bluuebunny/crossref_metadata_2025 huggingface dataset:
Moderated mediation model of relationship between perceived organizational justice and counterproductive work behavior
Authors: Wu Mingzheng , Sun Xiaoling , Zhang Delin , Wang Ci
Published: December 2016

Purpose

This study aimed to develop a moderated mediation model to explain the relationship between perceived organizational justice and the counterproductive work behavior (CWB) of Chinese public servants. In this model, the authors assumed that job burnout mediates the relationship between perceived organizational justice and CWB and that moral identity moderates the relationship between job burnout and CWB.

Design/methodology/approach

A total of 210 public servants in China participated in this study, and their characteristics were measured by self-report tools. Hierarchical multiple regression analyses were used to test the moderated mediation model.

Findings

Analysis of the data demonstrated that perceived organizational justice, job burnout and moral identity influenced CWB. Moral identity moderated the relationship between job burnout and CWB, such that individuals with low moral identity are more likely to engage in CWB. Moreover, job burnout mediated the effect of perceived organizational justice on CWB, and the mediating effect of job burnout was moderated by moral identity. The indirect effect of perceived organizational justice on CWB through job burnout was significant among individuals with low moral identity but not among individuals with high moral identity.

Research limitations/implications

The findings highlight the self-regulatory function of moral identity in preventing CWB.

Practical implications

The study offers several significant suggestions to reduce CWB in Chinese public sector administration, such as by improving organizational justice perception, recruiting and selecting individuals with reference to their moral identity and monitoring employees’ job burnout regularly.

Originality/value

The authors developed and verified a moderated mediated model on the relationship between perceived organizational justice and CWB. The study revealed that job burnout has a mediating effect on the perceived organizational justice–CWB relation, providing important insights into the processes through which perceived organizational justice affects CWB.
How do Indian mothers use feeding practices with children?
Authors: Vohra Jyoti , Soni Pavleen
Published: December 2016

Purpose

The undesirable effects of TV advertisements and general parenting responsibility propel mothers to monitor and control the eating habits of children through meal time actions and feeding practices. The purpose of this paper is to identify feeding practices used by Indian mothers through the Comprehensive Feeding Practices Questionnaire (CFPQ) developed by Musher-Eizenman and Holub (2007) and to investigate differences in the use of feeding practices across demographic variables.

Design/methodology/approach

Using a cross-sectional design, a structured and pre-tested questionnaire was used to collect data from 473 mothers of children aged four to 11 years from Punjab (India). Data were analysed using exploratory factor analysis, confirmatory factor analysis (CFA) and ANOVA.

Findings

The present study confirms the validity and reliability of the nine-factor model through CFA with 28 items in the Indian context than original CFPQ. Further, significant differences exist in the responses of mothers for feeding practices followed with children across age and gender of child, mother’s education status and monthly family income.

Practical implications

Parents may understand the nature of feeding practices to mediate unhealthy food consumption habits of children. The government should formulate codes or regulations to sufficiently monitor food marketing activities directed at children. The food marketing companies should also act responsibly to protect well-being of children.

Originality/value

This piece of research is important as no such study (to the best of researchers’ knowledge) has already been conducted in India even though dietary patterns of children are transforming tremendously.
Small‐scale and regional spatial dynamics of an annual plant with contrasting sexual systems
Authors: Dorken Marcel E. , Freckleton Robert P. , Pannell John R.
Published: December 2016

Plant demography is known to depend on both spatial dynamics and life history, but how these two factors interact is poorly understood. We conducted a longitudinal study of the wind‐pollinated annual plant Mercurialis annua that varies geographically in its sexual system to investigate this interaction.

Metapopulation demographic models predict that regular population turnover should be a more common feature of monomorphic than dimorphic populations because males and females cannot found new populations by selfing but hermaphrodites can. We tested the prediction that rates of population turnover would be higher in monomorphic compared to dimorphic regions.

We surveyed 356 populations of M. annua along five regional transects in Morocco and the Iberian Peninsula over a 3‐year period to examine their demography and persistence. Each transect crossed a transition in the sexual system, from a monomorphic region where almost all populations were hermaphroditic to a dimorphic one in which most populations had separate sexes (males with females or hermaphrodites).

As predicted, rates of local apparent extinctions (i.e., the disappearance of adult plants) were nearly 50% higher in monomorphic compared to dimorphic regions. Local extinctions appeared to be driven by changes in vegetation cover, with extinctions tending to occur in sites in which perennial cover also declined. This suggests that disturbance is a primary agent of local extinctions.

We further examined the influence of regional dynamics on local demographic properties by investigating patterns of spatial autocorrelation in population density across years. We found positive spatial autocorrelations in plant densities within regions for both sexual systems. However, these positive autocorrelations extended over shorter distances in monomorphic regions, perhaps as a result of greater population flux in these regions.

Synthesis. Our study shows that population dynamics may be influenced by processes acting at a range of spatial scales: within patches, across patches within sites, and across sites within regions, as well as by life‐history variation. In Mercurialis annua, regional variation in apparent extinction rates is affected by life history and implicated in regulating the geographical distribution of populations with different sexual systems.
Mapping the illness trajectories of insomnia: a biographical disruption?
Authors: Cheung Janet M.Y. , Saini Bandana , Bartlett Delwyn J. , Laba Tracey‐Lea , Mason Paul H.
Published: December 2016

The insomnia illness experience can be conceptualised as a form of biographical disruption. Using a critical interpretive phenomenological lens 51 in‐depth semi‐structured interviews were conducted with patients from specialist sleep and psychology clinics (n = 22) and the general community (n = 29). Patients’ narratives revealed key phases of their illness trajectories as they recognise, rethink and respond to insomnia. Their biographical events served as reference points for both patient groups to make sense of their illness experiences as they transitioned from a perceived state of sleeplessness to clinical insomnia. The innate biological process of sleep at night and the sleep‐dependent daytime psychosocial function exerted a negative bi‐directional effect, creating a continuous circuit of disruption. Coping mechanisms were inspired by the participants’ immediate social environment and centred on sociocultural motifs of relaxation and alertness to break the ‘circuit’. Access to specialist clinic services appeared to be contingent on the richness of resources in one's social network and surrounding environment rather than the clinical severity of the disease alone. Treatment that can simultaneously target the night time and daytime consequences of insomnia resonates closely with participants’ depiction of insomnia as both a physiological and a psychosocial phenomenon.
Reasons for Lack of Consensus in Forensic Pathologist Interpretation of Photographs of Patterns of Injury of the Skin,
Authors: Oliver William R.
Published: December 2016

In a previous study, a survey‐based analysis of pathologist diagnoses of patterned injury in which participants were asked makes diagnoses from photographs in the absence of history or context. The level of consensus was low. A follow‐up survey was created to ask those who responded to the first survey why they answered as they did or why they were unsure of their answers. The most common reason for lack of consensus was that the lesion was nonspecific. Responses invoking ambiguity were more common than those that indicated a confident difference in diagnosis. There were differences between demographic groups, with age and experience being most prominent. These findings suggest that differences in image interpretation do not generally reflect firm differences in diagnosis as much as differing ways of dealing with ambiguity in the absence of history and context. A third survey will study the effect of the addition of contextual information.
Effect of Predialysis Recombinant Human Erythropoietin on Early Survival After Hemodialysis Initiation in Patients With Chronic Kidney Disease: Co‐JET Study
Authors: Watanabe Yuzo , Akizawa Tadao , Saito Akira , Gejyo Fumitake , Suzuki Masashi , Nishizawa Yoshiki , Tomino Yasuhiko , Tsubakihara Yoshiharu , Akiba Takashi , Hirakata Hideki , Kawanishi Hideki , Bessho Masami , Udagawa Yukio , Aoki Kotonari , Uemura Yukari , Ohashi Yasuo ,   the Co‐JET Study Group
Published: December 2016

Progression of anemia in patients with chronic kidney disease (CKD) is associated with an increased risk of death and hospitalization. It is not sufficiently clear whether treating renal anemia with recombinant human erythropoietin (rHuEPO) has a beneficial effect on early survival after hemodialysis (HD) initiation in patients with CKD. The study was an open‐label multicenter retrospective cohort study to evaluate the relationship between rHuEPO treatment and early survival after HD initiation in patients with CKD. Predialysis patients with CKD were divided into two groups: an rHuEPO‐treated group (rHuEPO group) and a non‐treatment group. The primary endpoint was all‐cause mortality in the year after HD initiation. A total of 3261 patients were enrolled (2275 in the rHuEPO group and 986 in the non‐treatment group). One‐year survival was 95.36% in the rHuEPO group and 90.36% in the non‐treatment group. The survival rate was significantly higher in the rHuEPO group (P < 0.0001). The results of multivariate analysis confirmed that predialysis treatment with rHuEPO is a predictor for reduced mortality risk (hazard ratio = 0.61, 95% confidence interval: 0.42–0.87, P = 0.006). Risk for the composite event of death/hospitalization was also lower in the rHuEPO group (hazard ratio = 0.88, 95% confidence interval: 0.78–0.98, P = 0.026). The results of this study suggest that treatment with rHuEPO can decrease early mortality risk after initiation of HD in patients with CKD. A prospective study is needed to further investigate early survival after HD initiation.
Comparison of three scoring systems in predicting clinical outcomes in patients with acute upper gastrointestinal bleeding: a prospective observational study
Authors: Zhong Min , Chen Wan Jun , Lu Xiao Ye , Qian Jie , Zhu Chang Qing
Published: December 2016

Objective

To compare the performances of the Glasgow‐Blatchford score (GBS), modified GBS (mGBS) and AIMS65 in predicting clinical outcomes in patients with acute upper gastrointestinal bleeding (AUGIB).

Methods

This study enrolled 320 consecutive patients with AUGIB. Patients at high and low risks of developing adverse clinical outcomes (rebleeding, the need of clinical intervention and death) were categorized according to the GBS, mGBS and AIMS65 scoring systems. The outcome of the patients were the occurrences of adverse clinical outcomes. The areas under the receiver operating characteristics curve (AUROC) of three scoring systems were compared.

Results

Irrespective of the systems used, the high‐risk groups showed higher rates of rebleeding, intervention and death compared with the low‐risk groups (P < 0.05). For the prediction of rebleeding, AIMS65 (AUROC 0.735, 95% CI 0.667–0.802) performed significantly better than GBS (AUROC 0.672, 95% CI 0.597–0.747; P < 0.01) and mGBS (AUROC 0.677, 95% CI 0.602–0.753; P < 0.01). For the prediction of interventions, there was no significant difference among the three systems (GBS: AUROC 0.769, 95% CI 0.668–0.870; mGBS: AUROC 0.745, 95% CI 0.643–0.847; AIMS65: AUROC 0.746, 95% CI 0.640–0.851). For the prediction of in‐hospital mortality, there was no significant difference among the three systems (GBS: AUROC 0.796, 95% CI 0.694–0.898; mGBS: AUROC 0.803, 95% CI 0.703–0.904; AIMS65: AUROC 0.786, 95% CI 0.670–0.903).

Conclusions

The three scoring systems are reliable and accurate in predicting the rates of rebleeding, surgery and mortality in AUGIB. However, AIMS65 outperforms GBS and mGBS in predicting rebleeding.
Systematic review with meta‐analysis: recurrence of Crohn's disease after total colectomy with permanent ileostomy
Authors: Fumery M. , Dulai P. S. , Meirick P. , Farrell A. M. , Ramamoorthy S. , Sandborn W. J. , Singh S.
Published: December 2016

Background

Subtotal or total colectomy or proctocolectomy with permanent ileostomy (TC‐PI) may be a treatment option for medically refractory colonic Crohn's disease (CD).

Aim

To perform a systematic review and meta‐analysis to evaluate the rate, risk factors and outcomes of CD recurrence after TC‐PI.

Methods

In a systematic review ending 31 March 2016, we identified 18 cohort studies (1438 adults) who underwent TC‐PI for colonic CD (median follow‐up, 7.4 years; interquartile range, 5.3–9.0). We estimated pooled rates [with 95% confidence interval (CI)] of clinical and surgical recurrence, and risk factors for disease recurrence.

Results

On meta‐analysis, the risk of clinical recurrence after TC‐PI was 28.0% (95% CI, 21.7–35.3; 14 studies, 260/1004 patients), with a 5 and 10‐year median cumulative rate of 23.5% (range, 7–35) and 40% (range, 11–60) respectively. The risk of surgical recurrence was 16.0% (95% CI, 11.1–22.7; 10 studies; 183/1092 patients), with a 5 and 10‐year median cumulative rate of 10% (range, 3–29) and 18.5% (range, 14–34) respectively. The risk of clinical and surgical recurrence in patients without ileal disease at baseline was 11.5% (95% CI, 7.7–16.8) and 10.4% (95% CI, 4.5–22.5) respectively. History of ileal disease was associated with 3.2 times higher risk of disease recurrence (RR, 3.2; 95% CI, 1.8–5.6). Other inconsistent risk factors for disease recurrence were penetrating disease and young age at disease onset.

Conclusions

Small bowel clinical recurrence occurs in about 28% of patients after total colectomy with permanent ileostomy for colonic Crohn's disease. Disease recurrence risk is 3.2 times higher in patients with history of ileal disease, and continued medical therapy may be advisable in this population. In patients without ileal inflammation at surgery, continued endoscopic surveillance may identify asymptomatic disease recurrence to guide therapy.
‘It was always the plan’: international study as ‘learning to migrate’
Authors: Findlay Allan , Prazeres Laura , McCollum David , Packwood Helen
Published: December 2016

International student mobility has mainly been theorised in terms of cultural capital accumulation and its prospective benefits on returning home following graduation. Yet, despite a growing body of work in this area, most research on post‐study mobility fails to recognise that the social forces that generate international student mobility also contribute to lifetime mobility plans. Moreover, these forces produce at least four types of post‐study destination, of which returning ‘home’ is only one option. Our findings challenge the idea that a circular trajectory is necessarily the ‘desired’ norm. In line with wider migration theory, we suggest that return may even be seen as failure. Instead we advance the idea that cultural and social capital acquired through international studies is cultivated for onward mobility and may be specifically channelled towards goals such as an international career. We contribute a geographically nuanced conceptual frame for understanding the relation between international student mobility and lifetime mobility aspirations. By building on studies that highlight the role of family and social networks in international student mobility, we illustrate how influential familial and social institutions – both in the place of origin and newly encountered abroad – underpin and complicate students’ motivations, mobility aspirations and life planning pre‐ and post‐study. We argue for a fluidity of life plans and conclude by discussing how geographies of origin matter within students’ lifetime mobility plans.
Glucagon‐like peptide‐1 receptor expression on human eosinophils and its regulation of eosinophil activation
Authors: Mitchell P. D. , Salter B. M. , Oliveria J. P. , El‐Gammal A. , Tworek D. , Smith S. G. , Sehmi R. , Gauvreau G. M. , Butler M. , O'Byrne P. M.
Published: December 2016

Background

Glucagon‐like peptide‐1 (GLP‐1) and its receptor are part of the incretin family of hormones that regulate glucose metabolism. GLP‐1 also has immune modulatory roles.

Objectives

To measure the expression of the GLP‐1 receptor (GLP‐1R) on eosinophils and neutrophils in normal and asthmatic subjects and evaluate effects of a GLP‐1 analog on eosinophil function.

Methods

Peripheral blood samples were taken from 10 normal and 10 allergic asthmatic subjects. GLP‐1R expression was measured on eosinophils and neutrophils. Subsequently, the asthmatic subjects underwent allergen and diluent inhalation challenges, and GLP‐1R expression was measured. Purified eosinophils, collected from mild asthmatic subjects, were stimulated with lipopolysaccharide (LPS) and a GLP‐1 analog to evaluate eosinophil cell activation markers CD11b and CD69 and cytokine (IL‐4, IL‐5, IL‐8 and IL‐13) production.

Results

Glucagon‐like peptide‐1 receptor is expressed on human eosinophils and neutrophils. Eosinophil, but not neutrophil, expression of GLP‐1R is significantly higher in normal controls compared to allergic asthmatics. The expression of GLP‐1R did not change on either eosinophils or neutrophils following allergen challenge. A GLP‐1 analog significantly decreased the expression of eosinophil‐surface activation markers following LPS stimulation and decreased eosinophil production of IL‐4, IL‐8 and IL‐13, but not IL‐5.

Conclusion and Clinical Relevance

Glucagon‐like peptide‐1 receptor is expressed on human eosinophils and neutrophils. A GLP‐1 analog attenuates LPS‐stimulated eosinophil activation. GLP‐1 agonists may have additional adjunctive indications in treating persons with concomitant type 2 diabetes mellitus and asthma.
CTRP‐3 is permeable to the blood–brain barrier and is not regulated by glucose or lipids in vivo
Authors: Schmid Andreas , Berghoff Martin , Hochberg Alexandra , Schäffler Andreas , Karrasch Thomas
Published: December 2016

Background

C1q/TNF‐related protein‐3 (CTRP‐3) represents a novel anti‐inflammatory and antidiabetic adipokine secreted by adipose tissue. The physiological and postprandial regulation of CTRP‐3 remains obscure and it is not known whether CTRP‐3 is permeable to the brain. The postprandial regulation of CTRP‐3 during an oral glucose tolerance test (n = 100) and an oral lipid tolerance test (n = 100) in humans was investigated. Moreover, CTRP‐3 concentrations were measured in paired serum and cerebrospinal fluid (CSF) samples of patients (n = 270) undergoing neurological evaluation. The expression of CTRP‐3 mRNA was investigated in adipocytes upon stimulation with glucose, sex hormones and a broad panel of fatty acids.

Materials and methods

Serum and CSF CTRP‐3 concentrations were measured by ELISA. 3T3‐L1 adipocytes were used for stimulation experiments. CTRP‐3 mRNA expression was quantified by using real‐time PCR analysis.

Results

CTRP‐3 is present in human cerebrospinal fluid with a mean CSF/serum ratio of 110 ± 64 × 10−3. CTRP‐3 is not regulated postprandially by carbohydrates or lipids in the healthy state. Females have slightly higher levels of CTRP‐3 when compared to males. A significant and positive correlation of CTRP‐3 to LDL cholesterol serum levels is reproducible in several cohorts and deserves further mechanistic investigation. Whereas glucose concentrations do not influence CTRP‐3 mRNA expression in 3T3‐L1 adipocytes in vitro, fatty acids differentially modulate CTRP‐3 expression.

Conclusions

The novel adipokine CTRP‐3 is detectable in human cerebrospinal fluid (proof of principle). Due to its blood–brain barrier permeability, CTRP‐3 represents a novel putative candidate for a physiological regulator molecule affecting central nervous functions.
Prognostic implications of epicardial fat volume quantification in acute pericarditis
Authors: Lazaros George , Antonopoulos Alexios S. , Oikonomou Evangelos K. , Vasileiou Panagiotis , Oikonomou Evangelos , Stroumpouli Evangelia , Karavidas Apostolos , Antoniades Charalambos , Tousoulis Dimitris
Published: December 2016

Background

The pathophysiology of acute pericarditis remains largely unknown, and biomarkers are needed to identify patients susceptible to complications. As adipose tissue has a pivotal role in cardiovascular disease pathogenesis, we hypothesized that quantification of epicardial fat volume (EFV) provides prognostic information in patients with acute pericarditis.

Materials and methods

Fifty (n = 50) patients with first diagnosis of acute pericarditis were enrolled in this study. Patients underwent a cardiac computerized tomography (CT) scan to quantify EFV on a dedicated workstation. Patients were followed up in hospital for atrial fibrillation (AF) development and up to 18 months for the composite clinical endpoint of development of constrictive, recurrent or incessant pericarditis or poor response to nonsteroidal anti‐inflammatory drugs.

Results

Patients presenting with chest pain had lower EFV vs. patients without chest pain (167·2 ± 21·7 vs. 105·1 ± 11·1 cm3, respectively, P < 0·01); EFV (but not body mass index) was strongly positively correlated with pericardial effusion size (r = 0·395, P = 0·007) and associated with in‐hospital AF. At follow‐up, patients that reached the composite clinical endpoint had lower EFV (P < 0·05). After adjustment for age, EFV was associated with lower odds ratio for the composite clinical endpoint point of poor response to NSAIDs or the development of constrictive, recurrent or incessant pericarditis during follow‐up (per 20 cm3 increase in EFV: OR = 0·802 [0·656–0·981], P < 0·05).

Conclusions

We report for the first time a significant association of EFV with the clinical features and the outcome of patients with acute pericarditis. Measurement of EFV by CT may have important prognostic implications in these patients.
Evaluation of the long‐term effect of biochar on properties of temperate agricultural soil at pre‐industrial charcoal kiln sites in Wallonia, Belgium
Authors: Hardy B. , Cornelis J.‐T. , Houben D. , Leifeld J. , Lambert R. , Dufey J. E.
Published: December 2016

Research on biochar has increased, but its long‐term effect on the fertility of temperate agricultural soil remains unclear. In Wallonia, Belgium, pre‐industrial charcoal production affected former forested areas that were cleared for cultivation in the nineteenth century. The sites of traditional charcoal kilns, largely enriched in charcoal residues, are similar to soil amended with hardwood biochar more than 150 years ago. We sampled 17 charcoal kiln sites to characterize their effect on soil properties compared with adjacent reference soils. Charcoal‐C content was estimated by differential scanning calorimetry. The kiln soil contains from 1.8 to 33.1 g kg−1 of charcoal‐C, which markedly increases organic C:N and C:P ratios. It also contains slightly more uncharred soil organic carbon (SOC) than the reference soil, which accords with larger total N content. We measured a small increase in nitrates in the kiln soil that might relate to greater mineralization and nitrification of organic N. Frequent application of lime raised the pH to values close to neutral, which offset the residual effect of charcoal production on soil acidity. A cation exchange capacity (CEC) of 414 cmolc kg−1 was estimated for charcoal‐C, whereas that of uncharred SOC was 213 cmolc kg−1. Despite the large CEC of the kiln soil, exchangeable K+ content was no different from the adjacent soil, whereas exchangeable Ca2+ and Mg2+ contents were considerably larger. Charcoal enrichment has little effect on available, inorganic and total P, but it can form strong complexes with Cu, which reduces the availability of the metal. Biochar is very persistent in soil; therefore, long‐term implications should not be overlooked.

Highlights

Charcoal kiln soil contains from 1.8 to 33.1 g kg−1 of charcoal‐C, which raises C:N and C:P ratios.

Charcoal‐C content was estimated by differential scanning calorimetry.

We estimated a CEC of 414 cmolc kg−1 for charcoal‐C and 213 cmolc kg−1 for uncharred SOC.

Retention of exchangeable K+ remained unaffected by charcoal but that of Ca2+ and Mg2+ increased.
Note on using nuclear 28S rDNA for sequencing ancient and strongly degraded insect DNA
Authors: Büsse Sebastian , von Grumbkow Philipp , Mazanec Janine , Tröster Gert , Hummel Susanne , Hörnschemeyer Thomas
Published: December 2016

A protocol using insect specimens or parts thereof allows for sequencing of sections of nuclear 28S rDNA. In the present note it is demonstrated that this protocol can readily be applied to strongly degraded DNA (ancient, fixed or contaminated). Primers that are specifically designed to discriminate against human DNA but also other non‐arthropod species are tested on a range of species covering all insect groups (59 insect species from all 33 orders). Additionally, the samples represent a selection of various, mostly DNA‐degrading, preservation methods, including the most common fixatives used for morphological investigations and for long‐term storage in collections. Successful amplification was possible for all tested samples including ca. 200 year‐old dried museum specimens as well as for over 4000 year‐old fossil insects embedded in copal. When the NCBI database contained information on the tested species an unambiguous taxonomic discrimination was possible. This approach is based on a standardized protocol that guarantees easy application. This note presents primer pairs for 28S rDNA that can be a useful tool for ancient DNA (aDNA) research.
Measuring the quality of haemophilia care across different settings: a set of performance indicators derived from demographics data
Authors: Iorio A. , Stonebraker J. S. , Brooker M. , Soucie J. M. ,   the Data and Demographics Committee of the World Federation of Hemophilia
Published: December 2016

Background

Haemophilia is a rare disease for which quality of care varies around the world. We propose data‐driven indicators as surrogate measures for the provision of haemophilia care across countries and over time.

Materials and methods

The guiding criteria for selection of possible indicators were ease of calculation and direct applicability to a wide range of countries with basic data collection capacities. General population epidemiological data and haemophilia A population data from the World Federation of Hemophilia (WFH) Annual Global Survey (AGS) for the years 2013 and 2010 in a sample of 10 countries were used for this pilot exercise.

Results

Three indicators were identified: (i) the percentage difference between the observed and the expected haemophilia A incidence, which would be close to null when all of the people with haemophilia A (PWHA) theoretically expected in a country would be known and reported to the AGS; (ii) the percentage of the total number of PWHA with severe disease; and (iii) the ratio of adults to children among PWHA standardized to the ratio of adults to children for males in the general population, which would be close to one if the survival of PWHA is equal to that of the general population. Country‐specific values have been calculated for the 10 countries.

Conclusions

We have identified and evaluated three promising indicators of quality of care in haemophilia. Further evaluation on a wider set of data from the AGS will be needed to confirm their value and further explore their measurement properties.
Factors affecting SPF in vitro measurement and correlation with in vivo results
Authors: Dimitrovska Cvetkovska A. , Manfredini S. , Ziosi P. , Molesini S. , Dissette V. , Magri I. , Scapoli C. , Carrieri A. , Durini E. , Vertuani S.
Published: December 2016

Objective

The in vitro evaluation of SPF is still a problem due to the lack of repeatability and correlation between the in vitro and in vivo data, and many authors are currently working to develop an internationally harmonized method. Very recently, the use of several “adjuvant” ingredients such as boosters, antioxidants, immunomodulators, solvents and film‐forming ingredients have further complicated the pattern for product developers that should frequently run in vivo test. The aim of this study was to understand whether a simple and cheap in vitro method could be optimized in order to provide both statistically repeatable and predictive SPF measurement.

Methods

In vitro SPF assessments were carried out on 75 commercial products. The SPF was measured according to two laboratory methods (A and B), using different substrates (PMMA and surgical tape Transpore™), quantity of product and spectrophotometers. In order to evaluate whether a standard technique of spreading could lead to a statistically reliable result, we applied different spreading pressure (100 g and 200 g). Furthermore, we investigate whether other parameters characterizing the product (SPF category, filter and texture) might represent statically significant variables affecting the measures. We then compared the results obtained from in vitro SPF measure of 11 products to in vivo SPF, in order to assess the predictability of in vitro methods.

Results

Several problems were encountered in confirming the weakness of the in vitro procedures. Pressure, SPF category, filter and texture did not affect significantly the results. Overall best results were obtained with the B2 method that in terms of repeatability and predictivity provided statistically better results. Method A with Transpore™ tape showed better in vitro–in vivo correlation than Method B with PMMA plates.

Conclusion

In our investigation, we demonstrated that it is possible for a single laboratory to optimize internal methods and protocols to achieve repeatable and predictive in vitro results, but it is extremely difficult to develop methods reproducible and equally reliable in different laboratories, probably due to “external variables” (e.g. environmental, operator), which are difficult to control.
Pioglitazone improves whole‐body aerobic capacity and skeletal muscle energy metabolism in patients with metabolic syndrome
Authors: Yokota Takashi , Kinugawa Shintaro , Hirabayashi Kagami , Suga Tadashi , Takada Shingo , Omokawa Masashi , Kadoguchi Tomoyasu , Takahashi Masashige , Fukushima Arata , Matsushima Shouji , Yamato Mayumi , Okita Koichi , Tsutsui Hiroyuki
Published: December 2016

Aims/Introduction

Low aerobic capacity is a strong and independent predictor of all‐cause mortality in patients with metabolic syndrome (MetS). Here, we investigated the effects of pioglitazone treatment on whole‐body aerobic capacity and skeletal muscle energy metabolism in MetS patients.

Materials and Methods

A total of 14 male patients with MetS received oral pioglitazone 15 mg/day for 4 months. To assess whole‐body aerobic capacity, exercise testing with a bicycle ergometer was carried out before and after pioglitazone treatment. To assess skeletal muscle energy metabolism, intramyocellular lipid in the resting leg and high‐energy phosphates in the calf muscle during plantar‐flexion exercise were measured using 1proton‐ and 31phosphorus magnetic resonance spectroscopy, respectively.

Results

Pioglitazone significantly increased peak oxygen uptake (25.1 ± 4.9 mL/kg/min pretreatment vs 27.2 ± 3.9 mL/kg/min post‐ treatment, P < 0.05) and anaerobic threshold (12.7 ± 1.9 mL/kg/min pretreatment vs 13.6 ± 1.6 mL/kg/min post‐treatment, P < 0.05), although daily physical activity was comparable before and after the treatment. Intramyocellular lipid content was significantly reduced after pioglitazone treatment by 26%, indicating improved skeletal muscle fatty acid metabolism. Pioglitazone also significantly decreased the muscle phosphocreatine loss during exercise by 13%, indicating improved skeletal muscle high‐energy phosphate metabolism. Notably, the increase in anaerobic threshold; that is, submaximal aerobic capacity, closely correlated with the decrease in intramyocellular lipid content after pioglitazone treatment.

Conclusions

Pioglitazone significantly improved the MetS patients’ whole‐body aerobic capacity and skeletal muscle energy metabolism. The beneficial effect of pioglitazone on whole‐body aerobic capacity might be at least in part through improved fatty acid metabolism in the skeletal muscle.
Diabetes, hepatocellular carcinoma, and mortality in hepatitis C‐infected patients: A population‐based cohort study
Authors: Huang Ting‐Shuo , Lin Chih‐Lang , Lu Mu‐Jie , Yeh Chau‐Ting , Liang Kung‐Hao , Sun Chi‐Chin , Shyu Yu‐Chiau , Chien Rong‐Nan
Published: December 2016

Background and Aim

The effect of diabetes mellitus (DM) on the development of hepatocellular carcinoma (HCC) and all‐cause mortality after HCC development in chronic hepatitis C virus (HCV)‐infected patients remains inconclusive. This cohort study aimed to investigate these issues using the Taiwanese National Health Insurance Research Database.

Methods

We retrieved and enrolled newly diagnosed DM patients with HCV from the Longitudinal Cohort of Diabetes Patients database. Propensity score matching—including age, sex, alcohol‐related liver disease, and baseline liver cirrhosis—was used to identify and enroll HCV patients without DM from the Longitudinal Health Insurance Database (n = 1686). A multi‐state model was used to investigate transitions from “start‐to‐HCC,” “start‐to‐death,” and “HCC‐to‐death.”

Results

The multi‐state model showed higher cumulative hazards for “start‐to‐HCC,” “start‐to‐death,” and “HCC‐to‐death” transitions in the DM (vs non‐DM) cohort. The cumulative probability of death with or without HCC after 10 years of follow‐up was higher in the DM cohort than in the non‐DM cohort. Multivariable transition‐specific Cox models demonstrated that DM significantly increased the risk for transition from “start‐to‐HCC” (adjusted hazard ratio [aHR] 1.36; 95% confidence interval [CI] 1.16–1.59; P < 0.001), “start‐to‐death” (aHR 2.61; 95% CI: 2.05–3.33; P < 0.001), and “HCC‐to‐death” (aHR 1.36; 95% CI 1.10–1.68; P = 0.005). The effect of liver cirrhosis on “start‐to‐HCC” and “start‐to‐death” transitions decreased over time, particularly within 2 years.

Conclusions

Diabetes mellitus increased the risk of HCC development in HCV‐infected patients and the risk of all‐cause mortality in patients with or without HCC.
Locally advanced carcinoma of the cervix associated with pelvic kidney treated with intensity‐modulated radiotherapy: Overcoming a therapeutic challenge
Authors: Kashyap Lakhan , Gandhi Ajeet Kumar , Pandey Rambha , Sharma Daya Nand
Published: December 2016

The simultaneous occurrence of carcinoma of the cervix and pelvic kidney is rare. As the pelvic kidney occupies the conventional radiation portal for carcinoma of the cervix, treatment of these patients with radiation presents a therapeutic challenge. A 48‐year‐old stage IIIB cervical carcinoma patient with an incidental diagnosis of pelvic kidney was treated with radical chemoradiotherapy using intensity‐modulated radiotherapy with concurrent weekly cisplatin, followed by intracavitary radiotherapy. The bilateral kidney dose was restricted within a tolerance limit of 16.6 Gy. At the 18‐month follow‐up, the patient was disease free and had no deterioration in kidney function. Intensity‐modulated radiotherapy provided the necessary means for delivering radical radiation doses in this case scenario with adequate sparing of the kidney.
Vaginal misoprostol and cervical ripening balloon for induction of labor in late‐term pregnancies
Authors: Duro Gómez Jorge , Garrido Oyarzún María Fernanda , Rodríguez Marín Ana Belén , de la Torre González Antonio Jesús , Arjona Berral José Eduardo , Castelo‐Branco Camil
Published: December 2016

Aim

The aim of this study was to compare vaginal misoprostol with the Cook cervical ripening balloon (CCRB) for induction of labor in late‐term nulliparous women.

Methods

This open, quasi‐experimental, prospective study included 109 nulliparous women with late‐term pregnancies and Bishop scores < 7. Fifty‐five women were allocated to receive vaginal misoprostol 25 mcg and 54 received the CCRB to induce labor. The primary outcome was the time until delivery. Secondary outcomes included time to the onset of labor and obstetric and perinatal outcomes.

Results

Women in the misoprostol group experienced shorter time until delivery (25.41 h vs 31.26 h; P < 0.01) and in a greater percentage gave birth within the first 24 h. Time to active stage of labor was 19.5 h and 23.8 h (P < 0.01) for misoprostol and the CCRB, respectively. There were no differences in the rates of cesarean section or post‐partum anemia. Additionally, there were no differences in rates of tachysystolia, intrapartum fever, or meconium. Perinatal outcomes, post‐partum pH, Apgar scores, and neonatal admissions were similar in the two groups.

Conclusion

Misoprostol 25 mcg reduces labor induction time compared with the CCRB with similar safety in late‐term pregnancies.
Carcinoma of the lower uterine segment diagnosed with Lynch syndrome based on MSH6 germline mutation: A case report
Authors: Adachi Masataka , Banno Kouji , Masuda Kenta , Yanokura Megumi , Iijima Moito , Takeda Takashi , Kunitomi Haruko , Kobayashi Yusuke , Yamagami Wataru , Hirasawa Akira , Kameyama Kaori , Sugano Kokichi , Aoki Daisuke
Published: December 2016

Endometrial cancer in the lower uterine segment (LUS) is associated with Lynch syndrome with MLH1 or MSH2 germline mutation. Here, we report a case of carcinoma of the LUS diagnosed with Lynch syndrome based on MSH6 germline mutation in a 46‐year‐old woman with abnormal vaginal bleeding. She had had rectal cancer at age 39 with a family history of colon cancer (father, 75 years), pancreatic cancer (paternal grandmother, 74 years), and colon cancer (maternal grandmother, 85 years). Magnetic resonance imaging showed a tumor in the LUS. Endometrial biopsy revealed endometrioid adenocarcinoma G1. As her cancer history met the revised Bethesda criteria, we examined microsatellite instability and the result was negative, but loss of the MSH6 expression was detected by immunohistochemistry. Genetic testing revealed deleterious germline mutation of MSH6, which was compatible with Lynch syndrome. To our knowledge, this is the first case of endometrial carcinoma of the LUS with MSH6 germline mutation.
Physical activity, subjective sleep quality and time in bed do not vary by moon phase in German adolescents
Authors: Smith Maia P. , Standl Marie , Schulz Holger , Heinrich Joachim
Published: December 2016

Lunar periodicity in human biology and behaviour, particularly sleep, has been reported. However, estimated relationships vary in direction (more or less sleep with full moon) if they exist at all, and studies tend to be so small that there is potential for confounding by weekly or monthly cycles. Lunar variation in physical activity has been posited as a driver of this relationship, but is likewise not well studied. We explore the association between lunar cycle, sleep and physical activity in a population‐based sample of 1411 Germans age 14–17 years (46% male). Physical activity (daily minutes moderate‐to‐vigorous activity) was objectively assessed by accelerometry for a total of 8832 days between 2011 and 2014. At the same time, time in bed (h) and subjective sleep quality (1–6) were diaried each morning. In models corrected for confounding, we found that lunar phase was not significantly associated with physical activity, subjective sleep quality or time in bed in either sex, regardless of season. Observed relationships varied randomly in direction between models, suggesting artefact. Thus, this large, objectively‐measured and well‐controlled population of adolescents displayed no lunar periodicity in objective physical activity, subjective sleep quality or time in bed.
Is consumption of sugar‐sweetened soft drinks during pregnancy associated with birth weight?
Authors: Grundt Jacob H. , Eide Geir Egil , Brantsæter Anne‐Lise , Haugen Margaretha , Markestad Trond
Published: December 2016

In Norway, there were parallel increases and subsequent decreases in birth weight (BW) and consumption of sugar‐sweetened carbonated soft drinks (SSC) during the period 1990–2010, and by an ecological approach, we have suggested that the relationship was causal. The objective of this study was to examine if such a relationship was present in a prospectively followed cohort of pregnant women. The study population included 62,494 term singleton mother–infant dyads in the Norwegian Mother and Child Cohort Study (MoBa), a national prospective cohort study in Norway from 1999 to 2008. The association between SSC consumption and BW was assessed using multiple regression analyses with adjustment for potential confounders. Each 100 ml intake of SSC was associated with a 7.8 g (95% confidence interval [CI]: −10.3 to −5.3) decrease in BW, a decreased risk of BW > 4,500 g (odds ratio [OR]: 0.94, 95% CI: 0.90 to 0.97) and a near significantly increased risk of BW < 2,500 g (OR: 1.05, 95% CI: 0.99 to 1.10). The negative association with SSC consumption was aggravated by smoking, lack of exercise, and obesity. For mothers with gestational diabetes mellitus, we observed an increased risk of BW > 4,500 g (OR: 1.18, 95% CI: 1.00 to 1.39) and a trend towards significant increase in mean BW (25.1 g, 95% CI: −2.0 to 52.2) per 100 ml SSC. Our findings suggest that increasing consumption of rapidly absorbed sugar from SSC had opposite associations with BW in normal pregnancies and pregnancies complicated by gestational diabetes mellitus.
Canine distemper virus in the Serengeti ecosystem: molecular adaptation to different carnivore species
Authors: Nikolin Veljko M. , Olarte‐Castillo Ximena A. , Osterrieder Nikolaus , Hofer Heribert , Dubovi Edward , Mazzoni Camila J. , Brunner Edgar , Goller Katja V. , Fyumagwa Robert D. , Moehlman Patricia D. , Thierer Dagmar , East Marion L.
Published: December 2016

Was the 1993/1994 fatal canine distemper virus (CDV) epidemic in lions and spotted hyaenas in the Serengeti ecosystem caused by the recent spillover of a virulent domestic dog strain or one well adapted to these noncanids? We examine this question using sequence data from 13 ‘Serengeti’ strains including five complete genomes obtained between 1993 and 2011. Phylogenetic and haplotype network analyses reveal that strains from noncanids during the epidemic were more closely related to each other than to those from domestic or wild canids. All noncanid ‘Serengeti’ strains during the epidemic encoded: (1) one novel substitution G134S in the CDV‐V protein; and (2) the rare amino acid combination 519I/549H at two sites under positive selection in the region of the CDV‐H protein that binds to SLAM (CD 150) host cell receptors. Worldwide, only a few noncanid strains in the America II lineage encode CDV‐H 519I/549H. All canid ‘Serengeti’ strains during the epidemic coded CDV‐V 134G, and CDV‐H 519R/549Y, or 519R/549H. A functional assay of cell entry revealed the highest performance by CDV‐H proteins encoding 519I/549H in cells expressing lion SLAM receptors, and the highest performance by proteins encoding 519R/549Y, typical of dog strains worldwide, in cells expressing dog SLAM receptors. Our findings are consistent with an epidemic in lions and hyaenas caused by CDV variants better adapted to noncanids than canids, but not with the recent spillover of a dog strain. Our study reveals a greater complexity of CDV molecular epidemiology in multihost environments than previously thought.
Wide QRS Complex Arrhythmia with Alternating QRS Morphology: What Is the Mechanism?
Authors: GONZÁLEZ‐TORRECILLA ESTEBAN , ARENAL MAÍZ ÁNGEL , ÁVILA ALONSO PABLO , FERNÁNDEZ‐AVILÉS FRANCISCO
Published: December 2016

A 75‐year‐old man was admitted due to an electrical storm with appropriate recurrent implantable cardioverter defibrillator (ICD) discharges. The patient had had an extensive anterolateral myocardial infarction with associated severe left ventricular dysfunction 10 years earlier (left ventricular ejection fraction, 25%), and an ICD was placed 9 years before admission for primary prevention of sudden cardiac death. A first invasive study induced up to five ventricular tachycardias and an extensive endocardial substrate ablation was performed. Despite intravenous β‐blockers, general anesthesia and procainamide infusion, the patient continued to have recurrent episodes of very slow sustained ventricular tachycardia with a right bundle branch block pattern. In a subsequent invasive study, no mid‐diastolic activity was found despite careful mapping during the induced clinical ventricular tachycardia and ablation attempts inside the apical endocardial scar were unsuccessful. A percutaneous epicardial approach with navigation system support (EnSite PrecisionTM Cardiac Mapping System v. 2.0, St. Jude Medical, St. Paul, MN, USA) without antiarrhythmic infusion was planned. A wide QRS complex rhythm with alternating QRS morphology was readily induced by epicardial ventricular pacing trains (Fig. 1, top) that elicited both arrhythmia QRS patterns with very long stimulus QRS intervals (Fig. 1, bottom). What is the possible mechanism of this arrhythmia? Do we need further pacing maneuvers during the arrhythmia to localize critical sites at which ablation pulses can predictably be successful?
Dissecting the Photoprotective Mechanism Encoded by the flv4‐2 Operon: a Distinct Contribution of Sll0218 in Photosystem II Stabilization
Authors: Bersanini Luca , Allahverdiyeva Yagut , Battchikova Natalia , Heinz Steffen , Lespinasse Maija , Ruohisto Essi , Mustila Henna , Nickelsen Jörg , Vass Imre , Aro Eva‐Mari
Published: December 2016

In Synechocystis sp. PCC 6803, the flv4‐2 operon encodes the flavodiiron proteins Flv2 and Flv4 together with a small protein, Sll0218, providing photoprotection for Photosystem II (PSII). Here, the distinct roles of Flv2/Flv4 and Sll0218 were addressed, using a number of flv4‐2 operon mutants. In the ∆sll0218 mutant, the presence of Flv2/Flv4 rescued PSII functionality as compared with ∆sll0218‐flv2, where neither Sll0218 nor the Flv2/Flv4 heterodimer are expressed. Nevertheless, both the ∆sll0218 and ∆sll0218‐flv2 mutants demonstrated deficiency in accumulation of PSII proteins suggesting a role for Sll0218 in PSII stabilization, which was further supported by photoinhibition experiments. Moreover, the accumulation of PSII assembly intermediates occurred in Sll0218‐lacking mutants. The YFP‐tagged Sll0218 protein localized in a few spots per cell at the external side of the thylakoid membrane, and biochemical membrane fractionation revealed clear enrichment of Sll0218 in the PratA‐defined membranes, where the early biogenesis steps of PSII occur. Further, the characteristic antenna uncoupling feature of the ∆flv4‐2 operon mutants is shown to be related to PSII destabilization in the absence of Sll0218. It is concluded that the Flv2/Flv4 heterodimer supports PSII functionality, while the Sll0218 protein assists PSII assembly and stabilization, including optimization of light harvesting.