bluuebunny/crossref_metadata_2025 huggingface dataset:
Spartina alterniflora invasion drastically increases methane production potential by shifting methanogenesis from hydrogenotrophic to methylotrophic pathway in a coastal marsh
Authors: Yuan Junji , Liu Deyan , Ji Yang , Xiang Jian , Lin Yongxin , Wu Ming , Ding Weixin
Published: March 2019

Plant invasion can strongly influence carbon (C) cycling processes, thus it may affect climate change by altering C sequestration and greenhouse gas emissions in the invaded ecosystem. Since 1979, the exotic Spartina alterniflora has rapidly expanded in China’s coastal areas, where significant increase in methane (CH4) emissions has been documented from post‐invaded sites. However, a mechanistic understanding of the structural and functional changes of associated methanogens accompanying this invasion remains elusive.

Here we conducted integrated biogeochemical investigations on methanogenic substrates, activity, and diversity to identify implications of S. alterniflora invasion for methanogenesis in coastal wetlands. To do this, we collected and analysed 0–50 cm soil profiles from an uncolonised tidal flat (TF) and salt marshes that S. alterniflora has invaded for 1 year (SA‐1) and 12 years (SA‐12) in Jiangsu, China. Methanogenic community composition was characterised by massive parallel sequencing. The rates and pathways of methanogenesis were determined by adding trace concentrations of 13C‐labelled substrates to anaerobic incubated samples.

Our results revealed that 12‐year invasion of S. alterniflora drastically increased CH4 production potential by one order of magnitude over that of TF. This substantial increase was primarily attributed to methanogenesis from trimethylamine; its rates increased by two orders of magnitude over TF whereas those from acetate and H2/CO2 increased far less. Hydrogenotrophic methanogenesis was the dominant pathway operating in the TF, but methanotrophic pathway contributed most to CH4 production in the surface layer of SA‐1 and uppermost 40‐cm layers of SA‐12. Consistent with these observations, the dominant methanogens shifted from obligate hydrogenotrophic Methanococcales in TF to potential methylamine‐utilising Methanosarcinaceaein SA‐12. Our Mantel analysis indicated that ‘non‐competitive’ trimethylamine, derived from cytoplasmic osmolytes of S. alterniflora, was the major driver of this change in methanogenic community composition.

Synthesis. Our results suggest that invasive Spartina alternifloraplants gradually facilitated the local dominance of methylotrophic Methanosarcinaceae by changing the key type of methanogenic substrate in coastal marshes. Shifts in methanogen communities and enhanced availability of trimethylamine elevated the rates and importance of methylotrophic methanogenesis, thereby markedly increasing CH4 production potential and emission rates in this type of ecosystem.
Reducing pupils’ barriers to learning in a special needs school: integrating applied behaviour analysis into Key Stages 1–3
Authors: Pitts Laura , Gent Stacey , Hoerger Marguerite L.
Published: March 2019

Interventions based on applied behaviour analysis (ABA) have been shown to improve outcomes for young children with autism spectrum disorder (ASD), but there is very little research into outcomes for older pupils. This study evaluated the effectiveness of an ABA intervention for pupils with ASD and additional learning difficulties in a UK special needs school. The aim of the intervention was to reduce barriers to learning for individuals aged four to 13 years old. Behaviour analysts collaborated with school‐based teaching teams to design and implement function‐based behaviour support plans, individual education programmes and ABA teaching strategies, and to promote the generalisation of skills. Pupils were assessed at baseline and again following one academic year of intervention. The pupils demonstrated significant gains in learning skills, language and communication, social and play skills and self‐help skills. Pupils of all ages acquired essential ‘learning to learn’ skills which have reduced their barriers to learning and are enabling them to learn more effectively. The article discusses how a behavioural model was successfully and affordably implemented across key stages within a special educational needs school.
A tale of two epidemics: gay men's mental health and the biomedicalisation of HIV prevention and care in Toronto
Authors: Gaspar Mark , Marshall Zack , Rodrigues Ricky , Adam Barry D. , Brennan David J. , Hart Trevor A. , Grace Daniel
Published: March 2019

There is mounting urgency regarding the mental health of gay, bisexual and other men who have sex with men (GBM). We examined how GBM are understanding the relationship between HIV and their mental health given the increasing biomedicalisation of HIV prevention and care. Our Grounded Theory analysis derived from qualitative interviews with 24 GBM living in Toronto, Canada, including both HIV‐negative and HIV‐positive men. Participants understood biomedical advances, such as undetectable viral load and pre‐exposure prophylaxis (PrEP), as providing some relief from HIV‐related distress. However, they offered ambivalent perspectives on the biomedicalisation of HIV. Some considered non‐HIV‐specific stressors (e.g. unemployment, racial discrimination) more significant than HIV‐related concerns. These men expressed HIV‐related distress as being under control due to biomedical advances or as always negligible when compared to non‐HIV‐specific stressors. Others emphasised the ongoing mental health implications of HIV (e.g. enduring risk and stigma). We describe a tension between optimistic responses to biomedicine's ability to ease the psychosocial burdens associated with HIV and the inability for biomedicine to address the social and economic determinants driving the dual epidemics of HIV and mental distress amongst GBM. We argue for more socio‐material analysis over further sexual behavioural analysis of GBM mental health disparities.
Raman Spectroscopic Differences between Ephedrine and Pseudoephedrine
Authors: Shu Tianmin , Yang Xing , Li Wenbo , Yao Xiaojun
Published: March 2019

Ephedrine (EPH) and pseudoephedrine (PSE) were studied by micro‐Raman spectroscopy and UV resonance Raman spectroscopy excited at 785 and 360 nm, respectively. Raman bands at approximately 245 and 410 cm−1 for ephedrine have apparent differences from the same bands at approximately 215, 265, 350, 450, and 555 cm−1 for pseudoephedrine, and these differences can be applied to distinguish between EPH and PSE. Additionally, density functional theory was used for the Raman calculations to obtain results identical to the experimental spectra. This work is expected to expand the applications of Raman spectroscopy in forensic science.
Breakfast skipping in Greek schoolchildren connected to an unhealthy lifestyle profile. Results from the National Action for Children's Health program
Authors: Tambalis Konstantinos D. , Panagiotakos Demosthenes B. , Psarra Glykeria , Sidossis Labros S.
Published: March 2019

Aim

The aim of the present study was to examine prevalence and correlates of skipping breakfast in a representative sample of children and adolescents.

Methods

Cross‐sectional, observational study. Population data derived from a school‐based health survey carried out in 2015 on 177 091 Greek children aged 8–17 years. Trained investigators performed all anthropometric evaluations. Breakfast skipping and adherence to the Mediterranean diet (MD) was assessed through the Mediterranean Diet Quality Index for children and adolescents. Physical activity status, sedentary activities and sleeping hours were assessed through self‐completed questionnaires.

Results

Almost one in four (22.4% of boys, 23.1% of girls) schoolchildren skipped breakfast. Participants’ characteristics associated with skipping breakfast were being female, being older, being overweight/obese, poorer diet, inadequate physical activity levels, insufficient sleep and increased screen time. Regression models adjusted for several potential confounders demonstrated that poor dietary habits, insufficient sleeping status (<8–9 hours per day), and increased screen time (>2 hours per day), increased the odds for skipping breakfast by almost 80% (95% CI: 1.78–1.82), 23% (95% CI: 1.20–1.26) and 22.5% (95% CI: 1.19–1.26), respectively.

Conclusions

Skipping breakfast was common among schoolchildren. Participants who skipped breakfast tended to have an unhealthy lifestyle profile. Policies designed to increase breakfast consumption should target schoolchildren with unhealthy lifestyle profiles.
New insights into the kinetics of bacterial growth and decay in pig manure–wheat straw aerobic composting based on an optimized PMA–qPCR method
Authors: Ge Jinyi , Huang Guangqun , Sun Xiaoxi , Yin Hongjie , Han Lujia
Published: March 2019

Aerobic composting is a bacteria‐driven process to degrade and recycle wastes. This study quantified the kinetics of bacterial growth and decay during pig manure–wheat straw composting, which may provide insights into microbial reaction mechanisms and composting operations. First, a propidium monoazide–quantitative polymerase chain reaction (PMA–qPCR) method was developed to quantify the viable bacteria concentration of composting samples. The optimal PMA concentration and light exposure time were 100 μM and 8 min respectively. Subsequently, the concentrations of total and decayed bacteria were quantified. Viable and decayed bacteria coexisted during the entire composting period (experiments A and B), and the proportion of viable bacteria finally fell to only 35.1%. At the beginning, bacteria grew logarithmically and decayed rapidly. Later, the bacterial growth in experiment A remained stable, while that of experiment B was stable at first and then decomposed. The duration of the stable stage was positively related to the soluble sugar content of composting materials. The logarithmic growth and rapid decay of bacteria followed Monod equations with a specific growth (0.0317 ± 0.0033 h−1) and decay rate (0.0019 ± 0.0000 h−1). The findings better identified the bacterial growth stages and might enable better prediction of composting temperatures and the degree of maturation.
Streamflow Forecasting Using Singular Value Decomposition and Support Vector Machine for the Upper Rio Grande River Basin
Authors: Bhandari Swastik , Thakur Balbhadra , Kalra Ajay , Miller William P. , Lakshmi Venkat , Pathak Pratik
Published: March 2019

The current study improves streamflow forecast lead‐time by coupling climate information in a data‐driven modeling framework. The spatial–temporal correlation between streamflow and oceanic–atmospheric variability represented by sea surface temperature (SST), 500‐mbar geopotential height (Z500), 500‐mbar specific humidity (SH500), and 500‐mbar east–west wind (U500) of the Pacific and the Atlantic Ocean is obtained through singular value decomposition (SVD). SVD significant regions are weighted using a nonparametric method and utilized as input in a support vector machine (SVM) framework. The Upper Rio Grande River Basin (URGRB) is selected to test the applicability of the proposed model for the period of 1965–2014. The April–August streamflow volume is forecasted using previous year climate variability, creating a lagged relationship of 1–13 months. SVD results showed the streamflow variability was better explained by SST and U500 as compared to Z500 and SH500. The SVM model showed satisfactory forecasting ability with best results achieved using a one‐month lead to forecast the following four‐month period. Overall, the SVM results showed excellent predictive ability with average correlation coefficient of 0.89 and Nash–Sutcliffe efficiency of 0.79. This study contributes toward identifying new SVD significant regions and improving streamflow forecast lead‐time of the URGRB.
Modeling Connectivity of Non‐floodplain Wetlands: Insights, Approaches, and Recommendations
Authors: Jones C. Nathan , Ameli Ali , Neff Brian P. , Evenson Grey R. , McLaughlin Daniel L. , Golden Heather E. , Lane Charles R.
Published: March 2019

Representing hydrologic connectivity of non‐floodplain wetlands (NFWs) to downstream waters in process‐based models is an emerging challenge relevant to many research, regulatory, and management activities. We review four case studies that utilize process‐based models developed to simulate NFW hydrology. Models range from a simple, lumped parameter model to a highly complex, fully distributed model. Across case studies, we highlight appropriate application of each model, emphasizing spatial scale, computational demands, process representation, and model limitations. We end with a synthesis of recommended “best modeling practices” to guide model application. These recommendations include: (1) clearly articulate modeling objectives, and revisit and adjust those objectives regularly; (2) develop a conceptualization of NFW connectivity using qualitative observations, empirical data, and process‐based modeling; (3) select a model to represent NFW connectivity by balancing both modeling objectives and available resources; (4) use innovative techniques and data sources to validate and calibrate NFW connectivity simulations; and (5) clearly articulate the limits of the resulting NFW connectivity representation. Our review and synthesis of these case studies highlights modeling approaches that incorporate NFW connectivity, demonstrates tradeoffs in model selection, and ultimately provides actionable guidance for future model application and development.
Unexpected significant findings non‐related to prostate cancer identified using combined prostate‐specific membrane antigen positron emission tomography/CT and diagnostic CT scan in primary staging for prostate cancer
Authors: McEwan Louise , McBean Rhiannon , Yaxley John , Wong David
Published: March 2019

Introduction

There is increasing scientific evidence that whole‐body Gallium‐68 prostate‐specific membrane antigen (68Ga‐PSMA) positron emission tomography/computed tomography (PET/CT) improves the sensitivity of prostate cancer detection above standard staging radiology. Diagnostic IV‐contrasted CT scanning offers high‐quality recognition and delineation of organs and structures with a high sensitivity and specificity for diagnoses of many non‐prostate pathologies. At our institution, imaging for prostate cancer staging and restaging involves a 68Ga‐PSMA PET/CT scan combined with a diagnostic IV‐contrasted CT scan of the head, neck, chest, abdomen and pelvis. In this study, we aimed to determine the incidence of significant findings unrelated to prostate cancer identified when this combined imaging approach is utilized for prostate cancer imaging.

Methods

In this single‐centre retrospective review, 68Ga‐PSMA PET/CT and diagnostic IV‐contrasted CT scans undertaken for prostate cancer staging over a 12‐month period (n = 1200) were reviewed for significant findings not related to prostate cancer. In cases with a significant other finding, follow‐up imaging and/or pathology results were reviewed, where available. The overall incidence of significant other non‐prostate cancer findings was determined, as was the incidence of unsuspected neoplasms.

Results

Significant findings, unrelated to prostate cancer, were identified in a total of 5.7% of scans (n = 68) with 3.2% (n = 38) of findings being unsuspected neoplasms.

Conclusion

Diagnostic quality IV‐contrasted CT combined with 68Ga‐PSMA PET/CT for staging of prostate cancer identified significant other non‐prostate cancer findings, including renal, lung, gastrointestinal and haematological malignancies. Many of these conditions impact on patient management and required further investigation or treatment prior to management of the prostate cancer.
FLOT1 promotes tumor development, induces epithelial–mesenchymal transition, and modulates the cell cycle by regulating the Erk/Akt signaling pathway in lung adenocarcinoma
Authors: Zhang Louqian , Mao Yuan , Mao Qixing , Fan Weifei , Xu Li , Chen Yan , Xu Lin , Wang Jun
Published: March 2019

Background

FLOT1 is a scaffolding protein of lipid rafts that is believed to be involved in numerous cellular processes. However, few studies have explored the function of FLOT1 in the development of lung adenocarcinoma (LUAD) and the underlying mechanisms of FLOT1 activity.

Methods

FLOT1 knockdown and overexpression models were constructed via lentivirus. Cell growth, invasion, migration, and apoptosis were detected to evaluate the role of FLOT1 in LUAD development. Epithelial–mesenchymal transition (EMT) and cell cycle regulatory markers were then examined. Finally, the influence of FLOT1 on the Erk/Akt signaling pathway was investigated.

Results

FLOT1 promoted cell growth, invasion, and migration and inhibited cell apoptosis. In addition, FLOT1 induced EMT and modulated the cell cycle by activating the Erk/Akt signaling pathway.

Conclusion

The findings indicate a significant role of FLOT1 in LUAD development. Targeting FLOT1 may be a potential therapeutic strategy for LUAD.
A comparison of deep learning and citizen science techniques for counting wildlife in aerial survey images
Authors: Torney Colin J. , Lloyd‐Jones David J. , Chevallier Mark , Moyer David C. , Maliti Honori T. , Mwita Machoke , Kohi Edward M. , Hopcraft Grant C.
Published: March 2019

Fast and accurate estimates of wildlife abundance are an essential component of efforts to conserve ecosystems in the face of rapid environmental change. A widely used method for estimating species abundance involves flying aerial transects, taking photographs, counting animals within the images and then inferring total population size based on a statistical estimate of species density in the region. The intermediate task of manually counting the aerial images is highly labour intensive and is often the limiting step in making a population estimate.

Here, we assess the use of two novel approaches to perform this task by deploying both citizen scientists and deep learning to count aerial images of the 2015 survey of wildebeest (Connochaetes taurinus) in Serengeti National Park, Tanzania.

Through the use of the online platform Zooniverse, we collected multiple non‐expert counts by citizen scientists and used three different aggregation methods to obtain a single count for the survey images. We also counted the images by developing a bespoke deep learning method via the use of a convolutional neural network. The results of both approaches were then compared.

After filtering of the citizen science counts, both approaches provided highly accurate total estimates. The deep learning method was far faster and appears to be a more reliable and predictable approach; however, we note that citizen science volunteers played an important role when creating training data for the algorithm. Notably, our results show that accurate, species‐specific, automated counting of aerial wildlife images is now possible.
Financial outreach and household financial constraint
Authors: Bai Yiyi , Li Zhisheng , Liu Huan
Published: March 2019

This paper analyses how financial outreach affects the probability of households having financial constraint (i.e. being ‘discouraged’ and ‘rejected’ for loan applications). We show that households residing in communities with more bank branches are less likely to be financially constrained. Using the distance to the closest fruit and vegetable (open) market as an instrument for financial outreach, we address the potential endogeneity problem and find our results remain robust. We further provide evidence on the negative relationship between the number of bank branches nearby and the probability of loan rejection, in particular for middle‐income young households.
Cross‐national patterns of substance use disorder treatment and associations with mental disorder comorbidity in the WHO World Mental Health Surveys
Authors: Harris Meredith G. , Bharat Chrianna , Glantz Meyer D. , Sampson Nancy A. , Al‐Hamzawi Ali , Alonso Jordi , Bruffaerts Ronny , Caldas de Almeida José Miguel , Cia Alfredo H. , de Girolamo Giovanni , Florescu Silvia , Gureje Oye , Haro Josep Maria , Hinkov Hristo , Karam Elie G. , Karam Georges , Lee Sing , Lépine Jean‐Pierre , Levinson Daphna , Makanjuola Victor , McGrath John , Mneimneh Zeina , Navarro‐Mateu Fernando , Piazza Marina , Posada‐Villa José , Rapsey Charlene , Tachimori Hisateru , ten Have Margreet , Torres Yolanda , Viana Maria Carmen , Chatterji Somnath , Zaslavsky Alan M. , Kessler Ronald C. , Degenhardt Louisa ,   on behalf of the World Health Organization's World Mental Health Surveys collaborators
Published: March 2019

Aims

To examine cross‐national patterns of 12‐month substance use disorder (SUD) treatment and minimally adequate treatment (MAT), and associations with mental disorder comorbidity.

Design

Cross‐sectional, representative household surveys.

Setting

Twenty‐seven surveys from 25 countries of the WHO World Mental Health Survey Initiative.

Participants

A total of 2446 people with past‐year DSM‐IV SUD diagnoses (alcohol or illicit drug abuse and dependence).

Measurements

Outcomes were SUD treatment, defined as having either received professional treatment or attended a self‐help group for substance‐related problems in the past 12 months, and MAT, defined as having either four or more SUD treatment visits to a health‐care professional, six or more visits to a non‐health‐care professional or being in ongoing treatment at the time of interview. Covariates were mental disorder comorbidity and several socio‐economic characteristics. Pooled estimates reflect country sample sizes rather than population sizes.

Findings

Of respondents with past‐year SUD, 11.0% [standard error (SE) = 0.8] received past 12‐month SUD treatment. SUD treatment was more common among people with comorbid mental disorders than with pure SUDs (18.1%, SE = 1.6 versus 6.8%, SE = 0.7), as was MAT (84.0%, SE = 2.5 versus 68.3%, SE = 3.8) and treatment by health‐care professionals (88.9%, SE = 1.9 versus 78.8%, SE = 3.0) among treated SUD cases. Adjusting for socio‐economic characteristics, mental disorder comorbidity doubled the odds of SUD treatment [odds ratio (OR) = 2.34; 95% confidence interval (CI) = 1.71–3.20], MAT among SUD cases (OR = 2.75; 95% CI = 1.90–3.97) and MAT among treated cases (OR = 2.48; 95% CI = 1.23–5.02). Patterns were similar within country income groups, although the proportions receiving SUD treatment and MAT were higher in high‐ than low‐/middle‐income countries.

Conclusions

Few people with past‐year substance use disorders receive adequate 12‐month substance use disorder treatment, even when comorbid with a mental disorder. This is largely due to the low proportion of people receiving any substance use disorder treatment, as the proportion of patients whose treatment is at least minimally adequate is high.
Genetic determinants of paediatric food allergy: A systematic review
Authors: Suaini Noor H. A. , Wang Yichao , Soriano Victoria X. , Martino David J. , Allen Katrina J. , Ellis Justine A. , Koplin Jennifer J.
Published: March 2019

Background

The genetic determinants of food allergy have not been systematically reviewed. We therefore systematically reviewed the literature on the genetic basis of food allergy, identifying areas for further investigation.

Methods

We searched three electronic databases (MEDLINE, EMBASE and PubMed) on 9 January 2018. Two authors screened retrieved articles for review according to inclusion criteria and extracted relevant information on study characteristics and measures of association. Eligible studies included those that reported an unaffected nonatopic control group, had genetic information and were carried out in children.

Results

Of the 2088 studies retrieved, 32 met our inclusion criteria. Five were genome‐wide association studies, and the remaining were candidate gene studies. Twenty‐two of the studies were carried out in a predominantly Caucasian population with the remaining 10 from Asian‐specific populations or unspecified ethnicity. We found FLG, HLA, IL10, IL13, as well as some evidence for other variants (SPINK5, SERPINB and C11orf30) that are associated with food allergy.

Conclusions

Little genetic research has been carried out in food allergy, with FLG, HLA and IL13 being the most reproducible genes for an association with food allergy. Despite promising results, existing genetic studies on food allergy are inundated with issues such as inadequate sample size and absence of multiple testing correction. Few included replication analyses or population stratification measures. Studies addressing these limitations along with functional studies are therefore needed to unravel the mechanisms of action of the identified genes.
Urethral syringocele: unseen but existing
Authors: Saadat Paria , Borzi Peter , Patel Bhavesh , Winkle David
Published: March 2019

Background

Bulbourethral syringocele is an uncommon and under‐diagnosed condition most commonly seen in the paediatric population, although there is increasing recognition in adults. Due to the difficulty in diagnosis, we report our experience of urethral syringocele in a quaternary paediatric hospital, with differing presentations, diagnosis and treatment.

Methods

This is a retrospective review of seven cases of children over a period of 14 years, including their presentations, diagnosis, treatment and follow‐up. A review of the current literature is presented.

Results

The median age of these seven cases at presentation was 11 years (6 days to 16 years). Clinical features varied with age, with obstructive uropathy in a neonate, urinary tract infection in an infant, scrotal abscess in two children and lower urinary tract obstructive symptoms in three teenagers. Diagnostic voiding cystogram diagnosed the majority of syringoceles and two were seen on magnetic resonance imaging. Five boys underwent endoscopic transurethral deroofing and two children required transperineal marsupialization. Long‐term follow‐up showed all had complete resolution of symptoms.

Conclusion

Urethral syringocele presents from the neonatal period to late adolescence, with the presenting features reflective of age. Surgical management can be performed endoscopically or by open approach. Awareness of this condition and inclusion in the differential diagnosis, particularly in the setting of an atypical or recurrent scrotal abscess, could avoid a prolonged therapeutic course.
Focal radiation therapy for limited brain metastases is associated with high rates of local control and low subsequent whole brain radiation therapy
Authors: Or Michelle , Jayamanne Dasantha , Guo Lesley , Stevens Mark , Parkinson Jonathon , Cook Raymond , Little Nicholas , Back Michael
Published: March 2019

Background

Assess clinical outcomes of focal radiotherapy (RT) in patients with limited brain metastasis (LBM) with whole brain RT (WBRT) avoidance.

Methods

Patients diagnosed with LBM were entered into a database between January 2010 and February 2017. Patients were recommended WBRT avoidance with focal therapy and three‐monthly magnetic resonance imaging. The primary endpoint was overall survival. Secondary endpoints included progression‐free survival, initial‐site failure (ISF), distant brain relapse (DBF), leptomeningeal disease and rate of WBRT. Analysis involved Kaplan–Meier survival estimate with log‐rank tests and Cox‐regression analysis.

Results

One hundred and sixty‐six patients were managed with median follow‐up of 13 months and median overall survival of 15 months (95% confidence interval (CI) 10.8–19.2). Eighty‐three patients had central nervous system (CNS) relapse with median progression‐free survival of 11 months (95% CI 6.7–15.3), of which most failures were DBF (83.1%) with 27 ISF (32.5%). Of the ISFs, 12 (43%) had surgery alone, six had chemotherapy alone and nine received RT. Surgery or chemotherapy alone compared with RT had a significantly higher incidence of ISF with a hazard ratio of 4.96 (P < 0.0001, 95% CI 2.10–11.83) and 6.54 (P = 0.001, 95% CI 2.26–18.87), respectively. WBRT was utilized in only 24 patients, with 83% patients free of WBRT at 12 months. On univariate analysis, number of metastases (P = 0.04), symptomatic extracranial disease (P = 0.04) and early CNS relapse within 6 months (P < 0.01) had worse survival. No grade 3–4 toxicity events were noted in 129 patients undergoing RT.

Conclusion

Focal RT has a low rate of ISF with low toxicity in patients with LBMs. CNS progression was mainly DBF with low rates of salvage WBRT.
Derivation and validation of a cardiovascular risk score for prediction of major acute cardiovascular events in non‐alcoholic fatty liver disease; the importance of an elevated mean platelet volume
Authors: Abeles Robin D. , Mullish Benjamin H. , Forlano Roberta , Kimhofer Torben , Adler Maciej , Tzallas Alexandros , Giannakeas Nikolaos , Yee Michael , Mayet Jamil , Goldin Robert D. , Thursz Mark R. , Manousou Pinelopi
Published: March 2019

Background

Atherosclerotic cardiovascular disease is a key cause of morbidity in non‐alcoholic fatty liver disease (NAFLD) but appropriate means to predict major acute cardiovascular events (MACE) are lacking.

Aim

To design a bespoke cardiovascular risk score in NAFLD.

Methods

A retrospective derivation (2008‐2016, 356 patients) and a prospective validation (2016‐ 2017, 111 patients) NAFLD cohort study was performed. Clinical and biochemical data were recorded at enrolment and mean platelet volume (MPV), Qrisk2 and Framingham scores were recorded one year prior to MACE (Cardiovascular death, acute coronary syndrome, stroke and transient ischaemic attack).

Results

The derivation and validation cohorts were well‐matched, with MACE prevalence 12.6% and 12%, respectively. On univariate analysis, age, diabetes, advanced fibrosis, collagen proportionate area >5%, MPV and liver stiffness were associated with MACE. After multivariate analysis, age, diabetes and MPV remained independently predictive of MACE. The “NAFLD CV‐risk score” was generated using binary logistic regression:

0.06*(Age) + 0.963*(MPV) + 0.26*(DM1) – 16.44;

1Diabetes mellitus: 1: present; 2: absent.

(AUROC 0.84). A cut‐off of −3.98 gave a sensitivity 97%, specificity 27%, PPV 16%, and NPV 99%. An MPV alone of >10.05 gave a sensitivity 97%, specificity 59%, PPV 24% and NPV 97% (AUROC 0.83). Validation cohort AUROCs were comparable at 0.77 (NAFLD CV‐risk) and 0.72 (MPV). In the full cohort, the NAFLD CV‐risk score and MPV outperformed both Qrisk2 and Framingham scores.

Conclusions

The NAFLD CV risk score and MPV accurately predict 1‐year risk of MACE, thereby allowing better identification of patients that require optimisation of their cardiovascular risk profile.
Genomic data in prognostic models—what is lost in translation? The case of deletion 17p and mutantTP53in chronic lymphocytic leukaemia
Authors: Chin‐Yee Benjamin , Sadikovic Bekim , Chin‐Yee Ian H.
Published: March 2019

Genomic technologies are revolutionizing the practice of haematology‐oncology, leading to improved disease detection, more accurate prognostication and targeted treatment decisions. These advances, however, have also introduced new clinical challenges, which include problems of prognostic underdetermination and its attendant risks of over‐ and undertreatment. Genomic data is generated from different technologies, from cytogenetics to next‐generation sequencing, which are often interpreted interchangeably and in a binary fashion—as the presence or absence of a given chromosomal deletion or mutation—an oversimplification which may lead to mistaken prognosis. We discuss the clinical use of one such prognostic marker, represented by sequence and copy number alterations inTP53, located on chromosome 17p. Mutations inTP53are strongly linked to poor prognosis in a variety of haematological malignancies, including chronic lymphocytic leukaemia (CLL). We review studies inCLLwhich utilize the 17p deletion orTP53mutations for prognostic stratification with specific focus on the technologies used for detection, the thresholds established for clinical significance, and the clinical contexts in which these alterations are identified. The case ofCLLillustrates issues arising from simplistic, binary interpretation of genetic testing and highlights the need to apply a critical lens when incorporating genomics into prognostic models.
L‐cysteine/cystathionine‐β‐synthase‐induced relaxation in mouse aorta involves a L‐serine/sphingosine‐1‐phosphate/NO pathway
Authors: Mitidieri Emma , Gurgone Danila , Caiazzo Elisabetta , Tramontano Teresa , Cicala Carla , Sorrentino Raffaella , d'Emmanuele di Villa Bianca Roberta
Published: March 2019

Background and Purpose

Among the three enzymes involved in the transsulfuration pathway, only cystathionine β‐synthase (CBS) converts L‐cysteine into L‐serine and H2S. L‐serine is also involved in the de novo sphingolipid biosynthesis through a condensation with palmitoyl‐CoA by the action of serine palmitoyltransferase (SPT). Here, we have investigated if L‐serine contributes to the vasorelaxant effect.

Experimental Approach

The presence of CBS in mouse vascular endothelium was assessed by immunohistochemistry and immunofluorescence. The relaxant activity of L‐serine (0.1–300 μM) and L‐cysteine (0.1–300 μM) was estimated on mouse aorta rings, with or without endothelium. A pharmacological modulation study evaluated NO and sphingosine‐1‐phosphate (S1P) involvement. Levels of NO and S1P were also measured following incubation of aorta tissue with either L‐serine (1, 10, and 100 μM) or L‐cysteine (10, 100 μM, and 1 mM).

Key Results

L‐serine relaxed aorta rings in an endothelium‐dependent manner. The vascular effect was reduced by L‐NG‐nitro‐arginine methyl ester and wortmaninn. A similar pattern was obtained with L‐cysteine. The S1P1 receptor antagonist (W146) or the SPT inhibitor (myriocin) reduced either L‐serine or L‐cysteine relaxant effect. L‐serine or L‐cysteine incubation increased NO and S1P levels in mouse aorta.

Conclusions and Implications

L‐serine, a by‐product formed within the transsulfuration pathway starting from L‐cysteine via CBS, contributes to the vasodilator action of L‐cysteine. The L‐serine effect involves both NO and S1P. This mechanism could be involved in the marked dysregulation of vascular tone in hyperhomocysteinemic patients (CBS deficiency) and may represent a feasible therapeutic target.

Linked Articles

This article is part of a themed section on Hydrogen Sulfide in Biology & Medicine. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.4/issuetoc
Readiness for transition and health‐care satisfaction in adolescents with complex medical conditions
Authors: Haarbauer‐Krupa Juliet , Alexander Nneka Morris , Mee Laura , Johnson Alcuin , Wise Justin , Arora Gupta Nitika , Schechter Michael S. , Wasilewski‐Masker Karen , Gilleland Marchak Jordan
Published: March 2019

Background

The purpose of this study is to examine contributions to patient perceptions of transition readiness and satisfaction with care amongst adolescents and young adults (AYAs) with complex health conditions engaging in paediatric care.

Methods

Participants included 94 patients aged 14–20 years (M = 16.41, SD = 1.56) with cystic fibrosis (n = 31), sickle cell disease (n = 27), and solid organ transplants (n = 36). Participants completed self‐report questionnaires and medical providers completed measures of their medication regimen complexity. One‐way analysis of variance compared differences between disease groups on study variables. Pearson product–moment correlation coefficients and linear regression models evaluated factors associated with AYA reported transition readiness and satisfaction with health care.

Results

There were no significant differences between disease groups on patient‐reported transition readiness, barriers to medication adherence, health care self‐management, or satisfaction. Patient age, self‐reported health‐care responsibility, medication barriers, and academic performance predicted a large portion of the variance in AYA perceptions of transition readiness (R2 = 0.27, F (4, 83) = 7.74, p < 0.001, Cohen's f2 = 0.37). Patient gender, self‐reported health‐care responsibility, and medication barriers predicted a medium portion of the variance in AYA satisfaction with health care (R2 = 0.23, F (3, 88) = 8.56, p < 0.001, Cohen's f2 = 0.30).

Conclusions

Patient perceptions of health care self‐management and barriers to medication adherence are important predictors of readiness for transition and satisfaction with care. Considering a holistic approach that includes these factors allows for improved understanding of individual needs for transition interventions that can improve adult outcomes for individuals with complex health conditions.
Influence of a single preoperative dose of antibiotics on the early implant failure rate. A randomized clinical trial
Authors: Kashani Hossein , Hilon Jack , Rasoul Mahdi Hasan , Friberg Bertil
Published: March 2019

Background

The use of a preoperative single dose of antibiotics as routine in conjunction with implant surgery is controversial, in light of the unclear effect on early implant failure rate and risk for development of resistant bacterial strains.

Purpose

This randomized clinical trial compared the early implant failure rates in two different patient cohorts: One group receiving a single dose of preoperative antibiotics (AB group) and one group receiving no antibiotics, prior to implant surgery (noAB group).

Materials and Methods

Patients were referred for treatment at four specialist clinics in the county council of West Sweden, Vastra Gotaland and randomly assigned into one of the two groups. A total of 447 patients received 963 implants were included in the study.

Of these, 223 patients (535 implants) belonged to the AB‐group and 224 patients (428 implants) to the noAB‐group. Four commercial implant brands were utilized, albeit one system was only represented with four implants.

The outcome was evaluated after 4 months using either a one‐stage or two‐stage procedure. The surgical procedures were performed by experienced implant surgeons and the surgical protocol for implant placement follows standard. Failure was defined as removal of an implant for any reason. The study outcomes were statistically analyzed to evaluate the differences between the two groups.

Results

Twelve implants failed in 11 patients for the AB group, and 32 implants failed in 29 patients for the noAB group. Preoperative antibiotics, AB group, had significantly (P < 0.0011) lower implant failure 2.2% compared to 7.5% in the noAB group analyzed on implant level adjusted for dependence within patients, OR = 0.30, 95% confidence interval (0.14‐0.62).

Conclusion

Administration of a single dose of antibiotics in conjunction with implant placement surgery resulted in a statistically significant lower early implant failure rate compared to when no antibiotics were used.
Effects of air abrasive decontamination on titanium surfaces: A systematic review of in vitro studies
Authors: Moharrami Mohammad , Perrotti Vittoria , Iaculli Flavia , Love Robert M. , Quaranta Alessandro
Published: March 2019

Background

Air abrasion (AA) is one of the decontamination methods that have demonstrated promising results in treating peri‐implant diseases.

Purpose

This systematic review aimed at evaluating the in vitro effect of AA on surface change, cleaning efficacy, and biocompatibility of titanium surfaces and at comparing it with other decontamination methods.

Materials and Methods

A comprehensive search was conducted up to April 2018 using PubMed, Scopus, and Google Scholar databases to identify studies on the decontamination effect of AA. All types of titanium surfaces, abrasive powders, contaminated surfaces, and measuring methods were included.

Results

Overall, 1502 articles were identified. After screening the titles and abstracts, and carefully reading the full‐texts, 48 articles published between 1989 and 2018 were selected. AA was considered almost safe, particularly for the nonmodified surfaces. Nevertheless, harder powders such as sodium bicarbonate tended to damage the surface more than glycine. AA resulted in surface change similar to plastic curettes and Er: YAG lasers. Regarding the cleaning efficacy, there was no significant difference between glycine and sodium bicarbonate, but different mixtures of calcium phosphate, hydroxyapatite, and erythritol were superior to glycine. AA was superior or equal to all other decontamination methods in cleaning. Regarding biocompatibility, AA was more successful in preserving biocompatibility for noncontaminated surfaces compared with contaminated surfaces and when used with erythritol and osteoinductive powders.

Conclusions

AA can efficiently remove contamination without serious damage to the surface. The main drawback of the AA method seems to be its limitation in restoring the biocompatibility of the surface.
Effect of body mass index on depression in a UK cohort of 363 037 obese patients: A longitudinal analysis of transition
Authors: Moussa Osama M. , Ardissino Maddalena , Kulatilake Priyantha , Faraj Ara , Muttoni Elisabetta , Darzi Ara , Ziprin Paul , Scholtz Samantha , Purkayastha Sanjay
Published: March 2019

With obesity levels increasing, it is important to consider the mental health risks associated with this condition to optimize patient care. Links between depression and obesity have been explored, but few studies focus on the risk profiles of patients across stratified body mass index (BMI) classes above 30 kg/m2. This study aims to determine the impact of BMI on depression risk in patients with obesity and to investigate trends of depression in a large cohort of British patients with BMI > 30 kg/m2. A nationwide primary care database, the Clinical Practice Research Datalink (CPRD), was analysed for diagnoses of obesity (BMI > 30 kg/m2). Obese patients were then sub‐classified into seven BMI categories. Primary health care–based records of patients entered in the CPRD were analysed. A total of 363 037 patients had a BMI ≥ 30 kg/m2; of these patients 97 392 (26.8%) also had a diagnosis of depression. Absolute event rates over time and hazard risk of depression were analysed by BMI category. On Cox regression analysis of time to development of depression, the cumulative hazard increased significantly and linearly across BMI groups (P < 0.001). Compared to those with BMI 30 to 35 kg/m2, patients with BMI 35 to 40 kg/m2 had a 20% higher risk of depression (hazard ratio [HR] 1.206, confidence interval [CI] 1.170‐1.424), and those with BMI > 60 kg/m2 had a 98% higher risk (HR 1.988, CI 1.513‐2.612). This study identified the prevalence and time course of depression in a cohort of obese patients in the United Kingdom. Findings suggest the risk of depression is directly proportional to BMI above 30 kg/m2. Therefore, clinicians should note higher BMI levels confer increased risk of depression.
Twenty‐first Century Industrial Policy in a Small Developing Country: The Challenges of Reviving Manufacturing in Rwanda
Authors: Behuria Pritish
Published: March 2019

The Rwandan government — widely lauded for its political commitment to development — has refocused its efforts on reviving growth in the manufacturing sector. This article examines how pressures from different levels — international, regional and domestic — have shaped the evolving political economy of two priority sectors (apparel and cement). To achieve its goals of manufacturing sector growth, the Rwandan government aims to access foreign markets (on preferential terms) and larger regional markets while developing effective state–business relationships with locally based firms. Despite the government's political commitment to reviving its manufacturing sector, its strategy has been both shaped and impeded by shifting pressures at the international level (through Rwanda's recent suspension from the African Growth and Opportunity Act), the regional level (through competition from regional firms) and the domestic level (through over‐reliance on single firms). Within the current industrial policy literature, there is limited reflection on how developing countries are dealing with the multi‐scalar challenges of enacting industrial policy in a much‐changed global trading environment. This article contributes to the industrial policy literature by addressing this lacuna.
Beyond Color‐Blind and Color‐Conscious: Approaches to Racial Socialization Among Parents of Transracially Adopted Children
Authors: Killian Caitlin , Khanna Nikki
Published: March 2019

Objective

To examine how parents of transracially adopted children think about and practice ethnic–racial socialization.

Background

Previous research has highlighted how some parents are color‐blind and others are color‐conscious, yet these 2 categorizations fail to cover the range and fluidity of adoptive parents' approaches to ethnic socialization.

Method

Semistructured interviews were conducted with 34 parents of children with Asian, Latino, and Black ancestry. Parents were recruited through adoption agencies and support groups, personal contacts, and snowball sampling and were asked about attempts and concerns in ethnically and racially socializing their children. Interviews were recorded, transcribed, and coded for common themes using the grounded theory method.

Results

Some parents downplayed race/ethnicity, but our findings elucidate their range of motivations from “protecting” their children from a racialized society to prioritizing other goals. More parents attempted to ethnically socialize but did so in varied ways, such as buying consumer items or forging relationships with people of their children's ethnic group. Compared with “color‐conscious” parents of Asian and Latino children, “color‐conscious” parents of Black children were more likely to emphasize preparation for bias.

Conclusion

Adoptive parents can vacillate between minimizing the impact of race to talking about steps taken to ethnically socialize children. Some parents note a profound change in their perspective at some point after adopting their children.

Implications

Delving into more than 2 approaches to ethnic socialization and identifying changes over time affords a deeper understanding of parents' perspectives and behaviors and helps researchers interpret the mixed results found in past studies.
The impact of business group affiliation on stock price informativeness: Evidence from an emerging market
Authors: Küllü A. Melih , Dyer Doug , Yilmaz Gokhan , Sharma Zenu
Published: March 2019

This paper examines the relationship between business group affiliation and stock price informativeness in an emerging market setting. We use stock price synchronicity as a measure, and study the impact of group affiliation‐specifically the extent of affiliation, ownership structure and existence of group bank‐on firm specific information content. Results reveal that the amount of firm‐specific information capitalized into stock prices tends to be lower(higher)when the firm is group‐affiliated(unaffiliated), indirectly(directly)owned, and affiliated group has(does not have)a group bank. Additionally, the extent of group affiliation maintains a non‐linear relationship with synchronicity, suggesting that the perception of higher versus lower levels of group ownership differs.
What is the impact of problem loans on Japanese bank productivity growth?
Authors: Mamatzakis Emmanuel , Matousek Roman , Vu Anh Nguyet
Published: March 2019

This paper examines for the first time the impact of problem loans on Japanese productivity growth. We exploit a new data set of Japanese problem loans classified into two categories: bankrupt and restructured loans. We opt for a novel and flexible productivity growth decomposition that allows to measure the direct impact of these problem loans on productivity growth. The results reveal that Japanese bank productivity growth was severely constrained by bankrupt and restructured loans early in 2000s, whilst some persistence of the negative impact of problem loans on productivity growth is observed in the late 2000s. Thereafter, there is only some partial recovery in the productivity growth from 2012 to 2015. Further, we also perform cluster analysis to examine convergence or divergence across regions and over time. We observe limited convergence, though Regional Banks seem to form clusters in some regions.