bluuebunny/crossref_metadata_2025 huggingface dataset:
Does evolutionary history determine specificity in broad ecological interactions?
Authors: Shefferson Richard P. , Bunch William , Cowden Charles C. , Lee Yung‐I , Kartzinel Tyler R. , Yukawa Tomohisa , Downing Jason , Jiang Hong
Published: March 2019

Most species engage in broad interactions, in which they interact with multiple partner species. The evolutionary processes that generate such generalized interactions remain unknown, partly due to the difficulty in comparing their breadth.

We argue that the interaction specificity of species involved in broad interactions evolves in three ways: (a)assemblage specialization, in which a species specializes on particular host species that contribute unique resources, yielding specialization on the entire host assemblage; (b)apparent generalism, in which a species specializes on one or few host species that contribute unique resources, but also associates with other host species that contribute functionally redundant resources; and (c)true generalism, in which a species associates with multiple hosts that overlap functionally, and that are geographically interchangeable based on opportunity for encounter, leading to frequent host switching.

We performed a phylogenetically controlled analysis of data on mycorrhizal fungal associations for approximately 25% of the orchid subfamily Cypripedioideae to determine whether these plants have specialized on their mycorrhizal fungal communities, or whether they are true generalists. We also assessed the impact of environmental factors on these associations.

Our results suggested strong support for apparent generalism, suggesting strong specialization on particular, dominant fungi and weak specialization on others. Large orchid clades associated with dominant fungal species, notablyTulasnella cystidiophorafor genusCypripedium, andT. cystidiophoraandT. calosporafor genusPaphiopedilum. Significant phylogenetic signal in fungal species richness per plant species, but not in the fungal phylogenetic diversity per plant species nor in the composition of fungal assemblages across orchid species suggested that plant phylogeny is an important determinant of fungal association. Mixed linear models showed that environment influenced specificity across plant species, and that observed differences were strongly driven by differences in sampling effort.

Synthesis.We found evidence of specialization of plant species on dominant fungal species, and to a lesser extent on their close relatives. The strong dominance of particular fungal species in these associations suggests important ecological roles for them, while environmental gradients in specificity suggest strong environmental filtering of these interactions.
Syntrophus aciditrophicus uses the same enzymes in a reversible manner to degrade and synthesize aromatic and alicyclic acids
Authors: James Kimberly L. , Kung Johannes W. , Crable Bryan R. , Mouttaki Housna , Sieber Jessica R. , Nguyen Hong H. , Yang Yanan , Xie Yongming , Erde Jonathan , Wofford Neil Q. , Karr Elizabeth A. , Loo Joseph A. , Ogorzalek Loo Rachel R. , Gunsalus Robert P. , McInerney Michael J.
Published: March 2019

Syntrophy is essential for the efficient conversion of organic carbon to methane in natural and constructed environments, but little is known about the enzymes involved in syntrophic carbon and electron flow. Syntrophus aciditrophicus strain SB syntrophically degrades benzoate and cyclohexane‐1‐carboxylate and catalyses the novel synthesis of benzoate and cyclohexane‐1‐carboxylate from crotonate. We used proteomic, biochemical and metabolomic approaches to determine what enzymes are used for fatty, aromatic and alicyclic acid degradation versus for benzoate and cyclohexane‐1‐carboxylate synthesis. Enzymes involved in the metabolism of cyclohex‐1,5‐diene carboxyl‐CoA to acetyl‐CoA were in high abundance in S. aciditrophicus cells grown in pure culture on crotonate and in coculture with Methanospirillum hungatei on crotonate, benzoate or cyclohexane‐1‐carboxylate. Incorporation of 13C‐atoms from 1‐[13C]‐acetate into crotonate, benzoate and cyclohexane‐1‐carboxylate during growth on these different substrates showed that the pathways are reversible. A protein conduit for syntrophic reverse electron transfer from acyl‐CoA intermediates to formate was detected. Ligases and membrane‐bound pyrophosphatases make pyrophosphate needed for the synthesis of ATP by an acetyl‐CoA synthetase. Syntrophus aciditrophicus, thus, uses a core set of enzymes that operates close to thermodynamic equilibrium to conserve energy in a novel and highly efficient manner.
A feed‐forward signalling circuit controls bacterial virulence through linking cyclic di‐GMP and two mechanistically distinct sRNAs, ArcZ and RsmB
Authors: Yuan Xiaochen , Zeng Quan , Khokhani Devanshi , Tian Fang , Severin Geoffrey B. , Waters Christopher M. , Xu Jingsheng , Zhou Xiang , Sundin George W. , Ibekwe Abasiofiok M. , Liu Fengquan , Yang Ching‐Hong
Published: March 2019

Dickeya dadantii is a plant pathogen that causes soft rot disease on vegetable and potato crops. To successfully cause infection, this pathogen needs to coordinately modulate the expression of genes encoding several virulence determinants, including plant cell wall degrading enzymes (PCWDEs), type III secretion system (T3SS) and flagellar motility. Here, we uncover a novel feed‐forward signalling circuit for controlling virulence. Global RNA chaperone Hfq interacts with an Hfq‐dependent sRNA ArcZ and represses the translation of pecT, encoding a LysR‐type transcriptional regulator. We demonstrate that the ability of ArcZ to be processed to a 50 nt 3′‐ end fragment is essential for its regulation of pecT. PecT down‐regulates PCWDE and the T3SS by repressing the expression of a global post‐transcriptional regulator‐ (RsmA‐) associated sRNA encoding gene rsmB. In addition, we show that the protein levels of two cyclic di‐GMP (c‐di‐GMP) diguanylate cyclases (DGCs), GcpA and GcpL, are repressed by Hfq. Further studies show that both DGCs are essential for the Hfq‐mediated post‐transcriptional regulation on RsmB. Overall, our report provides new insights into the interplays between ubiquitous signalling transduction systems that were most studied independently and sheds light on multitiered regulatory mechanisms for a precise disease regulation in bacteria.
Interrogating the tribal: the aporia of ‘tribalism’ in the sociological study of the Middle East
Authors: Mohammadpour Ahmad , Soleimani Kamal
Published: March 2019

In this paper, we intend to deconstruct the term ‘tribalism’ as a colonial category, which figures as a prominent concept in social studies on Kurds as well as the Middle East at large. Blithely used, tribalism has occupied a central place, especially in the existing scholarship on Kurdistan. Some earlier anthropological works have gone so far as to regard tribalism as the ‘DNA’ of Middle Eastern people. Drawing on recent studies on Latin America, Africa and Central Asia, we argue that the use of tribalism as if it is the natural constitution of Kurdish society has caused a significant misrepresentation and oversimplification of socio‐political life in Kurdistan as well as the broader Middle East. In a way, the existing body of scholarship on this region has reproduced statist‐nationalist discourses at the expense of dominated communities (e.g., Kurds). The historical context of both colonial powers and nation‐states ‘combating tribes and tribalism’ coincided with the emergence of the discourse of racial biopolitics. Thus, the use of the term tribalism to define certain nations or ethnic groups should not be viewed as merely an application of socio‐anthropological categories. Hence, we argue that the ethical aspects and implications of the use of tribalism by both colonial powers and later by nation‐states to define certain ethnic groups must not be overlooked.
Postacute care outcomes and medicare payments for patients treated by physicians and advanced practitioners who specialize in nursing home practice
Authors: Ryskina Kira L. , Yuan Yihao , Werner Rachel M.
Published: March 2019

Objective

To measure the association between clinician specialization in nursing home (NH) practice and outcomes of patients who received postacute care in skilled nursing facilities (SNFs).

Data Sources

Medicare claims and NH assessments for 2 118 941 hospital discharges to 14 526 SNFs in January 2012‐October 2014 and MD‐PPAS data for 52 379 clinicians.

Study Design

Generalist physicians and advanced practitioners with ≥ 90 percent of claims for NH‐based care were considered NH specialists. The primary clinician during each SNF stay was determined based on plurality of claims during that stay. We estimated the effect of being treated by a NH specialist on 30‐day rehospitalizations, successful discharge to community, and 60‐day episode‐of‐care Medicare payments (Parts A and B). All models included patient demographics, clinical variables, and SNF fixed effects.

Principal Findings

Nursing home specialists' patients were less likely to be rehospitalized (14.71 percent vs 16.23 percent; adjusted difference, −1.51 percent, 95% CI −1.78 to −1.24), more likely to be successfully discharged to community (56.33 percent vs 55.49 percent; adjusted difference, 0.84 percent, 95% CI 0.54 to 1.14), but had higher 60‐day Medicare payments ($31 628 vs $31 292; adjusted difference, $335; 95% CI $242 to $429).

Conclusions

Clinicians who specialize in NH practice may achieve better postacute care outcomes at slightly higher costs.
Discordance of Gross and Histologic Findings in Estimating the Range of Fire of Gunshot Wounds
Authors: Hlavaty Leigh , Roquero Leonardo , Amley Jeffery , Root Kelly , Ishikawa Martin , Koopmeiners Andrew , Zhao Lili , Sung LokMan
Published: March 2019

Forensic pathologist use soot and/or stippling surrounding entrance gunshot wounds in categorizing range of fire. If absent, some pathologists suggest utilizing histology when the range is diagnostically critical. This study investigates the concordance of macroscopic and microscopic findings in estimating range of fire by evaluating gunshot entrance and exit wounds made through human tissue analogs at defined distances using two handgun calibers. Examination of over 150 entrance wounds verified the ease of visually detecting soot from a muzzle distance of contact to 1 foot (30.5 cm), and its absence at 9 feet (274.3 cm). Distinctly apparent was bullet wipe surrounding the entrance wounds regardless of muzzle distance. Although variations existed, dark material was histologically identified in many skin, soft tissue, and bone sections at all ranges with both calibers. These nonparallel results decrease the dependability of histology for range of fire estimation and reinforce using gross observation.
Retrospective descriptive observational study of patients who presented to an Australian hospital emergency department with neck soft tissue injury
Authors: Nikles Jane , Khan Subaat , Leou John , Keijzers Gerben , Ng Joanna , Bond Catherine , Nakamura Gota , Le Rhonda , Sterling Michele
Published: March 2019

Objective

To describe clinical presentation and management of neck soft tissue injury in an Australian ED.

Methods

This is a retrospective cohort study conducted in a tertiary hospital ED in Queensland, Australia. This study included all patients aged 18–65 years presenting with neck sprain/strain in 2016. Main outcome measures are patient demographics, comorbidities, presentation, acute management and follow up.

Results

Of 339 patients, 176 (52%) had cervical computed tomography (CT) scans and 3% plain radiographs. Two had fractures (CT yield of 2/176; 1.1%) and three were admitted with neurological symptoms, leaving 334 patients. Of 264 patients receiving medications in the ED, simple analgesia + oral opioid (146, 55.3%) was most frequently used, followed by simple analgesia (89, 33.7%) and opioid + benzodiazepine +/− simple analgesia (16, 6%). Opioids were prescribed for 169 (64%) (including i.v. opioids for 34 [12.9%] and for 85/97 (88%) with pain scores ≤4), and benzodiazepines for 22 (8.3%). Ten (3%) were referred for physiotherapy management in ED and eight (2.4%) for outpatient physiotherapy follow up. Of 113/334 (33.8%) receiving discharge prescription, 60 (53.1%) were prescribed oral opioid + simple analgesia, 37 (32.7%) oral opioids and seven (6.2%) opioids + benzodiazepines; 205 (61%) were discharged without a recorded follow‐up plan.

Conclusions

There is large practice variation in management of neck soft tissue injury in ED. Over half of the patients received CT scans with modest yield. Opioids were commonly used both in ED and on discharge. There is need for a standard management plan to be developed for patients presenting with acute neck soft tissue injury.
Effects of supervisor gender on promotability of female managers
Authors: Kim Hyondong , Kang Tong Hyouk
Published: March 2019

In order to more fully understand the importance of same‐gender competition in female supervisor–subordinate working relationships, this study examined the effects of supervisor gender on promotion probabilities for Korean female managers with or without managerial qualifications (e.g. mentoring participation and job ranks). Using a balanced panel sample of 568 Korean female managers in each of four waves (in total, 2272 female managers over 7 years), we conducted a multinomial logistic regression analysis to estimate the promotability of female managers. Our findings showed that mentoring participation negatively affects promotion probability for female managers when they have female supervisors (vs male supervisors). Competitive interdependence can be exacerbated between female managers and female supervisors, especially when they are qualified to compete for the same resources and opportunities, which are limited for female managers and supervisors.
Oral Candida Colonization as a Risk Factor for Chronic Inflammation and Atherosclerosis in Hemodialysis Patients
Authors: Yeter Hasan H , Erten Yasemin , Sevmez Hatice , Korucu Berfu , Kalkanci Ayse , Elbeg Sehri , Altok Kadriye , Bali Musa , Yilmaz Handan
Published: March 2019

The purpose of this study was to determine the prevalence of oral Candida spp. in HD patients and to investigate its relation with systemic inflammation and atherosclerosis. Microbiological samples were taken from buccal mucosa, palate, and dental prosthesis with a cotton swab. High‐sensitivity CRP (hsCRP) and IL‐6 were measured as inflammation markers. A total of 69 patients (58% male and median age 62 years) were enrolled in this study; 53.6% of total patients had oral Candida colonization. HsCRP and IL‐6 levels were found to be significantly higher in the oral Candida colonization positive group than in the Candida colonization negative group (P = 0.002 and P = 0.01, respectively). HDL levels were significantly lower in the Candida colonization positive group (P = 0.03). Peripheral artery disease (P = 0.05) and oral Candida colonization (P = 0.002) were significantly associated with inflammation. In addition to conventional risk factors such as age (P = 0.03), diabetes (P = 0.001), and peripheral artery disease (P = 0.002), oral Candida colonization is associated with coronary artery disease (P = 0.04). Oral Candida colonization might be associated with chronic inflammation and development of atherosclerosis in HD patients.
Co‐occupancy of spider‐engineered burrows within a grassland community changes temporally
Authors: Clayton Jessica , Gardner Michael G. , Fenner Aaron L. , Bull Michael
Published: March 2019

Burrow‐digging organisms act as ecosystem engineers, providing potential habitat to other organisms. In the Mid North region of South Australia, wolf and trapdoor spiders in fragmented grassland communities provide this service. Pygmy bluetongue lizards are an endangered skink, endemic to these grasslands. The lizards obligatorily use burrows dug by these spider groups as refuges, basking sites and ambush points. We investigated the occupancy of these spider burrows by lizards and other organisms within the grassland community, identifying the occasions that burrows were shared by multiple taxa. We found that the lizards and trapdoor spiders are predominantly solitary, while wolf spiders co‐shared burrows more frequently with either weevils or snails. There were numerous taxa that were found to regularly co‐share with other taxa, particularly snails, centipedes and weevils. There was a strong temporal influence on burrow sharing, with most co‐sharing occurring late in summer. This study provides an insight into the use of burrows by the lizards and co‐existing taxa within these grassland communities. The dynamics of burrow‐use by other taxa have the potential to influence long‐term conservation of these lizards as burrow availability is crucial to their survival in these grasslands.
Increased nutrient availability decreases insect resistance in cranberry
Authors: de Lange Elvira S. , Kyryczenko‐Roth Vera , Johnson‐Cicalese Jennifer , Davenport Joan , Vorsa Nicholi , Rodriguez‐Saona Cesar
Published: March 2019

Herbivorous insects are considered to be a major problem in cranberry (Vaccinium macrocarpon Ait.) production. Spraying chemical pesticides is common practice, although beneficial insects could also be affected.

We aimed to strengthen the resistance mechanisms that cranberry plants themselves use to combat insect pests by manipulating available nutrient levels. We hypothesized that cranberry genotypes respond differently from nutrient availability with regard to growth and defence against multiple herbivores.

In the present study, six cranberry varieties (i.e. genotypes) were subjected to four different fertilizer rates. In a greenhouse setting, we assessed soil and leaf nitrogen concentrations; weight gain of the native pests spotted fireworm (Choristoneura parallela Robinson), sparganothis fruitworm (Sparganothis sulfureana Clemens) and the invasive pest gypsy moth (Lymantria dispar L.); levels of leaf proanthocyanidins (PACs); and plant growth.

The results obtained showed that cranberry varieties differ in their insect resistance qualities, although this depended on the insect species identity; genotypic variation was observed in resistance against the invasive pest L. dispar but not against the two native insect pests. Overall, increased nutrient availability decreased plant resistance to the three herbivores (i.e. increased larval weight gain and reduced PAC levels), regardless of the cranberry genotype. Nutrient availability correlated negatively with PAC levels and positively with herbivore weight gain and plant growth, indicating a potential trade‐off between growth and defence.

Fertilization management to strengthen insect resistance in cranberry may contribute to the development of more sustainable pest management practices, especially for organic production.
Association of rs10490924 in ARMS2/HTRA1 with age‐related macular degeneration in the Pakistani population
Authors: Ayub Humaira , Shafique Sobia , Azam Aisha , Muslim Irfan , Qazi Nauman A , Akhtar Farah , Khan Muhammad Asim , Ayub Adil , Bashir Shaheena , Bakker Bjorn , Ahmed Shakil , Azam Maleeha , den Hollander Anneke I. , Qamar Raheel
Published: March 2019

Age‐related macular degeneration (AMD) is a disease of the elderly in which central vision is lost because of degenerative changes of the macula. The current study investigated the association of single‐nucleotide polymorphisms (SNPs) with AMD in the Pakistani population. Four SNPs were analyzed in this study: rs1061170 in the CFH, rs429608 near CFB, rs2230199 in the C3, and rs10490924 in ARMS2/HTRA1. This case‐control association study was conducted on 300 AMD patients (125 wet AMD and 175 dry AMD) and 200 unaffected age‐ and gender‐matched control individuals. The association of the SNP genotypes and allele frequency distributions were compared between patients and healthy controls, keeping age, gender, and smoking status as covariates. A significant genotype and variant allele association was found of rs10490924 in ARMS2/HTRA1 with wet AMD, while the SNPs in CFH, CFB, and C3 were not associated with AMD in the current Pakistani cohort. The lack of association of CFH, CFB, and C3 may be attributed to limited sample size. This study demonstrates that genetic causative factors of AMD differ among populations and supports the need for genetic association studies among cohorts from various populations to increase our global understanding of the disease pathogenesis.
The Political Economy of Confucian Harmony: A Xunzian Vision
Authors: Kim Sungmoon
Published: March 2019

A global market economy of pure instrumental rationality now poses a growing threat, jeopardizing common citizenship, the capacity for human flourishing, and harmony between humans and nature. Growing skepticism about the sustainability of market capitalism and its moral legitimacy propels us to search for a new economic model in which humans are no longer held hostage to the unbridled pursuit of self‐interest and limitless possession at the expense of the well‐being of others and nature and that attempts to overcome the old conflict between capitalism and socialism. We can call this alternative model “moral economy,” an economic system that reconciles private interests with the public good broadly construed. In this article I reconstruct the Confucian ideal of moral economy by paying close attention to Xunzi's ethical and political thought. Xunzi, one of the key classical Confucians, stipulates the threshold of sufficiency by extending the ruler's care to the most destitute of society as well as giving moral priority to their basic needs without dismissing the foundational importance of individual merit and contribution. Rejecting both pure economic meritocracy and dogmatic egalitarianism, Xunzian Confucianism aims to create a political economy of harmony where various distributive values (need, equality, and merit, among other things) each have their own place.
Economic Religion and the Worship of Progress
Authors: Nelson Robert H.
Published: March 2019

In contemporary thought, the terms “secular” and “religious” are polar opposites. They are held to occupy separate domains. But that view is mistaken. Religious belief organizes society around fundamental ideas about ethics and existence. This article examines the way economic belief systems function as religions. Economic thought in various forms (Marxist, Keynesian, neoclassical) is brimming with implicit religious meaning. Instead of belief in an afterlife and heaven, modern economics promises heaven on earth in the form of continuous material progress. Adherents of competing economic ideologies often promote them with the energy of religious zealots. Thus, modern societies are still organized around religious principles, but they are now hidden from sight. This article shows how the religious dimension of the modern worship of economic progress is rooted in Christian theology: Calvinism in the United States and Lutheranism in the Nordic countries, which are famous for their own brand of social democracy. In recent decades, secular faith in the religion of economic progress has begun to falter. The failures of mainstream economics to warn of impending crisis has reduced its credibility, even among economists. More importantly, the rise of environmentalism as a religion has vastly increased the number of citizens who question the goal of material progress. The attack on economic religion may have also undermined the credibility of mainstream political parties, partially explaining Brexit in England and the election of Donald Trump in the United States.
Islam’s Gift: An Economy of Spiritual Development
Authors: Zaman Asad
Published: March 2019

According to the standard narrative, economics is an objective and scientific study of universal laws applicable to economic affairs of modern societies. After a brief introduction, the second section of the article presents a counter‐narrative that disputes this claim, and provides an alternative point of view that situates modern economics within its European historical, political, and social context. We briefly discuss why the conventional methodology of modern economics makes false claims to objectivity and universality. The third section provides an alternative methodology that is based on the recognition that human behavior is inherently and unavoidably normative, and any study of human beings and societies must take this into account. The fourth section of the article brings out the norms concealed within the foundations of modern economics, since the avowed methodology does not permit explicit and open expression of these norms. The fifth section describes Islamic views that describe the normative ideals for our personal and social lives. In particular, Islam aims at the development of the potential for excellence that every human being is born with. It does not aim at accumulation of wealth and material possessions. Nor does it aim at achievement of happiness through the maximization of pleasure achieved by consumption. The sixth section describes the transformational strategies required for spiritual progress in different dimensions of our human existence. The seventh section describes some of the institutional structures required in the economic realm to assist in the achievement of the transformation towards the normative ideals. The final section explains how we should use our unique and precious lives to aim for higher goals than mere consumption of goods and acquisition of wealth.
Catholicism and Economics: Towards a “Deeper Reflection on the Nature of the Economy and its Purposes”
Authors: Clark Charles M.A.
Published: March 2019

Many of the problems neoclassical economic theory has in explaining the real world stem from its narrow view of human nature—the “rational economic man” model, which forces economists to exclude social and historical context. Every social theory starts with a view of human nature that necessarily comes from outside the social sciences. Philosophy and theology are the sources of our ideas about the nature of humans, society, and the good that humans pursue. Catholic Social Thought has a rich understanding of human nature, which includes both the uniqueness of persons and their inherently social nature. Starting from this foundation, economists can develop a deeper understanding of the nature of the economy. Catholic Social Thought does not offer a different economic theory or model, but it does provide an alternative vision upon which more adequate and realistic economic theories can be constructed.
P‐wave vector magnitude predicts recurrence of atrial fibrillation after catheter ablation in patients with persistent atrial fibrillation
Authors: Nakatani Yosuke , Sakamoto Tamotsu , Yamaguchi Yoshiaki , Tsujino Yasushi , Kataoka Naoya , Kinugawa Koichiro
Published: March 2019

Background

The predictive efficacies of parameters related to P‐wave amplitude (PWA) for atrial fibrillation (AF) recurrence after catheter ablation are unclear.

Methods

We measured multiple PWA parameters using an automated system in 126 consecutive patients with persistent and long‐standing persistent AF who underwent catheter ablation. The relationships between AF recurrence and various PWA parameters were examined, including the association with P‐wave vector magnitude (calculated as the square root of the sum of lead II PWA squared, lead V6 PWA squared, and a one‐half lead V2 PWA squared).

Results

Atrial fibrillation did not recur in 87 patients (69%) during 32 ± 15 months of follow‐up. The maximum PWA, mean PWA, and P‐wave vector magnitude were lower in patients with AF recurrence than those without (maximum PWA, 0.14 ± 0.05 mV vs. 0.16 ± 0.05 mV, p = 0.017; mean PWA, 0.05 ± 0.02 mV vs. 0.06 ± 0.02 mV, p = 0.003; P‐wave vector magnitude, 0.09 ± 0.03 mV vs. 0.13 ± 0.04 mV, p < 0.001). A multivariate Cox regression analysis revealed that the predictive ability of P‐wave vector magnitude for AF recurrence was independent of other clinical properties (hazard ratio: 0.153, 95% confidence interval: 0.046–0.507, p = 0.002). Atrial fibrillation freedom rates of patients with P‐wave vector magnitude higher and lower than 0.13 mV were 93% and 57%, respectively. P‐wave vector magnitude weakly correlated with left atrial dimension (R = −0.280, p = 0.004).

Conclusions

P‐wave vector magnitude can predict AF recurrence after catheter ablation in patients with persistent AF.
Prognostic impact of the combination of the neutrophil‐to‐lymphocyte ratio and serum carbohydrate antigen 19‐9 in patients with pancreas head cancer
Authors: Kim Wan‐Joon , Lim Tae‐Wan , Park Pyoung‐Jae , Choi Sae‐Byeol , Kim Wan‐Bae
Published: March 2019

Background

This study aimed to evaluate the clinical value of the combination of a traditional prognostic factor with a systemic inflammation‐based prognostic factor in patients undergoing curative resection for pancreas head cancer diagnosed as pancreatic ductal adenocarcinoma.

Methods

From January 2005 to December 2015, 198 patients were enrolled. Various clinicopathological factors potentially associated with survival and recurrence were evaluated in this study.

Results

The selected cut‐off values for the test prognostic factors with sufficient sensitivity and specificity were 2.8 for the neutrophil‐to‐lymphocyte ratio (NLR) and 70 U/mL for serum carbohydrate antigen 19‐9 (CA19‐9). Kaplan–Meier survival analysis demonstrated that the 5‐year survival rate in patients with a high NLR and CA19‐9 was 21.8% compared with 79.8% for patients with a low NLR and CA19‐9. The 5‐year disease‐free survival rate in patients with a high NLR and CA19‐9 was 0% compared with 33.9% for patients with a low NLR and CA19‐9. Patients with high NLRs and high CA19‐9 were more likely to have an early recurrence and multiple relapse patterns.

Conclusion

Preoperative NLR and serum CA19‐9 offer significant prognostic information for survival following curative resection of pancreas head cancer diagnosed as pancreatic ductal adenocarcinoma.
Qualitative study showed that a culturally tailored parenting programme improved the confidence and skills of Somali immigrants
Authors: Osman Fatumo , Flacking Renée , Klingberg Allvin Marie , Schön Ulla‐Karin
Published: March 2019

Aim

Parenting programmes tailored to immigrant parents have been reported to improve the mental health of the children and parents, as well as parents’ sense of competence in parenting. However, research on parents’ experiences of programmes tailored to their needs is scarce. This qualitative study aimed to describe Somali parents’ experiences of how a culturally sensitive programme affected their parenting.

Methods

The study was conducted in a middle‐sized city in Sweden in 2015. Data were collected through semi‐structured interviews with 50 participants two months after they took part in a parenting support programme. Inductive and deductive qualitative content analyses were used.

Results

A light has been shed was a metaphor that emerged from the analysis and that captured the knowledge the parents gained from the parenting system in Sweden. Parents gained confidence in their parenting role and became emotionally aware of their child's social and emotional needs and how to respond to them. Holding the sessions in the participant's native language was important for the parents’ participation and acceptance of the programme.

Conclusion

Parenting programmes should be tailored to the specific needs of the participants and cultural sensitivity should be factored into programmes to attract immigrant parents.
Single‐incision laparoscopic surgery using the glove technique with improved maneuverability achieved through fulcrum creation via a simple ring technique
Authors: Yoshida Makoto , Oshiro Takafumi , Fukuda Toshikatsu , Yano Masatsugu , Ochi Makoto , Okamoto Yuzo , Ono Eiji , Ohdan Hideki
Published: March 2019

Introduction

Single‐incision laparoscopic surgery (SILS) is widely used in many surgical procedures in various specialties. Among the access methods used in SILS, the glove technique, which is typically similar to the multi‐trocar approach, is simple, convenient, and inexpensive. However, given the absence of a fulcrum supporting the endoscopic surgical forceps, the technique is less advantageous than methods using commercially available access devices because of the poor maneuverability of the forceps.

Materials and Surgical Technique

By creating a fulcrum as a support to use with existing surgical forceps in the glove technique, we designed and used a novel method known as the “ring technique.” This technique aimed to improve the maneuverability of endoscopic surgical forceps.

Discussion

Placing a fulcrum resulted in the improvement of the forceps' maneuverability, which helped to ameliorate a weakness of the glove technique. The ring technique could be a useful option as a method of access in SILS.
New era of research on cancer‐associated glycosphingolipids
Authors: Furukawa Koichi , Ohmi Yuhsuke , Ohkawa Yuki , Bhuiyan Robiul H. , Zhang Pu , Tajima Orie , Hashimoto Noboru , Hamamura Kazunori , Furukawa Keiko
Published: March 2019

Cancer‐associated glycosphingolipids have been used as markers for diagnosis and targets for immunotherapy of malignant tumors. Recent progress in the analysis of their implications in the malignant properties of cancer cells revealed that cancer‐associated glycosphingolipids are not only tumor markers, but also functional molecules regulating various signals introduced by membrane microdomains, lipid rafts. In particular, a novel approach, enzyme‐mediated activation of radical sources combined with mass spectrometry, has enabled us to clarify the mechanisms by which cancer‐associated glycosphingolipids regulate cell signals based on the interaction with membrane molecules and formation of molecular complexes on the cell surface. Novel findings obtained from these approaches are now providing us with insights into the development of new anticancer therapies targeting membrane molecular complexes consisting of cancer‐associated glycolipids and their associated membrane molecules. Thus, a new era of cancer‐associated glycosphingolipids has now begun.
Single‐incision laparoscopic reversal of Hartmann's operation through the stoma site: comparative outcomes with conventional laparoscopic and open surgery
Authors: Thambi P. , Borowski D. W. , Sathasivam R. , Obuobi R.‐B. , Viswanath Y. K. S. , Gill T. S.
Published: March 2019

Aim

Restoration of bowel continuity after Hartmann's procedure (RoH) can be challenging and associated with considerable morbidity. A technique using single‐incision laparoscopic surgery through the stoma site (SIL RoH) has been shown to be feasible and safe. In this study, we compared clinical outcomes of SIL RoH with conventional laparoscopic surgery (CL) and open surgery (OS).

Methods

This was a retrospective analysis of a prospectively maintained database between 2007 and 2017 in a UK colorectal unit. The access technique was decided by the surgeon on a case by case basis.

Results

A total of 106 patients underwent RoH. It was carried out for diverticular disease (n = 71, 67.6%), cancer (n = 19, 17.9%) and anastomotic leak (n = 4, 3.8%). The remainder (n = 12, 11.3%) were for miscellaneous reasons including trauma. Most RoHs were performed via OS (n = 87, 81.1%). The most common intended approaches for RoH were SIL (n = 56, 52.8%) and OS (n = 34, 32.1%) with fewer starting with CL (n = 16, 15.1%). Conversion to OS took place in five (8.9%) patients with SIL and six (37.5%) with CL (P = 0.005). Postoperative complications occurred in 17 (30.4%) for SIL, seven (43.8%) for CL and 17 (50.0%) for OS (P = 0.162). Median operating time for SIL was 146 min (range 44–389), 211 min (109–320) for CL and 211 min (85–420) for OS (P < 0.001). Median length of stay was 4 days (2–44) for SIL compared to 6 (3–34) for CL and 7 (4–34) for OS (P < 0.001). Discharge on or before day 5 was achieved in 41 (74.5%) patients for SIL compared to six (37.5%) for CL and seven (20.6%) for OS (P < 0.001).

Conclusion

Compared to OS and CL, SIL RoH appears to have shorter operating times and hospitalization, with no discernible difference in morbidity; this finding requires further evaluation in a randomized setting.
Single cell‐derived clonally expanded mesenchymal progenitor cells from somatic cell nuclear transfer‐derived pluripotent stem cells ameliorate the endometrial function in the uterus of a murine model with Asherman’s syndrome
Authors: Jun Sung‐Min , Park Mira , Lee Ji Yoon , Jung Sookyung , Lee Jeoung Eun , Shim Sung Han , Song Haengseok , Lee Dong Ryul
Published: March 2019

Objectives

Because primary mesenchymal progenitor cells (adult‐MPCs) have various functions that depend on the tissue origin and donor, de novo MPCs from human pluripotent stem cells (hPSCs) would be required in regenerative medicine. However, the characteristics and function of MPCs derived from reprogrammed hPSCs have not been well studied. Thus, we show that functional MPCs can be successfully established from a single cell‐derived clonal expansion following MPC derivation from somatic cell nuclear transfer‐derived (SCNT)‐hPSCs, and these cells can serve as therapeutic contributors in an animal model of Asherman's syndrome (AS).

Materials and methods

We developed single cell‐derived clonal expansion following MPC derivation from SCNT‐hPSCs to offer a pure population and a higher biological activity. Additionally, we investigated the therapeutic effects of SCNT‐hPSC‐MPCs in model mice of Asherman's syndrome (AS), which is characterized by synechiae or fibrosis with endometrial injury.

Results

Their humoral effects in proliferating host cells encouraged angiogenesis and decreased pro‐inflammatory factors via a host‐dependent mechanism, resulting in reduction in AS. We also addressed that cellular activities such as the cell proliferation and population doubling of SCNT‐hPSC‐MPCs resemble those of human embryonic stem cell‐derived MPCs (hESC‐MPCs) and are much higher than those of adult‐MPCs.

Conclusions

Somatic cell nuclear transfer‐derived‐hPSCs‐MPCs could be an advanced therapeutic strategy for specific diseases in the field of regenerative medicine.
Exploring perceptions among people who drive after cannabis use: Collision risk, comparative optimism and normative influence
Authors: Wickens Christine M. , Watson Tara Marie , Mann Robert E. , Brands Bruna
Published: March 2019

Introduction and Aims

While the perceived risks of driving under the influence of cannabis (DUIC) have been a focus of recent drug‐driving research, relevant concepts from the social cognition literature have rarely been applied to inform understanding of DUIC. This study aims to expand knowledge of perceived collision risk and social influences associated with DUIC and driving after other substance use.

Design and Methods

Semi‐structured interviews were conducted with 20 participants of a remedial program for impaired drivers. Thematic analysis began with two independent coders. Early discussion of emergent themes resulted in the identification of applicable social cognition concepts, resulting in selective coding and interpretation.

Results

Many participants identified DUIC as less risky than driving under the influence of alcohol or other drugs. Mixed perceptions regarding the dangerousness of DUIC were expressed, with some participants denying increased collision risk except among novice cannabis users. Comparative optimism bias was also expressed by participants who perceived themselves as less likely than others to be involved in a collision when DUIC. In view of normative influence, friends were generally seen as more accepting of DUIC than family, and there were indications that the opinions of others who use cannabis were regarded as more credible than the opinions of those who do not use the drug.

Discussion and Conclusions

Comparative optimism bias and normative influence may contribute to perceived risks associated with DUIC and may, therefore, be useful concepts to employ to increase the effectiveness of public health and road safety initiatives.
A Case of Heterotopic Gastric Mucosa of the Terminal Ileum Presenting Multiple Diffuse Polyps
Authors: AKASHI-TANAKA Sadako , KURAMOTO Shu , KAMINISHI Michio , OOHARA Takeshi , MIMURA Toshiki , MURAKAMI Toshikazu
Published: March 2019

We report a rare case of inflammation of the terminal ileum presenting numerous diffuse pseudopolyps and erosions. The patient was a 41‐year‐old man with multiple polypoid lesions in the terminal ileum causing anemia and hypoalbuminemia, which were found incidentally during preoperative evaluation of an early gastric cancer. Ileocecal resection was performed, and histological examination revealed the presence of heterotopic gastric mucosa (HGM) with fundic‐type glands. Tuberculous colitis and non‐specific inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, were ruled out clinically and histologically, and no other primary lesions capable of causing gastric metaplasia, such as Meckel's diverticulum, were detected. We therefore concluded that the HGM in this patient was not a metaplastic response to inflammation, but rather of congenital inflammation‐inducing origin. To our knowledge, only 29 cases of HGM of the small intestine beyond the ligament of Treitz, excluding Meckel's diverticulum and other congenital anomalies of the bowel, have been reported in the literature. Furthermore, we have found no reference to cases similar to our present patient. (Dig Endosc 1996 ; 8 : 225‐230)
Relationship between corneal confocal microscopy and markers of peripheral nerve structure and function in Type 2 diabetes
Authors: Yan A. , Issar T. , Tummanapalli S. S. , Markoulli M. , Kwai N. C. G. , Poynten A. M. , Krishnan A. V.
Published: March 2019

Aims

To investigate changes in corneal nerve morphology in Type 2 diabetes and to establish relationships between in vivo corneal confocal microscopy and markers of peripheral nerve structure and function.

Participants and methods

We recruited 57 participants with Type 2 diabetes and 26 healthy controls of similar age and sex distribution. We also recruited a disease control group of 54 participants with Type 1 diabetes. All participants were assessed for distal symmetrical polyneuropathy using the Total Neuropathy Score. In vivo corneal confocal microscopy was used to assess corneal nerve fibre length, corneal nerve fibre density, corneal nerve branch density and inferior whorl length. Peripheral nerve structure was assessed using median nerve ultrasonography. Large fibre function was assessed according to median nerve axonal excitability. Small fibre function was assessed using SudoscanTM and the Survey of Autonomic Symptoms.

Results

Corneal nerve fibre length, fibre density and branch density and inferior whorl length were significantly lower in individuals with Type 2 diabetes compared to controls (P<0.001 for all). In the Type 2 diabetes cohort, correlations were observed between neuropathy severity and corneal nerve fibre density (P=0.004), corneal nerve branch density (P=0.003), corneal nerve fibre length (P=0.002) and inferior whorl length (P=0.01). Significant correlations were observed between corneal confocal outcomes and axonal excitability measurements. No association was found between corneal confocal microscopy and median nerve cross‐sectional area, Sudoscan measurements or the Survey of Autonomic Symptoms.

Conclusions

This study demonstrated significant changes in corneal nerves in individuals with Type 2 diabetes. Reductions in corneal nerve measures correlated with increasing neuropathy severity. Associations were found between corneal confocal microscopy and markers of voltage‐gated potassium channel function.
Repeated payment delinquency among young adults in the United States
Authors: Letkiewicz Jodi C. , Heckman Stuart J.
Published: March 2019

There is concern in the United States about young adults falling behind financially due to the increased use of student loans and low wages. This study investigates payment delinquency as a measure of financial distress to better understand how young adults might be struggling. Personality traits are incorporated into the model to determine the extent to which behavioural factors are correlated with financial behaviors and if they predict a habit trend of payment delinquency. The 1997 National Longitudinal Survey of Youth, a nationally representative longitudinal data set, is used in the study. A random effects probit model and a dynamic random effects probit model are used to examine late bill pay (harassed by bill collectors) and late rent or mortgage payments (more than 60 days late) over a period of 8 years (2007–2015). Results from the analysis indicate that payment delinquency in a previous period increases the likelihood of payment delinquency by 10 percentage points in a subsequent period. Conscientiousness decreases the likelihood by 2.1 percentage points, while neuroticism increases the likelihood by 1.6 percentage points.
Clinical utility of the German Ghent Global IAD Categorization tool including incontinence‐associated dermatitis prevalence and categories
Authors: Hödl Manuela , Eglseer Doris , Lohrmann Christa
Published: March 2019

Is the German pilot version of the Ghent Global IAD Categorization (GLOBIAD) tool a clinical useful tool from the users' perspective and what are the incontinence‐associated dermatitis (IAD) prevalence and categories in the hospital and geriatric settings? Before evaluating the psychometric properties of an instrument, it is recommended to carry out a pre‐test with target users. Recent research on IAD has focused on the design and evaluation of the psychometric properties of the English GLOBIAD. In 2017, the annual, multicentre, cross‐sectional survey was conducted. This survey includes the German pilot version of the GLOBIAD tool as well as the Staff View Assessment Instrument, a questionnaire distributed to evaluate the clinical utility of the German pilot version of the GLOBIAD tool. The majority of the patients in both types of institutions were female with average ages of 66 years (hospital setting) and 82 years (geriatric setting). Patients in the geriatric institution (N = 634) were statistically significantly more care dependent compared to hospital patients (N = 2955). Patients in the geriatric institutions suffered statistically significantly more often from urinary, faecal and double (UI, FI, DI) incontinence than hospital patients. More than 75% of the ward nurses agreed that the German pilot version of the GLOBIAD tool was useful. The highest IAD prevalence was observed in the DI hospital patients, who were statistically significantly more often affected by IAD than geriatric patients. Due to the high level of agreement regarding the clinical utility of this tool, we can recommend it to clinicians. As this was a pilot version of the tool, further testing of the psychometric properties of this version in hospital and geriatric settings is warranted.
Examining the Global North Migration Policies: A “Push Out – Push Back” Approach to Forced Migration
Authors: Klaus Witold , Pachocka Marta
Published: March 2019

In this paper we focus on adapting the concept of push – pull factors to forced migration by proposing a “push out – push back” approach that underlines two most crucial elements of forced migrants’ experience. On the one hand, it stresses the reasons for leaving countries of origin or of temporary refuge that are not dependant on the will of people who flew those places, thus the “push out” factors. On the other hand, it represents the refusal of the countries of the Global North to accept forced migrants and their use of various practices, amounting to “push back” factors, to prevent them from entering or leaving their territory if they manage to reach it. These factors can be divided into three groups: passive, active, and symbolic.