bluuebunny/crossref_metadata_2025 huggingface dataset:
The association of discharge decisions after deceased donor kidney transplantation with the risk of early readmission: Results from the deceased donor study
Authors: Harhay Meera Nair , Jia Yaqi , Thiessen‐Philbrook Heather , Besharatian Behdad , Gumber Ramnika , Weng Francis L. , Hall Isaac E. , Doshi Mona , Schroppel Bernd , Parikh Chirag R. , Reese Peter P.
Published: February 2018

Background

Kidney transplant (KT) recipients experience high rates of early (≤30 days) hospital readmission (EHR) after KT, and existing studies provide limited data on modifiable discharge factors that may mitigate EHR risk.

Methods

We performed a retrospective cohort study of 468 adult deceased donor KT recipients transplanted between 4/2010 and 11/2013 at 5 United States transplant centers. We fit multivariable mixed effects models to assess the association of two potentially modifiable discharge factors with the probability of EHR after KT: (i) weekend discharge and (ii) days to first scheduled follow‐up.

Results

Among 468 KT recipients, 38% (n = 178) experienced EHR after KT. In fully adjusted analyses, compared to weekday discharges, KT recipients discharged on the weekend had a 29% lower risk of EHR (adjusted odds ratio [aOR] 0.71, 95% confidence interval [CI] 0.41‐0.94). Compared to follow‐up within 2 days of discharge, KT recipients with follow‐up within 3 to 6 days had a 28% higher probability of EHR (aOR 1.28, 95% CI 1.13‐1.45).

Conclusions

These findings suggest that clinical decisions related to the timing of discharge and follow‐up modify EHR risk after KT, independent of traditional risk factors.
Angioplasty vs stent in the treatment of transplant renal artery stenosis
Authors: Chen Ling‐Xin , De Mattos Angelo , Bang Heejung , Vu Catherine T. , Gandhi Mehul , Alnimri Muna , Gallay Brian , Fananapazir Ghaneh
Published: February 2018

Objective

To compare outcomes between percutaneous transluminal angioplasty and stent placement in the treatment of transplant renal artery stenosis (TRAS).

Methods

We retrospectively studied patients who underwent angiography for TRAS between 1/1/2008 and 9/20/2016 at 1 center. We compared the rates of restenosis in patients who were treated with angioplasty alone vs those who were treated with stenting. Secondary outcomes included serum creatinine and blood pressure after intervention and graft and patient survival.

Results

A total of 82 patients were identified as having TRAS after angiography. Restenosis occurred in 28% (16 of 58) of the angioplasty patients compared with 8% (2 of 24) of the stented patients (P = .04). Repeat angiography occurred in 14% (8 of 58) of angioplasty patients vs 13% (3 of 24) of stented patients (P = .9). The stented group had significantly higher pre‐intervention stenosis (71% vs 64%, P = .01) and lower postintervention stenosis (4% vs 30%, P < .001). Serum creatinine and blood pressures were not significantly different between the 2 groups at 30, 90, or 360 days postintervention. There was no statistically significant difference in graft or patient survival between groups (P = .37).

Conclusions

Stent placement resulted in fewer cases of restenosis compared with angioplasty alone, although no benefit in terms of serum creatinine, blood pressure, or patient and graft survival was shown.
PTH, vitamin D, and the FGF‐23–klotho axis and heart: Going beyond the confines of nephrology
Authors: Navarro‐García José Alberto , Fernández‐Velasco María , Delgado Carmen , Delgado Juan F. , Kuro‐o Makoto , Ruilope Luis M. , Ruiz‐Hurtado Gema
Published: February 2018

Background

Profound disturbances in mineral metabolism are closely linked to the progression of chronic kidney disease. However, increasing clinical and experimental evidence indicates that alterations in phosphate homoeostasis could have an even stronger impact on the heart.

Aim

The aim of this review is to provide the reader with an update of how alterations in mineral metabolism are related to direct and indirect cardiotoxic effects beyond the nephrology setting.

Results

Evidence exists that alterations in mineral metabolism that are related to changes in parathyroid hormone (PTH), vitamin D, and the FGF‐23–klotho axis have direct pathological consequences for the heart. Alterations in plasma PTH levels are associated with cardiac dysfunction and detrimental cardiac remodelling. Several clinical studies have associated vitamin D deficiency with the prevalence of cardiovascular disease (CV) and its risk factors. Recent evidences support deleterious direct and nonphosphaturic effects of FGF‐23 on the heart as hypertrophy development. In contrast, reduced systemic klotho levels are related to CV damage, at least when advanced age is present. In addition, we discuss how these mineral metabolism molecules can counteract each other in some situations, in the context of failed clinical trials on cardiac protection as is the case of vitamin D supplementation.

Conclusions

Among all mineral components, an increase in systemic FGF‐23 levels is considered to have the greatest CV impact and risk. However, it is quite possible that many intracellular mechanisms mediated by FGF‐23, especially those related to cardiomyocyte function, remain to be discovered.
Comparing the prediction of joint species distribution models with respect to characteristics of sampling data
Authors: Zhang Chongliang , Chen Yong , Xu Binduo , Xue Ying , Ren Yiping
Published: February 2018

Biotic interactions have been rarely included in traditional species distribution models, wherein joint species distribution models (JSDMs) emerge as a feasible approach to incorporate environmental factors and interspecific interactions simultaneously, making it a powerful tool for analyzing the structure and assembly processes of biotic communities. However, the predictability and statistical robustness of JSDMs are largely unknown because of the lack of research efforts for those newly developed models. This study systematically evaluated the performances of five JSDMs in predicting the occurrence and biomass of multiple species, with a particular focus on diverse characteristics of sampling data, including type of response variables, number of sampling sites, and the number of species included in models. In general, most models yielded satisfactory performances on fitting to observed data and on the estimation of environmental effects; however, they showed less well performances in evaluating species associations, and their predictability had large variations. The JSDMs showed inconsistent performances between the goodness‐of‐fit and predictability in cross‐validation, and the Boral model was relatively robust than others. The predictability of JSDMs was less influenced by sample sizes and substantially improved by incorporating rare species. This study contributes to an appropriate model selection and application of JSDMs.
The question of land access and the Spanish land reform of 1932
Authors: Carmona Juan , Rosés Joan R. , Simpson James
Published: February 2018

Spanish land reform, involving the breakup of the large southern estates, was a central issue during the first decades of the twentieth century, and was justified on economic and political grounds. This article employs new provincial data on landless workers, land prices, and agrarian wages to consider whether government intervention was needed because of the failure of the free action of markets to redistribute land. Our evidence shows that the relative number of landless workers decreased significantly from 1860 to 1930, before the approval of the 1932 Land reform during the Second Republic (1931–6). This was due to two interrelated market forces: the falling ratio between land prices and rural wages, which made plots of land cheaper for landless workers to rent and buy; and structural change that drained the rural population from the countryside Given that shifts in factor prices were already helping workers gain access to land by the 1930s, the economic arguments for introducing reform at that time remain unclear.
Rituximab in combination with chemotherapy for the treatment of chronic lymphocytic leukaemia in clinical practice
Authors: Reiser Marcel , Dörfel Steffen , Hensel Manfred , Hoesl Mark , Jordan Wolf‐Oliver , Koenigsmann Michael , Meyer Dirk , Reichert Dietmar , Schwarzer Andreas , Marquardt Moritz , Kellershohn Kerstin , Jentsch‐Ullrich Kathleen
Published: February 2018

Objectives

This study was conducted to investigate the real‐world effectiveness and tolerability of rituximab‐containing chemoimmunotherapies, which have become the standard of care for chronic lymphocytic leukaemia (CLL), particularly for physically fit patients. Furthermore, current treatment patterns in clinical practice were documented, and an unselected real‐life population was compared with older, comorbid patients.

Methods

Prospective, multicentre, observational study with rituximab‐containing chemoimmunotherapy in CLL patients.

Results

Of 681 patients in total, 485 were enroled in cohort 1 (unselected) and 196 in cohort 2 (comorbid “slow‐go” patients). The median patient age was higher than in most randomised controlled trials (cohort 1: 70 years and cohort 2: 75 years). The most common treatment regimen in both first‐line and relapsed patients was rituximab‐bendamustine. Two‐year progression‐free survival rate for first‐line therapy was 84.1% for cohort 1 and 69.8% for cohort 2 (with best overall response rate 81.8% for cohort 1 and 76.6% for cohort 2). General and B‐symptoms declined during treatment and remained at low level or decreased further until study end. The safety profile observed in randomised clinical trials was confirmed.

Conclusion

Chemoimmunotherapy with rituximab is feasible and safe in a wide variety of clinical settings in CLL, including the treatment of older patients with comorbidities (ClinicalTrials.gov NCT01178086).
Genuine halitosis in patients with dental and laryngological etiologies of mouth odor: severity and role of oral hygiene behaviors
Authors: Herman Sabina , Lisowska Grażyna , Herman Joanna , Wojtyna Ewa , Misiołek Maciej
Published: February 2018

The aims of the study were to determine the severity of halitosis and the association between oral hygiene practices and the severity of malodor in patients with dental and laryngological etiologies of genuine halitosis. Thirty‐five laryngological and 40 dental patients with halitosis completed a structured interview and underwent laryngological and dental examinations. Halitosis was assessed using organoleptic and halimeter tests. Greater halitosis severity in laryngological patients was associated with worse clinical status of the palatine tonsils, less frequent toothbrushing, less frequent use of tongue cleaners, fewer daily meals, and increased use of mouthrinses. Among dental patients, more severe halitosis was associated with worse clinical status of the periodontium, more tongue coating, less saliva secretion, and less frequent use of dental floss, interdental toothbrushes, and tongue cleaners. Oral hygiene was found to be a key moderator of the relationship between status of the periodontium or tonsils and severity of halitosis. The severity of halitosis in laryngological patients and dental patients is essentially similar; however, oral hygiene routines are associated with different effects in each group. Consequently, individual recommendations for patients with halitosis should be adjusted for the underlying disease and emphasize the role of effective specific hygiene behaviors.
Laser ablation is effective for temporal lobe epilepsy with and without mesial temporal sclerosis if hippocampal seizure onsets are localized by stereoelectroencephalography
Authors: Youngerman Brett E. , Oh Justin Y. , Anbarasan Deepti , Billakota Santoshi , Casadei Camilla H. , Corrigan Emily K. , Banks Garret P. , Pack Alison M. , Choi Hyunmi , Bazil Carl W. , Srinivasan Shraddha , Bateman Lisa M. , Schevon Catherine A. , Feldstein Neil A. , Sheth Sameer A. , McKhann Guy M. ,   the Columbia Comprehensive Epilepsy Center Co‐Authors
Published: February 2018

Objective

Selective laser amygdalohippocampotomy (SLAH) using magnetic resonance–guided laser interstitial thermal therapy (MRgLITT) is emerging as a treatment option for drug‐resistant mesial temporal lobe epilepsy (MTLE).SLAHis less invasive than open resection, but there are limited series reporting its safety and efficacy, particularly in patients without clear evidence of mesial temporal sclerosis (MTS).

Methods

We report seizure outcomes and complications in our first 30 patients who underwentSLAHfor drug‐resistantMTLEbetween January 2013 and December 2016. We compare patients who required stereoelectroencephalography (SEEG) to confirm mesial temporal onset with those treated based on imaging evidence ofMTS.

Results

Twelve patients withSEEG‐confirmed, non‐MTS MTLEand 18 patients withMRI‐confirmedMTSunderwentSLAH.MTSpatients were older (median age 50 vs 30 years) and had longer standing epilepsy (median 40.5 vs 5.5 years) than non‐MTSpatients. Engel class I seizure freedom was achieved in 7 of 12 non‐MTSpatients (58%, 95%confidence interval [CI] 30%‐86%) and 10 of 18MTSpatients (56%, 95%CI33%‐79%), with no significant difference between groups (odds ratio [OR]1.12, 95%CI0.26‐4.91,P = .88). Length of stay was 1 day for most patients (range 0‐3 days). Procedural complications were rare and without long‐term sequelae.

Significance

We report similar rates of seizure freedom followingSLAHin patients withMTSandSEEG‐confirmed, non‐MTS MTLE. Consistent with early literature, these rates are slightly lower than typically observed with surgical resection (60%‐80%). However,SLAHis less invasive than open surgery, with shorter hospital stays and recovery, and severe procedural complications are rare.SLAHmay be a reasonable first‐line surgical option for patients with bothMTSandSEEGconfirmed, non‐MTS MTLE.
Insulo‐opercular cortex generates oroalimentary automatisms in temporal seizures
Authors: Aupy Jerome , Noviawaty Ika , Krishnan Balu , Suwankpakdee Piradee , Bulacio Juan , Gonzalez‐Martinez Jorge , Najm Imad , Chauvel Patrick
Published: February 2018

Objective

Oroalimentary automatisms (OAAs) resembling normal alimentary behavior are stereotyped complex movements that may occur during epileptic seizures. They are considered common clinical signs in temporal lobe seizures, but their anatomofunctional mechanisms are not established. We took the opportunity of presurgical intracerebral recordings to study the relations between the occurrence of OAAs and temporal/spatial features of ictal activities.

Methods

We retrospectively reviewed patients with medically intractable medial temporal lobe epilepsy who underwent stereoelectroencephalography (SEEG) at Cleveland Clinic between 2009 and 2016. Patients presenting oroalimentary automatisms during seizures, with intracerebral electrodes spanning temporal and extratemporal areas, were selected. SEEG‐clinical correlations with latency measurements were done. Coherence analyses were performed on regions of interest as defined by the areas involved at the onset of oroalimentary automatisms.

Results

Fifteen patients (115 seizures) were analyzed. Sixty‐nine seizures exhibited overt oroalimentary automatisms. Only insulo‐opercular cortex ictal involvement was consistently related to the occurrence of OAAs, with a linear correlation between OAA onset and ictal oscillatory activity onset in the insulo‐opercular cortex. SEEG signal processing showed an increase in theta coherence preceding oroalimentary automatism onset between mediobasal‐temporal structures and insulo‐opercular cortex, as well as between the 2 insulo‐opercular regions.

Significance

The underlying mechanism for the production of oroalimentary automatisms in medial temporal seizures is based on temporal‐insulo‐opercular theta coherence leading to a synchronous state generating rhythmic patterned outputs from the cortical masticatory area.
Arthroscopic treatment for cervical articular process joint osteochondrosis in a Thoroughbred horse
Authors: Tucker R. , Piercy R. J. , Dixon J. J. , Muir C. F. , Smith K. C. , Potter K. E. , Leaman T. R. , Smith R. K. W.
Published: February 2018

A yearling Thoroughbred colt was presented for investigation of neck stiffness and episodes of intermittent neck pain without neurological signs. Osteochondrosis (OCD) of the cervical articular process joints (APJs) was diagnosed with the aid of radiography and computed tomography. An articular osteochondral fragment of the left fourth caudal cervical articular process was removed arthroscopically following a cut down approach to the joint capsule of the affected APJ. Surgical removal resulted in resolution of clinical signs at 4 weeks. However, subsequently the horse was markedly ataxic 6 weeks post surgery after being found cast in its stable. Cervical stenotic myelopathy was considered the most likely cause based on clinical and radiographic signs and the horse was subjected to euthanasia due to a poor prognosis for racing. Post‐mortem examination identified atypical cartilage within several cervical APJs with histological changes consistent with OCD. This case report supports OCD of the APJs as a cause of neck pain and confirms the clinical practicality and short‐term effectiveness of arthroscopic fragment removal. Surgical treatment for cervical OCD should be considered in horses without neurological signs, although case selection is important and the underlying pathology remains a risk factor for the development of subsequent neurological signs.
“It is the innocence which constitutes the crime”: Political geographies of white supremacy, the construction of white innocence, and the Flint water crisis
Authors: Inwood Joshua F.J.
Published: February 2018

Using the Flint, Michigan water crisis as a backdrop, this review piece explores the concept of white innocence. The concept of white innocence presents us with an analytic tool to understand the frustrating endurance of white supremacy within the U.S. settler state and how white supremacy operates through a range of geographically grounded practices. This paper makes an explicit link between work on settler colonialism and white innocence outlining how the burgeoning work on settler societies opens space to a productive engagement with the concept of innocence. I contend that white innocence as a concept needs to be more fully grounded in work that engages with settler colonialism and within the United States specifically. White innocence also inculcates the agency of whites in a society that is built through the explicit exploitation of persons of color as well as the way white institutions continue to expose persons of color to a range of negative impacts. This paper begins with a review of the literature on whiteness within geographic research. The last several years has seen a series of important interventions in the literature and geographers are increasingly turning to the concept of white supremacy to explain racism in 21st century U.S. society.
Quantitative estimation of progression of chronic liver disease using gadoxetate disodium‐enhanced magnetic resonance imaging
Authors: Yamada Akira , Fujinaga Yasunari , Suzuki Takeshi , Komatsu Daisuke , Kitoh Yoshihiro , Iwadate Yuji , Nozaki Atsushi , Ueda Kazuhiko , Kadoya Masumi
Published: February 2018

Aim

The purpose of this study was to determine whether the liver stiffness (LS) measured on magnetic resonance (MR) elastography can be estimated by a combination of gadoxetate disodium‐enhanced MR imaging (EOB‐MRI) and ordinary blood tests.

Methods

We evaluated 33 consecutive patients with suspected liver disease who underwent EOB‐MRI using a Differential Subsampling with Cartesian Ordering MR sequence and MR elastography using a 1.5‐T MR system in this prospective study. A stepwise multiple linear regression model analysis of LS was performed using various predictive values obtained from two‐in‐one‐uptake, two‐compartment model analysis of EOB‐MRI (velocity constants of arterial inflow [K1a], portal venous inflow [K1p], hepatocellular uptake [Ki]), and ordinary blood test results (blood platelet count, serum albumin level [ALB], total serum bilirubin level [T‐BIL], and prothrombin time [PT%]).

Results

Multiple linear regression model analysis revealed that hepatic perfusion‐uptake index (HPUI = –K1a + K1p + Ki) (P < 0.0001), albumin‐bilirubin linear predictor (ALBI‐LP = 0.66 × log10T‐BIL – 0.085 × ALB) (P = 0.034), and blood platelet count (P = 0.046) were significant independent predictors of LS (r = 0.863). The area under receiver operator characteristics curve of multiple linear regression model in prediction of the liver stiffness corresponding to higher (LS > 5.0 kPa) and lower (LS < 4.2 kPa) risk for developing hepatocellular carcinoma were 0.956 and 0.938, respectively.

Conclusion

LS can be estimated quantitatively with the use of HPUI obtained from compartment model analysis of EOB‐MRI combined with ALBI‐LP and blood platelet count.
Diagnosis of a severe congenital anomaly: A qualitative analysis of parental decision making and the implications for healthcare encounters
Authors: Lotto Robyn , Smith Lucy K. , Armstrong Natalie
Published: February 2018

Objective

To explore parental decision making following diagnosis of a severe congenital anomaly, and implications for healthcare encounters.

Design

Qualitative semi‐structured interviews with 38 parents‐to‐be were collated and triangulated with data generated from consultation recordings.

Analysis

Data were analysed using a constant comparative‐based approach.

Setting

Recruitment was undertaken across four fetal medicine sites in two tertiary referral trusts.

Participants

Parents‐to‐be whose pregnancy was suspected or diagnosed as being affected by a severe congenital anomaly. This sample was purposive to include known factors affecting the decision to terminate or continue the affected pregnancy.

Findings

In trying to make a decision about how to proceed with their pregnancy, parents‐to‐be typically had to work hard to negotiate multiple uncertainties around the diagnosis and prognosis of the suspected anomaly. This was influenced by parents’ capacity to cope with uncertainty and the way in which uncertainty was managed by the clinical team. This negotiation of uncertainty was enacted within a fluid, nonlinear three‐phase process: “information seeking,” reflecting the way parents‐to‐be face the uncertainty associated with a fetal diagnosis and associated prognosis; “implications,” where consideration is given to future consequences of the decision; and “decision making,” which reflects the way in which the decision is made (head‐ or heart‐led). Spectrums of responses were apparent within each phase.

Conclusions

This study provides important insights into how parents‐to‐be make decisions following diagnosis or suspicion of a severe congenital anomaly. The impact of these on healthcare encounters is discussed, alongside recommendations for clinical practice.
ENTRY REGULATIONS, WELFARE, AND DETERMINANTS OF MARKET STRUCTURE
Authors: Maican Florin G. , Orth Matilda
Published: February 2018

Welfare effects of entry regulations are theoretically ambiguous in differentiated product markets. We use a dynamic oligopoly model of entry and exit with store‐type differentiation and static price setting to evaluate how entry regulations affect long‐run profitability, market structure, and welfare. Based on unique data for all retail food stores in Sweden, we estimate demand, recover variable profits, and estimate entry costs and fixed costs by store type. Counterfactual policy experiments show that welfare increases when competition is enhanced by lower entry costs. Protecting small stores by imposing licensing fees on large stores is not welfare enhancing.
Immune modulatory effects of statins
Authors: Zeiser Robert
Published: February 2018

Despite major advances in recent years, immunosuppressive regimens for multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus and graft‐versus‐host disease still have major adverse effects and immunomodulation rather than immune paralysis would be desirable. Statins inhibit the rate‐limiting enzyme of the l‐mevalonate pathway, the 3‐hydroxy‐3‐methyl‐glutaryl‐coenzyme A reductase. It was shown that blocking the l‐mevalonate pathway reduces inflammation through effects on downstream metabolites of the pathway including farnesylpyrophosphates and geranylgeranylpyrophosphates, which are essential for the attachment of GTPases like RhoA, Rac and Ras to the cell membrane. Therefore, l‐mevalonate pathway downstream products play critical roles in the different steps of an immune response including immune cell activation, migration, cytokine production, immune metabolism and survival. This review discusses the relevance of the different metabolites for the immunomodulatory effect of statins and connects preclinical results with data from clinical studies that tested statins for the treatment of different inflammatory diseases.
Finite element analysis of fracture statistics of ceramics: Effects of grain size and pore size distributions
Authors: Ozaki Shingo , Aoki Yuya , Osada Toshio , Takeo Kyohei , Nakao Wataru
Published: February 2018

A novel numerical simulation method based on finite element analysis (FEA), which can evaluate the fracture probability caused by the characteristics of flaw distribution, is considered an effective tool to facilitate and increase the use of ceramics in components and members. In this study, we propose an FEA methodology to predict the scatter of ceramic strength. Specifically, the data on the microstructure distribution (i.e., relative density, size and aspect ratio of pore, and grain size) are taken as the input values and reflected onto the parameters of a continuum damage model via a fracture mechanical model based on the circumferential circular crack emanating from an oval spherical pore. In addition, we numerically create a Weibull distribution based on multiple FEA results of a three‐point bending test. Its validity is confirmed by a quantitative comparison with the actual test results. The results suggest that the proposed FEA methodology can be applied to the analysis of the fracture probability of ceramics.
Partial migration in inexperienced pied avocetsRecurvirostra avosetta: distribution pattern and correlates
Authors: Chambon Rémi , Dugravot Sébastien , Paillisson Jean‐Marc , Lemesle Jean‐Christophe , Ysnel Frédéric , Gélinaud Guillaume
Published: February 2018

Birds exhibit a range of wintering behaviour from strictly migrant to strictly resident species. In partially migrating ones, some birds overwinter within their breeding region (resident birds) while others, although breeding in the same area, winter far away (migrant birds). Accordingly, choosing a wintering region is a key stage in the annual life cycle of birds, notably for inexperienced first‐year individuals. The present study aimed to investigate this issue, and more specifically to study the distribution pattern during winter and factors influencing the wintering behaviour of first‐year pied avocetsRecurvirostra avosetta. Based on a 10‐yr ringing study carried out on five of the major French breeding colonies distributed along the Atlantic coast, we showed the coexistence of different wintering tactics. The resident tactic was predominant (approximately 86% of the 575 birds re‐sighted), while the other birds adopted migration. Among resident individuals, two different tactics occurred: 43% of birds overwintered within their natal colony, whereas the others wintered in another site located at relatively close proximity along the French Atlantic coast. Hatching date was a consistent predictor of all wintering tactics. More specifically, the probability of migrating was the highest for early‐hatched birds, and for resident ones, the probability of wintering within their natal colony rather than in another French site was the highest for both median‐ and late‐hatched individuals. In addition, a colony effect was demonstrated for resident birds. Several biological interpretations, including social system, variations in both individual body condition and habitat quality, were put forward to explain these correlates.
An experimental test of the relationship between yolk testosterone and the social environment in a colonial passerine
Authors: Bentz Alexandra B. , Andreasen Victoria A. , Navara Kristen J.
Published: February 2018

Maternal hormones can be transferred to offspring during prenatal development in response to the maternal social environment, and may adaptively alter offspring phenotype. For example, numerous avian studies show that aggressive competition with conspecifics tends to result in females allocating more testosterone to their egg yolks, and this may cause offspring to have more competitive phenotypes. However, deviations from this pattern of maternal testosterone allocation are found, largely in studies of colonial species, and have yet to be explained. Colonial species may have different life‐history constraints causing different yolk testosterone allocation strategies in response to conspecific competition, but few studies have experimentally tested whether colonial species do indeed differ from that of solitary species. To test this, we collected eggs from zebra finchesTaeniopygia guttata, a colonial species, in the presence and absence of conspecific intrusions. Females did not alter the concentration of testosterone deposited in eggs laid during intrusions despite becoming more aggressive. These results suggest that maternal effects are not characterized by a uniform response to the social environment, but rather need to be contextualized with life‐history traits.
The development of situational interest during a digital mathematics game
Authors: Rodríguez‐Aflecht G. , Jaakkola T. , Pongsakdi N. , Hannula‐Sormunen M. , Brezovszky B. , Lehtinen E.
Published: February 2018

The present study focused on 212 fifth graders' situational interest trajectories during an intervention with a digital mathematics game called Number Navigation. Our aims were to explore the development of situational interest whilst playing the game and to investigate the relationship between situational interest and individual math interest. Growth mixture model analyses showed that in the whole sample situational interest was stable within sessions but decreased across sessions. Three different situational interest trajectories were found. Situational interest trajectories were predicted by pre‐test individual interest. In turn, situational interest had an effect on post‐test individual interest. Students whose situational interest trajectories were stable (either high or low) presented no changes in individual interest, yet the individual interest of students whose situational interest was triggered but not maintained markedly decreased from pre‐test to post‐test. Results suggest that it is important to use game‐based learning not because games are believed to be “motivating”; rather, games with proven learning outcomes should be carefully selected.
Fibromodulin reduces scar size and increases scar tensile strength in normal and excessive‐mechanical‐loading porcine cutaneous wounds
Authors: Jiang Wenlu , Ting Kang , Lee Soonchul , Zara Janette N. , Song Richard , Li Chenshuang , Chen Eric , Zhang Xinli , Zhao Zhihe , Soo Chia , Zheng Zhong
Published: February 2018

Hypertrophic scarring is a major postoperative complication which leads to severe disfigurement and dysfunction in patients and usually requires multiple surgical revisions due to its high recurrence rates. Excessive‐mechanical‐loading across wounds is an important initiator of hypertrophic scarring formation. In this study, we demonstrate that intradermal administration of a single extracellular matrix (ECM) molecule—fibromodulin (FMOD) protein—can significantly reduce scar size, increase tensile strength, and improve dermal collagen architecture organization in the normal and even excessive‐mechanical‐loading red Duroc pig wound models. Since pig skin is recognized by the Food and Drug Administration as the closest animal equivalent to human skin, and because red Duroc pigs show scarring that closely resembles human proliferative scarring and hypertrophic scarring, FMOD‐based technologies hold high translational potential and applicability to human patients suffering from scarring—especially hypertrophic scarring.
Crosstalk between long non‐coding RNAs and Wnt/β‐catenin signalling in cancer
Authors: Yang Gang , Shen Tianyi , Yi Xiaoming , Zhang Zhengyu , Tang Chaopeng , Wang Longxin , Zhou Yulin , Zhou Wenquan
Published: February 2018

Long non‐coding RNAs (lncRNAs) are non‐protein‐coding transcripts in the human genome which perform crucial functions in diverse biological processes. The abnormal expression of some lncRNAs has been found in tumorigenesis, development and therapy resistance of cancers. They may act as oncogenes or tumour suppressors and can be used as diagnostic or prognostic markers, prompting their therapeutic potentials in cancer treatments. Studies have indicated that many lncRNAs are involved in the regulation of several signal pathways, including Wnt/β‐catenin signalling pathway, which has been reported to play a significant role in regulating embryogenesis, cell proliferation and controlling tumour biology. Emerging evidences have suggested that lncRNAs can interact with several components of the Wnt/β‐catenin signalling pathway to regulate the expression of Wnt target genes in cancer. Moreover, the expression of lncRNAs can also be influenced by the pathway. Nevertheless, Wnt/β‐catenin signalling pathway‐related lncRNAs and their interactions in cancer are not systematically analysed before. Considering these, this review emphasized the associations between lncRNAs and Wnt/β‐catenin signalling pathway in cancer initiation, progression and their therapeutic influence. We also provided an overview on characteristics of lncRNAs and Wnt/β‐catenin signalling pathway and discussed their functions in tumour biology. Finally, targeting lncRNAs or/and molecules associated with the Wnt/β‐catenin signalling pathway may be a feasible therapeutic method in the future.
The Crisis of the European Union as a Complex Adaptive System
Authors: Lehmann Kai Enno
Published: February 2018

The present article argues that the current crisis of the European Union (EU) is much deeper and more profound than many EU officials and analysts care to admit. Taking the so‐called sovereign debt crisis and the refugee crisis as illustrative case studies it is argued that the crisis needs to be reframed as a Complex Adaptive System which is self‐organizing in a deeply incoherent manner and which current EU policies are not only not addressing but exacerbating. As an alternative, the article suggests using Adaptive Action as a framework to identify the conditions which sustain the current dysfunctionality of the European Union and makes concrete suggestions on how these conditions can be altered. Areas of further research are also identified.
Psoriasis and cardiovascular disease risk factors: the HUNT Study, Norway
Authors: Snekvik I. , Nilsen T.I.L. , Romundstad P.R. , Saunes M.
Published: February 2018

Background

Studies have examined the associations between psoriasis and cardiovascular diseases and their risk factors, but the results are conflicting, especially in the general population.

Objectives

To investigate the association of psoriasis, and in particular psoriasis severity, with objectively measured cardiovascular disease risk factors and cardiovascular morbidity in a large population‐based cross‐sectional study.

Methods

We linked data on 50 245 persons in the HUNT3 Study, Norway, with information from the National Prescription Database to obtain information on use of psoriasis medication. A total of 2894 persons reported to have psoriasis; 2643 were classified as mild; and 251 as moderate/severe psoriasis. We used linear and logistic regression to estimate adjusted associations with 95% confidence intervals (CIs) between psoriasis and cardiovascular disease risk factors and morbidity.

Results

We observed a positive association between psoriasis and objective measures of body mass index (BMI), waist circumference and high‐sensitivity C‐reactive protein, but no clear association with blood pressure and blood lipids. People with moderate/severe psoriasis had an odds ratio for being overweight of 1.94 (95% CI 1.42, 2.67), whereas the odds ratio for metabolic syndrome was 1.91 (95% CI 1.47, 2.49). Psoriasis was also positively associated with self‐reported diabetes, myocardial infarction and angina pectoris.

Conclusions

In this population‐based study, we found that psoriasis was positively associated with measures of adiposity, as well as with a clustering of cardiovascular disease risk factors. Overall, these associations were strongest for people with moderate/severe psoriasis.
The characteristics of small intestinal bacterial overgrowth in patients with gallstone diseases
Authors: Kim Dae Bum , Paik Chang‐Nyol , Song Do Seon , Kim Yeon Ji , Lee Ji Min
Published: February 2018

Background and Aim

Small intestinal bacterial overgrowth (SIBO) might be prevalent in gallstone disease, including cases involving cholecystectomy and gallstones. The study aimed to investigate the prevalence and characteristics of SIBO in patients with gallstone disease.

Methods

This prospective study evaluated 265 patients for gallstone disease (200, gallstones; 65, cholecystectomy) and 39 healthy controls. Laboratory data, abdominal ultrasonography, and glucose breath test (GBT) with bowel symptom questionnaire were performed.

Results

Glucose breath test positivity (+) in patients with gallstone disease (36.6%) was significantly higher than that in controls (20.5%). GBT+ in the gallstone group (40.5%) was significantly higher than that in the control or cholecystectomy group (24.6%). The number of patients with gallstone, tend to be higher in the GBT (H2)+, (CH4)+, and (mixed)+ groups (56 [28.0%], 11 [5.5%], and 14 [7.00%]), respectively. Gallbladder disease was independently associated with fatty liver, metabolic syndrome, and SIBO. Of 97 GBT+ patients, 70 (72.1%), 12 (12.4%), and 15 (15.5%) were in the GBT (H2)+, (CH4)+, and (mixed)+ groups, respectively. GBT (CH4)+ or GBT (mixed)+ were significantly associated with the gallstone group compared with the cholecystectomy group. The GBT (mixed)+ group had higher total symptom scores than the GBT− group for hard stool and urgency tendency, or the GBT (H2)+ group in hard stool and loose stool tendency. Gallstone was the only independent factor for SIBO in patients with gallstone diseases.

Conclusions

Small intestinal bacterial overgrowth is common among patients with gallstone. Especially, CH4 or mixed‐type SIBO seems to be prevalent and to worsen intestinal symptoms.
Comparison of the effectiveness of pulsed dye laser vs pulsed dye laser combined with ultrapulse fractional CO2 laser in the treatment of immature red hypertrophic scars
Authors: Ouyang Hua‐wei , Li Gao‐feng , Lei Ying , Gold Michael H , Tan Jun
Published: February 2018

Introduction

The objective was to investigate the clinical effect of an adjustable pulse width Pulsed Dye Laser (PDL) vs an adjustable pulse width PDL combined with fractional CO2 laser in treating immature red hypertrophic scars.

Methods

Fifty‐six patients (56 sites)were randomly divided into a treatment group and control group. The control group was treated with the 595 nm PDL at a fluence of 7‐15J/cm2 and pulse widths of 1.5‐3 ms, 7 mm spot size. The treatment group was treated with a fractional CO2 laser (UltraPulse CO2: Deep FX, Energy: 30~50 mJ, Frequency: 300 Hz, Density 5%, Scan Shape, and Spot Size were decided by shape and area of scar) after utilizing the 595 nm adjustable pulse width PDL (Fluence: 7‐15J/cm2, Pulse widths: 1.5‐3 ms, Spot size: 7 mm). MEBT/MEBO, previously described as a post‐treatment wound ointment, was used after laser treatment. The scars of the treatment group and the control group were evaluated for changes in pigment, height, vascularity, and pliability using the Vancouver Scar Scale (VSS) after two laser treatments.

Results

The total VSS score, as well as the score for melanin, height, vascularity, pliability in both groups, showed an obvious decrease following the treatments. There were statistically significant differences between before treatment and after treatment (P < .05); however, the total score of the VSS, and score of the melanin, height, vascularity, and pliability in the control group decreased more than that of treatment group, and there was a statistically significant difference (P < .05).

Conclusions

The 595 nm adjustable pulse width PDL combined with the fractional CO2 fractional laser appears to have a beneficial clinical effect on fresh red hypertrophic scars, with no severe adverse reactions seen.
Interpreting Factor Models
Authors: KOZAK SERHIY , NAGEL STEFAN , SANTOSH SHRIHARI
Published: February 2018

We argue that tests of reduced‐form factor models and horse races between “characteristics” and “covariances” cannot discriminate between alternative models of investor beliefs. Since asset returns have substantial commonality, absence of near‐arbitrage opportunities implies that the stochastic discount factor can be represented as a function of a few dominant sources of return variation. As long as some arbitrageurs are present, this conclusion applies even in an economy in which all cross‐sectional variation in expected returns is caused by sentiment. Sentiment‐investor demand results in substantial mispricing only if arbitrageurs are exposed to factor risk when taking the other side of these trades.
Intraluminal pressure of uterine balloon tamponade in the management of severe post‐partum hemorrhage
Authors: Kong Choi Wah , To William W. K.
Published: February 2018

Aim

Intrauterine balloon tamponade has been increasingly used for the management of post‐partum hemorrhage (PPH) in recent years. However, data on the precise mechanisms and pressure required for the balloon tamponade are scanty in the literature. This study aims to review the intraluminal pressure (ILP) generated by the Bakri intrauterine balloon that is necessary to produce a ‘positive tamponade test’ during severe PPH.

Methods

This was a prospective cohort study. The ILP of the Bakri balloon was measured using a manometer after a positive tamponade test was clinically achieved during severe PPH (blood loss >1 L). The patient's blood pressure was recorded, and ultrasound scan was performed to verify the position of the balloon and the presence of forward flow in the uterine arteries. The main outcome measure is the ILP of the Bakri balloon required to achieve a positive tamponade test.

Results

Twenty patients were included for final analysis. The net ILP measured ranged from 67 to 92 mmHg, and this pressure was lower than the concurrent systolic pressure in all cases. Color Doppler confirmed positive forward flow in the uterine vessels in all cases. There were no differences in the pressure measured with the balloon position, and there was no relationship between the volumes of saline infused and the net pressure.

Conclusion

A positive tamponade test in an intrauterine balloon is probably achieved by local compression pressure exerted on the vasculature of the placental bed rather than by generating an ILP exceeding systemic blood pressure or by occlusion of flow to the uterine arteries.
Body size and lean mass of brown bears across and within four diverse ecosystems
Authors: Hilderbrand G. V. , Gustine D. D. , Mangipane B. A. , Joly K. , Leacock W. , Mangipane L. S. , Erlenbach J. , Sorum M. S. , Cameron M. D. , Belant J. L. , Cambier T.
Published: February 2018

Variation in body size across populations of brown bears (Ursus arctos) is largely a function of the availability and quality of nutritional resources while plasticity within populations reflects utilized niche width with implications for population resiliency. We assessed skull size, body length, and lean mass of adult female and male brown bears in four Alaskan study areas that differed in climate, primary food resources, population density, and harvest regime. Full body‐frame size, as evidenced by asymptotic skull size and body length, was achieved by 8–14 years of age across populations and sexes. Lean body mass of both sexes continued to increase throughout their life. Differences between populations existed for all morphological measures in both sexes, bears in ecosystems with abundant salmon were generally larger. Within all populations, broad variation was seen in body size measures of adults with females displaying roughly a 2‐fold difference in lean mass and males showing a 3‐ to 4‐fold difference. The high level of intraspecific variation seen across and within populations suggests the presence of multiple life‐history strategies and niche variation relative to resource partitioning, risk tolerance or aversion, and competition. Furthermore, this level of variation indicates broad potential to adapt to changes within a given ecosystem and across the species’ range.
Ghrelin secretion in humans – a role for the vagus nerve?
Authors: Veedfald S. , Plamboeck A. , Hartmann B. , Vilsbøll T. , Knop F. K. , Deacon C. F. , Svendsen L. B. , Holst J. J.
Published: February 2018

Background

Ghrelin, an orexigenic peptide, is secreted from endocrine cells in the gastric mucosa. Circulating levels rise in the preprandial phase, suggesting an anticipatory or cephalic phase of release, and decline in the postprandial phase, suggesting either the loss of a stimulatory factor or inhibition by factors released when nutrients enter the intestine. We hypothesized that vagal signals are not required for the (i) preprandial increase or (ii) postprandial suppression of ghrelin levels. Further, we wanted to investigate the hypothesis that (iii) glucagon‐like peptide‐1 might be implicated in the postprandial decline in ghrelin levels.

Methods

We measured ghrelin levels in plasma from sham‐feeding and meal studies carried out in vagotomized individuals and controls, and from a GLP‐1 infusion study carried out in fasting healthy young individuals.

Key Results

We find that (i) ghrelin secretion is unchanged during indirect vagal stimulation as elicited by modified sham‐feeding in vagotomized individuals and matched controls, (ii) ghrelin secretion is similarly suppressed after meal ingestion in vagotomized individuals and controls, and (iii) infusion of GLP‐1 does not lower ghrelin levels.

Conclusions & inferences

We conclude that for postprandial suppression of circulating ghrelin levels, a circulating factor (but not GLP‐1) or short (duodeno‐gastric) reflexes seem to be implicated.