bluuebunny/crossref_metadata_2025 huggingface dataset:
Computational assessment of arrhythmia potential in the heterogeneously perfused ventricle
Authors: Kharche Sanjay R , McIntyre Christopher W
Published: April 2018

Background

The heterogeneity in the human left ventricle is augmented by heterogeneous perfusion defects in dialysis patients. We hypothesized that ischemic zones generated by heterogeneous perfusion are a cause of clinically observed post-dialysis arrhythmia. This preliminary study assessed the arrhythmia potential in a heterogeneously perfused 2D human ventricle computational model.

Aim

Our aim was to ascertain a relationship between the number of ischemia zones and incidence of multiple re-entrant waves in a 2D model of the human ventricle.

Methods

A human ventricle action potential model was modified to include the adenosine triphosphate (ATP) sensitive potassium current. Within ischemic zones, cell electrophysiological alterations due to ischemia were implemented as increased extracellular potassium, reduced intracellular ATP concentrations, as well as reduced upstroke current conductances. The cell model was incorporated into a spatial 2D model. The inter-cellular gap junction coupling was adjusted to simulate slow conduction in dialysis patient hearts. CT imaging data of the heart obtained during dialysis was analysed to estimate the approximate spatial size of ischemic zones. An ischemic border zone between the normal and central ischemic zones was implemented which had smoothly varying electrophysiological parameters. Arrhythmic potential was assessed using the paths of the centres of the re-entrant waves, called tip trajectories, and dominant frequency maps.

Results

Extracellular potassium elevated the resting potential and IKATP reduced the action potential’s duration. In the absence of ischemic zones, the propensity of the model to induce multiple re-entrant waves was low. The inclusion of ischemic zones provided the substrate for initiation of re-entrant wave fibrillation. The dominant frequency which measured the highest rate of pacing in the tissue increased drastically with the inclusion of ischemic zones, going from 3 Hz in the pre-dialysis state to over 6 Hz in the post-dialysis state. Re-entrant wave tip numbers increased from 1 tip in the pre-dialysis case to 34 in the post-dialysis case, a 34 fold increase. The increase of tip number was found to be strongly correlated to tissue heterogeneity in terms of ischemic zone numbers. Computational factors limiting a more extensive simulation of cause-effect combinations were identified.

Conclusions

A dialysis session restores systemic homeostasis, but promotes deleterious arrhythmias. Structure-function mechanistic modelling will permit patient-specific assessment of health status. Such an effort is expected to lead to application of wider physical sciences methods in the improvement of the lives of critically ill patients. High performance computing is a crucial requirement for such mechanistic assessment of health status.
Evolved sequence features within the intrinsically disordered tail influence FtsZ assembly and bacterial cell division
Authors: Cohan Megan C. , Posey Ammon E. , Grigsby Steven J. , Mittal Anuradha , Holehouse Alex S. , Buske Paul J. , Levin Petra A. , Pappu Rohit V.
Published: April 2018

Intrinsically disordered regions (IDRs) challenge the well-established sequence-structure-function paradigm for describing protein function and evolution. Here, we direct a combination of biophysical and cellular studies to further our understanding of how the intrinsically disordered C-terminal tail of FtsZ contributes to cell division in rod-shaped bacteria. FtsZ is a modular protein that encompasses a conserved GTPase domain and a highly variable intrinsically disordered C-terminal tail (CTT). The CTT is essential for forming the cytokinetic Z-ring. Despite poor sequence conservation of the CTT, the patterning of oppositely charged residues, which refers to the extent of linear mixing / segregation of oppositely charged residues within CTT sequences is bounded within a narrow range. To assess the impact of evolutionary bounds on charge patterning within CTT sequences we performed experiments, aided by sequence design, to quantify the impact of changing the patterning of oppositely charged residues within the CTT on the functions of FtsZ from B. subtilis. Z-ring formation is robust if and only if the extent of linear mixing / segregation of oppositely charged residues within the CTT sequences is within evolutionarily observed bounds. Otherwise, aberrant, CTT-mediated, FtsZ assemblies impair Z-ring formation. The complexities of CTT sequences also have to be above a threshold value because FtsZ variants with low complexity CTTs are not tolerated in cells. Taken together, our results suggest that CTT sequences have evolved to be “just right” and that this is achieved through an optimal extent of charge patterning while maintaining the sequence complexity above a threshold value.
A zero percent plastic ingestion rate by silver hake (Merluccius bilinearis) from the south coast of Newfoundland, Canada
Authors: Liboiron France , Ammendolia Justine , Saturno Jacquelyn , Melvin Jessica , Zahara Alex , Richárd Natalie , Liboiron Max
Published: April 2018

Silver hake, (Merluccius bilinearis), contributes significant biomass to Northwest Atlantic ecosystems. The incidence of plastic ingestion for 134 individuals collected from Newfoundland, Canada was examined through visual examination of gastrointestinal contents and Raman spectrometry. We found a frequency of occurrence of ingestion of 0%. Through a comprehensive literature review of globally published fish ingestion studies, we found our value to be consistent with 41% (n=100) of all reported fish ingestion rates. We could not statistically compare silver hake results to other species due to low sample sizes in other studies (less thann=20) and a lack of standardized sampling methods. We recommend that further studies should 1) continue to report 0% plastic ingestion rates and 2) should describe location and species-specific traits that may contribute to 0% ingestion rates, particularly in locations where fish consumption has cultural and economic significance.
Lon recognition of the replication initiator DnaA is not confined to a single degron
Authors: Liu Jing , Francis Laura , Chien Peter
Published: April 2018

DnaA initiates chromosome replication in bacteria. InCaulobacter crescentus, the Lon protease degrades DnaA to coordinate replication with nutrient availability and to halt the cell cycle during acute stress. Here we characterize the mechanism of DnaA recognition by Lon. We find that the native folded state of DnaA is crucial for its degradation, in contrast to the well-known role of Lon in degrading misfolded proteins. We fail to identify a single degradation motif (degron) sufficient for DnaA degradation, rather we show that both the ATPase domain and a species-specific N-terminal motif are important for productive Lon degradation of DnaA. Mutations in either of these determinants disrupt DnaA degradationin vitroandin vivo.DnaA switches from an inactive to active state depending on its nucleotide state and we find that locking DnaA in an active state inhibits degradation. Our working model is that Lon engages DnaA through at least two elements, one of which anchors DnaA to Lon and the other acting as an initiation site for degradation.
Alteration of serum thymus and activation‐regulated chemokine level during biologic therapy for psoriasis: Possibility as a marker reflecting favorable response to anti‐interleukin‐17A agents
Authors: Shibuya Takashi , Honma Masaru , Iinuma Shin , Iwasaki Takeshi , Takahashi Hidetoshi , Ishida‐Yamamoto Akemi
Published: April 2018

Biologics show great efficacy in treating psoriasis, a chronic inflammatory skin disease. The high cost and side‐effects of biologics, dose‐reduction, elongation of administration interval and suspension are possible options. However, there has been no reliable biomarker we can use when we consider these moderations in therapy. This study was conducted to test the possibility of using serum thymus and activation‐regulated chemokine (TARC) level as an indicator for step down of biologic therapy. Serum TARC level was measured in 70 psoriatic patients at Asahikawa Medical University, and a correlation of TARC and severity of skin lesions was analyzed. Referring to serum TARC level, psoriatic patients can be divided into two groups. One is a population in which serum TARC level is positively correlated with severity of skin lesions, and the other is a population with low psoriatic severity and high TARC level. Serum TARC level was higher in the group that achieved PASI‐clear with biologics than in the group which did not achieve PASI‐clear. Among biologics, the group treated with secukinumab, an anti‐interleukin (IL)‐17A agent, showed significantly higher TARC level compared with the group treated with anti‐tumor necrosis factor agents. In certain populations achieving PASI‐clear, serum TARC level may be a potent marker reflecting better response to IL‐17A inhibitors, and in this case step down of treatment for psoriasis is possible.
Successful treatment with interleukin‐17A antagonists of generalized pustular psoriasis in patients without IL36RN mutations
Authors: Wilsmann‐Theis Dagmar , Schnell Lisa Marie , Ralser‐Isselstein Veronika , Bieber Thomas , Schön Michael P. , Hüffmeier Ulrike , Mössner Rotraut
Published: April 2018

Generalized pustular psoriasis (GPP) is a potentially life‐threatening disease that can be attributed to mutations in IL36RN in a subgroup of patients. In small trials, interleukin (IL)‐17A and IL‐17RA antagonists have been shown to be effective in patients with generalized pustular psoriasis in Japan. We identified seven patients who received the IL‐17A antagonists secukinumab (six cases) or ixekizumab (one case) in two dermatological centers. All patients showed a good or excellent clinical response. Anti‐IL‐17A therapy was well tolerated and ongoing in all patients after an average therapy duration of 12.9 months. Analysis of IL36RN mutation status was performed in six patients, one patient carried a heterozygous mutation, while the other five patients did not show a mutation in IL36RN. This is the first report of a successful treatment of GPP patients without IL36RN mutations responding to anti‐IL‐17A therapy.
Bone marrow ‐ mesenchymal stem cells impact on the U937 cells in the presence of staphylococcal enterotoxin B (SEB)
Authors: Ejtehadifar Mostafa , Halabian Raheleh , Ghazavi Ali , Khansarinejad Behzad , Mosayebi Ghasem , Imani Fooladi Abbas Ali
Published: April 2018

The growing resistance against conventional chemotherapy in acute myeloid leukemia (AML) is a noticeable clinical concern. Therefore, many researchers are looking for novel substances to overcome drug resistance in cancer. Staphylococcal enterotoxin B (SEB) is a superantigen (SAg) and a promising compound which has lethal effects on malignant cells. In this unprecedented study, SEB was used against U937 cells in a co‐culture system in the presence of human bone marrow‐mesenchymal stem cells (hBM‐MSCs). The effects of hBM‐MSCs on the proliferation and survival of U937 cell line with SEB was assessed using MTT assay and AnnexinV/PI flowcytometry, respectively. Moreover, the expression of IL‐6, IL‐10, TGF‐β, and inhibitor of nuclear factor kappa‐B kinase (IKKb) was evaluated by real‐time PCR technique. The same experiments were also carried out using hBM‐MSCs‐conditioned medium (hBM‐MSCs‐CM). The results showed that SEB reduced the proliferation and survival of U937 cell line, but hBM‐MSCs or hBM‐MSCs‐CM suppressed the effects of SEB. Furthermore, real‐timePCR demonstrated that SEB could decrease the expression of IL‐6, IL‐10, and TGF‐β in hBM‐MSCs (P < .05), while the production of IKKb was increased in comparison with the control group. These findings help us to have a broader understanding ofthe usage of SEB in the treatment of haematological malignancies, especially if it is targeted against hBM‐MSCs to disrupt their supportive effects on malignant cells.
The role of interleukin‐4 in rheumatic diseases
Authors: Dong Chen , Fu Ting , Ji Juan , Li Zhenyu , Gu Zhifeng
Published: April 2018

Rheumatism is a group of diseases, most of which are autoimmune diseases, that violate joints, bones, muscles, blood vessels and related soft tissue. As is well known, cytokines play a role in the pathogenesis of several rheumatic diseases, such as rheumatoid arthritis, spondyloarthritides, and systemic lupus erythematosus. Recently, the role of interleukin‐4 (IL‐4), which may participate in the mechanism of rheumatism, have been discovered. It is reported that IL‐4 takes part in the regulation of T cell activation, differentiation, proliferation, and survival of different T cell types. IL‐4 also has an immunomodulatory effect on B cells, mast cells, macrophages, and many cell types. A review of the literature on functions of IL‐4 in rheumatic diseases is presented.
Avian preparedness: simulations of bird diseases and reverse scenarios of extinction in Hong Kong, Taiwan, and Singapore
Authors: Keck Frédéric
Published: April 2018

This article describes relations between humans, animals, artefacts, and pathogens in simulations of disasters, taking bird diseases in three Chinese sentinel posts as ethnographic cases. Drawing on distinctions between simulation, ritual, and play, it shows that the engagement of actors in the imaginary of simulations, which they describe as ‘realism’, reflectively reverses the oppositions between humans and nonhumans, active and passive, fiction and reality that shape ordinary life. Borrowing from the anthropology of hunting societies, it argues that simulations of bird diseases, considered as signs of future species extinction, rely on cynegetic techniques of power, in which humans and animals symmetrically shift perspectives, and not only on pastoralist techniques, in which humans are above the population they monitor and sometimes sacrifice.
‘Music is my AK‐47’: performing resistance in Belfast's rebel music scene
Authors: Millar Stephen R.
Published: April 2018

This article examines how some Irish republicans have used ‘rebel songs’ as a means to resist the hegemonic power of the British state, and how militant republicanism is invoked musically, through sonic and physical references to gunfire. It explores how the use of rebel songs has changed, the inherent tensions within today's scene, and how republicans attempt to co‐opt other conflicts as a means to strengthen their claim as resistance fighters. The article also analyses more nuanced resistances within the rebel music scene, exploring how competing republican factions use the same music to express opposing political positions, and why some musicians ultimately leave the scene on account of the musical and political restrictions placed upon them. In so doing, the article connects with ongoing attempts to rethink, remap, and develop new approaches to resistance within anthropology, while contributing to the developing subfield of ‘ethnomusicology in times of trouble’.
Layers of union organising and representation: the case study of a strike in a Japanese‐funded auto plant in China
Authors: Chang Cheng , Cooke Fang Lee
Published: April 2018

Research on trade unions in China has commonly pointed to their inefficacy in organising and representing the workers as a formal institutional actor in industrial relations. Few empirical studies have examined the differing role of the unions at various levels during a strike through an in‐depth study of the strike process and its settlement. This study addresses this research gap through a case study of a strike that took place in 2010 in a Japanese‐funded auto plant in southern China. The paper extends existing knowledge of Chinese labour disputes/relations by highlighting the agency role of union actors at the grassroots level. We argue for a more nuanced view in understanding union officials’ and representatives’ respective roles and agency underpinned by their personal ideology, organisational resources and the broader political environment. These complexities and nuances shape the strike outcomes and the ensuing changes in the labour relations of each case company. This study makes a contribution towards the decent work agenda in China by demonstrating, through empirical evidence, what trade unions can do to help workers improve their employment terms and conditions at the workplace level.
Humerus photon starvation streak artefact
Authors: Al‐Ogaili Zeyad , Reed Anita J , Burrage John
Published: April 2018

Introduction

The reduced (attenuated) number of photons passing through the arm can result in a combination of fine and thick streak artefacts, particularly with the use of thin CT slices and lower radiation dose parameters. This phenomenon is known as photon starvation. We noted an abnormal appearance of the humerus when imaged with certain arm position. This appearance was thought to be artefact due to photon starvation.

Methods

A human radius bone was imaged in different positions and the kV and mA were varied in an attempt to reproduce the artefact, which would support the hypothesis that the artefact may be caused by bone attenuation.

Results

Scanning the bone in a different angle and radiation dose parameters reproduced the artefactual appearance of the bone.

Conclusion

Performing a chest CT scan with arms up can occasionally result in an abnormal appearance to the humerus due to photon starvation artefact. Familiarity with this artefact is essential to avoid misinterpretation.
The Strategizing of Policy Entrepreneurs towards the Global Alliance for Climate‐Smart Agriculture
Authors: Faling Marijn , Biesbroek Robbert , Karlsson‐Vinkhuyzen Sylvia
Published: April 2018

Global collaborations across level, domain, and sector boundaries are on the rise. This article analyses policy entrepreneurship for the establishment of the Global Alliance for Climate‐Smart Agriculture (GACSA), a global multi‐actor collaboration to address climate change and foster food security and development. We explore policy entrepreneurship as a process embedded within specific contexts. To that end we focus on the strategizing process, consisting of conditions, activities, and implications. Through a congruence case study based on interviews, documents, survey, and observation we find that: (1) accommodating a varied global community requires flexibility and adaptability from entrepreneurs towards a dynamic and changing environment; (2) the variety of actors constituting GACSA compromises vigour of the collaboration, and confuses the meaning of CSA; (3) whereas collective entrepreneurship is often depicted as joint operation of multiple actors, it might also be characterized by conflicting activities and/or successive involvement; (4) policy entrepreneurship is useful to establish collaborations, but its role is temporary. Entrepreneurs must therefore be sensitive to their potential obsoleteness and withdraw at the right moment. Our results show that policy entrepreneurship is a useful lens to study global policy processes, while providing guidelines to inspire and support practitioners to engage with global policy processes.
Rise of Complementarity between Global and Regional Financial Institutions: Perspectives from Asia
Authors: Rana Pradumna B. , Pacheco Pardo Ramon
Published: April 2018

Global economic governance is in flux. The institutions and norms set up by the US and other Western powers decades ago are being eroded. Regional organisations and emerging powers are challenging them. This is especially the case in East Asia and China. Or are they? In this article we argue that East Asian countries in general and China in particular are not challenging existing global institutions and norms. Instead, they are setting up and developing institutions that complement – rather than compete against – existing institutions. Even though there is a degree of ‘healthy’ competition between regional institutions and their global counterparts, the former are essentially complementary to the latter. Global institutions can offer knowledge and capacity building to regional institutions, which in turn can provide access to a larger pool of resources. To prove our argument, we analyse the cases of liquidity provision – in the form of the IMF and the Chiang Mai Initiative Multilateralisation – and development financing – with the World Bank on the one hand and the Asian Infrastructure Investment Bank and the New Development Bank on the other. Our findings suggest that the multi‐layering of international governance need not lead to competition between layers.
Gold at the end of the Rainbow? TheBRIand the Middle East
Authors: Ehteshami Anoushiravan
Published: April 2018

In 2013 China embarked on a new path of engagement with its Asian neighbours, a process which just three years later resulted in Asia's most daring and ambitious macro‐economic undertaking – an ‘initiative’ now known as China's Belt and Road Initiative (BRI). TheBRIhas the potential to transform Asia's political economy and the level of political, institutional and financial support from Beijing is underlining the importance of this major initiative to the world's fast‐emerging largest economy. The success of theBRIwill place China at the heart of the international system and help it build strong organic networks across Asia, and into Europe and East Africa. But it is in the outlying regions such as Central Asia and the Middle East that theBRI's metal will be tested, as indeed China's resilience as a major power. If China is able to overcome the geopolitical, cultural, institutional and socio‐economic barriers of these Asian regions then it will have made some headway towards creating Asia's first international community, arguably an ‘Asian international society’.
The United Nations and Civil Society in Times of Change: Four Propositions
Authors: Anheier Helmut K.
Published: April 2018

The United Nations and organized civil society in the form of international NGOs have yet to find an optimal mode of engagement that works for both sides. This has many reasons, but foremost it is caused by a formalized and politicized administrative process with, in the end, rather limited participation opportunities for NGOs. The current regime fails to live up to its potential – a deficit that is becoming more acute as both the UN and NGOs face legitimacy pressures and have to brave geopolitical and resource uncertainties. In response, the article proposes a more differentiated cooperation model based on functional roles and new organizational formats. Such an approach could enable a mutually beneficial relationship to emerge between the United Nations system and international civil society.
A Time for Hope? Pursuing a Vision of a Fair, Sustainable and Healthy World
Authors: Friel Sharon
Published: April 2018

The confluence of social and health inequities and global environmental degradation shines a light on fundamental ruptures in society. A systems view of humanity reminds us that this status quo is not static, and that the shifting political and economic sands provide an important window of opportunity to collectively change the system towards the public good, such that communities are able to live with good health, dignity and in an environmentally sustainable way. To enable this, global policy, and in particular global health policy must break out of the policy silos and refocus in a systems way. If the system is to adapt, an ambitious vision for the system is needed that is different to the status quo. No one regulatory model that can improve complex societal problems, rather we must use a plurality of approaches. Reorienting the system to achieve positive outcomes depends on reimagining the purpose of structural regulatory powers, and the releasing the agency of networks of concerned actors. In a hyper‐connected world there are many partners to help create systems of hope.
Combination TS‐1 plus EGFR‐tyrosine kinase inhibitors (TKIs) for the treatment of non‐small cell lung cancer after progression on first‐line or further EGFR‐TKIs: A phase II, single‐arm trial
Authors: Yang Lu , Yang Sheng , Liu Yutao , Li Junling , Hu Xingsheng , Wang Yalei , Zhang Yan , Wang Yan
Published: April 2018

Background

EGFR‐tyrosine kinase inhibitors (TKIs) combined with TS‐1 might overcome EGFR‐TKI resistance, which has been indicated by several preclinical studies. We investigated the synergistic efficacy and safety of the combination therapy of EGFR‐TKIs and TS‐1 in non‐small cell lung cancer (NSCLC) patients with acquired resistance to previous EGFR‐TKI therapy.

Methods

This was a phase II, single‐arm and single‐center prospective study. Stage IIIB–IV NSCLC patients with acquired resistance to prior EGFR‐TKI treatment were enrolled. All patients were administered combination therapy of TS‐1 and continuing EGFR‐TKIs in this study. The primary endpoints were progression‐free survival (PFS), while overall survival (OS), disease control rate (DCR), and safety were secondary endpoints.

Results

A total of 42 patients with acquired resistance to EGFR‐TKIs were eligible for this study. The median PFS for all patients was five months (95% confidence interval [CI] 3.6–5.4). The OS and DCR were 31.9 (95% CI 17.8–46.0) months and 69.0% (29/42), respectively. No grade 4 toxicity or grade 3 hematologic toxicity was observed in this study. One patient (2%) experienced grade 3 elevated total serum bilirubin.

Conclusion

The combination treatment of TS‐1 and EGFR‐TKIs was effective and well tolerated by patients who had experienced prior EGFR‐TKI treatment failure. Our results need to be validated by larger prospective clinical trials.
Enhanced longevity and metabolism by brown adipose tissue with disruption of the regulator of G protein signaling 14
Authors: Vatner Dorothy E. , Zhang Jie , Oydanich Marko , Guers John , Katsyuba Elena , Yan Lin , Sinclair David , Auwerx Johan , Vatner Stephen F.
Published: April 2018

Disruption of the regulator for G protein signaling 14 (RGS14) knockout (KO) in mice extends their lifespan and has multiple beneficial effects related to healthful aging, that is, protection from obesity, as reflected by reduced white adipose tissue, protection against cold exposure, and improved metabolism. The observed beneficial effects were mediated by improved mitochondrial function. But most importantly, the main mechanism responsible for the salutary properties of the RGS14 KO involved an increase in brown adipose tissue (BAT), which was confirmed by surgical BAT removal and transplantation to wild‐type (WT) mice, a surgical simulation of a molecular knockout. This technique reversed the phenotype of the RGS14 KO and WT, resulting in loss of the improved metabolism and protection against cold exposure in RGS14 KO and conferring this protection to the WT BAT recipients. Another mechanism mediating the salutary features in the RGS14 KO was increased SIRT3. This mechanism was confirmed in the RGS14 X SIRT3 double KO, which no longer demonstrated improved metabolism and protection against cold exposure. Loss of function of the Caenorhabditis elegans RGS‐14 homolog confirmed the evolutionary conservation of this mechanism. Thus, disruption of RGS14 is a model of healthful aging, as it not only enhances lifespan, but also protects against obesity and cold exposure and improves metabolism with a key mechanism of increased BAT, which, when removed, eliminates the features of healthful aging.
Costal Margin Tenderness and the Risk for Intraabdominal Injuries in Children With Blunt Abdominal Trauma
Authors: Flynn‐O'Brien Katherine T. , Kuppermann Nathan , Holmes James F.
Published: April 2018

Background

The risk of radiation exposure from computed tomography (CT) imaging in children is well recognized. Patient history and physical examination findings, including costal margin tenderness (CMT), influence a physician's decision to image a child with blunt torso trauma. The objective of this study was to determine the importance of CMT for identifying children with intraabdominal injuries (IAI) found on CT and IAI undergoing acute intervention.

Methods

We conducted an analysis of the Pediatric Emergency Care Applied Research Network (PECARN) IAI public use data set, representing a large prospective multicenter cohort study from May 2007 to January 2010. Isolated CMT was defined as CMT without other identified PECARN risk factors for IAI (i.e., abdominal or thoracic wall trauma, abdominal tenderness or pain, decreased breath sounds, or vomiting). Logistic regression was used to calculate adjusted odds of IAI in children presenting with isolated and nonisolated CMT. Risk differences were calculated to estimate the risk of IAI independently attributable to CMT in the setting of isolated PECARN risk factors. Finally, CT use among exposure groups was estimated to quantify potentially avoidable imaging.

Results

Among 9,174 children with Glasgow Coma Scale scores of 14 or 15 who sustained blunt torso trauma, 1,267 (13.8%) had CMT. Among those with CMT, 177 (14.0%) had isolated CMT and 1,090 (86.0%) had nonisolated CMT. No children (0/177; 0%, 95% confidence interval [CI] = 0.0%–2.1%) with isolated CMT had IAI, compared to 17.2% (187/1,090; 95% CI = 15.0%–19.5%) of those with nonisolated CMT. The risk differences were not statistically significant. 36/177 (20.3%; 95% CI = 14.7%–27.0%) children with isolated CMT underwent abdominal CT scans.

Conclusions

The risk of IAI associated with isolated CMT is minimal. For children with blunt abdominal trauma and isolated CMT, abdominal CT scan is of low yield.
Financial literacy amongst elderly Australians
Authors: Xue Rui , Gepp Adrian , O'Neill Terry J. , Stern Steven , Vanstone Bruce J.
Published: April 2018

Financial illiteracy is widespread amongst the elderly. Financially illiterate people are more likely to experience asset loss and outlive their savings after retirement. This paper measures financial literacy of elderly Australians using Item Responses Theory. Using a Lasso regression, we find that younger, married males with higher income and greater net wealth are more likely to be financially literate. Better financial literacy is also associated with good health, higher educational attainment, better occupation and outright home ownership. Our findings suggest policy‐makers take action and we make informed and practicable policy recommendations.
Behavioral adaptations of a large carnivore to human activity in an extremely arid landscape
Authors: Barocas A. , Hefner R. , Ucko M. , Merkle J. A. , Geffen E.
Published: April 2018

Driven by the availability of food subsidies and landscape transformation, large carnivore populations are increasingly inhabiting the vicinity of humans. To persist in human proximity, while avoiding conflict and mortality, they must make adjustments in their spatial behavior. Understanding such behavioral adaptations can be crucial to formulate conservation strategies. We used GPS location data to study the movement and space use of protected Arabian wolves in the extremely arid Negev Desert (Israel), where natural prey densities are reduced. We examined wolf preference for the proximity of human infrastructure, while testing the hypothesis that wolves would use areas where ungulates were more likely to occur. Wolves showed a strong spatial association with humans, spending a large proportion of their time in proximity of human infrastructure and moving primarily along roads. Wolves also increased their movement during the night. In addition, wolves that had higher availability of human infrastructure in their home ranges showed increased selection for such features, suggesting a positive functional response. Finally, wolves did not show preference for areas of high ungulate occurrence at either spatial scale. These findings, combined with recent diet analyses, indicate that wolves rely on human subsidies, proportioned by the availability of garbage and agricultural produce. Our results demonstrate that wolves fine‐tune their space use to persist in the vicinity of humans. Additional conditions that enable such persistence include effective legal protection and positive local attitudes toward wolves. We conclude that such circumstances can promote spatial coexistence of humans and large carnivores. The strong observed spatial association and evident dietary dependence of wolves on subsidies from a low‐density human population may also reflect the conditions that led to dog domestication.
Residents from non‐English‐speaking countries of birth in Australian aged care facilities
Authors: Low Lee‐Fay , LoGiudice Dina
Published: April 2018

Objective

To describe the activity of daily living and behavioural and complex care needs of residents born in non‐English‐speaking countries in Australian aged care facilities.

Methods

De‐identified cross‐sectional data were provided by the Australian Institute of Health and Welfare for all residents in government‐funded facilities on 30 June 2015. Analyses included t‐tests, chi‐squared tests and logistic regressions.

Results

A total of 33 168 (19%) residents were born in one of 188 non‐English‐speaking countries. Compared to residents born in English‐speaking countries, they were significantly younger, lived in larger facilities, were more likely to be male and live in an urban area. Their care requirements were greater for activities of daily living and behavioural and complex care. Residents from non‐English‐speaking countries living in ethno‐specific facilities had higher levels of these needs.

Conclusion

The needs of residents born in non‐English‐speaking countries should be considered when planning aged care services.
Measuring medical students’ attitudes and knowledge about geriatrics and gerontology in Brazilian medical students: A comparison of instruments
Authors: Lucchetti Alessandra LG , da S Ezequiel Oscarina , Moreira‐Almeida Alexander , Lucchetti Giancarlo
Published: April 2018

Objective

To compare instruments available for evaluating attitudes and knowledge about geriatrics and gerontology.

Methods

This cross‐sectional study investigated 83 third‐year Brazilian medical students (with exposure to geriatrics and gerontology) and 75 incoming students (with no exposure to this content). We used the University of California at Los Angeles Geriatrics Attitudes Scale, Palmore's Facts on Aging Quiz, modified Maxwell–Sullivan Attitude Survey, Aging Semantic Differential Scale and an instrument assessing their cognitive knowledge in geriatrics.

Results

The instruments investigated had moderate‐to‐high correlations when evaluating similar constructs, had satisfactory or borderline internal consistency for the most part (Cronbach's α: 0.62–0.94) and were capable of discriminating between students exposed or not to practical and theoretical content.

Conclusion

Our findings reinforce previous studies that these scales are capable of differentiating students who have or have not had exposure/intervention and, in general, seem to be assessing different constructs.
Population density estimates of forest duikers (Philantomba monticola & Cephalophus spp.) differ greatly between survey methods
Authors: Kamgaing Towa Olivier William , Bobo Kadiri Serge , Djekda Daniel , Azobou Keumbeng Blondel Vasco , Hamadjida Bobo Réné , Balangounde Moaga Yannick , Simo Kamdem Joel , Yasuoka Hirokazu
Published: April 2018

Estimating duiker populations is essential for conservation programmes in Central Africa, but what the most reliable survey method is remains unclear. We estimated forest duiker population densities in Southeast Cameroon using three line‐transect methods: dung counts and diurnal direct observation over 338.2 km, and nocturnal direct observation over 334.7 km. Nocturnal observations resulted in 59.8 and 9.0 individuals km−2 for the blue duiker (Philantomba monticola) and red duikers (Cephalophus callipygus, C. dorsalis, C. leucogaster and C. nigrifrons), respectively, which were much higher than estimates by dung counts and diurnal observation. Only dung counting was applicable for the yellow‐backed duiker (0.8 individuals km−2), due to low encounter rates obtained by the other methods. We argue that nocturnal observation is the most accurate method because the torchlight can pick out duikers' eyes even if the animals are shy and hiding and because multiple counts are unlikely. By contrast, the other methods probably underestimate densities due to poor visibility and reliance on dung production and decay rates calculated in different areas. These results can affect figures used in wildlife management decisions, such as the maximum sustainable yield of game animals, which generally have been based on densities estimated using a single survey method.
Birch pollen‐related foods can cause late eczematous reactions in patients with atopic dermatitis
Authors: Wassmann‐Otto A. , Heratizadeh A. , Wichmann K. , Werfel T.
Published: April 2018

Background

Previous studies have indicated that in patients with atopic dermatitis (AD) and birch pollen allergy pollen‐related foods are able to cause late eczematous response. However, the relevance of AD worsening by ingestion of birch pollen‐related foods is still a matter of debate.

Objective

The purpose of this retrospective study was to determine how frequently birch pollen‐related foods induce a deterioration of eczema. Additionally, the diagnostic value of specific IgE (sIgE) determination was evaluated.

Methods

A total of 182 children and adults with AD and suspected birch pollen‐related food allergy underwent 261 double‐blind placebo‐controlled food challenges (DBPCFC). Total and sIgE levels were determined prior to DBPCFC.

Results

Sixty‐five patients developed allergic reactions (responders) upon DBPCFC with birch pollen‐related foods (n = 103 DBPCFC). Of these, 32 patients exhibited significant deterioration of AD defined as a median increase of 15.4 severity scoring of atopic dermatitis index points (95% CI 12.4‐16.3) from baseline making up 37% of all positive reactions. Responders showed significantly higher sIgE levels to birch pollen and apple as well as a higher prevalence of allergic rhinoconjunctivitis compared to nonresponders (P < .05). However, patients with late eczematous response could not be differentiated from those with isolated immediate‐type reactions by sIgE levels.

Conclusion

In a subpopulation of patients with AD and birch pollen sensitization, related foods should be considered as a trigger for an aggravation of eczema. As sufficient markers for prediction of late eczematous reactions are still lacking, DBPCFC cannot be replaced in diagnosis of birch pollen‐related foods in patients with AD.

Clinical implications

In patients with AD and birch pollen allergy, birch pollen‐related foods should be considered as a provocation factor for an aggravation of disease signs and symptoms.
An immunologically relevant rodent model demonstrates safety of therapy using a tumour‐specific IgE
Authors: Josephs D. H. , Nakamura M. , Bax H. J. , Dodev T. S. , Muirhead G. , Saul L. , Karagiannis P. , Ilieva K. M. , Crescioli S. , Gazinska P. , Woodman N. , Lombardelli C. , Kareemaghay S. , Selkirk C. , Lentfer H. , Barton C. , Canevari S. , Figini M. , Downes N. , Dombrowicz D. , Corrigan C. J. , Nestle F. O. , Jones P. S. , Gould H. J. , Blower P. J. , Tsoka S. , Spicer J. F. , Karagiannis S. N.
Published: April 2018

Background

Designing biologically informative models for assessing the safety of novel agents, especially for cancer immunotherapy, carries substantial challenges. The choice of an in vivo system for studies on IgE antibodies represents a major impediment to their clinical translation, especially with respect to class‐specific immunological functions and safety. Fcε receptor expression and structure are different in humans and mice, so that the murine system is not informative when studying human IgE biology. By contrast, FcεRI expression and cellular distribution in rats mirror that of humans.

Methods

We are developing MOv18 IgE, a human chimeric antibody recognizing the tumour‐associated antigen folate receptor alpha. We created an immunologically congruent surrogate rat model likely to recapitulate human IgE‐FcεR interactions and engineered a surrogate rat IgE equivalent to MOv18. Employing this model, we examined in vivo safety and efficacy of antitumour IgE antibodies.

Results

In immunocompetent rats, rodent IgE restricted growth of syngeneic tumours in the absence of clinical, histopathological or metabolic signs associated with obvious toxicity. No physiological or immunological evidence of a “cytokine storm” or allergic response was seen, even at 50 mg/kg weekly doses. IgE treatment was associated with elevated serum concentrations of TNFα, a mediator previously linked with IgE‐mediated antitumour and antiparasitic functions, alongside evidence of substantially elevated tumoural immune cell infiltration and immunological pathway activation in tumour‐bearing lungs.

Conclusion

Our findings indicate safety of MOv18 IgE, in conjunction with efficacy and immune activation, supporting the translation of this therapeutic approach to the clinical arena.
Neuromuscular blocking agents induced anaphylaxis: Results and trends of a French pharmacovigilance survey from 2000 to 2012
Authors: Petitpain N. , Argoullon L. , Masmoudi K. , Fedrizzi S. , Cottin J. , Latarche C. , Mertes P. M. , Gillet P. ,   The French Network of Regional Pharmacovigilance Centres
Published: April 2018

Background

Perioperative anaphylaxis mainly involves neuromuscular blocking agents (NMBAs) with an IgE‐mediated mechanism. In France, this life‐threatening condition is reported by anesthetists and allergologists, and two safety alerts concerning suxamethonium were raised in 2011 and 2012. This led to start a national survey over the 2000‐2012 period which objectives were to provide a descriptive analysis, to estimate incidence rates, and to analyze the trends over this period.

Methods

The French pharmacovigilance database was retrospectively queried for all the available NMBAs. Anaphylaxis cases with elevated tryptase and positive skin tests were qualified as “confirmed cases.” Subgroup analysis compared atracurium and cisatracurium vs suxamethonium and rocuronium.

Results

A total of 680 confirmed cases and 944 nonconfirmed cases were identified. Suxamethonium was the most implied NMBA (64%). Incidence rates (according to sales data) of suxamethonium and rocuronium were, respectively, 10‐ and 13‐folds higher than those of the others NMBAs, regardless the confirmed/nonconfirmed status. Cisatracurium incidence rates remained stable over the period, while suxamethonium and atracurium increased and rocuronium first decreased but re‐increased after 2006. Male patients were more frequent in the subgroup “atracurium‐cisatracurium” (P = .019), whereas obesity and emergency setting were more frequent in the subgroup “rocuronium‐suxamethonium.” Shared characteristics were the poorly documented previous exposure to NMBA(s) and an insufficient adherence of patients to perform skin tests, showing the need to improve this procedure.

Conclusion

Suxamethonium and rocuronium are markedly more involved in perioperative anaphylaxis than the other available NMBAs. Patients should be more informed about their perioperative anaphylaxis and its consequences.
Virgin coconut oil extract mitigates testicular‐induced toxicity of alcohol use in antiretroviral therapy
Authors: Ogedengbe O. O. , Naidu E. C. S. , Akang E. N. , Offor U. , Onanuga I. O. , Peter A. I. , Jegede A. I. , Azu O. O.
Published: April 2018

The consumption of alcohol by people living with HIV/AIDS is associated with a graver prognosis. Long‐term use of antiretrovirals may have certain health challenges that may be aggravated by concomitant alcohol use. This study investigated virgin coconut oil (VCO) as an adjuvant to the deleterious effects of highly active antiretroviral therapy (HAART) and alcohol on the cyto‐architecture and functioning of the testis. Forty adult male Sprague‐Dawley rats, weighing 165~176 g, were divided into eight groups and treated according to protocol. Testicular histology, stereological parameters, seminal fluid, testosterone, luteinizing hormone, follicle‐stimulating hormone, the antioxidants marker malondialdehyde (MDA), and antioxidant glutathione (GSH) were examined. The use of ethanol alone and ethanol + HAART showed extensive degeneration in the seminiferous epithelium, decreased semen quality, disorganized basement membrane and widened, hypocellular interstitium. GSH was significantly decreased in the ethanol alone treated group with no significant effect on testosterone, LH, and MDA levels. Adjuvant treatment with VCO at low dose (2.5 mL/kg/bw) improved sperm motility with a partial restoration of the histopathological alterations. High doses of VCO (5.0 mL/kg/bw) showed greater improvement with respect to sperm counts, increased FSH hormonal and GSH antioxidant levels, and a well‐preserved testicular cyto‐architecture.
Incidence and associations of painful neuroma in a contemporary cohort of lower‐limb amputees
Authors: Penna Anthony , Konstantatos Alex H. , Cranwell William , Paul Eldho , Bruscino‐Raiola Francesco‐Raffaele
Published: April 2018

Background

The painful post amputation neuroma significantly impairs the prosthesis‐wearing lower‐limb amputee. It remains poorly understood, with literature limited to cohorts of traumatic amputees. This paper reports the incidence and associations of painful neuroma in a modern tertiary centre with a case load of amputations performed for both traumatic and non‐traumatic indications.

Method

This retrospective cohort study analysed the records of 304 patients who underwent all‐cause lower‐limb amputation at The Alfred Hospital between January 2002 and March 2012. Patients were included in our analysis if they completed 1‐year follow‐up at our Amputee Rehabilitation Clinic, producing a final cohort of 96 patients. In order to identify a painful neuroma post‐operatively, both clinical suspicion, and either histopathological or radiological evidence were required.

Results

The overall incidence of symptomatic neuromas was 4.17%. There was no significant difference between patients who underwent amputation for a traumatic indication (6.25% (2/32) versus 3.13% (2/64); P = 0.59) compared to non‐traumatic indication (P = 0.59). Visual analogue score at discharge and the presence of phantom limb pain at follow‐up showed significant associations with the formation of painful neuroma. Dose of opioid on discharge, history of depression and current smoking did not reach statistical significance.

Conclusion

This study presents a lower incidence of painful post‐amputation neuroma to those published in the literature. This may be attributed to improved methodology. The described associations require further investigation into central factors leading to neuroma sensitization.