bluuebunny/crossref_metadata_2025 huggingface dataset:
Supragastric belch may be related to globus symptom – a prospective clinical study
Authors: Nevalainen P. , Walamies M. , Kruuna O. , Arkkila P. , Aaltonen L.‐M.
Published: January 2016

Background

The etiology of globus is poorly understood. It is controversial, whether gastroesophageal reflux disease (GERD) has a role in globus. To investigate the possible esophageal background of this symptom, we performed transnasal esophagoscopy (TNE), high‐resolution manometry (HRM), and 24‐h multichannel intraluminal impedance (MII) and pH monitoring on globus patients.

Methods

Thirty consecutive patients were referred to Helsinki University Hospital, Department of Otorhinolaryngology – Head and Neck Surgery for treatment of globus; 24 consecutive patients with difficult reflux symptoms from the Department of Surgery served as controls. We compared the results of the patient groups in endoscopies, HRM, and 24‐h MII‐pH monitoring.

Key Results

In MII monitoring, globus patients had supragastric belch (6/20, 30% vs 1/24, 4%; p = 0.038) more often than controls. Total reflux time was higher in controls (p = 0.004), and they had more acid reflux events (p = 0.002) in MII, but between groups, the number of non‐acid reflux events was similar. In pH monitoring, DeMeester score and total pH <4 time were higher in controls (P < 0.001). In HRM, the upper esophageal sphincter (UES) mean basal and residual pressures did not differ.

Conclusions & Inferences

Supragastric belch was more common in globus patients, suggesting the possible role of this condition in globus sensation. However, globus patients in this series had no acid or non‐acid GERD or elevated UES pressure.
Phylogeographic analysis of the brown alga Cutleria multifida (Tilopteridales, Phaeophyceae) suggests a complicated introduction history
Authors: Kawai Hiroshi , Kogishi Keita , Hanyuda Takeaki , Arai Shogo , Gurgel C. Frederico , Nelson Wendy , Meinesz Alexandre , Tsiamis Kostas , Peters Akira F.
Published: January 2016

In depth genetic comparisons of populations of Cutleria multifida (Tilopteridales, Phaeophyceae) collected from Europe, the northwestern Pacific Ocean, Australia and New Zealand using the DNA sequences of four gene regions (the mitochondrial cox2 and cox3 genes, the intergeneric spacer region adjacent to cox3, and the open reading frame) suggested that the northwestern European and Japanese populations were considerably greater in terms of their genetic divergence than Mediterranean, Australian or New Zealand populations. The haplotypes of the populations in northwestern European (distribution range including the type locality, seven haplotypes) and Japanese populations (seven haplotypes) were unique except for one shared haplotype. There were weak but positive correlations between the geographical distance and the genetic divergence among northwestern European and Japanese populations. Moreover, both female and male gametophytes occurred in eight of the nine Japanese localities, suggesting Japanese populations showed normal sexual heteromorphic life history of the species. In light of these results, it appears that Japanese populations were native to the area despite earlier hypothesis. In contrast, Australian and New Zealand populations were composed of only one haplotype that is very close to those found in northwestern Europe and Japan, suggesting a recent introduction history from Europe (or from northeastern Asia via Europe) by ship transport to Australia and New Zealand. The Mediterranean populations included two haplotypes identical to those found in northwestern Europe and Japan, and it is suggestive of transoceanic introductions of some populations between Mediterranean and Japanese coasts.
Survey of Ambient Air Pollution Health Risk Assessment Tools
Authors: Anenberg Susan C. , Belova Anna , Brandt Jørgen , Fann Neal , Greco Sue , Guttikunda Sarath , Heroux Marie‐Eve , Hurley Fintan , Krzyzanowski Michal , Medina Sylvia , Miller Brian , Pandey Kiran , Roos Joachim , Van Dingenen Rita
Published: January 2016

Designing air quality policies that improve public health can benefit from information about air pollution health risks and impacts, which include respiratory and cardiovascular diseases and premature death. Several computer‐based tools help automate air pollution health impact assessments and are being used for a variety of contexts. Expanding information gathered for a May 2014 World Health Organization expert meeting, we survey 12 multinational air pollution health impact assessment tools, categorize them according to key technical and operational characteristics, and identify limitations and challenges. Key characteristics include spatial resolution, pollutants and health effect outcomes evaluated, and method for characterizing population exposure, as well as tool format, accessibility, complexity, and degree of peer review and application in policy contexts. While many of the tools use common data sources for concentration‐response associations, population, and baseline mortality rates, they vary in the exposure information source, format, and degree of technical complexity. We find that there is an important tradeoff between technical refinement and accessibility for a broad range of applications. Analysts should apply tools that provide the appropriate geographic scope, resolution, and maximum degree of technical rigor for the intended assessment, within resources constraints. A systematic intercomparison of the tools’ inputs, assumptions, calculations, and results would be helpful to determine the appropriateness of each for different types of assessment. Future work would benefit from accounting for multiple uncertainty sources and integrating ambient air pollution health impact assessment tools with those addressing other related health risks (e.g., smoking, indoor pollution, climate change, vehicle accidents, physical activity).
Has Greater Stock Market Participation Increased Wealth Inequality in the Us?
Authors: Bilias Yannis , Georgarakos Dimitris , Haliassos Michael
Published: January 2016

Is wider access to stockholding opportunities related to reduced wealth inequality, given that it creates challenges for small and less sophisticated investors? Counterfactual analysis is used to study the influence of changes in the U.S. stockholder pool and economic environment, on the distribution of stock and net household wealth during a period of dramatic increase in stock market participation. We uncover substantial shifts in stockholder pool composition, favoring smaller holdings during the 1990s upswing but larger holdings around the burst of the Internet bubble. We find no evidence that widening access to stocks was associated with reduced net wealth inequality.
Utstein‐style guidelines on uniform reporting of in‐hospital cardiopulmonary resuscitation in dogs and cats. A RECOVER statement
Authors: Boller Manuel , Fletcher Dan J. , Brainard Benjamin M. , Haskins Steve , Hopper Kate , Nadkarni Vinay M. , Morley Peter T. , McMichael Maureen , Nishimura Ryohei , Robben Joris H. , Rozanski Elizabeth , Rudloff Elke , Rush John , Shih Andre , Smarick Sean , Tello Luis H.
Published: January 2016

Objective

To provide recommendations for reviewing and reporting clinical in‐hospital cardiopulmonary resuscitation (CPR) events in dogs and cats and to establish nonambiguous operational definitions for CPR terminology.

Design

Consensus guidelines.

Setting

International, academia, referral practice, general practice, and human medicine.

Methods

An international veterinary Utstein task force was convened in April 2013 in San Francisco to determine the scope of the project, the variables to be reported, their definitions, and a reporting template. Factors that were essential for meaningful data reporting and were amenable to accurate collection (ie, core variables) and additional variables useful for research projects and hypothesis generation (ie, supplemental variables) were defined. Consensus on each item was either achieved during that meeting or during the subsequent online modified Delphi process and dialogue between task force members.

Results

Variables were defined and categorized as hospital, animal, event (arrest), and outcome variables. This report recommends a template for standardized reporting of veterinary in‐hospital CPR studies involving dogs or cats. Core elements include the suspected cause(s) and location of arrest, first rhythm identified, the occurrence of return of spontaneous circulation (ROSC) of more than 30 seconds (any ROSC) or more than 20 minutes (sustained ROSC), survival to discharge, and functional capacity at discharge. If CPR is discontinued or the patient is euthanized by owner request, a reason is reported. The task force suggests a case report form to be used for individual resuscitation events.

Conclusions

The availability of these veterinary small animal CPR reporting guidelines will encourage and facilitate high‐quality veterinary CPR research, improve data comparison between studies and across study sites, and serve as the foundation for veterinary CPR registries.
Complete Genome Sequence of Helicobacter pylori Strain 7C Isolated from a Mexican Patient with Chronic Gastritis
Authors: Mucito-Varela Eduardo , Castillo-Rojas Gonzalo , Cevallos Miguel A. , Lozano Luis , Merino Enrique , López-Leal Gamaliel , López-Vidal Yolanda
Published: January 2016

Helicobacter pylori
-induced gastritis is a risk factor for developing gastric pathologies. Here, we report the complete genome sequence of a multidrug-resistant
H. pylori
strain isolated from a chronic gastritis patient in Mexico City, Mexico. Nonvirulent VacA and
cag
-pathogenicity island (PAI) genotypes were found, but the presence of a potential mobilizable plasmid carrying an IS
605
element is of outstanding interest.
Complete Genome Sequence of a Strain of Azospirillum thiophilum Isolated from a Sulfide Spring
Authors: Fomenkov Alexey , Vincze Tamas , Grabovich Margarita , Anton Brian P. , Dubinina Galina , Orlova Maria , Belousova Elena , Roberts Richard J.
Published: January 2016

We report the complete, closed genome sequence and complete methylome of
Azospirillum thiophilum
strain BV-S
T
.
Ischiofemoral impingement due to a lipoma of the ischiofemoral space
Authors: Papoutsi Dimitra , Daniels Jessica , Mistry Alpesh , Chandraseker Coonoor
Published: January 2016

Non-focal hip and groin pain can frequently be a diagnostic problem, particularly if it is related to uncommon causes such as ischiofemoral impingement. The vast majority of published cases of ischiofemoral impingement are caused by osseous changes of the ischiofemoral interval. We describe an unusual case of ischiofemoral impingement caused by an intermuscular lipoma. Surgical resection of the tumour and histology confirmed the lipomatous nature of the tumour, with subsequent resolution of symptoms. To the best of our knowledge, this is the first case of a lipoma causing ischiofemoral impingement described in the English literature and emphasises that impingement can occur on the basis of a soft tissue mass occupying the interval of otherwise normal osseous interval and boundaries.
An unusual cause of focal hand dystonia due to a retained implant of the distal radius
Authors: Vaishya Raju , Agarwal Amit Kumar , Vijay Vipul
Published: January 2016

Focal hand dystonia (FHD) is characterised clinically by a task-specific symptom and typical electromyography findings of a characteristic pattern of cocontraction of the agonist and antagonist muscles of the hand and forearm. The aetiopathogenesis of this condition is still not clear. We present a case of a patient with an unusual aetiology for this condition, in the form of retained hardware in the distal radius. This patient had complete resolution of symptoms after removal of a retained radial plate. Thorough history-taking, clinical examination and necessary investigations are the cornerstones for making a diagnosis of FHD.
Progressive resistance training in Parkinson's disease: a systematic review and meta-analysis
Authors: Saltychev Mikhail , Bärlund Esa , Paltamaa Jaana , Katajapuu Niina , Laimi Katri
Published: January 2016

Objectives

To investigate if there is evidence on effectiveness of progressive resistance training in rehabilitation of Parkinson disease.

Design

Systematic review and meta-analysis. Data sources: Central, Medline, Embase, Cinahl, Web of Science, Pedro until May 2014. Randomised controlled or controlled clinical trials. The methodological quality of studies was assessed according to the Cochrane Collaboration's domain-based evaluation framework. Data synthesis: random effects meta-analysis with test for heterogeneity using the I² and pooled estimate as the raw mean difference.

Participants

Adults with primary/idiopathic Parkinson's disease of any severity, excluding other concurrent neurological condition.

Interventions

Progressive resistance training defined as training consisting of a small number of repetitions until fatigue, allowing sufficient rest between exercises for recovery, and increasing the resistance as the ability to generate force improves.

Comparison

Progressive resistance training versus no treatment, placebo or other treatment in randomised controlled or controlled clinical trials.

Primary and secondary outcome measures

Any outcome.

Results

Of 516 records, 12 were considered relevant. Nine of them had low risk of bias. All studies were randomised controlled trials conducted on small samples with none or 1 month follow-up after the end of intervention. Of them, six were included in quantitative analysis. Pooled effect sizes of meta-analyses on fast and comfortable walking speed, the 6 min walking test, Timed Up and Go test and maximal oxygen consumption were below the level of minimal clinical significance.

Conclusions

There is so far no evidence on the superiority of progressive resistance training compared with other physical training to support the use of this technique in rehabilitation of Parkinson's disease.

Systematic review registration number

PROSPERO 2014:CRD42014009844.
Systematic review of the literature on viral persistence and sexual transmission from recovered Ebola survivors: evidence and recommendations
Authors: Thorson Anna , Formenty Pierre , Lofthouse Clare , Broutet Nathalie
Published: January 2016

Objective

The main aim of this article is to present a comprehensive, systematic review on evidence of sexual transmission from Ebola survivors and persistence of Ebola virus in body fluids of relevance to sexual transmission, and additionally to review condom effectiveness against sexual transmission of Ebola.

Design

We performed a systematic review of viral persistence in body fluids of relevance to sexual transmission of Ebola survivors and evidence of sexual transmission of Ebola, and carried out a targeted review of condom effectiveness.

Results

We identified nine published original articles presenting results on persistence of Ebola virus in relevant body fluids, or reporting suspect sexual transmission from Ebola survivors. We also included unpublished reports from the current 2014/2015 Ebola epidemic in West Africa. We found no articles reporting on condom effectiveness, but have included a targeted review on general condom efficacy and effectiveness.

Conclusions

We conclude that the risk of sexual transmission from people who have recovered from Ebola cannot be ruled out. We found the longest duration of persistent Ebola RNA in a relevant body fluid from a survivor, to be reported from a man in Sierra Leone who had reverse transcriptase PCR (RT-PCR) positive semen 284 days after symptom onset. In line with current WHO recommendations. We recommend that men are offered the possibility to test their semen regularly for presence of Ebola RNA from3 months post-symptom onset. Safe sex practices including sexual abstinence, or else condom use, are recommended by WHO until semen has tested negative twice, or in absence of testing for at least 6 months post-symptom onset. Based on evidence reviewed, we conclude that male and female latex condoms offer some protection against EBOV compared to no condom use. Survivors should be offered access to care and prevention, in order to provide them with possibilities to mitigate any risks that may occur, and efforts should be linked to destigmatising activities.
What do pharmaceutical industry professionals in Europe believe about involving patients and the public in research and development of medicines? A qualitative interview study
Authors: Parsons Suzanne , Starling Bella , Mullan-Jensen Christine , Tham Su-Gwan , Warner Kay , Wever Kim
Published: January 2016

Objectives

To explore European-based pharmaceutical industry professionals’ beliefs about patient and public involvement (PPI) in medicines research and development (R&D).

Setting

Pharmaceutical companies in the UK, Poland and Spain.

Participants

21 pharmaceutical industry professionals, four based in the UK, five with pan-European roles, four based in Spain and eight based in Poland.

Method

Qualitative interview study (telephone and face-to-face, semistructured interviews). All interviews were audio taped, translated (where appropriate) and transcribed for analysis using the Framework approach.

Results

21 pharmaceutical industry professionals participated. Key themes were: beliefs about (1) whether patients and the public should be involved in medicines R&D; (2) the barriers and facilitators to PPI in medicines R&D and (3) how the current relationships between the pharmaceutical industry, patient organisations and patients influence PPI in medicines R&D.

Conclusions

Although interviewees appeared positive about PPI, many were uncertain about when, how and which patients to involve. Patients and the public's lack of knowledge and interest in medicines R&D, and the pharmaceutical industry's lack of knowledge, interest and receptivity to PPI were believed to be key challenges to increasing PPI. Interviewees also believed that relationships between the pharmaceutical industry, patient organisations, patients and the public needed to change to facilitate PPI in medicines R&D. Existing pharmaceutical industry codes of practice and negative media reporting of the pharmaceutical industry were also seen as negative influences on these relationships.
A nationwide survey of public healthcare providers’ impressions of family medicine specialists in Malaysia: a qualitative analysis of written comments
Authors: Chew Boon-How , Cheong Ai-Theng , Ismail Mastura , Hamzah Zuhra , A-Rashid Mohd-Radzniwan , Md-Yasin Mazapuspavina , Ali Norsiah , Mohd-Salleh Noridah , Bashah Baizury
Published: January 2016

Objective

To examine impressions of public healthcare providers/professionals (PHCPs) who are working closely with family medicine specialists (FMSs) at public health clinics.

Design

Cross-sectional study.

Setting

This study is part of a larger national study on the perception of Malaysian public healthcare professionals on FMSs (PERMFAMS).

Participants

PHCPs from three categories of health facility: hospitals, health clinics and health offices.

Main outcome measures

Qualitative analyses of written comments of respondents’ general impression of FMSs.

Results

The participants’ response rate was 58.0% (780/1345), with almost equal proportions from each public healthcare facility. A total of 23 categories for each of the 648 impression comments were identified. The six emerging themes were: (1) importance of FMSs; (2) roles of FMSs; (3) clinical performance of FMSs; (4) attributes of FMSs; (5) FMS practice challenges; (6) misconception of FMS roles. Overall, FMS practice was perceived to be safe and able to provide effective treatments in a challenging medical discipline that was in line with the current standards of medical care and ethical and professional values. The areas of concern were in clinical performance expressed by PHCPs from some hospitals and the lack of personal attributes and professionalism among FMSs mentioned by PHCPs from health clinics and offices.

Conclusions

FMSs were perceived to be capable of providing effective treatment and were considered to be important primary care physicians. There were a few negative impressions in some areas of FMS practice, which demanded attention by the FMSs themselves and the relevant authorities in order to improve efficiency and safeguard the fraternity's reputation.
Relationship between use of general practice and healthcare costs at the end of life: a data linkage study in New South Wales, Australia
Authors: Tran Bich , Falster Michael O , Girosi Federico , Jorm Louisa
Published: January 2016

Objective

This analysis investigated the relationships between healthcare expenditures in the last 6 months of life and use of general practitioner (GP) services in the preceding 12-month period among older residents of New South Wales, Australia.

Methods

Questionnaire data (2006–2009) for more than 260 000 people aged 45 years and over were linked to individual hospital and death records and cost data. For 14 819 participants who died during follow-up, generalised linear mixed models were used to explore the relationships between costs of hospital, emergency department (ED) and Medicare-funded outpatient and pharmaceutical services in the last 6 months of life, and quintile of GP use in the 18–7 months before death. Analyses were adjusted for age at death, sex, educational level, language, private health insurance, household income, self-reported health status, functional limitation, psychological distress, number of comorbidities and geographic clustering.

Results

Almost 85% of decedents had at least one hospitalisation in the last 6 months, and the mean (median) of total cost for each person in this period was $A20 453 (14 835). There was no significant difference in the hospital cost, including cost for preventable hospitalisations in the last 6 months of life, across quintiles of GP use in the 18–7 months before death. Participants in the lowest quintile of GP use incurred more ED costs, but ED costs were similar across the other quintiles of GP use. Costs for Medicare-funded outpatient services and pharmaceuticals increased steeply according to quintile of GP use.

Conclusions

In the Australian setting, there was no association between use of GP services in the 18–7 months before death and hospital costs in the last 6 months, but there was significant association with higher costs for outpatient services and pharmaceuticals. However, there was some indication that limited GP access might be associated with increased ED use at end of life.
A qualitative study exploring how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England
Authors: Moxey Jordan M , Jones Laura L
Published: January 2016

Objectives

To explore how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England. We explored women's perceptions of deinfibulation, caesarean section and vaginal delivery; their experiences of care during pregnancy and labour; and factors that affect ability to access these services, in order to make recommendations about future practice.

Design

A descriptive, exploratory qualitative study using face-to-face semistructured interviews. Interviews were audio-recorded, transcribed and data were analysed using a thematic approach. An interpreter was used when required (n=3).

Setting

Participants recruited from 2 community centres in Birmingham, England.

Participants

Convenience and snowball sample of 10 Somali women resident in Birmingham, who had accessed antenatal care services in England within the past 5 years.

Results

3 core themes were interpreted: (1)Experiences of female genital mutilation during life, pregnancy and labour: Female genital mutilation had a significant physical and psychological impact, influencing decisions to undergo deinfibulation or caesarean section. Women delayed deinfibulation until labour to avoid undergoing multiple operations if an episiotomy was anticipated. (2)Experience of care from midwives: Awareness of female genital mutilation from midwives led to open communication and stronger relationships with women, resulting in more positive experiences. (3)Adaptation to English life: Good language skills and social support networks enabled women to access these services, while unfavourable social factors (eg, inability to drive) impeded.

Conclusions

Female genital mutilation impacts Somali women's experiences of antenatal and intrapartum care. This study suggests that midwives should routinely ask Somali women about female genital mutilation to encourage open communication and facilitate more positive experiences. As antenatal deinfibulation is unpopular, we should consider developing strategies to promote deinfibulation to non-pregnant women, to align with current guidelines. Women with unfavourable social factors may require additional support to improve access to English antenatal care services.
‘Keeping your body and mind active’: an ethnographic study of aspirations for healthy ageing
Authors: Guell Cornelia , Shefer Guy , Griffin Simon , Ogilvie David
Published: January 2016

Objective

To describe and explore perceptions, practices and motivations for active living in later life.

Design

Qualitative study with semistructured interviews and ‘semistructured’ participant observations of participant-selected activities, such as exercise classes, private or organised walks, shopping and gardening.

Participants

27 participants (65–80 years) from the European Prospective Investigation into Cancer Norfolk study, purposefully selected by gender, age, occupational class, living status and residential location; 19 of the participants agreed to be accompanied for observed activities.

Setting

Participants’ homes, neighbourhoods, places of leisure activities and workplaces in Norfolk, England.

Results

All participants regarded a positive attitude as important for healthy ageing; this included staying active, both physically and mentally through sedentary activities such as reading and crosswords. ‘Getting out of the house’, being busy, or following a variety of interests were regarded as both important motivators and descriptions of their ‘activeness’. Purposeful activities formed an important part of this, for example, still being engaged in paid or voluntary work, having caring responsibilities, or smaller incidental activities such as helping neighbours or walking for transport. Many also reported adapting previous, often lifelong, activity preferences and habits to their ageing body, or replacing them altogether with lower impact activities such as walking. This included adapting to the physical limitations of partners and friends which dictated the intensity and frequency of shared activities. The social context of activities could thus form a barrier to active living, but could also encourage it through companionship, social responsibilities and social pressures.

Conclusions

Promoting and maintaining physical activity among older people may require more attention to activeness as an attitude and way of life as well as to its social context, and initiatives encouraging broader activity habits rather than discrete activities.
Gas flow unified measurement system for sequential measurement of gas diffusion and gas permeability of partially hydrated geosynthetic clay liners
Authors: Rouf Md A. , Bouazza Abdelmalek , Singh Rao M. , Gates Will P. , Rowe R. Kerry
Published: January 2016

A gas flow unified measurement system (UMS-G) for sequential measurement of gas diffusion and gas permeability of geosynthetic clay liners (GCLs) under applied stress conditions (2 to 20 kPa) is described. Measurements made with the UMS-G are compared with measurements made with conventional experimental devices and are found to give similar results. The UMS-G removes the need to rely on two separate systems and increases further the reliability of the gas properties’ measurements. This study also shows that the gas diffusion and gas permeability reduce greatly with the increase of both gravimetric water content and apparent degree of saturation. The effect of applied stress on gas diffusion and gas permeability is found to be more pronounced at gravimetric water content greater than 60%. These findings suggest that at a nominal overburden stress of 20 kPa, the GCL used in the present investigation needs to be hydrated to 134% gravimetric water content (65% apparent degree of saturation) before gas diffusion and gas permeability drop to 5.5 × 10−11 m2·s−1 and 8.0 × 10−13 m·s−1, respectively, and to an even higher gravimetric water content (apparent degrees of saturation) at lower stress.
CATASTROPHES AND CONSUMPTION FAILURE
Authors: BANERJEE LOPAMUDRA
Published: January 2016

Disaster research has been concerned with the role of adverse environmental conditions vis-à-vis adverse social conditions in determining food access during catastrophes. This paper investigates the issue, and presents household-data from flood-devastated Bangladesh to argue that, while hunger is clearly associated with exposure to disaster conditions, prior deficits in resources (given the education, occupation and ownership of productive assets of household-members) are more significant in determining the risk of consumption failure during catastrophes. The paper finds that, the risk-generating factors are often interrelated, but, their relative contributions vary across households having varying locations of natural hazards and in consumption distribution.
THE BEHAVIOR OF FISCAL POLICY IN INDONESIA IN RESPONSE TO ECONOMIC CYCLES
Authors: ABDUROHMAN  , RESOSUDARMO BUDY P.
Published: January 2016

The current general wisdom regarding fiscal policy in response to fluctuations in economic cycles is to adopt countercyclical strategies: contractive during a boom to avoid overheating the economy and expansive during a recession to stimulate economic activity. This paper attempts to investigate the practical behavior of fiscal policy in Indonesia in response to economic cycles to establish whether it follows general fiscal wisdom (countercyclical) or amplifies the cycle (procyclical). An error correction model (ECM) and an alternative model to deal with the possible endogeneity problem are utilized. This paper shows that fiscal policy in Indonesia tends to be procyclical. Observations of some other ASEAN countries, namely Malaysia, the Philippines, Singapore and Thailand, indicate that Singapore could be the only country in ASEAN that is able to implement a countercyclical fiscal policy.
Fuzzy (and Interval) Techniques in the Age of Big Data: An Overview with Applications to Environmental Science, Geosciences, Engineering, and Medicine
Authors: Kreinovich Vladik , Ouncharoen Rujira
Published: January 2016

In some practical situations – e.g., when treating a new illness – we do not have enough data to make valid statistical conclusions. In such situations, it is necessary to use expert knowledge – and thus, it is beneficial to use fuzzy techniques that were specifically designed to process such knowledge. At first glance, it may seem that in situations when we have large amounts of data, the relative importance of expert knowledge should decrease. However, somewhat surprisingly, it turns out that expert knowledge is still very useful in the current age of big data. In this paper, we explain how exactly (and why) expert knowledge is useful, and we overview efficient methods for processing this knowledge. This overview is illustrated by examples from environmental science, geosciences, engineering (in particular, aircraft maintenance and underwater robots), and medicine.
Metabolome Analyses Uncovered a Novel Inhibitory Effect of Acyclic Retinoid on Aberrant Lipogenesis in a Mouse Diethylnitrosamine-Induced Hepatic Tumorigenesis Model
Authors: Qin Xian-Yang , Tatsukawa Hideki , Hitomi Kiyotaka , Shirakami Yohei , Ishibashi Naoto , Shimizu Masahito , Moriwaki Hisataka , Kojima Soichi
Published: January 2016

Acyclic retinoid (ACR) is a promising drug under clinical trials for preventing recurrence of hepatocellular carcinoma. The objective of this study was to gain insights into molecular basis of the antitumorigenic action of ACR from a metabolic point of view. To achieve this, comprehensive cationic and lipophilic liver metabolic profiling was performed in mouse diethylnitrosamine (DEN)-induced hepatic tumorigenesis model using both capillary electrophoresis time-of-flight mass spectrometry and liquid chromatography time-of-flight mass spectrometry. ACR significantly counteracted against acceleration of lipogenesis but not glucose metabolism in DEN-treated mice liver, suggesting an important role of lipid metabolic reprogramming in the initiation step of hepatic tumorigenesis. Knowledge-based pathway analysis suggested that inhibition of linoleic acid metabolites such as arachidonic acid, a proinflammatory precursor, played a crucial role in the prevention by ACR of DEN-induced chronic inflammation–mediated tumorigenesis of the liver. As a molecular mechanism of the ACR's effect to prevent the aberrant lipogenesis, microarray analysis identified that a key transcription regulator of both embryogenesis and tumorigenesis, COUP transcription factor 2, also known as NR2F2, was associated with the metabolic effect of ACR in human hepatocellular carcinoma cells. Our study provided potential therapeutic targets for the chemoprevention of hepatocellular carcinoma as well as new insights into the mechanisms underlying prevention of hepatic tumorigenesis. Cancer Prev Res; 9(3); 205–14. ©2016 AACR.
Anticancer Teamwork: Cross-Presenting Dendritic Cells Collaborate with Therapeutic Monoclonal Antibodies
Authors: Robert-Tissot Céline , Speiser Daniel E.
Published: January 2016

Summary: Cross-presentation of tumor antigens represents a key pathway in antitumor immune responses that can be exploited to synergize not only with the already prominent “checkpoint blockade,” but also with newer attempts to use T-cell stimulatory monoclonal antibodies in immunotherapy. Cancer Discov; 6(1); 17–9. ©2016 AACR.

See related article by Sánchez-Paulete et al., p. 71.
Targeting ALK: The Ten Lives of a Tumor
Authors: Versteeg Rogier , George Rani E.
Published: January 2016

Summary: In this issue, Infarinato and colleagues report the results of preclinical testing of a novel ALK/ROS1 inhibitor, PF-06463922, in neuroblastoma. This small-molecule inhibitor was shown to efficiently inhibit the growth of patient-derived and established neuroblastoma xenograft models expressing mutated ALK. Although the in vivo data are impressive and the authors suggest that clinical trials are warranted, the presented data also suggest that it is as yet too early to welcome the new drug as a magic bullet. Cancer Discov; 6(1); 20–1. ©2016 AACR.

See related article by Infarinato et al., p. 96.
Effect of Amyloid Imaging on the Diagnosis and Management of Patients with Cognitive Decline: Impact of Appropriate Use Criteria
Authors: Grundman Michael , Johnson Keith A. , Lu Ming , Siderowf Andrew , Dell''Agnello Grazia , Arora Anupa K. , Skovronsky Daniel M. , Mintun Mark A. , Pontecorvo Michael J. ,   for the 18F-AV-45-A17 Study Group
Published: January 2016

Background: Published appropriate use criteria (AUC) describe patients for whom amyloid positron emission tomography (PET) might be most useful. This study compared the impact of amyloid PET on diagnosis and management in subjects likely to either meet or not meet AUC. Methods: Physicians provided a provisional diagnosis and management plan for patients presenting with cognitive decline before and after amyloid PET imaging with florbetapir F 18. Participants were classified as AUC-like or not, based on the prescan diagnosis and demographic features. Results: In all, 125 of 229 participants (55%) were classified as AUC-like. Sixty-two percent of the AUC-like subjects had a change in diagnosis after scanning compared with 45% of the non-AUC subjects (p = 0.011). Both groups demonstrated high rates of change in their management plans after scanning (88.0% for AUC-like cases, 85.6% for non-AUC cases). Conclusions: The impact of amyloid imaging on diagnosis and planned management was maintained and, if anything, amplified in AUC-like patients.
Reduction of Caloric Intake Might Override the Prosteatotic Effects of the PNPLA3 p.I148M and TM6SF2 p.E167K Variants in Patients with Fatty Liver: Ultrasound-Based Prospective Study
Authors: Krawczyk Marcin , Stachowska Ewa , Milkiewicz Piotr , Lammert Frank , Milkiewicz Malgorzata
Published: January 2016

Background: The adiponutrin (PNPLA3) p.I148M and transmembrane 6 superfamily member 2 (TM6SF2) p.E167K variants represent risk factors for non-alcoholic fatty liver disease (NAFLD). In this study, we assessed the effects of caloric restriction on liver phenotypes in NAFLD patients in relation to the PNPLA3 and TM6SF2 genotypes. Methods: We genotyped both variants in 143 individuals with NAFLD (55 females, age 18-74 years) and 180 controls (85 females, age 33-66 years). Liver steatosis was assessed using the ultrasound-based Hamaguchi score. A 4-month dietetic intervention, consisting of restriction of daily caloric intake without changes in physical activity, was performed. Results: Both PNPLA3 (p = 0.002) and TM6SF2 (p = 0.041) variants were associated with NAFLD before intervention. Overall, 88 patients completed the intervention, which led to a significant decrease of steatosis, ALT activities, body mass index, hip and waist circumferences, and waist-hip ratio (all p < 0.0001). Hepatic steatosis and anthropometric traits improved significantly (p < 0.05) in carriers of either PNPLA3 or TM6SF2 risk genotype. The improvement of phenotypic traits, apart from WHR (p = 0.02), was not modified by the presence of PNPLA3 or TM6SF2 variants. Conclusions: The PNPLA3 and TM6SF2 polymorphisms are associated with NAFLD assessed by the Hamaguchi score. Neither PNPLA3 nor TM6SF2 risk alleles impair the response to dietetic intervention in NAFLD.
Hyperenhancement of the Pericardium on Cardiac Magnetic Resonance Imaging: A Marker of Acute Inflammation and Neovascularization or a Chronic Fibrotic State?
Authors: Mullen Liam , Chew Pei Gee , Frost Frederick , Ahmed Ayesha , Khand Aleem
Published: January 2016

In cardiac magnetic resonance imaging, hyperenhancement of the pericardium post gadolinium administration in acute chest pain often signifies pericarditis with an acute inflammatory response and neovascularization. In the context of constrictive pericarditis, case series have indicated that the intensity of hyperenhancement and the thickness of the pericardium imply reversibility of the physiology of the constrictive pericarditis. We present a case of intense hyperenhancement and marked thickening of the pericardium in a patient with constrictive pericarditis with antecedent chest pain. Surgical resection of the pericardium and microscopy revealed a chronic fibrotic state with no evidence of inflammation or neovascularization, thus clarifying the failure of initial medical/anti-inflammatory treatment. Our case highlights the fact that hyperenhancement of the pericardium post gadolinium is non-specific for histology and does not necessarily imply the reversibility of pericardial constriction.
Proteomic Analysis of Minimally Damaged Renal Tubular Tissue from Two-Kidney-One-Clip Hypertensive Rats Demonstrates Extensive Changes Compared to Tissue from Controls
Authors: Finne Kenneth , Marti Hans-Peter , Leh Sabine , Skogstrand Trude , Vethe Heidrun , Tenstad Olav , Berven Frode S. , Scherer Andreas , Vikse Bjørn Egil
Published: January 2016

Background: Tubular atrophy and interstitial fibrosis mark the final stage in most forms of progressive kidney diseases. Little is known regarding changes in the tubular proteome. In this study, we investigated changes in the tubular proteome of normal or minimally damaged tubular tissue in the non-clipped kidney from rats with two-kidney one-clip (2K1C) hypertension. Methods: Formalin-fixed paraffin-embedded kidney sections from four 2K1C rats with hypertensive kidney damage and 6 sham rats were used. Tubulointerstitial tissue without discernable interstitial expansion or pronounced tubular alterations was microdissected and this was assumed to represent an early stage of chronic tubular damage in 2K1C. Samples were analyzed by mass spectrometry and relative protein abundances were compared between 2K1C and sham. Results: A total of 1,160 proteins were identified with at least 2 unique peptides, allowing for relative quantitation between samples. Among these, 151 proteins were more abundant, and 192 proteins were less abundant in 2K1C compared with sham. Transgelin, vimentin and creatine kinase B-type were among the proteins that were most increased in 2K1C. Ingenuity Pathway Analysis showed increased abundance of proteins related to Rho signaling and protein turnover (eIF2 signaling and protein ubiquitination), and decreased abundance of proteins related to fatty acid β-oxidation. Conclusion: Tubular tissue from normal or minimally damaged hypertensive kidney damage demonstrate extensive proteomic changes with upregulation of pathways associated with progressive kidney damage, such as Rho signaling and protein turnover. Thus, proteomics presents itself to be a promising tool for the discovery of early damage markers from not yet morphologically visible tubular damage.
Adverse Effects of Intraoperative Blood Loss on Long-Term Outcomes after Curative Gastrectomy of Patients with Stage II/III Gastric Cancer
Authors: Mizuno Akira , Kanda Mitsuro , Kobayashi Daisuke , Tanaka Chie , Iwata Naoki , Yamada Suguru , Fujii Tsutomu , Nakayama Goro , Sugimoto Hiroyuki , Koike Masahiko , Fujiwara Michitaka , Kodera Yasuhiro
Published: January 2016

Background/Aims: Gastrectomy with systemic lymphadenectomy sometimes causes excessive bleeding even by experienced surgeons. The aim of this study was to evaluate how intraoperative estimated blood loss (EBL) affected the long-term outcomes after curative surgery of patients with stage II/III gastric cancer (GC). Methods: This study included 203 patients with stage II/III GC who did not receive perioperative blood transfusion between 1999 and 2015. The optimal cutoff and the prognostic significance of EBL were determined retrospectively. Results: The median EBL was 285 ml. Receiver operating characteristic curve analysis identified 400 ml as an optimal cutoff. Patients with EBL ≥400 ml were more likely to have hepatic relapse and worse prognosis compared to those with EBL <400 ml. EBL ≥400 ml was identified as an independent prognostic factor for mortality by multivariable analysis. When patients were subdivided according to administration of adjuvant chemotherapy, there was a significant difference between the EBL ≥400 and <400 ml groups in patients who underwent surgery alone, whereas the prognosis was similar for patients of both groups who received adjuvant chemotherapy. Conclusion: EBL serves as a useful predictor for risk stratification after curative gastrectomy in patients with stage II/III GC.
The Relationship between Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms and Mean Platelet Volume: The Role of Metabolic Syndrome
Authors: Zhao Sicong , Tang Jianchun , Shao Sujun , Yan Yong
Published: January 2016

Objective: The aim of the present study was to investigate the relationship among serum mean platelet volume (MPV) levels, benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and metabolic syndrome (MetS), and study the potential role of serum MPV levels in BPH/LUTS progression in an indirect manner. Methods: Five hundred fifty-one men aged 45 or older with moderate to severe LUTS due to benign prostatic enlargement were recruited into this study by consecutive routine physical examination programs. Urologic evaluation included transrectal ultrasound, International Prostate Symptom Score and maximum urinary flow rate (Qmax). Overnight fasting venous blood specimens were collected and serum levels of prostate-specific antigen, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, triglyceride and C-reactive protein (CRP) were recorded. In addition, MPV were determined by automated hematology analyzer. We divided subjects into 2 groups according to the presence of MetS. We also took the MPV values as a categorical variable and divided subjects into 2 groups (≥11.8 or <11.8 fl) or 4 groups according to the different levels of MPV (9.3-11.0, 11.1-11.5, 11.6-11.9, 12.0-12.5 and ≥12.5 fl). The clinical characteristics and parameters of BPH/LUTS in different groups were measured and compared to identify their relationships. Results: MetS was diagnosed in 37.0% of the subjects. There were significant interactive correlation among the number of positive MetS components, CRP, MPV and parameters of BPH/LUTS. The ratio of PV ≥31 ml and Qmax <10.6 ml/s were positively correlated with the increased level of MPV. Additionally, the OR in relation to PV ≥31 ml and Qmax <10.6 ml/s significantly rose as the level of MPV increased after adjusting for age, suggesting of a threshold effect at 12.0-12.5 fl for PV ≥31 ml (OR 2.678, 95% CI 1.425-5.035) and at >12.5 fl for Qmax <10.6 ml/s (OR 3.190, 95% CI 1.768-5.755). However, only the value of MPV more than 12.5 fl still showed statistically significant effect on Qmax <10.6 ml/s after adjusting for age and the presence of MetS (OR 2.164, 95% CI 1.162-4.032). Conclusions: Our results add to the evidence that chronic inflammation is a candidate mechanism at the crossroad between MetS and BPH/LUTS, and the presence of elevated MPV may serve as a predictor of MetS-induced inflammation in the progression of BPH/LUTS.
Patient Outcomes From a Specialized Inherited Arrhythmia Clinic
Authors: Adler Arnon , Sadek Mouhannad M. , Chan Anita Y.M. , Dell Edith , Rutberg Julie , Davis Darryl , Green Martin S. , Spears Danna A. , Gollob Michael H.
Published: January 2016

Background—

Patients with inherited arrhythmia syndromes are at an increased risk of sudden cardiac death (SCD). Specialized inherited arrhythmia clinics were founded to optimize management and prevention of SCD in this population. However, the clinical effectiveness of these clinics has never been evaluated.

Methods and Results—

Clinical outcome data of patients referred to a specialized inherited arrhythmia clinic between 2005 and 2014 for a possible primary electric syndrome or arrhythmogenic right ventricular cardiomyopathy were analyzed. Of 720 patients evaluated, 278 received a definite or probable diagnosis and received long-term management in the inherited arrhythmia clinic. All patients diagnosed with long QT syndrome and catecholaminergic polymorphic ventricular tachycardia received routine β-blocker therapy and demonstrated >90% long-term compliance. In patients with arrhythmogenic right ventricular cardiomyopathy, those demonstrating an arrhythmia burden on Holter or treadmill testing received β-blocker therapy (17%). In diagnosed channelopathy or arrhythmogenic right ventricular cardiomyopathy index cases, 44 patients received secondary prevention implantable cardioverter-defibrillators (long QT syndrome, 9; Brugada syndrome, 8; catecholaminergic polymorphic ventricular tachycardia, 3; short QT syndrome, 1; and arrhythmogenic right ventricular cardiomyopathy, 23). Median follow-up was 4.1 years with 43% having a follow-up period of >5 years. SCD occurred in a single patient (annualized risk of SCD, 0.1% per year). In individuals determined to have clinical or genetic disease by cascade screening, no SCD has occurred over a median follow-up of 5.6 years (55%, >5 years). Low event rates occurred despite a low rate (4.0%) of primary prevention implantable cardioverter-defibrillator utilization.

Conclusions—

Longitudinal care in a specialized inherited arrhythmia clinic is associated with a low incidence of SCD and a low rate of primary implantable cardioverter-defibrillator utilization in patients with inherited arrhythmia syndromes.