bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of flattening‐filter‐free beam in stereotactic body radiation therapy planning and treatment: A systematic review with meta‐analysis
Authors: Dang Thu M , Peters Mitchell J , Hickey Brigid , Semciw Adam
Published: January 2017

A linear accelerator with the flattening‐filter removed generates a non‐uniform dose profile beam. We aimed to analyse and compare plan quality and treatment time between flattened beam (FB) and flattening‐filter‐free (FFF) beam to assess the efficacy of FFF beam for stereotactic body radiation therapy (SBRT). The search strategy was based around 3 concepts; radiation therapy, flattening‐filter‐free and treatment delivery. The years searched were restricted from 2010 to date of review (October 2015). All plan quality comparisons were between FFF and FB plans from the same data sets. We identified 210 potential studies based on the three searched concepts. All articles were screened by two authors for title and abstract and by three authors for full text. Ten studies met the eligibility criteria. Plan quality was evaluated using conformity index (CI), heterogeneity index (HI) and gradient index (GI). Dose to organs‐at‐risk (OAR) and healthy tissues were compared. Differences between beam‐on‐time (BOT) and treatment time (T × T) were also analysed. Normalized percentage ratios of CI and HI demonstrated no clinical differences among the studied articles. GI displayed small variations between the articles favouring FFF beam. The BOT with FFF is substantially reduced, and appears to impact the frequency of intra‐fraction imaging which, in turn, affects total treatment time. Based on planning tumour volume (PTV) coverage, dose to OAR and healthy tissue sparing, FFF beam is clinically effective for the treatment of cancer patients using SBRT. We recommend the use of FFF beam for SBRT based on these factors and the reported overall treatment time reduction.
paco: implementing Procrustean Approach to Cophylogeny in R
Authors: Hutchinson Matthew C. , Cagua E. Fernando , Balbuena Juan A. , Stouffer Daniel B. , Poisot Timothée
Published: January 2017

The concordance of evolutionary histories and extant species interactions provides a useful metric for addressing questions of how the structure of ecological communities is influenced by macro‐evolutionary processes.

We introduce paco (v0.3.1), an R package to perform Procrustean Approach to Cophylogeny. This method assesses the phylogenetic congruence, or evolutionary dependence, of two groups of interacting species using both ecological interaction networks and their phylogenetic history.

We demonstrate the functionality of paco through its application to empirical host‐parasite and plant‐pollinator communities.

Although the package is intended to assess the phylogenetic congruence between groups of interacting species, the method is also directly applicable to other scenarios that may show phylogenetic congruence including historical biogeography, molecular systematics, and cultural evolution.
Negative Affect‐Associated USV Acoustic Characteristics Predict Future Excessive Alcohol Drinking and Alcohol Avoidance in Male P and NP Rats
Authors: Reno James M. , Thakore Neha , Cormack Lawrence K. , Schallert Timothy , Bell Richard L. , Maddox W. Todd , Duvauchelle Christine L.
Published: January 2017

Background

Negative emotional status and adverse emotional events increase vulnerability to alcohol abuse. Ultrasonic vocalizations (USVs) emitted by rats are a well‐established model of emotional status that can reflect positive or negative affective responses in real time. Most USV studies assess counts, yet each USV is a multidimensional data point characterized by several acoustic characteristics that may provide insight into the neurocircuitry underlying emotional response.

Methods

USVs emitted from selectively bred alcohol‐naïve and alcohol‐experienced alcohol‐preferring and nonpreferring rats (P and NP rats) were recorded during 4‐hour sessions on alternating days over 4 weeks. Linear mixed modeling (LMM) and linear discriminant analysis (LDA) were applied to USV acoustic characteristics (e.g., frequency, duration, power, and bandwidth) of negative affect (22 to 28 kilohertz [kHz])‐ and positive (50 to 55 kHz) affect‐related USVs.

Results

Hundred percent separation between alcohol‐naïve P and NP rats was achieved through a linear combination (produced by LDA) of USV acoustic characteristics of 22‐ to 28‐kHz USVs, whereas poor separation (36.5%) was observed for 50‐ to 55‐kHz USVs. 22‐ to 28‐kHz LDA separation was high (87%) between alcohol‐experienced P and NP rats, but was poor for 50‐ to 55‐kHz USVs (57.3%). USV mean frequency and duration were the highest weighted characteristics in both the naïve and experienced 22‐ to 28‐kHz LDA representations suggesting that alcohol experience does not alter the representations. LMM analyses of 22‐ to 28‐kHz USV acoustic characteristics matched the LDA results. Poor LDA separation was observed between alcohol‐naïve and alcohol‐experienced P rats for both 22‐ to 28‐kHz and 50‐ to 55‐kHz USVs.

Conclusions

Advanced statistical analysis of negative affect‐associated USV data predicts future behaviors of excessive alcohol drinking and alcohol avoidance in selectively bred rats. USV characteristics across rat lines reveal affect‐related motivation to consume alcohol and may predict neural pathways mediating emotional response. Further characterization of these differences could delineate particular neurocircuitry and methods to ameliorate dysregulated emotional states often observed in human alcohol abusers.
The political salience of the cost of alcohol should make it a research priority
Authors: Bhattacharya Aveek
Published: January 2017

Commentary to: Which cost of alcohol? What should we compare it against?
Surgical wisdom and Genghis Khan'sPax Mongolica
Authors: Köstenbauer Jakob
Published: January 2017

Background

The unrivalled conquests of Genghis Khan (CE c.1162–1227) led to the establishment of the Greater Mongolian Empire. By 1279, the Mongol dynasty controlled a vast Empire which, for the first time in history, unified Europe and China via the famous Silk Road. The ensuing century of peace and stability is referred to by historians as thePax Mongolica, which facilitated Europe's renaissance and remarkably contributed to the rise of modern medicine and surgery.

Methods

Secondary sources from published literature, primary sources from manuscripts and illustrations courtesy of universities, museum libraries and archives.

Results

There is ample evidence detailing the Mongol Empire's power during the thirteenth century and the Silk Road's role as a vehicle of commercial, cultural and scientific exchange. Advances in medical knowledge and surgical skills were made in all parts of the Empire and exchanged from China to Constantinople and back. Prominent medical figures traversed these centres, and no doubt contributed to the spread of surgical science, including Rashid al‐Din and Mansur Ibn Ilyas. Their works, it is argued, enriched the practice of surgery and may have indirectly ushered‐in the rise of modern surgery in the early medical schools at Salerno, Bologna, Pavia, Oxford, Montpellier and Constantinople to name but a few.

Conclusion

The blossoming and diversification of medical and surgical knowledge was an integral part of the great cultural exchange facilitated by thePax Mongolica. This enhanced surgical practice in China, Persia and Arabia, while coinciding with the renaissance of surgical teaching in Europe.
Predicting malignancy in adrenal incidentaloma and evaluation of a novel risk stratification algorithm
Authors: Foo Elizabeth , Turner Robin , Wang Kuan‐Chi , Aniss Adam , Gill Anthony J. , Sidhu Stanley , Clifton‐Bligh Roderick , Sywak Mark
Published: January 2017

Background

Incidentally discovered adrenal lesions known as adrenal incidentalomas (AI) are being encountered with increasing frequency due to the widespread use of abdominal computed tomography (CT). The aim of this study was to identify the clinical predictors of malignancy in AI and to evaluate the accuracy of a recently proposed risk stratification algorithm.

Methods

A retrospective analysis of 96 patients presenting with AI between 2004 and 2014 was undertaken; 66 patients underwent adrenalectomy, and 30 were managed non‐operatively. Univariate analysis including patient demographics, CT features of tumour size, density and heterogeneity was performed. Hormonal parameters including 24‐h urinary‐free cortisol and serum dehydroepiandrosterone sulphate (DHEAS) were also included. A Cleveland Clinic risk stratification model utilizing adrenal size and density was evaluated.

Results

The overall rate of malignancy was 8%. On univariate analysis, the following preoperative variables were predictive of malignancy – tumour size on pathology (P = 0.0031) and CT (P = 0.0016), heterogeneity on CT imaging (P = 0.0036), a relative percentage washout of less than 40% (P = 0.0178), elevated 24‐h urinary‐free cortisol levels (P = 0.0176), elevated DHEAs (P = 0.0061) and younger age at presentation (P < 0.0001). Evaluation of the Cleveland Clinic algorithm found an area under the receiver operating characteristic curve of 0.81 (95% confidence interval 0.52–1.00).

Conclusion

CT characteristics of tumour size, density and heterogeneity are significantly associated with malignancy in AI and applied together reliably exclude malignancy. The risk stratification algorithm utilizing size and density alone may fail to identify some smaller adrenal cancers.
Intrapartum predictors of maternal levator ani injury
Authors: Caudwell‐Hall Jessica , Kamisan Atan Ixora , Martin Andrew , Guzman Rojas Rodrigo , Langer Susanne , Shek Kalai , Dietz Hans P.
Published: January 2017

Introduction

Damage to the pelvic floor during vaginal childbirth is common, and may take the form of levator avulsion or irreversible overdistension of the levator hiatus (microtrauma). Such trauma is a major risk factor for pelvic organ prolapse later in life. In this study we aimed to identify intrapartum risk factors for levator trauma.

Material and methods

This is a retrospective analysis of data obtained in two perinatal studies on primiparous women. Between 2005 and 2014, 1148 women carrying an uncomplicated singleton pregnancy in the late third trimester were seen for 4D pelvic floor ultrasound and an interview. They were invited for a repeat assessment at three months postpartum.

Results

Of 1148 women, 871 (76%) returned for assessment at a mean of five months postpartum. The datasets of 844 women were analyzed due to missing data or concurrent pregnancy in 27. In all, 452 (54%) had a normal vaginal delivery, 102 (12%) a vacuum, 55 (6%) a forceps, and 235 (28%) a cesarean section. On multivariate analysis forceps, length of second stage and obstetric anal sphincter tears were significantly associated with levator avulsion. There were no significant predictors identified for irreversible overdistension.

Conclusions

The use of forceps, a prolonged second stage, and obstetric anal sphincter tears were associated with levator avulsion. There were no associated intrapartum predictors for hiatal overdistension.
Special diets are common among preschool children aged one to five years in south‐east Sweden according to a population‐based cross‐sectional survey
Authors: Servin Caroline , Hellerfelt Sofia , Botvid Christina , Ekström Magnus
Published: January 2017

Aim

Information about the prevalence of special diets in preschool children is limited. The aim of this study was to measure the prevalence of all special diets among preschool children in a Swedish municipality.

Methods

This was a population‐based cross‐sectional survey of all 3276 preschool children aged one to five years in the municipality of Karlskrona, Sweden. The questionnaire assessed the number of children at each preschool, how many were on special diets, their dietary requirements, age, sex, whether they had a medical certificate and whether the special diet had a perceived medical cause.

Results

We obtained data for 3221 (98%) of the children, and 19% had special diets, including 12% on nonmedical diets and 6.3% on medical diets. The five most common diets were avoiding pork (7.8%), a vegetarian diet (4.8%), and avoiding cows' milk (3.5%), hens' eggs (1.2%) and lactose (1.1%). Gluten avoidance was more common in girls than boys (0.8% versus 0.2%, p = 0.032). Half (47%) of the children on special medical diets lacked a medical certificate.

Conclusion

Special diets were common in preschool children in south‐east Sweden, and the causes were mainly nonmedical. Mandatory medical certificates for medically based special diets might reduce unnecessary dietary restrictions.
Motility of Campylobacter concisus isolated from saliva, feces, and gut mucosal biopsies
Authors: Ovesen Sandra , Kirk Karina Frahm , Nielsen Hans Linde , Nielsen Henrik
Published: January 2017

Campylobacter concisus is an emerging pathogen associated with gastrointestinal disorders such as gastroenteritis and inflammatory bowel diseases (IBD), but the species is also found in healthy subjects. The heterogeneous genome of C. concisus increases the likelihood of varying virulence between strains. Flagella motility is a crucial virulence factor for the well‐recognized Campylobacter jejuni; therefore, this study aimed to analyze the motility of C. concisus isolated from saliva, gut biopsies, and feces of patients with IBD, gastroenteritis, and healthy subjects. The motility zones of 63 isolates from 52 patients were measured after microaerobic growth in soft‐agar plates for 72 hours. The motility of C. concisus was significantly lower than that of Campylobacter jejuni and Campylobacter fetus subsp. fetus. The motility of C. concisus varied between isolates (4–22 mm), but there was no statistical significant difference between isolates from IBD patients and healthy subjects (p = 0.14). A tendency of a larger motility zones was observed for IBD gut mucosa isolates, although it did not reach statistical significance (p = 0.13), and no difference was found between oral or fecal isolates between groups. In conclusion, the varying motility of C. concisus could not be related to disease outcome or colonization sites.
Guano core evidence of palaeoenvironmental change and Woodland Indian inhabitance in Fern Cave, Alabama, USA, from the mid‐Holocene to present
Authors: Campbell Joshua W. , Waters Matthew N. , Rich Fred
Published: January 2017

Bat guano cores have been used as a source of palaeoenvironmental information to aid in the reconstruction of past climates and vegetation. We collected a 104‐cm‐long (43 cm compacted) guano core from Fern Cave, Alabama, USA, that provided a c. 6000‐year record of guano accumulation. Pollen, nutrients (C, N, P) and stable isotopes (δ13C, δ15N) were measured on the guano core with the objective of reconstructing the environmental history of the area from the mid‐Holocene to present. Our data indicate that bats have utilized Fern Cave for at least 6000 years and that Woodland Indians also utilized the cave for a short period. A 3‐cm charcoal layer was dated to 2720±30 cal. a BP and inferred to be Woodland Indian in origin from microscopic inspection and thickness. Pollen and geochemical data showed that bat diets changed in the late Holocene possibly linked to food supply and climate changes. These results demonstrate that guano cores are a useful tool of palaeoenvironmental reconstruction when other forms of palaeorecords do not exist and can add to local archaeological information.
Compromising Adjustment Strategy Based on TKI Conflict Mode for Multi‐Times Bilateral Closed Negotiations
Authors: Fujita Katsuhide
Published: January 2017

Bilateral multi‐issue closed negotiation is an important class for real‐life negotiations. Usually, negotiation problems have constraints such as a complex and unknown opponent's utility in real time, or time discounting. In the class of negotiation with some constraints, the effective automated negotiation agents can adjust their behavior depending on the characteristics of their opponents and negotiation scenarios. Recently, the attention of this study has focused on the interleaving learning with negotiation strategies from the past negotiation sessions. By analyzing the past negotiation sessions, agents can estimate the opponent's utility function based on exchanging bids.

In this article, we propose a negotiation strategy that estimates the opponent's strategies based on the past negotiation sessions. Our agent tries to compromise to the estimated maximum utility of the opponent by the end of the negotiation. In addition, our agent can adjust the speed of compromise by judging the opponent's Thomas–Kilmann conflict mode and search for the Pareto frontier using past negotiation sessions. In the experiments, we demonstrate that the proposed agent has better outcomes and greater search technique for the Pareto frontier than existing agents in the linear and nonlinear utility functions.
Response to O'Leary et al.: Misuse of Models Leads to Misguided Conservation Recommendations
Authors: White J. Wilson , Nickols Kerry J. , Botsford Louis W.
Published: January 2017

O'Leary et al. sought to evaluate the scientific basis for global targets for marine protected area (MPA) coverage (e.g., 10% of marine habitats) using a meta‐analysis of published MPA modeling studies. Unfortunately, their approach was flawed in both methodology and philosophy, as we explain in this letter.
Endoscopic ultrasonography‐guided biliary and pancreatic duct interventions
Authors: Dhir Vinay , Isayama Hiroyuki , Itoi Takao , Almadi Majid , Siripun Aroon , Teoh Anthony Y. B. , Ho Khek Yu
Published: January 2017

Drainage of obstructed bile duct and pancreatic duct under endoscopic ultrasonography (EUS) guidance has evolved into viable techniques suitable for patients with failed endoscopic retrograde cholangiopancreatography (ERCP) and/or altered surgical anatomy. One of the major advantages of EUS guidance is the possibility of multiple access points depending upon patient and ductal anatomy. Unlike ERCP, an approachable papilla is not a requisite for successful EUS‐guided biliary or pancreatic ductal drainage. Moreover, as the access is away from the papilla, there is the possibility of reduced pancreatitis. A variety of procedures have become available for EUS‐guided drainage, and it is important to develop standard terminology and procedural details. EUS‐specific stents, including lumen‐apposing metal stents have recently become available, and are likely to impact the outcomes of these procedures. Available data show a high success rate and acceptable adverse event rate for EUS‐guided biliary drainage. Success rate appears to be low for pancreatic duct drainage because of a variety of reasons. Outcomes of EUS‐guided biliary drainage appear equivalent to percutaneous drainage and ERCP. EUS‐guided gallbladder drainage appears promising for patients requiring gallbladder drainage but unfit for surgery. Further large controlled studies are needed to evaluate the exact role of these procedures.
The association between exercise‐induced pulmonary haemorrhage and race‐day performance in Thoroughbred racehorses
Authors: Crispe E. J. , Lester G. D. , Secombe C. J. , Perera D. I.
Published: January 2017

Background

Exercise‐induced pulmonary haemorrhage (EIPH) is commonly implicated as a cause of poor athletic performance but there is limited and conflicting evidence for this association.

Objectives

The aim of this study was to determine if EIPH, based on endoscopic examination after racing, is associated with a variety of novel and established performance parameters.

Study design

Prospective, observational cross‐sectional study.

Methods

Thoroughbred racehorses competing between 2012 and 2015 were examined on‐course no earlier than 30 min after racing. Examinations were recorded and graded blindly by experienced veterinarians using a 0–4 scale. Linear mixed effect models were used for analysis of continuous response variables with horse name incorporated as a random effect to account for repeated sampling and horse variability. Generalised estimating equations were used for analysis of binary responses. Performance variables were examined in 2 models, comparing EIPH grade 0 to grades 1–4, and EIPH grade ≤2 compared with EIPH grades ≥3, controlling race factors that could influence performance.

Results

There were 3794 observations collected from 1567 horses. EIPH was detected in 55.1% of observations. Horses with grade 4 EIPH were significantly more likely to have a lower finishing position and finish further behind the winner, less likely to place in the first 3 positions and collect race earnings, collected less earnings per race start and were slower over the last 600 m of the race than horses without EIPH (grade 0). Similar associations were seen in Model 2, with horses with EIPH grade ≥3 having inferior performance when compared to horses with EIPH ≤2.

Main limitations

Enrolment was voluntary.

Conclusion

Mild to moderate haemorrhage was not associated with inferior race day performance in this population of Thoroughbred racehorses.
Asp263 missense variants perturb the active site of human phosphoglucomutase 1
Authors: Stiers Kyle M. , Graham Abigail C. , Kain Bailee N. , Beamer Lesa J.
Published: January 2017

The enzyme phosphoglucomutase 1 (PGM1) plays a central role in glucose homeostasis. Clinical studies have identified mutations in human PGM1 as the cause of PGM1 deficiency, an inherited metabolic disease. One residue, Asp263, has two known variants associated with disease: D263G and D263Y. Biochemical studies have shown that these mutants are soluble and well folded, but have significant catalytic impairment. To better understand this catalytic defect, we determined crystal structures of these two missense variants, both of which reveal a similar and indirect structural change due to the loss of a conserved salt bridge between Asp263 and Arg293. The arginine reorients into the active site, making interactions with residues responsible for substrate binding. Biochemical studies also show that the catalytic phosphoserine of the missense variants is more stable to hydrolysis relative to wild‐type enzyme. The structural perturbation resulting from mutation of this single amino acid reveals the molecular mechanism underlying PGM1 deficiency in these missense variants.

Database

Structural data are available in the PDB under the accession numbers 5JN5 and 5TR2.
A Discriminatory Mechanism to Reduce Urban Congestion
Authors: Mougeot Michel , Schwartz Sonia
Published: January 2017

In this article, we propose an optimal mechanism to reduce congestion when information is asymmetric. Each car driver receives a quantity of traffic rights such that his adjusted marginal benefit is equal to the marginal cost of congestion and payments are based on willingness to pay. We show that the level of congestion achieved is lower and each car user can receive more or fewer rights than under complete information. With symmetric beliefs, the payment rule results from a seconddegree price discrimination. When beliefs are asymmetric, it results simultaneously from a second-degree price discrimination and from a third-degree price discrimination and high willingness-to-pay car users are discriminated against. The revenue raised can be used to reduce distortionary taxes, thereby gaining public acceptability.
Protected Area Designation, Natural Amenities, and Rural Development of Forested Counties in the Continental United States
Authors: Kovacs Kent , Haight Robert G. , West Grant
Published: January 2017

Policy makers who wish to spur economic development in rural forests face challenges that include population decline and poverty. Protected land and natural amenities enhance the quality of life and prospects for economic development, but there is limited research on how different types of protected land or natural amenities affect the rural forest economy. We use county level variables for protected areas differentiated by access and extractive use, and natural amenities differentiated by climate, water area, and topography to explain spatial variation in labor and built space markets. Results show that temperate summers and water area increase wages and housing prices and explain more than 30 percent of the spatial differences in wages, housing price, employment density, built space percent, human capital, and local road density. Protected area decreases wages, but, if open access, increase housing prices and human capital and explain more than 20 percent of the spatial differences in human capital, built space percent, and local road density.
Beyond the consultation room: Proposals to approach health promotion in primary care according to health‐care users, key community informants and primary care centre workers
Authors: Berenguera Anna , Pons‐Vigués Mariona , Moreno‐Peral Patricia , March Sebastià , Ripoll Joana , Rubio‐Valera Maria , Pombo‐Ramos Haizea , Asensio‐Martínez Angela , Bolaños‐Gallardo Eva , Martínez‐Carazo Catalina , Maderuelo‐Fernández José Ángel , Martínez‐Andrés Maria , Pujol‐Ribera Enriqueta
Published: January 2017

Background

Primary health care (PHC) is the ideal setting to provide integrated services centred on the person and to implement health promotion (HP) activities.

Objective

To identify proposals to approach HP in the context of primary care according to health‐care users aged 45‐75 years, key community informants and primary care centre (PCC) workers.

Methods

Descriptive‐interpretive qualitative research with 276 participants from 14 PCC of seven Spanish regions. A theoretical sampling was used for selection. A total of 25 discussion groups, two triangular groups and 30 semi‐structured interviews were carried out. A thematic interpretive contents analysis was carried out.

Results

Participants consider that HP is not solely a matter for the health sector and they emphasize intersectoral collaboration. They believe that it is important to strengthen community initiatives and to create a healthy social environment that encourages greater responsibility and participation of health‐care users in decisions regarding their own health and better management of public services and resources. HP, care in the community and demedicalization should be priorities for PHC. Participants propose organizational changes in the PCC to improve HP. PCC workers are aware that HP falls within the scope of their responsibilities and propose to increase their training, motivation, competences and knowledge of the social environment. Informants emphasize that HP should be person‐centred approach and empathic communication. HP activities should be appealing, ludic and of proven effectiveness.

Conclusions

According to a socio‐ecological and intersectoral model, PHC services must get actively involved in HP together with community and through outreach interventions.
Influence of maternal psychological traits on sleep bruxism in children
Authors: Goettems Marilia Leão , Poletto‐Neto Victorio , Shqair Ayah Qassem , Pinheiro Ricardo Tavares , Demarco Flavio Fernando
Published: January 2017

Background

Sleep bruxism (SB) is a sleep disorder with high incidence in toddlers and may perpetuate to adulthood. The multifactorial etiology of bruxism includes pathophysiologic and psychological factors.

Aim

To investigate the relationship between depression, stressful events, and the presence of symptoms of anxiety and depression with SB in children of adolescent mothers.

Design

This cross‐sectional study nested in a cohort evaluated a sample of 536 mothers and their children aged 24–36 months. Interviews were conducted with mothers. Maternal report of SB was collected. Mother's major depressive disorder was assessed using the Mini International Neuropsychiatric Interview (MINI Plus); Life Events Scale assessed the stressful events; Beck Depression Inventory and Beck Anxiety Inventory investigated the symptoms of depression and anxiety. Poisson regression analysis was applied to assess the association of maternal psychological disorders and stressful events with SB on children.

Results

Prevalence of SB was 25.93% (95% CI 22.2–29.7). After adjustments, maternal major depression disorder [PR 1.43 (95% CI 1.06–1.92)] and the presence of stressful events mainly environmental changes [PR 1.47 (95% CI 1.08–2.00)] showed significant association with bruxism in children.

Conclusion

This study showed a positive association between mother's psychological traits and SB development in their toddlers.
Health knowledge and the impact of social exclusion on young people with intellectual disabilities
Authors: Pownall Jaycee , Wilson Sarah , Jahoda Andrew
Published: January 2017

Background

Cognitive impairments are often assumed to underlie individuals’ difficulties with understanding health issues. However, it was predicted that socially excluded individuals would have greater difficulty gaining understanding of sensitive topics related to sexuality than other public health messages, such as alcohol use.

Method

The health knowledge of 31 typically developing young people, 29 young people with mild intellectual disabilities (ID) and 23 participants with physical disabilities but no cognitive impairments was compared.

Results

The largest group differences were related to more private and personal health issues, such as pregnancy/contraception. Both groups of young people with disabilities had less knowledge of pregnancy/contraception than their non‐disabled peers. Thus, deficits in this sexual knowledge did not just appear to be the result of cognitive deficits.

Conclusions

The findings suggest social exclusion may contribute to young people with intellectual disabilities’ poorer knowledge of pregnancy and contraception. The results have implications for interventions.
Efficacy of trapping systems for monitoring of Afrotropical fruit flies
Authors: Manrakhan A. , Daneel J.‐H. , Beck R. , Virgilio M. , Meganck K. , De Meyer M.
Published: January 2017

The efficacy of different attractant trap combinations for monitoring of Afrotropical fruit flies was evaluated in commercial fruit production areas and natural areas in the northern parts of South Africa. Five food‐based attractants: three‐component Biolure, a combination of ammonium acetate and trimethylamine, a combination of ammonium acetate and putrescine, torula yeast and Questlure, were evaluated in McPhail‐type traps. Two male lures targeting Ceratitis species: EGO Pherolure and trimedlure, were evaluated in Sensus bucket traps. Three male lures targeting Dacine fruit flies: methyl eugenol, cue lure and zingerone, were evaluated in Moroccan bucket traps. The three‐component Biolure was among the most effective food‐based attractant for females of Ceratitis capitata, C. rosa (R1 and R2), C. cosyra and Bactrocera dorsalis. EGO Pherolure attracted a wider range of Ceratitis species than trimedlure but was equally as effective as trimedlure for males of C. capitata and C. rosa (R1 and R2). Dacine flies were specific in their responses to male lures. Bactrocera dorsalis males responded mainly to methyl eugenol. Males of Dacus species responded to either cue lure or zingerone. Zingerone attracted two cucurbit‐infesting Dacus species: D. frontalis and D. durbanensis. For B. dorsalis, C. capitata and C. cosyra in commercial fruit production areas, patterns of female catches in traps containing food‐based attractants were different to patterns of male catches in male lure‐based traps. Implications of these trapping results are discussed.
Improving causal inference with a doubly robust estimator that combines propensity score stratification and weighting
Authors: Linden Ariel
Published: January 2017

Rationale, aims and objectives

When a randomized controlled trial is not feasible, health researchers typically use observational data and rely on statistical methods to adjust for confounding when estimating treatment effects. These methods generally fall into 3 categories: (1) estimators based on a model for the outcome using conventional regression adjustment; (2) weighted estimators based on the propensity score (ie, a model for the treatment assignment); and (3) “doubly robust” (DR) estimators that model both the outcome and propensity score within the same framework. In this paper, we introduce a new DR estimator that utilizes marginal mean weighting through stratification (MMWS) as the basis for weighted adjustment. This estimator may prove more accurate than treatment effect estimators because MMWS has been shown to be more accurate than other models when the propensity score is misspecified. We therefore compare the performance of this new estimator to other commonly used treatment effects estimators.

Method

Monte Carlo simulation is used to compare the DR‐MMWS estimator to regression adjustment, 2 weighted estimators based on the propensity score and 2 other DR methods. To assess performance under varied conditions, we vary the level of misspecification of the propensity score model as well as misspecify the outcome model.

Results

Overall, DR estimators generally outperform methods that model one or the other components (eg, propensity score or outcome). The DR‐MMWS estimator outperforms all other estimators when both the propensity score and outcome models are misspecified and performs equally as well as other DR estimators when only the propensity score is misspecified.

Conclusions

Health researchers should consider using DR‐MMWS as the principal evaluation strategy in observational studies, as this estimator appears to outperform other estimators in its class.
The use of smartphone health apps and other mobile health (mHealth) technologies in dietetic practice: a three country study
Authors: Chen J. , Lieffers J. , Bauman A. , Hanning R. , Allman‐Farinelli M.
Published: January 2017

Background

Smartphone health applications (apps) and other mobile health (mHealth) technologies may assist dietitians in improving the efficiency of patient care. The present study investigated the use of health apps and text messaging in dietetic practice and formulated intervention recommendations for supporting app uptake by dietitians based on the behavioural ‘COM‐B’ system, where interactions between capability, opportunity and motivation influence behaviour.

Methods

A 52‐item online survey tool, taking 20 min to complete, was developed and piloted, with questions exploring the use of health apps and text messaging in dietetic practice, types of apps dietitians recommended and that patients used, and barriers and enablers to app use in dietetic practice. The Australian, New Zealand and British dietetic associations distributed the survey to their members.

Results

A 5% response rate was achieved internationally, with 570 completed responses included for further analysis. Health apps, namely nutrition apps, were used by 62% of dietitians in their practice, primarily as an information resource (74%) and for patient self‐monitoring (60%). The top two nutrition apps recommended were MyFitnessPal® (62%) and the Monash University Low FODMAP Diet® (44%). Text messaging was used by 51% of respondents, mainly for appointment‐related purposes (84%).

Conclusions

Although the reported use of smartphone health apps in dietetic practice is high, health apps and other mHealth technologies are not currently being used for behaviour change, nor are they an integral part of the nutrition care process. Dietetic associations should provide training, education and advocacy to enable the profession to more effectively engage with and implement apps into their practice.
Intestinal smooth muscle is required for patterning the enteric nervous system
Authors: Graham Hannah K. , Maina Ivy , Goldstein Allan M. , Nagy Nandor
Published: January 2017

The development of the enteric nervous system (ENS) and intestinal smooth muscle occurs in a spatially and temporally correlated manner, but how they influence each other is unknown. In the developing mid‐gut of the chick embryo, we find that α‐smooth muscle actin expression, indicating early muscle differentiation, occurs after the arrival of migrating enteric neural crest‐derived cells (ENCCs). In contrast, hindgut smooth muscle develops prior to ENCC arrival. Smooth muscle development is normal in experimentally aganglionic hindguts, suggesting that proper development and patterning of the muscle layers does not rely on the ENS. However, inhibiting early smooth muscle development severely disrupts ENS patterning without affecting ENCC proliferation or apoptosis. Our results demonstrate that early intestinal smooth muscle differentiation is required for patterning the developing ENS.
The Crisis Sequence: The Case of Secessionism in Tuscaloosa County, Alabama
Authors: de Leon Cedric
Published: January 2017

Prevailing scholarly approaches to the U.S. Secession Crisis suggest that the crisis reflected either the interests of slaveowners or mounting socioeconomic pressure in the electorate. Both arguments suffer from empirical and analytical challenges, chief among these being that the southern Whig Party and its planter base actively resisted secession until the early 1850s. Why did the largest slaveowners oppose disunion only to fold by 1861? Drawing on beat‐level electoral returns, newspapers, and private correspondence from antebellum Tuscaloosa County, Alabama, I argue that the answer lies in conceiving of the prelude to secession as a “crisis sequence,” so named because it precipitates crises of hegemony, when no one political actor possesses the mass consent to rule and once salient social cleavages cease to resonate. Such sequences destabilize the relationship between parties and their constituents and allow political allegiances to swing wildly from one party to the next, giving such sequences their nonlinear character.
CAD/CAM‐Assisted Auricular Prosthesis Fabrication for a Quick, Precise, and More Retentive Outcome: A Clinical Report
Authors: Yadav Sushma , Narayan Aparna Ichangod , Choudhry Archit , Balakrishnan Dhanasekar
Published: January 2017

Auricular defects comprise a large proportion of maxillofacial deformities. Most patients with acquired deformities have psychosocial ineptness and seek cosmetic rehabilitation. Although minor defects can be corrected surgically, extensive deformities are difficult to reconstruct with plastic surgery. Contrary to that, prosthetic restoration can provide excellent esthetic results. The conventional methods of maxillofacial prosthesis fabrication are time consuming and the outcome depends on the technician's skill. The advent of CAD/CAM technology in the field of dentistry has brought enormous improvement in the quality of health care provided. In the past decade, several methods have been described employing CAD/CAM techniques for the cosmetic rehabilitation of auricular defects. This clinical report details the integration of multiple digital technologies of CT scanning, computer aided design, and rapid prototyping to construct an ear prosthesis with limited number of appointments.
Variation in Aggressiveness Components in theHemileia vastatrixPopulation in Brazil
Authors: Maia Thiago , Badel Jorge Luis , Fernandes Michelle Bayer , Bragança Carlos Augusto Dórea , Mizubuti Eduardo Seiti Gomide , Brommonschenkel Sérgio Hermínio
Published: January 2017

The Pucciniomycete fungusHemileia vastatrixcauses leaf rust on coffee trees. The pathogen is responsible for considerable yield losses in susceptible coffee cultivars if appropriate management strategies are not implemented. Rapid spread and epidemics of rust fungi are usually associated with the emergence of new races of the pathogen that overcome resistance or with the emergence of more aggressive populations of the pathogen. In Brazil, coffee production is dominated by susceptible cultivars ofCoffea arabicaandCoffea canephora. We assessed aggressiveness in 46 populations ofH. vastatrixfrom Minas Gerais and Espírito Santo, two of the most important coffee‐producing states in Brazil. We observed a significant difference in the incubation period between the populations from Minas Gerais and Espírito Santo when 183 single‐pustule isolates were inoculated onto Catuaí VermelhoIAC44, a susceptibleC. arabicacultivar. Variation in aggressiveness components was observed between and within localities. Isolates with longer incubation periods also tended to have longer latent periods, although there was only a low correlation between these two aggressiveness components (r2 = 0.34, P = 2.2 × 10−16). Low‐sporulating isolates also had significantly longer incubation and latent periods. TheH. vastatrixpopulation from Minas Gerais and Espírito Santo is structured by the formation of groups of individuals with differential level of aggressiveness. Our results indicate that the variation in aggressiveness of the BrazilianH. vastatrixpopulation may be associated with the geographic coffee‐producing areas.
Melatonin prevents mitochondrial dysfunction and promotes neuroprotection by inducing autophagy during oxaliplatin‐evoked peripheral neuropathy
Authors: Areti Aparna , Komirishetty Prashanth , Akuthota Manasaveena , Malik Rayaz A. , Kumar Ashutosh
Published: January 2017

Oxaliplatin, an organoplatinum compound, is used in the treatment of colorectal cancer, but its clinical use can be limited due to the development of peripheral neuropathy. Whilst mitochondrial dysfunction has been implicated as a major pathomechanism for oxaliplatin‐induced neurotoxicity, the prevention of autophagy may also aggravate neuronal cell death. Melatonin, a well‐known mitoprotectant and autophagy inducer, was used to examine its neuroprotective role in oxaliplatin‐induced peripheral neuropathy (OIPN). Melatonin prevented the loss of mitochondrial membrane potential (Ψm) and promoted neuritogenesis in oxaliplatin‐challenged neuro‐2a cells. It did not interfere with the cytotoxic activity of oxaliplatin in human colon cancer cell line, HT‐29. Melatonin treatment significantly alleviated oxaliplatin‐induced pain behavior and neuropathic deficits in rats. It also ameliorated nitro‐oxidative stress mediated by oxaliplatin, thus prevented nitrosylation of proteins and loss of antioxidant enzymes, and therefore, it improved mitochondrial electron transport chain function and maintained cellular bioenergetics by improving the ATP levels. The protective effects of melatonin were attributed to preventing oxaliplatin‐induced neuronal apoptosis by increasing the autophagy pathway (via LC3A/3B) in peripheral nerves and dorsal root ganglion (DRG). Hence, it preserved the epidermal nerve fiber density in oxaliplatin‐induced neuropathic rats. Taken together, we provide detailed molecular mechanisms for the neuroprotective effect of melatonin and suggest it has translational potential for oxaliplatin‐induced neuropathy.
Psychosocial work characteristics, sleep disturbances and risk of subsequent depressive symptoms: a study of time‐varying effect modification
Authors: Magnusson Hanson Linda L. , Peristera Paraskevi , Chungkham Holendro S. , Westerlund Hugo
Published: January 2017

Job strain and low social support at work are recognized risk factors for depression. However, people with poor sleep may represent a high‐risk group more likely to benefit from interventions against work stress. The present study examined whether the associations between these work stressors and depressive symptoms differed by strata of sleep disturbances (effect modification/effect moderation) considering repeat measures of work characteristics and sleep. The study was based on five biennial measurements of the Swedish Longitudinal Occupational Survey of Health, including 1537 respondents recurrently in paid work, from an originally representative sample of the Swedish working population. High work demands, low decision authority and low social support were measured waves 2 and 4, sleep disturbances (putative moderator/modifier) waves 1 and 3, and depressive symptoms (outcome) wave 5. Causal effect modification, whether the effect of working conditions differed by strata of sleep disturbances, was analysed by structural nested mean modelling estimated using a regression‐with‐residuals with inverse‐probability‐of‐treatment weighting approach. High demands and low social support, but not low decision authority, influenced subsequent depressive symptoms. The relationship between social support and depressive symptoms was not apparently modified by sleep disturbances. However, disturbed sleep wave 3 modified the effect of high demands wave 4 (coefficient 1.77, P < 0.05) on depressive symptoms wave 5. The results indicate that high job demands is a stronger risk factor for depressive symptoms in people with pre‐existing sleep disturbances, suggesting that targeted workplace interventions may be more effective when it comes to preventing negative effects of job demands.
Assessing the benefits of napping and short rest breaks on processing speed in sleep‐restricted adolescents
Authors: Lim Julian , Lo June C. , Chee Michael W. L.
Published: January 2017

Achievement‐oriented adolescents often study long hours under conditions of chronic sleep restriction, adversely affecting cognitive function. Here, we studied how napping and rest breaks (interleaved off‐task periods) might ameliorate the negative effects of sleep restriction on processing speed. Fifty‐seven healthy adolescents (26 female, age = 15–19 years) participated in a 15‐day live‐in protocol. All participants underwent sleep restriction (5 h time‐in‐bed), but were then randomized into two groups: one of these groups received a daily 1‐h nap opportunity. Data from seven of the study days (sleep restriction days 1–5, and recovery days 1–2) are reported here. The Blocked Symbol Decoding Test, administered once a day, was used to assess time‐on‐task effects and the effects of rest breaks on processing speed. Controlling for baseline differences, participants who took a nap demonstrated faster speed of processing and greater benefit across testing sessions from practice. These participants were also affected significantly less by time‐on‐task effects. In contrast, participants who did not receive a nap benefited more from the rest breaks that were permitted between blocks of the test. Our results indicate that napping partially reverses the detrimental effects of sleep restriction on processing speed. However, rest breaks have a greater effect as a countermeasure against poor performance when sleep pressure is higher. These data add to the growing body of evidence showing the importance of sleep for good cognitive functioning in adolescents, and suggest that more frequent rest breaks might be important in situations where sleep loss is unavoidable.
Replacement of Fishmeal by a Mixture of Soybean Meal and Chlorella Meal in Practical Diets for Juvenile Crucian Carp, Carassius auratus
Authors: Shi Xi , Luo Zhi , Chen Guang‐Hui , Chen Feng , Zhang Li‐Han , Zhu Xiao‐Ming , Liu Xu
Published: January 2017

A growth trial was conducted to evaluate the effect of a mixture of soybean meal and Chlorella meal (SCM) as a dietary fishmeal (FM) substitute on growth performance, apparent digestibility coefficients (ADCs), digestive enzymatic activities, and histology of juvenile crucian carp, Carassius auratus. Five isonitrogenous and isoenergetic diets were formulated to replace 0 (SCM0), 25 (SCM25), 50 (SCM50), 75 (SCM75), and 100% (SCM100) of protein from FM with SCM, respectively. The diets were fed to triplicate groups of juvenile crucian carp for 6 wk. Weight gain, specific growth rate, feed intake, protein efficiency ratio, and intestinal digestive enzymatic activities (amylase, trypsin, and lipase) tended to decline with increasing FM replacement levels (P > 0.05). Dietary SCM substitution significantly influenced dry matter content in muscle, and crude protein and lipid contents in liver (P < 0.05). ADCs for dry matter, protein, lipid, energy, and most amino acids showed no significant differences between the control and SCM25 group, but tended to decline with replacement levels over 25%. Higher SCM substitution (50–100%) caused karyopyknosis and necrosis in liver, but intestinal histology did not show noticeable pathological changes. The present study indicated that FM could be replaced by 25% of SCM, without significant adverse growth performance, feed utilization, and histology of crucian carp.