bluuebunny/crossref_metadata_2025 huggingface dataset:
Successful Relief of a Male Breast Lymphedema by Supermicrosurgical Lymphaticovenular Anastomosis
Authors: Ayestaray Benoit , Chrelias Theodoros
Published: July 2018

Background

Breast lymphedema is a common issue after breast cancer surgery but remains understudied because it is difficult to be quantified. Untreated breast lymphedema may lead to severe form of delayed breast cellulitis. Supermicrosurgical lymphaticovenular anastomosis is one option for the treatment of breast cancer–related lymphedema but has not been described for the treatment of breast lymphedema.

Methods

This report presented a rare case of male breast lymphedema secondary to axillary lymph node dissection for the treatment of a forearm melanoma. Deep lymphatic vessels and adjacent venules were individualized under high magnification in the periareolar area. Six lymphaticovenular anastomoses were performed using supermicrosurgical techniques. A clinical examination and a volume assessment under magnetic resonance imaging were used to assess the efficiency of surgery.

Results

Postoperative outcome was uneventful. The patient was followed-up during 1 year. Swelling relief was clinically significant 3 months postoperatively. The pinch test reduction was 2 cm after 12 months. The breast volume reduction rate was 47.2%.

Conclusions

Supermicrosurgical lymphaticovenular anastomosis may be efficient for the treatment of postoperative breast lymphedema, even in male patients.
Nitrogen enrichment offsets direct negative effects of ocean acidification on a reef-building crustose coralline alga
Authors: Johnson Maggie D. , Carpenter Robert C.
Published: July 2018

Ocean acidification (OA) and nutrient enrichment threaten the persistence of near shore ecosystems, yet little is known about their combined effects on marine organisms. Here, we show that a threefold increase in nitrogen concentrations, simulating enrichment due to coastal eutrophication or consumer excretions, offset the direct negative effects of near-future OA on calcification and photophysiology of the reef-building crustose coralline alga,
Porolithon onkodes
. Projected near-future pCO
2
levels (approx. 850 µatm) decreased calcification by 30% relative to ambient conditions. Conversely, nitrogen enrichment (nitrate + nitrite and ammonium) increased calcification by 90–130% in ambient and high pCO
2
treatments, respectively. pCO
2
and nitrogen enrichment interactively affected instantaneous photophysiology, with highest relative electron transport rates under high pCO
2
and high nitrogen. Nitrogen enrichment alone increased concentrations of the photosynthetic pigments chlorophyll
a
, phycocyanin and phycoerythrin by approximately 80–450%, regardless of pCO
2
. These results demonstrate that nutrient enrichment can mediate direct organismal responses to OA. In natural systems, however, such direct benefits may be counteracted by simultaneous increases in negative indirect effects, such as heightened competition. Experiments exploring the effects of multiple stressors are increasingly becoming important for improving our ability to understand the ramifications of local and global change stressors in near shore ecosystems.
Noise control for molecular computing
Authors: Plesa Tomislav , Zygalakis Konstantinos C. , Anderson David F. , Erban Radek
Published: July 2018

Synthetic biology is a growing interdisciplinary field, with far-reaching applications, which aims to design biochemical systems that behave in a desired manner. With the advancement in nucleic-acid-based technology in general, and strand-displacement DNA computing in particular, a large class of abstract biochemical networks may be physically realized using nucleic acids. Methods for systematic design of the abstract systems with prescribed behaviours have been predominantly developed at the (less-detailed) deterministic level. However, stochastic effects, neglected at the deterministic level, are increasingly found to play an important role in biochemistry. In such circumstances, methods for controlling the intrinsic noise in the system are necessary for a successful network design at the (more-detailed) stochastic level. To bridge the gap, the
noise-control algorithm
for designing biochemical networks is developed in this paper. The algorithm structurally modifies any given reaction network under mass-action kinetics, in such a way that (i) controllable state-dependent noise is introduced into the stochastic dynamics, while (ii) the deterministic dynamics are preserved. The capabilities of the algorithm are demonstrated on a production–decay reaction system, and on an exotic system displaying bistability. For the production–decay system, it is shown that the algorithm may be used to redesign the network to achieve noise-induced multistability. For the exotic system, the algorithm is used to redesign the network to control the stochastic switching, and achieve noise-induced oscillations.
A combined low-frequency electromagnetic and fluidic stimulation for a controlled drug release from superparamagnetic calcium phosphate nanoparticles: potential application for cardiovascular diseases
Authors: Marrella Alessandra , Iafisco Michele , Adamiano Alessio , Rossi Stefano , Aiello Maurizio , Barandalla-Sobrados Maria , Carullo Pierluigi , Miragoli Michele , Tampieri Anna , Scaglione Silvia , Catalucci Daniele
Published: July 2018

Alternative drug delivery approaches to treat cardiovascular diseases are currently under intense investigation. In this domain, the possibility to target the heart and tailor the amount of drug dose by using a combination of magnetic nanoparticles (NPs) and electromagnetic devices is a fascinating approach. Here, an electromagnetic device based on Helmholtz coils was generated for the application of low-frequency magnetic stimulations to manage drug release from biocompatible superparamagnetic Fe-hydroxyapatite NPs (FeHAs). Integrated with a fluidic circuit mimicking the flow of the cardiovascular environment, the device was efficient to trigger the release of a model drug (ibuprofen) from FeHAs as a function of the applied frequencies. Furthermore, the biological effects on the cardiac system of the identified electromagnetic exposure were assessed
in vitro
and
in vivo
by acute stimulation of isolated adult cardiomyocytes and in an animal model. The cardio-compatibility of FeHAs was also assessed
in vitro
and in an animal model. No alterations of cardiac electrophysiological properties were observed in both cases, providing the evidence that the combination of low-frequency magnetic stimulations and FeHAs might represent a promising strategy for controlled drug delivery to the failing heart.
Phenotypic plasticity in genitalia: baculum shape responds to sperm competition risk in house mice
Authors: André Gonçalo I. , Firman Renée C. , Simmons Leigh W.
Published: July 2018

Males are known to adjust their expenditure on testes growth and sperm production in response to sperm competition risk. Genital morphology can also contribute to competitive fertilization success but whether male genital morphology can respond plastically to the sperm competition environment has received little attention. Here, we exposed male house mice to two different sperm competition environments during their sexual development and quantified phenotypic plasticity in baculum morphology. The sperm competition environment generated plasticity in body growth. Males maturing under sperm competition risk were larger and heavier than males maturing under no sperm competition risk. We used a landmark-based geometric morphometric approach to measure baculum size and shape. Independent of variation in body size, males maintained under risk of sperm competition had a relatively thicker and more distally extended baculum bulb compared with males maintained under no sperm competition risk. Plasticity in baculum shape paralleled evolutionary responses to selection from sperm competition reported in previous studies of house mice. Our findings provide experimental evidence of socially mediated phenotypic plasticity in male genitalia.
Neurocomputational mechanisms underlying motivated seeing
Authors: Leong Yuan Chang , Hughes Brent L. , Wang Yiyu , Zaki Jamil
Published: July 2018

People tend to believe their perceptions are veridical representations of the world, but also commonly report perceiving what they want to see or hear, a phenomenon known as motivated perception. It remains unclear whether this phenomenon reflects an actual change in what people perceive or merely a bias in their responding. We manipulated the percept participants wanted to see as they performed a visual categorization task for reward. Even though the reward maximizing strategy was to perform the task accurately, this manipulation biased participants’ perceptual judgments. Motivation increased activity in voxels within visual cortex selective for the motivationally relevant category, indicating a bias in participants’ neural representation of the presented image. Using a drift diffusion model, we decomposed motivated seeing into response and perceptual components. Response bias was associated with anticipatory activity in the nucleus accumbens, whereas perceptual bias tracked category-selective neural activity. Our results highlight the role of the reward circuitry in biasing perceptual processes and provide a computational description of how the drive for reward can lead to inaccurate representations of the world.
Do we predict upcoming speech content in naturalistic environments?
Authors: Heyselaar Evelien , Peeters David , Hagoort Peter
Published: July 2018

The ability to predict upcoming actions is a characteristic hallmark of cognition and therefore not surprisingly a central topic in cognitive science. It remains unclear, however, whether the predictive behaviour commonly observed in strictly controlled lab environments generalizes to rich, everyday settings. In four virtual reality experiments, we tested whether a well-established marker of linguistic prediction (i.e. anticipatory eye movements as observed in the visual world paradigm) replicated when increasing the naturalness of the paradigm by means of i) immersing participants in naturalistic everyday scenes, ii) increasing the number of distractor objects present, iii) manipulating the location of referents in central versus peripheral vision, and iv) modifying the proportion of predictable noun-referents in the experiment. Robust anticipatory eye movements were observed, even in the presence of 10 objects (hereby testing working memory) and when only 25% of all sentences contained a visually present referent (hereby testing error-based learning). The anticipatory effect disappeared, however, when referents were placed in peripheral vision. Together, our findings suggest that working memory may play an important role in predictive processing in everyday communication, but only in contexts where upcoming referents have been explicitly attended to prior to encountering the spoken referential act. Methodologically, our study confirms that ecological validity and experimental control may go hand in hand in future studies of human predictive behaviour.
Multi-stage chemical heating for instrument-free biosensing
Authors: Goertz John P. , Colvin Kenya M. , Lippe Andrew B. , Daristotle John L. , Kofinas Peter , White Ian M.
Published: July 2018

Improving the portability of diagnostic medicine is crucial to alleviating global access-to-care deficiencies. This requires not only designing devices that are small and lightweight but also autonomous and independent of electricity. Here, we present a strategy for conducting automated multi-step diagnostic assays using chemically generated, passively regulated heat. Ligation and polymerization reagents for Rolling Circle Amplification of nucleic acids are separated by melt-able phase-change partitions, thus replacing precise manual reagent additions with automated partition melting. To actuate these barriers and individually initiate the various steps of the reaction, field ration heaters exothermically generate heat in a thermos while fatty acids embedded in a carbonaceous matrix passively buffer the temperature around their melting points. Achieving multi-stage temperature profiles extends the capability of instrument-free diagnostic devices and improves the portability of reaction automation systems built around phase-change partitions.
Structures and functions linked to genome-wide adaptation of human influenza A viruses
Authors: Klingen Thorsten R. , Loers Jens , Stanelle-Bertram Stephanie , Gabriel Gülsah , McHardy Alice C.
Published: July 2018

Human influenza A viruses elicit short-term respiratory infections with considerable mortality and morbidity. While H3N2 viruses circulate since almost 50 years, the recent introduction of pH1N1 viruses presents an excellent opportunity for a comparative analysis of the genome-wide evolutionary forces acting on both subtypes. Here, we inferred patches of sites relevant for adaptation, i.e. being under positive selection, on eleven viral protein structures, from all available data since 1968 and correlated these with known functional properties. Overall, pH1N1 had more patches than H3N2 viruses, especially in the viral polymerase complex, while antigenic evolution is more apparent for H3N2 viruses. In both subtypes, NS1 had the highest patch and patch site frequency, indicating that NS1-mediated viral attenuation of host inflammatory responses is a continuously intensifying process, elevated even in the longtime-circulating subtype H3N2. We confirmed the resistance-causing effects of two pH1N1 changes against oseltamivir in NA activity assays, demonstrating the value of the resource for discovering functionally relevant changes. Our results represent an atlas of protein regions and sites with links to host adaptation, antiviral drug resistances and immune evasion for both subtypes for further study.
University-industry linkage and technology transfer management
Authors: Puerta Sierra Lizbeth Magdalena , Jasso Villazul Sergio Javier
Published: July 2018

Purpose

The purpose of this paper is to contribute to the understanding of the variables that play a relevant role in the management of university-industry linkage and technology transfer in the context of a public university in Mexico.

Design/methodology/approach

This study is quantitative, and the method is based on an exploratory factor analysis (EFA), to identify the group of variables that relates to university-industry technology transfer, by applying a questionnaire to full time professors and researchers.

Findings

The EFA allowed for the analysis of the relationships within a group of variables, and found that the structure of the principal components presents a close connection to the literature review. The first, second and third factors, named institutional support in the linkage and technology transfer activities, research results management, and university linkage activities planning, respectively, explain the original problem in a greater percentage. Additionally, it is suggested to include other variables, to increase the explained variance percentage of the components.

Social implications

The study of university-industry linkage and technology transfer allows for improvement in the institutional management of these activities, their entrepreneurship, and consequently, their use by companies, government and society.

Originality/value

This study focuses on analyzing a group of variables in a questionnaire, in order to identify those that are related to the university-industry technology transfer management, in the context of a public university in Mexico.
Is your anti-money laundering program ready for FinCEN’s Customer Due Diligence Rule?
Authors: Kuhlman Rick , Ziesman Jeff , Browne Carolyn , Kempf Jason
Published: July 2018

Purpose

The purpose of this paper is to bring broker-dealers’ attention to the upcoming deadline for compliance with the Financial Crimes Enforcement Network’s (FinCEN’s) final rule on Customer Due Diligence Requirements for Financial Institutions (the CDD Rule).

Design/methodology/approach

The paper explores the origins of the anti-money laundering (AML) requirements and then explores the new CDD Rule requirements as outlined by FINRA Regulatory Notice 17-40.

Findings

Firms are likely largely already in compliance with most aspects of the CDD Rule.

Practical implications

Most firms likely will not need to make any significant changes to their AML polices. However, for some they will need to evaluate and modify their AML policies and procedures.

Originality/value

Practical guidance is obtained from experienced broker-dealer, investment adviser, securities litigation and compliance lawyers.
Corporate risk and the humpback of CEO narcissism
Authors: Aabo Tom , Eriksen Nicklas Bang
Published: July 2018

Purpose

The purpose of this paper is to investigate the association between CEO narcissism and corporate risk taking.

Design/methodology/approach

The authors provide a novel and unobtrusive measure of CEO narcissism based on LinkedIn profiling. The authors investigate the relationship between CEO narcissism and corporate risk taking (stock return volatility) for a sample of 475 US manufacturing firms in the period 2010-2014.

Findings

The authors find an inverse U-shape relationship between CEO narcissism and stock return volatility. The inverse U-shape relationship (the “humpback”) is caused by the paradoxical nature of the narcissistic personality in which the self-esteem is high but at the same time fragile with a combination of self-admiration and a constant need of having this positive self-view confirmed. The results are robust to alternative specifications of CEO narcissism and corporate risk taking. The results are economically meaningful. Thus, a moderate degree of CEO narcissism – as compared to a very low or a very high level of CEO narcissism – is associated with an increase in corporate risk taking of approximately 12 percent.

Originality/value

Previous literature provides multiple analyses on the association between managerial overconfidence and corporate decisions. As opposed to overconfidence, narcissism is a personality trait having both cognitive and behavioral dimensions. This paper provides a novel contribution to the growing literature on the association between managerial biases/traits and corporate decision-making.
Does E-government reduce corruption? Evidence from a heterogeneous panel data model
Authors: Basyal Devid Kumar , Poudyal Niraj , Seo Jin-Wan
Published: July 2018

Purpose

The purpose of this paper is to revisit the relationship between E-government and corruption using global panel data from 176 countries covering the period from 2003 to 2014, considering other potential determinants, such as economic prosperity (gross domestic product per capita [GDPPC]), price stability (inflation), good governance (political stability and government effectiveness) and press freedom (civil liberties and political rights) indicators. Hence, the main rationale of this study is to reexamine the conventional wisdom as to the relationship between E-government and corruption using panel data independent of any preexisting notions.

Design/methodology/approach

The probability reduction approach of empirical modeling proposed by Spanos (2009) is used to test the relationship. Secondary data were collected from the United Nations, the World Bank, Transparency International and Freedom House.

Findings

No statistical evidence was found for the idea that E-government has a positive impact on corruption reduction following a rigorous test of the proposition. However, strong evidence was found for the positive impact of a country’s government effectiveness, political stability and economic status. There also appears to be some evidence for the effect of GDPPC and civil liberties. There is no evidence to prove that inflation and political rights have any corruption reducing the effect.

Research limitations/implications

Case studies suggest that E-government is helpful for curbing corruption. This study includes and examines some of the potential and important variables associated with corruption. Further research is encouraged and it should include more variables, such as national culture, poverty, religion and geography. Regarding methodology, a more parsimonious model must be sought to take into account adequately the entire probabilistic structure of the data.

Practical implications

The findings of the study demonstrate that E-government is less significant for reducing corruption compared to other factors. Hence, policymakers should further focus on other potential areas such as socio-economic factors, good governance, culture and transparency to combat corruption in addition to improving digital government.

Originality/value

This research applies a new methodological approach to the study of the relationship between E-government and corruption.
Learning disability services: user views on transition planning
Authors: Hughes Jane , Davies Sue , Chester Helen , Clarkson Paul , Stewart Karen , Challis David
Published: July 2018

Purpose

The purpose of this paper is to explore the views of people with learning disabilities on issues associated with continuity of care in the transition from full-time education to adult care and support.

Design/methodology/approach

Data collection was undertaken with people with learning disabilities and staff in two advocacy organisations in one area of England in 2012. In total, 19 participants attended three focus groups. Analysis focussed on continuity of care and was guided by the framework approach to qualitative analysis.

Findings

Teachers, social workers in children’s services and youth workers were identified as making important contributions to the transition process. Information relating to learning and social development was identified as most important to inform transition planning with less priority accorded to health, communication, and self-care and independence. Participants appeared to value principles which underpin continuity of care.

Research limitations/implications

This study provides insights into attributes of continuity of care valued by people with a learning disability. Possibilities of translating these attributes into practice within localities are explored. Findings could be used to inform strategic planning locally to promote service integration thereby contributing to continuity of care within transition planning.

Originality/value

Continuity of care in the transition planning process is highlighted in policy guidance with recognition that both practice and procedures require improvement. This research explores areas for development from the perspective of people with learning disabilities.
Designing an integrated methodology for knowledge management strategic planning
Authors: Jami Pour Mona , Kouchak Zadeh Zahra , Ahmad Zadeh Nima
Published: July 2018

Purpose

Today, knowledge extraction and sharing in the organizations have been positioned as one of the most significant managers’ priorities. However, despite huge investments in knowledge management (KM) area, the failure rates of these projects are high. One of the main reasons for these failures is the lack of a roadmap and a methodology for KM strategic planning which assist organizations to develop an integrated and aligned plan with business strategies which eventually reduces project’s failure rate. Yet, despite the extension of KM domain, little studies were conducted on strategic topics and especially KM strategic planning. Therefore, the purpose of this study is to offer an integrated methodology for KM strategic planning.

Design/methodology/approach

This study introduces a methodology for KM strategic planning by using the mixed methods. At the first stage, along with a comprehensive literature review, some semi-structured interviews with KM experts were conducted and the obtained data have been analyzed using the thematic analysis. After that, a survey is conducted to validate the extracted dimensions and activities of the proposed methodology via experts’ viewpoints.

Findings

The results of this study indicate that the main phases of the KM strategic planning methodology are as follows: strategic review, strategic orientation, implementation and evaluation. In the proposed methodology, main phases along with their related activities and their implementation order are presented as a roadmap for applying KM initiatives strategically.

Research implications/implications

In KM planning strategically, all phases of strategic management along with their related activities must be considered simultaneously. The proposed methodology can assist KM policy-makers to identify and guide KM initiatives as well as to perform appropriate actions for progress. This study tries to develop a coherent roadmap for knowledge initiatives by a strategic approach.

Originality/value

One of the major reasons for the failure of many KM projects is the absence of a strategic planning methodology. A review of the KM literature shows that there are few studies, which adequately integrate strategic KM planning process, yet most researchers view KM planning as the most difficult and complex part of KM implementation process. This study aims to introduce a novel methodology to KM strategic planning comprehensively. The main contribution of this study is to develop a new integrated methodology for strategic planning that considers the strategy formulation aspects along with strategy execution and control aspects, synchronously.
Increased risk of incident psoriasis in end‐stage renal disease patients on chronic hemodialysis: A nationwide population‐based cohort study
Authors: Wang Chia‐Chen , Tang Chao‐Hsiun , Huang Kuan‐Chih , Huang Siao‐Yuan , Sue Yuh‐Mou
Published: July 2018

Patients with end‐stage renal disease (ESRD) on chronic hemodialysis (HD) experience chronic inflammation and immune dysregulation; whether these affect the development of chronic inflammatory disease such as psoriasis is unknown. We aimed to investigate the impact of ESRD on the development of psoriasis. We performed a retrospective cohort study using records between 1999 and 2013 from Taiwan's National Health Insurance Research Database. Among 74 916 patients with ESRD on chronic HD and the control group comprising 74 916 sex and age group‐matched patients, 165 and 81 incident psoriasis developed after a mean follow up of 2.4 and 2.9 years, respectively. The incidence rates of psoriasis in HD patients and the control group were 91.7 and 37.1 per 100 000 person‐years, respectively (difference between groups, P < 0.001). HD patients had a shorter time to psoriasis diagnosis than the control group (P < 0.05). Cox proportional hazard adjustment showed the hazard ratio (HR) for psoriasis in HD patients as 2.09 (95% confidence interval [CI], 1.49–2.94; P < 0.001) than that of the control group. Younger HD patients had relatively higher risk of psoriatic development (age <60 years; adjusted HR, 3.68; 95% CI, 1.93–7.02; P < 0.001). The relative risk of psoriatic arthritis was not increased in HD patients compared with the control group. In conclusion, patients with ESRD on chronic HD had a greater risk of developing psoriasis. Physicians should be aware of the predisposition to psoriasis in patients with ESRD on chronic HD.
Quantifying the impact of pesticides on learning and memory in bees
Authors: Siviter Harry , Koricheva Julia , Brown Mark J. F. , Leadbeater Ellouise
Published: July 2018

Most insecticides are insect neurotoxins. Evidence is emerging that sublethal doses of these neurotoxins are affecting the learning and memory of both wild and managed bee colonies, exacerbating the negative effects of pesticide exposure and reducing individual foraging efficiency.

Variation in methodologies and interpretation of results across studies has precluded the quantitative evaluation of these impacts that is needed to make recommendations for policy change. It is not clear whether robust effects occur under acute exposure regimes (often argued to be more field‐realistic than the chronic regimes upon which many studies are based), for field‐realistic dosages, and for pesticides other than neonicotinoids.

Here we use meta‐analysis to examine the impact of pesticides on bee performance in proboscis extension‐based learning assays, the paradigm most commonly used to assess learning and memory in bees. We draw together 104 (learning) and 167 (memory) estimated effect sizes across a diverse range of studies.

We detected significant negative effects of pesticides on learning and memory (i) at field realistic dosages, (ii) under both chronic and acute application, and (iii) for both neonicotinoid and non‐neonicotinoid pesticides groups.

We also expose key gaps in the literature that include a critical lack of studies on non‐Apis bees, on larval exposure (potentially one of the major exposure routes), and on performance in alternative learning paradigms.

Policy implications. Procedures for the registration of new pesticides within EU member states now typically require assessment of risks to pollinators if potential target crops are attractive to bees. However, our results provide robust quantitative evidence for subtle, sublethal effects, the consequences of which are unlikely to be detected within small‐scale prelicensing laboratory or field trials, but can be critical when pesticides are used at a landscape scale. Our findings highlight the need for long‐term postlicensing environmental safety monitoring as a requirement within licensing policy for plant protection products.
Innovative Financing: An Empirical Study on Public–Private Partnership Securitisation in China
Authors: Yu Po shan , Chen Zuo zhang , Sun Jin
Published: July 2018

Many localities in China are faced with an outdated, segmented infrastructure system and a shrinking budget. However, the state‐led promotion of Public–Private Partnerships (PPPs) in China is providing an innovative solution. This paper looks at financing innovations in China such as industrial funds and asset‐backed securitisation for PPP projects. Particularly, this paper empirically studies the characteristics of project revenue bonds and PPP asset‐backed securities (PPP–ABS) in China. The study finds that the majority of social investors remain state‐owned enterprises (SOEs) and returns on whole business securitisation (WBS) of projects could vary with the volume issued and the credit of the company. Securitisation not only solves the problem of limited source of financing, but also improves the efficiency of management. While securitisation of PPP projects can succeed in tapping social capital to invest infrastructures, the banking system should handle with caution the credit risk and default risk caused by rising leverage of PPP special purpose vehicles (SPVs).
Convective Dialysis Reduces Mortality Risk: Results From a Large Observational, Population‐Based Analysis
Authors: Cernaro Valeria , Tripepi Giovanni , Visconti Luca , Lacquaniti Antonio , Montalto Gaetano , Romeo Adolfo , Cimadoro Domenica , Costantino Giuseppe , Torre Francesco , Santoro Domenico , Buemi Michele ,   on behalf of the Workgroup of the Sicilian Registry of Nephrology, Dialysis and Transplantation
Published: July 2018

Abstracts

According to many studies, extracorporeal dialysis with convective methods is associated with better clinical outcomes and a survival benefit compared to diffusive techniques. However, there is no full agreement on the actual superiority of this kind of renal replacement therapy on hard end‐points such as mortality. We performed a retrospective epidemiological cohort study to provide “real‐world” evidence on the impact of convective and non‐convective dialysis techniques on all‐cause and cardiac mortality and biochemical outcomes among dialysis patients in Sicily, the southernmost region of Italy. Data of all incident adult patients (N = 6529) who have started chronic extracorporeal dialysis over the period 2009–2015 were retrieved from the Sicilian Registry of Nephrology, Dialysis and Transplantation. There were 1558 patients receiving convective techniques (23.86%). Overall mortality rate was 45.21% with a significant difference between convective (31.39%) and non‐convective (49.55%) groups (P < 0.0001). After adjustment for potential confounders in multiple Cox regression models of increasing complexity, the mortality risk remained significantly lower for patients treated with convective methods (HR, 0.581; 95%CI, 0.525 to 0.643; P < 0.0001). Moreover, the convective group had a better blood chemistry profile, improved dialysis efficacy, and reduced mortality rate from cardiac diseases compared to the non‐convective group. As a sensitivity analysis, patients were categorized according to propensity score quartiles and the hazard ratio for both all‐cause and cardiac mortality was significantly lower for the convective group in each quartile. In conclusion, despite the observational and retrospective design, the results of the present study further support the use of convective therapies for the treatment of end‐stage renal disease.
Plasma proteomic signature of age in healthy humans
Authors: Tanaka Toshiko , Biancotto Angelique , Moaddel Ruin , Moore Ann Zenobia , Gonzalez‐Freire Marta , Aon Miguel A. , Candia Julián , Zhang Pingbo , Cheung Foo , Fantoni Giovanna ,   CHI consortium, Semba Richard D. , Ferrucci Luigi
Published: July 2018

To characterize the proteomic signature of chronological age, 1,301 proteins were measured in plasma using the SOMAscan assay (SomaLogic, Boulder, CO, USA) in a population of 240 healthy men and women, 22–93 years old, who were disease‐ and treatment‐free and had no physical and cognitive impairment. Using a p ≤ 3.83 × 10−5 significance threshold, 197 proteins were positively associated, and 20 proteins were negatively associated with age. Growth differentiation factor 15 (GDF15) had the strongest, positive association with age (GDF15; 0.018 ± 0.001, p = 7.49 × 10−56). In our sample, GDF15 was not associated with other cardiovascular risk factors such as cholesterol or inflammatory markers. The functional pathways enriched in the 217 age‐associated proteins included blood coagulation, chemokine and inflammatory pathways, axon guidance, peptidase activity, and apoptosis. Using elastic net regression models, we created a proteomic signature of age based on relative concentrations of 76 proteins that highly correlated with chronological age (r = 0.94). The generalizability of our findings needs replication in an independent cohort.
Analysis of Multiple Survival Events in Generalized Case-Cohort Designs
Authors: Kim Soyoung , Zeng Donglin , Cai Jianwen
Published: July 2018

Generalized case-cohort design has been proposed to assess the effects of exposures on survival outcomes when measuring exposures is expensive and events are not rare in the cohort. In such design, expensive exposure information is collected from both a (stratified) randomly selected subcohort and a subset of individuals with events. In this article, we consider extension of such design to study multiple types of survival events by selecting a proportion of cases for each type of event. We propose a general weighting scheme to analyze data. Furthermore, we examine the optimal choice of weights and show that this optimal weighting yields much improved efficiency gain both asymptotically and in simulation studies. Finally, we apply our proposed methods to data from the Atherosclerosis Risk in Communities study.
α‐Blockers for uncomplicated ureteric stones: a clinical practice guideline
Authors: Vermandere Mieke , Kuijpers Ton , Burgers Jako S. , Kunnamo Ilkka , van Lieshout Jan , Wallace Emma , Vlayen Joan , Schoenfeld Elizabeth , Siemieniuk Reed A. , Trevena Lyndal , Zhu Xiaoye , Verermen Francis , Neuschwander Ben , Dahm Philipp H. , Tikkinen Kari A.O. , Aubrey‐Bassler Kris , Vernooij Robin W.M. , Aertgeerts Bert , Bekkering Gertrude E.
Published: July 2018

Objective

To develop an evidence‐based recommendation concerning the use of α‐blockers for uncomplicated ureteric stones based on an up‐to‐date Cochrane review, as the role of medical expulsive therapy for uncomplicated ureteric stones remains controversial in the light of new contradictory trial evidence.

Methods

We applied the Rapid Recommendations approach to guideline development, which represents an innovative approach by an international collaborative network of clinicians, researchers, methodologists and patient representatives seeking to rapidly respond to new, potentially practice‐changing evidence with recommendations developed according to standards for trustworthy guidelines.

Results

The panel suggests the use of α‐blockers in addition to standard care over standard care alone in patients with uncomplicated ureteric stones (weak recommendation based on low‐quality evidence). The panel judged that the net benefit of α‐blockers was small and that there was considerable uncertainty about patients’ values and preferences. This means that the panel expects that most patients would choose treatment with α‐blockers but that a substantial proportion would not. This recommendation applies to both patients in whom the presence of ureteric stones is confirmed by imaging, as well as patients in whom the diagnosis is made based on clinical grounds only.

Conclusion

The Rapid Recommendations panel suggests the use of α‐blockers for patients with ureteric stones. Shared decision‐making is emphasised in making the final choice between the treatment options.
Agency and observation in knowledge of one's own thinking
Authors: Doyle Casey
Published: July 2018

This essay addresses the question how we know our conscious thinking. Conscious thinking typically takes the form of a series of discrete episodes that constitute a complex cognitive activity. We must distinguish the discrete episodes of thinking in which a particular content is represented in phenomenal consciousness and is present “before the mind's eye” from the extended activities of which these episodes form a part. The extended activities are themselves contentful and we have first‐person access to them. But because their content is not represented in phenomenal consciousness, this access cannot be broadly observational. Instead, I argue, it is agential. Furthermore, that extended activities are intentional explains the possibility of a nonobservational form of introspective access to the discrete episodes in consciousness.
Variability of in vitro ruminal fermentation and nutritional value of cell‐disrupted and nondisrupted microalgae for ruminants
Authors: Wild Katharina J. , Steingaß Herbert , Rodehutscord Markus
Published: July 2018

The objective of this study was to investigate ruminal fermentation and the nutritional value of different microalgae products (MAP) for ruminants, including inter‐ and intra‐genera variability. Furthermore, the effect of mechanical cell disruption was also evaluated. Cell‐disrupted and nondisrupted MAP of four genera were investigated using the Hohenheim Gas Test. The investigations included characterization of gas production (GP), production of volatile fatty acids (VFA) and methane, organic matter digestibility, and energetic value as well as utilizable crude protein at the duodenum and ruminally undegradable crude protein (RUP). Furthermore, a three‐step enzymatic in vitro system was used to estimate intestinal digestibility of RUP (IDP). Ruminal fermentation was low for all investigated microalgae genera, as indicated by overall low GP, low production of VFA, and low ruminal protein degradation. Nevertheless, all microalgae genera were characterized by high RUP concentrations (236–407 g/kg dry matter; passage rate = 8% hr−1), indicating that microalgae might be a promising protein source for high‐performing ruminants. Low IDP (26%–49% of RUP) considerably contradicted this potential. Mechanical cell disruption in general enhanced the extent of ruminal fermentation of MAP but, as RUP was decreased and IDP was hardly affected, mechanical cell disruption appears not to be necessary when microalgae are intended for application as a protein source for ruminants. Because of the high variability in the characteristics of the nutritional value, general means are inappropriate to characterize the nutritional value of MAP. In conclusion, suitability of microalgae as a protein source for ruminants might be limited because of low IDP, although further studies are necessary to prove these findings in vivo.
Oral health status of long‐term care residents in Canada: Results of a national cross‐sectional study
Authors: Yoon Minn N. , Ickert Carla , Slaughter Susan E. , Lengyel Christina , Carrier Natalie , Keller Heather
Published: July 2018

Objective

To describe the oral health and oral prosthetic status of long‐term care residents in four Canadian provinces.

Background

Oral health can have significant impact on the health and quality of life of older adults. Seniors in long‐term care are highly dependent on care staff for basic activities of daily living and are at risk for poor oral health.

Materials and methods

Five hundred and fifty‐nine randomly selected residents were examined from thirty‐two long‐term care homes in Alberta, Manitoba, Ontario and New Brunswick, Canada. Four experienced registered dental hygienists, one in each province, completed a standardised oral health examination with each participant, examining lip health, breath odour, saliva appearance, natural teeth count, gingival inflammation, tooth and jaw pain, denture status, mucosal status and oral health abnormalities.

Results

Of the examined residents, 57.6% were dentate, with an average of 16.4 (SD = 8.0) teeth. Most dentate residents had moderate or severe inflammation on at least one tooth (79.6%). Sixty per cent of residents wore dentures, and 43.2% of edentulous residents had poor hygiene of their dentures. Nine per cent of residents required urgent dental treatment for oral health problems such as broken teeth, infection, severe decay and ulcers.

Conclusion

This study provides an estimate of the prevalence of oral health problems in residents living in long‐term care homes across Canada and indicates that improvement in oral health care is needed. Future work on development strategies aimed at optimising oral health for long‐term care residents is required.
Femininity, Shame, and Redemption
Authors: Mann Bonnie
Published: July 2018

At a time when some modicum of formal gender equality has been won in many late‐capitalist societies of the West, what explains the persistence of practices that extract labor and value from women and girls while granting a “surplus” of value to men and boys? Gendered shame is a central mechanism of the apparatus that secures the continued subordination of women across a number of class and race contexts in the mediatized, late‐capitalist West. Focusing on the story of Amanda Todd, two forms of shame are distinguished. “Ubiquitous shame” is that shame that accrues to feminine existence as such, and is structured in relation to a futural temporality of redemption. “Unbounded shame” is a brute form of value‐extraction that has found its ecological niche in social media—and destroys all futural aspirations.
Complex Perovskite system Dy0.5‐xBaxSr0.5Co0.80Fe0.20O3‐δ: As cathode for IT‐SOFCs
Authors: Kautkar Pranay R. , Ojha Prasanta , Acharya Smita A.
Published: July 2018

The present work is intended to study mixed conductivity of complex perovskite oxide of chemical formula Dy0.5‐xBaxSr0.5Co0.8Fe0.2O3‐δ (DBSCF‐x) (0 ≤ x ≤ 0.07) to check its suitability as cathode for intermediate temperature solid oxide fuel cell (IT‐SOFCs). Low‐temperature sol‐gel combustion route has been used to prepare DBSCF‐x systems. Structures are confirmed by X‐ray diffraction (XRD), exhibit single‐phase perovskite structures with orthorhombic symmetry (space group Pbnm) for all compositions. Thermogravimetry (TG) results indicate lattice oxygen loss in Ba‐doped DBSCF system by heat treatment in temperature interval 50‐850°C, which is enhanced in N2 atmosphere then air; in contrast to that lattice oxygen, gain is observed for DBSCF‐0 system. Temperature profile of DC conductivity exhibits metallic behavior of DBSCF‐x system; however, the DBSCF‐0 system shows semiconductor‐to‐metal transition at temperature around 450°C. DBSCF‐0.03 system displays maximum electronic conductivity. Electrochemical performance of electrodes is studied in three‐layer symmetrical cell configuration DBSCF‐x/Ce0.85Sm0.15O2‐δ/DBSCF‐x by complex impedance spectroscopy (CIS). Impedance diagram reveals the presence of three processes mainly associated with (a) diffusion of oxide ions/oxygen intermediates through electrode/electrolyte interface, (b) atomic oxygen diffusion within the electrode, and (c) oxide ion diffusion in the crystal lattice. ASR of the DBSCF‐0.05 system is found 2.21 ohm cm2 at 700°C, which is lowest amongst all studied compositions. Results show that it is possible to modify the electrochemical properties of the DBSCF‐x system by changing the composition, but much more work even including optimization of layer thickness and microstructure will be needed to reduce the ASR to the level of the state‐of‐art‐electrodes and thereby better utilize the potential of the DBSCF‐x system.
International normalised ratio monitoring in the community populations of the Auckland and Northland regions of New Zealand: time in therapeutic range and frequency of testing
Authors: McAuliffe Gary N. , De Silva Fransisca , Upton Arlo , Chan George
Published: July 2018

Background

Warfarin remains a commonly used anticoagulant for the treatment and prevention of thrombosis. To balance the risks and benefits of therapy, monitoring of the international normalised ratio (INR) is necessary. Patients derive most benefit from warfarin when they spend ≥65% of time in the therapeutic range (INR 2–3). We performed an analysis of INR monitoring for the Auckland and Northland regions of New Zealand in order to estimate anticoagulation control and appropriateness of testing at the population level.

Methods

INR test results and patient demographics (age and sex) were extracted from the laboratory information system of Labtests and Northland Pathology Laboratories for the period of 1 January 2016 to 27 July 2016.

Results

We included 126 184 INR results from 10 922 patients. The median age of patients represented was 74 years and 57% were male. The overall mean time in therapeutic range was 63%, with a mean interval between INR tests of 14 days.

Conclusion

Our results indicate that anticoagulant control in our communities could be improved, and that inappropriately frequent INR testing should be redressed. Appropriate interventions could lead to net clinical benefits and reduce resource misallocation.
Factors Associated with Strategic Corporate Decisions in Family Firms: Evidence from Sweden
Authors: Sekerci Naciye
Published: July 2018

By using detailed ownership data from Sweden, we investigate the factors associated with corporate investment decisions in family firms compared to nonfamily firms. We find that the family owner's portfolio diversification level is to some extent, and the use of dual‐class share mechanism by the family owner is strongly, associated with reduced corporate investment. We further demonstrate where entrenched family owners, holding dual‐class shares, canalize their firm free cash flows to: they prefer to distribute it as dividends with catering motivations. They opt to pay higher dividends over increasing corporate investment, which indicates some evidence of private benefits of control.