bluuebunny/crossref_metadata_2025 huggingface dataset:
Clomiphene citrate before and after withdrawal bleeding for induction of ovulation in women with polycystic ovary syndrome: Randomized cross‐over trial
Authors: Elbohoty Ahmed E.H. , Amer Mohamed , Abdelmoaz Mohamed
Published: April 2016

Aim

To compare the ovarian response to early versus late clomiphene citrate (CC) in women with polycystic ovary syndrome (PCOS).

Methods

This cross‐over randomized controlled clinical trial included 90 infertile amenorrheic women with PCOS. After inducing withdrawal bleeding, patients were randomly divided into two equal groups to receive ovulation induction with CC 100 mg/day for 5 days. Group I started treatment the next day after finishing medroxyprogesterone acetate course for a menstrual cycle, and after a washout period of another menstrual cycle, the treatment was shifted to start on day 2 of withdrawal bleeding. Group II received a reversed protocol: late then early treatment. Women were followed up on transvaginal ultrasonography to monitor follicular growth, endometrial thickness and evidence of ovulation. Human chorionic gonadotropin 10 000 IU was given i.m. to trigger ovulation when at least one mature follicle measured ≥18 mm at day 14.

Results

In all cases, early induction protocol resulted in significantly higher proportion of ovulating patients, thicker endometrium and higher number of follicles 14–17 mm in diameter, ≥ 18 mm in diameter and total number of follicles (P < 0.001 for all comparisons).

Conclusion

In women with PCOS, early initiation of CC before withdrawal bleeding or during the last days of the luteal phase can achieve a better ovulatory response.
Lysosomal storage disorders: A review of the musculoskeletal features
Authors: James Rebecca A. , Singh‐Grewal Davinder , Lee Senq‐J , McGill Jim , Adib Navid ,   on behalf of the Australian Paediatric Rheumatology Group
Published: April 2016

The lysosomal storage disorders are a collection of progressive, multisystem disorders that frequently present in childhood. Their timely diagnosis is paramount as they are becoming increasingly treatable. Musculoskeletal manifestations often occur early in the disease course, hence are useful as diagnostics clues. Non‐inflammatory joint stiffness or pain, carpal tunnel syndrome, trigger fingers, unexplained pain crises and short stature should all prompt consideration of a lysosomal storage disorder. Recurrent ENT infections, hepatosplenomegaly, recurrent hernias and visual/hearing impairment – especially when clustered together – are important extra‐skeletal features. As diagnostic and therapeutic options continue to evolve, children with lysosomal storage disorders and their families are facing more sophisticated options for screening and treatment. The aim of this article is to highlight the paediatric presentations of lysosomal storage disorders, with an emphasis on the musculoskeletal features.
Injection–Infiltration of Attached Grapefruit with Xanthomonas citri subsp. citri to Evaluate Seasonal Population Dynamics in Citrus Canker Lesions
Authors: Graham James H. , Gerberich Kayla M. , Davis Craig L.
Published: April 2016

To study population dynamics of Xanthomonas citri subsp. citri (Xcc) in citrus canker lesions on fruit, a needle‐free injector was used for infiltration of bacterial inoculum into fruit in situ on mature ‘Ruby Red’ grapefruit (Citrus paradisi Macf.) trees in Florida. Inoculations of Xcc at 105 colony‐forming units (cfu) per ml were conducted in 2012 and 2013 on attached fruit varying from 15 mm to 90 mm in diameter. Inoculations were repeated every 2–3 weeks until the fruit were no longer injectable. On fruit less than 40 mm in size, erumpent lesions formed within 2 weeks of inoculation and expanded 1–9 mm in diameter from 30 to 120 days postinoculation (dpi). Xcc populations in lesions were 6–8 log cfu per lesion at 30 dpi and maintained this population up to 90 dpi. By 120 dpi, Xcc populations declined 1–3 log units as rainfall and temperature decreased in September–October. Xcc populations declined to ~3 log cfu per lesion after 120 dpi in November 2012 and 2013, whereas the population resurged to 5 log cfu per lesion after 180 dpi in January–February 2014.
Inhibitory Action of Biofungicide Physcion on Initial and Secondary Infection of Magnaporthe oryzae
Authors: Wang Na , Cai Mengling , Wang Xin , Xie Yaqiong , Ni Hanwen
Published: April 2016

Rice blast, caused by the ascomycete fungus Magnaporthe oryzae, is one of the most destructive plant diseases in the world and a serious threat to global food security. Biofungicide physcion, extracted from roots of Chinese traditional herb rhubarb, has been commercialized to control cucumber powdery mildew (Podosphaera fuliginea) in China as a new active and environmentally‐friendly ingredient. This study investigated its bioactivity on rice blast and impact on the infection of M. oryzae. Physcion was effective on M. oryzae with 50% inhibition concentration of 18.19 mg/l on the fungus mycelium growth in vitro and provided 86 and 98% control efficacy in vivo at the concentrations of 40 and 60 mg/l, respectively. It inhibited the initial infection of M. oryzae by inhibiting growth of mycelia, the germination of conidia and the formation of appressoria. Moreover, it inhibited the secondary infection of the fungus at the concentration of 40 mg/l, but had no influence at the low concentrations of 1.25–20 mg/l. So physcion might be a promising natural plant extract that is worthy of being explored to apply on the control of rice blast.
Effects of Dietary Protein Source and Feeding Regime on Growth Performance, Nutrient Digestibility, Fatty Acids, and Quality Characteristics of Rainbow Trout, Oncorhynchus mykiss, Fillets
Authors: Gai Francesco , Peiretti Pier Giorgio , Brugiapaglia Alberto , Gasco Laura
Published: April 2016

This study investigated the effects of dietary protein source and feeding regime (apparent satiation and rationed) on growth performance, nutrient digestibility, fatty acid (FA) profile, and fillet quality traits in rainbow trout. A stock of 1200 juvenile trout (mean weight 114.6 ± 0.2 g) were randomly distributed into 24 fiberglass tanks (four diets × three replications × two feeding regimes). The experimental diets were formulated to be isoproteic and isoenergetic based on bacterial protein meal (BPM), pea protein concentrate (PPC), mixture thereof (MIX), and fish meal (FM), respectively. The feeding trial lasted 77 d with water temperature of 13 C. Statistical differences appeared among the diets only in terms of crude protein digestibility. Growth performance and somatic indexes were significantly affected by the diet, while only the condition factor was influenced by the feeding regime. None of the parameters appeared to be affected by the interaction effects. Differences appeared between the FA profiles of the dorsal muscle. Oleic, linoleic, α‐linolenic, and docosahexaenoic acid contents were influenced by diet, while only minor FAs were influenced by feeding regime. In conclusion, growth performance and nutrient digestibility resulted lower in fish fed BPM diet than other groups, while PPC group was similar to FM group.
Household food insecurity and child health
Authors: Schmeer Kammi K. , Piperata Barbara A.
Published: April 2016

Food insecurity, the lack of consistent access to sufficient quality and quantity of food, affects an estimated 800 million people around the world. Although household food insecurity is generally associated with poor child nutrition and health in the USA, we know less about household food insecurity and child health in developing countries. Particularly lacking is research assessing how associations between household food insecurity and children's health outcomes may differ by child age and among children beyond age 5 years in low‐income settings. We use data from a population‐based sample of households with children ages 3–11 years (N = 431) in León, Nicaragua to consider how household food insecurity is associated with three measures of child health: illness, anaemia and low height‐for‐age. Our results provide new evidence that even mild household food insecurity is detrimental to children's health; and that child age conditions the associations between household food insecurity and child health. We find that food insecurity is especially harmful to health during early childhood, but continues to have significant associations with health into middle childhood (up to ages 7–8 years). We discuss the potential implications of these results for future child health research and policies in low‐income countries. © 2016 John Wiley & Sons Ltd
Assessment of the WHO Stunting Framework using Ethiopia as a case study
Authors: Wirth James P. , Rohner Fabian , Petry Nicolai , Onyango Adelheid W. , Matji Joan , Bailes Adam , de Onis Mercedes , Woodruff Bradley A.
Published: April 2016

Poor linear growth in children <5 years old, or stunting, is a serious public health problem particularly in Sub‐Saharan Africa. In 2013, the World Health Organization (WHO) released a conceptual framework on the Context, Causes and Consequences of Childhood Stunting (the ‘WHO framework’) that identifies specific and general factors associated with stunting. The framework is based upon a global review of data, and we have applied it to a country‐level analysis where health and nutrition policies are made and public health and nutrition data are collected. We reviewed the literature related to sub‐optimal linear growth, stunting and birth outcomes in Ethiopia as a case study. We found consistent associations between poor linear growth and indicators of birth size, recent illness (e.g. diarrhoea and fever), maternal height and education. Other factors listed as causes in the framework such as inflammation, exposure to mycotoxins and inadequate feeding during and after illness have not been examined in Ethiopia, and the existing literature suggests that these are clear data gaps. Some factors associated with poor linear growth in Ethiopia are missing in the framework, such as household characteristics (e.g. exposure to indoor smoke). Examination of the factors included in the WHO framework in a country setting helps identifying data gaps helping to target further data collection and research efforts. © 2016 John Wiley & Sons Ltd
Epistemics and Expertise in Peer Tutoring Interactions: Co‐Constructing Knowledge of Spanish
Authors: BACK MICHELE
Published: April 2016

Peer tutoring is viewed as a valuable component of additional language learning due to the presence of a more knowledgeable interlocutor. Yet researchers and language program directors alike often ignore the linguistic and cultural differences that peer tutors possess, instead categorizing them homogeneously as ‘experts’ or ‘native speakers.’ In this article, I use a case study to closely examine how knowledge is negotiated in one peer tutoring cohort. Grounding my analysis in ethnomethodological and linguistic anthropological notions of epistemics and expertise, I show how one peer tutor drew from various embodied, artifactual, and historical resources in order to negotiate lexical gaps and position herself as an expert in the target language. At the same time, I demonstrate how essentialist ideologies help construct a language expert by highlighting the learners’ alignments to the tutor's epistemic stance as knower, even when faced with conflicting information. These findings question the ways knowledge and expertise are traditionally perceived in peer tutoring and other additional language learning contexts, emphasize the need for training peer tutors in cooperative learning methods and articulating their knowledge with that from the classroom setting, and highlight the complex ideologies that surround the ‘right to know’ a target language.
A Meta‐Analysis of Reliability Coefficients in Second Language Research
Authors: PLONSKY LUKE , DERRICK DEIRDRE J.
Published: April 2016

Ensuring internal validity in quantitative research requires, among other conditions, reliable instrumentation. Unfortunately, however, second language (L2) researchers often fail to report and even more often fail to interpret reliability estimates beyond generic benchmarks for acceptability. As a means to guide interpretations of such estimates, this article meta‐analyzes reliability coefficients (internal consistency, interrater, and intrarater) as reported in published L2 research. We recorded 2,244 reliability estimates in 537 individual articles along with study (e.g., sample size) and instrument features (e.g., item formats) proposed to influence reliability. We also coded for the indices employed (e.g., alpha, KR20). The coefficients were then aggregated (i.e., meta‐analyzed). The three types of reliability varied, with internal consistency as the lowest: median = .82. Interrater and intrarater estimates were substantially higher (.92 and .95, respectively). Overall estimates were also found to vary according to study and instrument features such as proficiency (low = .79, intermediate = .84, advanced = .89) and target skill (e.g., writing = .88 vs. listening = .77). We use our results to inform and encourage interpretations of reliability estimates relative to the larger field as well as to the substantive and methodological features particular to individual studies and subdomains.
Resistance to root‐knot nematodes Meloidogyne spp. in woody plants
Authors: Saucet Simon Bernard , Van Ghelder Cyril , Abad Pierre , Duval Henri , Esmenjaud Daniel
Published: April 2016

Root‐knot nematodes (RKNs) Meloidogyne spp. cause major damage to cultivated woody plants. Among them, Prunus, grapevine and coffee are the crops most infested by worldwide polyphagous species and species with a more limited distribution and/or narrower host range. The identification and characterization of natural sources of resistance are important steps to develop RKN control strategies. In woody crops, resistant rootstocks genetically different from the scion of agronomical interest may be engineered. We describe herein the interactions between RKNs and different woody crops, and highlight the plant species in which resistance and corresponding resistance (R) genes have been discovered. Even though grapevine and, to a lesser extent, coffee have a history of rootstock selection for RKN resistance, few cases of resistance have been documented. By contrast, in Prunus, R genes with different spectra have been mapped in plums, peach and almond and can be pyramided for durable resistance in interspecific rootstocks. We particularly discuss here the Ma Toll/interleukin‐1 receptor‐like‐nucleotide binding‐leucine‐rich repeat gene from Myrobalan plum, one of the longest plant R genes cloned to date, due to its unique biological and structural properties. RKN R genes in Prunus will enable us to carry out molecular studies aimed at improving our knowledge of plant immunity in woody plants.

Contents

Summary

I.
Introduction
42

II.
RKN species in woody plants
43

III.
Resistance in the genus Prunus
44

IV.
Resistance in grapevine
47

V.
Resistance in coffee
49

VI.
Resistance in other woody crops
50

VII.
Relationships between RKN resistance and diseases
50

VIII.
Towards a better understanding of NB-LRR (NLR) immunity in woody plants
50

IX.
Conclusion
52

Acknowledgements
52

References
52
Zebrafish as a model for acetylcholinesterase‐inhibiting organophosphorus agent exposure and oxime reactivation
Authors: Koenig Jeffrey A. , Dao Thuy L. , Kan Robert K. , Shih Tsung‐Ming
Published: April 2016

The current research progression efforts for investigating novel treatments for exposure to organophosphorus (OP) compounds that inhibit acetylcholinesterase (AChE), including pesticides and chemical warfare nerve agents (CWNAs), rely solely on in vitro cell assays and in vivo rodent models. The zebrafish (Danio rerio) is a popular, well‐established vertebrate model in biomedical research that offers high‐throughput capabilities and genetic manipulation not readily available with rodents. A number of research studies have investigated the effects of subacute developmental exposure to OP pesticides in zebrafish, observing detrimental effects on gross morphology, neuronal development, and behavior. Few studies, however, have utilized this model to evaluate treatments, such as oxime reactivators, anticholinergics, or anticonvulsants, following acute exposure. Preliminary work has investigated the effects of CWNA exposure. The results clearly demonstrated relative toxicity and oxime efficacy similar to that reported for the rodent model. This review surveys the current literature utilizing zebrafish as a model for OP exposure and highlights its potential use as a high‐throughput system for evaluating AChE reactivator antidotal treatments to acute pesticide and CWNA exposure.
Transcending as a driver of development
Authors: Travis Frederick
Published: April 2016

This paper draws from three different bodies of research to discuss the hypothesis that age‐appropriate experiences enhance brain and cognitive development throughout the life span. These age‐appropriate experiences could be considered as the drivers of development at each age, including drivers to foster development beyond adult abstract thinking, as described in Piaget's formal operational stage. We explore how a nurturing caregiver is the driver in the first 2 years of life, how language learning is the driver from 3 to 10 years, and how problem solving is the driver in the teenage years. To develop beyond adult rational thinking, we suggest that the driver is transcending thought, which can result when practicing meditations in the automatic self‐transcending category, such as Transcendental Meditation.
Associations between parent–child relationship quality and obesogenic risk in adolescence: a systematic review of recent literature
Authors: Blewitt Claire , Bergmeier Heidi , Macdonald Jacqui A. , Olsson Craig A. , Skouteris Helen
Published: April 2016

Adolescence is a period of significant cognitive, social and physiological change, presenting unique risk factors for weight gain. Childhood obesity research has traditionally focused on the influence of parent‐level factors on children's eating and weight status. Increasingly, emphasis is turning towards the reciprocal nature of the parent–child relationship and its influence on health behaviour. A systematic literature review was conducted to investigate the relationship between parent–child relationship quality (defined as the felt emotional bond between parent and child) and obesogenic risk (weight status, eating attitudes and behaviours, level of physical activity and sedentary behaviour) in adolescence; 26 papers were included in the review. The results neither support nor challenge an association between parent–child relationship quality and weight, with study design flaws and limited measurement of the parent–child relationship precluding robust conclusions. The review does however suggests that several aspects of the parent–child relationship are important in understanding eating attitudes and behaviours, including the felt emotional bond between the parent and child, the child's perception of how much the parent cares for them and the mother's sensitivity towards the child. The need for further longitudinal research into the association between parent–child relationship quality and obesity risk across this developmental period is discussed.
Effect of diet‐induced weight loss on muscle strength in adults with overweight or obesity – a systematic review and meta‐analysis of clinical trials
Authors: Zibellini J. , Seimon R. V. , Lee C. M. Y. , Gibson A. A. , Hsu M. S. H. , Sainsbury A.
Published: April 2016

We conducted a systematic review and meta‐analysis to identify how diet‐induced weight loss in adults with overweight or obesity impacts on muscle strength. Twenty‐seven publications, including 33 interventions, most of which were 8–24 weeks in duration, were included. Meta‐analysis of seven interventions measuring knee extensor strength by isokinetic dynamometry in 108 participants found a significant decrease following diet‐induced weight loss (−9.0 [95% confidence interval: −13.8, −4.1] N/m, P < 0.001), representing a 7.5% decrease from baseline values. Meta‐analysis of handgrip strength from 10 interventions in 231 participants showed a non‐significant decrease (−1.7 [−3.6, 0.1] kg, P = 0.070), with significant heterogeneity (I2 = 83.9%, P < 0.001). This heterogeneity may have been due to diet type, because there was a significant decrease in handgrip strength in seven interventions in 169 participants involving moderate energy restriction (−2.4 [−4.8, −0.0] kg, P = 0.046), representing a 4.6% decrease from baseline values, but not in three interventions in 62 participants involving very‐low‐energy diet (−0.4 [−2.0, 1.2] kg, P = 0.610). Because of variability in methodology and muscles tested, no other data could be meta‐analyzed, and qualitative assessment of the remaining interventions revealed mixed results. Despite varying methodologies, diets and small sample sizes, these findings suggest a potential adverse effect of diet‐induced weight loss on muscle strength. While these findings should not act as a deterrent against weight loss, due to the known health benefits of losing excess weight, they call for strategies to combat strength loss – such as weight training and other exercises – during diet‐induced weight loss. © 2016 World Obesity
Subclinical atherosclerosis in patients with recurrent aphthous stomatitis
Authors: Sereflican M , Sereflican B , Dagistan E , Goksugur N , Kizildag B
Published: April 2016

Objective

Recurrent aphtous stomatitis (RAS) is an inflammatory oral mucosal disease. It has been known that inflammatory cascade plays important role in the atherosclerotic process. The aim of the study was to investigate the relationship between subclinical atherosclerotic findings and a systemic inflammatory disease, RAS.

Methods

In total, 32 patients with RAS were matched with 30 control subjects on the basis of age, sex, and major cardiovascular risk factors. Laboratory parameters including lipid profiles were determined for patients and controls. B‐mode ultrasonography was used to assess carotid extra‐medial thickness (cEMT) and carotid intima‐media thickness (cIMT).

Results

Both cEMT and cIMT in the RAS group were significantly higher than in the control group (P = 0.002 and 0.013, respectively). There was a significant positive correlation between cIMT and cEMT (r = 0.381, P = 0.034). cIMT was positively correlated with age, triglyceride levels, and systolic blood pressure, while cEMT was positively correlated with age in patients with RAS.

Conclusions

To our knowledge, this is the first reported study to evaluate cEMT and cIMT in patients with RAS. This study presents morphological evidence of subclinical atherosclerosis in patients with RAS. Further studies investigating the relationship between atherosclerosis and RAS are needed.
Fine‐Needle Aspiration as a Method of Diagnosis of Subcutaneous Fat Necrosis of the Newborn
Authors: Schubert Pawel Tomasz , Razak Rubina , Jordaan Henry Francois
Published: April 2016

A 5‐day‐old boy presented with cellulitis‐like, fluctuant lesions since birth. Clinically, subcutaneous fat necrosis was suspected, but an infective lesion could not be excluded. By performing a fine‐needle aspiration biopsy, a diagnosis was established within minutes.
Anesthetic management of a pediatric patient with pulmonary arteriovenous fistula undergoing liver transplantation – a case report
Authors: Lee Ho‐Jin , Lee Jung‐Man , Jung Chul‐Woo , Lee Jiwon
Published: April 2016

For patients with HPS who require anesthesia for a procedure, HPV should be maintained to prevent worsening hypoxemia. Here, the case of a 9‐yr‐old girl who was scheduled for a living donor liver transplantation is presented. The patient suffered from end‐stage liver disease with HPS due to biliary atresia, which contributed to the development of a diffuse pulmonary AVF. Consequently, anesthetic management of this patient involved two different types of pulmonary shunt. It is important to maintain HPV, not only to prevent worsening of the hypoxia caused by HPS but also to inhibit an increase in PVR that could cause an increase of shunt flow through the pathological fistula. A TIVA technique was performed, and a nitrous oxide inhaler was prepared in case of a possible increase in PVR during the reperfusion period. There were no adverse events during the operation. Thus, anesthesiologists should be aware of the pathophysiological status of HPS and its potential to progress to a pulmonary AVF in order to meticulously determine an anesthesia plan that accounts for the hypoxia and PVR that are associated with HPS.
Angelica archangelia Prevented Collagen Degradation by Blocking Production of Matrix Metalloproteinases in UVB‐exposed Dermal Fibroblasts
Authors: Sun Zhengwang , Hwang Eunson , Park Sang Yong , Zhang Mengyang , Gao Wei , Lin Pei , Yi Tae‐Hoo
Published: April 2016

Angelica archangelia (AA), a traditional herb, has attracted attention as an agent with potential for use in the prevention of chronic skin diseases. This study examined the photoprotective effects of AA on the inhibition of matrix metalloproteinases (MMPs) and collagen degradation in UVB‐irradiated normal human dermal fibroblasts. Our results showed that AA markedly blocked collagen degradation by restraining the production of MMPs in UVB‐exposed fibroblasts. We also investigated the underlying mechanism behind the effects of AA. AA attenuated UVB‐triggered interleukin‐6 (IL‐6) and promoted the expression of transforming growth factor β1. Application of AA extract (10, 100 μg mL−1) significantly diminished UVB‐induced extracellular signal‐regulated kinase and Jun‐N‐terminal kinase phosphorylation, which consequently reduced phosphorylated c‐Fos and c‐Jun. Our results indicated that AA inhibited the UVB‐induced expression of MMPs by inhibiting mitogen‐activated protein kinase signaling pathways and activator protein‐1 activation. Our results suggest that AA is a promising botanical agent for use against skin photoaging.
Unpacking the Collaborative Toolbox: Why and When Do Public Managers Choose Collaborative Governance Strategies?
Authors: Scott Tyler A. , Thomas Craig W.
Published: April 2016

The public policy and public management literatures together support a vibrant discussion of collaborative governance. Much of this scholarship takes a broad perspective focusing on questions such as what collaborative governance is; why collaborative governance emerges; or why individuals and organizations choose to participate in voluntary, nonbinding collaborative efforts. This paper focuses specifically on the role of public managers as leaders, encouragers, and followers of collaborative governance. We examine the decision calculus factoring into the choice of collaborative governance as a toolbox for achieving desired policy goals. That is, we ask why public managers choose to devote public resources to collaborative governance. What motivates public managers to pick up the phone, write a check, or otherwise change their current behavior? We develop 20 propositions that contextualize this choice in terms of two overarching questions: (i) How do institutional structure and organizational strategy intersect to influence the ways in which public managers design and implement collaborative governance?; and (ii) Why do public managers choose particular roles within collaborative institutions? In doing so, we demonstrate how the public policy and public management literatures can be coupled to better understand a theoretical issue that each research body struggles to encapsulate in isolation.
We Wait Too Long to Refer Patients for Transplantation
Authors: Peev Vasil
Published: April 2016

Late referral of patients with chronic kidney disease (CKD) and end‐stage renal disease (ESRD) for evaluation of kidney transplantation is common. Even though renal transplantation offers a clear survival benefit to patients with advanced CKD and ESRD and should be considered the renal replacement therapy of choice, numerous barriers to early renal transplant referral have been observed. Some of these barriers can be overcome by improving the communication between the referring providers and the transplant centers. Furthermore, providing more intensive education to both patients and referring providers with regard to the eligibility of CKD and ESRD patients for a transplant will likely result in higher referral rates. This in turn will lead to improved survival outcomes in this group of patients with otherwise significantly increased morbidity and mortality.
Eastern European Rurality in a Neo‐Liberal, European Union World
Authors: Swain Nigel
Published: April 2016

The article first argues that we live in a neo‐liberal world in that neo‐liberalism has become the economic orthodoxy which informs policy‐making, but that the commitment of the European Union and its Common Agricultural Policy to neo‐liberalism is somewhat ambiguous. It then examines the impact of that ambiguous Common Agricultural Policy on Eastern European rurality in the decade or so since the New Member States joined. In many respects it has resulted in scenarios similar to developments in western Europe, but in one respect a phenomenon that is present throughout the European Union has been amplified dramatically in its eastern half. Overall, the weaknesses that many have identified in the Common Agricultural Policy have been reproduced in the east, but in a more extreme form.
Economic burden of gastrointestinal cancer under the protection of the New Rural Cooperative Medical Scheme in a region of rural China with high incidence of oesophageal cancer: cross‐sectional survey
Authors: Li Xiang , Cai Hong , Wang Chaoyi , Guo Chuanhai , He Zhonghu , Ke Yang
Published: April 2016

Objective

To evaluate the financial burden of oesophageal cancer under the protection of the new Rural Cooperative Medical Scheme (NCMS) and to provide evidence and suggestions to policymakers in a high‐incidence region in China.

Methods

We analysed inpatient claim data for oesophageal cancer, gastric cancer and colorectal cancer from 1 January to 31 December 2013. The data were extracted from the NCMS management system of Hua County, Henan Province, a typical high‐risk region for oesophageal cancer in China. Cancer‐specific health economic indicators were calculated to evaluate the financial burden under the protection of the local NCMS.

Results

The total cost of oesophageal cancer was 2.7–3.6 times higher than that of gastric cancer and colorectal cancer, respectively, due to high incidence of oesophageal cancer. For each hospitalisation to treat oesophageal cancer, the average total cost and out‐of‐pocket expenses after reimbursement equalled an entire year's gross domestic product per capita and per capita disposable income, respectively, for the local area. The average total cost per hospitalisation for oesophageal cancer increased monotonically with hospital level for surgical hospitalisations, and it increased more rapidly for non‐surgical hospitalisations (from $301 to $2589, 860%) than for gastric cancer (from $289 to $1453, 503%) and colorectal cancer (from $359 to $1610, 448%). Vulnerable groups with less access to high‐level hospitals were found in different gender and age groups.

Conclusions

Oesophageal cancer imposes serious financial burdens on communities and patients' households in this high‐incidence region, and no preferential policy from the local NCMS has been designed to address this issue. A special supportive policy should be developed on the basis of local disease profiles and population characteristics to alleviate the financial burden of populations at high risk for certain high‐cost diseases.
Modelling the duration of residence and plans for future residential relocation: a multilevel analysis
Authors: Thomas Michael J , Stillwell John C H , Gould Myles I
Published: April 2016

Among the multitude of studies of factors that determine residential (im)mobility, relatively little attention has been paid to the length of time that people spend in a particular location and the importance of duration of stay for future relocation propensities. This study uses a large and detailed commercial survey sample of individuals in England and Wales and an appropriately tailored statistical approach to uncover new insights into the multilevel and spatially heterogeneous interactions that exist between residential duration, place attachment and plans for future residential relocation. We demonstrate how an individual's residential duration, as an essential ingredient for the accumulation of social capital and place‐based attachment, is critical for informing plans for future (im)mobility. After controlling for a range of individual and contextual covariates, the predicted probability of planning a residential relocation is found to increase initially with duration of stay, to a peak after 4–5 years, and then to decline as the length of duration increases. However, there is evidence of strong geographical variation in this relationship, with some neighbourhoods being characterised by stable or even increasing propensities for movement with duration. The paper pays particular attention to the importance of wider neighbourhood dynamics (composition, selective sorting and population (in)stability), suggesting that they too play an important role in mediating duration‐of‐stay effects for individuals. The paper concludes by highlighting the need for researchers and policy practitioners interested in community dynamics, the development/accumulation of social capital and place attachment/rootedness, to give due consideration to multilevel durations of residence and, more broadly, the inherently spatial and temporal ties that bind individuals to place.
Accounting for the Differences Between Gross and Value Added Trade Balances
Authors: Nagengast Arne J. , Stehrer Robert
Published: April 2016

One of the main stylised facts that has emerged from the recent literature on global value chains is that bilateral trade imbalances in gross terms can differ substantially from those measured in value added terms. However, the factors underlying the extent and sign of the differences between the two measures have so far not been investigated. Here, we propose a novel decomposition of bilateral gross trade balances that accounts for the differences between gross and value added concepts. The bilateral analysis contributes conceptually to the literature on double counting in trade by identifying the trade flow in which value added is actually recorded for the first time in international trade statistics. We apply our decomposition framework to the development of intra‐EU‐27 trade balances from 1995 to 2011 and show that a growing share of intra‐EU bilateral trade balances is due to demand in countries other than the two direct trading partners. The latter accounted for 25 per cent of the total variance of intra‐EU gross bilateral trade balances in 2011, which marks a considerable rise from 3 per cent in 1995.
Aerobic Toluene Degraders in the Rhizosphere of a Constructed Wetland Model Show Diurnal Polyhydroxyalkanoate Metabolism
Authors: Lünsmann Vanessa , Kappelmeyer Uwe , Taubert Anja , Nijenhuis Ivonne , von Bergen Martin , Heipieper Hermann J. , Müller Jochen A. , Jehmlich Nico
Published: April 2016

Constructed wetlands (CWs) are successfully applied for the treatment of waters contaminated with aromatic compounds. In these systems, plants provide oxygen and root exudates to the rhizosphere and thereby stimulate microbial degradation processes. Root exudation of oxygen and organic compounds depends on photosynthetic activity and thus may show day-night fluctuations. While diurnal changes in CW effluent composition have been observed, information on respective fluctuations of bacterial activity are scarce. We investigated microbial processes in a CW model system treating toluene-contaminated water which showed diurnal oscillations of oxygen concentrations using metaproteomics. Quantitative real-time PCR was applied to assess diurnal expression patterns of genes involved in aerobic and anaerobic toluene degradation. We observed stable aerobic toluene turnover by
Burkholderiales
during the day and night. Polyhydroxyalkanoate synthesis was upregulated in these bacteria during the day, suggesting that they additionally feed on organic root exudates while reutilizing the stored carbon compounds during the night via the glyoxylate cycle. Although mRNA copies encoding the anaerobic enzyme benzylsuccinate synthase (
bssA
) were relatively abundant and increased slightly at night, the corresponding protein could not be detected in the CW model system. Our study provides insights into diurnal patterns of microbial processes occurring in the rhizosphere of an aquatic ecosystem.

IMPORTANCE
Constructed wetlands are a well-established and cost-efficient option for the bioremediation of contaminated waters. While it is commonly accepted knowledge that the function of CWs is determined by the interplay of plants and microorganisms, the detailed molecular processes are considered a black box. Here, we used a well-characterized CW model system treating toluene-contaminated water to investigate the microbial processes influenced by diurnal plant root exudation. Our results indicated stable aerobic toluene degradation by members of the
Burkholderiales
during the day and night. Polyhydroxyalkanoate synthesis in these bacteria was higher during the day, suggesting that they additionally fed on organic root exudates and reutilized the stored carbon compounds during the night. Our study illuminates microbial processes occurring in the rhizosphere of an aquatic ecosystem.
Next-Generation Sequencing Confirms Presumed Nosocomial Transmission of Livestock-Associated Methicillin-Resistant Staphylococcus aureus in the Netherlands
Authors: Bosch Thijs , Witteveen Sandra , Haenen Anja , Landman Fabian , Schouls Leo M.
Published: April 2016

Livestock-associated methicillin-resistant
Staphylococcus aureus
(LA-MRSA) was detected in 2003 and rapidly became the predominant MRSA clade in the Netherlands. Studies have shown that transmissions are difficult to identify, since this MRSA variant represents a genetically homogenous clade when current typing techniques are used. Here, next-generation sequencing was performed on 206 LA-MRSA isolates to assess the capability of LA-MRSA to be transmitted between humans. The usefulness of single nucleotide variants (SNVs), the composition of the SCC
mec
region, and the presence of plasmids to identify transmission of LA-MRSA were assessed. In total, 30 presumed putative nosocomial transmission events and 2 LA-MRSA outbreaks were studied; in most cases, SNV analysis revealed that the isolates of the index patient and the contact(s) clustered closely together. In three presumed events, the isolates did not cluster together, indicating that transmission was unlikely. The composition of the SCC
mec
region corroborated these findings. However, plasmid identification did not support our SNV analysis, since different plasmids were present in several cases where SNV and SCC
mec
analysis suggested that transmission was likely. Next-generation sequencing shows that transmission of LA-MRSA does occur in Dutch health care settings. Transmission was identified based on SNV analysis combined with epidemiological data and in the context of epidemiologically related and unrelated isolates. Analysis of the SCC
mec
region provided limited, albeit useful, information to corroborate conclusions on transmissions, but plasmid identification did not.

IMPORTANCE
In 2003, a variant of methicillin-resistant
Staphylococcus aureus
(MRSA) isolated from pigs was also found in pig farmers in France and the Netherlands. Soon thereafter, this livestock-associated MRSA (LA-MRSA) was identified in many other countries. Transmission of LA-MRSA between humans, particularly in the health care setting, is regarded to occur sporadically. Moreover, studies that describe LA-MRSA transmission used molecular characterization of isolates with limited discriminatory power, making the validity of the conclusion that transmission occurred questionable. In our study, we sequenced the complete genomes of 206 LA-MRSA isolates, obtained from more than 30 presumed LA-MRSA transmission events. Analysis of the data showed that transmission of LA-MRSA between humans had indeed occurred in more than 90% of these events. We conclude that transmission of LA-MRSA between humans does occur in Dutch health care settings; therefore, a decision to discontinue the search and destroy policy for LA-MRSA should be taken with caution.
The relationship and effects of golf on physical and mental health: a scoping review protocol
Authors: Murray A , Daines L , Archibald D , Hawkes R , Grant L , Mutrie N
Published: April 2016

Introduction

Golf is a sport played in 206 countries worldwide by over 50 million people. It is possible that participation in golf, which is a form of physical activity, may be associated with effects on longevity, the cardiovascular, metabolic and musculoskeletal systems, as well as on mental health and well-being. We outline our scoping review protocol to examine the relationships and effects of golf on physical and mental health.

Methods and analysis

Best practice methodological frameworks suggested by Arksey and O'Malley, Levacet aland the Joanna Briggs Institute will serve as our guide, providing clarity and rigour. A scoping review provides a framework to (1) map the key concepts and evidence, (2) summarise and disseminate existing research findings to practitioners and policymakers and (3) identify gaps in the existing research. A three-step search strategy will identify reviews as well as original research, published and grey literature. An initial search will identify suitable search terms, followed by a search using keyword and index terms. Two reviewers will independently screen identified studies for final inclusion.

Dissemination

We will map key concepts and evidence, and disseminate existing research findings to practitioners and policymakers through peer-reviewed and non-peer reviewed publications, conferences and in-person communications. We will identify priorities for further study. This method may prove useful to examine the relationships and effects of other sports on health.
HUWE1 mutations in Juberg-Marsidi and Brooks syndromes: the results of an X-chromosome exome sequencing study
Authors: Friez Michael J , Brooks Susan Sklower , Stevenson Roger E , Field Michael , Basehore Monica J , Adès Lesley C , Sebold Courtney , McGee Stephen , Saxon Samantha , Skinner Cindy , Craig Maria E , Murray Lucy , Simensen Richard J , Yap Ying Yzu , Shaw Marie A , Gardner Alison , Corbett Mark , Kumar Raman , Bosshard Matthias , van Loon Barbara , Tarpey Patrick S , Abidi Fatima , Gecz Jozef , Schwartz Charles E
Published: April 2016

Background

X linked intellectual disability (XLID) syndromes account for a substantial number of males with ID. Much progress has been made in identifying the genetic cause in many of the syndromes described 20–40 years ago. Next generation sequencing (NGS) has contributed to the rapid discovery of XLID genes and identifying novel mutations in known XLID genes for many of these syndromes.

Methods

2 NGS approaches were employed to identify mutations in X linked genes in families with XLID disorders. 1 involved exome sequencing of genes on the X chromosome using the Agilent SureSelect Human X Chromosome Kit. The second approach was to conduct targeted NGS sequencing of 90 known XLID genes.

Results

We identified the same mutation, a c.12928 G>C transversion in theHUWE1gene, which gives rise to a p.G4310R missense mutation in 2 XLID disorders: Juberg-Marsidi syndrome (JMS) and Brooks syndrome. Although the original families with these disorders were considered separate entities, they indeed overlap clinically. A third family was also found to have a novelHUWE1mutation.

Conclusions

As we identified aHUWE1mutation in an affected male from the original family reported by Juberg and Marsidi, it is evident the syndrome does not result from a mutation inATRXas reported in the literature. Additionally, our data indicate that JMS and Brooks syndromes are allelic having the sameHUWE1mutation.
Prognostic models in acute pulmonary embolism: a systematic review and meta-analysis
Authors: Elias Antoine , Mallett Susan , Daoud-Elias Marie , Poggi Jean-Noël , Clarke Mike
Published: April 2016

Objective

To review the evidence for existing prognostic models in acute pulmonary embolism (PE) and determine how valid and useful they are for predicting patient outcomes.

Design

Systematic review and meta-analysis.

Data sources

OVID MEDLINE and EMBASE, and The Cochrane Library from inception to July 2014, and sources of grey literature.

Eligibility criteria

Studies aiming at constructing, validating, updating or studying the impact of prognostic models to predict all-cause death, PE-related death or venous thromboembolic events up to a 3-month follow-up in patients with an acute symptomatic PE.

Data extraction

Study characteristics and study quality using prognostic criteria. Studies were selected and data extracted by 2 reviewers.

Data analysis

Summary estimates (95% CI) for proportion of risk groups and event rates within risk groups, and accuracy.

Results

We included 71 studies (44 298 patients). Among them, 17 were model construction studies specific to PE prognosis. The most validated models were the PE Severity Index (PESI) and its simplified version (sPESI). The overall 30-day mortality rate was 2.3% (1.7% to 2.9%) in the low-risk group and 11.4% (9.9% to 13.1%) in the high-risk group for PESI (9 studies), and 1.5% (0.9% to 2.5%) in the low-risk group and 10.7% (8.8% to12.9%) in the high-risk group for sPESI (11 studies). PESI has proved clinically useful in an impact study. Shifting the cut-off or using novel and updated models specifically developed for normotensive PE improves the ability for identifying patients at lower risk for early death or adverse outcome (0.5–1%) and those at higher risk (up to 20–29% of event rate).

Conclusions

We provide evidence-based information about the validity and utility of the existing prognostic models in acute PE that may be helpful for identifying patients at low risk. Novel models seem attractive for the high-risk normotensive PE but need to be externally validated then be assessed in impact studies.