bluuebunny/crossref_metadata_2025 huggingface dataset:
Simplified dynamic analysis of stepped thickness rectangular plate structures by the assumed mode method
Authors: Cho Dae-Seung , Kim Byung Hee , Kim Jin-Hyeong , Vladimir Nikola , Choi Tae-Muk
Published: March 2016

In this article, the assumed mode method is applied to simplified dynamic analysis of stepped thickness rectangular Mindlin plates and stiffened panels with arbitrary boundary conditions. The natural and frequency responses of stepped thickness plate structures subjected to harmonic point excitation force and enforced acceleration at boundaries, respectively, are considered. Potential and kinetic energies of the system are formulated and used to derive eigenvalue problem utilizing Lagrange’s equation of motion, and mode superposition method is further used for forced response assessment. Characteristic orthogonal polynomials having the property of Timoshenko beam functions are used for the assumed modes. Numerical examples analysing vibration of stepped thickness plate structures with different topologies and various sets of boundary conditions are provided. Numerical results are compared with the results from the relevant literature and finite element solutions obtained by a general finite element tool, and a very good agreement is achieved. Hence, it is expected that stepped rectangular plate structures satisfying the prescribed criteria regarding natural and frequency responses can be efficiently designed based on the proposed method.
Rivals’ reactions to mergers and acquisitions
Authors: Uhlenbruck Klaus , Hughes-Morgan Margaret , Hitt Michael A. , Ferrier Walter J. , Brymer Rhett
Published: March 2016

Mergers and acquisitions research has principally focused on attributes of the acquiring firm and post-acquisition outcomes. To extend our knowledge, we focus on external factors, in particular rival responses, and explore when and how rivals respond to their competitor’s acquisitions. Leveraging the awareness–motivation–capability framework, we predict and find evidence that a rival’s dependence on markets in common with the acquirer, resource similarity between rival and acquirer, and a rival’s organizational slack increase the volume and, in some cases, also the complexity of a rival’s competitive actions following an acquisition. Furthermore, the type of acquisition positively moderates some of these relationships. The results extend our understanding of the influence of mergers and acquisitions on competitive dynamics in the marketplace.
The Point Prevalence of Malignancy in a Wound Clinic
Authors: Ghasemi Farhad , Anooshirvani Niloofar , Sibbald R. Gary , Alavi Afsaneh
Published: March 2016

The aim of this study was to determine the prevalence of malignant leg ulcers and to identify the most frequent characteristics of such wounds. This study was a retrospective investigation of patients with chronic leg ulcers in a North American tertiary wound clinic. Between January 2011 and September 2013, a total of 1189 patients with lower extremity wounds, including 726 patients with leg wounds, were identified. A total of 124 of the 726 had undergone a biopsy of their atypical wound, 16.1% (20/124) of which were malignant. Patients with malignant wounds were older than patients with nonmalignant leg wounds ( P < .0001), and the common location of the malignant wound was the anterior shin (odds ratio = 3.5). The limitation of this analysis is the lack of distinction between malignant transformation of wounds and de novo presentation of malignancies as chronic nonhealing wounds. Three distinguishing morphological features in malignant wounds were irregular borders ( P = .0002), presence of hypergranulation tissue ( P < .0001), and friable/bleeding wound surface ( P < .0001). The frequency of malignant wounds in patients with chronic leg ulcers highlights the need for a systematic approach, which would involve biopsy of wounds to identify malignancy in this patient population early on.
Participants and Study Decliners’ Perspectives About the Risks of Participating in a Clinical Trial of Whole Genome Sequencing
Authors: Robinson Jill Oliver , Carroll Thomas M. , Feuerman Lindsay Z. , Perry Denise L. , Hoffman-Andrews Lily , Walsh Rebecca C. , Christensen Kurt D. , Green Robert C. , McGuire Amy L. ,   for the MedSeq Project Team
Published: March 2016

An increasing number of individuals are being recruited to whole genome sequencing (WGS) research. When asked hypothetically, the majority of the public express willingness to participate in this type of research, yet little is known about how many individuals will actually consent to research participation or what they perceive the risks to be. The MedSeq Project is a clinical trial exploring WGS in clinical care. We documented primary reason(s) for declining participation and reviewed audio-recorded informed consent sessions to identify participants’ concerns. Of 514 individuals recruited, 173 (34%) actively declined, 205 (40%) enrolled, and the remaining 136 (26%) were ineligible, unresponsive or waitlisted. Although the majority of active decliners cited logistical barriers, 40% cited risks related to the ethical, legal, and social implications (ELSI) of WGS research. Participants similarly discussed ELSI-related concerns but felt the potential benefits of participation outweighed the risks. Findings provide insight into the perspectives of potential WGS research participants and identify potential barriers to participation.
Ethics of Online Assent
Authors: Friedman Mark S. , Chiu ChingChe J. , Croft Colby , Guadamuz Thomas E. , Stall Ron , Marshal Michael P.
Published: March 2016

Individuals, including youth, often participate in online research without understanding the characteristics of studies they have agreed to be part of. We assessed the impact of including questions as part of the assent process by randomizing 568 youth to one of three groups: (a) asking youth to only read study information and then indicate their willingness to participate, (b) requiring youth to answer two questions about the study’s risks and voluntary nature as part of the assent process, and (c) requiring youth to answer seven questions. Participants in the two- and seven-question groups, compared with the no-question group, were less likely to complete the assent process but, among those who did complete it, were more likely to read and understand study information.
Investigation into the flow details of runner region in a pump turbine at off-design conditions
Authors: Gong Ruzhi , Li Deyou , Wang Hongjie , Wei Xianzhu , Qin Daqing
Published: March 2016

Due to the rapid development of large thermal power stations and nuclear power stations, it requires that the power grid should provide greater capability and flexibility. Security, stability, and economy in operation should also be taken into consideration. The pumped storage power station which has double peak regulating capability is a good choice to realize this goal. However, the existence of S shape characteristic of a pump turbine in generating mode at off-design condition makes it difficult to connect to the power grid. So it is necessary to analyze the reason of S shape characteristic in pump turbine by experimental investigation and numerical simulations. To achieve the above-mentioned object, numerical simulations of a pump turbine’s internal flow field were performed. The generating mode was analyzed by unsteady computational fluid dynamics simulation. The evolution of flow details in runner regions under the S shape characteristic conditions was observed by changing the guide vane opening. The unsteady flow structure and load on the blades in regions of S shape characteristic were obtained, which will contribute to the design of hydro-turbine.
Moral Panic and Reading: Early Elite Anxieties About the Media Effect
Authors: Furedi Frank
Published: March 2016

From its inception the medium of writing has been a source of moral concern. The growth of the printed media reinforced these apprehensions. Fears about the media effect on the behaviour of readers became recurring phenomena – in some cases provoking reactions characterised as a moral panic. These periodic outbursts of disquiet can be best understood as panics about the potential impact of the media on public morality. Such reactions were not simply media panics but panics about the effects of the media. The focus of anxiety was not on any particular issue but on the threat to moral authority posed by the media on the outlook and behaviour of the public. By its very existence the media appeared to represent a potential threat to the moral order. Exploring the moral dimension of this reaction is essential for the study of moral panics.
Novel approaches to the management of noneosinophilic asthma
Authors: Thomson Neil C.
Published: March 2016

Noneosinophilic airway inflammation occurs in approximately 50% of patients with asthma. It is subdivided into neutrophilic or paucigranulocytic inflammation, although the proportion of each subtype is uncertain because of variable cut-off points used to define neutrophilia. This article reviews the evidence for noneosinophilic inflammation being a target for therapy in asthma and assesses clinical trials of licensed drugs, novel small molecules and biologics agents in noneosinophilic inflammation. Current symptoms, rate of exacerbations and decline in lung function are generally less in noneosinophilic asthma than eosinophilic asthma. Noneosinophilic inflammation is associated with corticosteroid insensitivity. Neutrophil activation in the airways and systemic inflammation is reported in neutrophilic asthma. Neutrophilia in asthma may be due to corticosteroids, associated chronic pulmonary infection, altered airway microbiome or delayed neutrophil apoptosis. The cause of poorly controlled noneosinophilic asthma may differ between patients and involve several mechanism including neutrophilic inflammation, T helper 2 (Th2)-low or other subtypes of airway inflammation or corticosteroid insensitivity as well as noninflammatory pathways such as airway hyperreactivity and remodelling. Smoking cessation in asthmatic smokers and removal from exposure to some occupational agents reduces neutrophilic inflammation. Preliminary studies of ‘off-label’ use of licensed drugs suggest that macrolides show efficacy in nonsmokers with noneosinophilic severe asthma and statins, low-dose theophylline and peroxisome proliferator-activated receptor gamma (PPARγ) agonists may benefit asthmatic smokers with noneosinophilic inflammation. Novel small molecules targeting neutrophilic inflammation, such as chemokine (CXC) receptor 2 (CXCR2) antagonists reduce neutrophils, but do not improve clinical outcomes in studies to date. Inhaled phosphodiesterase (PDE)4 inhibitors, dual PDE3 and PDE4 inhibitors, p38MAPK (mitogen-activated protein kinase) inhibitors, tyrosine kinase inhibitors and PI (phosphoinositide) 3kinase inhibitors are under development and these compounds may be of benefit in noneosinophilic inflammation. The results of clinical trials of biological agents targeting mediators associated with noneosinophilic inflammation, such as interleukin (IL)-17 and tumor necrosis factor (TNF)-α are disappointing. Greater understanding of the mechanisms of noneosinophilic inflammation in asthma should lead to improved therapies.
Institutional facts and principles of global political legitimacy
Authors: Macdonald Terry
Published: March 2016

How should the content and justification of action-guiding normative ‘principles’ in political life be responsive to social ‘facts’? In this article, I answer this question by sketching a contextualist methodology for identifying and justifying principles for guiding international institutional action, which is based on an original account of the regulative role and conceptual structure of principles of political legitimacy. I develop my argument for this approach in three steps. First, I argue that a special non-utopian category of normative political principles has the regulatory role of helping solve collective action problems that emerge in practice among actors engaged in shared institutional projects. Next, I argue that analysis of such normative political principles can be helpfully framed by what I call a collective agency conception of political legitimacy. Finally, I draw out the implications of these claims to show how the content and justification of normative political principles should vary across institutional contexts, in response to a particular set of motivational and empirical social facts. This contextualist methodology has useful applications to international politics insofar it can help to account for the widespread intuition that standards of political legitimacy for institutions may vary both across domestic and international levels and among international institutions operating in different functional domains.
Meaningful activities for improving the wellbeing of people with dementia: beyond mere pleasure to meeting fundamental psychological needs
Authors: Nyman Samuel R , Szymczynska Paulina
Published: March 2016

Aims:

Dementia is being increasingly recognised as a major public health issue for our ageing populations. A critical aspect of supporting people with dementia is facilitating their participation in meaningful activities. However, research to date has not drawn on theories of ageing from developmental psychology that would help undergird the importance of such meaningful activity. For the first time, we connect existing activity provision for people with dementia with developmental psychology theories of ageing.

Method:

We reviewed the literature in two stages: first, we narratively searched the literature to demonstrate the relevance of psychological theories of ageing for provision of meaningful activities for people with dementia, and in particular focused on stage-based theories of adult development (Carl Jung and Erik Erikson), gerotranscendence (Tornstam), selective optimisation with compensation (Baltes and Baltes), and optimisation in primary and secondary control (Heckhausen and Schulz). Second, we systematically searched PubMed and PsycINFO for studies with people with dementia that made use of the aforementioned theories.

Results:

The narrative review highlights that activity provision for people with dementia goes beyond mere pleasure to meeting fundamental psychological needs. More specifically, that life review therapy and life story work address the need for life review; spiritual/religious activities address the need for death preparation; intergenerational activities address the need for intergenerational relationships; re-acquaintance with previously conducted leisure activities addresses the need for a sense of control and to achieve life goals; and pursuit of new leisure activities addresses the need to be creative. The systematic searches identified two studies that demonstrated the utility of applying Erikson’s theory of psychosocial development to dementia care.

Conclusion:

We argue for the importance of activity provision for people with dementia to help promote wellbeing among an increasing proportion of older people.
On terrorist attacks in Nigeria: Stance and engagement in conversations on Nairaland
Authors: Chiluwa Innocent , Odebunmi Akin
Published: March 2016

Terrorist attacks in Nigeria have generated a huge body of conversations and debates on the Internet. This study investigates the contents of these online conversations on Nairaland and how such conversations exhibit stance and civic engagement in response to the attacks. Nairaland is an online community and public space that serves as a meeting place for Nigerians at home and in the Diaspora, who constantly follow-up on the events in Nigeria and participate in political debates about the country. This study argues that the frequent negative evaluations of Boko Haram and the attribution of the activities to Islam and the consistent constructions of northern Nigeria as ‘violent people’ and Islam as an ‘evil’ religion in Nairaland are potential to further worsen religious and ethnic relations in Nigeria.
Conversation is the soul of democracy: Expression effects, communication mediation, and digital media
Authors: Shah Dhavan V.
Published: March 2016

A sizable body of empirical evidence indicates political conversation—both face-to-face and online—drives participatory engagement. Digital, social, and mobile media provide new avenues and tools for political talk, with affordances that may be particularly conducive to expression effects—that is, the impact of message production on the sender. This essay contends that an emphasis on deliberative democracy has limited attention to the psychological implications of political expression and creative production via information technologies and digital media.
The administrative subcontract: Significance, relevance and implications for intergovernmental relations in China
Authors: Zhou Li-An
Published: March 2016

This article attempts to demonstrate the significance, relevance and implications of the ‘administrative subcontract’ as an analytical framework for understanding China’s intergovernmental relations, bureaucratic incentives and administrative governance. As an ideal type, the term ‘administrative subcontract’ refers to a subcontracting relationship inside the government system, representing a hybrid governance structure between bureaucracy in the Weberian sense and a ‘pure’ subcontract which occurs among independent entities having no hierarchical relationships. An administrative subcontract exhibits a coherent and consistent set of characteristics along the dimensions of authority relations, economic incentives and internal control. It is argued that these three dimensions are complementary and mutually supportive, and tend to move together if the system encounters systemic shocks. This new framework helps with identifying the key and durable features of China’s intergovernmental relations and administrative governance. The notion of the administrative subcontract enables many puzzling observations and patterns regarding the workings of China’s government system to be reinterpreted and some important and as yet long understudied issues brought to our attention. The theory of the administrative subcontract is combined with that of ‘political tournaments’ to extend the analysis of China’s political incentives and governance. With regard to vertical subcontracting and horizontal (political) competition inside the government system, an attempt is made to explain the strength and weakness of China’s state capacity in various areas of public service.
Housing inequality in urban China
Authors: Ren Qiang , Hu Rongqin
Published: March 2016

Using data from a nationwide longitudinal survey, the current inequalities in housing conditions, property, ownership rate, market value, and dynamic changes of housing with difficulties were studied, and the affected factors from the characteristics of households and regional variations in urban China were explored. It was found that 77% of urban households owned their own houses, but 14% had housing difficulties in 2012. In addition, it was found that more than 67% of families owned one house, and more than 15% owned two or more. The median market value of current housing was 250,000 yuan, and the median market value per square meter was 2587 yuan. Finally, it was determined that household-level characteristics played important roles in housing inequality, and that regional variations significantly affected the likelihood of housing difficulties being present.
The emergence of comparative politics in Japan
Authors: Inoguchi Takashi
Published: March 2016

This article describes the emergence of comparative politics in Japan in the new millennium. Applying Lipset’s American exceptionalism as a negation of comparative politics to the oft-used Japanese uniqueness and particularism, I characterized a newly-born comparative politics Japanese style as: 1) metamorphosis of standard comparative politics; 2) dramatic rise of cross-national survey research; and 3) bringing area specialists and comparativists together. Some pronounced conceptual, theoretical, methodological, and empirical issues that remain to be tackled are discussed. In conclusion, the non-exceptionalist comparative politics based on conceptual clarity, methodological sophistication, and narrative persuasiveness is the line along which Japanese comparative politics should be evolving.
Democratic consolidation in Taiwan in comparative perspective
Authors: McAllister Ian
Published: March 2016

Taiwan has been one of the most successful East Asian countries in transitioning from authoritarian rule to liberal democracy. Using a wide range of survey data, this paper examines the process of democratic consolidation in Taiwan from 1996 to 2012, and benchmarks the country’s progress with other East Asian democracies, third wave democracies, and established democracies. The results show that positive regime evaluations have been generally stable since the mid-1990s, although efficacy is slightly lower than is found elsewhere. Party attachments among the mass public have increased incrementally, against the international trends. The level of polarization within the party system has remained consistently low by international standards. Overall, the results confirm that the process of democratic consolidation in Taiwan is close to completion.
Surging progressives in the conservative mood
Authors: Iida Takeshi
Published: March 2016

This article examines the conditional effects of income and urbanism on vote choice in an attempt to explain why both the conservative Liberal Democratic Party (LDP) and the progressive Japanese Communist Party (JCP) were successful in the 2014 Japanese Lower House election. Casting doubt on the conventional explanations, it argues that social division along income lines caused a polarization of voting in urban areas, which in turn allowed the two parties to prosper in the election. More specifically, Prime Minister Abe’s monetarist economic policies implemented during an economic downturn influenced the welfare of people differently according to income level, and consequently divided them into voters for the LDP and for the JCP. Using Japan as a case study, this research shows how an economic policy implemented during an economic downturn can create social and political divisions among people, which in turn impacts elections.
The development of political science in Thailand
Authors: Sawasdee Siripan Nogsuan
Published: March 2016

This paper recounts the development of political science in Thailand and identifies the subfields and approaches used in political science studies. The paper argues that the orientation of political science has been a product of the historical process of semi-colonialism and Thailand’s pattern of development based on internal colonization with a high degree of centralization in Bangkok in all dimensions, whether economic, political, or cultural. Moreover, the alternation between varying forms of military rule and prolonged colour-coded politics have been major factors influencing the debates and the substance of political science in the country which has also brought about the politicization of Thai academics. The paper seeks to assess the current situation of and challenges to the study of political science in Thailand.
The Value and Benefits of an Environmental Health Bachelor’s Degree Accredited by the National Environmental Health Science and Protection Accreditation Council for Community College Transfer Students
Authors: Fletcher Michael D. , Aighewi Isoken Tito , Murphy Timothy James
Published: March 2016

The approximately 45,000 environmental health practitioners in the United States are in the front line of public health by preventing disease and injury. Environmental health practitioners enjoy good pay, good benefits, and rewarding careers. Growth of the profession is projected to be faster than average at about 15% in the next 10 years. However, few community college students, faculty, and administrators know about this career path. Students that obtain a bachelor’s degree in Environmental Health accredited by the National Environmental Health Science and Protection Accreditation Council (EHAC) have a means to assure a successful career in the field of environmental health as this degree is deemed the “industry standard” by environmental health leaders. Currently, there are 31 universities across the nation that offer EHAC-accredited Environmental Health bachelor’s degrees with courses being taught on campus and online. Students that seek transfer from a community college to an EHAC-accredited university need to have the background courses necessary to assist in a seamless transfer. Community colleges that desire their graduates to successfully transfer to EHAC-accredited programs need to offer the general education, math, and basic science courses that are the underlying requirements of an EHAC-accredited Environmental Health degree.
A Vison for the Role of Community Colleges in the Profession of Public Health
Authors: Honoré Peggy A.
Published: March 2016

The missions of public health and community colleges bind them intimately to their service areas. Programs delivered by both members are influenced by the health and educational needs in the communities they serve. This alignment of missions supports a vision for greater cross-sectoral collaborations between public health and community colleges to advance improvements in health and education. Doing so has mutual benefits for both sectors while also supporting the achievement of national goals. A particular area ripe for exploration is on strengthening the public health workforce through the expansion of U.S. community college offerings in this discipline. Enhanced public health workforce skills increase the probability of achieving population health improvement goals of the Affordable Care Act as well as for strengthening community capacity so urgently needed to stimulate thriving communities across the United States.
Foundational Courses in Health Education
Authors: Lohrmann David K. , Auld M. Elaine , Hawkins Mary I. , Hicks Elaine R. , Hutton-Rogers Laurencia S.
Published: March 2016

Community colleges educate a substantial proportion of future health professionals. In particular, they provide an important incubator for health education specialists who may pursue their foundational courses in a 2-year degree setting, with an opportunity to articulate to a 4-year degree program in health education. Community colleges also have strong connections to the communities they serve, a foundational element shared with health education, and enroll many students from underserved communities who could enhance the diversity of the future health education workforce. This article describes the development of three foundational courses in health education by the Society for Public Health Education, Inc. (SOPHE), working as part of The Framing the Future: The Second 100 Years of Public Health Task Force under the aegis of the Association of Schools and Programs in Public Health and the League for Innovation in Community College in the United States. Using the latest available competencies for the health education profession, three prototype curricular outlines were created in 2014, including an introduction to health education, accessing and analyzing health information, and advocacy and leadership in public health (a service-learning course). The course content outlines are presented herein, and their relationship to the 2010 health education competencies. We outline next steps in linking SOPHE health education faculty and practitioners with community college representatives to develop quality associate degree course offerings that articulate to baccalaureate degree programs in health education.
Long-acting muscarinic antagonists: a potential add-on therapy in the treatment of asthma?
Authors: Busse William W. , Dahl Ronald , Jenkins Christine , Cruz Alvaro A.
Published: March 2016

Asthma is a chronic inflammatory disorder of the airways that is a major global burden on both individuals and healthcare systems. Despite guideline-directed treatment, a significant proportion of patients with asthma do not achieve control. This review focuses on the potential use of long-acting anticholinergics as bronchodilators in the treatment of asthma, with results published from clinical trials of glycopyrrolate, umeclidinium and tiotropium. The tiotropium clinical trial programme is the most advanced, with data available from a number of phase II and III studies of tiotropium as an add-on to inhaled corticosteroid maintenance therapy, with or without a long-acting β2-agonist, in patients across asthma severities. Recent studies using the Respimat Soft Mist inhaler have identified 5 µg once daily as the preferred dosing regimen, which has shown promising results in adults, adolescents and children with asthma. Tiotropium Respimat has recently been incorporated into the Global Initiative for Asthma 2015 treatment strategy as a recommended alternative therapy at steps 4 and 5 in adult patients with a history of exacerbations. The increasing availability of evidence from ongoing and future clinical trials will be beneficial in determining where long-acting anticholinergic agents fit in future treatment guidelines across a variety of patient populations and disease severities.
Radio(chemo)therapy in locally advanced nonsmall cell lung cancer
Authors: Glatzer Markus , Elicin Olgun , Ramella Sara , Nestle Ursula , Putora Paul Martin
Published: March 2016

Definitive radiochemotherapy is the standard treatment for many patients with locally advanced nonsmall cell lung cancer (NSCLC). Treatment outcomes have improved over the last decades. Several treatment regimens have been shown effective and safe. This review summarises the results of significant studies between 1996 and 2015 on concomitant and sequential radiochemotherapy regimens and radiation dose per fraction. Beside therapy regimens, optimised radiotherapy planning is indispensable to improve outcome and minimise radiation-induced toxicity. An insight into the rationale of radiotherapy planning for stage III NSCLC is also provided.
KRASoncogene in lung cancer: focus on molecularly driven clinical trials
Authors: Kempf Emmanuelle , Rousseau Benoît , Besse Benjamin , Paz-Ares Luis
Published: March 2016

KRASmutations are the most frequent molecular abnormalities found in one out of four nonsmall cell lung cancers (NSCLC). Their incidence increases in cases of adenocarcinoma, smokers and Caucasian patients. Their negative value in terms of prognosis and responsiveness to both standard chemotherapy and targeted therapies remains under debate. Many drugs have been developed specifically forKRAS-mutated NSCLC patients. Direct inhibition ofRASactivation failed to show any clinical efficacy. Inhibition of downstream targets of the mitogen-activated protein kinase (MEK) pathway is a promising strategy: phase II combinations of MEK 1/2 kinase inhibitors with chemotherapy doubled patients’ clinical outcomes. One phase III trial in such a setting is ongoing. Double inhibition of MEK and epidermal growth factor receptor proteins is currently being assessed in early-phase trials. The association with mammalian target of rapamycin pathway inhibition leads to non-manageable toxicity. Other strategies, such as inhibition of molecular heat-shock proteins 90 or focal adhesion kinase are currently assessed. Abemaciclib, a cyclin-dependent kinase 4/6 inhibitor, showed promising results in a phase I trial, with a 54% disease control rate. Results of an ongoing phase III trial are warranted. Immunotherapy might be the next relevant step inKRAS-mutated NSCLC management due to the high burden of associated mutations and neo-antigens.
Sleep apnoea
Authors: Jun Jonathan C. , Chopra Swati , Schwartz Alan R.
Published: March 2016

Sleep apnoea is a disorder characterised by repetitive pauses in breathing during sleep caused by airway occlusion (obstructive sleep apnoea) or altered control of breathing (central sleep apnoea). In this Clinical Year in Review, we summarise high-impact research from the past year pertaining to management, diagnosis and cardio-metabolic consequences of sleep apnoea.
Paediatric respiratory infections
Authors: Everard Mark L.
Published: March 2016

Pulmonary infections remain a major cause of infant and child mortality worldwide and are responsible for a substantial burden of morbidity. During the 2015 European Respiratory Society International Congress in Amsterdam, some of the main findings from peer-reviewed articles addressing this topic that were published in the preceding 12 months were reviewed in a Paediatric Clinical Year in Review session. The following article highlights some of the insights provided by these articles into the complex interactions of the human host with the extensive and dynamic populations of microorganisms that call an individual “home”.
Rapid assessment of insect fauna based on local knowledge: comparing ecological and ethnobiological methods
Authors: Lima Daniele Cristina de Oliveira , Ramos Marcelo Alves , da Silva Henrique Costa Hermenegildo , Alves Angelo Giuseppe Chaves
Published: March 2016

Background

The rapid assessment of biodiversity making use of surveys of local knowledge has been successful for different biological taxa. However, there are no reports on the testing of such tools for sampling insect fauna. The present study aimed to evaluate the efficiency of different ethnobiological techniques for rapid sampling of insect fauna.

Methods

Field research for the conventional survey of insect fauna was conducted on a private farm (9 ° 43'38.95 "S, 37 ° 45'11.97" W) , where there was intensive cultivation of okra (Abelmoschus esculentus L. (Moench)). The survey of local entomological knowledge was conducted among all the producers of okra living in the rural villages Pereira, Santa Luzia, and Nassau de Souza, within the Jacaré Curituba irrigated settlement scheme. The combined use of the techniques “free list” and projective interviews was analyzed, using two types of visual stimuli: stock photos and an entomological box.

Results

During the conventional survey of insect fauna, the species Bemisia tabaci biotype B, Aphis gossypii, Phenacoccus sp., Icerya purchasi and Lagria villosa were the primary pests found in the okra crop. Regarding the survey of insect pests, the results were convergent  in both techniques (conventional sampling and free list). Comparing the interview with visual stimuli (pictures) and specimen witnesses (entomological box) revealed that the latter was more effective.

Conclusion

Techniques based on the recording and analysis of local knowledge about insects are effective for quick sampling of pest insects, but ineffective in sampling predator insects. The utilization of collected insects, infested branches, or photos of the symptoms of damage caused by pests in projective interviews is recommended.
Draft genome sequences of Pantoea agglomerans and Pantoea vagans isolates associated with termites
Authors: Palmer Marike , de Maayer Pieter , Poulsen Michael , Steenkamp Emma T. , van Zyl Elritha , Coutinho Teresa A. , Venter Stephanus N.
Published: March 2016

The genus Pantoea incorporates many economically and clinically important species. The plant-associated species, Pantoea agglomerans and Pantoea vagans, are closely related and are often isolated from similar environments. Plasmids conferring certain metabolic capabilities are also shared amongst these two species. The genomes of two isolates obtained from fungus-growing termites in South Africa were sequenced, assembled and annotated. A high number of orthologous genes are conserved within and between these species. The difference in genome size between P. agglomerans MP2 (4,733,829 bp) and P. vagans MP7 (4,598,703 bp) can largely be attributed to the differences in plasmid content. The genome sequences of these isolates may shed light on the common traits that enable P. agglomerans and P. vagans to co-occur in plant- and insect-associated niches.
Editorial: Senescent angiogenic T cells: the use of CD28 makes the difference in endothelial homeostasis
Authors: Della Bella Silvia , Mavilio Domenico
Published: March 2016

Discussion of senescent T cells involved in the control of angiogenesis and endothelial homeostasis.
Consultation liaison in primary care for people with mental disorders
Authors: Gillies Donna , Buykx Penny , Parker Alexandra G. , Hetrick Sarah E.
Published: March 2016

Approximately 25% of people will be affected by a mental disorder at some stage in their life. Despite the prevalence and negative impacts of mental disorders, many people are not diagnosed or do not receive adequate treatment. Therefore primary healthcare has been identified as essential to improving the delivery of mental healthcare. Consultation liaison is a model of mental healthcare where the primary care provider maintains the central role in the delivery of mental healthcare, with a mental health specialist providing consultative support. Consultation liaison has the potential to enhance the delivery of mental healthcare in the primary care setting and, in turn, improve outcomes for people with a mental disorder.
The usefulness and interpretation of systematic reviews
Authors: Smith Katharine A. , Cipriani Andrea , Geddes John R.
Published: March 2016

Keeping up to date with the best evidence on treatment interventions is an essential part of clinical practice, but it can seem an overwhelming task for busy clinicians. Systematic reviews and meta-analyses provide a useful and convenient summary of knowledge and form an essential part of an evidence-based approach to clinical practice. However, these reviews vary in methodology and therefore in the quality of the recommendations they provide. Clinicians need to feel confident in their skills of critical appraisal, so that they can assess the relative merits of systematic reviews. In this article we discuss the strengths and limitations of different types of evidence synthesis to enable the reader to feel more confident in assessing the scientific information to use in clinical practice.
Personalised approaches to pharmacotherapy for schizophrenia
Authors: Lally John , MacCabe James H.
Published: March 2016

The traditional approach to selecting antipsychotic medication involves little more than trial and error. Recent advances in genetics and molecular science offer the hope of a ‘personalised medicine’ approach to antipsychotic development and prescribing in schizophrenia. Personalised medicine is the practice of tailoring medical treatment to the individual characteristics of each patient. In schizophrenia, this will involve the identification of more homogeneous subsets of patients through the application of genetics, epigenetics, proteomics and metabolomics, neuroimaging and other biomarkers, and the use of these findings to stratify patients according to their response to treatment. In this article, we focus on the emerging evidence in pharmacogenetics and biomarkers for assessing individual response and tolerability of antipsychotic medication in schizophrenia.
Update on advances in psychiatric treatment in primary care
Authors: Dowrick Christopher
Published: March 2016

This article updates previous evidence on the role of primary care in the management of depression and related disorders, unexplained physical symptoms, and severe and enduring mental illness. Regarding depression and related disorders, there is now evidence for the benefits of non-medical interventions and collaborative care, providing alternatives to the simplistic over prescription of antidepressant medication. For severe and enduring illness, the emphasis in primary care is now on the effective management of comorbid physical health problems. The article also summarises best practice for the primary care assessment and management of dementia, including the need for holistic review of care quality and the potential benefits of collaborative care. Finally, it notes the growing emphasis on primary mental healthcare in low- and middle-income countries (LMIC).
The interface between general adult psychiatry and behavioural neurology/neuropsychiatry
Authors: Jethwa Ketan Dipak , Joseph Verghese , Khosla Vivek , Cavanna Andrea E.
Published: March 2016

With the subspecialisation of psychiatry in the UK, clinicians may encounter problems at the interface between specialties. This article focuses on the interface between general adult psychiatry and behavioural neurology/neuropsychiatry. Important interface issues include the identification of psychiatric symptoms in patients with organic brain pathology and the remit and organisation of general and specialist services. Options for optimum cooperation are presented alongside practical examples of clinical issues of neuropsychiatric relevance.
CBT: mindful moments – a five-minute mindfulness strategy
Authors: Wilson Alistair , Williams Chris
Published: March 2016

Mindfulness is increasingly being recommended to help patients with recurrent depression and anxiety stay well. However, current treatment recommendations ask a lot in terms of commitment, with around 100 hours of practice and learning over a 2-month period. There is therefore increased interest in approaches that deliver key mindfulness skills in a shorter time frame.
Anxiety and new onset of cardiovascular disease: critical review and meta-analysis
Authors: Batelaan Neeltje M. , Seldenrijk Adrie , Bot Mariska , van Balkom Anton J. L. M. , Penninx Brenda W. J. H.
Published: March 2016

Background

Anxiety has been associated with new-onset cardiovascular disease (CVD), but the quality of this relationship is unclear. Only if anxiety is a causal, independent cardiovascular risk factor might it be a target for CVD prevention.

Aims

To determine and examine the independent association and causality between anxiety and incident CVD.

Method

PubMed, EMBASE and PsycINFO databases were searched up to October 2013. A review of Hill's criteria for causality and random effects meta-analysis were conducted of prospective, population-based studies examining anxiety and incident CVD in people free from CVD at baseline.

Results

The meta-analysis comprised 37 papers (n= 1 565 699). The follow-up ranged from 1 to 24 years. Anxiety was associated with a 52% increased incidence of CVD (hazard ratio = 1.52, 95% CI 1.36–1.71). The risk seemed independent of traditional risk factors and depression. The evaluation of Hill's criteria largely argued in favour of causality.

Conclusions

Anxiety may be of interest for CVD prevention. Future research should examine biological and behavioural underpinnings of the association in order to identify targets for intervention.
Interconnected or disconnected? Promotion of mental health and prevention of mental disorder in the digital age
Authors: Hayes Joseph F. , Maughan Daniel L. , Grant-Peterkin Hugh
Published: March 2016

To date there have been few peer-reviewed studies on the feasibility, acceptability and effectiveness of digital technologies for mental health promotion and disorder prevention. Any evaluation of these evolving technologies is complicated by a lack of understanding about the specific risks and possible benefits of the many forms of internet use on mental health. To adequately meet the mental health needs of today's society, psychiatry must engage in rigorous assessment of the impact of digital technologies.
Patient experience of negative effects of psychological
treatment: results of a national survey
Authors: Crawford Mike J. , Thana Lavanya , Farquharson Lorna , Palmer Lucy , Hancock Elizabeth , Bassett Paul , Clarke Jeremy , Parry Glenys D.
Published: March 2016

Background

To make informed choices, patients need information about negative as
well as positive effects of treatments. There is little information about
negative effects of psychological interventions.

Aims

To determine the prevalence of and risk factors for perceived negative
effects of psychological treatment for common mental disorders.

Method

Cross-sectional survey of people receiving psychological treatment from
184 services in England and Wales. Respondents were asked whether they
had experienced lasting bad effects from the treatment they received.

Results

Of 14 587 respondents, 763 (5.2%) reported experiencing lasting bad
effects. People aged over 65 were less likely to report such effects and
sexual and ethnic minorities were more likely to report them. People who
were unsure what type of therapy they received were more likely to report
negative effects (odds ratio (OR) = 1.51, 95% CI 1.22–1.87), and those
that stated that they were given enough information about therapy before
it started were less likely to report them (OR = 0.65, 95% CI
0.54–0.79).

Conclusions

One in 20 people responding to this survey reported lasting bad effects
from psychological treatment. Clinicians should discuss the potential for
both the positive and negative effects of therapy before it starts.
West German Study Group Phase III PlanB Trial: First Prospective Outcome Data for the 21-Gene Recurrence Score Assay and Concordance of Prognostic Markers by Central and Local Pathology Assessment
Authors: Gluz Oleg , Nitz Ulrike A. , Christgen Matthias , Kates Ronald E. , Shak Steven , Clemens Michael , Kraemer Stefan , Aktas Bahriye , Kuemmel Sherko , Reimer Toralf , Kusche Manfred , Heyl Volker , Lorenz-Salehi Fatemeh , Just Marianne , Hofmann Daniel , Degenhardt Tom , Liedtke Cornelia , Svedman Christer , Wuerstlein Rachel , Kreipe Hans H. , Harbeck Nadia
Published: March 2016

Purpose

The 21-gene Recurrence Score (RS) assay is a validated prognostic/predictive tool in early hormone receptor–positive breast cancer (BC); however, only a few prospective outcome results have been available so far. In the phase III PlanB trial, RS was prospectively used to define a subset of patients who received only endocrine therapy. We present 3-year outcome data and concordance analysis (among biomarkers/RS).

Patients and Methods

Central tumor bank was established prospectively from PlanB (intermediate and high-risk, locally human epidermal growth factor receptor 2–negative BC). After an early amendment, HR-positive, pN0-1 patients with RS ≤ 11 were recommended to omit chemotherapy.

Results

From 2009 to 2011, PlanB enrolled 3,198 patients with a median age of 56 years; 41.1% had node-positive and 32.5% grade 3 disease. In 348 patients (15.3%), chemotherapy was omitted based on RS ≤ 11. After 35 months median follow-up, 3-year disease-free survival in patients with RS ≤ 11 and endocrine therapy alone was 98% versus 92% and 98% in RS > 25 and RS 12 to 25 in chemotherapy-treated patients, respectively. Nodal status, central and local grade, the Ki-67 protein encoded by the MKI67 gene, estrogen receptor, progesterone receptor, tumor size, and RS were univariate prognostic factors for disease-free survival; only nodal status, both central and local grade, and RS were independent multivariate factors. Histologic grade was discordant between central and local laboratories in 44%. RS was positively but moderately correlated with the Ki-67 protein encoded by the MKI67 gene and grade and negatively correlated with progesterone receptor and estrogen receptor.

Conclusion

In this prospective trial, patients with enhanced clinical risk and omitted chemotherapy on the basis of RS ≤ 11 had excellent 3-year survival. The substantial discordance observed between traditional prognostic markers and RS emphasizes the need for standardized assessment and supports the potential integration of standardized, well-validated genomic assays such as RS with clinicopathologic prognostic factors for chemotherapy indication in early hormone receptor–positive BC.