bluuebunny/crossref_metadata_2025 huggingface dataset:
Massed versus spaced practice in vocology: effect of a short‐term intensive voice training versus a longer‐term traditional voice training
Authors: Meerschman Iris , Van Lierde Kristiane , Van Puyvelde Caro , Bostyn Astrid , Claeys Sofie , D'haeseleer Evelien
Published: December 2017

Background

In contrast with most medical and pharmaceutical therapies, the optimal dosage for voice therapy or training is unknown.

Aims

The aim of this study was to compare the effect of a short‐term intensive voice training (IVT) with a longer‐term traditional voice training (TVT) on the vocal quality and vocal capacities of vocally healthy non‐professional voice users.

Methods & Procedures

A pre‐/post‐test randomized control group design with follow‐up measurements was used. Twenty healthy female non‐professional voice users with a mean age of 21.7 years (range = 20–24 years) were randomly assigned into a short‐term IVT group (n = 10) or a longer‐term TVT group (n = 10). Both groups received an identical 6‐h lasting voice training. Only the distribution of practice varied between the groups: 2 h a day for 3 consecutive days for the IVT group versus two 30‐min sessions a week for 6 weeks for the TVT group. In both groups, a voice assessment protocol consisting of subjective (questionnaire, participant's self‐report, auditory–perceptual evaluation) and objective (maximum performance task, acoustic analysis, voice range profile, dysphonia severity index) measurements and determinations was used to evaluate the participants’ voice pre‐ and post‐training and at 6 weeks follow‐up. Groups were compared over time using linear mixed models and generalized linear mixed models. Within‐group effects of time were determined using post‐hoc pairwise comparisons with Bonferroni corrections.

Outcomes & Results

No significant time‐by‐group interactions were found for any of the outcome measures, indicating no significant differences in evolution over time between the groups. Significant time effects were found for maximum phonation time, lowest intensity, lowest frequency, highest frequency and dysphonia severity index, all improving over time in both groups. More in‐depth within‐group analyses indicate a preference for the IVT group regarding the evolution of maximum phonation time, lowest frequency and dysphonia severity index, and a preference for the TVT group regarding the evolution of lowest intensity.

Conclusions & Implications

Short‐term IVT may be equally, or even more, effective in training vocally healthy non‐professional voice users compared with longer‐term TVT.
Working the Spaces in between: A Case Study of a Boundary‐Spanning Model to Help Facilitate Cross‐Sectoral Policy Work
Authors: Carey Gemma , Landvogt Kathy , Corrie Tanya
Published: December 2017

Since the 1990s, ‘joined‐up government,’ ‘whole‐of‐government,’ and ‘horizontal governance’ approaches have emerged in many industrialized countries, resulting in the devolution of government functions to diverse policy networks. From these shifts, complex systems of networked actors have emerged, involved in designing, implementation, and influencing policy. Arguably, networked approaches to policy may solve some problems. However, as with all paradigm shifts, new problems have emerged. Specifically, skill and knowledge gaps have opened up, reflecting the need for new collaborative and networked relationships that can increase the capabilities and agility to work in these ways. In response to these gaps, we developed the Power to Persuade initiative. Power to Persuade is an annual symposium and online forum, aimed at deepening knowledge and awareness of current problems faced by policy networks, and providing the skills and knowledge to overcome them. In this paper, we discuss how Power to Persuade works within the spaces in between as a vehicle for relationship building and better policy.
Relation of Serum ADMA, Apelin‐13 and LOX‐1 Levels with Inflammatory and Echocardiographic Parameters in Hemodialysis Patients
Authors: Dogan Ibrahim , Dogan Tolga , Yetim Mucahit , Kayadibi Huseyin , Yilmaz Mehmet B , Eser Baris , Kalcik Macit , Karavelioglu Yusuf
Published: December 2017

Cardiovascular diseases are the leading causes of mortality in patients with chronic kidney disease. Nitric oxide has a critical role in both endothelial dysfunction and the atherosclerosis process. We aimed to investigate the relationships between serum asymmetric dimethyl arginine (ADMA), LOX‐1, and Apelin‐13 levels, which are known to act over nitric oxide with endothelial dysfunction and cardiac morphology as well as with each other in hemodialysis patients. The study comprised a total of 120 patients (53 females and 67 males) receiving hemodialysis three times a week for at least 6 months and an age‐gender matched control group (55 females and 58 males). Serum ADMA, LOX‐1, and Apelin‐13 levels were measured using the ELISA technique. Echocardiography, 24‐h blood pressure monitoring by the Holter and carotid artery intima‐media thickness (CIMT) measurement was performed on all of the included subjects. The associations between serum ADMA, LOX‐1, and Apelin‐13 levels with CIMT, echocardiographic parameters [left ventricular mass (LVM) and left ventricular mass index (LVMI)], and inflammatory markers [high sensitive C‐reactive protein (hsCRP) and neutrophil lymphocyte ratio (NLR)] were evaluated by correlation analysis. Serum ADMA, Apelin‐13, and LOX‐1 levels were significantly higher in the hemodialysis group than the controls (P < 0.001, P < 0.001, and P < 0.001, respectively). CIMT, hsCRP, and NLR levels were also significantly higher in the hemodialysis group (P < 0.05, P < 0.001, P < 0.001, respectively). Significant correlations were observed among the serum ADMA, Apelin‐13, and LOX‐1 levels. Moreover, notably positive correlations were found between these three biochemical markers and LVM, LVMI, hsCRP, and CIMT. Serum ADMA, Apelin‐13, and LOX‐1 levels can be indicators not only for the inflammatory process but also for the pathogenesis of cardiovascular diseases in hemodialysis patients.
Validation of Alcohol Flushing Questionnaires in Determining Inactive Aldehyde Dehydrogenase‐2 and Its Clinical Implication in Alcohol‐Related Diseases
Authors: Shin Cheol Min , Kim Nayoung , Cho Sung‐Il , Sung Joohon , Lee Hee‐Jung
Published: December 2017

Background

Our aim was to validate alcohol flushing questionnaires in detecting inactive ALDH2 (ALDH2*1/*2 or ALDH2*2/*2).

Methods

Two study sets were established; in study set 1, 210 healthy male subjects (age 22 to 59 years) were enrolled; in study set 2, 756 subjects were enrolled who received esophagogastroduodenoscopy to evaluate their dyspeptic symptoms or as part of a gastric cancer screening program. Subjects in study sets 1 and 2 completed the modified alcohol flushing questionnaires of Yokoyama and colleagues (, ). Polymerase chain reaction–restriction fragment length polymorphism method was used to determine ALDH2 genotype.

Results

In study set 1, 29.0% (61 of 210) had inactive ALDH2. The sensitivity and specificity of the modified alcohol flushing questionnaire for detecting inactive ALDH2 were 95.1 and 76.5%, respectively. Drinking problems negatively correlated with positive alcohol flushing response and inactive ALDH2 (all p‐values < 0.05). In study set 2, the sensitivity and specificity of the alcohol flushing questionnaire for detecting inactive ALDH2 were 78.9 and 82.1%, respectively. Interestingly, drinking ≥7 units/wk in men or ≥3.5 units/wk in women significantly increased the risk of benign gastric ulcer (BGU) among positive alcohol flushers (odds ratio, 8.97; 95% confidence interval, 1.38 to 58.30), but not among negative alcohol flushers.

Conclusions

Simple flushing questionnaires may be administered to the Korean population as a screening tool in detecting individuals who carry inactive ALDH2. Alcohol flushing response negatively correlates with drinking problems and can modify the risk for BGU by alcohol intake.
Effects of the Acute and Chronic Ethanol Intoxication on Acetate Metabolism and Kinetics in the Rat Brain
Authors: Hsieh Ya‐Ju , Wu Liang‐Chih , Ke Chien‐Chih , Chang Chi‐Wei , Kuo Jung‐Wen , Huang Wen‐Sheng , Chen Fu‐Du , Yang Bang‐Hung , Tai Hsiao‐Ting , Chen Sharon Chia‐Ju , Liu Ren‐Shyan
Published: December 2017

Background

Ethanol (EtOH) intoxication inhibits glucose transport and decreases overall brain glucose metabolism; however, humans with long‐term EtOH consumption were found to have a significant increase in [1‐11C]‐acetate uptake in the brain. The relationship between the cause and effect of [1‐11C]‐acetate kinetics and acute/chronic EtOH intoxication, however, is still unclear.

Methods

[1‐11C]‐acetate positron emission tomography (PET) with dynamic measurement of K1 and k2 rate constants was used to investigate the changes in acetate metabolism in different brain regions of rats with acute or chronic EtOH intoxication.

Results

PET imaging demonstrated decreased [1‐11C]‐acetate uptake in rat brain with acute EtOH intoxication, but this increased with chronic EtOH intoxication. Tracer uptake rate constant K1 and clearance rate constant k2 were decreased in acutely intoxicated rats. No significant change was noted in K1 and k2 in chronic EtOH intoxication, although 6 of 7 brain regions showed slightly higher k2 than baseline. These results indicate that acute EtOH intoxication accelerated acetate transport and metabolism in the rat brain, whereas chronic EtOH intoxication status showed no significant effect.

Conclusions

In vivo PET study confirmed the modulatory role of EtOH, administered acutely or chronically, in [1‐11C]‐acetate kinetics and metabolism in the rat brain. Acute EtOH intoxication may inhibit the transport and metabolism of acetate in the brain, whereas chronic EtOH exposure may lead to the adaptation of the rat brain to EtOH in acetate utilization. [1‐11C]‐acetate PET imaging is a feasible approach to study the effect of EtOH on acetate metabolism in rat brain.
Localization of thrombospondin‐1 and its receptor CD36 in the ovary of the ostrich (Struthio camelus)
Authors: Rodler D. , Sinowatz F.
Published: December 2017

Angiogenesis, the formation of new blood vessels from pre‐existing vasculature, plays a decisive role for the rapid growth of avian follicles. Compared to mammals, few data on the angiogenesis in the avian ovary are available. However, whereas several pro‐angiogenic factors in the avian ovary have been recently studied in detail, little information is available on the localization of anti‐angiogenic factors. The aim of this study was to determine the localization and possible function of the anti‐angiogenic factor thrombospondin‐1 (TSP‐1) and its receptor CD36 in the ovary of the ostrich using immunohistochemistry and to correlate the results with ultrastructural data. Whereas the oocytes and granulosa cells of all follicular stages were negative for TSP‐1, myofibroblasts of the theca externa and smooth muscle cells of blood vessels showed distinct reactions. A distinctly different staining pattern was observed for CD36. The oocytes were CD36 negative. No immunostaining for CD36 could be observed neither in the granulosa cells nor in the adjacent theca interna of vitellogenic follicles. In the theca externa, blood vessels protruding towards the oocyte showed CD36‐positive endothelial cells. In conclusion, a fine balance between angiogenic and anti‐angiogenic processes assures that a dense net of blood vessels develops during the rapid growth of a selected follicle. Anti‐angiogenic molecules, such as TSP‐1 and its receptor CD36 may, after the oocyte has reached its final size, inhibit further angiogenesis and limit the transport of yolk material to the mature oocyte. By this mechanism, the growth of the megalecithal oocyte during folliculogenesis may cease.
Immune checkpoint molecules soluble program death ligand 1 and galectin‐9 are increased in pregnancy
Authors: Enninga Elizabeth Ann L. , Harrington Susan M. , Creedon Douglas J. , Ruano Rodrigo , Markovic Svetomir N. , Dong Haidong , Dronca Roxana S.
Published: December 2017

Problem

Pregnancy requires balance between tolerance to the haploidentical fetus and the mother's ability to mount immune responses. There are parallels to this phenomenon that occur in metastatic cancer. We assessed soluble program death ligand‐1 soluble PD‐L1 (sPD‐L1) and galectin‐9 in the blood of pregnant women during gestation as these molecules are highly involved in immune suppression during cancer.

Method of study

Maternal blood was collected from 30 primigravida women at monthly intervals during pregnancy, delivery and 6‐week post‐partum. Blood was analyzed for sPD‐L1 and galectin‐9 concentrations by ELISA. Term placentas were collected in formalin and IHC was completed for PD‐L1 and galectin‐9 expression.

Results

Maternal blood levels of sPD‐L1 (0.438 ng/mL) and galectin‐9 (1976 pg/mL) were elevated early in normal pregnancies compared to non‐pregnant controls (0.242 ng/mL and 773 pg/mL, respectively). sPD‐L1 increased throughout gestation, whereas galectin‐9 remained elevated until parturition; both proteins returned to control levels post‐partum. Women carrying male fetuses had significantly higher galectin‐9 levels, but not sPD‐L1, than those carrying females (2263 pg/mL vs 1874 pg/mL; P = .0005). Trophoblast cells of the term placenta coexpress galectin‐9 and PD‐L1.

Conclusion

Immune‐regulatory molecules galectin‐9 and sPD‐L1 increased during pregnancy and may play a role in immune tolerance that is critical for the fetus.
Vitamin D facilitates trophoblast invasion through induction of epithelial‐mesenchymal transition
Authors: Kim Ryang Hee , Ryu Byung Jun , Lee Ki Mo , Han Jae Won , Lee Sung Ki
Published: December 2017

Problem

Vitamin D deficiency increases the risk of developing pregnancy‐related complications, including preeclampsia and small‐for‐gestational‐age infants. Vitamin D was demonstrated to promote the invasiveness of human extravillous trophoblasts (EVTs). However, whether vitamin D induces the epithelial‐mesenchymal transition (EMT) of EVTs remains unclear. Therefore, we investigated whether vitamin D promotes EMT and the related signaling pathways.

Method of study

In this study, we performed EMT experiments using JAR cells based on the expression of the mesenchymal markers and vitamin D receptor. JAR cells were treated with calcitriol, the active form of vitamin D. Western blotting was performed to evaluate EMT markers and key molecules of signaling pathways. Invasion assays were conducted. Expression and secretion of MMPs were analyzed by real‐time PCR and zymography.

Results

Calcitriol significantly enhanced EMT and the invasive capability of JAR cells, along with increased expression and secretion of MMP‐2 and MMP‐9. Moreover, ERK signaling pathway was activated by calcitriol. The effects of calcitriol were neutralized by ERK signaling blocker.

Conclusion

Calcitriol facilitated EMT induction and expression of MMPs via ERK signaling pathway, which promoted the invasive capability of EVTs. Further studies are warranted to elucidate the potential application of vitamin D in the prevention of pregnancy complications.
Maternal CD8+ T‐cell depletion alleviates intrauterine inflammation‐induced perinatal brain injury
Authors: Lei Jun , Xie Li , Zhao Hongxi , Gard Candice , Clemens Julia L. , McLane Michael W. , Feller Mia C. , Ozen Maide , Novak Christopher , Alshehri Wael , Alhejaily Nader , Shabi Yahya , Rosenzweig Jason M. , Facciabene Andrea , Burd Irina
Published: December 2017

We investigated the mechanisms by which CD8+ T‐cell trafficking in placenta contributes to perinatal brain injury by studying effects of maternal CD8+ T‐cell depletion (DEP) in a mouse model of intrauterine inflammation (IUI). Maternal CD8+ T cells were depleted with anti‐CD8+ antibodies. IUI was induced with lipopolysaccharide (LPS). DEP was confirmed using flow cytometry. Preterm birth rate was evaluated. Offspring neurologic sequelae were assessed by Nissl staining, immune arrays, confirmatory individual TaqMan® gene assays, and neurobehavioral tests. DEP did not significantly prevent LPS‐induced preterm birth but improved neurobehavioral performance (P < .001) and increased cortical neuronal density (P < .05) in LPS‐exposed pups compared to controls. These changes were associated with decreased CCL3 and CXCL10 and increased CCL5 in DEP LPS‐exposed mice. We demonstrate that DEP reduces perinatal brain injury following IUI. This supports a role for maternal CD8+ T‐cell trafficking in placenta in mediating perinatal brain injury separate from preterm birth mechanisms.
Combined treatment approach to chronic anal fissure with associated anal fistula
Authors: FitzDowse Andrew J. , Behrenbruch Corina C. , Hayes Ian P.
Published: December 2017

Background

Anal fistula in association with chronic anal fissure (fissure‐fistula) is infrequently described. Recognizing this association and managing both components may help prevent some treatment failures seen with chronic anal fissure. This study aims to report on the outcomes of 20 consecutive patients with fissure‐fistula managed with fistulotomy and injection of botulinum A toxin.

Methods

The study is a retrospective, observational study, assessing the success of symptom resolution following fistulotomy with botulinum A toxin, in patients identified as having a chronic anal fissure with associated anal fistula. The study included all patients with this condition treated with combination treatment by a single surgeon at a tertiary care hospital between January 2013 and January 2016.

Results

Twenty patients with fissure‐fistula treated with fistulotomy and botulinum toxin A were identified. The median cohort age was 44 years (range 25–78), with a predominance of males (80%) and posterior fissure position (80%). The most common presenting symptoms were anal pain (70%), rectal bleeding (55%), anal discharge (35%) and anal pruritus (35%). Mean follow‐up was 10.5 weeks and all patients who attended follow‐up appointments reported resolution of symptoms. There were no cases of incontinence and none of the cohort required further surgical intervention for the condition.

Conclusion

Chronic anal fissure with associated anal fistula can be successfully managed with fistulotomy and injection of botulinum toxin A. Further studies would be helpful in determining if recognition and management of the fistula component in isolation with fistulotomy is as effective as fistulotomy plus botulinum A toxin.
Getting close to clothes: Using material objects to rethink the creative geographies of post‐war London fashion
Authors: Bide Bethan
Published: December 2017

Getting close to clothes provides new perspectives on the geographies of fashion cities and the processes and collaborations by which they function. Taking the history of London's garment industry in the post‐war 1940s as a case study, this paper traces the major stages of the making process of clothes – pattern making, cutting, machining and finishing – through four garments from the Museum of London's fashion collection. By understanding these material fashion objects as processes, it uncovers the hidden stories of historic garment workers through the tiny clues left in old stitching, revealing the creativity of the individuals who made them and how they contributed to the creative cultures of the historic fashion city. This study of material processes shows how individual makers shaped garments and contributed to a creative culture that played a vital role in London's growing post‐war reputation as a fashion city. It also broadens the boundaries of London as a fashion city beyond the confines of the West End by revealing that a network of workrooms and factories across the city supported this centrally located cluster of fashion businesses. Having established the historical role of making in the creative cultures of London fashion, this paper concludes by questioning how future studies of contemporary fashion cities might look to material objects in order to reconsider the creative agency of subcontracted garment workers in the new international division of labour and the contributions they make towards the symbolic reputations of major fashion cities, in spite of geographical distances.
Effect of fermented total mixed rations on the growth performance, carcass and meat quality characteristics of Hanwoo steers
Authors: Kim Tae‐Il , Mayakrishnan Vijayakumar , Lim Dong‐Hyun , Yeon Jeong‐Ha , Baek Kwang‐Soo
Published: December 2017

This study was conducted to assess the effects of fermented total mixed ration (FTMR) on the growth performance, carcass and meat quality traits of Hanwoo steers. The present study evidenced that the FTMR had a strong effect on dry matter intake, body weight, daily gain, slaughter weight and carcass characteristics compared with control animals. The results showed that the dry matter intake (7.17 ± 0.13 kg), average body weight (615.20 ± 112.82 kg), and daily gain (0.56 ± 0.16 kg) were greater in animals receiving FTMR than in control animals (P < 0.05). The meat quality characteristics indicated that cooking loss and the pH values did not vary between control and FTMR treated animals; however, animals in the treated groups (FTMR) had higher meat quality grades, carcass weight (396.13 ± 18.35), fat thickness (13.25 ± 1.75), marbling score (5.63 ± 0.56), meat color (40.06 ± 1.23), crude fat (18.39 ± 1.32) and sensory characteristics (flavor 5.03 ± 0.17; tenderness 4.42 ± 0.33; juiciness 5.10 ± 0.16). Nevertheless, the shear force values decreased significantly in FTMR‐treated animals compared with control group steers. Overall, FTMR may not only improve the growth performance, biochemical metabolites, and fatty and acetic acid profiles of steers, but may also enhance the carcass and meat quality characteristics of Hanwoo steers. Regarding economics, our research findings suggest that FTMR‐based feeds may enhance Hanwoo steer meat quality at a low cost.
Instructor personality matters for student evaluations: Evidence from two subject areas at university
Authors: Kim Lisa E. , MacCann Carolyn
Published: December 2017

Background

Instructors are under pressure to produce excellent outcomes in students. Although the contribution of student personality on student outcomes is well established, the contribution of instructor personality to student outcomes is largely unknown.

Aim

This study examined the influence of instructor personality (as reported by both students and instructors themselves) on student educational outcomes at university.

Sample and method

Mathematics and psychology university students (N = 515) and their instructors (n = 45) reported their personality under the Big Five framework.

Results

Multilevel regressions were conducted to predict each outcome from instructor personality, taking into account the effects of student gender, age, cognitive ability, and personality, as well as instructor gender and age. Student‐reports of instructor personality predicted student evaluations of teaching but not performance self‐efficacy or academic achievement. Instructor self‐reports did not predict any of the outcomes. Stronger associations between student‐reports and the outcomes than instructor self‐reports could be explained by students providing information on both the predictor and the outcome variables, as well as a greater number of raters providing information on instructor personality. Different domains of the instructor Big Five were important for different element of student evaluations of teaching.

Conclusions

The study highlights the importance of studying instructor personality, especially through other‐reports, to understand students’ educational experiences. This has implications for how tertiary institutions should use and interpret student evaluations.
Clinical and genetic factors are associated with pain and hospitalisation rates in sickle cell anaemia in Cameroon
Authors: Wonkam Ambroise , Mnika Khuthala , Ngo Bitoungui Valentina J. , Chetcha Chemegni Bernard , Chimusa Emile R. , Dandara Collet , Kengne Andre P.
Published: December 2017

We aimed to investigate the clinical and genetic predictors of painful vaso‐occlusive crises (VOC) in sickle cell disease (SCD) in Cameroon. Socio‐demographics, clinical variables/events and haematological indices were acquired. Genotyping was performed for 40 variants in 17 pain‐related genes, three fetal haemoglobin (HbF)‐promoting loci, two kidney dysfunctions‐related genes, and HBA1/HBA2 genes. Statistical models using regression frameworks were performed in R®. A total of 436 hydoxycarbamide‐ and opioid‐naïve patients were studied; median age was 16 years. Female sex, body mass index, Hb/HbF, blood transfusions, leucocytosis and consultation or hospitalisation rates significantly correlated with VOC. Three pain‐related genes variants correlated with VOC (CACNA2D3‐rs6777055, P = 0·025; DRD2‐rs4274224, P = 0·037; KCNS1‐rs734784, P = 0·01). Five pain‐related genes variants correlated with hospitalisation/consultation rates. (COMT‐rs6269, P = 0·027; FAAH‐rs4141964, P = 0·003; OPRM1‐rs1799971, P = 0·031; ADRB2‐rs1042713; P < 0·001; UGT2B7‐rs7438135, P = 0·037). The 3·7 kb HBA1/HBA2 deletion correlated with increased VOC (P = 0·002). HbF‐promoting loci variants correlated with decreased hospitalisation (BCL11A‐rs4671393, P = 0·026; HBS1L‐MYB‐rs28384513, P = 0·01). APOL1 G1/G2 correlated with increased hospitalisation (P = 0·048). This first study from Africa has provided evidence supporting possible development of genetic risk model for pain in SCD.
Regulatory B cells induced by ultraviolet B through toll‐like receptor 4 signalling contribute to the suppression of contact hypersensitivity responses in mice
Authors: Liu Xiaoming , Huang Haiyan , Gao Hongbin , Wu Xia , Zhang Wei , Yu Bo , Dou Xia
Published: December 2017

Background

Ultraviolet (UV) B irradiation is known to suppress contact hypersensitivity (CHS) responses in mouse models by suppressing immune responses. However, the cellular mechanisms responsible for UVB‐induced systemic suppression remain unclear. Regulatory B cells have been reported to play an inhibitory role during CHS. It is presently unknown whether regulatory B cells contribute to the effect of UVB phototherapy.

Objective

To investigate the inductive effect of UVB on regulatory B cells and the underlying mechanisms by using a CHS mouse model.

Methods

CHS was induced with oxazolone, and evaluated by histopathology, flow cytometry, and quantitative real‐time polymerase chain reaction.

Result

We found that UVB irradiation induced regulatory B cell expansion and ameliorated CHS. UVB‐induced regulatory B cells contribute to systemic immunosuppression by inhibiting the proliferation of T cells. Moreover, we determined that toll‐like receptor (TLR) 4, the expression of which was upregulated in B cells after UVB exposure, played an essential role in the induction of regulatory B cells.

Conclusion

Our data identified regulatory B cells as regulators of UVB‐induced immunosuppression in CHS, and suggest the importance of the UVB–TLR4 axis in the generation of regulatory B cells.
Colonoscopy conversion after flexible sigmoidoscopy screening: results from the UK Bowel Scope Screening Programme
Authors: Siau K. , Yew A. C. , Ishaq S. , Jewes S. , Shetty S. , Brookes M. , Veitch A. , McKaig B. , Murugananthan A.
Published: December 2017

Aim

In the UK Bowel Scope Screening Programme (BSSP), patients progress to colonoscopy based on high‐risk features on flexible sigmoidoscopy (FS). We aim to assess the practice of colonoscopy conversion and predictors of detection of additional adenomas on colonoscopy.

Method

The Bowel Cancer Screening database was interrogated and collated with endoscopic and histological findings from patients undergoing colonoscopy following FS between August 2013 and August 2016. Multivariate analysis was performed to identify predictors of new adenomas.

Results

FS was performed on 11 711 patients, with an adenoma detection rate (ADR) of 8.5% and conversion to colonoscopy in 421 (3.6%). The additional ADR at colonoscopy was 35.2%, with one additional malignant diagnosis (0.26%). The adenoma miss rate was 3.6%. On multivariate analysis, a polyp ≥ 10 mm was the only high‐risk indication associated with additional ADR at colonoscopy (OR 3.68, 95% CI 1.51–3.65, P < 0.001), in addition to male gender (OR 2.36, 95% CI 1.46–3.83, P < 0.001). Predictors of detection of a new adenoma ≥ 10 mm included: villous adenoma (P = 0.002), polyp ≥ 10 mm (P = 0.007) and male gender (P = 0.039). The presence of any conversion criterion was associated with the detection of any proximal adenoma (P < 0.001) and adenoma ≥ 10 mm (P = 0.031).

Conclusion

Male gender, polyps ≥ 10 mm and villous‐preponderant histology at FS were predictors of adenomas < 10 mm and ≥ 10 mm at colonoscopy. Further data are required to assess the role for gender‐based stratification of conversion criteria.
Detection and analysis of abnormal nuclear changes in oral cytological smears byPapanicolaoustaining
Authors: Nag R. , Raza H. , Kumar S. , Seal R. , Banerjee A. , Paul R. R. , Pal M. , Chatterjee J. , Das R. K.
Published: December 2017

The authors demonstrate the usefulness of careful characterisation of nuclear features in oral smear preparations in detecting abnormal squamous cells. This could lead to early discovery of premalignant oral lesions and allow prompt treatment to prevent cancer development.
The impact of repeat FNA in non‐diagnostic and indeterminate thyroid nodules: A 5‐year single‐centre experience
Authors: Saieg M. A. , Barbosa B. , Nishi J. , Ferrari A. , Costa F.
Published: December 2017

Introduction

FNA is a well‐established method for the preoperative diagnosis of thyroid nodules, but limitations still reside among non‐diagnostic and indeterminate samples. The objective of the present study was to assess the impact of repeat FNA in thyroid nodules primarily classified as non‐diagnostic and indeterminate, with the evaluation of the diagnostic resolution rate after the reassessment of the nodule.

Methods

We retrospectively collected all cases of thyroid FNA at our institution in the last 5 years that had one or more repeat aspirations of the same nodule, calculating the percentage of samples with change in the diagnostic category. Additional collected data included sex, age and interval between the repeat aspirations.

Results

One hundred and seventy‐eight specimens from 167 patients (140 female, 27 male) with a median age of 56 years (range 11‐90) were included in the study. Among the 86 cases primarily classified as non‐diagnostic, 25 (29.1%) remained in the same category after the first reassessment and only 18 (20.9%) after the second repeat aspiration. Among the 40 indeterminate cases, only 10 (25%) retained their status after the second aspiration, with no change after the third assessment.

Conclusion

Repeat aspiration of non‐diagnostic and indeterminate thyroid nodules had a positive impact in both groups, with diagnostic resolution rates of 80% and 75%, respectively. The present study therefore endorses the use of such strategy for the initial follow‐up of nodules with no definite diagnosis, especially in low‐resource centres with limited access to modern molecular technologies.
Comparison of glucose‐lowering agents after dual therapy failure in type 2 diabetes: A systematic review and network meta‐analysis of randomized controlled trials
Authors: Zaccardi Francesco , Dhalwani Nafeesa N. , Dales Jolyon , Mani Hamid , Khunti Kamlesh , Davies Melanie J. , Webb David R.
Published: December 2017

Aims

To assess the evidence supporting the choice of third‐line agents in adults with inadequately controlled type 2 diabetes.

Materials and methods

We searched randomized controlled trials (RCTs) published between January 2000 and July 2017 that reported data on cardiometabolic outcomes and hypoglycaemia for glucose‐lowering agents added to metformin‐based dual treatments. Data were stratified by background therapy and RCT duration, and synthesized, when possible, with network meta‐analyses.

Results

A total of 43 RCTs (16 590 participants) were included, with metformin combined with: sulphonylureas (SUs) in 20 RCTs; thiazolidinediones (TZDs) in 10; basal or rapid‐acting insulin in 6; dipeptidyl peptidase‐4 (DPP‐4) inhibitors in 3; glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) in 2; and sodium‐glucose co‐transporter‐2 (SGLT‐2) inhibitors in 2. When added to metformin and SUs, after 24 to 36 weeks, rapid‐acting insulin resulted in the largest reduction in glycated haemoglobin (HbA1c; 1.6% vs placebo), followed by GLP‐1RAs (1.0%), basal insulin (0.8%) and SGLT‐2 inhibitors (0.7%), with no difference between GLP‐1RAs and SGLT‐2 inhibitors; body weight increased with insulin treatment (~3 kg vs placebo), while the greatest reduction was observed for SGLT‐2 inhibitors compared with all other therapies. Limited data for hypoglycaemia indicated a similar risk for SGLT‐2 inhibitors and GLP‐1RAs. Results for third‐line agents added to metformin and TZDs were comparable, showing similar HbA1c reduction and risk of hypoglycaemia between SGLT‐2 inhibitors and GLP‐1RAs, and a slightly greater reduction in body weight with SGLT‐2 inhibitors vs GLP‐1RAs. Data for 52 to 54 weeks were more limited: added to metformin and a SU, TZDs, GLP‐1RAs or SGLT‐2 inhibitors reduced HbA1c to a similar extent but had different effects on body weight (7 kg and 5 kg more with TZDs vs SGLT‐2 inhibitors and GLP‐1RAs, respectively; 2 kg less when comparing SGLT‐2 inhibitors with GLP‐1RAs). Formal analyses could not be performed for any other dual therapy failure combinations because of the small number of available RCTs.

Conclusions

Moderate‐quality evidence supports the choice of a third‐line agent only in patients on metformin combined with a SU or a TZD, with SGLT‐2 inhibitors performing generally better than other drugs. In suggesting third‐line agents, future guidelines should recognize the widely differing evidence on the various dual therapy failures.
Pharmacokinetics and tolerability of semaglutide in people with hepatic impairment
Authors: Jensen Lene , Kupcova Viera , Arold Gerhard , Pettersson Jonas , Hjerpsted Julie B.
Published: December 2017

Aims

To investigate whether the pharmacokinetic characteristics of semaglutide were altered in people with hepatic impairment, assessed using Child–Pugh criteria, vs those with normal hepatic function.

Methods

In this multicentre, open‐label, parallel‐group trial (sponsor Novo Nordisk, ClinicalTrials.gov ID NCT02210871), four groups of participants with normal hepatic function (n = 19) or mild (n = 8), moderate (n = 10) or severe (n = 7) hepatic impairment received a single, subcutaneous dose of 0.5 mg semaglutide. Semaglutide plasma concentrations were assessed frequently for 35 days after dosing. The primary endpoint was area under the semaglutide plasma concentration–time curve from time zero to infinity (AUC0‐∞). No effect of hepatic impairment was declared if the 90% confidence interval (CI) for the between‐group ratio (hepatic impairment/normal function) was within the interval 0.70 to 1.43.

Results

Semaglutide exposure was similar across all groups, with AUC0‐∞ treatment ratios for mild impairment/normal function of 0.95 (90% CI 0.77, 1.16), moderate impairment/normal function 1.02 (90% CI 0.93, 1.12), and severe impairment/normal function 0.97 (90% CI 0.84, 1.12). The maximum plasma semaglutide concentration (Cmax) did not appear to be influenced by hepatic function, with mild impairment/normal function treatment ratios of 0.99 (90% CI 0.80, 1.23), moderate impairment/normal function 1.02 (90% CI 0.88, 1.18) and severe impairment/normal function 1.15 (90% CI 0.89, 1.48; sensitivity analysis excluding one extreme semaglutide concentration: 1.05 [90% CI 0.88, 1.25]). In all, 10 participants reported 12 mild or moderate non‐serious adverse events. No unexpected safety or tolerability issues were observed.

Conclusions

Semaglutide exposure did not appear to be affected by hepatic impairment, suggesting that dose adjustment may not be necessary in patients with hepatic impairment. Semaglutide was well tolerated and there were no unexpected safety issues.
MULTIREGIONAL FIRMS AND REGION SWITCHING IN THE U.S. MANUFACTURING SECTOR
Authors: Gervais Antoine
Published: December 2017

I use data on U.S. manufacturing establishments to study the spatial reallocation of resources that takes place within surviving firms as they open and close establishments in different regions. To motivate the empirical analysis, I extend existing models of industry dynamics to include production‐location decisions within firms. Consistent with the theory, the empirical results show that only a fraction of firms make the same product in multiple regions, that multiregional firms are larger and more productive on average compared to single‐region firms, and that “region switching” is pervasive among multiregional firms and correlated with changes in firm and firm‐region characteristics. (JEL L2, F12, F23)
DISSECTING THE MONTY HALL ANOMALY
Authors: James Duncan , Friedman Daniel , Louie Christina , O'Meara Taylor
Published: December 2017

We assess competing explanations of irrational behavior in the Monty Hall problem by creating new variants of the problem. Some variants employ a feature that automates the merging of probabilities, thus rendering transparent the probabilistic advantage of the rational choice. That feature also enables systematic variation in informational asymmetry, and in ordering of actions. Data from 77 subjects, each of whom makes 30 binary decisions, indicate that automated merging raises the fraction of rational choices from around 40% to over 80%. Other features examined have much less impact, indicating the importance of a Bayesian updating failure. (JELC91, D02, D81, D83)
JOBLESS RECOVERIES: STAGNATION OR STRUCTURAL CHANGE?
Authors: Burger John D. , Schwartz Jeremy S.
Published: December 2017

Within the existing literature a number of competing explanations for jobless recoveries have emerged. On the one hand there is evidence of dynamic structural change including offshoring/globalization and technological advances that are resulting in the loss of middle‐skill (routine) employment. Other studies emphasize a less dynamic economy with slower growth, reduced labor market fluidity, a decline in startup activity, and even economic stagnation. This study exploits variation among U.S. states to assess the degree that stagnation and/or important structural changes in the economy contribute to the recent phenomenon of jobless recoveries. We find support for both the stagnation and structural change theories of jobless recoveries. On the stagnation side, we find evidence that lower startup rates are a significant predictor of jobless recoveries. We also find evidence that links dynamic structural change to the jobless recovery phenomenon. More specifically states experiencing a long‐run downward trend in the share of routine employment are more likely to experience a jobless recovery. Our results are consistent with the polarization theory where routine‐replacing technological advances permanently reduce demand for middle‐skill labor, thus contributing to jobless recoveries. (JEL E32, E24)
Biotic filtering and mass effects in small shrub patches: is arthropod community structure predictable based on the quality of the vegetation?
Authors: LANTA VOJTĚCH , NORRDAHL KAI , GILBERT SONJA , SÖDERMAN GUY , RINNE VEIKKO
Published: December 2017

1. Community assembly is affected by four processes: dispersal, filtering effects (selection), ecological drift and evolution. The role of filtering relative to dispersal and drift should decline with patch size, hampering possibilities to predict which organisms will be observed within small‐sized patches. However, vegetation structure is known to have a marked impact on species assemblages, and plant quality may act as a biotic filter. This challenges the assumption of unpredictable species assemblages in small‐sized vegetation patches.

2. Using 32 stands of five shrub species in south‐west Finland, this study investigated whether biotic filtering effects caused by patch‐forming plants are strong enough to overcome the mixing of mobile arthropod assemblages across small patches.

3. Stochastic variation did not hide the signals of biotic filtering and dispersal in the small shrub patches. Habitat richness around the patches explained a three times larger share of variation in the species composition than did the identity of the patch‐forming plant, but it had less effect on the abundance of arthropods. A radius of 50–100 m around a patch explained the species composition best.

4. Abundance patterns varied between the feeding guilds; the patch‐forming shrub influenced the abundances of detritivores and leaf‐feeding herbivores, whereas the abundances of flower‐visiting herbivores appeared to track the flowering phenology of the plants. Shrub identity had little effect on omnivores or predators. Predator abundances were correlated with the abundance of potential prey.

5. The results of this study suggest that community composition within a vegetation patch may be predictable even if dispersal overrides local filtering effects, as suggested by the mass‐effects paradigm.
Refinement of detecting atrial fibrillation in stroke patients: results from the TRACK‐AF Study
Authors: Reinke F. , Bettin M. , Ross L. S. , Kochhäuser S. , Kleffner I. , Ritter M. , Minnerup J. , Dechering D. , Eckardt L. , Dittrich R.
Published: December 2017

Background and purpose

Detection of occult atrial fibrillation (AF) is crucial for optimal secondary prevention in stroke patients. The AF detection rate was determined by implantable cardiac monitor (ICM) and compared to the prediction rate of the probability of incident AF by software based analysis of a continuously monitored electrocardiogram at follow‐up (stroke risk analysis, SRA); an optimized AF detection algorithm is proposed by combining both tools.

Methods

In a monocentric prospective study 105 out of 389 patients with cryptogenic stroke despite extensive diagnostic workup were investigated with two additional cardiac monitoring tools: (a) 20 months’ monitoring by ICM and (b) SRA during hospitalization at the stroke unit.

Results

The detection rate of occult AF was 18% by ICM (n = 19) (range 6–575 days) and 62% (n = 65) had an increased risk for AF predicted by SRA. When comparing the predictive accuracy of SRA to ICM, the sensitivity was 95%, specificity 35%, positive predictive value 27% and negative predictive value 96%. In 18 patients with AF detected by ICM, SRA also showed a medium risk for AF. Only one patient with a very low risk predicted by SRA developed AF revealed by ICM after 417 days.

Conclusions

A combination of SRA and ICM is a promising strategy to detect occult AF. SRA is reliable in predicting incident AF with a high negative predictive value. Thus, SRA may serve as a cost‐effective pre‐selection tool identifying patients at risk for AF who may benefit from further cardiac monitoring by ICM.
Collared peccary (Pecari tajacu) behavioral reactions toward a dead member of the herd
Authors: de Kort Dante , Altrichter Mariana , Cortez Sara , Camino Micaela
Published: December 2017

Humans, elephants, chimpanzees, and cetaceans show concern with the death of other members of their species and respond to death in particular ways. Science considers that these species are exceptions and that other mammal species show little or no reaction to the dead bodies of individuals of their species. Collared peccaries (Pecari tajacu; Tayassuidae) are social animals that live in groups of 5–50 individuals maintaining close and complex social relationships. The collared peccary occupies many different environments and it is widely distributed from the south of North America to the north of Argentina. Their behavior is well studied, but we know little about their behavior toward the dead. We directly observed and filmed with a camera trap the reactions of a five‐member herd of collared peccaries to the death of a herd member. We worked on a suburban forested area in the mountains of central Arizona. We found that the herd visited and spent time with the dead body for 10 days after the peccary died. The frequency of the visits declined until the cadaver was consumed by coyotes. Most of the videos showed two individuals visited the dead animal (44%), solitary records were also frequent (39%) and only 4% of the videos recorded three peccaries. Visits were more frequent during the night (64%). Peccaries do react to the death of a herd member by behaving in particular ways. Reactions include pushing at the dead individual, staring at it, biting it, and trying to pick it up by putting their snout under the corpse and pushing it up, and defending it from coyotes, among others. These levels of behavioral complexity for peccaries are beyond those known so far. The behaviors of this herd of peccaries resemble those of humans, cetaceans, chimpanzees, and elephants and show that these groups are not the only ones that react to death.
Experimental manipulation of female tail length did not cause differential allocation by males in the barn swallow
Authors: Hasegawa Masaru , Arai Emi , Nakamura Masahiko
Published: December 2017

The evolution and maintenance of female ornamentation has attracted increasing attention, because the previous explanation, that is a non‐functional copy of functional male ornamentation, seems insufficient to explain female ornamentation. A post‐mating sexual selection, differential allocation, may be more common than pre‐mating sexual selection, but few studies have investigated differential allocation by males. Here, we studied differential allocation of incubation investment by male barn swallowsHirundo rustica, a model species for the study of sexual selection, because our previous correlative study demonstrated a positive relationship between female tail length and male incubation investment. We manipulated the length of the outermost tail feathers in females after clutch completion and examined whether males adjust incubation investment according to female ornamentation. Because extra‐pair paternity is virtually absent in the study population, we were able to study differential allocation based on the tradeoff between current and future reproductive investments, rather than the tradeoff between current paternal investment and additional mating effort. The experimental treatment had no significant effect on male nest attentiveness, whereas female tail length before manipulation predicted male nest attentiveness. The observed pattern is consistent with differential access; that is, well‐ornamented individuals have greater access to mates with high reproductive (parental) ability, rather than differential allocation during incubation. Alternatively, males can directly assess eggs in their nests, and thus, as seen in other species, males might adjust their incubation investment based on the egg characteristics of long‐tailed females.
Disentangling the effects of genetic and environmental factors on movement behaviour
Authors: Bombieri Giulia , Fasciolo Antonio , Penteriani Vincenzo , Illera Juan Carlos , Chamberlain Dan , Delgado María del Mar
Published: December 2017

Individual variability in animal movement behaviour is well documented for many species. However, it remains unclear whether this variability reflects genetic variation, environmental variation or a combination of the two. Here, we conduct a cross‐fostering experiment with the aim of investigating the role of these two components in movement patterns during the post‐fledging dependence period and early natal dispersal of 21 eagle owls Bubo bubo. Our experiment showed that cross‐fostering did not influence any of the movement parameters considered. Movement parameters were, however, affected by the age and sex of the owlets. We therefore suggest that individual variability and family resemblance in movement behaviour during the post‐fledging dependence period and early natal dispersal might not be due to the common genetic origin of siblings, but rather that it originates from factors related to the rearing environment.