bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of tongue‐tie in breastfeeding problems—A prospective observational study
Authors: Schlatter Sara‐Maria , Schupp Wiebke , Otten Jörg‐Elard , Harnisch Sabine , Kunze Mirjam , Stavropoulou Dimitra , Hentschel Roland
Published: July 2019

Aim

We evaluated what determined breastfeeding problems in a non‐selected mother‐infant cohort, with special reference to tongue‐tie and improvements in breastfeeding following frenulotomy.

Methods

This 2014‐2015 prospective, observational study was carried out in a tertiary level maternity unit affiliated to the University of Freiburg, Germany, using a breastfeeding questionnaire, standardised breastfeeding scores and the Assessment Tool For Lingual Frenulum Function (ATLFF). The standard intervention was breastfeeding support, a frenulotomy for tongue‐tie was performed if necessary. All cases of breastfeeding problems and, or tongue‐tie, were followed up by telephone 2.5 weeks after birth.

Results

We enrolled 776 newborn‐mother dyads: 345 had breastfeeding problems, 116 had a tongue‐tie and 30 underwent a frenulotomy. In the multivariate analysis, severe breastfeeding problems were more frequent in newborn infants with tongue‐tie, with an odds ratio (OR) of 2.6 (P= 0.014). Other risk factors were: no breastfeeding experience (OR 4.4, P = 0.001), low birth weight (OR 2.9, P = 0.001), prematurity (OR 3.6, P = 0.000) and Caesarean section (OR 1.6, P = 0.023). There was a significant reduction in breastfeeding problems after frenulotomy (P = 0.01).

Conclusion

Tongue‐tie had a significant impact on breastfeeding and so did low birth weights and prematurity. Frenulotomy proved helpful when breastfeeding problems were reported.
Hypoxia with acidosis in extremely preterm born infants was not associated with an increased risk of death or impaired neurodevelopmental outcome at 6.5 years
Authors: Zaigham Mehreen , Källén Karin , Maršál Karel , Olofsson Per
Published: July 2019

Aim

It is not clear whether perinatal acidosis can predict poor outcomes in extremely preterm infants and we investigated associations between intrapartum hypoxia and mortality and neurodevelopmental outcomes.

Methods

We used nationwide data on 705 infants from the Extremely Preterm Infants in Sweden Study, delivered at 22‐26 weeks of gestation during 2004‐2007. Comprehensive neurodevelopmental assessments were performed on survivors at 2.5 (n = 456) and 6.5 (n = 441) years of corrected age. Gestational age‐related changes in umbilical cord arterial pH were compared with reference values for term newborn infants, and base excess was also calculated. Associations between low blood gas values (<10th percentile) and mortality and neurodevelopmental outcome were estimated.

Results

Cord blood determination was more common in surviving infants (P < .001), with pH determined in 322/705 (46%) and base excess in 311/705 (44%). Extremely preterm infants had higher pH values than term infants (P < .0001), with no change from 22 to 26 weeks of gestation (P = .61, r2 = .001). Multiple logistic regression showed no association between low blood gas values and risk of death or neurodevelopmental impairment at 6.5 years (P ≥ .17).

Conclusion

Hypoxia with acidosis at birth was not associated with an increased risk of death or impaired neurodevelopmental in extremely preterm born children at 6.5 years.
The international dimensions of antimicrobial resistance: Contextual factors shape distinct ethical challenges in South Africa, Sri Lanka and the United Kingdom
Authors: Krockow Eva M. , Tarrant Carolyn
Published: July 2019

Antimicrobial resistance (AMR) describes the evolution of treatment‐resistant pathogens, with potentially catastrophic consequences for human medicine. AMR is driven by the over‐prescription of antibiotics, and could be reduced through consideration of the ethical dimensions of the dilemma faced by doctors. This dilemma involves balancing apparently opposed interests of current and future patients, and unique contextual factors in different countries, which may modify the core dilemma. We describe three example countries with different economic backgrounds and cultures—South Africa, Sri Lanka and the United Kingdom. Then we discuss how country‐specific factors impact on the prominence of various ethical dimensions of the dilemma (visibility and moral equality of future generations; Rule of Rescue; prescribing autonomy and conflicts of interest; consensus on collective action). We conclude that a nuanced understanding of national prescribing dilemmas is critical to inform the design of effective stewardship approaches.
Intentionally remembering or forgetting own‐ and other‐race faces: Evidence from directed forgetting
Authors: Tüttenberg Simone C. , Wiese Holger
Published: July 2019

People are better at remembering faces of their own relative to another ethnic group. This so‐called own‐race bias (ORB) has been explained in terms of differential perceptual expertise for own‐ and other‐race faces or, alternatively, as resulting from socio‐cognitive factors. To test predictions derived from the latter account, we examined item‐method directed forgetting (DF), a paradigm sensitive to an intentional modulation of memory, for faces belonging to different ethnic and social groups. In a series of five experiments, participants during learning received cues following each face to either remember or forget the item, but at test were required to recognize all items irrespective of instruction. In Experiments 1 and 5, Caucasian participants showed DF for own‐race faces only while, in Experiment 2, East Asian participants with considerable expertise for Caucasian faces demonstrated DF for own‐ and other‐race faces. Experiments 3 and 4 found clear DF for social in‐ and outgroup faces. These results suggest that a modulation of face memory by motivational processes is limited to faces with which we have acquired perceptual expertise. Thus, motivation alone is not sufficient to modulate memory for other‐race faces and cannot fully explain the ORB.
Effect of surgeon experience and bony pelvic dimensions on surgical performance and patient outcomes in robot‐assisted radical prostatectomy
Authors: Chen Jian , Chu Tiffany , Ghodoussipour Saum , Bowman Sean , Patel Heetabh , King Kevin , Hung Andrew J.
Published: July 2019

Objectives

To evaluate the effects of surgeon experience, body habitus, and bony pelvic dimensions on surgeon performance and patient outcomes after robot‐assisted radical prostatectomy (RARP).

Patients, Subjects and Methods

The pelvic dimensions of 78 RARP patients were measured on preoperative magnetic resonance imaging and computed tomography by three radiologists. Surgeon automated performance metrics (APMs [instrument motion tracking and system events data, i.e., camera movement, third‐arm swap, energy use]) were obtained by a systems data recorder (Intuitive Surgical, Sunnyvale, CA, USA) during RARP. Two analyses were performed: Analysis 1, examined effects of patient characteristics, pelvic dimensions and prior surgeon RARP caseload on APMs using linear regression; Analysis 2, the effects of patient body habitus, bony pelvic measurement, and surgeon experience on short‐ and long‐term outcomes were analysed by multivariable regression.

Results

Analysis 1 showed that while surgeon experience affected the greatest number of APMs (P < 0.044), the patient's body mass index, bony pelvic dimensions, and prostate size also affected APMs during each surgical step (P < 0.043, P < 0.046, P < 0.034, respectively). Analysis 2 showed that RARP duration was significantly affected by pelvic depth (β = 13.7, P = 0.039) and prostate volume (β = 0.5, P = 0.024). A wider and shallower pelvis was less likely to result in a positive margin (odds ratio 0.25, 95% confidence interval [CI] 0.09–0.72). On multivariate analysis, urinary continence recovery was associated with surgeon's prior RARP experience (hazard ratio [HR] 2.38, 95% CI 1.18–4.81; P = 0.015), but not on pelvic dimensions (HR 1.44, 95% CI 0.95–2.17).

Conclusion

Limited surgical workspace, due to a narrower and deeper pelvis, does affect surgeon performance and patient outcomes, most notably in longer surgery time and an increased positive margin rate.
Territoire et actions collectives atikamekw nehirowisiwok dans l'espace médiatique québécois: légitimité politique ou persistance d'une vision coloniale?
Authors: Pelletier Raphaël , Guimont Marceau Stéphane
Published: July 2019

The reception by the media of Indigenous peoples' political actions raises the issues of the discourses and representations at work in the public space. This paper examines how the Atikamekw Nehirowisiw Nation, their territorialities and political actions are represented by French‐speaking written media in Quebec. What are the discourses mobilized to apprehend the issues related to their land claims and contestation? By mobilizing a corpus of newspapers' articles published between 2000 and 2015, this study underlines the coexistence of opposed discourses. On the one hand, a colonial conception remains, reinterpreting the legal and historical legitimacy of the Atikamekw occupation and claims on the territory. On the other hand, the presence and reproduction, particularly through the words of Indigenous leaders, of an accommodating discourse towards Atikamekw's political actions cannot be ignored. The cohabitation between these two discourses highlights different sets of representations, emphasizing the ongoing colonial imaginaries in Quebec.
Osimertinib for Japanese patients with T790M‐positive advanced non‐small‐cell lung cancer: A pooled subgroup analysis
Authors: Hirashima Tomonori , Satouchi Miyako , Hida Toyoaki , Nishio Makoto , Kato Terufumi , Sakai Hiroshi , Imamura Fumio , Kiura Katsuyuki , Okamoto Isamu , Kasahara Kazuo , Uchida Hirohiko , Vowler Sarah L. , Mitsudomi Tetsuya
Published: July 2019

Epidermal growth factor receptor (EGFR)‐tyrosine kinase inhibitors (TKIs) are the standard of care for non‐small‐cell lung cancer (NSCLC) patients harboring EGFR mutations. However, almost all patients develop resistance after approximately 1 y of treatment, with >50% of cases due to the T790M secondary mutation of the EGFR gene. A large global Phase III study (AURA3) demonstrated that osimertinib significantly prolonged progression‐free survival (PFS) over platinum‐doublet chemotherapy in patients with T790M‐positive NSCLC who had progressed on previous EGFR‐TKI therapy. However, it is not clear whether efficacy or safety of osimertinib in Japanese patients is similar to the overall population. We report a pre‐planned subgroup analysis of pooled Phase II data from the AURA Extension and AURA2 trials to investigate the efficacy and safety of osimertinib in Japanese patients. This study included 81 Japanese patients. Patients were administered 80 mg osimertinib orally once daily until disease progression. The main endpoints were objective response rate (ORR), PFS, and safety. The ORR was 63.6% and median PFS was 13.8 mo. Overall survival rate at 36 mo was 54.0%. The most common all‐cause adverse events (AEs) were rash (grouped term; 65.4%), diarrhea (51.9%), paronychia (grouped term; 49.4%), and dry skin (grouped term; 39.5%). Most AEs were grade 1‐2. Five patients (6.2%) developed interstitial lung disease, resulting in two deaths (2.5%). Osimertinib demonstrated favorable ORR and PFS in Japanese patients, similar to the overall population. Additionally, osimertinib has good efficacy and a manageable safety profile in Japanese patients with NSCLC who had acquired resistance due to the T790M mutation.
Six‐year trends in dental pain and maternal education inequalities among Brazilian adolescents
Authors: Freire Maria C.M. , Jordão Lidia M.R. , Peres Marco A. , Abreu Mauro H.N.G.
Published: July 2019

Objective

To analyse trends in dental pain prevalence among Brazilian adolescent students over 6 years, focusing on inequalities by maternal education.

Methods

Data from the National Adolescent School‐Based Health Survey (PeNSE) carried out in 2009 (n = 45 239), 2012 (n = 46 482) and 2015 (n = 35 592) were analysed, including ninth grade students from the 27 state capitals in Brazil who were of ages 11‐17 years or older. Variables analysed were dental pain within the last 6 months (yes/no) and the following sociodemographic factors: age, sex, race, type of school and maternal schooling (years of study: ≤8; 9‐11; ≥12). The prevalence of dental pain in the 3 years was compared using the Rao‐Scott test. Relative and absolute measures of socioeconomic (maternal education) inequalities in dental pain were applied using the slope index of inequality (SII) and the relative concentration index (RCI).

Results

The prevalence of dental pain increased from 17.5% (95% CI = 16.9‐18.2) in 2009 to 20.4% (95% CI = 19.7‐21.1) in 2012, then to 21.8% (95% CI = 21.1‐22.5) in 2015. All sociodemographic factors investigated were associated with dental pain in all survey years. There was an increasing proportion of the outcome in all categories of maternal education over the years studied. Absolute (SII) and relative (RCI) inequalities regarding of maternal education were found; these indicate higher levels of dental pain in the lower socioeconomic group in each study year. However, no significant changes in inequalities were found from 2009 to 2015.

Conclusions

The prevalence of dental pain increased in the 2009‐2012 and 2012‐2015 periods, and social inequalities were found. Higher levels of dental pain persisted in the lower maternal education group. Inequalities remained stable over time. Broader actions to reduce the existing inequalities are needed and should be a priority for public policies.
Effects of VEGF inhibitors on human retinal pigment epithelium under high glucose and hypoxia
Authors: Bahrami Bobak , Shen Weiyong , Zhu Ling , Zhang Ting , Chang Andrew , Gillies Mark C.
Published: July 2019

Background

Retinal pigment epithelium (RPE) is known to secrete factors important for retinal homeostasis. How this secretome changes in diabetic eyes treated with anti‐vascular endothelial growth factor (VEGF) inhibitors is unclear.

Methods

Diabetic conditions were simulated in vitro using ARPE‐19 cell‐line culture, with high glucose (25 mM) culture media, and hypoxia was chemically induced using cobalt chloride. Stress was assessed using cell viability assays as well as Western blots and enzyme‐linked immunosorbent assay (ELISA) for production of HIF‐1a and VEGF‐A. Production of neurotrophic factors was quantified once conditions were established using ELISA under stress with and without the addition of VEGF inhibitors. Changes were analysed with one‐way ANOVA.

Results

Hypoxia downregulated pigment epithelium‐derived factor (PEDF) expression. The addition of bevacizumab, ranibizumab and aflibercept in normoxic conditions all led to a significant downregulation of PEDF. Glucose concentration had no effect on secretion of PEDF. Brain‐derived neurotrophic factor (BDNF) secretion was downregulated in high glucose and was upregulated in hypoxia. Placental growth factor (PlGF) secretion by ARPE‐19 was undetectable by ELISA.

Conclusions

We found that hypoxia, high glucose or VEGF inhibitors affected secretion of neurotrophic factors. This variation under different conditions may influence neuron and photoreceptor survival in the diabetic state and VEGF inhibitor treated eyes.
Five‐year study of mandibular overdentures on stud abutments: Clinical outcome, patient satisfaction and prosthetic maintenance—Influence of bone resorption and implant position
Authors: Matthys Carine , Vervaeke Stijn , Besseler Jos , De Bruyn Hugo
Published: July 2019

Objectives

This prospective study analyses the 5‐year clinical outcome, patient satisfaction and the technical outcome of a 2‐implant overdenture on stud abutments. In addition, the influence of mandibular resorption and implant position on these outcomes was assessed.

Material and methods

Patients received two implants in a one‐stage delayed protocol. Final prosthesis on stud abutments was finalized after 3 months. Implant survival, bone loss, plaque and sulcus bleeding index, OHIP‐14, technical outcome and costs were assessed after 5 years. The Cawood–Howell classification defined the mandibular resorption. Inter‐implant distances and angles (frontal, sagittal) were digitally measured. The significance level wasp < .05.

Results

Fifty‐six patients, 23 female and 33 males (mean age = 66.3, range 41–82), completed the follow‐up. No implants were lost. Radiographical crestal bone loss was on average 1.25 mm (standard deviationSD1.06), bleeding index was 0.75 (SD0.73), and plaque index was 1.15 (SD0.75) and higher for low mandibles (p = .001). The OHIP‐14 reduction post‐connection and after 5 years was significant (p < .001). Five‐year maintenance required on average 6.7 (SD4.8, range 0–25) interventions per patient. A larger inter‐implant distance was associated with fewer replacement of retention inserts (p = .034) and less interventions (p = .006). Larger frontal (p = .023) and sagittal (p = .046) inter‐implant angles (non‐parallelism) required more inserts. The maintenance cost negatively influences the patient satisfaction (p = .004). 83% of the stud abutments showed wear.

Conclusion

The implant overdenture on cylindrical stud abutments is a good and stable solution, irrespective of the resorption profile of the mandible. OHIP‐14 improved permanently up to 5 years but is negatively influenced by complication cost. A small inter‐implant distance, more frontal, sagittal inter‐implant divergence increased maintenance.
Behind the Seven Veils of Inequality. What if it's all about the Struggle within just One Half of the Population over just One Half of the National Income?
Authors: Palma José Gabriel
Published: July 2019

This article addresses three main issues: why there is such a huge diversity of disposable income inequality across the world, why there is such a deterioration of market inequality among countries of the Organization for Economic Cooperation and Development (OECD), and why inequality seems to move in ‘waves’. There are many underlying questions: does diversity reflect a variety of fundamentals, or a multiplicity of power structures and choice? Is rising market inequality the product of somehow ‘exogenous’ factors (e.g., r>g), or of complex interactions between political settlements and market failures? How do we get through the veils obscuring these interactions and distorting our vision of the often self‐constructed nature of inequality? Has neoliberal globalization broadened the scope for ‘distributional failures’ by, for example, triggering a process of ‘reverse catching‐up’ in the OECD, so that highly unequal middle‐income countries like those in Latin America now embody the shape of things to come? Are we all converging towards features such as mobile élites creaming off the rewards of economic growth, and ‘magic realist’ politics that lack self‐respect if not originality? Should I say, ‘Welcome to the Third World’? In this paper I also develop a new approach for examining and measuring inequality (distance from distributive targets), and a new concept of ‘distributional waves’. The article concludes that, to understand current distributive dynamics, what matters is to comprehend the forces determining the share of the rich — and, in terms of growth, what they choose to do with it (and how they are allowed do it).
The Urbanization of the Sanitation Crisis: Placing Waste in the City
Authors: McFarlane Colin
Published: July 2019

Sanitation systems are the most vital provisions in a city. Today, however, the global sanitation crisis is urbanizing, and growing numbers of city residents live with the struggle and consequences of not having safe, reliable facilities. While there is a large and vibrant literature on sanitation and cities, we have yet to account for the specifically urban nature of the deepening sanitation crisis in the global South. This article sets out a framework for understanding the dimensions of the urban sanitation crisis through a relational approach comprising five areas: people, life, things, spaces and distributions. Drawing on literature and research on urban sanitation in the global South, the author argues that if research, policy and practice is to better understand and respond to challenges of urban sanitation poverty, an expansive conception of its specifically urban dimensions is crucial.
Risk of clinically relevant hypoglycaemia in patients with type 2 diabetes self‐titrating insulin glargine U‐100
Authors: Hollander Priscilla A. , Kiljanski Jacek , Spaepen Erik , Harris Cynthia J.
Published: July 2019

Aims

We evaluated risk factors for clinically relevant hypoglycaemia (blood glucose <3 mmol/L) in patients with type 2 diabetes during insulin glargine self‐titration. Data were from two clinical trials in which patients were able to improve glycaemic control by self‐titration of insulin glargine using a simple algorithm.

Materials and Methods

We performed post hoc analyses of pooled treatment groups from each of two Phase 3 studies comparing LY2963016 with LANTUS: ELEMENT‐2 (double‐blind) and ELEMENT‐5 (open label). Clinically relevant hypoglycaemia was analysed by category of HbA1c (<7%, 7%‐8.5%, >8.5%) at Week 12 (titration period) and at Week 24 (overall study), and by subgroups of age (<65, ≥65 years) and previous insulin use (naïve or not).

Results

In the ELEMENT‐2 study (N = 756), there were no overall differences in rate or incidence of hypoglycaemia among HbA1c categories. In the ELEMENT‐5 study (N = 493), patients with HbA1c greater than 8.5% had a lower rate and incidence of hypoglycaemia throughout the study compared to those in the lower HbA1c categories. In both studies, patients 65 years of age or older, compared to those less than 65 years, had a higher rate and incidence of hypoglycaemia during the titration phase, had lower baseline HbA1c, and experienced smaller increases in dose, with no differences in HbA1c post baseline. The rate and incidence of hypoglycaemia was similar between naïve patients and patients previously using basal insulin, across all levels of glycaemic control. With the exception of the older subgroup, hypoglycaemia rates were similar during titration and maintenance periods.

Conclusion

Our results support broader use of self‐titration algorithms for patients with type 2 diabetes.
Effects of dapagliflozin on urinary metabolites in people with type 2 diabetes
Authors: Mulder Skander , Heerspink Hiddo J. L. , Darshi Manjula , Kim Jiwan J. , Laverman Gozewijn D. , Sharma Kumar , Pena Michelle J.
Published: July 2019

Aim

To assess the effects of the sodium‐glucose co‐transporter‐2 (SGLT2) inhibitor dapagliflozin on a pre‐specified panel of 13 urinary metabolites linked to mitochondrial metabolism in people with type 2 diabetes and elevated urine albumin levels.

Materials and methods

Urine and plasma samples were used from a double‐blind, randomized, placebo‐controlled crossover trial in 31 people with type 2 diabetes, with an albumin:creatinine ratio >100 mg/g, and who were on a stable dose of an angiotensin‐converting enzyme inhibitor or an angiotensin receptor blocker. Dapagliflozin or placebo treatment periods each lasted 6 weeks, with a 6‐week washout period in between. Urinary and plasma metabolites were quantified by gas‐chromatography mass spectrometry, corrected for creatinine level, and then combined into a single‐valued urinary metabolite index. Fractional excretion of the metabolites was calculated.

Results

All 13 urinary metabolites were detectable. After 6 weeks of dapagliflozin therapy, nine of the 13 metabolites were significantly increased from baseline. The urinary metabolite index increased by 42% (95% confidence interval [CI] 8.5 to 85.6; P = .01) with placebo versus 121% (95% CI 69 to 189; P < .001) with dapaglifozin. The placebo‐adjusted effect was 56% (95% CI 11 to 118; P = .012). In plasma, seven of the 13 metabolites were detectable, and none was modified by dapagliflozin.

Conclusions

Dapagliflozin significantly increased a panel of urinary metabolites previously linked to mitochondrial metabolism. These data support the hypothesis that SGLT2 inhibitors improve mitochondrial function, and improvements in mitochondrial function could be a mechanism for kidney protection. Future studies with longer treatment duration and clinical outcomes are needed to confirm the clinical impact of these findings.
The legacy of past human land use in current patterns of mammal distribution
Authors: Polaina Ester , González‐Suárez Manuela , Revilla Eloy
Published: July 2019

Multiple environmental factors are known to shape species distributions at the global scale, including climate and topography, but understanding current extents of occurrence and biodiversity patterns requires considering anthropogenic factors as well. Numerous studies have explored the relationship between contemporary human activities and different biodiversity metrics, but the influence of past activities, such as land‐use, remains poorly understood despite being one of the oldest human impacts. Here we evaluate the role of past land‐use modifications in the current distribution and conservation status of mammals worldwide using spatial data characterizing human land use from ca BC 6000 to ca AD 2000. First, we applied a clustering method that revealed three generalized past human land‐use trajectories that represent low‐, recently‐ and steadily‐used areas widely represented across the globe. Second, we fitted boosted regression trees to predict total and threatened mammalian richness, globally and within trajectory‐clusters, testing the role of environmental factors and multiple human land‐use metrics reflecting: total used area at different time spans, rates of land‐use change, and the occurrence of remarkable land‐use shifts. Environmental factors were identified as the main correlates of current mammalian richness, but several proposed metrics of past land‐use were also relevant predictors. Overall, these results highlight the likely existence of a land‐use legacy in some regions of the world that has influenced the distribution of extant mammals, particularly of those currently classified as threatened. Even if we cannot change that legacy, our results show that we need to account for past human impacts to understand present biodiversity patterns and, arguably, to guide future actions.
Is Serum Amyloid A elevated in horses with equine gastric ulcer syndrome?
Authors: Spanton J. A. , Smith L. , Mair T. S.
Published: July 2019

Serum Amyloid A (SAA) is an acute‐phase protein. Increased concentrations are seen in response to inflammatory stimuli. Equine gastric ulcer syndrome (EGUS) is a common condition in the horse and has an inflammatory component, but there are few studies assessing SAA concentrations in horses with EGUS. The objective of this prospective cohort study was to assay SAA in horses presented for gastroscopy with suspected EGUS over a 2‐year period and to establish whether significant elevations in SAA concentration occur with any form of EGUS. Horses presented for gastroscopy for suspected EGUS had blood collected for SAA evaluation at the time of i.v. sedative administration. Two experienced clinicians reviewed the gastroscopic examinations and classified lesions according to the ECEIM EGUS consensus statement (2015). A total of 94 horses had 114 gastroscopic examinations. Twenty‐three horses were negative for EGUS, 25 had glandular EGUS, 38 had squamous EGUS, and 28 had both squamous and glandular EGUS. Four horses had SAA concentration >10 mg/L (range 11.4–104.7); one had mild multifocal pyloric ulceration, one had mild multifocal pyloric ulceration and grade 2 squamous ulceration, one had moderate multifocal pyloric ulceration and grade 1 squamous ulceration, and one had no ulceration. A limitation was that low sample numbers compromised the power of the study. It was concluded that no association was found between SAA concentrations and the presence or degree of squamous or glandular EGUS.
Failure mechanisms of friction stir spot welds of AA6061‐T6/DP590 steel during tensile‐shear testing
Authors: Niroumand‐Jadidi A. , Kashani‐Bozorg S.F.
Published: July 2019

The tensile‐shear test was conducted for the evaluation of shear load and failure mechanisms of dissimilar friction stir spot weldments of AA6061‐T6/DP590 dual‐phase steel sheets. The joints were fabricated using a penetrated pin into the steel sheet (lower member). Such design resulted in the formation of a hook at the joint interface and an intermetallic compound layer (IMC) between the upper part of the hook and Al‐side. A maximum tensile‐shear load of ~2950 N was measured for the joint fabricated using a heat input of ~10 kJ; a lower strength was noted by varying the heat input. Partial plug was the failure mechanism in all joints. However, three different types of crack propagation paths were found depending on the heat input: along the interface between 6061 Al and IMC layer, thru 6061 Al near the joint interface, or within the IMC layer using relatively low, moderate, and high heat inputs.
Chemiluminescence imaging immunoassay for multiple aminoglycoside antibiotics in cow milk
Authors: Zeng Kun , Zhang Xuyun , Wei Dali , Huang Zhe , Cheng Sizhu , Chen Jiqing
Published: July 2019

A simple and rapid multiplexed direct competitive chemiluminescent (CL) imaging immunoassay had been developed for the simultaneous detection of kanamycin (KAN) and streptomycin (STR), which were widely used against bacterial infections in animals. To achieve the multiplexed detection of the two targets, a microarray format based on nitrocellulose membranes (NCMs) has been designed. Then, the peroxidase activity of the captured HRP‐labelled immunocomplex in each channel was measured by an enhanced luminol‐based chemiluminescent solution using a cooled low‐light CCD with high resolution. For qualitative analysis, the limit of detection (LOD) was 0.5 ng mL−1 for KAN and 3.13 ng mL−1 for STR by the naked eye. Through the CL data collected, KAN and STR could be detected quantitatively at the LOD of 0.03 and 0.33 ng mL−1, respectively. This method can be utilised as a screening test to evaluate the presence of antibiotics in milk samples.
Implementation of patient involvement methods in the clinical setting: A qualitative study exploring the health professional perspective
Authors: Jørgensen Marianne Johansson , Pedersen Charlotte Gjørup , Martin Helle Max , Lomborg Kirsten
Published: July 2019

Rationale, aims and objectives

Patient involvement is increasingly recognized as a key component on the international health care agenda. This attention has brought a need for developing generic and standardized open‐source methods, tools, and guidelines on how to systematically implement patient involvement initiatives in the clinical setting. The large‐scale projectthe User‐involving Hospitalwas initiated to implement two systematic methods for patient involvement at a Danish university hospital, but the required methods can only be implemented if embraced by the health professionals. This evaluation study aimed to explore the health professional perspective on the development and implementation ofshared decision making (SDM)anduser‐led health care. Specifically, the objectives were to identify the most crucial preconditions for success and to translate the findings into practice recommendations.

Method

The study was based on a simple questionnaire survey and a qualitative descriptive analysis of semistructured focus group interviews with representatives of 21 multidisciplinary clinical teams (nine interviews) and 18 health professional department managers (six interviews).

Results

Two years after the initiation of the User‐involving Hospital, 13 out of 21 developed patient involvement initiatives were fully incorporated into clinical practice. Five domains were found significant for successful development and implementation of the patient involvement methods: the patients' perspectives, composition of multidisciplinary teams, bottom‐up and skill building, support from management, and information sharing with colleagues.

Conclusions

The findings draw attention to several significant factors for successful implementation of large‐scale patient involvement initiatives in hospitals, including the importance of having both a top‐down and bottom‐up approach and of active listening to the patients' perspectives. On the basis of these findings, the study outlines four recommendations incorporating the five identified key domains, which may inspire future projects on systematic development and implementation of patient‐involvement initiatives based on either shared decision making or user‐led health care in the clinical setting.
Establishment of an organoid bank of biliary tract and pancreatic cancers and its application for personalized therapy and future treatment
Authors: Saito Yoshimasa
Published: July 2019

Biliary tract cancers and pancreatic cancers are aggressive malignancies that are difficult to diagnose early and have a poor prognosis. Patients with inoperable biliary tract and pancreatic cancers generally receive chemotherapy regimens including gemcitabine. However, the effects of these drugs are limited, and the 5‐year survival rates of patients are very low. The newly developed three‐dimensional culture system known as “organoid culture” allows long‐term expansion of stem cells into cyst‐like structures (organoids) with properties resembling those of the original tissues. We and other groups have successfully established long‐term in vitro cultures of organoids derived from biliary tract and pancreatic cancers. Organoids derived from biliary tract and pancreatic cancers closely recapitulate the properties of the original tumors including genetic alterations, gene expression profiles, and histopathological structures. These patient‐derived cancer organoids can be applied for drug sensitivity testing, drug screening, epigenetic therapy, and differentiation‐inducing therapy to identify therapeutic agents optimal for each patient. We intend to further establish organoids derived from various cancer cases and construct an organoid bank of biliary tract and pancreatic cancers. These powerful in vitro preclinical models of refractory cancers may bridge the gap between basic research and clinical trials and allow personalized therapy for patients.
Association between parental history of Helicobacter pylori treatment failure and treatment failure in the offspring
Authors: Deguchi Hisato , Yamazaki Hajime , Yamamoto Yosuke , Fukuhara Shunichi
Published: July 2019

Background and Aim

Both clarithromycin‐resistant Helicobacter pylori and CYP2C19 polymorphisms may be passed down for generations and are known risk factors for the failure of H. pylori eradication therapy. However, no study has evaluated the risk of clarithromycin triple therapy failure in patients with a parental history of such failure. This study investigated the association between a history of clarithromycin triple therapy failure in parents and clarithromycin triple therapy failure in the offspring.

Methods

This cross‐sectional study was conducted using a large administrative claims database of 3 100 000 insured individuals. We identified 404 patients who had both personal and parental records of prescriptions for first‐line clarithromycin triple therapy between January 2005 and February 2018. Failure of clarithromycin triple therapy was defined as treatment with second‐line therapy after having received first‐line clarithromycin triple therapy. A parental history of clarithromycin triple therapy failure was defined as failure of clarithromycin triple therapy by either the father or the mother. Odds ratios were estimated using logistic regression models adjusted for age, sex, diabetes mellitus, and peptic ulcer.

Results

The incidence of clarithromycin triple therapy failure was 22.5% (91/404). Based on univariate analysis (odds ratio [95% confidence interval], 1.90 [1.10–3.29]) and multivariable analysis (odds ratio [95% confidence interval], 1.93 [1.10–3.39]), parental history of clarithromycin triple therapy failure was associated with failure of clarithromycin triple therapy in the offspring.

Conclusion

A parental history of clarithromycin triple therapy failure is a risk factor for failure of clarithromycin triple therapy in the offspring.
The impact of home‐delivered meal services on the nutritional intake of community living older adults: a systematic literature review
Authors: Walton K. , do Rosario V. A. , Pettingill H. , Cassimatis E. , Charlton K.
Published: July 2019

Background

There is a global increase in populations aged over 65 years. Physiological changes that occur during ageing may increase the nutritional risk for older adults. To avoid malnutrition and address some of the barriers to obtain an adequate food supply, home‐delivered meals services provide meals in the home or in congregate settings for older adults who require nutritional support.

Methods

This systematic literature review explored whether nutritional intake is improved in community‐living older adults when receiving meal services compared to when meal services are not received. Four electronic databases were searched up to 31 January 2019. In total, 13 original studies were included in this analysis with the components: intervention of home‐delivered meal or congregate meal services to older adults; comparison with groups not receiving meal services or days not receiving the meal service; and nutritional intake as an outcome measured by food history, dietary recall and/or food frequency questionnaire.

Results

The results supported a beneficial effect of home‐delivered meals on dietary intake of energy, protein and/or certain micronutrients in older adults.

Conclusions

The increased total energy intake is a positive influence on malnutrition risk in frail older adults and the increased protein intake supports good health, promotes recovery from illness and assists in maintaining functionality in older adults. Additionally, there was a particular increase in calcium intake, which is relevant in ageing, especially for bone health.
Financial Literacy: The Role of the Local Context
Authors: Cucinelli Doriana , Trivellato Paolo , Zenga Mariangela
Published: July 2019

In this article, we investigate the role of local factors associated with the financial literacy of Italian adults (no. 945). Using a multilevel regression model, together with the common socioeconomic and sociodemographic variables already used in previous studies, we also add certain environmental variables at the local level. We separately analyze the three indexes that define the OECD financial literacy index—Financial Attitude Index (FAI), Financial Knowledge Index (FKI), and Financial Behavior Index (FBI)—because they show a dynamic of their own in each region. Our findings confirm that the FKI and the FAI are associated to some extent with environmental traits, while the FBI is not. We conclude that not only the sociodemographic and socioeconomic conditions of individuals but also certain features of the regional context where they live have an impact on their financial literacy. Consequences for financial education programs are highlighted.
A topical regimen improves skin healing and aesthetic outcomes when combined with a radiofrequency microneedling procedure
Authors: Gold Michael H. , Sensing Whitney , Biron Julie A.
Published: July 2019

Introduction

Novel topical products formulated using tri‐ and hexapeptide technology (TriHex Technology®; Alastin Skincare®, Inc) are used to clear the extracellular matrix, stimulate neocollagenesis and elastogenesis, decrease inflammation, and accelerate the epidermal healing process.

Aims

This study assessed the efficacy of two topical tri‐ and hexapeptide‐containing products pre‐ and post‐treatment with radiofrequency (RF) microneedling of the photoaged neck with respect to healing and aesthetic outcomes.

Subjects/Methods

In this open‐label, nonrandomized study, eligible subjects underwent one screening visit, one RF microneedling procedure and follow‐up visits on post‐treatment Days 3, 7, 30, and 90. Subjects were instructed to apply one product to the neck for 2 weeks prior to treatment and 7 days post‐treatment. On post‐treatment Day 7, subjects switched to the other product until the end of the study. At each visit, subject and investigator questionnaires were completed and standardized digital images were obtained.

Results

Female subjects (N = 10) with a mean age of 51.3 years (range, 44‐59 years) completed the study. All subjects achieved statistically significant improvements in Investigator Global Assessment scales at post‐treatment Day 90 and reported improvement in all Skin Quality Assessments. Among Subjective Tolerability Assessments, all post‐treatment reports of tingling and burning resolved by Day 3. 90% of stinging resolved by Day 3 with 100% resolving by Day 7. 40% of subjects had minimal itching on Day 3 which resolved by Day 7. Among the Investigator Post‐treatment Tolerability Assessments, edema resolved in all subjects by Day 3 and erythema settled between Day 3 and Day 7.

Conclusion

Pre‐ and post‐treatment use of topical products formulated with tri‐ and hexapeptide technology appears to hasten healing and complement aesthetic outcomes associated with RF microneedling of the neck.
A Note on “Risk Reduction in Large Portfolios: Why Imposing the Wrong Constraints Helps”
Authors: JAGANNATHAN RAVI , MA TONGSHU , ZHANG JIAQI
Published: July 2019

This note corrects an error in the proof of Proposition 2 of “Risk Reduction in Large Portfolios: Why Imposing the Wrong Constraint Helps” that appeared in the Journal of Finance, August 2003.
The bruxism construct: From cut‐off points to a continuum spectrum
Authors: Manfredini Daniele , Ahlberg Jari , Wetselaar Peter , Svensson Peter , Lobbezoo Frank
Published: July 2019

This commentary discusses the need to move on from the adoption of cut‐off points for the definition of the presence/absence of bruxism and justifies the need to embrace an evaluation based on the continuum of jaw motor behaviours. Currently, the number of events per hour, as identified by polysomnography (PSG), is used to define the presence of sleep bruxism (SB). Whilst PSG still remains the indispensable equipment to study the neurophysiological correlates of SB, the scoring criteria based on a cut‐off point are of questionable clinical usefulness for the study of oral health outcomes. For awake bruxism (AB), criteria for a definite diagnosis have never been proposed. Some goal‐oriented strategies are proposed to identify bruxism behaviours that increase the risk of negative oral health outcomes (eg, tooth wear, muscle and/or temporomandibular joint [TMJ] pain, restorative complications). One possible strategy would embrace an improved knowledge on the epidemiology and natural variability of bruxism, even including study of the amount of PSG/SB and electromyography masticatory muscle activity (EMG/MMA) during sleep and the frequency/prevalence of bruxism behaviours during wakefulness that are needed to represent a risk factor for clinical consequences, if any. There should not be any preclusion about the diagnostic strategies to pursue that goal, and a combination of instrumental and non‐instrumental approaches may even emerge as the best available option. Once data are available, large‐scale, non‐selected population samples representing the entire continuum of EMG/MMA activities are also needed, in the attempt to estimate untreated health risks in the population.
Māori knowledge under the microscope: Appropriation and patenting of mātauranga Māori and related resources
Authors: Lai Jessica C. , Robinson Daniel F. , Stirrup Tim , Tualima Hai‐Yuean
Published: July 2019

Since the early 1990s there has been considerable global discussion and debate surrounding biodiscovery activities and the utilisation of both genetic resources (including biochemical derivatives) and associated traditional/Indigenous knowledge (TK/IK). Concerns about misappropriations and biopiracy have often been raised; however it has been difficult to quantify the scale of this problem beyond some common examples and anecdotes. This paper contributes to emerging research in this area (e.g., see Oldham et al. 2013, PLOS One, 8, e78737; and Robinson and Raven, 2017, Aust Geogr, 48, 311) and seeks to quantify patent utilisation of specific GRs where there is documented TK. A patent landscaping approach was undertaken with a focus on plants with associated mātaraunga Māori (Māori knowledge) from Aotearoa New Zealand. We explain our methodology and highlight 77 patent families of interest identified through our search. Although the findings are not definitive about misappropriation without additional analysis of the patents’ specifications and claims, and sources of mātauranga Māori, the data we outline may be useful for drawing out cases of misappropriation and biopiracy. These findings might also be useful for considering the potential implications of these for Māori claims under the Waitangi Tribunal Wai 262, potential access and benefit‐sharing (ABS) systems, and intellectual property regulations or reforms.
Massive postglacial gene flow between European white oaks uncovered genes underlying species barriers
Authors: Leroy Thibault , Rougemont Quentin , Dupouey Jean‐Luc , Bodénès Catherine , Lalanne Céline , Belser Caroline , Labadie Karine , Le Provost Grégoire , Aury Jean‐Marc , Kremer Antoine , Plomion Christophe
Published: July 2019

Oaks are dominant forest tree species widely distributed across the Northern Hemisphere, where they constitute natural resources of economic, ecological, social and historical value. Hybridisation and adaptive introgression have long been thought to be major drivers of their ecological success. Therefore, the maintenance of species barriers remains a key question, given the extent of interspecific gene flow.

In this study, we made use of the tremendous genetic variation among four European white oak species (31 million single nucleotide polymorphisms (SNPs)) to infer the evolutionary history of these species, study patterns of genetic differentiation and identify reproductive barriers.

We first analysed the ecological and historical relationships among these species and inferred a long‐term strict isolation followed by a recent and extensive postglacial contact using approximate Bayesian computation. Assuming this demographic scenario, we then performed backward simulations to generate the expected distributions of differentiation under neutrality to scan their genomes for reproductive barriers. We finally identified important intrinsic and ecological functions driving the reproductive isolation.

We discussed the importance of identifying the genetic basis for the ecological preferences between these oak species and its implications for the renewal of European forests under global warming.