bluuebunny/crossref_metadata_2025 huggingface dataset:
Base excision repair deficiency signatures implicate germline and somatic MUTYH aberrations in pancreatic ductal adenocarcinoma and breast cancer oncogenesis
Authors: Thibodeau My Linh , Zhao Eric Y. , Reisle Caralyn , Ch'ng Carolyn , Wong Hui-Li , Shen Yaoqing , Jones Martin R. , Lim Howard J. , Young Sean , Cremin Carol , Pleasance Erin , Zhang Wei , Holt Robert , Eirew Peter , Karasinska Joanna , Kalloger Steve E. , Taylor Greg , Majounie Elisa , Bonakdar Melika , Zong Zusheng , Bleile Dustin , Chiu Readman , Birol Inanc , Gelmon Karen , Lohrisch Caroline , Mungall Karen L. , Mungall Andrew J. , Moore Richard , Ma Yussanne P. , Fok Alexandra , Yip Stephen , Karsan Aly , Huntsman David , Schaeffer David F. , Laskin Janessa , Marra Marco A. , Renouf Daniel J. , Jones Steven J.M. , Schrader Kasmintan A.
Published: March 2019

We report a case of early-onset pancreatic ductal adenocarcinoma in a patient harboring biallelic MUTYH germline mutations, whose tumor featured somatic mutational signatures consistent with defective MUTYH-mediated base excision repair and the associated driver KRAS transversion mutation p.Gly12Cys. Analysis of an additional 730 advanced cancer cases (N = 731) was undertaken to determine whether the mutational signatures were also present in tumors from germline MUTYH heterozygote carriers or if instead the signatures were only seen in those with biallelic loss of function. We identified two patients with breast cancer each carrying a pathogenic germline MUTYH variant with a somatic MUTYH copy loss leading to the germline variant being homozygous in the tumor and demonstrating the same somatic signatures. Our results suggest that monoallelic inactivation of MUTYH is not sufficient for C:G>A:T transversion signatures previously linked to MUTYH deficiency to arise (N = 9), but that biallelic complete loss of MUTYH function can cause such signatures to arise even in tumors not classically seen in MUTYH-associated polyposis (N = 3). Although defective MUTYH is not the only determinant of these signatures, MUTYH germline variants may be present in a subset of patients with tumors demonstrating elevated somatic signatures possibly suggestive of MUTYH deficiency (e.g., COSMIC Signature 18, SigProfiler SBS18/SBS36, SignatureAnalyzer SBS18/SBS36).
The potential of foods treated with supercritical carbon dioxide (sc-CO2) as novel foods
Authors: Smigic Nada , Djekic Ilija , Tomic Nikola , Udovicki Bozidar , Rajkovic Andreja
Published: March 2019

Purpose

Supercritical carbon dioxide (sc-CO2) is a promising novel treatment that might be used in the food industry, such as sc-CO2pasteurisation and sc-CO2drying. Before sc-CO2treated foodstuffs may be introduced to European market, they have to be authorised according to novel food regulation. Therefore, the purpose of this paper is to give an overview of available literature data on sc-CO2treated fruits and vegetables, which might be used for novel food authorisation.

Design/methodology/approach

The paper is based on literature data available via Science Direct, EBSCO and Wiley concerning sc-CO2pasteurisation and drying of fruits/vegetables. Studies performed on animal foodstuffs were manually excluded, while articles related to novel foods and legislation were included in the study.

Findings

Database search resulted 34 articles related to microbiological and compositional/nutritional changes in sc-CO2treated foods. Obtained data indicated that sc-CO2pasteurisation is effective in inactivating microorganisms in liquids, while no general conclusion on the microbiological quality of sc-CO2pasteurised solid foods or sc-CO2dried foods could be made. Available literature data showed that sc-CO2pasteurisation did not result in significant compositional/nutritional changes in liquids, while for sc-CO2pasteurised solid foods or sc-CO2dried foods, one is not able to make common conclusions due to insufficient research data. Therefore, additional research and case-by-case study for each treated food have to be prepared.

Originality/value

This study is original to the extent that it brought together available information on sc-CO2pasteurised and dried foods, needed the novel food application.
Measuring the quality of life of incarcerated individuals
Authors: Muller Ashley Elizabeth , Bukten Anne
Published: March 2019

Purpose

Measuring quality of life (QoL) under incarceration can be used to track successful rehabilitation and risk of re-offending. However, few studies have measured QoL among general incarcerated populations, and it is important to use psychometrically strong measures that pose minimal burdens to respondents and administrators. The paper aims to discuss these issues.

Design/methodology/approach

The aim of this analysis was to explore the utility of a short generic tool measuring overall QoL, the QOL5, in an incarcerated population. The authors drew data from the Norwegian Offender Mental Health and Addiction Study, a cross-sectional survey of 1,499 individuals from Norwegian prisons.

Findings

Factor analysis suggested a unidimensional structure that explained 53.2 percent of variance in QoL scores. Intrascale correlations were high and internal consistency was acceptable (α=0.764). The QOL5 was strongly correlated with mental health, moderately correlated with exercise frequency and weakly correlated with ward security.

Practical implications

The QOL5 is a short measure that presents minimal burden to respondents and administrators. The authors recommend its further use in incarcerated populations to measure overall QoL as well as cross-cultural adaptation and validation in more languages.

Originality/value

In this analysis of the largest published sample to date of incarcerated individuals and their QoL, the QOL5 appears to be an acceptable and valid measure of overall QoL.
Mental health and wellbeing benefits from a prisons horticultural programme
Authors: Farrier Alan , Baybutt Michelle , Dooris Mark
Published: March 2019

Purpose

In the context of current prison safety and reform, the purpose of this paper is to discuss findings of an impact evaluation of a horticultural programme delivered in 12 prisons in North West England.

Design/methodology/approach

The programme was evaluated using quantitative and qualitative methods, including Green Gym© questionnaires, the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) and Biographic-Narrative Interpretive Method interviews.

Findings

Against a backdrop of high rates of suicide, self-harm and poor mental health, the horticultural programme studied proved beneficial to prisoner participants, the most marked effect was on mental health and wellbeing. In addition to data related to the original mental health outcome indicators, the study revealed multiple layers of “added value” related to mental health arising from horticultural work in a prison setting.

Research limitations/implications

The main research limitations were the limited completion of follow-on questionnaires due to prisoners being released and the inability to conduct longitudinal data collection post-release. There was also concern about response bias and lack of resource to compare with the experience of prisoners not participating in the programme.

Social implications

Positive impacts on prisoners’ mental health and wellbeing included increased confidence, social interactions with staff and other prisoners and gaining skills and qualifications and work experience, increasing potential for post-release employment.

Originality/value

Benefits of horticulture work on health are well established. However, to date, there is little research concerning the effects this work may have on mental wellbeing of prisoners both within prisons and more so upon their release back into the community.
Values congruence in multicultural groups: the causal mapping method
Authors: Bogodistov Yevgen , Botts Moritz , Schlatterer Florian
Published: March 2019

Purpose

The purpose of this paper is to present the adoption and application of the causal mapping method for cognitive distances measurement in the multicultural domain.

Design/methodology/approach

Causal mapping was used to estimate differences in mental models between participants. The developed method was applied in a multicultural setting for the selection of teaching cases.

Findings

In the main study, 129 people participated in the test. Overall, 7,217 relationships were tested. A set of demographic variables were used to test the reliability and external validity of the method. The method proved to be reliable and easy to apply. A smaller second study is an application example of the method.

Research limitations/implications

The main study proposes a formula for distance ratio calculation. Moreover, this formula proved to be externally valid and reliable. Thus, it is of interest for further research in this domain.

Practical implications

Practitioners are provided with a tool for the analysis of intercultural differences with the example of the perception of cultural values to develop a better understanding and improve education in a multicultural setting. Study 2 proposes an example of the methodology application.

Originality/value

This is the first application of causal mapping in the field of values research performed in a multicultural education setting. The formula for comparing causal maps is improved upon, and an application for the field of multicultural university classes is provided.
Spatiotemporal successions of shrimp gut microbial colonization: high consistency despite distinct species pool
Authors: Xiong Jinbo , Xuan Lixia , Yu Weina , Zhu Jinyong , Qiu Qiongfen , Chen Jiong
Published: March 2019

Aquatic animals encounter suites of novel planktonic microbes during their development. Although hosts have been shown to exert strong selection on their gut microbiota from surrounding environment, to what extent and the generality that the gut microbiota and the underlying ecological processes are affected by biotic and abiotic variations are largely unclear. Here, these concerns were explored by coupling spatiotemporal data on gut and rearing water bacterial communities with environmental variables over shrimp life stages at spatially distant locations. Shrimp gut microbiotas significantly changed mirroring their development, as evidenced by gut bacterial signatures of shrimp life stage contributing 95.5% stratification accuracy. Shrimp sourced little (2.6%–15.8%) of their gut microbiota from their rearing water. This microbial resistance was reflected by weak compositional differences between shrimp farming spatially distinct locations where species pools were distinct. Consistently, the assembly of shrimp gut microbiota was not adequately explained by the rearing water variables and bacterial community, but rather by host‐age‐associated biotic features. The successions of shrimp gut microbiota were droved by replacement (βsim), rather than by nestedness (βnes), while those of bacterioplankton communities were equally governed by replacement and nestedness. Our study highlights how shrimp gut bacterial community assembly is coupled to their development, rearing species pool, and that the successional pattern of host‐associated communities is differed from that of free‐living bacteria.
Individual and neighborhood characteristics as predictors of depression symptom response
Authors: Panaite Vanessa , Bowersox Nicholas W. , Zivin Kara , Ganoczy Dara , Kim Hyungjin Myra , Pfeiffer Paul N.
Published: March 2019

Objective

Assess whether neighborhood characteristics predict patient‐reported outcomes for depression.

Data Sources

VA electronic medical record data and U.S. census data.

Study Design

Retrospective longitudinal cohort.

Data Extraction Methods

Neighborhood and individual characteristics of patients (N = 4,269) with a unipolar depressive disorder diagnosis and an initial Patient Health Questionnaire (PHQ‐9) score ≥10 were used to predict 50 percent improvement in 4‐8‐month PHQ‐9 scores.

Principal Findings

The proportion of a patient's neighborhood living in poverty (OR = 0.98; 95% CI: 0.97‐.1.00; P = 0.03) was associated with lower likelihood of depression symptom improvement in addition to whether the patient was black (OR = 0.76; 95% CI:0.61‐0.96; P = 0.02) had PTSD (OR = 0.59; 95% CI:0.50‐0.69; P < 0.001) or had any service‐connected disability (OR = 0.73; 95% CI:0.61‐0.87; P < 0.001).

Conclusions

Neighborhood poverty should be considered along with patient characteristics when determining likelihood of depression improvement.
Visceral adipose ratio as a novel predictor for acute bowel toxicity in patients receiving pelvic radiation: Preliminary dosimetric analysis and clinical validation
Authors: Hoover Andrew , Gunan Ganju Rohit , TenNapel Mindi , Chen Allen
Published: March 2019

Introduction

During radiation treatment planning, the small bowel (SB) is often contoured as a ‘bowel bag’ encompassing the entire peritoneal space that may be occupied by SB. This method incorporates large volumes of visceral adipose, potentially resulting in misleading estimates of radiation dose to the SB. We evaluated the relative volume of adipose within the peritoneal space and applied this as a correction factor to standard bowel bag dosimetric measures, hypothesizing that corrected SB measures would better correlate with acute toxicity.

Methods

Eighteen consecutive patients receiving pelvic radiation for gynaecologic cancers over a 1‐year period at an academic medical centre were included. Bowel function was assessed with the Expanded Prostate Index Composite (EPIC) questionnaire. Bowel bags were contoured on simulation computed tomography (CT) scans. Adipose was auto‐contoured using previously published Hounsfield Unit criteria and used to create an adipose correction factor (ACF). The ACF was applied to V45 cc and V40% volumes to create adipose corrected measures (AC‐V45 cc and AC‐V40%). Correlations between EPIC scores and dosimetric measures were assessed using Spearman coefficients.

Results

V45 cc and V40% did not correlate with overall EPIC bowel domain score; however, AC‐V40% did show a significant correlation (P = 0.02). Correlations of V45 cc and V40% with the bowel bother subdomain of EPIC were both significantly improved by applying the ACF (P = 0.02 for AC‐V45 cc; P < 0.01 for AC‐V40%).

Conclusions

Adipose corrected bowel bag dosimetric constraints correlate better with acute bowel toxicity than current standard practice. Longer follow‐up is needed to determine if similar findings are seen with late toxicity.
An early‐senescence state in aged mesenchymal stromal cells contributes to hematopoietic stem and progenitor cell clonogenic impairment through the activation of a pro‐inflammatory program
Authors: Gnani Daniela , Crippa Stefania , della Volpe Lucrezia , Rossella Valeria , Conti Anastasia , Lettera Emanuele , Rivis Silvia , Ometti Marco , Fraschini Gianfranco , Bernardo Maria Ester , Di Micco Raffaella
Published: March 2019

Hematopoietic stem and progenitor cells (HSPC) reside in the bone marrow (BM) niche and serve as a reservoir for mature blood cells throughout life. Aging in the BM is characterized by low‐grade chronic inflammation that could contribute to the reduced functionality of aged HSPC. Mesenchymal stromal cells (MSC) in the BM support HSPC self‐renewal. However, changes in MSC function with age and the crosstalk between MSC and HSPC remain understudied. Here, we conducted an extensive characterization of senescence features in BM‐derived MSC from young and aged healthy donors. Aged MSC displayed an enlarged senescent‐like morphology, a delayed clonogenic potential and reduced proliferation ability when compared to younger counterparts. Of note, the observed proliferation delay was associated with increased levels of SA‐β‐galactosidase (SA‐β‐Gal) and lipofuscin in aged MSC at early passages and a modest but consistent accumulation of physical DNA damage and DNA damage response (DDR) activation. Consistent with the establishment of a senescence‐like state in aged MSC, we detected an increase in pro‐inflammatory senescence‐associated secretory phenotype (SASP) factors, both at the transcript and protein levels. Conversely, the immunomodulatory properties of aged MSC were significantly reduced. Importantly, exposure of young HSPC to factors secreted by aged MSC induced pro‐inflammatory genes in HSPC and impaired HSPC clonogenic potential in a SASP‐dependent manner. Altogether, our results reveal that BM‐derived MSC from aged healthy donors display features of senescence and that, during aging, MSC‐associated secretomes contribute to activate an inflammatory transcriptional program in HSPC that may ultimately impair their functionality.
Brain Imaging‐Guided Analysis Reveals DNA Methylation Profiles Correlated with Insular Surface Area and Alcohol Use Disorder
Authors: Zhao Yihong , Ge Yongchao , Zheng Zhi‐Liang
Published: March 2019

Background

Alcohol use disorder (AUD) is a wide‐spread, heritable brain disease, but few studies have linked genetic variants or epigenetic factors to brain structures related to AUD in humans, due to many factors including the high‐dimensional nature of imaging and genomic data.

Methods

To provide potential insights into the links among epigenetic regulation, brain structure, and AUD, we have performed an integrative analysis of brain structural imaging and blood DNA methylome data from 52 AUD and 58 healthy control (HC) subjects collected in the Nathan Kline Institute‐Rockland Sample.

Results

We first found that AUD subjects had significantly larger insular surface area than HC in both left and right hemispheres. We then found that 7,827 DNA methylation probes on the HumanMethylation450K BeadChip had significant correlations with the right insular surface area (false discovery rate [FDR] < 0.05). Furthermore, we showed that 44 of the insular surface area‐correlated methylation probes were also strongly correlated with AUD status (FDR < 0.05). These AUD‐correlated probes are annotated to 36 protein‐coding genes, with 16 genes (44%) having been reported by others to be related to AUD or alcohol response, including TAS2R16 and PER2. The remaining 20 genes, in particular ARHGAP22, might represent novel genes involved in AUD or responsive to alcohol.

Conclusions

We have identified 36 insular surface area‐ and AUD‐correlated protein‐coding genes that are either known to be AUD‐ or alcohol‐related or not yet reported by prior studies. Therefore, our study suggests that the brain imaging‐guided epigenetic analysis has a potential of identifying possible epigenetic mechanisms involved in AUD.
General practice nurse–led screening for anxiety in later life in Australian primary care settings
Authors: Hills Danny , Hills Sharon , Robinson Tracy , Northam Holly , Hungerford Catherine
Published: March 2019

Objective

To test the feasibility of general practice nurse (GPN)–led screening for clinically significant symptoms of anxiety (CSSA) in older people and to estimate the prevalence of CSSA.

Methods

General practice nurse‐led screening for CSSA was undertaken in eight general practices by integrating the five‐item Geriatric Anxiety Inventory—Short Form (GAI‐SF) into the annual 75 years and older health assessment (75+ HA). Prevalence rates were calculated, and field notes were analysed.

Results

Over 30 months, 736 patients were screened for CSSA, with a detected prevalence rate of 20.1%. The application of the GAI‐SF into the 75+ HA was feasible and readily accepted by patients.

Conclusions

The five‐item GAI‐SF is an age‐appropriate screening tool for CSSA in general practice settings. Further research is warranted, particularly in relation to the development and implementation of evidence‐informed, general practice–based interventions for CSSA that can be effectively delivered to meet the needs of older people.
A response to commentaries on positivity
Authors: Caprara Gian Vittorio , Alessandri Guido , Caprara Maria Giovanna
Published: March 2019

In our response, we aim to further contribute to the ongoing discussion of the construct of positivity and of the related research. We believe that each of the three commentaries has something unique to offer to the literature. By this response we take the opportunity to discuss the ideas that they present, and to illustrate some additional thoughts about positivity and its relationships with germane psychological constructs.
Systematic review: outcomes and adverse events from randomised trials in Crohn's disease
Authors: Catt Heather , Hughes Dyfrig , Kirkham Jamie J. , Bodger Keith
Published: March 2019

Background

The suitability of disease activity indices has been challenged, with growing interest in objective measures of inflammation.

Aim

To undertake a systematic review of efficacy and safety outcomes in placebo‐controlled randomised controlled trials (RCTs) of patients with Crohn's disease.

Methods

MEDLINE, EMBASE, CINAHL and Cochrane Library were searched until November 2015, for RCTs of adult Crohn's disease patients treated with medical or surgical therapies. Data on efficacy and safety outcomes, end‐point definitions, and measurement instruments were extracted and stratified by publication date (pre‐2009 and 2009 onwards).

Results

One hundred and eighty‐one RCTs (110 induction and 71 maintenance) were identified, including 23 850 patients. About 92.3% reported clinical efficacy endpoints. The Crohn's Disease Activity Index (CDAI) dominated, defining clinical response or remission in 63.5% of trials (35 definitions of response or remission). CDAI < 150 was the commonest endpoint, but reporting reduced between periods (46.4%‐41.1%), whilst use of CDAI100 increased (16.8%‐30.4%). Fistula studies most commonly reported fistula closure (9, 90.0%). Reporting of biomarker, endoscopy and histology endpoints increased overall (33.3%‐40.6%, 14.4%‐30.4% and 3.2%‐12.5%, respectively), but were heterogeneous and rarely reported in fistula trials. Patient‐reported outcome measures were reported in 41.4% of trials and safety endpoints in 35.4%. Many of the common adverse events relate to disease exacerbation or treatment failure.

Conclusions

Trial endpoints vary across studies, over time and are distinct in fistula studies. Despite growth in reporting of objective measures of inflammation and in patient‐reported outcome measures, there is a lack of standardisation. This confirms the need for a core outcome set for comparative effectiveness research in Crohn's disease.
Farmers as experts: Interpreting the “hidden” messages of participatory video across African contexts
Authors: Snyder Katherine A. , Cullen Beth , Braslow Juliet
Published: March 2019

Recent scholarship has contributed important insights into the political dynamics inherent in the process of making and showing participatory videos. As a research method and an instrument for social change, participatory video has both potential and limitations for overturning the power dynamics embedded within research and in development processes. This paper focuses on experiences of incorporating participatory video in land management projects in four countries in Africa. Along with other participatory methods, the videos represented an effort to include community perspectives and objectives into the research process. Analysis of participatory video has largely focused on examining the tensions and contradictions involved in the process of making participatory videos. There has been less focus on the content of the videos themselves and what it might suggest for empowerment, voice and representation. This paper attempts to address this gap by examining the implications of the narratives that emerge in five different videos. On the surface, the participants appear to repeat dominant national and global narratives about land degradation. However, the fact that farmers present themselves as experts on these topics and the ways in which they appropriate and reconfigure the dominant narratives, can be seen as an act of empowerment. In this way, they preclude the need for external intervention on how to manage their resources.
Symbolic spaces: Nationalism and compromise in the former border enclaves of Bangladesh and India
Authors: Ferdoush Md. Azmeary
Published: March 2019

Bangladesh and India exchanged all of their 162 border enclaves in 2015 after 70 years of protracted negotiations. This paper offers an explanation as to why these enclaves were exchanged and why it took so long for the exchange to be executed. In so doing, I offer the concept of “symbolic spaces” to demonstrate that in postcolonial South Asia, enclaves gained oversized significance in nationalistic and territorial discourses. Such elevated significance effectively turned them into symbols of nationalism and territoriality, which played the major role in both their existence and their exchange. In explaining the exchange, I also contend that, although rare, states may exchange territories if it serves significant geopolitical and geo‐economic interests for the parties involved and if the exchange can be portrayed as a victory for the nation.
Beta diversity and oligarchic dominance in the tropical forests of Southern Costa Rica
Authors: Morera‐Beita Albert , Sánchez Damián , Wanek Wolfgang , Hofhansl Florian , Werner Huber , Chacón‐Madrigal Eduardo , Montero‐Muñoz Jorge L. , Silla Fernando
Published: March 2019

Recent studies have reported a consistent pattern of strong dominance of a small subset of tree species in neotropical forests. These species have been called “hyperdominant” at large geographical scales and “oligarchs” at regional‐landscape scales when being abundant and frequent. Forest community assembly is shaped by environmental factors and stochastic processes, but so far the contribution of oligarchic species to the variation of community composition (i.e., beta diversity) remains poorly known. To that end, we established 20.1‐ha plots, that is, five sites with four forest types (ridge, slope and ravine primary forest, and secondary forest) per site, in humid lowland tropical forests of southwestern Costa Rica to (a) investigate how community composition responds to differences in topography, successional stage, and distance among plots for different groups of species (all, oligarch, common and rare/very rare species) and (b) identify oligarch species characterizing changes in community composition among forest types. From a total of 485 species of trees, lianas and palms recorded in this study only 27 species (i.e., 6%) were nominated as oligarch species. Oligarch species accounted for 37% of all recorded individuals and were present in at least half of the plots. Plant community composition significantly differed among forest types, thus contributing to beta diversity at the landscape scale. Oligarch species was the component best explained by geographical and topographic variables, allowing a confident characterization of the beta diversity among tropical lowland forest stands.

Abstract in Spanish is available with online material.
Identification of two early life eczema and non‐eczema phenotypes with high risk for asthma development
Authors: Johansson Elisabet , Biagini Myers Jocelyn M. , Martin Lisa J. , He Hua , Ryan Patrick , LeMasters Grace K. , Bernstein David I. , Lockey James , Khurana Hershey Gurjit K.
Published: March 2019

Background

The “atopic march” has been considered a linear progression starting with eczema and culminating with development of asthma. Not all asthma cases, however, are preceded by eczema, and not all children with eczema go on to develop asthma.

Objective

The aim of this study was to explore the impact of allergic sensitization patterns on the association between early eczema and later childhood asthma. Given the numerous reported associations of the ciliary gene KIF3A with the atopic march, we also examined the impact of KIF3A risk allele rs12186803 on our analyses.

Methods

We studied 505 participants in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS), a prospective birth cohort, with longitudinal eczema and asthma outcomes as well as prospective data regarding timing of sensitization to foods and aeroallergens. KIF3A genotypes were available on all children.

Results

Two high‐risk groups were identified: one with and one without early eczema. The high‐risk group with early eczema was more likely to be sensitized to food allergens, while the group without early eczema was more likely to be polysensitized to aeroallergens. The KIF3A rs12186803 risk allele interacted with food sensitization to increase asthma risk in children with eczema (P = 0.02). In children without eczema, asthma was associated with the interaction between rs12186803 and aeroallergen sensitization (P = 0.007).

Conclusions & Clinical Relevance

KIF3A interacted differentially with sensitization pattern to increase the risk of asthma in two high‐risk groups of children with and without early eczema. Given the reported role of KIF3A in epithelial cell functioning, the results add evidence to the hypothesis that an impaired epithelial barrier is a key aspect in the development of allergic disease.
Evaluating unmet needs in patients undergoing surgery for colorectal cancer: a patient reported outcome measures study
Authors: Sutton P. A. , Bourdon‐Pierre R. , Smith C. , Appleton N. , Lightfoot T. , Gabriel C. , Richards B. , Mohamed S. , Mason‐Whitehead E. , Hulbert‐Williams N. J. , Vimalachandran D.
Published: March 2019

Aim

Patient reported outcome measures (PROMs) are self‐reported measures of patients’ health status or health‐related quality of life at a single point in time. We aimed to evaluate the use of a colorectal PROM and conducted a focus group to further explore this and other unmet needs in our patient population treated surgically for colorectal cancer.

Method

A multidisciplinary research group consisting of colorectal surgeons, nurse specialists, psychologists, sociologists and patient representatives devised a composite tool of new and existing outcome measures which was piloted in our local population (n = 35). Participants were subsequently invited to attend a semi‐structured focus group during which the PROM was reviewed and an unmet needs analysis was performed. Thematic analysis of focus group transcripts was undertaken for emergent themes.

Results

Initial consensus was for a tool including the EQ‐5D, Functional Assessment of Cancer Therapy – Colorectal (FACT‐C), the distress thermometer, a validated measure of stigma, an unmet needs analysis, and questions assessing the psychological impact of cancer. Median and interquartile range values suggested that all metrics were discriminatory with the exception of FACT‐C. All participants agreed that the tool was acceptable and reflected the current state of their health and emotions. Thematic analysis of focus group transcripts identified four major themes: physical symptoms, emotional response, information provision and coping mechanisms.

Conclusion

Through expert consensus, local piloting and patient focus groups we have evaluated a novel PROM for colorectal cancer. Furthermore, through our direct engagement with patients we have identified several unmet needs which we are currently exploring within the clinical service.
Frequency, characteristics, and outcome of PTLD after allo‐SCT: A multicenter study from the Spanish group of blood and marrow transplantation (GETH)
Authors: García‐Cadenas Irene , Yáñez Lucrecia , Jarque Isidro , Martino Rodrigo , Pérez‐Simón Jose Antonio , Valcárcel David , Sanz Jaime , Bermúdez Arantxa , Muñoz Cristina , Calderón‐Cabrera Cristina , García Estefania , Alonso Laura , Suárez‐Lledó Maria , González Vicent Marta , Heras Inmaculada , Viguria Mª Cruz , Batlle Montserrat , Vázquez Lourdes , López Javier , Solano Carlos ,   the Spanish group of blood and marrow transplantation (GETH)
Published: March 2019

Post‐transplant lymphoproliferative disorder (PTLD) is an infrequent complication of allogeneic stem cell transplant (allo‐SCT).

Aims

To estimate the frequency and management of PTLD in Spain and to identify prognostic factors influencing outcomes.

Methods

Multicenter, retrospective analysis of allo‐SCT performed in 14 transplant units over a 15‐year period.

Results

102 PTLD were diagnosed among 12 641 allo‐SCT, leading to an estimated frequency of 0.8%. PTLD was diagnosed at a median of 106 days after SCT. Eighty‐seven cases (85%) were diagnosed between 2007 and 2013. At diagnosis, 22% and 17% of the patients had gastrointestinal tract and CNS involvement. Eighty‐seven (85%) received rituximab treatment, alone or in combination with immunosuppression reduction, with an ORR of 50.6%. With a median follow‐up for survivors of 58 months, the 2‐year overall survival (OS) was 33% and the PTLD‐related mortality 45%. Age ≥ 40 years, malignant underlying disease, non‐response to rituximab, and severe thrombocytopenia or lymphocytopenia at PTLD diagnosis were associated with worse overall survival.

Conclusions

Only a small proportion of allografted patients were diagnosed a PTLD. Its clinical course was highly aggressive, and prognosis poor, especially in those failing rituximab. The prognostic impact found of the platelet, and lymphocyte count at diagnosis requires further confirmation.
Equine congenital heart disease and respiratory disease interactions
Authors: Navas De Solis C. , Wesselowski S.
Published: March 2019

The interactions between the respiratory and cardiovascular system in neonates with severe illness are relevant to the equine clinician. There is little information available regarding the treatment of congenital heart disease or pulmonary hypertension in foals, thus a team approach with experts in these fields may help our equine cases.
Required return on equity when capital structure is dynamic
Authors: Dai Na , Piccotti Louis R.
Published: March 2019

We link the firm's required return on equity to its target debt ratio. We find that a firm's expected return on equity is increasing in the product of the distance between its debt ratio and its target debt ratio, its speed of adjustment, and the spread of the tax benefits of its debt over its bankruptcy costs of debt. Our empirical tests validate the testable implications of our model.
Quantifying the biophysical and socioeconomic drivers of changes in forest and agricultural land in South and Southeast Asia
Authors: Xu Xiaoming , Jain Atul K. , Calvin Katherine V.
Published: March 2019

South and Southeast Asia (SSEA) has been a hotspot for land use and land cover change (LULCC) in the past few decades. The identification and quantification of the drivers of LULCC are crucial for improving our understanding of LULCC trends. So far, the biophysical and socioeconomic drivers of forest change have not been quantified at the regional scale, particularly for SSEA. In this study, we quantify the biophysical and socioeconomic drivers of forest change on a country‐by‐country basis in SSEA using an integrated quantitative methodology, which systematically accounts for previously published driver information and regional datasets. We synthesize more than 200 publications to identify the drivers of the forest change at different spatial scales in SSEA. Subsequently, we collect spatially explicit proxy data to represent the identified drivers. We quantify the dynamics of forest and agricultural land from 1992 to 2015 using the Climate Change Initiative (CCI) land cover data developed by the European Space Agency (ESA). A geographically weighted regression method is employed to quantify the spatially heterogeneous drivers of forest change. Our results show that socioeconomic drivers are more important than biophysical drivers for the conversion of forest to agricultural land in South Asia and maritime Southeast Asia. In contrast, biophysical drivers are more important than socioeconomic drivers for the conversion of agricultural land to forest in maritime Southeast Asia and less important in South Asia. Both biophysical and socioeconomic drivers contribute approximately equally to both changes in the mainland Southeast Asia region. By quantifying the dynamics of forest and agricultural land and the spatially explicit drivers of their changes in SSEA, this study provides a solid foundation for LULCC modeling and projection.
Seasonal niche‐tracking behaviour of two partially migratory passerines
Authors: Fandos Guillermo , Tellería José Luis
Published: March 2019

Migratory birds spend periods of the year in different locations as a response to seasonal changes in environmental suitability. They are classified as either ‘niche‐trackers’ or ‘niche‐switchers’, depending on whether they track or switch environmental conditions throughout the year. However, the relationship between these strategies and their migratory behaviour is still unclear. Here we examine whether migratory European Robins Erithacus rubecula and Eurasian Blackcaps Sylvia atricapilla track environmental conditions between breeding and wintering areas and whether their behaviour differs from that of their sedentary counterparts. We used ringing data for both migratory and sedentary individuals wintering sympatrically in the Iberian Peninsula to assess the environmental conditions relating to their seasonal distributions. We explored seasonal niche‐tracking using two multivariate analyses with alternative sets of predictor variables (landscape and climate) to generate different environmental scenarios. Our results show that migratory individuals track similar climatic conditions throughout their seasonal distributions, whereas sedentary birds cope with great variation in climate over the course of the year. In addition, migratory birds show less seasonal overlap in the landscape structure of their chosen habitats compared with sedentary individuals. These results suggest that there is a trade‐off between, on the one hand, the cost for migrants of travelling long distances and, on the other, the increased flexibility required by sedentary birds if they are to tolerate a wider suite of environmental conditions within their permanent ranges. Given that sedentary populations in the southern Iberian Peninsula seem to be linked to populations of migratory individuals of these two species that started to move northwards after the last glacial cycle, the observed patterns suggest that migrant birds represent a fraction of the southern population that is specialized in the exploitation of a narrower range of environmental conditions.
Pathways from workplace flexibility to turnover intention: Role of work–family conflict, family–work conflict, and job satisfaction
Authors: Rhee Min‐Kyoung , Park Soo Kyung , Lee Chung‐Kwon
Published: March 2019

This study examined the prevalence of workplace flexibility and the mechanisms that allow workplace flexibility to influence turnover intentions through work–family and family–work conflicts and job satisfaction among low‐wage workers in South Korea. Participants included 250 low‐wage workers whose monthly salary was less than 2 million Korean won (approx. $1,900). The study results indicate that low‐wage workers have limited access to workplace flexibility and that workplace flexibility plays a significant protective role in reducing their turnover intention, indirectly by decreasing work–family conflicts and enhancing job satisfaction. This article also discusses the implications of these findings for labor policy and social work practice.
Industry sponsorship bias in clinical trials in implant dentistry: Systematic review and meta‐regression
Authors: dos Santos Mateus Bertolini Fernandes , Agostini Bernardo Antônio , de Moraes Rafael Ratto , Schwendicke Falk , Sarkis‐Onofre Rafael
Published: March 2019

Aim

Industry sponsorship might distort the conduct and findings of studies in a large range of medical disciplines. The objective of this study was to assess whether industry sponsorship bias is present in randomized controlled trials (RCTs) on dental implants.

Material and methods

Two databases were searched (MEDLINE; Web of Science) to identify RCTs published between 1996 and 2016 assessing different implant systems, components or techniques, such as implant‐abutment connections, geometries, surfaces, loading protocols or regions of placement. Studies’ sponsorship status was classified as unclear, non‐sponsored or sponsored. Our outcome was marginal bone loss per year (MBL/year) of follow‐up. Random‐effects meta‐analysis of MBL/year with subgroup analysis according to sponsorship status was performed. Moreover, multivariable stepwise‐selection meta‐regression was performed to assess whether sponsorship status, among other covariates, was associated with MBL/year.

Results

One hundred and two RCTs (4,775 patients, 8,806 implants) were included. Overall mean (95% confidence interval) MBL/year was 0.74 mm (95% CI 0.67/0.82). There was no significant difference in MBL/year among sponsorship categories; unclear: 0.64 (95% CI 0.37/0.91); non‐sponsored: 0.65 (095% CI 0.55/0.75); and sponsored: 0.82 (95% CI 0.71/0.94).

Conclusion

Meta‐regression did not demonstrate a significant association of MBL/year with sponsorship status or other covariates was found. We did not detect significant sponsorship bias in RCTs on dental implants.
Chemoprevention of gastric cancer by Helicobacter pylori eradication and its underlying mechanism
Authors: Kim Nayoung
Published: March 2019

The cascade of gastric cancer, a leading cause of cancer incidence and mortality, is multifactorial. Helicobacter pylori (HP) infection plays a major role in gastric cancer (GC), and there has been an accumulation of data regarding the chemopreventive effect of HP eradication. However, it remains unclear how HP infection causes GC and how HP eradication prevents GC. To clarify this issue, the following approaches were performed in this review article. First, how HP‐induced atrophic gastritis (AG) and intestinal metaplasia (IM) provoke the development of GC is shown, followed by how long HP eradication takes to induce a reversible change in AG and IM. Second, epigenetic studies of PTPN6, MOS, DCC, CRK, and VAV1 were performed in noncancerous gastric specimens in terms of HP status. Among these genes, MOS was found to be a possible surrogate marker for GC development. HP eradication decreased aberrant DNA methylation in a gene‐specific manner, and MOS played a role in metachronous gastric neoplasms. Third, transforming growth factor‐β1 (TGF‐β1) and TGF‐β1‐induced epithelial‐mesenchymal transition (EMT) markers were investigated in gastric mucosa. HP infection triggered the TGF‐β1‐induced EMT pathway and caused the emergence of GC stem cells, such as CD44v8‐10. When HP was eradicated, these two pathways were inhibited. Finally, a 2222 cohort study showed that HP eradication significantly decreased the risk of noncardiac GC. Taken together, HP eradication is effective as a primary GC prevention method, and its underlying mechanism includes reversibility of AG and IM, methylation, EMT, and stem cells.
End‐of‐Life Care in Patients Exposed to Home‐Based Palliative Care vs Hospice Only
Authors: Wang Susan E. , Liu In‐Lu Amy , Lee Janet S. , Khang Peter , Rosen Romina , Reinke Lynn F. , Mularski Richard A. , Nguyen Huong Q.
Published: March 2019

OBJECTIVES

The current evidence base regarding the effectiveness of home‐based palliative care (HomePal) on outcomes of importance to multiple stakeholders remains limited. The purpose of this study was to compare end‐of‐life care in decedents who received HomePal with two cohorts that either received hospice only (HO) or did not receive HomePal or hospice (No HomePal‐HO).

DESIGN

Retrospective cohorts from an ongoing study of care transition from hospital to home. Data were collected from 2011 to 2016.

SETTING

Kaiser Permanente Southern California.

PARTICIPANTS

Decedents 65 and older who received HomePal (n = 7177) after a hospitalization and two comparison cohorts (HO only = 25 102; No HomePal‐HO = 22 472).

MEASUREMENTS

Utilization data were extracted from administrative, clinical, and claims databases, and death data were obtained from state and national indices. Days at home was calculated as days not spent in the hospital or in a skilled nursing facility (SNF).

RESULTS

Patients who received HomePal were enrolled for a median of 43 days and had comparable length of stay on hospice as patients who enrolled only in hospice (median days = 13 vs 12). Deaths at home were comparable between HomePal and HO (59% vs 60%) and were higher compared with No HomePal‐HO (16%). For patients who survived at least 6 months after HomePal admission (n = 2289), the mean number of days at home in the last 6 months of life was 163 ± 30 vs 161 ± 30 (HO) vs 149 ± 40 (No HomePal‐HO). Similar trends were also noted for the last 30 days of life, 25 ± 8 (HomePal, n = 5516), 24 ± 8 (HO), and 18 ± 11 (No HomePal‐HO); HomePal patients had a significantly lower risk of hospitalizations (relative risk [RR] = .58‐.87) and SNF stays (RR = .32‐.77) compared with both HO and No HomePal‐HO patients.

CONCLUSION

Earlier comprehensive palliative care in patients’ home in place of or preceding hospice is associated with fewer hospitalizations and SNF stays and more time at home in the final 6 months of life. J Am Geriatr Soc, 2019.
Mixed‐methods evaluation of an educational intervention to change mental health nurses' attitudes to people diagnosed with borderline personality disorder
Authors: Dickens Geoffrey L. , Lamont Emma , Mullen Jo , MacArthur Nadine , Stirling Fiona J.
Published: March 2019

Aims and objectives

To evaluate and explore mental health nurses’ responses to and experience of an educational intervention to improve attitudes towards people with a diagnosis of borderline personality disorder (BPD). Report findings are concordant with relevant EQUATOR guidelines (STROBE and COREQ).

Background

Attitudes towards people with a diagnosis of BPD are poorer than for people with other diagnoses. There is limited evidence about what might improve this situation. One intervention with reportedly good effect uses an underlying biosocial model of BPD. No previous intervention has been co‐produced with an expert by experience. We developed and delivered a 1‐day intervention comprising these elements.

Design

A mixed‐methods design was used comprising prospective within‐subjects cohort intervention and qualitative elements. Participants were mental health nursing staff working in inpatient and community settings in one NHS Board in Scotland, UK.

Methods

Measurement of cognitive and emotional attitudes to people with a diagnosis of BPD at pre‐ and postintervention (N = 28) and at 4‐month follow‐up. Focus groups were used to explore participants’ experiences of the intervention (N = 11).

Results

Quantitative evaluation revealed some sustained changes consistent with expected attitudinal gains in relation to the perceived treatment characteristics of this group, the perception of their suicidal tendencies and negative attitudes in general. Qualitative findings revealed some hostility towards the underpinning biosocial model and positive appreciation for the involvement of an expert by experience.

Conclusions

Sustained benefits of an educational intervention for people working with people diagnosed with BPD in some but not all areas. Participants provided contrasting messages about what they think will be useful.

Relevance to clinical practice

The study provides further evidence for incorporation of a biosocial model into staff training as well as the benefits of expert by experience co‐production. Mental health nurses, however, believe that more well‐resourced services are the key to improving care.