bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic comorbidity in multiple sclerosis is associated with lower incomes and dissolved intimate relationships
Authors: Thormann A. , Sørensen P. S. , Koch‐Henriksen N. , Thygesen L. C. , Laursen B. , Magyari M.
Published: May 2017

Background and purpose

The social and economic consequences of comorbidity in multiple sclerosis (MS) are largely unexplored. Differences were investigated in income and in the rate of broken relationships between cases of MS with and without chronic comorbidity.

Methods

We conducted a nationwide cohort study including all incident cases of MS in Denmark with clinical MS onset between 1980 and 2005. The difference in income was investigated at MS onset and 5 and 10 years after MS onset. The difference in the rate of broken relationships was investigated in subjects who were in a relationship at MS onset or who entered a relationship after MS onset. We used logistic, multiple linear and Poisson regression analyses.

Results

Cases of MS with somatic comorbidity had increased odds of low incomes both 5 years {odds ratio (OR), 1.41 [95% confidence interval (CI), 1.19–1.67; P < 0.0005]} and 10 years [OR, 1.37 (95% CI, 1.17–1.60); P < 0.0005] after MS onset. The odds of a low income with psychiatric comorbidity was increased 10 years after MS onset [OR, 3.06 (95% CI, 1.47–6.37); P = 0.003]. The rate of broken relationships was increased in cases of MS with any somatic comorbidity [incidence rate ratio, 1.46 (95% CI, 1.32–1.61); P < 0.0005].

Conclusions

Our results underscore the burden of comorbidity in MS on patients, their partners and society.
No relevant impact of ambient temperature on disability measurements in a large cohort of patients with multiple sclerosis
Authors: Stellmann J.‐P. , Young K. L. , Vettorazzi E. , Pöttgen J. , Heesen C.
Published: May 2017

Background and purpose

Many patients with multiple sclerosis (MS) report a worsening of symptoms due to high ambient temperatures, but objective data about this association are rare and contradictory. The aim of this study was to investigate the influence of ambient temperature on standard clinical tests.

Methods

We extracted the Symbol Digit Modality Test, Nine Hole Peg Test, Timed 25 Foot Walk (T25FW), Timed Tandem Walk, Expanded Disability Status Scale (EDSS) and quality‐of‐life items on cognition, fatigue and depression from our clinical database and matched them to historical temperatures. We used linear mixed‐effect models to investigate the association between temperature and outcomes.

Results

A total of 1254 patients with MS (mean age, 42.7 years; 69.9% females; 52.1% relapsing–remitting MS, mean EDSS, 3.8) had 5751 assessments between 1996 and 2012. We observed a worsening in the T25FW with higher ambient temperatures in moderately disabled patients (EDSS ≥ 4) but not in less disabled patients. However, an increase of 10°C prolonged the T25FW by just 0.4 s. Other outcomes were not associated with ambient temperatures.

Conclusions

Higher ambient temperature might compromise walking capabilities in patients with MS with a manifest walking impairment. However, effects are small and not detectable in mildly disabled patients. Hand function, cognition, mood and fatigue do not appear to be correlated with ambient temperature.
Defining epileptogenic networks: Contribution of SEEG and signal analysis
Authors: Bartolomei Fabrice , Lagarde Stanislas , Wendling Fabrice , McGonigal Aileen , Jirsa Viktor , Guye Maxime , Bénar Christian
Published: May 2017

Epileptogenic networks are defined by the brain regions involved in the production and propagation of epileptic activities. In this review we describe the historical, methodologic, and conceptual bases of this model in the analysis of electrophysiologic intracerebral recordings. In the context of epilepsy surgery, the determination of cerebral regions producing seizures (i.e., the “epileptogenic zone”) is a crucial objective. In contrast with a traditional focal vision of focal drug‐resistant epilepsies, the concept of epileptogenic networks has been progressively introduced as a model better able to describe the complexity of seizure dynamics and realistically describe the distribution of epileptogenic anomalies in the brain. The concept of epileptogenic networks is historically linked to the development of the stereoelectroencephalography (SEEG) method and subsequent introduction of means of quantifying the recorded signals. Seizures, and preictal and interictal discharges produce clear patterns on SEEG. These patterns can be analyzed utilizing signal analysis methods that quantify high‐frequency oscillations or changes in functional connectivity. Dramatic changes in SEEG brain connectivity can be described during seizure genesis and propagation within cortical and subcortical regions, associated with the production of different patterns of seizure semiology. The interictal state is characterized by networks generating abnormal activities (interictal spikes) and also by modified functional properties. The introduction of novel approaches to large‐scale modeling of these networks offers new methods in the goal of better predicting the effects of epilepsy surgery. The epileptogenic network concept is a key factor in identifying the anatomic distribution of the epileptogenic process, which is particularly important in the context of epilepsy surgery.
Problem‐solving skills are linked to parental care and offspring survival in wild house sparrows
Authors: Wetzel Daniel P.
Published: May 2017

Individuals within a population often exhibit consistent differences in important behavioral traits such as parental care. One interesting, yet largely unexplored explanation for the existence of these consistent differences among parents is the idea that cognitive differences between individuals could lead to between‐individual variation in parenting behavior. I used a wild population of house sparrows (Passer domesticus) to test the nature of the relationship between aspects of cognitive ability (problem‐solving performance and learning) and parental care behavior, both measured in the wild. Furthermore, because parental care is tightly linked to fitness, I also investigated the relationship between problem‐solving performance and offspring survival. Parent sparrows were presented with a novel problem‐solving task that required them to remove an obstacle to obtain food. While there was no relationship between the ability to complete the task and measures of parental care (nestling provisioning rate or likelihood of provisioning with large food items), parents that solved the task quickly had higher provisioning rates than slow solvers. Additionally, the ability of fathers to complete the problem‐solving task was positively related to offspring survival. These results provide evidence that aspects of problem‐solving performance are positively correlated with parenting behavior and fitness in the wild.
A widened substrate selectivity filter of eukaryotic formate‐nitrite transporters enables high‐level lactate conductance
Authors: Wiechert Marie , Erler Holger , Golldack André , Beitz Eric
Published: May 2017

Bacterial formate‐nitrite transporters (FNT) regulate the metabolic flow of small weak mono‐acids derived from anaerobic mixed‐acid fermentation, such as formate, and further transport nitrite and hydrosulfide. The eukaryotic Plasmodium falciparumFNT is vital for the malaria parasite by its ability to release the larger l‐lactate substrate as the metabolic end product of anaerobic glycolysis in symport with protons preventing cytosolic acidification. However, the molecular basis for substrate discrimination by FNTs has remained unclear. Here, we identified a size‐selective FNT substrate filter region around an invariant lysine at the bottom of the periplasmic/extracellular vestibule. The selectivity filter is reminiscent of the aromatic/arginine constriction of aquaporin water and solute channels regarding composition, location in the protein, and the size‐selection principle. Bioinformatics support an adaptation of the eukaryotic FNT selectivity filter to accommodate larger physiologically relevant substrates. Mutations that affect the diameter at the filter site predictably modulated substrate selectivity. The shape of the vestibule immediately above the filter region further affects selectivity. This study indicates that eukaryotic FNTs evolved to transport larger mono‐acid substrates, especially l‐lactic acid as a product of energy metabolism.
Toward Useful Assessment and Evaluation of Heritage Language Learning
Authors: Son Young‐A
Published: May 2017

With a growing population of heritage language speakers in the United States and an increasing enrollment of heritage language learners (HLLs) in language classrooms (Beaudrie & Ducar, 2012; Carreira & Kagan, 2011), heritage language (HL) education has become a special concern within the language acquisition research community. Although there has been a proliferation of studies in this field, research oriented toward assessment and evaluation in HL education has been limited. This article addresses three major areas of research on the design and implementation of assessment for adult HLLs and the evaluation of the programs that serve them. First, the article examines the considerable ongoing discussion of appropriate HL assessments, in particular the applicability of the ACTFL Proficiency Guidelines (ACTFL, 2012). Next, it examines investigations of different sociocultural factors that may predict HL proficiency. Finally, the article considers the small but growing line of research on the evaluation of HL programs, often conducted through national‐level surveys or through the systematic evaluation of HL programs. Developing from these existing lines of inquiry, the review offers a number of recommendations to improve future research in this area.
Potential implications of acoustic stimuli as a non‐physical barrier to silver carp and bighead carp
Authors: Murchy K. A. , Cupp A. R. , Amberg J. J. , Vetter B. J. , Fredricks K. T. , Gaikowski M. P. , Mensinger A. F.
Published: May 2017

The effectiveness of an acoustic barrier to deter the movement of silver carp, Hypophthalmichthys molitrix (Valenciennes) and bighead carp, H. nobilis (Richardson) was evaluated. A pond (10 m × 5 m × 1.2 m) was divided in half by a concrete‐block barrier with a channel (1 m across) allowing fish access to each side. Underwater speakers were placed on each side of the barrier opening, and an outboard motor noise (broadband sound; 0.06–10 kHz) was broadcast to repel carp that approached within 1 m of the channel. Broadband sound was effective at reducing the number of successful crossings in schools of silver carp, bighead carp and a combined school. Repulsion rates were 82.5% (silver carp), 93.7% (bighead carp) and 90.5% (combined). This study demonstrates that broadband sound is effective in deterring carp and could be used as a deterrent in an integrated pest management system.
Climbing success of adult Pacific lamprey on a vertical wetted wall
Authors: Frick K. E. , Corbett S. C. , Moser M. L.
Published: May 2017

The ability of adult Pacific lamprey, Entosphenus tridentatus (Gairdner), to climb has enabled development of lamprey‐specific fishways. Sheer vertical climbing elements are needed for these structures when fishway installation space is limited. A 1.6‐m high aluminium wetted wall was built to test Pacific lamprey vertical climbing in relation to flow and three water delivery mechanisms: overflow, upwelling and sidewelling. Passage success and passage times were recorded for individual Pacific lamprey (n = 122). For those that interacted with the structure (n = 104), 94% successfully ascended the wall (76% on their first attempt). Average time from first interaction with the structure to exit ranged from 19.5 to 47.0 min. Success rates and passage times were not significantly affected by flow or water delivery treatments. This indicates that vertical elements can facilitate lamprey passage in the 0.13–3.59 L min−1 cm−1 flow range tested and may greatly expand the design alternatives in certain situations.
Evaluation of external fish injury caused by hydropower plants based on a novel field‐based protocol
Authors: Mueller M. , Pander J. , Geist J.
Published: May 2017

Knowledge on the extent and mechanisms of fish damage caused by hydropower facilities is important for their ecological improvement. Herein, a novel field‐based fish injury assessment protocol is proposed that includes vitality and four general health criteria, as well as nine lethal and sub‐lethal injury types across 18 body parts. The protocol was validated using 3,087 specimens from four species of hatchery‐reared fish, as well as 2,262 specimens from 32 species of wild fish. The protocol allowed a detailed and systematic evaluation of different fish injury types in the field. Injuries related to handling and to contact with different parts of the hydropower structure could be distinguished applying multivariate statistics. This approach allows quantification and comparison of fish injuries across sites, and can help to identify the technologies and operational procedures that minimise damage to fish. It may also be useful to assess fish health in other contexts including aquaculture.
Release during night enhances survival of wild Atlantic salmon smolts
Authors: Vollset K. W. , Barlaup B. T. , Normann E. S.
Published: May 2017

The effect of nocturnal and diurnal releases on survival and migration of wild and hatchery‐reared Atlantic salmon, Salmo salar, L., smolts (n = 82) was investigated by releasing acoustically tagged smolts at the lower end of the River Vosso, Norway. Hatchery smolts was registered in the estuary within hours of their release, whereas wild smolts migrated over a prolonged period. The time of estuary exit was affected by river discharge but not by time of release. Progression rates were slow through the estuary (0.25 BL/s ± 0.18 SD) and fast through the fjord (1.80 BL/s ± 0.69 SD), and they were not affected by the time of release or origin. Survival to the fjord was low (0%–15%). Survival was not affected by body length but was lower for wild smolts than for hatchery smolts, and survival of the former was lower when the fish were released in daylight.
Soil organic carbon dynamics jointly controlled by climate, carbon inputs, soil properties and soil carbon fractions
Authors: Luo Zhongkui , Feng Wenting , Luo Yiqi , Baldock Jeff , Wang Enli
Published: May 2017

Soil organic carbon (SOC) dynamics are regulated by the complex interplay of climatic, edaphic and biotic conditions. However, the interrelation of SOC and these drivers and their potential connection networks are rarely assessed quantitatively. Using observations of SOC dynamics with detailed soil properties from 90 field trials at 28 sites under different agroecosystems across the Australian cropping regions, we investigated the direct and indirect effects of climate, soil properties, carbon (C) inputs and soil C pools (a total of 17 variables) on SOC change rate (rC, Mg C ha−1 yr−1). Among these variables, we found that the most influential variables on rC were the average C input amount and annual precipitation, and the total SOC stock at the beginning of the trials. Overall, C inputs (including C input amount and pasture frequency in the crop rotation system) accounted for 27% of the relative influence on rC, followed by climate 25% (including precipitation and temperature), soil C pools 24% (including pool size and composition) and soil properties (such as cation exchange capacity, clay content, bulk density) 24%. Path analysis identified a network of intercorrelations of climate, soil properties, C inputs and soil C pools in determining rC. The direct correlation of rC with climate was significantly weakened if removing the effects of soil properties and C pools, and vice versa. These results reveal the relative importance of climate, soil properties, C inputs and C pools and their complex interconnections in regulating SOC dynamics. Ignorance of the impact of changes in soil properties, C pool composition and C input (quantity and quality) on SOC dynamics is likely one of the main sources of uncertainty in SOC predictions from the process‐based SOC models.
Simulated climate change, epidemic size, and host evolution across host–parasite populations
Authors: Auld Stuart K.J.R. , Brand June
Published: May 2017

Climate change is causing warmer and more variable temperatures as well as physical flux in natural populations, which will affect the ecology and evolution of infectious disease epidemics. Using replicate seminatural populations of a coevolving freshwater invertebrate‐parasite system (host: Daphnia magna, parasite: Pasteuria ramosa), we quantified the effects of ambient temperature and population mixing (physical flux within populations) on epidemic size and population health. Each population was seeded with an identical suite of host genotypes and dose of parasite transmission spores. Biologically reasonable increases in environmental temperature caused larger epidemics, and population mixing reduced overall epidemic size. Mixing also had a detrimental effect on host populations independent of disease. Epidemics drove parasite‐mediated selection, leading to a loss of host genetic diversity, and mixed populations experienced greater evolution due to genetic drift over the season. These findings further our understanding of how diversity loss will reduce the host populations’ capacity to respond to changes in selection, therefore stymying adaptation to further environmental change.
Increasing carbon discrimination rates and depth of water uptake favor the growth of Mediterranean evergreen trees in the ecotone with temperate deciduous forests
Authors: Barbeta Adrià , Peñuelas Josep
Published: May 2017

Tree populations at the low‐altitudinal or ‐latitudinal limits of species' distributional ranges are predicted to retreat toward higher altitudes and latitudes to track the ongoing changes in climate. Studies have focused on the climatic sensitivity of the retreating species, whereas little is known about the potential replacements. Competition between tree species in forest ecotones will likely be strongly influenced by the ecophysiological responses to heat and drought. We used tree‐ring widths and δ13C and δ18O chronologies to compare the growth rates and long‐term ecophysiological responses to climate in the temperate‐Mediterranean ecotone formed by the deciduous Fagus sylvatica and the evergreen Quercus ilex at the low altitudinal and southern latitudinal limit of F. sylvatica (NE Iberian Peninsula). F. sylvatica growth rates were similar to those of other southern populations and were surprisingly not higher than those of Q. ilex, which were an order of magnitude higher than those in nearby drier sites. Higher Q. ilex growth rates were associated with high temperatures, which have increased carbon discrimination rates in the last 25 years. In contrast, stomatal regulation in F. sylvatica was proportional to the increase in atmospheric CO2. Tree‐ring δ18O for both species were mostly correlated with δ18O in the source water. In contrast to many previous studies, relative humidity was not negatively correlated with tree‐ring δ18O but had a positive effect on Q. ilex tree‐ring δ18O. Furthermore, tree‐ring δ18O decreased in Q. ilex over time. The sensitivity of Q. ilex to climate likely reflects the uptake of deep water that allowed it to benefit from the effect of CO2 fertilization, in contrast to the water‐limited F. sylvatica. Consequently, Q. ilex is a strong competitor at sites currently dominated by F. sylvatica and could be favored by increasingly warmer conditions.
Clinical features of extremely elderly patients with heart failure
Authors: Yokokawa Tetsuro , Yoshihisa Akiomi , Kanno Yuki , Sato Takamasa , Suzuki Satoshi , Misaka Tomofumi , Oikawa Masayoshi , Kobayashi Atsushi , Yamaki Takayoshi , Kunii Hiroyuki , Nakazato Kazuhiko , Suzuki Hitoshi , Saitoh Shu‐Ichi , Takeishi Yasuchika
Published: May 2017

Aim

To investigate the clinical features of heart failure in extremely elderly patients.

Methods

We analyzed 1163 consecutive hospitalized heart failure patients. The patients were divided into an extremely elderly group (≥85 years‐of‐age, n = 88) and a non‐extremely elderly group (<85 years‐of‐age, n = 1075).

Results

The extremely elderly group had higher rates of hypertension, chronic kidney disease, anemia, higher systolic blood pressure and lower body mass index, and lower use of β‐blockers and anticoagulants compared with the non‐extremely elderly group. During the mean follow‐up period of 1038 days, the extremely elderly group had higher mortality compared with the non‐extremely elderly group (P < 0.001). In multivariate analysis, in the non‐extremely elderly group, age (HR 1.027, P < 0.001), body mass index (HR 0.919, P < 0.001), New York Heart Association III or IV (HR 3.626, P < 0.001), preserved ejection fraction (HR 0.553, P < 0.001), anemia (HR 1.941, P < 0.001), β‐blockers (HR 0.695, P = 0.028) and renin–angiotensin system inhibitors (HR 0.603, P = 0.001) were independent predictors for all‐cause death. In contrast, atrial fibrillation (HR 2.042, P = 0.015) and renin–angiotensin system inhibitors (HR 0.470, P = 0.014) were independent predictors for all‐cause death in the extremely elderly group, suggesting that the prognostic factors were different between the two groups.

Conclusions

We should be careful of atrial fibrillation and renin–angiotensin system inhibitors in managing extremely elderly patients with heart failure. Geriatr Gerontol Int 2017; 17: 2194–2199.
Novel tool for deprescribing in chronic patients with multimorbidity: List of Evidence‐Based Deprescribing for Chronic Patients criteria
Authors: Rodríguez‐Pérez Aitana , Alfaro‐Lara Eva Rocío , Albiñana‐Perez Sandra , Nieto‐Martín María Dolores , Díez‐Manglano Jesús , Pérez‐Guerrero Concepción , Santos‐Ramos Bernardo
Published: May 2017

Aim

To create a tool to identify drugs and clinical situations that offers an opportunity of deprescribing in patients with multimorbidity.

Methods

A literature review completed with electronic brainstorming, and subsequently, a panel of experts using the Delphi methodology were applied. The experts assessed the criteria identified in the literature and brainstorming as possible situations for deprescribing. They were also asked to assess the influence of life prognosis in each criterion. A tool was composed of the most appropriate criteria according to the strength of their evidence, usefulness in patients with multimorbidity and applicability in clinical practice.

Results

Out of a total of 100, 27 criteria were selected to be included in the final list. It was named the LESS‐CHRON criteria (List of Evidence‐baSed depreScribing for CHRONic patients), and was organized by the anatomical group of the Anatomical, Therapeutic, Chemical (ATC) classification system of the drug to be deprescribed. Each criterion contains: drug indication for which it is prescribed, clinical situation that offers an opportunity to deprescribe, clinical variable to be monitored and the minimum time to follow up the patient after deprescribing.

Conclusions

The “LESS‐CHRON criteria” are the result of a comprehensive and standardized methodology to identify clinical situations for deprescribing drugs in chronic patients with multimorbidity. Geriatr Gerontol Int 2017; 17: 2200–2207.
DNA damage marker phosphorylated histone H2AX is a potential predictive marker for progression of epithelial dysplasia of the oral cavity
Authors: Leung Elaine Y , McMahon Jeremy D , McLellan Douglas R , Syyed Nazlie , McCarthy Caroline E , Nixon Colin , Orange Clare , Brock Claire , Hunter Keith D , Adams Peter D
Published: May 2017

Aims

To evaluate the relationships between immunohistochemical markers related to cellular senescence, cell proliferation and histological grade of epithelial dysplasia (OD) of the oral cavity. In addition, the predictive value of these markers for progression of OD was assessed.

Methods and results

Retrospective immunohistochemical analyses were performed on 86 formalin‐fixed paraffin‐embedded specimens of OD and oral squamous cell carcinoma (OSCC) for Ki67, phosphorylated histone H2AX (γH2AX), p53, p16, trimethyl‐histone H3 (Lys9) (H3K9me3) and cyclin D1 (CycD1). Three separate areas representing the highest severity of OD on each slide were annotated digitally by two independent pathologists. Mean automated histoscores of the selected markers were generated and compared to that of age‐matched healthy controls (n = 24). Follow‐up data of OD were retrieved and anonymized by a clinical team member and linked using unique participant identifiers. The median follow‐up was 10.9 years (interquartile range: 10.1–11.5). Ki67 (P < 0.0001), γH2AX (P = 0.03) and p53 (P = 0.04) were increased significantly with higher histological grade of OD. γH2AX (P = 0.03), but not histological grade of OD (P = 0.73), was associated prospectively with disease progression. Using the median histoscore for γH2AX (median histoscore = 17) as a cut‐off, histoscore ≥17 was associated with an increased risk of disease progression [hazard ratio (HR) = 3.15, 95% confidence interval (CI): 1.41–7.39, P = 0.0064].

Conclusions

Although proliferation marker Ki67, DNA damage/checkpoint markers γH2AX and p53 were increased in higher grade of OD, only γH2AX was predictive of disease progression. These observations may reflect the role of DNA replicative stress in the transformation from OD to OSCC. Larger studies should evaluate whether γH2AX can be used as a predictive marker of OD.
Effect of ultrasonic and sonic activation of root canal sealers on the push‐out bond strength and interfacial adaptation to root canal dentine
Authors: Wiesse P. E. B. , Silva‐Sousa Y. T. , Pereira R. D. , Estrela C. , Domingues L. M. , Pécora J. D. , Sousa‐Neto M. D.
Published: May 2017

Aim

To evaluate the effect of ultrasonic and sonic activation of two root canal sealers on interfacial adaptation and push‐out bond strength (BS) to root canal dentine.

Methodology

The root canals of seventy‐eight roots of maxillary canines were prepared with NiTi rotary instruments under irrigation with 2.5% NaOCl and 17% EDTA. Canals were filled by lateral condensation of gutta‐percha and AH Plus (n = 39) or MTA Fillapex (n = 39). Three subgroups (n = 13) were formed according to sealer activation: no activation (NA), sonic activation (SA, 20 s) and ultrasonic activation (US, 20 s). In three specimens of each subgroup, 0.1% rhodamine B was added to the sealer. Three 1‐mm‐thick slices were obtained from each root third. The first and second were used for push‐out BS test and the third for a qualitative analysis of interfacial adaptation (gaps) and voids by confocal laser scanning microscopy (CLSM). Intratubular penetration of rhodamine B‐labelled sealer was also assessed by CLSM. Data were analysed by two‐way anova and Tukey's test (α = 0.05).

Results

AH Plus (2.58 ± 1.21) had higher push‐out BS than MTA Fillapex (1.45 ± 0.71) (P = 0.000). UA (2.64 ± 1.44) had higher BS (P = 0.000) than NA (1.58 ± 0.73) and SA (1.83 ± 0.85), which did not differ significantly from each other (P = 0.3303). The coronal third had higher BS (2.48 ± 1.49) than the middle (2.08 ± 0.94) (P = 0.0003) and apical (1.48 ± 0.58) (P = 0.00) thirds. For both sealers, UA was associated with a more homogeneous filling material with better interfacial adaptation and greater quantity, density and length of tags in dentinal tubules. When UA was used, the tags had similar quantity, density and length to those formed without activation, but interfacial gaps and voids were observed.

Conclusion

Ultrasonic activation was associated with higher BS values, deeper intratubular penetration and greater interfacial adaptation to root dentine than sonic activation and no activation techniques, AH Plus had higher BS values than MTA Fillapex irrespective of the type of activation.
Maternity Management in SMEs: A Transdisciplinary Review and Research Agenda
Authors: Stumbitz Bianca , Lewis Suzan , Rouse Julia
Published: May 2017

This paper provides a transdisciplinary critical review of the literature on maternity management in small and medium‐sized enterprises (SMEs), embedded within the wider literatures on maternity in the workplace. The key objectives are to describe what is known about the relations that shape maternity management in smaller workplaces and to identify research directions to enhance this knowledge. The review is guided by theory of organizational gendering and small business management, conceptualizing adaptions to maternity as a process of mutual adjustment and dynamic capability within smaller firms’ informally negotiated order, resource endowments and wider labour and product/service markets. A context‐sensitive lens is also applied. The review highlights the complex range of processes involved in SME maternity management and identifies major research gaps in relation to pregnancy, maternity leave and the return to work (family‐friendly working and breastfeeding) in these contexts. This blind spot is surprising, as SMEs employ the majority of women worldwide. A detailed agenda for future research is outlined, building on the gaps identified by the review and founded on renewed theoretical direction.
Global analysis of strategies to tackle antimicrobial resistance†
Authors: Adeniji Funke
Published: May 2017

Background

Antimicrobial resistance (AMR) is a global public health issue driven by inappropriate use of antimicrobials resulting in decreased efficacy on the background of an extremely limited pipeline for new antibiotics. We sought to analyse the effectiveness of key policies and strategies in tackling AMR globally and identify gaps in these.

Method

The scope, magnitude, history and drivers of AMR were reviewed using supporting evidence. Our methodology included a literature review and semi-structured survey, whilst the analyses process was guided by an adapted health policy analyses framework.

Results

Six key policies of global, UK and Nigerian origin were identified along with supporting literature. Seven respondents from key organisations were identified and interviewed. Their responses were analysed using framework analyses principles.

Conclusions

Antimicrobial resistance is driven by several factors, ranging from poverty to poor implementation of inadequate policies. The UK AMR strategy is the most comprehensive with room for improvement. Nigeria lacks a specific AMR policy, but has other policies which address health system drivers of AMR. Similarly, the UK's surveillance system is extensive with recent findings corresponding to global findings. Nigeria's surveillance system is focused on detecting and tackling epidemics as indicated by its recent success with Ebola, but there is room for improvement and it could be expanded to cover AMR. Global policies do not add much value to the UK strategy and provide little guidance on how low-income countries, for example Nigeria can fill current gaps in surveillance and policies as key drivers are not fully addressed.
Epidemiology of urothelial carcinoma
Authors: Miyazaki Jun , Nishiyama Hiroyuki
Published: May 2017

The epithelium lining is defined as the mucosal surfaces of the renal collecting tubules, calyces and pelvis, as well as the ureter, bladder and urethra. The term “urothelium” is used to refer to these surfaces. Upper tract urothelial carcinoma is a rare subset of urothelial cancers with a poor prognosis. Urinary bladder cancer is the most common malignancy involving the urinary system. Upper tract urothelial carcinoma is more common in men than in women, with a male‐to‐female ratio of 2:1. The incidence of urinary bladder cancer is also higher in men. Cigarette smoking and occupational exposure are the main upper tract urothelial carcinoma and urinary bladder cancer risk factors, while other factors are more specific to the carcinogenesis of upper tract urothelial carcinoma (i.e. Balkan endemic nephropathy, Chinese herb nephropathy). In Egypt until recent years, urinary bladder cancer was the most frequently diagnosed cancer due to Schistosoma haematobium. Substantial knowledge exists regarding the causes of upper tract urothelial carcinoma and urinary bladder cancer, and epidemiological studies have identified various chemical carcinogens that are believed to be responsible for most cases of urothelial carcinoma. In the era of precision medicine, genetic effects might play a direct role in the initiation and progression of urothelial carcinoma.
The immune response to Prevotella bacteria in chronic inflammatory disease
Authors: Larsen Jeppe Madura
Published: May 2017

The microbiota plays a central role in human health and disease by shaping immune development, immune responses and metabolism, and by protecting from invading pathogens. Technical advances that allow comprehensive characterization of microbial communities by genetic sequencing have sparked the hunt for disease‐modulating bacteria. Emerging studies in humans have linked the increased abundance of Prevotella species at mucosal sites to localized and systemic disease, including periodontitis, bacterial vaginosis, rheumatoid arthritis, metabolic disorders and low‐grade systemic inflammation. Intriguingly, Prevotella abundance is reduced within the lung microbiota of patients with asthma and chronic obstructive pulmonary disease. Increased Prevotella abundance is associated with augmented T helper type 17 (Th17) ‐mediated mucosal inflammation, which is in line with the marked capacity of Prevotella in driving Th17 immune responses in vitro. Studies indicate that Prevotella predominantly activate Toll‐like receptor 2, leading to production of Th17‐polarizing cytokines by antigen‐presenting cells, including interleukin‐23 (IL‐23) and IL‐1. Furthermore, Prevotella stimulate epithelial cells to produce IL‐8, IL‐6 and CCL20, which can promote mucosal Th17 immune responses and neutrophil recruitment. Prevotella‐mediated mucosal inflammation leads to systemic dissemination of inflammatory mediators, bacteria and bacterial products, which in turn may affect systemic disease outcomes. Studies in mice support a causal role of Prevotella as colonization experiments promote clinical and inflammatory features of human disease. When compared with strict commensal bacteria, Prevotella exhibit increased inflammatory properties, as demonstrated by augmented release of inflammatory mediators from immune cells and various stromal cells. These findings indicate that some Prevotella strains may be clinically important pathobionts that can participate in human disease by promoting chronic inflammation.
Influence of diabetes mellitus on immunity to human tuberculosis
Authors: Kumar Nathella Pavan , Babu Subash
Published: May 2017

Type 2 diabetes mellitus(DM) is a major risk factor for the development of active pulmonary tuberculosis (TB), with development of DM pandemic in countries where TB is also endemic. Understanding the impact of DM on TB and the determinants of co‐morbidity is essential in responding to this growing public health problem with improved therapeutic approaches. Despite the clinical and public health significance posed by the dual burden of TB and DM, little is known about the immunological and biochemical mechanisms of susceptibility. One possible mechanism is that an impaired immune response in patients with DM facilitates either primary infection with Mycobacterium tuberculosis or reactivation of latent TB. Diabetes is associated with immune dysfunction and alterations in the components of the immune system, including altered levels of specific cytokines and chemokines. Some effects of DM on adaptive immunity that are potentially relevant to TB defence have been identified in humans. In this review, we summarize current findings regarding the alterations in the innate and adaptive immune responses and immunological mechanisms of susceptibility of patients with DM to M. tuberculosis infection and disease.
Political Affiliation and Pay Slice: Do Blue CEOs Accept Less Green?
Authors: Borghesi Richard , Chang Kiyoung
Published: May 2017

We examine the relationship among CEO political alignment, compensation, and pay disparity (relative to other high‐earning executives) and find that Democratic CEOs accept less pay and a significantly lower pay slice. That is, left‐leaning CEOs put their money where their mouth is regarding the Democratic ideology of economic and social equity. This smaller pay gap is not a function of variations in managerial ability; if anything, Democratic CEOs are more talented than Republican CEOs. Results suggest that Democratic CEOs may be more effective at running firms in which collaboration among top executives is more valuable than are the potential gains from tournament incentives.
Behavior of organic compounds in the pore solution of cement—experimental and molecular dynamics study
Authors: Chaudhari Ojas , Biernacki Joseph J. , Northrup Scott
Published: May 2017

This study summarizes molecular dynamics (MD) simulations and experiments using four ester‐based cement shrinkage reducing agents in pure water and simulated cement pore solution. The esters were found to completely dissociate in the alkaline pore solution to form acid and alcohol analogue compounds. The alcohol analogues were further found to be entirely responsible for the surface tension reduction capacity of the parent compounds. In addition, the surface tension reduction capacity of the alcohol analogues are not affected by relevant counterions present in the pore solution. The MD‐based analysis show that water molecules form stable hydrogen bonds with head groups of the alcohol analogues and that relevant dissolved ions, K+ and Na+, have virtually no effect on hydrogen bond stability. Furthermore, the higher the self‐diffusion coefficient of water molecules in the neighborhood of the head groups the lower the resulting surface tension at the air‐water interface.
Are fluvial islands “real” islands for arboreal mammals? Uncovering the effect of patch size under the species–area relationship
Authors: Rabelo Rafael M. , Bicca‐Marques Júlio César , Aragón Susan , Nelson Bruce Walker
Published: May 2017

Aim

We tested the “habitat amount hypothesis”, which predicts that the effect of patch size on number of species results from a “sample area effect” rather than an “island effect”. Specifically, we (1) compared parameters of the species–area relationship (SAR) of arboreal mammals in forested fluvial islands and continuous forest, and (2) separated the effects of island size and of landscape‐scale habitat amount on species richness.

Location

Middle‐Solimões River region, Central Amazon.

Methods

We surveyed arboreal mammals along line‐transects on 15 fluvial floodplain islands and nine transects in continuous floodplain forest. Transect length varied according to island size. Transects of similar length were established in continuous forest. We used power transformed (log‐log) models to construct a SAR for the set of island transects and another SAR for the set of continuous forest transects. We compared slope and intercept between the two SARs using ANCOVA. We used multiple regressions to separate the effects of island size and of habitat amount on the rarefied number of species across multiple spatial scales (500–6,000 m).

Results

The two species–area curves showed similar slopes, but the intercept was lower for islands. Multiple regressions showed the best fit at the 5,500 m spatial scale. At this scale, habitat amount predicted species richness, whereas island size did not.

Main conclusions

We conclude that the apparent effect of patch size on the number of species may be simply due to the sample area effect and that no island effect operates on this patchy system. Accordingly, island size per se does not increase the number of species at a sample site. Fluvial islands should not be treated as “real” islands from the island biogeography perspective. In sum, we found support for the habitat amount hypothesis for predicting the richness of arboreal mammals on fluvial islands.
Pre‐release host range determination of the parasitoid Allotropa burrelli for the biocontrol of Pseudococcus comstocki in France
Authors: Quaglietti B. , Gautier P. , Groussier G. , Fleisch A. , Kreiter P. , Ris N. , Malausa T.
Published: May 2017

We performed “no‐choice” tests to study the host range of the parasitoid Allotropa burrelli (Muesebeck) (Hymenoptera: Platygastridae) for use against the Comstock mealybug, Pseudococcus comstocki (Kuwana) (Hemiptera: Pseudococcidae), in Southern France. We tested three Pseudococcidae species as potential non‐target hosts: two species from the same genus (Pseudococcus longispinus and Pseudococcus viburni) and Planococcus citri. Allotropa burrelli did not parasitize any of the non‐target mealybug species tested. No attempt of oviposition was recorded for the three species tested during the first 20 min of parasitoid release and no parasitism occurred in 6–8 hr of exposure of the mealybugs to the parasitoid.
Role of fluorescence in situ hybridization in diagnosing cholangiocarcinoma in indeterminate biliary strictures
Authors: Liew Zhong Hong , Loh Tracy Jiezhen , Lim Tony Kiat Hon , Lim Tse Hui , Khor Christopher Jen Lock , Mesenas Steven Joseph , Kong Chris San Choon , Ong Wai Choung , Tan Damien Meng Yew
Published: May 2017

Background and Aim

Brush cytology, the conventional method to diagnose cholangiocarcinoma, has been plagued by low diagnostic sensitivity and false‐negative results. This paper aims to study the clinical utility of fluorescence in situ hybridization (FISH) in enhancing identification of malignant biliary strictures.

Methods

Brush cytologic specimens collected from endoscopic retrograde cholangiopancreatography for biliary strictures in a tertiary hospital in Singapore from March 2013 to July 2015 were examined by FISH technique using UroVysion probe set in this study.

Results

Thirty patients were chosen with five patients having multiple FISH performed due to indeterminate results. The diagnoses for biliary strictures were 13 (43.3%) cholangiocarcinomas, seven (23.3%) pancreatic cancers, seven (23.3%) benign biliary strictures, and three (10%) primary sclerosing cholangitis. Conventional brush cytology had sensitivity of 53.8% with specificity of 82.4%. FISH had sensitivity of 30.8% with specificity of 100%. When FISH results were interpreted in cases with negative or atypical brush cytology, two patients had positive FISH results and cholangiocarcinomas. Based on this pilot study, FISH increased sensitivity of brush cytology in detection of cholangiocarcinoma from 53.8% to 69.2% while preserving specificity of 82.4%.

Conclusion

Compared with conventional cytology with low sensitivity, FISH may help to increase sensitivity on top of brush cytology while maintaining high specificity.
Clinical characteristics and long‐term prognosis of elderly onset ulcerative colitis
Authors: Song Eun Mi , Lee Ho‐Su , Park Sang Hyoung , Kim Gwang‐Un , Seo Myeongsook , Hwang Sung Wook , Yang Dong‐Hoon , Kim Kyung‐Jo , Byeon Jeong‐Sik , Myung Seung‐Jae , Yang Suk‐Kyun , Ye Byong Duk
Published: May 2017

Background and Aim

The aim of this study was to investigate the clinical characteristics and prognosis of patients with elderly onset ulcerative colitis (EOUC), a new growing subgroup of UC.

Methods

This study retrospectively analyzed 3060 South Korean UC patients diagnosed between 1977 and 2014. The clinical characteristics and prognosis of EOUC, defined as UC in those aged ≥ 60 years at diagnosis, were compared with those of non‐EOUC (NEOUC).

Results

Among the 3060 patients, 226 were diagnosed with EOUC (7.4%, median age at diagnosis 65.9 years [interquartile range, 62.9–68.7 years], 58.4% male). The frequency of EOUC increased from 3.9% in the interval 1977–1999 to 9.7% in the interval 2008–2014 (P < 0.001). There were more ex‐smokers in the EOUC than in the NEOUC group (44.2% vs 19.9%, P < 0.001). In the EOUC group, extensive colitis at diagnosis, and the maximum extent thereof, was less than in the NEOUC group (13.7% vs 22.6%, P = 0.002, and 34.5% vs 42.5%, P = 0.011, respectively). The 10‐year cumulative colectomy rate was significantly higher in the EOUC than in the NEOUC group (12.6% vs 7.7%, P = 0.015). UC‐related and all‐cause mortality were higher in the EOUC than in the NEOUC group (3.5% vs 0.6%, P < 0.001, and 12.4% vs 1.8%, P < 0.001, respectively).

Conclusion

Elderly onset ulcerative colitis patients are likely to exhibit distinct features both at diagnosis and during follow‐up. It is necessary to pay more attention to, and to conduct further studies on, this particular group of patients.
“Urinary Tract Infection”—Requiem for a Heavyweight
Authors: Finucane Thomas E.
Published: May 2017

“Urinary tract infection” (“UTI”) is an ambiguous, expansive, overused diagnosis that can lead to marked, harmful antibiotic overtreatment. “Significant bacteriuria,” central to most definitions of “UTI,” has little significance in identifying individuals who will benefit from treatment. “Urinary symptoms” are similarly uninformative. Neither criterion is well defined. Bacteriuria and symptoms remit and recur spontaneously. Treatment is standard for acute uncomplicated cystitis and common for asymptomatic bacteriuria, but definite benefits are few. Treatment for “UTI” in older adults with delirium and bacteriuria is widespread but no evidence supports the practice, and expert opinion opposes it.

Sensitive diagnostic tests now demonstrate that healthy urinary tracts host a ubiquitous, complex microbial community. Recognition of this microbiome, largely undetectable using standard agar‐based cultures, offers a new perspective on “UTI.” Everyone is bacteriuric. From this perspective, most people who are treated for a “UTI” would probably be better off without treatment. Elderly adults, little studied in this regard, face particular risk. Invasive bacterial diseases such as pyelonephritis and bacteremic bacteriuria are also “UTIs.”

Mindful decisions about antibiotic use will require a far better understanding of how pathogenicity arises within microbial communities. It is likely that public education and meaningful informed‐consent discussions about antibiotic treatment of bacteriuria, emphasizing potential harms and uncertain benefits, would reduce overtreatment. Emphasizing the microbiome's significance and using the term “urinary tract dysbiosis” instead of “UTI” might also help and might encourage mindful study of the relationships among host, aging, microbiome, disease, and antibiotic treatment.