bluuebunny/crossref_metadata_2025 huggingface dataset:
Combination of clozapine with an atypical antipsychotic: a meta-analysis
Authors: Rolph Lauren , McGarry Ken
Published: October 2017

Purpose

The purpose of this paper is to review the efficacy of atypical antipsychotics in combination with clozapine. Previous meta-analyses have assessed the use of both typical and atypical antipsychotics in combination with clozapine, combination treatment being withheld only for those patients deemed treatment resistant.

Design/methodology/approach

Outcomes assessed included: positive, negative and overall symptom score. The total numbers of participants (n=588) were scored using the Positive and Negative Symptom Scale/the Brief Psychiatric Rating Scale and effect sizes were used to judge the efficacy of the combination treatments. Data gained from the ten randomized, double blind, placebo controlled trials were analysed using the R statistical software.

Findings

The effect sizes gained from analysis showed a small benefit of combination therapy over clozapine monotherapy. Therefore, it is the recommendation of this analysis that alternative avenues be sought in order to treat patients who have a sub-optimal response to clozapine with a combination other than two second generation antipsychotics.

Research limitations/implications

The initial trials search unveiled 1,412 studies. After the inclusion and exclusion criteria were applied, ten trials were used in this meta-analysis.

Practical implications

The recommendation of this analysis that alternative medications be sought in order to treat patients who have a sub-optimal response to clozapine with a combination other than two second generation antipsychotics. This route should only be used once all other treatment options have been exhausted.

Originality/value

This meta-analytical study looks specifically at the combination of atypical antipsychotics with clozapine in comparison to clozapine monotherapy. This work extends existing meta-analysis by incorporating data from more recent trials.
Trivisa or Amphetamine?
Authors: Ka Ming Chan
Published: October 2017

Purpose

Since the launch of the Mainland and Hong Kong Closer Economic Partnership Arrangement (CEPA) in 2003, Hong Kong cinema is believed to have confronted drastic changes. Hong Kong cinema is described to be dying, lacking creative space and losing local distinctiveness. A decade later, the rise of Hong Kong – China coproduction cinema under CEPA has been normalized and changed the once pessimism in the industry. The purpose of this paper is to demonstrate how Hong Kong cinema adjusted its production and creation in the first 10 years of CEPA.

Design/methodology/approach

Beginning with a review of the overall development, three paradigmatic cases are examined for reflecting upon what the major industrial and commercial concerns on the Hong Kong – China coproduction model are, and how such a coproduction model is not developed as smooth as what the Hong Kong filmmakers expected.

Findings

Collectively, this paper singles out the difficulties in operation and the limit of transnationality that occur in the Chinese context for the development of Hong Kong cinema under the Hong Kong – China coproduction model.

Originality/value

This is the author’s research in his five-year study of Hong Kong cinema and it contributes a lot to the field of cinema studies with relevant industrial and policy concern.
Three‐dimensional potential field data inversion with L0 quasinorm sparse constraints
Authors: Meng Zhaohai
Published: October 2017

The quantitative explanation of the potential field data of three‐dimensional geological structures remains one of the most challenging issues in modern geophysical inversion. Obtaining a stable solution that can simultaneously resolve complicated geological structures is a critical inverse problem in the geophysics field. I have developed a new method for determining a three‐dimensional petrophysical property distribution, which produces a corresponding potential field anomaly. In contrast with the tradition inverse algorithm, my inversion method proposes a new model norm, which incorporates two important weighting functions. One is the L0 quasi norm (enforcing sparse constraints), and the other is depth‐weighting that counteracts the influence of source depth on the resulting potential field data of the solution. Sparseness constraints are imposed by using the L0 quasinorm on model parameters. To solve the representation problem, an L0 quasinorm minimisation model with different smooth approximations is proposed. Hence, the data space (N) method, which is much smaller than model space (M), combined with the gradient‐projected method, and the model space, combined with the modified Newton method for L0 quasinorm sparse constraints, leads to a computationally efficient method by using anN×Nsystem versus anM×Mone becauseN≪M. Tests on synthetic data and real datasets demonstrate the stability and validity of the L0 quasinorm spare norms inversion method. With the aim of obtaining the blocky results, the inversion method with the L0 quasinorm sparse constraints method performs better than the traditional L2 norm (standard Tikhonov regularisation). It can obtain the focus and sparse results easily. Then, the Bouguer anomaly survey data of the salt dome, offshore Louisiana, is considered as a real case study. The real inversion result shows that the inclusion the L0 quasinorm sparse constraints leads to a simpler and better resolved solution, and the density distribution is obtained in this area to reveal its geological structure. These results confirm the validity of the L0 quasinorm sparse constraints method and indicate its application for other potential field data inversions and the exploration of geological structures.
Diel regulation of photosynthetic activity in the oceanic unicellular diazotrophic cyanobacterium Crocosphaera watsonii WH8501
Authors: Masuda Takako , Bernát Gábor , Bečková Martina , Kotabová Eva , Lawrenz Evelyn , Lukeš Martin , Komenda Josef , Prášil Ondřej
Published: October 2017

The oceanic unicellular diazotrophic cyanobacterium Crocosphaera watsonii WH8501 exhibits large diel changes in abundance of both Photosystem II (PSII) and Photosystem I (PSI). To understand the mechanisms underlying these dynamics, we assessed photosynthetic parameters, photosystem abundance and composition, and chlorophyll‐protein biosynthesis over a diel cycle. Our data show that the decline in PSII activity and abundance observed during the dark period was related to a light‐induced modification of PSII, which, in combination with the suppressed synthesis of membrane proteins, resulted in monomerization and gradual disassembly of a large portion of PSII core complexes. In the remaining population of assembled PSII monomeric complexes, we detected the non‐functional version of the D1 protein, rD1, which was absent in PSII during the light phase. During the dark period, we also observed a significant decoupling of phycobilisomes from PSII and a decline in the chlorophyll a quota, which matched the complete loss of functional PSIIs and a substantial decrease in PSI abundance. However, the remaining PSI complexes maintained their photochemical activity. Thus, during the nocturnal period of nitrogen fixation C. watsonii operates a suite of regulatory mechanisms for efficient utilization/recycling of cellular resources and protection of the nitrogenase enzyme.
The FgSsb‐FgZuo‐FgSsz complex regulates multiple stress responses and mycotoxin production via folding the soluble SNARE Vam7 and β2‐tubulin in Fusarium graminearum
Authors: Liu Zunyong , Wang Zhihui , Huang Mengmeng , Yan Leiyan , Ma Zhonghua , Yin Yanni
Published: October 2017

Hsp70 proteins play important roles in protein folding in the budding yeast, but their functions in pathogenic fungi are largely unknown. Here, we found that Fusarium graminearum Hsp70 proteins FgSsb, FgSsz and their cochaperone FgZuo formed a complex. This complex was required for microtubule morphology, vacuole fusion and endocytosis. More importantly, the β2‐tubulin FgTub2 and SNARE protein FgVam7 were identified as targeting proteins of this complex. We further found that the complex FgSsb‐FgZuo‐FgSsz controlled sensitivity of F. graminearum to the antimicrotubule drug carbendazim and cold stress via regulating the folding of FgTub2. Moreover, this complex assisted the folding of FgVam7, subsequently modulated vacuole fusion and responses to heavy metal, osmotic and oxidative stresses. In addition, the deletion of this complex led to dramatically decreased deoxynivalenol biosynthesis. This study uncovers a novel regulating mechanism of Hsp70 in multiple stress responses in a filamentous fungus.
Tuning the modular Paracoccus denitrificans respirome to adapt from aerobic respiration to anaerobic denitrification
Authors: Giannopoulos Georgios , Sullivan Matthew J. , Hartop Katherine R. , Rowley Gary , Gates Andrew J. , Watmough Nicholas J. , Richardson David J.
Published: October 2017

Bacterial denitrification is a respiratory process that is a major source and sink of the potent greenhouse gas nitrous oxide. Many denitrifying bacteria can adjust to life in both oxic and anoxic environments through differential expression of their respiromes in response to environmental signals such as oxygen, nitrate and nitric oxide. We used steady‐state oxic and anoxic chemostat cultures to demonstrate that the switch from aerobic to anaerobic metabolism is brought about by changes in the levels of expression of relatively few genes, but this is sufficient to adjust the configuration of the respirome to allow the organism to efficiently respire nitrate without the significant release of intermediates, such as nitrous oxide. The regulation of the denitrification respirome in strains deficient in the transcription factors FnrP, Nnr and NarR was explored and revealed that these have both inducer and repressor activities, possibly due to competitive binding at similar DNA binding sites. This may contribute to the fine tuning of expression of the denitrification respirome and so adds to the understanding of the regulation of nitrous oxide emission by denitrifying bacteria in response to different environmental signals.
Clerical admonitio, Letters of Advice to Kings and Episcopal Self‐Fashioning, c.1000–c.1200
Authors: WEILER BJÖRN
Published: October 2017

This article uses letters of advice, outlining key principles of royal power, to explore how abbots and bishops in high medieval Europe sought to demonstrate compliance with widely shared norms about the role and nature of clerical counsel when interacting with kings. It will show that the type of the remonstrating cleric was deeply engrained in epistolary culture. While this expectation may not always reflect how dealings between prelates and rulers unfolded in practice, it nonetheless points to a pervasive framework of remonstration and admonition that was integral to high medieval European political and clerical culture.
Demystified: Mergers and Acquisitions, Oil and Gas, and Ranching on the Southern Great Plains, 1921–1933
Authors: DAY MATTHEW
Published: October 2017

This article examines how concepts of mergers and acquisitions shaped potential horizontal mergers, namely stock swaps, and vertical mergers shaped oil and ranching on the Southern Great Plains in the late 1920s and early 1930s.
Effectiveness of seminal plasma in in vitro fertilisation treatment: a systematic review and meta‐analysis
Authors: Saccone G , Di Spiezio Sardo A , Ciardulli A , Caissutti C , Spinelli M , Surbek D , von Wolff M
Published: October 2017

Background

With in vitro fertilization (IVF) techniques, only 20–25% of the transferred embryos lead to a pregnancy.

Objective

To evaluate the beneficial effects of seminal plasma (SP) or semen applied at the time of oocyte aspiration or embryo transfer.

Search strategy

Electronic databases were searched from their inception up to August 2017.

Selection criteria

We included all randomized controlled trials (RCTs) evaluating the effects of SP or semen in IVF treatment. Trials were considered if women were exposed to any kind of SP or semen (either SP/semen injection or sexual intercourse) around the time of oocyte pickup and embryo transfer.

Data collection and analysis

The primary outcome was clinical pregnancy rate (CPR).

Main results

Eight RCTs on women undergoing IVF (2128 in total) were included in the meta‐analysis. Women randomized in the intervention group had a significantly higher CPR compared with controls (30.0 versus 25.1%; RR 1.20; 95% CI, 1.04–1.39). No significant differences were found in the secondary outcomes, including livebirth rate, biochemical pregnancy, miscarriage, multiple pregnancies, and birth weight. The subgroup analyses (four RCTs, 780 participants), including only those RCTs in which prepared undiluted SP was injected just after oocyte pickup, conformed with the overall analysis for the primary outcome (46.3 versus 37.2%; RR 1.23; 95% CI, 1.05–1.45).

Conclusion

Because intravaginal or intracervical SP application around the time of oocyte pickup is associated with higher CPR, local application SP may be considered as a potential treatment to improve implantation.

Tweetable abstract

SP at the time of oocyte pickup is associated with higher CPR.
Choosing public or private emergency departments in Australia
Authors: Walker Katherine , Ben‐Meir Michael
Published: October 2017

Emergency medicine was once exclusively provided in public hospitals in Australia, but now over half a million consultations per annum are in private (7% total emergency consultations). Private EDs have excess capacity and are staffed by senior doctors (majority FACEM) with open access to investigations and broad specialist inpatient services. Public EDs struggle with rising attendances and overcapacity. Private hospitals have high levels of patient satisfaction and aim to optimise service provision. A major barrier to private ED attendances is out‐of‐pocket costs. Insurers deem private EDs outpatient services and therefore do not contribute any funding to these attendances. Additionally state governments provide no funding while Medicare items cover only 10–15% of costs. Out‐of‐pocket consultation costs to patients vary nationally ($110–$480) but never cover the full cost of providing services. Patients may also pay out‐of‐pocket costs for investigations. Private EDs can provide many benefits to patients and the community. Patients can see senior doctors immediately (at less cost per patient than public EDs). Demand can be directed away from resource‐poor public EDs. Private EDs could also provide extra surge capacity during disasters. There is a need for further strong advocacy for private emergency medicine at many levels, particularly regarding the lack of funding. Stakeholder relationships should be strengthened. Research and education about decision‐making in the choice between public and private ED attendance should be encouraged, particularly regarding paramedic advice to patients. Finally, patients who have purchased private insurance should be able to utilise it during evaluation of an acute illness.
The Financial Impact of Different Stormwater Fee Types: A Case Study of Two Municipalities in Virginia
Authors: Fedorchak Amanda , Dymond Randel , Campbell Warren
Published: October 2017

Eight stormwater user fees (SUFs) were applied to the City of Roanoke and the Town of Blacksburg, Virginia, to determine the effect each has on how land use type impacts the sources of revenue. Roanoke is larger and includes more industrial areas, but less multifamily impervious areas than Blacksburg, which translates differently in the SUFs. Residential parcels comprise the highest percentage of the revenue in all eight SUFs in Blacksburg and four in Roanoke. For both municipalities, two specific SUFs consistently comprised the highest percentage burden for residential homeowners while three other SUFs demonstrated the highest burden for commercial parcels. Open space parcels contain little impervious area, yet account for up to 27% of the revenue in the Blacksburg Area fee structure. Industrial parcels comprise more revenue in Roanoke, averaging 10.1‐4.5% in Blacksburg. Fee types that are easier to administer (e.g., Flat fees) may not fully represent the stormwater contribution from the parcels. SUF types that more accurately represent the stormwater burden on the municipality are also more administratively intensive and are more variable with fee factors.
Retrospective review of CT‐guided intervertebral disc biopsies performed at a tertiary referral centre for suspected osteodiscitis
Authors: Lopes Floro Kylie , Munckhof Wendy , Coucher John
Published: October 2017

Introduction

Patients with osteodiscitis are often prescribed antibiotics prior to biopsy. There is controversy in the literature about whether antibiotic pre‐treatment prior to CT‐guided biopsy decreases the microbiological culture yield. Conclusions from previous studies are influenced by sample size error and selection bias. Our study, conducted in a large number of patients over a 10‐year period, clarifies this issue so that best clinical practice is assured.

Methods

We performed a retrospective audit of the clinical, radiological and microbiological features of adult patients who underwent CT‐guided biopsies for suspected osteodiscitis at a tertiary institution. Patients who had received intravenous antibiotic therapy in the month prior to biopsy or oral antibiotics 2 weeks prior to biopsy were considered as having had antecedent treatment.

Results

We initially found no significant difference in the likelihood of a positive culture between patients who had received antecedent treatment and those who had not. However, when we performed a subgroup analysis, we found that using multiple antibiotics influenced the likelihood of a positive culture. A second subgroup analysis demonstrated that pre‐treatment reduced the likelihood of a positive culture. This discrepancy arose from the match between the antecedent antibiotics and the organisms’ antibiotic sensitivity profile.

Conclusion

Antibiotic treatment preceding CT‐guided biopsy reduces the likelihood of a positive microbiological culture results. However, due to the often poor match, between the pre‐treatment antibiotic and the organisms’ antibiotic sensitivity profile, this is often not clinically apparent. Furthermore, positive cultures sensitive to the pre‐treatment antibiotics can still be obtained.
Adjunctive therapies in Kawasaki disease
Authors: Tremoulet Adriana H.
Published: October 2017

Despite the administration of intravenous immunoglobulin (IVIg) at a dose of 2 g/kg, approximately 3–5% of children with acute Kawasaki disease (KD) may develop coronary artery aneurysms. IVIg‐resistance, defined as recrudescence of fever more than 36 h after IVIg completion, is a risk factor for coronary artery abnormalities. Thus, several adjunctive therapies are being evaluated for use in IVIg‐resistant KD patients and in patients with coronary artery abnormalities. In this review the role of some of these adjunctive therapies in treatment of children with KD is discussed.
An Evaluation of Alternative Market‐Based Transfer Prices
Authors: Johnson Nicole Bastian , Loeffler Clemens , Pfeiffer Thomas
Published: October 2017

We investigate a transfer pricing problem between two divisions within a decentralized firm. An upstream division produces an intermediate good that is used by another division within the firm and is also sold in an external market, where the firm competes with a rival selling a differentiated substitute product. Assuming that headquarters has imperfect information about the upstream division's private information and that communication is restricted, we identify conditions under which the firm will prefer a market‐based transfer price based on the market price set by the firm's rival rather than on the market price set by the upstream division. The two transfer prices affect the price‐setting incentives of the upstream division and its rival differently, and convey different levels of private‐cost information to the downstream division, which impacts internal trade efficiency. The relative performance of the two transfer pricing regimes depends on the relative size of internal versus external demand for the upstream division's good and on the degree of uncertainty about the upstream division's costs. Overall, our analysis provides new insights about how alternative market‐based transfer prices can coordinate decentralized decision‐making in the absence of a perfectly competitive intermediate market.
Estimating dispersal kernels using genetic parentage data
Authors: Bode Michael , Williamson David H. , Harrison Hugo B. , Outram Nick , Jones Geoffrey P.
Published: October 2017

Dispersal kernels are the standard method in biology for describing and predicting the relationship between dispersal and distance. Statistically fitted dispersal kernels allow observations of a limited number of dispersal events to be extrapolated across a wider landscape, and form the basis of a wide range of theories and methods in ecology, evolution and conservation. Genetic parentage data are an increasingly common source of dispersal information, particularly for species where dispersal is difficult to observe directly. In particular, parentage analysis is now routinely applied to coral reef fish, whose larvae can potentially disperse over many kilometres, and are too small to track in situ.

It is not straightforward to estimate dispersal kernels from parentage data, and existing methods all have substantial limitations. These include the omission of important population processes such as density‐dependent mortality, and data on unassigned juveniles. Here we develop and proof a new likelihood estimator for fitting dispersal kernels to parentage data, applying it to simulated parentage datasets for coral reef fish on the Great Barrier Reef (GBR).

The method incorporates a series of factors not previously considered in other methods: the partial sampling of adults and juveniles on sampled sites; the existence of unassigned dispersers from unsampled habitat patches; and post‐settlement processes (e.g. density‐dependent mortality) that follow dispersal but precede parentage sampling. Including these additional factors requires an estimate of adult populations on unsampled habitat patches, but the result is a superior estimate of dispersal kernels and mean dispersal distances.

Our power analyses suggest that the parentage datasets currently available for reef fishes are large enough to fit accurate dispersal kernels. Based on the analyses in one particular region of the GBR, parentage sampling should be distributed equally between adults and juveniles, and should sample more than 3% of the adult population. However, while the resulting dispersal kernels offer reasonable estimates of mean dispersal, they fail to capture important variation in realistic dispersal patterns.
Genome‐wide association analysis of residual feed intake in Junmu No. 1 White pigs
Authors: Bai C. , Pan Y. , Wang D. , Cai F. , Yan S. , Zhao Z. , Sun B.
Published: October 2017

Residual feed intake (RFI) is a measure of feed efficiency. Pigs with low RFI have reduced feed costs without compromising their growth. For marker‐assisted selection, it is helpful to identify genes or genetic markers associated with RFI in animals with improved feed efficiency at an early age. Using Illumina's PorcineSNP60 BeadChip, we performed a pilot genome‐wide association study of 217 Junmu No. 1 white male pigs phenotyped for RFI. Two‐step and one‐step methods were used separately to identify associated SNPs. Both methods obtained similar results. Twelve SNPs were identified as significantly associated with RFI at a Bonferroni adjusted P‐level < 9.7 × 10−7, and 204 were found to have suggestive (moderately significant) association with RFI at P < 5 × 10−5. NMBR, KCTD16, ASGR1, PRKCQ, PITRM1, TIAM1 and RND3 were identified as candidate genes for RFI.
The MOSAICC study: Assessing feasibility for biological sample collection in epidemiology studies and comparison of DNA yields from saliva and whole blood samples
Authors: James Glen , McMullin Mary Frances , Duncombe Andrew S , Clarke Mike , Anderson Lesley A
Published: October 2017

Biological sample collection is becoming more common in epidemiology research to obtain DNA for genetic analysis. There are many different DNA collection methods but little evidence on their relative effectiveness. Therefore, we took the opportunity of a prospective case‐control study in myeloproliferative neoplasms (MPNs) to compare DNA yield from 8.5 mL PAXgene tubes for whole blood collection versus 2 mL Oragene OG‐500 saliva collection kits. MPNs include polycythaemia vera, essential thrombocythaemia, and primary myelofibrosis. These are rare diseases and our exploratory case–control study (MOSAICC) sought to improve knowledge regarding their aetiology and to determine optimal methodology for a larger UK‐wide study. Overall, 233 participants were recruited to the MOSIACC study, and we collected 187 blood and 214 saliva samples. The mean DNA yield from blood was 659.18 ng/μL, significantly higher than the mean DNA yield from saliva samples (275.79 ng/μL). The higher provision of saliva samples might reflect its non‐invasive and more convenient nature, compared to blood sample provision. The differences in mean DNA yields might reflect differences in clinical assistance, adherence to instructions, and health status of individuals. In conclusion, both sample collection techniques are simple, effective, and suitable for DNA collection for genetic analysis in future epidemiological research studies but OG‐500 kits offer a less invasive alternative for those who refuse to provide blood.
Moderate to late preterm intrauterine growth restriction: A restrospective, observational study of the indications for delivery and outcomes in an Australian perinatal centre
Authors: Stewart Bridie , Karahalios Amalia , Pszczola Rosalynn , Said Joanne
Published: October 2017

Background

The management of preterm intrauterine growth restriction is limited to fetal surveillance and timely delivery. Despite the existence of evidence‐based guidelines, uncertainty regarding the optimal timing of delivery is common, and management remains individualised for each patient.

Aims

To provide recent Australian data on the indications for delivery of moderate to late preterm growth restricted infants and the outcomes of these deliveries.

Materials and methods

Retrospective study of singleton live births delivered between 32 + 0 and 36 + 6 weeks gestation over a three‐year period (2012–2014) at a Melbourne Metropolitan Hospital. ‘Small for gestational age’ (birthweight < 10th centile for gestation) identified intrauterine growth restricted infants. Indications for iatrogenic delivery were broadly categorised into maternal, fetal or pregnancy related. Obstetric and neonatal outcome variables were compared to other preterm infants using logistic regression.

Results

Of the 146 (18.6%) small for gestational age infants born during the study period, 103 were iatrogenic deliveries, most commonly due to fetal indications (53.4%). Small for gestational age infants had higher odds of hypoglycaemia (adjusted odds ratio = 1.87, 95% CI: 1.23–2.84, P = 0.003) and jaundice (1.52, 1.01–2.28, P = 0.043) than their appropriately grown counterparts; however, there was no increase in the risk of serious morbidity or mortality.

Conclusions

In this cohort, iatrogenic preterm delivery of small for gestational age infants between 32 + 0 and 36 + 6 weeks gestation was most commonly due to fetal indications and did not increase the risk of serious, short‐term neonatal outcomes compared to their appropriately grown counterparts.
Randomised clinical trial: yoga vs a low‐FODMAP diet in patients with irritable bowel syndrome
Authors: Schumann D. , Langhorst J. , Dobos G. , Cramer H.
Published: October 2017

Background

Irritable bowel syndrome is the most frequent gastrointestinal disorder. It is assumed that lifestyle interventions might be a rational treatment approach.

Aim

To examine the effect of a yoga‐based intervention vs a low‐FODMAP diet on patients with irritable bowel syndrome.

Methods

Fifty‐nine patients with irritable bowel syndrome undertook a single‐blind, randomised controlled trial involving yoga or a low‐FODMAP diet for 12 weeks. Patients in the yoga group received two sessions weekly, while patients in the low‐FODMAP group received a total of three sessions of nutritional counselling. The primary outcome was a change in gastrointestinal symptoms (IBS‐SSS). Secondary outcomes explored changes in quality of life (IBS‐QOL), health (SF‐36), perceived stress (CPSS, PSQ), body awareness (BAQ), body responsiveness (BRS) and safety of the interventions. Outcomes were examined in weeks 12 and 24 by assessors “blinded” to patients’ group allocation.

Results

No statistically significant difference was found between the intervention groups, with regard to IBS‐SSS score, at either 12 (Δ = 31.80; 95%CI = −11.90, 75.50; P = .151) or 24 weeks (Δ = 33.41; 95%CI = −4.21, 71.04; P = .081). Within‐group comparisons showed statistically significant effects for yoga and low‐FODMAP diet at both 12 and 24 weeks (all P < .001). Comparable within‐group effects occurred for the other outcomes. One patient in each intervention group experienced serious adverse events (P = 1.00) and another, also in each group, experienced nonserious adverse events (P = 1.00).

Conclusions

Patients with irritable bowel syndrome might benefit from yoga and a low‐FODMAP diet, as both groups showed a reduction in gastrointestinal symptoms. More research on the underlying mechanisms of both interventions is warranted, as well as exploration of potential benefits from their combined use.
Hybrid approach to laparoscopic decapsulation combined with splenic artery balloon occlusion in a patient with carbohydrate antigen 19‐9 producing splenic cysts
Authors: Maeda Eri , Okano Keiichi , Suto Hironobu , Asano Eisuke , Oshima Minoru , Kishino Takayoshi , Fujiwara Masao , Yamamoto Naoki , Sanomura Takayuki , Suzuki Yasuyuki
Published: October 2017

Introduction

Carbohydrate antigen 19‐9 producing splenic cysts are relatively rare and usually occur in women and young individuals. This report describes the use of a novel splenic‐preserving surgical approach in the hybrid operating room to reduce the risk of bleeding.

Materials and Surgical Technique

A 27‐year‐old woman presented at our hospital with a chief complaint of chest pain. CT showed an encapsulated left pleural effusion and multiple splenic cysts. The patient was diagnosed with carbohydrate antigen 19‐9–producing splenic cysts and was treated with laparoscopic decapsulation. In the hybrid operating room, a balloon catheter was positioned in the splenic artery. Four ports were inserted into the abdomen, the cysts were punctured, and intracystic fluid was suctioned out. Combined splenic artery balloon occlusion was performed to control bleeding when the cyst wall was resected near the splenic parenchyma. Occlusion was performed to create intermittent blockage and consisted of 20‐min ischemia and 5‐min reperfusion. Then, the inner surface of the cyst wall was cauterized. The total operation time was 170 min (laparoscopic time, 110 min), and blood loss was 100 mL. There were no intraoperative or postoperative complications. The patient has remained healthy, with no recurrence for 8 months.

Discussion

Laparoscopic decapsulation for the treatment of splenic cysts can prevent life‐threatening bacterial infections by preserving the spleen, but this can increase the risk of bleeding from the left splenic parenchyma. Combining splenic artery occlusion with laparoscopic decapsulation is a useful approach in the hybrid operating room.
New Insights into SN‐38 Glucuronidation: Evidence for the Important Role of UDP Glucuronosyltransferase 1A9
Authors: Xiao Ling , Zhu Liangliang , Li Wenjuan , Li Conghu , Cao Yunfeng , Ge Guangbo , Sun Xiaoyu
Published: October 2017

Glucuronidation of SN‐38 serves as an important metabolic pathway in determining the toxic effects of irinotecan. The role of UDP‐glucuronosyltransferases (UGT) 1A9 in SN‐38 glucuronidation pathway is very confusing. This study re‐investigates the pathway through testing effects of bovine serum albumin (BSA) and the selective inhibitor on SN‐38 glucuronidation in pooled human liver microsomes (HLM) and recombinant UGT1A1/UGT1A9. For UGT1A1, SN‐38 glucuronidation was little affected by BSA. Whether in the presence of BSA or not, the reactions both obey Michaelis–Menten kinetics with closed Vmax/Km values. For UGT1A9 and HLM, BSA can significantly accelerate SN‐38 glucuronidation activities and similar effects are further observed on kinetic patterns. In the absence of BSA, reactions by HLM and UGT1A9 both display substrate inhibition kinetics. When BSA is included in the incubations, the reactions exhibit Michaelis–Menten kinetics. To get the true contribution of UGT1A9 in SN‐38 glucuronidation, a relative activity factor (RAF) approach was additionally used. It is suggested that UGT1A9 and 1A1 contribute equally to SN‐38 glucuronidation in HLM. Furthermore, in the presence of BSA, magnolol, a selective UGT1A9 inhibitor, displays moderate inhibition against HLM. Results together conclude that UGT1A9 serves as an additional important contributor to hepatic SN‐38 glucuronidation.
Forensic Toxicology Perspectives of Methadone‐associated Deaths in Tehran, Iran, a 7‐year Overview
Authors: Akhgari Maryam , Amini‐Shirazi Noushin , Iravani Fariba Sardari
Published: October 2017

Methadone has a long history of pain relief and successful substitute for maintenance treatment in heroin and narcotic addiction. The aim of the study was to assess the trends of methadone‐associated deaths in Tehran, Iran, in 2009–2015, from a forensic toxicology point of view. All methadone‐associated deaths during this 7‐year study period were evaluated according to demographic parameters and forensic toxicology analysis results. Results showed that 1274 cases of methadone‐associated deaths were investigated during the study period. The incidence rate of methadone‐associated deaths had risen 7.7 times in 2015 in comparison with 2009 (p < 0.05). The majority of cases were men (90.35%), aged from 20 to 40 years. About 80% of cases had shown positive results for other drugs and poisons in combination with methadone. Methamphetamine and tramadol were the most drugs detected in post‐mortem samples. Death rates among methadone users in Tehran, Iran, increased year by year during 2009–2015. These findings raise the attention to the concomitant use of drugs with the need for changes in regulation and regulatory policy to restrict access and use of controlled drugs.
What are the clinically important outcome measures in the surgical management of nasal obstruction?
Authors: Lodder Wouter L. , Leong Samuel C.
Published: October 2017

Objectives

To assess the correlation between the Nasal Obstruction Symptom Evaluation (NOSE) scale and peak nasal inspiratory flow (PNIF) measurement, and to determine which outcome variable correlates with patient satisfaction and thereby, provide an indication of successful surgical outcome.

Design

Prospective case series

Setting

Tertiary rhinology service (Liverpool, U.K)

Participants

Patients having surgery (septoplasty, turbinoplasty) for nasal obstruction.

Main outcome measures

NOSE, PNIF, 5‐point Likert scale (weighted from “very satisfied” to “not at all satisfied”) and a 10‐cm visual analogue scale (0 = not at all satisfied, 10 = very satisfied).

Results

Forty‐five (15 female) had complete data sets available for analysis. The mean preoperative NOSE score was 78.4 (standard deviation, SD 14.8) and improved significantly to 23.0 (SD 19.1) postoperatively. A similar trend was observed where the mean preoperative PNIF improved significantly by 40% from 91.8 L/min (SD 28.2) to 139.9 (SD 27.9) following surgery. The mean improvement in NOSE score of the overall study cohort was 55.4 (SD 22.3) while the mean improvement in PNIF was 48.0 (SD 31.1). Although no correlation was observed between pre‐ and postoperative NOSE and PNIF, a significant (P = .01) but weak positive correlation (r = .39) was observed between the magnitude of change in NOSE and PNIF. The mean change in NOSE score of patients who were “very satisfied” with their nasal operation was 64.0 (SD 18.5), significantly higher compared to 39.2 (SD 17.9) in patients who were “satisfied.”

Conclusions

Patients who rate being either “satisfied” or “very satisfied” demonstrated significant improvement in NOSE and PNIF following their nasal surgery; the magnitude being twice the calculated minimal clinically important difference.
Social fit of coral reef governance varies among individuals
Authors: Turner Rachel A , Forster Johanna , Fitzsimmons Clare , Gill David , Mahon Robin , Peterson Angelie , Stead Selina
Published: October 2017

Improved natural resource governance is critical for the effective conservation of ecosystems, and the well‐being of societies that depend on them. Understanding the social fit of institutional arrangements in different contexts can help guide the design of effective environmental governance. This empirical study assessed individual‐level variation in institutional acceptance of coral reef governance among 652 respondents in 12 fishing and tourism‐oriented communities in the Wider Caribbean. High institutional acceptance was strongly associated with perceptions of community cohesiveness, underlining the potential contribution of civil society to effective governance processes. Institutional acceptance was also influenced by reef use, awareness of rules, perceived trends in reef fish populations, education, and contextual community‐level factors. Understanding what influences diverse perceptions of coral reef governance among individuals can help to assess the likelihood of support for conservation measures. This study highlights how knowledge of institutional acceptance can inform the design of more targeted interventions that enhance the social fit of conservation governance to local contexts and diverse resource users.
Citizen participation in disaster recovery projects and programmes in rural communities: a comparison of the Haiti earthquake and Hurricane Katrina
Authors: Pyles Loretta , Svistova Juliana , Ahn Suran , Birkland Tom
Published: October 2017

This study investigates predictors of local participation in recovery projects and programmes following Hurricane Katrina in the United States in 2005 and the earthquake in Haiti in 2010. Using two sets of survey data, it examines whether disaster impacts and social capital (social trust and civic engagement) are associated with disaster recovery participation and compares predictors of such engagement in the two locations. Multivariate logistic regression results reveal that physical injuries, limited community mobility, and government trust increase recovery participation in Haiti (n=278), whereas emotional distress and homeownership decrease it. On the Gulf Coast of the US (n=259), physical injuries and higher civic engagement augment recovery participation, while homeownership and age reduce it. The confounding factors of national contexts and post‐disaster time frames might explain the differences in the results. The discussion addresses the relation between country‐specific vulnerability and recovery participation and suggests implications for policy and practice to improve local citizens’ capabilities to participate in sustainable recovery processes.
Family intervention for caregivers of people with recent‐onset psychosis: A systematic review and meta‐analysis
Authors: Ma Chak Fai , Chien Wai Tong , Bressington Daniel Thomas
Published: October 2017

Aim

We aimed to systematically review the evidence of the effectiveness of family interventions for caregivers of people with recent‐onset psychosis compared with usual psychiatric care. A secondary objective was to directly compare the effects of different types of family interventions.

Methods

MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL Complete and EBSCOhost were searched to identify relevant randomized controlled trials. Trial data were extracted following the procedures described in the Cochrane Handbook of systematic reviews. Random‐effects models were used to pool the intervention effects.

Results

Twelve studies including 1644 participants were included in this review. With the exception of a high risk of performance bias inherent to the nature of the psychosocial interventions, the studies had an overall low or unclear risk of bias, suggesting that sources of bias are unlikely to lower confidence in the estimate of intervention effects. Meta‐analyses were conducted for 4 different participant outcomes reported in 9 studies. Compared with usual psychiatric care, family intervention was more effective in reducing care burden over all follow‐up periods. Family intervention was also superior to usual care with regards to caregiving experience in the short term and improved utilization of formal support and family functioning over longer‐term follow up. Mutual support is more effective than psychoeducation in improving family functioning when measured 1 to 2 years after the intervention but had equivalent effects on utilization of formal support services.

Conclusions

This review provides evidence that family intervention is effective for caregivers of recent‐onset psychosis, especially for care burden where the positive effects are enhanced over time.
Negative symptoms of psychosis: A life course approach and implications for prevention and treatment
Authors: Lyne John , O'Donoghue Brian , Roche Eric , Renwick Laoise , Cannon Mary , Clarke Mary
Published: October 2017

Aim

Negative symptoms are a cause of enduring disability in serious mental illness. In spite of this, the development of effective treatments for negative symptoms has remained slow. The challenge of improving negative symptom outcomes is compounded by our limited understanding of their aetiology and longitudinal development.

Methods

A literature search was conducted for life course approach of negative symptoms using PubMed. Further articles were included following manual checking of reference lists and other search strategies. The paper contains a theoretical synthesis of the literature, summarized using conceptual models.

Results

Negative symptom definitions are compared and considered within a context of the life course. Previous studies suggest that several illness phases may contribute to negative symptoms, highlighting our uncertainty in relation to the origin of negative symptoms.

Conclusions

Similar to other aspects of schizophrenia, negative symptoms likely involve a complex interplay of several risk and protective factors at different life phases. Concepts suggested in this article, such as “negative symptom reserve” theory, require further research, which may inform future prevention and treatment strategies.
Increasing the speed of fuzzy k‐nearest neighbours algorithm
Authors: Nikdel Hamed , Forghani Yahya , Mohammad Hosein Moattar S.
Published: October 2017

Fuzzy k‐nearest neighbour (FKNN) is one of the most convenient classification approaches. The main challenge of this method is associated with finding the optimal values of its two hyperparameters. The present study attempts to decrease the running time of this approach by reducing the number of its hyperparameters through omitting the hyperparameter k. In the training phase of FKNN approach, the membership degree of each training data is refined by crisp KNN voting whereas a fuzzy voting is used in the training phase of our proposed approach. Training and test phases time complexities of our proposed approach are better than those of FKNN approach. The experiments on real data sets indicate that the accuracy of our proposed approach called ultra FKNN is higher than FKNN approach due to applying fuzzy voting instead of crisp voting in training phase. In addition, the training, test, and running time of our proposed approach are considerably less than those of FKNN.
Trehalose acts as a uridine 5′‐diphosphoglucose‐competitive inhibitor of trehalose 6‐phosphate synthase in Corynebacterium glutamicum
Authors: Oide Shinichi , Inui Masayuki
Published: October 2017

Trehalose is a compatible solute widely distributed in nature. The most prevalent pathway for its synthesis starts from condensation of glucose 6‐phosphate (Glc6P) and uridine 5′‐diphosphoglucose (UDP‐Glc) catalyzed by trehalose 6‐phosphate synthase (TPS). A previous laboratory evolution experiment with the bacterium Corynebacterium glutamicum generated strains adapted to supraoptimal temperatures, and the R328H substitution of the TPS encoded by otsA was shown to be associated with thermotolerance acquired by the evolved strains. In this study, we found that the OtsA:R328H substitution promotes both intra‐ and extracellular trehalose accumulation and demonstrated that build‐up of intracellular trehalose accounts for the OtsAR328H‐dependent thermotolerance, using the mycobacterial trehalose‐specific transporter. Counterintuitively, characterization of the recombinant OtsA proteins revealed that the mutation downshifts the temperature optimum of OtsA. A search for the molecular basis of OtsAR328H‐dependent enhancement of trehalose synthesis led to the unexpected findings that trehalose is an effective inhibitor of OtsA and that OtsAR328H is highly tolerant to the trehalose‐mediated inhibition. The only available report on such feedback regulation of TPS is for the silk moth from over 50 years ago [Murphy TA and Wyatt GR (1965) J Biol Chem 240, 1500–1508]. While trehalose acts as a Glc6P‐competitive inhibitor in the silk moth, the disaccharide was found to inhibit OtsA in a UDP‐Glc‐competitive manner in C. glutamicum, suggesting independent origins of the negative feedback regulations found for the two species. We showed that overexpression of the wild‐type OtsA counteracts the trehalose‐dependent regulation and restores the evolved strain‐like phenotype to the isogenic wild‐type otsA revertant, demonstrating that thermotolerance conferred by OtsAR328H is attributable to its feedback‐resistant property.
Is the temperature plateau of a self‐heating test a robust parameter to investigate the fatigue limit of steels with thermography?
Authors: de Finis R. , Palumbo D. , da Silva M.M. , Galietti U.
Published: October 2017

A critical aspect of standard test methods for fatigue characterization is that they do not provide any information on heat dissipation in the material and involve very expensive experimental campaigns in time and costs. In recent years, thermographic methods capable of reducing testing time have been developed, also providing more information on damage occurring in the material. A commonly used approach is based on the assessment of the temperature plateau during a stepwise loading procedure. At times, however, this approach can fail if temperature stabilization is not achieved. In this regard, in this paper, a new approach based on the assessment of 3 different thermal indexes was proposed to estimate the fatigue limit of 3 stainless steels: AISI 316, 17‐4PH, and ASTMA890 grade 4a, respectively, exhibiting fully austenitic, fully martensitic, and duplex biphasic microstructure. The fatigue tests were carried out by using a stepwise loading procedure, under loading ratio of 0.5.

The analysis demonstrated the possibility to further reduce testing time and, consequently, the fatigue experimental campaign. Moreover, some ideas are discussed about how to justify the different thermal behaviour of a biphasic stainless steel, in total temperature variation.

Moreover, a discussion of results regarding the various thermal behaviours of the investigated steels and a possible correlation with the microstructure has been proposed.