bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of low bone mass and prediction of fracture risk using metacarpal radiogrammetry method: a comparative study withDXAand X‐ray phantom
Authors: Ashok Kumar Devaraj , Anburajan Mariamicheal , Snekhalatha Umapathy
Published: July 2018

Objectives

(i) To predict the future risk of osteoporotic fracture in women using a simple forearm radiograph. (ii) To assess osteoporosis in southern Indian women by using radiogrammetric technique in comparison with dual‐energy X‐ray absorptiometry (DXA) and X‐ray phantom study.

Methods

The bone mineral density (BMD) of the right proximal femur byDXAand the X‐ray measurements were acquired from the right forearm. The combined cortical thickness at the second to fourth metacarpal region (M‐CCT), radius (R‐CCT) and ulna (U‐CCT) were derived in all the studied population. The aluminium phantom study was conducted by varying the X‐ray source to film distance at 100 cm and 150 cm, respectively. The feed forward back propagation neural network was used for classification of low bone mass group and normal.

Results

The combined cortical thickness of M‐CCT, R‐CCTand U‐CCTof the total studied population was strongly correlated withDXAfemur Th.BMDmeasurements (r = 0.77,r = 0.61 andr = 0.59 [P < 0.01]). The predicted future osteoporotic fracture risk for the low bone mass group, post‐menopausal women and old‐aged women population was found to be 92%, 62.8%, and 64.7%, respectively. The accuracy of neural network classifier for training set, testing set was found to be 97.5% and 87.5% in the studied population.

Conclusion

The results suggested that M‐CCTand M‐CCT(%) at the second metacarpal region are useful in predicting the future risk of osteoporotic fracture in women. The aluminium phantom study with an X‐ray tube to film distance of 100 cm mimics an exact condition of forearm radiogrammetry.
Interstitial lung disease in non‐sicca onset primary Sjögren's syndrome: a large‐scale case‐control study
Authors: Gao Hui , Zou Ya‐dan , Zhang Xue‐wu , He Jing , Zhang Jing , Sun Ye , Li Zhan‐guo
Published: July 2018

Aim

This study investigated the common initial clinical presentations of primary Sjögren's syndrome (pSS) with interstitial lung disease (ILD) and explored differences between sicca and non‐sicca onset pSS‐ILD patients.

Method

A total of 1341 SS patients hospitalized between 2003 and 2012 were retrospectively reviewed. Of them, 102 were analyzed and recruited to examine the differences between non‐sicca and sicca onset.

Results

Fifty‐one percent of pSS‐ILD patients presented with non‐sicca onset. Although the mean diagnosis time was equal, only 4% of non‐sicca onset patients were diagnosed with pSS at onset versus 34% with sicca onset (P = 0.000). Hyperglobulinemia, elevated rheumatoid factor (RF) titer, and anti‐SSA and/or anti‐SSB presence were less predominant in patients with non‐sicca onset (immunoglobulin G, 16 [12–21] vs. 21 [15–28] g/L, P = 0.032; RF, 22 [20–171] vs. 104 [20–237] IU/mL, P = 0.048; anti‐SSA and/or anti‐SSB presence, 33% vs. 72%, P = 0.000). The usual interstitial pneumonia pattern was more commonly seen in non‐sicca onset patients (20.0% vs. 14.3%). The high‐resolution computed tomography score was higher (12 [88–15] vs. 8 [5–13], P = 0.070) and predicted total lung capacity and forced vital capacity were lower (87 ± 23% vs. 97 ± 20%, P = 0.050; 88 ± 28% vs. 100 ± 27%, P = 0.089) in non‐sicca patients.

Conclusion

Non‐sicca is a common initial manifestation in pSS‐ILD. Anti‐SSA presence, elevated RF titer and hyperglobulinemia were less predominant, and pulmonary complications were more progressive and severe in non‐sicca onset patients than sicca onset patients.
Paracoccus denitrificans can utilize various long‐chain N‐acyl homoserine lactones and sequester them in membrane vesicles
Authors: Morinaga Kana , Yamamoto Tatsuya , Nomura Nobuhiko , Toyofuku Masanori
Published: July 2018

Many gram‐negative bacteria utilize N‐acyl homoserine lactone (AHL) signals to communicate with each other. Once they have been released, these signals are assumed to be shared among the population in the local environment. In contrast to this canonical quorum‐sensing (QS) model, recent study in Paracoccus denitrificans showed that they can traffic their signals to each other via membrane vesicles (MVs). Here, we demonstrate that various long‐chain AHLs inhibited cell aggregation in P. denitrificans, whereas the short‐chain AHLs alone did not. Furthermore, MVs released from P. denitrificans were able to take up the long‐chain AHLs from the environment into MVs. The AHLs associated with MVs triggered gene expression in P. denitrificans, indicating their role in QS. Our results suggest that P. denitrificans can sequester the AHL produced by other bacteria and deliver the signals to themselves via MVs. Utilizing the signals from other bacteria may be advantageous for P. denitrificans to reach the threshold QS concentration in a polymicrobial community in which the population of its own species is relatively low.
Using archived television video footage to quantify phenology responses to climate change
Authors: De Frenne Pieter , Van Langenhove Lisa , Van Driessche Alain , Bertrand Cédric , Verheyen Kris , Vangansbeke Pieter
Published: July 2018

Predicting how the timing of cyclic life‐history events, such as leafing and flowering, respond to climate change is of paramount importance due to the cascading impacts of vegetation phenology on species and ecosystem fitness. However, progress of this field is hampered by the relative scarcity, and geographic and phylogenetic bias, of long‐term phenology datasets.

By taking advantage of archived television video footage, we here developed an innovative tool using previously unexploited records to build long‐term datasets of phenological responses. To demonstrate the potential of this method, we worked with broadcast archives of sport events and focus on one of the most famous professional road cycling races world‐wide, the Tour of Flanders.

After viewing >200 hr of film, we compiled 523 individual × year observations of leaf‐out and flowering of 46 individual trees and shrubs visible in four decades (1981–2016) of video footage. We detect surprisingly strong advances in the timing of tree leaf‐out and flowering in the footage: trees almost never had flushed at the time of the spring race in the 1980s while significantly more individuals had flushed in the video footage between 2006 and 2016 (probabilities of leafing and flowering increased by 19% and 67%, respectively). These shifts were most strongly related to January–March temperatures and growing‐degree hours (cumulative heat) in the preceding months.

We demonstrate that this technical advance offers key benefits to fill gaps in existing phenology time series and reveal that archived video footage can indeed be applied to determine species‐temperature relationships with high spatiotemporal resolution. Only by compiling more data from the past will we be able to further our understanding on the effects of climate change on species and ecosystems in the future.
Overcoming the “Valley of Death” in Medications Development for Alcohol Use Disorder
Authors: Ray Lara A. , Bujarski Spencer , Roche Daniel James Olan , Magill Molly
Published: July 2018

As the development of novel pharmacotherapies for alcohol use disorder (AUD) has been slow, the discovery and testing of more efficacious pharmacotherapies for AUD represent a high priority research area. In fact, the transition from preclinical to clinical testing of novel compounds has been termed the “valley of death” in medications development. One key obstacle consists of the lack of an articulated set of goals for each stage of medications development. Specifically, the knowledge outputs required to make the transition from safety testing, to early efficacy detection, to confirming clinical efficacy remain unclear, and this is despite a great deal of interest and substantial financial investment in developing novel therapeutics for AUD. This qualitative critical review seeks to draw parallels and lessons from the well‐established stage model for behavioral therapies research with alcohol and other substance use disorders and to apply these insights into AUD pharmacotherapy development. We argue that human laboratory models and/or pilot randomized controlled trials should serve as intermediaries in the transition from preclinical studies to large, and costly, randomized controlled efficacy trials. The relative strengths and weaknesses of pilot clinical trials versus human laboratory studies for bridging the “valley of death” are discussed and explored via a Monte Carlo data simulation study. Multiple permutations of suitable research designs informed by the behavioral therapies development model are discussed with the overall goal of promoting consilience and maximizing efficiency across all phases of clinical testing of novel AUD pharmacotherapies.
Identifying Inhibitory Subcomponents Associated with Changes in Binge Drinking Behavior: A 6‐Month Longitudinal Design
Authors: Paz Andres L. , Rosselli Monica , Conniff Joshua
Published: July 2018

Background

Links between response inhibition and young adult problematic drinking (e.g., binge drinking) have been established, but only to an extent. Considering the presence of some inconsistent findings associated with these 2 variables, this study proposes the need to investigate the extent in which different inhibitory subcomponents are associated with binge drinking behaviors of the same sample.

Methods

Through the use of a 6‐month longitudinal design, changes in Alcohol Use Questionnaire (AUQ) binge score of 163 college students (50.3% female) with a mean age of 21.06 years (SD = 1.83) were correlated with performance on 3 different inhibitory control tasks. Each task was selected to assess separate inhibitory subcomponents: Stop Signal Task (e.g., cancellation of a response), Go/No‐Go Task (e.g., withholding of a response), and Simon Task (e.g., inhibiting response interference). Response inhibition was also compared between 2 groups, those who had a substantial increase in AUQ binge score during participation (inAUQ) and those who had a substantial decrease in AUQ binge score (deAUQ).

Results

A significant correlation was found with a change in AUQ binge score and stop signal reaction time among females only, where an increase in binge drinking score positively correlated with a reduced ability to cancel an already‐initiated inhibitory response. Differences in inhibitory performance, where inAUQ performed worse than deAUQ, approached significance.

Conclusions

The results suggest that the cancellation of a prepotent response, as opposed to the withholding of response or interference inhibition, is a more sensitive inhibitory measure associated with increases in binge drinking behavior among female young adult college students. Further exploration of inhibitory subcomponents relative to substance use is greatly needed (e.g., more extensive longitudinal designs and neuroimaging techniques).
Calibrating Play: Sociotemporality in South Korean Digital Gaming Culture
Authors: Rea Stephen C.
Published: July 2018

This article examines the significance of digital gaming culture amidst broader institutional transformations in South Korea over the past several decades. Digital gaming is contextualized by a popular narrative about Korean society “speeding up” and complementary sociotemporal expectations for being and acting that stress qualities of both quickness and endurance. Approaching digital gaming's virtual‐ and actual‐world sites as nested “taskscapes,” I contend that calibration—processes that bring phenomena across different taskscapes into correspondence with one another—best describes how Korean digital gamers align their individual, embodied play with sociotemporal expectations. Specifically, I analyze two digital gaming practices in their ethnographic contexts—an e‐sports performance metric called “actions per minute” (APM) and an online gaming activity known as nogada—as modes for calibrating play with dominant sociotemporalities. The contrast between quick and slow sociotemporalities and the necessity of continual recalibration across taskscapes is a source of unending stress and frustration for many Koreans. Thinking with play as a disposition for calibration helps to make sense of everyday strategies for making do in precarious circumstances. [digital games, temporality, play, South Korea]
Youth, Temporality, and Territorial Stigma: Finding Good in Camden, New Jersey
Authors: Cairns Kate
Published: July 2018

The concept of “territorial stigmatisation” identifies the role of symbolic denigration in the production of marginalised places. In this paper, I draw on ethnographic research with a food justice organisation in Camden, New Jersey, to examine youth's responses to territorial stigma. The analysis demonstrates how Black and Latinx youth rewrite the story of Camden in a way that locates the “good” within it, using narratives of the city's prosperous history and possible futures to recuperate value within a stigmatised place. I argue that the perspectives of youth illuminate the temporal dimensions of territorial stigma, situating the blemish of place in relation to conceptions of individual and social change. The article contributes to a growing literature examining the strategic responses of those who dwell in pathologised places. Because youth are uniquely situated within the production of place, their perspectives offer important insights in this process.
8 Sustainability as a Relative Process: A Long‐Term Perspective on Sustainability in the Northern Basin of Mexico
Authors: Millhauser John K. , Morehart Christopher T.
Published: July 2018

The notion of “sustainable development” has drawn attention to the precarious balance between populations and natural resources in terms of current and future needs. Approaches to the study of sustainability that focus on socio‐ecological systems may obscure the fact that what is sustainable at a broad scale may not be optimal for an entire population. Political ecology offers a complementary lens to investigate how relationships between humans and their environments unfold within historically situated structures of power. Archaeology provides a means to extend the historical gaze of political ecology to account for long‐term patterns of sustainability at multiple scales. This paper applies an archaeological approach to the historical political ecology of the northern Basin of Mexico. Specifically, it focuses on the people who settled in the wetland environment of Lake Xaltocan and their dynamic relationships with each other, land, and water over the last 2500 years. Over this time, local actors have adjusted to a variety of external constraints, from ecological change to political upheaval. A long‐term perspective reveals how politically‐situated actions transformed Lake Xaltocan physically and conceptually and how the sustainability of local regimes was unevenly determined by access to power rather than the husbanding of resources.
9 Questioning a Posthumanist Political Ecology: Ontologies, Environmental Materialities, and the Political in Iron Age South India
Authors: Bauer Andrew M.
Published: July 2018

This paper examines the political ecology of an 80 km2region of central Karnataka, detailing how social relationships of inequality were linked with the production of a variety of meaningful places and environmental resources in Iron Age (1200–300 BCE) South India. Such analysis is then intersected with modern framings of inselberg landforms as spaces of “Nature,” demonstrating how such framings potentially silence humans in their environmental history and reproduce a nature–society binary that has substantial implications for the politics of land use and conservation today. In doing so, the paper critically considers the implications and limitations of a posthumanist political ecology that advocates nonhumans as “actors” that contribute to socio‐political histories for understanding the politics of environmental production, both past and present.
Humanitarian medical aid to the Syrian people: Ethical implications and dilemmas
Authors: Zarka Salman , Farhat Morshid , Gidron Tamar
Published: July 2018

Medical professionals providing humanitarian aid in times of crisis face complicated ethical and clinical challenges. Today, humanitarian aid is given in accordance with existing guidelines developed by international humanitarian organizations and defined by international law. This paper considers the ethical aspects and frameworks of an atypical humanitarian project, namely one that provides medical support through an Israeli civilian hospital to Syrian Civil War casualties. We explore new ethical questions in this unique situation that pose a serious challenge for the medical community and conventional ethical norms, a challenge Israeli medical staff meet on a daily basis. Before discussing the ethical challenges, we give a description of the project and its unique status.
Pediatric CD8+/CD56+ mycosis fungoides with cytotoxic marker expression: A variant with indolent course
Authors: Rovaris Marco , Colato Chiara , Girolomoni Giampiero
Published: July 2018

Mycosis fungoides is predominantly a disease of older patients, but occasionally occurs in children. We report a rare case of CD8+/CD56+ mycosis fungoides with cytotoxic marker (perforin, TIA‐1, and granzyme B) expression in a 10‐year‐old boy. Disease presented with three asymptomatic, slowly progressive erythematous and scaling plaques, surrounded by hypochromic alone in the left tight and lower trunk. UVB narrow band associated with topical corticosteroids resulted in complete remission in about 2 months, and no recurrence at 2‐year follow‐up. Three similar cases have been retrieved in children through PubMed search, showing similar clinical presentation with erythematous scaling lesions, good response to skin‐directed treatments and a favorable prognosis.
Health risk and health seeking behaviours among people who inject performance and image enhancing drugs who access needle syringe programs in Australia
Authors: Van de Ven Katinka , Maher Lisa , Wand Handan , Memedovic Sonja , Jackson Eva , Iversen Jenny
Published: July 2018

Introduction and Aims

People who use performance and image enhancing drugs (PIED) are a growing population in needle syringe programs (NSP) in Australia. Previous international research has identified heterogeneity among the PIED‐using population. This study investigated health behaviours among NSP attendees who had recently (last 12 months) injected PIEDs and examined differences among this group according to recent psychoactive drug use.

Design and Methods

The Australian Needle and Syringe Program Survey is an annually repeated cross‐sectional survey conducted at approximately 50 NSPs nationally. In 2015, respondents provided information on their demographic characteristics, health risk and health monitoring behaviours, and provided a capillary dried blood spot for HIV and hepatitis C virus antibody testing. Univariable and multivariable logistic regressions assessed factors associated with recent (last 12 months) use (all routes of administration) of psychoactive drugs.

Results

Among recent PIED injectors (n= 156), 59% had recently used psychoactive substances. Those who had recently used psychoactive drugs were significantly younger, less educated and more likely to have experienced redness at an injection site in the previous 12 months but were more likely to report recent HIV/hepatitis C virus testing.

Discussion and Conclusions

This study identified significant differences in demographic characteristics, risk and health seeking behaviour among PIED users who did and did not also use psychoactive substances. There is a need to enhance and tailor harm reduction efforts and to build the capacity of NSP staff to better meet the needs of this diverse group.
Hurricane storm surge in Volusia County, Florida: evidence of a tipping point for infrastructure damage
Authors: Helderop Edward , Grubesic Tony H.
Published: July 2018

Storm surge often is the most destructive consequence of hurricanes and tropical storms, causing significant economic damage and loss of life. Many coastal communities that are located in high‐risk areas vis‐à‐vis hurricanes and tropical storms are prepared for moderate (between six and eight feet) storm surges. Such preparation, though, is not commensurate with more severe, but less frequent, storm surges (greater than eight feet). These gaps in preparedness have serious implications for community resilience. This paper explores elements of the vulnerability and resilience of coastal communities during major storm surge events, drawing on Volusia County, Florida, United States, as a case study. It simulates the impacts of five hurricanes (Categories I–V) and their associated storm surges on local infrastructure systems, populations, and access to resources. The results suggest that Volusia County is subject to a ‘tipping point’ , where surge damage from Category IV storms is significantly greater than that from Category III and lower hurricanes.
Perceptions of attenuated psychosis in a diverse sample of undergraduates
Authors: Trask Christi L. , Kameoka Velma A. , Schiffman Jason , Cicero David C.
Published: July 2018

Aim

Prior to the release of the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders, experts in the field of psychosis research considered including a psychosis high‐risk syndrome—attenuated psychosis syndrome—as a formal diagnosis. Opponents argued that such a diagnosis may increase the risk of stigmatization of individuals whose symptoms often remit. Although previous research has examined provider perceptions of attenuated psychosis syndrome, little work has focused on lay perceptions.

Methods

A total of 455 college students read three vignettes, each depicting a character with a different level of psychotic disorder (attenuated psychosis syndrome, schizophrenia or no psychosis). Following each vignette, participants responded to questions assessing: (1) identification of the character as mentally ill, (2) stigmatizing attitudes and (3) beliefs regarding the helpfulness of potential treatments.

Results

Compared to a character with no psychosis, participants identified the attenuated psychosis syndrome character as more likely to be experiencing mental illness, but endorsed only slightly more stigmatizing attitudes. Participants tended to rate psychological types of treatment as more helpful than other types for an attenuated psychosis syndrome character.

Conclusions

Non‐expert undergraduates appear to view attenuated psychosis symptoms as indicative of mental illness, though not as severe as schizophrenia symptoms. The minimal level of stigma endorsement indicates that college students may not be especially likely to spontaneously stigmatize peers with attenuated psychosis syndrome.
The construct validity of the Inventory of Psychotic‐Like Anomalous Self‐Experiences (IPASE) as a measure of minimal self‐disturbance: Preliminary data
Authors: Nelson Barnaby , Li Emily , Cicero David C. , Gawęda Łukasz , Hartmann Jessica A. , Koren Danny , Polari Andrea , Whitford Thomas J. , Lavoie Suzie
Published: July 2018

Aim

The Inventory of Psychotic‐Like Anomalous Self‐Experiences (IPASE) is a self‐report measure of minimal self‐disturbance. The aim of the current report was to assess the construct validity of the scale by examining its convergent validity with the gold‐standard measure of minimal self‐disturbance, the Examination of Anomalous Self‐Experience (EASE), and its discriminant validity.

Method

The sample consisted of 46 participants (21 ultra‐high risk for psychosis patients, 14 first episode psychosis patients, 11 healthy controls). Correlations between the clinical instruments were examined.

Results

The IPASE correlated strongly with general psychopathology and positive psychotic symptoms, moderately with negative symptoms, and weakly with manic symptoms. The strongest correlation (r = 0.92) was apparent between IPASE and EASE total scores.

Conclusion

These preliminary data indicate construct validity of the IPASE, demonstrating both convergent and discriminant validity. The IPASE may be suitable as a screener measure for minimal self‐disturbance, but should not be used as a replacement to measure the construct of minimal self‐disturbance, which requires considerable psychopathological sophistication.
Vocational engagement among young people entering mental health treatment compared with their general population peers
Authors: Caruana Emma , Farhall John , Cotton Susan M. , Parrish Emma , van‐der‐EL Kristi , Davey Christopher G. , Chanen Andrew M. , Bryce Shayden D. , Killackey Eoin , Allott Kelly
Published: July 2018

Aim

To compare rates of vocational engagement for youth entering specialist mental health treatment with the general population.

Methods

A file audit retrieved vocational data for 145 youth aged 15 to 25 entering treatment. Clinical and population data were stratified by age and sex and compared between cohorts.

Results

Compared to the population, young people entering mental health treatment were less likely to have completed at least Year 11 in school (77% vs 42%, P < 0.001); and demonstrated higher rates of “Not in Education, Employment or Training” (9% vs 33%, P < 0.001). Individuals aged 15 to 18 years entering treatment experienced greater rates of educational disengagement than the population (30% vs 11%, P < 0.001), whereas people aged 19 to 25 years showed higher unemployment rates (52% vs 35%, P = 0.003).

Conclusions

Youth entering specialist mental health treatment have marked levels of vocational disengagement compared to demographically‐matched peers. Early vocational intervention for these young people is essential.
Inherited or acquired modifiers of iron status may dramatically affect the phenotype in dehydrated hereditary stomatocytosis
Authors: Orvain Corentin , Da Costa Lydie , Van Wijk Richard , Pissard Serge , Picard Véronique , Mansour‐Hendili Lamisse , Cunat Séverine , Giansily‐Blaizot Muriel , Cartron Guillaume , Schved Jean‐François , Aguilar‐Martinez Patricia
Published: July 2018

Severe iron overload is frequent in dehydrated hereditary stomatocytosis (DHSt) despite well‐compensated hemolysis and no or little transfusion requirement. We investigated 4 patients with proven DHSt, in whom the degree of hemolysis was closely related to iron status. Genetic modifiers increasing iron stores (HFE:pCys282Tyr, HAMP:c‐153C>T mutations) were accompanied with high liver iron concentrations and increased hemolysis, whereas therapeutic phlebotomies alleviated the hemolytic phenotype. There were no manifestations of hemolysis in one patient with low iron stores. Hemolysis reappeared when iron supplementation was given. The search for genetic or acquired modifiers of iron status and the modulation of iron stores may help in the management of these patients.
The spatial structure of variation in salamander survival, body condition and morphology in a headwater stream network
Authors: Lowe Winsor H. , Addis Brett R. , Smith Margaret R. , Davenport Jon M.
Published: July 2018

Understanding the spatial structure of individual variation is critical to assessing the mechanisms and scale of species‐level ecological and evolutionary responses. But the continuity and complexity of streams can make it difficult to discern spatial structure, and data on individual variation spanning spatial scales are rare.

Our goal was to objectively resolve the scale of ecological and evolutionary processes affecting the salamander Gyrinophilus porphyriticus by testing for spatial structure in individual variation across a headwater stream network. We used 3 years of spatially explicit capture–mark–recapture data from four headwater streams in the Hubbard Brook Experimental Forest, New Hampshire, USA, to test for individual variation in survival at three scales: (a) among c. 2‐km2 watersheds, (b) in 500‐m downstream and upstream reaches within watersheds and (c) in riffle and pool habitats along reaches. We also tested for corresponding spatial variation in individual body condition and morphology to gain insight on the causes and implications of variation in survival.

Survival of G. porphyriticus larvae was constant among watersheds, but differed by reach and habitat. Larval survival was higher in upstream reaches than downstream reaches, matching the distribution of predatory brook trout (Salvelinus fontinalis), which were restricted to downstream reaches. Larval survival was also higher in pools than riffles. Survival of G. porphyriticus adults was constant at all scales.

Larval body condition was higher in downstream reaches than upstream reaches. Both larvae and adults differed in morphology at the habitat scale: individuals in pools had longer limbs than individuals in riffles.

Negative covariation in larval survival and body condition at the reach scale suggests that there is a trade‐off between fitness and proximate performance along streams. The surprising differences between habitats in survival and morphology show the potential for fine‐scale ecology–evolution interactions in streams, potentially driven by differences in flow and gradient conditions in riffles and pools.

Our results suggest that the larval stage is key to understanding individual, population and community‐level processes affecting G. porphyriticus. More broadly, this research provides a novel empirical link between traditional studies of fine‐scale ecological complexity in streams and recent studies showing consistent spatial dynamics at the network scale. By documenting differences in survival, body condition and morphology at reach and habitat scales, we hope this work shows the feasibility and value of spatially explicit approaches to species‐level ecological and evolutionary questions in streams.
Molecular insights into paediatric breast fibroepithelial tumours
Authors: Tay Timothy K Y , Guan Peiyong , Loke Benjamin N , Nasir Nur Diana M , Rajasegaran Vikneswari , Thike Aye Aye , Lian Derrick , Chang Kenneth T E , Teh Bin Tean , Ng Cedric C Y , Tan Puay‐Hoon
Published: July 2018

Aims

This study aims to examine the molecular genetics of paediatric breast fibroepithelial tumours through the targeted sequencing of 50 genes.

Methods and results

Formalin‐fixed paraffin‐embedded tissues of fibroepithelial tumours diagnosed in a cohort of patients aged 18 years and below were subjected to next generation sequencing using the Haloplex Target Enrichment System. Twenty‐five conventional and 17 juvenile fibroadenomas were studied, with MED12 mutations found in 53.8 and 35% of the tumours, respectively. There was also one benign fibroepithelial neoplasm with hybrid features of juvenile papillomatosis and infarcted benign phyllodes tumour‐like areas. Most tumours did not have mutations in well‐known cancer driver genes, none harboured TERT promoter mutations, while 25.6% (11 of 43) showed no mutations. Metachronous and synchronous tumours were found to have mutational heterogeneity with some containing mutations in MED12; other genes or no mutations were detected at all. Four of eight giant fibroadenomas (size 5 cm or larger) had no mutations detected, suggesting that there are other molecular mechanisms driving their growth. Tumours with MED12 mutations incidentally had a significantly higher stromal mitotic count compared with those without.

Conclusion

While paediatric fibroepithelial lesions can have cellular stroma potentially raising concern for phyllodes tumour, their lack of TERT promoter and cancer driver mutations is reassuring. The absence of mutations in a significant proportion of tumours, especially the giant fibroadenomas, warrants investigation of pathogenetic mechanisms beyond those involving the 50 genes.
A minimum‐wage model of unemployment and growth: The case of a backward‐bending demand curve for labor
Authors: Brecher Richard A. , Gross Till
Published: July 2018

We add a minimum wage and hence involuntary unemployment to a conventional two‐sector model of a perfectly competitive economy with optimal saving and endogenous growth. Our resulting model highlights the possible case of a backward‐bending demand curve for labor, along which a hike in the minimum wage might increase total employment. This theoretical possibility complements some controversial empirical studies, in challenging the standard textbook prediction of an inverse relationship between employment and the minimum wage. Our model also implies that a minimum‐wage hike has negative implications for both the growth rate and lifetime utility.
Transnational Corporate Elites in Japan: International Career Mobility in East and South Asia
Authors: Kwon Jaok , Pohlmann Markus , Schöttli Jivanta
Published: July 2018

Although mainstream globalization literature has attempted to provide an empirical proof of the rise of transnational business elites using several indicators, it is still not clear how to pinpoint transnationality and to establish whether globalization has led to the erosion of nation‐state boundaries through worldwide mobility and networks, as globalization theorists argue. Using empirical data on career paths and mobility over three decades in Japan – compared with other East Asia economies and India – we examine the shift in career mobility. First, we maintain that a comprehensive understanding of social, political and cultural dimensions need to be considered in a discussion of transnationality. Second, we suggest that the globalizing economy does not necessarily lead to the weakening of the nation‐state territory and its institutions in all sociocultural and political dimensions. In particular, transnationality in career mobility in Asian economies is not greatly evident. We propose instead that a new career pattern, which we call brain circulation, highlighting the importance of international experience, has emerged.
Vitamin C deficiency in Australian hospitalised patients: an observational study
Authors: Sharma Yogesh , Miller Michelle , Shahi Rashmi , Doyle Adrienne , Horwood Chris , Hakendorf Paul , Thompson Campbell
Published: July 2018

Background

Vitamin C has anti‐oxidant properties and acts as a cofactor for several enzymes. Hypovitaminosis C has been associated with bleeding, endothelial dysfunction and death. The prevalence of hypovitaminosis C is unknown in Australian hospitalised patients, and its clinical relevance is uncertain.

Aims

To determine the prevalence, characteristics and clinical outcomes of hospitalised patients with hypovitaminosis C.

Methods

This observational study included general‐medical inpatients in a tertiary‐level hospital in Australia. High‐performance liquid chromatography (HPLC) was used to determine plasma vitamin C levels. As per Johnston’s criteria, vitamin C levels of ≥28 μmol/L were classified as normal and <28 μmol/L as low. Clinical outcomes determined included length of hospital stay (LOS), nosocomial complications, intensive care unit admission and in‐hospital mortality.

Results

A total of 200 patients participated in this study, and vitamin C levels were available for 149 patients, of whom 35 (23.5%) had normal vitamin C levels, and 114 (76.5%) had hypovitaminosis C. Patients with hypovitaminosis C were older and had higher C‐reactive protein (CRP) levels. Median LOS was 2 days longer in patients with hypovitaminosis C (6 days (interquartile range (IQR) 4, 8) vs 4 days (IQR 3, 6), P = 0.02), and they had fourfold higher odds of staying in hospital for >5 days than those with normal vitamin C levels. Other clinical outcomes were similar between the two groups.

Conclusions

Hypovitaminosis C is common in hospitalised patients and is associated with prolonged LOS. Further research is needed to ascertain the benefits of vitamin C supplementation in vitamin C‐depleted patients.
Public Opinion and the Shaping of Immigration Policy in the European Council of Ministers
Authors: Arregui Javier , Creighton Mathew J.
Published: July 2018

Do EU citizens’ preferences shape EU immigration policy? Using mixed‐methods and a unique data source on policy‐making in the EU Council of Ministers, we qualitatively and quantitatively assess the link between public sentiment and immigration policy‐making. Accounting for the economic, political and institutional context, we find that domestic public opinion does not play a central role in the policy positions adopted by Member States nor in the salience Member States attach to immigration issues during the negotiation process. We discuss the implications of these findings for our understanding of how EU immigration policy reacts to public opinion.
Construction of nursing‐sensitive quality indicators for haemodialysis using Delphi method
Authors: Gao Ju‐Lin , Liu Xiao‐Min , Che Wen‐Fang , Xin Xia
Published: July 2018

Aims and objectives

To provide a set of nursing‐sensitive quality indicators (NSQIs) for the evaluation of clinical nursing quality in haemodialysis unit.

Background

There are no established objective indicators for evaluation of the quality of nursing care in haemodialysis units in China.

Design and methods

We performed a literature search for eligible studies published from 2006–2016. A total of six studies were screened out from which 13 potential NSQIs were identified. Two rounds of Delphi surveys were conducted with the purpose of collecting opinions from a panel of independent experts. At last, 11 NSQIs were selected by consensus after exclusion of 8 NSQIs and addition of another 6 NSQIs.

Results

Two rounds of expert inquiry were conducted; the questionnaire recovery rate was 100%. The average authoritative coefficients Cr for the two rounds were 0.79 and 0.90, respectively. The Kendall W values ranged from 0.273–0.388 (p < 0.001). Eleven NSQIs were identified: nurse‐to‐patient ratio, dialysis ultrafiltration rate compliance rate, KT/V compliance rate, incidence of emergency during haemodialysis, person‐time incidence rate of haemodialysis catheter‐related bloodstream infections, incidence of coagulation in extracorporeal circulation, incidence of blood loss in extracorporeal circulation, incidence of pseudoaneurysm induced by fistula puncture, incidence of falls among haemodialysis patients, emergency dialysis rate of outpatients and incidence of fistula complications.

Conclusion

The identified NSQIs reflect three aspects of haemodialysis nursing quality: importance, rationality of calculation formula and applicability of data collection methods.

Relevance to clinical practice

The study provides a reference for the evaluation of clinical nursing quality in haemodialysis units.
Development and effect of a rational‐emotive‐behaviour‐therapy‐based self‐management programme for early renal dialysis patients
Authors: Kim Eun Sook
Published: July 2018

Aims and objectives

This study attempts to develop and determine the effect a rational‐emotive‐behaviour‐therapy‐based self‐management programme can have on the self‐efficacy, self‐care, depression and dyssomnia of patients undergoing early renal dialysis.

Background

When renal dialysis is initiated, changes in everyday life are inevitable, and patients can suffer from both psychological and physical symptoms. Hence, to obtain the best results from renal dialysis, active self‐management is required.

Design

Quasi‐experimental and longitudinal.

Methods

Forty‐eight early‐stage renal dialysis patients registered for and undergoing renal dialysis at a hospital located in S city participated in this study. These individuals were divided into an experimental and control group. The former group engaged in a self‐management programme consisting of eight weekly sessions of 50 min in duration, while the latter received traditional nursing care. Data were collected from June 2012–May 2014 through the use of a preliminary survey, a postsurvey that was distributed after the eight sessions of the self‐management programme had been completed, and a follow‐up survey allocated 4 weeks after the postsurvey. Data collection was conducted using the Self‐efficacy Scale, Self‐care Practice Scale, Beck Depression Inventory, and Korean Sleep Scale, and a repeated‐measures ANOVA was used to perform analysis.

Results

The experimental group significantly differed from the control group in regard to self‐efficacy (p = 0.006) and self‐care (p = 0.031), but differences in terms of depression (p = 0.492) and dyssomnia (p = 0.141) were nonsignificant. In the experimental group, the depression decreased but then increased again, while the dyssomnia gradually decreased.

Conclusions

The provision of a rational‐emotive‐behaviour‐therapy‐based self‐management programme that involves lectures, discussions, teach‐backs, demonstrations and posters explaining diet choices improves the self‐efficacy and self‐care of patients receiving renal dialysis.

Relevance to clinical practice

Rational‐emotive‐behaviour‐therapy‐based self‐management programmes can be used in clinical nursing sites to improve the self‐efficacy and self‐care of early renal dialysis patients.
Frequency, nature and timing of clinical deterioration in the early postoperative period
Authors: Mohammed Iddrisu Suad , Considine Julie , Hutchinson Anastasia
Published: July 2018

Aims and objectives

To establish the frequency of clinical deterioration in the early postoperative period in patients who have undergone general or orthopaedic surgery.

Background

Worldwide, clinical deterioration is a significant problem in acute care settings. Early recognition and response to clinical deterioration is one of the ten National Safety and Quality Health Service Standards in Australia. However, there is limited understanding of the frequency of clinical deterioration in surgical patients.

Methods

A point prevalence study was conducted from September–October 2014. The records of 100 consecutive in patients admitted for orthopaedic (n = 48) or general surgery (n = 52) to a health service in Melbourne, Australia, were audited. The frequency of clinical deterioration episodes was summarised using descriptive statistics.

Results

Baseline characteristics of the two patient groups were equivalent except that orthopaedic patients were older than the general surgery patients (median age 71 [IQR19] years vs. 62 [IQR17] years). There were 17 medical emergency team calls and 23 calls for urgent clinical review in 28 patients. The main indications for emergency calls were hypotension (26%), fever (19%), hypoxia (15%), tachycardia (13%) and altered blood glucose level (11%). The majority of episodes were managed on the ward, and there were oneICUtransfer and no cardiac arrest calls.

Conclusion

One in four patients experienced early postoperative clinical deterioration. Hypotension was the most common trigger for escalation of care highlighting a need to optimise fluid and haemodynamic management of postoperative patients.

Relevance to clinical practice

Haemodynamic instability leading to the activation of rapid response systems is very common in the immediate postoperative period. There is the need for locally tailored interventions to optimise fluid management and decrease incidence of further complications.
Use of a national identification database to determine the lifetime prognosis in cattle with necrotic laryngitis and the predictive value of venous pCO2
Authors: Pardon Bart , Ribbens Stefaan , Van Damme Lien , Vlaminck Lieven , Martens Ann , Deprez Piet
Published: July 2018

Background

Necrotic laryngitis, caused byFusobacterium necrophorum, frequently requires surgical intervention (laryngostomy) in the chronic stage.

Hypothesis/Objectives

To determine survival until slaughter of cattle surgically treated for necrotic laryngitis and to identify predictors of mortality.

Animals

A total of 221 cattle diagnosed with necrotic laryngitis by laryngoscopy and surgically treated

Methods

Retrospective cohort study. Clinical records were matched with the national cattle identification, registration, and movement database. Information on possible predictors including clinical examination, biochemistry, and surgery was collected. A multivariable Cox proportional hazard model was used to identify predictors of mortality.

Results

The overall survival rate was 65.2% and 58.6% of the animals with a completed life cycle could be slaughtered. Animals <6 months old experienced significantly higher mortality risk (hazard ratio [HR], 2.0; 95% confidence interval [CI], 1.1‐3.5). The venous partial pressure of carbon dioxide (pCO2; HR, 2.4; 95% CI, 1.4‐4.2) at a 64.5 mm Hg cut‐off was most significantly associated with mortality. Sensitivity and specificity of the final model consisting of age and pCO2were 49.1 and 86.4%, respectively. Instead of pCO2, total carbon dioxide (TCO2) could also be used, with similar diagnostic accuracy.

Conclusions and Clinical Relevance

The lifetime prognosis for chronic necrotic laryngitis in cattle with surgical intervention appears fair. Age, venous pCO2and TCO2are easily accessible predictors of survival to support owners and veterinarians in their decision process of whether or not to operate and to identify high risk animals that require more intensive follow‐up.
Clinicopathological and immunohistochemical analysis of plasma cell‐rich rejection in renal transplantation: Involvement of intratubular Th1/Th2 balance in plasma cell enrichment
Authors: Nishimura Ayako , Masuzawa Naoko , Nakamura Tsukasa , Harada Shumpei , Nobori Shuji , Ushigome Hidetaka , Yoshimura Norio , Konishi Eiichi
Published: July 2018

Aim

Plasma cell‐rich rejection (PCRR) has been considered a subtype of acute T‐cell‐mediated rejection (ATCR). However, PCRR is recognized as refractory rejection and different from ATCR in various ways. In order to elucidate the pathogenesis of PCRR, we analysed PCRR clinicopathologically and immunohistochemically by comparing it with ATCR.

Methods

Twelve cases of PCRR (PCRRs) and 22 cases of usual ATCR (ATCRs) diagnosed at our hospital between January 2008 and March 2017 were included. Between PCRRs and ATCRs, we compared clinical data, Banff classification, graft outcome and the total sum number of T‐bet‐ and GATA3‐positive lymphocytes infiltrating in tubular epithelium using immunohistochemistry.

Results

Plasma cell‐rich rejections occurred later than ATCRs (median time after transplantation 1340.5 days vs. 52.5 days). Serum creatinine levels at discharge after treatment were significantly higher in PCRRs than in ATCRs (median 2.38 vs. 1.65 mg/dL). Cumulative rate of graft loss was significantly higher in PCRRs than in ATCRs (1‐, 2‐ and 5‐year: 26.7%, 51.1% and 51.1% vs. 0%, 0% and 17.5%). For profiles of Th1 and Th2, we found significantly lower ratio of T‐bet/GATA3‐positive lymphocytes in PCRRs compared with ATCRs.

Conclusion

This study suggests that PCRR is more refractory than ATCR and there are significant differences in populations of helper T‐cell subsets between them. We consider helper T‐cell subset analysis valuable for developing new treatment strategies for PCRR.