillation underwent PVI with PVAC (Group 1) or CB (Group 2), with 100 pts in each group. The incidence of PV reconnection (PVR) for each vein was examined in both groups at least 30 minutes after successful PVI. There were no significant clinical differences between both groups. Total procedure‐, fluoroscopy‐, and left atrial (LA) dwell time were significantly shorter in Group 2 pts (P < .0001). Early PVR was recorded in 69/388 (18%) isolated PVs or left common trunks (CTs) in Group 1 compared with 25/386 (7%) in Group 2 (P < .0001). Forty‐three pts in Group1 were found to have PVR compared with 22 pts in Group 2 (P = .0015). Group 1 pts with CTs showed significantly more PVR than pts of Group 2 (P = .047). In both groups, CTs and CT branches were found to reconnect significantly more frequent compared with all other veins.

Conclusion

Both PVAC and CB are effective to achieve PVI. Early PVR is observed with the significantly lower frequency with second‐generation CB compared with PVAC, contributing to shorter procedure‐, fluoroscopy, and LA dwell times. CTs and CT branches exhibit the highest incidence of PVR for both devices.
From persons to patients and back
Authors: Mitchell Derek
Published: May 2019

In this paper, I will show how philosophical theory can be applied in the most fundamental area of health care practice, the relationship between the provider and the receiver of care. I will look at the process of becoming a patient and remaining a person. This will begin with a discussion of Heidegger's notion of solicitude alongside the related notions of concern and care, leading to the affirmation of authentic solicitude as the most ontologically appropriate relationship between those who provide and those who receive care. I will then try to understand what happens to us when we become patients and to see what factors make it difficult for us to be persons as well as patients, within the health care environment. This will be followed by a brief discussion of the ancient idea ofphronesis(wisdom) in which I will attempt to elucidate, from the side of the health care professional, the way that their relationship with patients can work in a way that recognizes personhood in their patients. I will also consider the dialectical nature of the relationship between patients and doctors (and everyone else who treats us) and try to understand how this points towards the conclusion of a person‐centred approach to health care. Following this discussion, I will offer a couple of examples of what person‐centred health care might look like in practice, as a means of illustrating, in practical terms, the philosophical approach that I have used.
Fiscal Policy and Occupational Employment Dynamics
Authors: BREDEMEIER CHRISTIAN , JUESSEN FALKO , WINKLER ROLAND
Published: May 2019

We document substantial heterogeneity in occupational employment dynamics in response to government spending shocks in the United States. Employment rises most strongly in service, sales, and office (“pink‐collar”) occupations. By contrast, employment in blue‐collar occupations is hardly affected by fiscal policy. We provide evidence that occupation‐specific changes in labor demand are key for understanding these findings. We develop a business‐cycle model that explains the heterogeneous occupational employment dynamics as a consequence of composition effects due to heterogeneous employment changes across industries and occupation‐specific within‐industry employment shifts due to differences in the short‐run substitutability between labor and capital services across occupations.