bluuebunny/crossref_metadata_2025 huggingface dataset:
HIV preexposure prophylaxis for adolescents and young adults
Authors: Allen Emily , Gordon Allegra , Krakower Douglas , Hsu Katherine
Published: June 2017

Purpose of review

The review describes the evidence for HIV preexposure prophylaxis (PrEP) with daily combined tenofovir disoproxil fumarate and emtricitabine for adolescents and young adults. Current recommendations are described, as are the unique medical, socioeconomic, and legal considerations regarding the use of PrEP for youth.

Recent findings

PrEP with daily oral tenofovir disoproxil fumarate–emtricitabine has been shown to help prevent new HIV infection among adults at substantial risk. Evidence suggests a protective benefit of PrEP for youth at risk for HIV, although low adherence is emerging as a barrier to effective use.

Effective use of antiretrovirals for PrEP represents a seminal development in HIV prevention efforts. Improving access and adherence to PrEP for youth has the potential to substantially reduce the incidence of HIV in this population.
Impact of an Obstetrical Hospitalist Program on the Safety Events in a Mid-Sized Obstetrical Unit
Authors: Decesare Julie Z. , Bush Suzanne Y. , Morton Ashley N.
Published: June 2017

Objective

Because internal medicine hospitalist programs were developed to address issues in medicine such as a need to improve quality, improve efficiency, and decrease healthcare cost, obstetrical (OB) hospitalist models were developed to address needs specific to the obstetrics and gynecology field. Our objective was to compare outcomes measured by occurrence of safety events before and after implementation of an OB hospitalist program in a mid-sized OB unit.

Methods

From July 2012 to September 2014, 11 safety events occurred on the labor and delivery floor. A full-time OB hospitalist program was implemented in October 2014.

Results

From October 2014 to December 2016, there was 1 safety event associated with labor and delivery.

Conclusion

It has been speculated that implementation of an OB hospitalist model would be associated with improved maternal and neonatal outcomes; our regional OB referral hospital demonstrated a statistically significant decrease in OB safety events after the OB hospitalist program implementation.
A Nasal Brush-based Classifier of Asthma Identified by Machine Learning Analysis of Nasal RNA Sequence Data
Authors: Pandey Gaurav , Pandey Om P. , Rogers Angela J. , Ahsen Mehmet E. , Hoffman Gabriel E. , Raby Benjamin A. , Weiss Scott T. , Schadt Eric E. , Bunyavanich Supinda
Published: June 2017

Asthma is a common, under-diagnosed disease affecting all ages. We sought to identify a nasal brush-based classifier of mild/moderate asthma. 190 subjects with mild/moderate asthma and controls underwent nasal brushing and RNA sequencing of nasal samples. A machine learning-based pipeline identified an asthma classifier consisting of 90 genes interpreted via an L2-regularized logistic regression classification model. This classifier performed with strong predictive value and sensitivity across eight test sets, including (1) a test set of independent asthmatic and control subjects profiled by RNA sequencing (positive and negative predictive values of 1.00 and 0.96, respectively; AUC of 0.994), (2) two independent case-control cohorts of asthma profiled by microarray, and (3) five cohorts with other respiratory conditions (allergic rhinitis, upper respiratory infection, cystic fibrosis, smoking), where the classifier had a low to zero misclassification rate. Following validation in large, prospective cohorts, this classifier could be developed into a nasal biomarker of asthma.
Altered neurocognitive processing of tactile stimuli in patients with Complex Regional Pain Syndrome (CRPS)
Authors: Kuttikat Anoop , Noreika Valdas , Chennu Srivas , Shenker Nicholas , Bekinschtein Tristan , Brown Christopher A.
Published: June 2017

Chronic pain in CRPS has been linked to tactile misperceptions and deficits in somatotopic representation of the affected limb. Here, we identify altered cognitive processing of tactile stimuli in CRPS patients that we propose marks heterogeneity in tactile decision-making mechanisms. In a case-control design, we compared middle and late-latency somatosensory-evoked potentials (SEPs) in response to pseudo-randomised mechanical stimulation of the digits of both hands (including CRPS-affected and non-affected sides) between 13 CRPS patients and 13 matched healthy controls. During a task to discriminate the digit simulated, patients (compared to controls) had significantly lower accuracy and slowed response times but with high between-subject variability. At middle latencies (124-132 ms), tactile processing in patients relative to controls showed decrements in superior parietal lobe and precuneus (that were independent of task demands) but enhanced activity in superior frontal lobe (that were task-dependent). At late latencies, patients showed an augmented P300-like response under task demands that localised to supplementary motor area (SMA). Source activity in SMA correlated with slowed response times, while its scalp representation intriguingly correlated with better functioning of the affected limb, suggesting a compensatory mechanism. Future research should investigate the clinical utility of these putative markers of tactile decision-making mechanisms in CRPS.

Disclosures

The research was supported by funding from Cambridge Arthritis Research Endeavour (CARE). The study was sponsored by Cambridge University Hospitals NHS Foundation Trust and supported by its Rheumatology department. The authors report no conflicts of interest.

Perspective

We present evidence of altered but highly variable cognitive processing (124 - 268ms latency) in response to mechanical tactile stimuli in patients with CRPS compared to healthy controls. Such mid-to-late latency responses could potentially provide convenient and robust biomarkers of abnormal perceptual decision-making mechanisms in CRPS to aid in clinical detection and treatment.
Placental gene expression mediates the interaction between obstetrical history and genetic risk for schizophrenia
Authors: Ursini Gianluca , Punzi Giovanna , Chen Qiang , Marenco Stefano , Robinson Joshua F. , Porcelli Annamaria , Hamilton Emily G. , Mitjans Marina , Maddalena Giancarlo , Begemann Martin , Seidel Jan , Yanamori Hidenaga , Jaffe Andrew E. , Berman Karen F. , Egan Michael F. , Straub Richard E. , Colantuoni Carlo , Blasi Giuseppe , Hashimoto Ryota , Rujescu Dan , Ehrenreich Hannelore , Bertolino Alessandro , Weinberger Daniel R.
Published: June 2017

Defining the environmental context in which genes enhance susceptibility can provide insight into the pathogenesis of complex disorders, like schizophrenia. Here we show that the intrauterine and perinatal environment modulates the association of schizophrenia with genomic risk, as measured with polygenic risk scores (PRS) based primarily on GWAS significant variants. Genomic risk interacts with intrauterine and perinatal complications (Early Life Complications, ELCs) in each of three independent samples from USA, Italy and Germany (overall n= 1693, p= 6e-05). In each sample, the liability of schizophrenia explained by PRS is nominally more than five times greater in the presence of a history of ELCs compared with its absence. In each sample, patients with positive ELC histories have higher PRS than patients without ELCs, which is further confirmed in two additional patient samples from Germany and Japan (overall n=2038, p= 1e-04). The gene set based on the schizophrenia loci interacting with ELCs is highly expressed in multiple placental compartments and dynamically regulated in placenta from complicated in comparison with normal pregnancies. The same genes are differentially up-regulated in placentae from male compared with female offspring. The interaction between genomic risk and ELCs is mainly driven by GWAS significant loci enriched for genes highly expressed in the various placenta samples. Molecular pathway analyses based on the genes not driving this interaction reflect previous analyses about schizophrenia risk-genes, while genes highly and differentially expressed in placentae implicate an orthogonal biology involving cellular stress. These results suggest that the most significant genetic variants detected by current schizophrenia GWAS contribute to risk in part by converging on a developmental trajectory sensitive to events affecting placentation, which may underlie the male preponderance of schizophrenia and offer new insights into primary prevention.
Effects of progesterone on the reproductive physiology in zebrafish
Authors: Zhong Chunyun , Xiong Kewen , Wang Xin
Published: June 2017

Recent studies have investigated that the synthetic progestins may lead to health issues to the aquatic organisms. Progesterone is a steroidal progestin and has been used as a contraceptive drug, which is detected in the aquatic ecosystem. However, the potential effects of progesterone on the fish reproduction are largely unclear. Here, we tested the effects of progesterone on the fish reproductive and endocrine systems. Adult zebrafish were exposed to progesterone for 10 days at environmental concentrations. The production of eggs was reduced in the exposed fish, and the circulating concentrations of estradiol (E2) and testosterone (T) in female fish or 11-keto testosterone (11-KT) in male fish were significantly diminished. Our results suggested that progesterone may cause adverse health effects on fish by disrupting the endocrine system, and short-term exposure to progesterone could overt affect the fish reproduction.
Insights on lean gamification for higher education
Authors: Deif Ahmed
Published: June 2017

Purpose

There is no argument that using games (gamification) is an efficient way of learning in higher education. The questions, though, are which gamification approach is most suitable at that level and how to assess its suitability? This paper aims to attempt to partially answer these two questions, in the context of lean thinking education.

Design/methodology/approach

The paper offers an assessment criteria to investigate the impact of lean gamification based on the evaluation of motivational, cognitive and social processing during games. In addition, a study is conducted among selected games using these assessment criteria. The study included statistical as well as comparative analysis. The study was based on a sample of undergraduate students learning various lean thinking concepts through physical games over the course of six months.

Findings

Results showed different interaction levels between the three evaluation criteria depending on the type and design of the lean game. The reported scores and analysis drew various lessons on how to use gamification in the context of lean teaching, outlined some best practices in lean games design and suggested recommendations in mapping lean games from industrial domain to higher education domain.

Research limitations/implications

The scope of this research was bounded by the sample size of students as well as the selected nine lean thinking games. Larger pool of students as well as other lean thinking games can offer further insights and confirm the outlined ones.

Practical implications

The presented work will help lean thinking educators in higher education to better understand the student dynamics associated with engaging them in this type pf pedagogical approach. It will help guiding lean thinking games’ designer on how to better cater for this segment of lean thinking learners. Finally, it will aid in promoting lean gamification as an effective learning tool.

Social implications

The social impact is achieved through enhancing lean thinking education to a wide number of students. This will positively impact the society through the application of the effective lean tools at different stages, levels and places in these students’ life experiences.

Originality/value

This study offers one of the very few applications in gamification assessment in the context of lean thinking. Furthermore, it integrates the social processing criterion for the first time with the classical two other criteria (motivation and cognitive) used in games education assessment. Finally, it offers new insights for lean thinking game designers for higher education learners.
Understand, reduce, respond: project complexity management theory and practice
Authors: Maylor Harvey , Turner Neil
Published: June 2017

Purpose

The purpose of this paper is to contribute to the understanding of complexity and its management from an OM perspective, building on and extending the systematic literature review published in this journal in 2011, and provide a foundation for exploring the interactions between complexities and responses.

Design/methodology/approach

The paper takes a subjective view of complexity, focusing on the “lived experience” of managers. It takes an updated systematic literature review, and demonstrates the comprehensiveness of a framework to classify complexities of projects. It reports the findings from 43 workshops with over 1,100 managers.

Findings

First, the complexity framework is effective in aiding understanding. Second, and somewhat unexpectedly, managers were able to identify strategies to reduce the majority of complexities that they faced. Third, the workshops identified a typology of responses to residual complexities.

Research limitations/implications

The framework has demonstrated its utility, and a gap in understanding emergent complexities is identified. The framework further presents the opportunity to explore the recursive nature of complexity and response.

Practical implications

This paper provides a framework that is both comprehensive and comprehensible. The authors demonstrate that complexities can be reduced and provide a means to assess responses to residual complexities, including potentially matching managers to projects.

Originality/value

This work extends the previous systematic review combined with extensive empirical data to generate findings that are having impact in practice, and have the potential to strengthen a relatively neglected area within OM. A research agenda is suggested to support this.
Linkages between firm innovation strategy, suppliers, product innovation, and business performance
Authors: Jajja Muhammad Shakeel Sadiq , Kannan Vijay R. , Brah Shaukat Ali , Hassan Syed Zahoor
Published: June 2017

Purpose

The purpose of this paper is to use resource dependence theory to hypothesize that a buyer’s innovation strategy enhances supplier innovation focus and a buyer-supplier relationship that supports product innovation. These in turn positively impact buyer product innovation outcomes and business performance. Moreover, it is argued that the buyer-supplier relationship positively moderates the impact of supplier innovation focus on product innovation.

Design/methodology/approach

Structural equation modeling and hierarchical linear regression are used to test hypotheses.

Findings

The results support all hypotheses and suggest that company (buyer) age and variables related to buyer engagement with international markets directly influence performance. The results also indicate that the buyer-supplier relationship does not moderate the relationship between innovation strategy and innovation performance.

Research limitations/implications

This study demonstrates that how a firm builds the conditions to effectively leverage the complementary resources and capabilities of suppliers directly influence innovation outcomes and business performance.

Practical implications

An important factor in firms achieving their product innovation goals is the selection and management of suppliers that are strategically aligned with regard to innovation. While managers need to develop internal innovation capabilities, partnering with like-minded organizations, and creating conditions for effective cooperation are key drivers of innovation outcomes.

Originality/value

In contrast to prior research that has examined operational issues, this study shows how the strategic alignment of buyers and suppliers with regard to innovation is an antecedent of product innovation outcomes. Moreover, it adds to a limited literature on supply chain management practices in emerging markets.
Exploring the relationship between organizational structure and knowledge retention: a study of the Indian infrastructure consulting sector
Authors: Acharya Abhilash , Mishra Bijaya
Published: June 2017

Purpose

Infrastructure adds pace and efficiency into India’s progress. It is a country which has embraced the notion of a knowledge economy of late, and thus raised the importance of infrastructure consultingper se. The study aims to cover the consequent but underexplored role of organizational structure (OS)vis-à-visknowledge retention (KR) in this sector.

Design/methodology/approach

For conducting the research, the sampling organization that has been chosen is an infrastructure consulting organization. The researchers had undertaken an exploratory study to find out the dynamics between OS and KR. A qualitative approach has thus been adopted and the application of thematic analysis found place in conducting the research. The themes and sub-themes generated from the research, aligned with the theoretical backdrop, gave rise to a schematic model explaining the relationship between OS and KR.

Findings

From the above themes and sub-themes along with possible relationships which emerged from the study, the researchers observed that the theme “organizational structure” had a significant relationship with the sub-theme “knowledge retention”. In the order, what was the most noteworthy was that designing of an OS had a refined and somewhat directed influence on KR in the organization.

Originality/value

This paper tries to uncover the relationship between an organization’s structure formation and the key aspect of knowledge management cycle, which is KR. This shall be helpful for both academics (who can make advancements by testing the relationship in other contexts) and practitioners (who can look forward to minimizing business losses through the concept of KR).
Exploring the affective mechanism linking perceived organizational support and knowledge sharing intention: a moderated mediation model
Authors: Jeung Chang-Wook , Yoon Hea Jun , Choi Myungweon
Published: June 2017

Purpose

The purpose of this paper is to investigate the moderated mediation model in which the effect of perceived organizational support (POS) on knowledge sharing intention is mediated by levels of individual affective commitment to the organization, while the relationship between POS and affective commitment is moderated by organizational tenure.

Design/methodology/approach

Hypotheses on mediation, moderation and moderated mediation were tested with data collected from Korean for-profit organizations. Conditional process analyses with bootstrapping supported all three hypotheses.

Findings

The findings demonstrate that the relationship between POS and knowledge sharing intention is mediated by affective organizational commitment. In addition, the mediation effect is strengthened when an individual’s organizational tenure is low. Theoretical and practical implications and directions for future research are followed.

Originality/value

This study contributes to the literature on knowledge sharing by providing a basis for understanding the mediating mechanism through which POS influences knowledge sharing intention, and, ultimately, organizational functioning via individual affective attitude. This is the first attempt examining the role of organizational tenure as a key contingency factor in knowledge sharing. By investigating the underlying logic of individual intention to share knowledge, this study expands the current spectrum for knowledge management.
A method for trust evaluation in the cloud environments using a behavior graph and services grouping
Authors: Hajizadeh Roghiyeh , Jafari Navimipour Nima
Published: June 2017

Purpose

Cloud services have become very popular among researchers and people recently. In such a scenario, identifying reliable cloud services has become very important. The trust value plays a significant role in recognizing reliable providers. The purpose of this paper is to propose a new method to evaluate the trust metric among the cloud providers. The main goal is to increase the precision and accuracy of the trust evaluation method in the cloud environments.

Design/methodology/approach

This paper evaluates the trust metric among the cloud providers and entities by grouping the services and using a behavioral graph. Four parameters, availability, reliability, interaction evolution and identity, are used for evaluating the trust value. The performance of the proposed method is assessed using a simulator which is programmed in the cloud Azure 2013 based on C# codes.

Findings

The method is evaluated through various experiments in terms of precision, recall, error-hit, reliability and availability. The obtained results show that the proposed method has better reliability and availability than the FIFO and QoS models. Also, the results show that increasing the number of groups leads to increasing values of trust, precision and availability, and decreasing values of error-hit.

Originality/value

This paper proposes a trust evaluation method in the cloud environment by grouping the services and using a behavioral graph for improving the amount of availability, error-hit, precision and reliability values.
Modelling identity types through agency: part 2, personal identity and mindsets
Authors: Di Fatta Davide , Yolles Maurice
Published: June 2017

Purpose

The purpose of this paper is to evaluate the personal identity of Donald Trump in the US presidential election using the mindset agency theory framework and content analysis.

Design/methodology/approach

The qualitative evaluation of identity type is determined by the personality mindset agency theory (PMAT). This measures qualitatively by assigning a type to the personal identity. The methods being adopted are content analysis, and a coding frame is constructed that arises from the key words defined in PMAT.

Findings

Using PMAT, the authors determine that Trump’s personal identity is of the type hierarchical popularism (HP), from which behavioural patterns are derived, supposing that this is consistent with his public identity type measured using agency MAT (AMAT), which will be assessed in part 3 of this paper.

Originality/value

Appropriate image management can be used in an attempt to hide problematic purely self-interest aspects of a personality. This paper shows that it is possible to evaluate personality mindsets using content analysis. In a later paper, exploration of agency mindsets will occur that is indicative of the potential for behaviour.
Similarity-based approach for accurately retrieving similar cases to intelligently handle online complaints
Authors: Cui Xiaolan , Cai Shuqin , Qin Yuchu
Published: June 2017

Purpose

The purpose of this paper is to propose a similarity-based approach to accurately retrieve reference solutions for the intelligent handling of online complaints.

Design/methodology/approach

This approach uses a case-based reasoning framework and firstly formalizes existing online complaints and their solutions, new online complaints, and complaint products, problems and content as source cases, target cases and distinctive features of each case, respectively. Then the process of using existing word-level, sense-level and text-level measures to assess the similarities between complaint products, problems and contents is explained. Based on these similarities, a measure with high accuracy in assessing the overall similarity between cases is designed. The effectiveness of the approach is evaluated by numerical and empirical experiments.

Findings

The evaluation results show that a measure simultaneously considering the features of similarity at word, sense and text levels can obtain higher accuracy than those measures that consider only one level feature of similarity; and that the designed measure is more accurate than all of its linear combinations.

Practical implications

The approach offers a feasible way to reduce manual intervention in online complaint handling. Complaint products, problems and content should be synthetically considered when handling an online complaint. The designed procedure of the measure with high accuracy can be applied in other applications that consider multiple similarity features or linguistic levels.

Originality/value

A method for linearly combining the similarities at all linguistic levels to accurately assess the overall similarities between online complaint cases is presented. This method is experimentally verified to be helpful to improve the accuracy of online complaint case retrieval. This is the first study that considers the accuracy of the similarity measures for online complaint case retrieval.
Did the Affordable Care Act's Dependent Coverage Expansion Affect Race/Ethnic Disparities in Health Insurance Coverage?
Authors: Breslau Joshua , Han Bing , Stein Bradley D. , Burns Rachel M. , Yu Hao
Published: June 2017

Objective

To test the impact of the dependent coverage expansion (DCE) on insurance disparities across race/ethnic groups.

Data Sources/Study Setting

Survey data from the National Survey of Drug Use and Health (NSDUH).

Study Design

Triple‐difference (DDD) models were applied to repeated cross‐sectional surveys of the U.S. adult population.

Data Collection/Extraction Methods

Data from 6 years (2008–2013) of the NSDUH were combined.

Principal Findings

Following the DCE, the relative odds of insurance increased 1.5 times (95 percent CI 1.1, 1.9) among whites compared to blacks and 1.4 times (95 percent CI 1.1, 1.8) among whites compared to Hispanics.

Conclusions

Health reform efforts, such as the DCE, can have negative effects on race/ethnic disparities, despite positive impacts in the general population.
Composite measures of selection can improve the signal‐to‐noise ratio in genome scans
Authors: Lotterhos Katie E. , Card Daren C. , Schaal Sara M. , Wang Liuyang , Collins Caitlin , Verity Bob
Published: June 2017

The growing wealth of genomic data is yielding new insights into the genetic basis of adaptation, but it also presents the challenge of extracting the relevant signal from multi‐dimensional datasets. Different statistical approaches vary in their power to detect selection depending on the demographic history, type of selection, genetic architecture and experimental design.

Here, we develop and evaluate new approaches for combining results from multiple tests, including multivariate distance measures and methods for combining P‐values. We evaluate these methods on (i) simulated landscape genetic data analysed for differentiation outliers and genetic‐environment associations and (ii) empirical genomic data analysed for selective sweeps within dog breeds for loci known to be selected for during domestication. We also introduce and evaluate how robust statistical algorithms can be used for parameter estimation in statistical genomics.

On the simulated data, many of the composite measures performed well and had decreased variation in outcomes across many sampling designs. On the empirical dataset, methods based on combining P‐values generally performed better with clearer signals of selection, higher significance of the signal, and in closer proximity to the known selected locus. Although robust algorithms could identify neutral loci in our simulations, they did not universally improve power to detect selection. Overall, a composite statistic that measured a robust multivariate distance from rank‐based P‐values performed the best.

We found that composite measures of selection could improve the signal of selection in many cases, but they were not a panacea and their power is limited by the power of the univariate statistics they summarize. Since genome scans are widely used, improving inference for prioritizing candidate genes may be beneficial to medicine, agriculture, and breeding. Our results also have application to outlier detection in high‐dimensional datasets and to combining results in meta‐analyses in many disciplines. The compound measures we evaluate are implemented in the r package minotaur.
Identifying targets and agents of selection: innovative methods to evaluate the processes that contribute to local adaptation
Authors: Wadgymar Susana M. , Lowry David B. , Gould Billie A. , Byron Caitlyn N. , Mactavish Rachel M. , Anderson Jill T.
Published: June 2017

Extensive empirical work has demonstrated local adaptation to discrete environments, yet few studies have elucidated the genetic and environment mechanisms that generate it. Here, we advocate for research that broadens our understanding of local adaptation beyond pattern and towards process. We discuss how studies of local adaptation can be designed to address two unresolved questions in evolutionary ecology: Does local adaptation result from fitness trade‐offs at individual loci across habitats? How do agents of selection interact to generate local adaptation to discrete contrasting habitats types and continuous environmental gradients?

To inform future investigations of the genetic basis of local adaptation, we conducted a literature review of studies that mapped quantitative trait loci (QTL) for fitness in native field environments using reciprocal transplant experiments with hybrid mapping populations or Genome‐wide Association Study (GWAS) panels. We then reviewed the literature for field experiments that disentangle the contributions of various agents of selection to local adaptation. For each question, we suggest future lines of inquiry and discuss implications for climate change and agriculture research.

(i) Studies in the native habitats of five biological systems revealed that local adaptation is more often caused by conditional neutrality than genetic trade‐offs at the level of the QTL. We consider the ramifications of this result and discuss knowledge gaps in our current understanding of the genetic basis of local adaptation. (ii) We uncovered only five studies that identified the agents of selection that contribute to local adaptation, and nearly all were conducted in discrete habitats rather than across the continuous environmental gradients that many species inhabit. We introduce a novel experimental framework for illuminating the processes underlying local adaptation.

A holistic view of local adaptation is critical for predicting the responses of organisms to climate change, enhancing conservation efforts, and developing strategies to improve crop resilience to environmental stress. Experiments that manipulate agents of selection in native field environments using pedigreed populations or GWAS panels offer unique opportunities for detecting the genetic and environmental mechanisms that generate local adaptation.
Beyond SNPs: how to detect selection on transposable element insertions
Authors: Villanueva‐Cañas José Luis , Rech Gabriel E. , de Cara Maria Angeles Rodriguez , González Josefa
Published: June 2017

Identifying the genomic basis of adaptive evolution is a growing field of research. The number of statistics and methodologies aimed at identifying adaptive loci continues to increase. Moreover, the availability of whole‐genome sequences allows us to make inferences of selection on a diverse set of species. However, detecting footprints of selection has mostly been restricted to one type of genomic variation: single‐nucleotide polymorphisms (SNPs). Other genomic variants such as transposable element (TE) insertions that are likely to contribute to adaptive evolution have been largely ignored.

Here, we present an overview of different approaches that can be used to infer selection acting on TE insertions. We focused on five main approaches: (i) DNA sequence conservation analysis; (ii) selection on linked polymorphisms; (iii) environmental association analyses; (iv) estimation of allele age; and (v) functional assays to identify the molecular and fitness effects.

For each of these five approaches, we focus on the latest developments and illustrate them with recent examples from the literature. We also identify the data requirements and the limitations associated with the different methodologies.

We conclude that the availability of third‐generation sequencing technologies should allow for a systematic analysis of TE insertions as sources of adaptive mutations. Incorporating the knowledge of the role of TE insertions in adaptive evolution will allow us to get a more complete picture of the adaptive process.
Age 80 years and over is not associated with increased morbidity and mortality following pancreaticoduodenectomy
Authors: Kim Sandy Y. , Fink Michael A. , Perini Marcos , Houli Nezor , Weinberg Laurence , Muralidharan Vijayaragavan , Starkey Graham , Jones Robert M. , Christophi Christopher , Nikfarjam Mehrdad
Published: June 2017

Background

Pancreaticoduodenectomy (PD) is associated with high morbidity, which is perceived to be increased in the elderly. To our knowledge there have been no Australian series that have compared outcomes of patients over the age of 80 undergoing PD to those who are younger.

Methods

Patients who underwent PD between January 2008 and November 2015 were identified from a prospectively maintained database.

Results

A total of 165 patients underwent PD of whom 17 (10.3%) were aged 80 or over. The pre‐operative health status, according to American Society of Anesthesiologists class was similar between the groups (P = 0.420). The 90‐day mortality rates (5.9% in the elderly and 2% in the younger group; P = 0.355) and the post‐operative complication rates (64.7% in the elderly versus 62.8% in the younger group; P = 0.88) were similar. Overall median length of hospital stay was also similar between the groups, but older patients were far more likely to be discharged to a rehabilitation facility than younger patients (47.1 versus 12.8%; P < 0.0001). Older patients with pancreatic adenocarcinoma (n = 10) had significantly lower median survival than the younger group (n = 69) (16.6 versus 22.5 months; P = 0.048).

Conclusion

No significant differences were seen in the rate of complications following PD in patients aged 80 or over compared to younger patients, although there appears to be a shorter survival in the elderly patients treated for pancreatic cancer. Careful selection of elderly patients and optimal peri‐operative care, rather than age should be used to determine whether surgical intervention is indicated in this patient group.
Effects of different n‐6 to n‐3 polyunsaturated fatty acids ratio on reproductive performance, fecal microbiota and nutrient digestibility of gestation‐lactating sows and suckling piglets
Authors: Yin Jia , Lee Kwang Yong , Kim Jong Keun , Kim In Ho
Published: June 2017

This study was conducted to evaluate the effects of dietary ratios of n‐6:n‐3 polyunsaturated fatty acids (PUFA) on reproductive performance, fecal microbiota and nutrient digestibility of gestation‐lactating sows and suckling piglets. Fifteen primiparous sows (Landrace × Yorkshire) were randomly allotted into three treatments. Fed diets contained different ratios of n‐6:n‐3 PUFA, including 20:1, 15:1 and 10:1. No differences were detected among the treatments for average daily feed intake (ADFI) of sows and the back fat levels during lactation (P > 0.05). Body weight (BW) loss of sows after farrowing to weanling was greater in the 10:1 treatment compared with 15:1 or 20:1 (P < 0.05). In piglets, a great significant difference for BW was observed at 4 weeks (P < 0.01). Furthermore, average daily gain (ADG) of piglets in the 10:1 treatment was higher (P < 0.05). No difference was observed among treatments in nutrient digestibility of sows (P > 0.05). A great significant difference for fecal microbiota was in the 10:1 treatment compared with 20:1 and 15:1 treatments (P < 0.01). In conclusion, altering the ratio of n‐6:n‐3 PUFA in gestation‐lactating sow diet had no difference on nutrient digestibility in gestation‐lactating sows, but it can partially improve reproductive performance.
Initial anticoagulation in patients with pulmonary embolism: thrombolysis, unfractionated heparin, LMWH, fondaparinux, or DOACs?
Authors: Leentjens Jenneke , Peters Mike , Esselink Anne C. , Smulders Yvo , Kramers Cornelis
Published: June 2017

The initial treatment of haemodynamically stable patients with pulmonary embolism (PE) has dramatically changed since the introduction of low molecular weight heparins (LMWHs). With the recent discovery of the direct oral anticoagulant drugs (DOACs), initial treatment of PE will be simplified even further. In several large clinical trials it has been demonstrated that DOACs are not inferior to standard therapy for the initial treatment of PE, and because of their practicability they are becoming the agents of first choice. However, many relative contraindications to DOACs were exclusion criteria in the clinical trials. Therefore, LMWHs will continue to play an important role in initial PE treatment and in some cases there still is a role for unfractionated heparin (UFH). In this review we will give an overview of the biophysical, pharmacokinetic and pharmacodynamic properties of anticoagulants currently available for the initial management of PE. In addition, we will provide a comprehensive overview of the indications for the use of UFH, LMWHs and DOACs in the initial management of PE from a pharmacokinetic/‐dynamic point of view.
Labor, delivery, and anesthesia experiences of women with physical disability
Authors: Smeltzer Suzanne C. , Wint Amy J. , Ecker Jeffrey L. , Iezzoni Lisa I.
Published: June 2017

Background

Although many women with physical disabilities report poor quality reproductive health care, little research has addressed labor, delivery, and anesthesia experiences of these women. This study was conducted to explore these experiences in women with significant mobility disabilities.

Methods

A qualitative descriptive study was conducted with 22 women from the United States who had delivered newborns within the prior 10 years. All had significant mobility disabilities. Two‐hour, in‐depth telephone interviews were conducted using a semistructured, open‐ended interview protocol, which addressed many topics, including labor, delivery, and anesthesia experiences. We recruited most participants through social networks, interviewing women from 17 states. Conventional content analysis, facilitated by NVivo software, was used to identify major themes.

Results

The mean age of women was 34.8 ± 5.3 years. Most women were white, college educated, and used wheeled mobility aids. Four key themes emerged from participants’ narratives of laboring and giving birth with a disability. These included women's preferences for type of delivery, clinicians and some women expected no labor pain, fears prompting active advocacy, and positive experiences. As participants discussed their experiences with anesthesia, four additional themes were identified: importance of consultation with the anesthesia team, decisions about epidural/spinal vs general anesthesia, failed epidural with repeated efforts, and fear of injury related to anesthesia.

Conclusions

The responses of women in this study suggest that there is need to make intrapartum care better for women with physical disabilities and to improve their experiences with labor, birth, and obstetric anesthesia care.
A sequence analysis of patterns in self‐harm in young people with and without experience of being looked after in care
Authors: Wadman Ruth , Clarke David , Sayal Kapil , Armstrong Marie , Harroe Caroline , Majumder Pallab , Vostanis Panos , Townsend Ellen
Published: June 2017

Objectives

Young people in the public care system (‘looked‐after’ young people) have high levels of self‐harm.

Design

This paper reports the first detailed study of factors leading to self‐harm over time in looked‐after young people in England, using sequence analyses of the Card Sort Task for Self‐harm (CaTS).

Methods

Young people in care (looked‐after group: n = 24; 14–21 years) and young people who had never been in care (contrast group: n = 21; 13–21 years) completed the CaTS, describing sequences of factors leading to their first and most recent episodes of self‐harm. Lag sequential analysis determined patterns of significant transitions between factors (thoughts, feelings, behaviours, events) leading to self‐harm across 6 months.

Results

Young people in care reported feeling better immediately following their first episode of self‐harm. However, fearlessness of death, impulsivity, and access to means were reported most proximal to recent self‐harm. Although difficult negative emotions were salient to self‐harm sequences in both groups, young people with no experience of being in care reported a greater range of negative emotions and transitions between them. For the contrast group, feelings of depression and sadness were a significant starting point of the self‐harm sequence 6 months prior to most recent self‐harm.

Conclusions

Sequences of factors leading to self‐harm can change and evolve over time, so regular monitoring and assessment of each self‐harm episode are needed. Support around easing and dealing with emotional distress is required. Restricting access to means to carry out potentially fatal self‐harm attempts, particularly for the young persons with experience of being in care, is recommended.

Practitioner points

Self‐harm (and factors associated with self‐harm) can change and evolve over time; assessments need to reflect this.

Looked‐after young people reported feeling better after first self‐harm; fearlessness of death, access to means, and impulsivity were reported as key in recent self‐harm.

Underlying emotional distress, particularly depression and self‐hatred were important in both first and most recent self‐harm.

Looked‐after young people should undergo regular monitoring and assessment of each self‐harm episode and access to potentially fatal means should be restricted.

The CaTS would have clinical utility as an assessment tool

Recruiting participants can be a significant challenge in studies with looked‐after children and young people.

Future research with larger clinical samples would be valuable.
More Effective Consolidation of Episodic Long‐Term Memory in Children Than Adults—Unrelated to Sleep
Authors: Wang Jing‐Yi , Weber Frederik D. , Zinke Katharina , Inostroza Marion , Born Jan
Published: June 2017

Abilities to encode and remember events in their spatiotemporal context (episodic memory) rely on brain regions that mature late during childhood and are supported by sleep. We compared the temporal dynamics of episodic memory formation and the role of sleep in this process between 62 children (8–12 years) and 57 adults (18–37 years). Subjects recalled “what–where–when” memories after a short 1‐hr retention interval or after a long 10.5‐hr interval containing either nocturnal sleep or daytime wakefulness. Although children showed diminished recall of episodes after 1 hr, possibly resulting from inferior encoding, unlike adults, they showed no further decrease in recall after 10.5 hr. In both age groups, episodic memory benefitted from sleep. However, children's more effective offline retention was unrelated to sleep.
The evolution of basal septal hypertrophy: From benign and age‐related normal variant to potentially obstructive and symptomatic cardiomyopathy
Authors: Pearson Anthony C.
Published: June 2017

Localized thickening of the basal portion of the ventricular septum or basal septal hypertrophy (BSH) has been identified both at autopsy and by imaging studies for decades; despite numerous investigations, there is no consensus on the significance of this finding and a remarkable lack of consistency in terminology. This paper summarizes the scientific literature on the topic, focusing on recent echocardiographic findings. A case description illustrating some of the complex issues involved in measurement and diagnosis and differentiation from sigmoidal hypertrophic cardiomyopathy (HCM) is presented. Criteria are proposed for diagnosing pathologic BSH which include the following: (1) Exertional symptoms compatible with left ventricular outflow tract obstruction (LVOTO) such as dyspnea, near‐syncope, and chest discomfort; (2) Documented LVOTO gradient demonstrated at peak bicycle or post‐treadmill exercise >30 mm Hg; and (3) Symptomatic improvement with β‐blocker (or other negative inotropic) therapy (preferably accompanied by documentation of reduction of exercise‐induced LVOT).
Maximum diversification strategies along commodity risk factors
Authors: Bernardi Simone , Leippold Markus , Lohre Harald
Published: June 2017

Pursuing risk‐based allocation across a universe of commodity assets, we find diversified risk parity (DRP) strategies to provide convincing results. DRP strives for maximum diversification along uncorrelated risk sources. A straightforward way to derive uncorrelated risk sources relies on principal components analysis (PCA). While the ensuing statistical factors can be associated with commodity sector bets, the corresponding DRP strategy entails excessive turnover because of the instability of the PCA factors. We suggest an alternative design of the DRP strategy relative to common commodity risk factors that implicitly allows for a uniform exposure to commodity risk premia.
Imbalanced nutrient recycling in a warmer ocean driven by differential response of extracellular enzymatic activities
Authors: Ayo Begoña , Abad Naiara , Artolozaga Itxaso , Azua Iñigo , Baña Zuriñe , Unanue Marian , Gasol Josep M. , Duarte Carlos M. , Iriberri Juan
Published: June 2017

Ocean oligotrophication concurrent with warming weakens the capacity of marine primary producers to support marine food webs and act as a CO2 sink, and is believed to result from reduced nutrient inputs associated to the stabilization of the thermocline. However, nutrient supply in the oligotrophic ocean is largely dependent on the recycling of organic matter. This involves hydrolytic processes catalyzed by extracellular enzymes released by bacteria, which temperature dependence has not yet been evaluated. Here, we report a global assessment of the temperature‐sensitivity, as represented by the activation energies (Ea), of extracellular β‐glucosidase (βG), leucine aminopeptidase (LAP) and alkaline phosphatase (AP) enzymatic activities, which enable the uptake by bacteria of substrates rich in carbon, nitrogen, and phosphorus, respectively. These Ea were calculated from two different approaches, temperature experimental manipulations and a space‐for‐time substitution approach, which generated congruent results. The three activities showed contrasting Ea in the subtropical and tropical ocean, with βG increasing the fastest with warming, followed by LAP, while AP showed the smallest increase. The estimated activation energies predict that the hydrolysis products under projected warming scenarios will have higher C:N, C:P and N:P molar ratios than those currently generated, and suggest that the warming of oceanic surface waters leads to a decline in the nutrient supply to the microbial heterotrophic community relative to that of carbon, particularly so for phosphorus, slowing down nutrient recycling and contributing to further ocean oligotrophication.