bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying Emergency Department Patients at Low Risk for a Variceal Source of Upper Gastrointestinal Hemorrhage
Authors: Klein Lauren R. , Money Joel , Maharaj Kaveesh , Robinson Aaron , Lai Tarissa , Driver Brian E.
Published: August 2017

Background

Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage.

Methods

This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization. Clinical and laboratory data were abstracted from the medical record. The source of the UGIB was defined as variceal or nonvariceal based on endoscopic reports. Binary recursive partitioning was utilized to create a clinical decision rule. The rule was internally validated and test characteristics were calculated with 1,000 bootstrap replications.

Results

A total of 719 patients were identified; mean age was 55 years and 61% were male. There were 71 (10%) patients with a variceal UGIB identified on endoscopy. Binary recursive partitioning yielded a two‐step decision rule (platelet count > 200 × 109/L and an international normalized ratio [INR] < 1.3), which identified patients who were low risk for a variceal source of hemorrhage. For the bootstrapped samples, the rule performed with 97% sensitivity (95% confidence interval [CI] = 91%–100%) and 49% specificity (95% CI = 44%–53%).

Conclusion

Although this derivation study must be externally validated before widespread use, patients presenting to the ED with an acute UGIB with platelet count of >200 × 109/L and an INR of <1.3 may be at very low risk for a variceal source of their upper gastrointestinal hemorrhage.
Effects of high alcohol intake, alcohol‐related symptoms and smoking on mortality
Authors: Whitfield John B. , Heath Andrew C. , Madden Pamela A. F. , Landers J. George , Martin Nicholas G.
Published: August 2017

Background and Aims

Both high alcohol intake and alcohol dependence increase mortality, and both are associated with smoking. We aimed to compare the associations of quantity of alcohol, number of alcohol‐related symptoms and smoking history with all‐cause mortality, and to assess symptom count and smoking history as confounders or mediators of the effects of high alcohol intake.

Design

Survival was analysed by Cox regression with sex, body mass index, alcohol intake (overall and by beverage), maximum drinks on any day, alcohol symptom count and smoking status as potential predictors of age at death.

Setting

Australia.

Participants

Participants were apparently healthy volunteers consisting of 33 593 Australian adult twins and their relatives who completed questionnaires or interviews between 1979 and 2005.

Measurements

Data on alcohol use, smoking and occurrence of symptoms related to alcohol use disorders and death records from the Australian National Death Index.

Findings

A total of 3764 participants were matched with deaths occurring within Australia up to July 2014. Individually, alcohol intake [hazard ratio (HR) = 1.0082, 95% confidence interval (CI) = 1.0063–1.0102, per drink per week], beer intake (HR = 1.0159, 95% CI = 1.0123–1.0195, per drink per week), life‐time maximum number of drinks in 1 day (HR = 1.0176, 95% CI = 1.0130–1.0221, per drink), symptom count (HR = 1.0867, 95% CI = 1.0633–1.1106, per symptom) and smoking status (HR = 2.82, 95% CI = 2.52–3.16 for smokers of 10+ cigarettes/day versus never‐smokers) were each significant predictors of all‐cause mortality. After adjustment for the independently significant predictors alcohol symptom count and smoking status, alcohol intake was no longer significant (adjusted HR = 1.0012 per drink per week, 95% CI = 0.9979–1.0145).

Conclusions

Number of symptoms related to high alcohol intake and tobacco smoking appear to account for the positive association between alcohol consumption and premature mortality.
New cancer cases in France in 2015 attributable to different levels of alcohol consumption
Authors: Shield Kevin D. , Marant Micallef Claire , Hill Catherine , Touvier Mathilde , Arwidson Pierre , Bonaldi Christophe , Ferrari Pietro , Bray Freddie , Soerjomataram Isabelle
Published: August 2017

Background and aims

Alcohol consumption increases the risk of cancer. Thus, to inform policy decisions, this study estimated the number of new cancer cases in France in 2015 attributable to alcohol consumption generally and to light (< 20 g per day (g/day) among women; < 40 g/day among men), moderate (20 to < 40 g/day among women; 40 to < 60 g/day among men) and heavy drinking (≥ 40 g/day among women; ≥ 60 g/day among men), and the number of cancer cases that would have been prevented assuming a previous 10% decrease in alcohol consumption.

Design

New cancer cases attributable to alcohol were estimated using a population‐attributable fraction methodology, assuming a 10‐year latency period between exposure and diagnosis.

Setting and participants

Population of France, 2015.

Measurements

Alcohol consumption was estimated by coordinating data from the Baromètre santé 2005, a national representative survey (n = 30 455), with data from the Global Information System on Alcohol and Health. Relative risks were obtained from meta‐analyses. Cancer data were estimated based on data from the French Cancer Registries Network. Uncertainty intervals (UI) were estimated using a Monte Carlo procedure.

Findings

In France in 2015, an estimated 27 894 (95% UI = 24 287–30 996) or 7.9% of all new cancer cases were attributable to alcohol. The number of alcohol‐attributable new cancer cases was similar for both men and women, with oesophageal squamous cell carcinomas having the largest attributable fraction (57.7%). Light, moderate, heavy and former alcohol drinking were responsible for 1.5, 1.3, 4.4 and 0.6% of all new cancer cases, respectively. Lastly, if there had been a previous 10% reduction in alcohol consumption, 2178 (95% UI = 1687–2601) new cancer cases would have been prevented.

Conclusions

Alcohol consumption in France appears to cause almost 8% of new cancer cases, with light and moderate drinking contributing appreciably to this burden. A 10% drop in drinking in France would have prevented more than 2000 (estimated) new cancer cases in 2015.
Socio‐economic differentials in cannabis use trends in Australia
Authors: Chan Gary C. K. , Leung Janni , Quinn Catherine , Weier Megan , Hall Wayne
Published: August 2017

Aim

To test if the degree of change in cannabis use between 2001 and 2013 differed according to socio‐economic status.

Design

Repeated cross‐sectional household surveys that were nationally representative.

Setting

Australia.

Participants

Adult samples from the 2001 and 2013 National Drug Strategy Household Surveys (n = 23 642 in 2001 and n = 21 353 in 2013), the largest nationally representative survey on drug use in Australia.

Measurements

Frequency of cannabis use coded as daily use, weekly use, less than weekly use and non‐current use; socio‐economic status (SES) as measured by personal income and educational level.

Finding

There were significant differences in changes to levels of cannabis use between SES groups. Among participants who completed high school, the probability of daily use decreased from 0.014 to 0.009 (P < 0.001), and the probability of weekly use decreased from 0.025 to 0.017 (P < 0.001). These probabilities remained stable for participants who did not complete high school. The probability of weekly cannabis use decreased from 0.032 to 0.023 among participants with middle level income (P = 0.004), and from 0.021 to 0.013 among those with high income (P = 0.005). There were no significant changes in these probabilities among those with low income (0.026 in 2001 and 0.032 in 2013; P = 0.203).

Conclusion

The decline in cannabis use in Australia from 2001 to 2013 occurred largely among higher socio‐economic status groups. For people with lower income and/or lower education, rates of frequent cannabis use remained unchanged.
Chlamydia testing and diagnosis following initiation of long‐acting reversible contraception: A retrospective cohort study
Authors: Rose Sally B. , Garrett Susan M. , Stanley James , Pullon Susan R. H.
Published: August 2017

Background

Long‐acting reversible contraception (LARC) effectively protects against pregnancy but provides no protection against sexually transmitted infections (STIs).

Aim

To compare rates of chlamydia testing and diagnosis for women initiating long‐acting versus oral contraception.

Materials and methods

Retrospective cohort study involving data collection for 6160 women initiating post‐abortion contraception at a large New Zealand regional public hospital abortion clinic (2009–2012), with chlamydia testing data obtained from the local laboratory during two‐year follow up. Negative binomial regression modelling examined the effect of contraceptive method on two outcome measures: chlamydia testing and chlamydia diagnosis (adjusting for potential covariates of age, ethnicity, past chlamydia infection, pregnancy history) in year one and two of follow up.

Results

Two thousand seven hundred and twenty nine women (44%) received a LARC and 1764 (28.6%) were prescribed oral contraception. Adjusted testing rates differed by contraceptive method only in year one (P < 0.01): with higher rates among copper intrauterine device users (relative risk (RR) 1.2, 95% CI 1.06–1.35), and lower rates for implant users (RR 0.84, 95% CI 0.72–0.99) compared with oral contraceptive users (reference group). No significant differences were observed in chlamydia diagnosis rates by contraceptive method (P > 0.05). Younger age, past chlamydia infection, Maori and Pacific ethnicity were associated with higher rates of chlamydia diagnosis (P < 0.01).

Conclusions

Known STI‐related risk factors (age, ethnicity, past infection) but not contraceptive method were independently related to rates of subsequent chlamydia diagnosis. This suggests that increased LARC uptake would not occur at the expense of chlamydia control. Regular screening and risk reduction advice (including condom use) are important chlamydia control measures for at‐risk groups.
Health utilities for controlled and uncontrolled chronic hand eczema in healthcare employees
Authors: Küster Denise , Haufe Eva , Rethberg Constanze , Bauer Andrea , Seidler Andreas , Schmitt Jochen
Published: August 2017

Background

Health utilities provide a universally applicable method for measuring the relative preferences or values of specific health states. Health economic studies use health utilities to estimate disease burden and the cost‐effectiveness of interventions. Chronic hand eczema (CHE) affects many individuals and adversely affects work productivity. Health utilities forCHEfrom the perspective of healthcare professionals are lacking.

Objectives

To assess health utilities forCHEfrom the perspectives of employees in the healthcare sector and affected patients.

Methods

A cross‐sectional study with volunteers from the healthcare sector (n = 126) and patients (n = 32) was conducted to establish health utilities (ranging from 1 = perfect health to 0 = death) for mild and severeCHE.

Results

The median health utilities of the healthy volunteers derived with the time trade‐off method were 0.97 (mean: 0.92) for mildCHEand 0.77 (mean: 0.75) for severeCHE. The median health utilities for mild and severeCHEfrom the perspective of affected patients were 0.98 (mean: 0.91) and 0.82 (mean: 0.77), respectively. Differences in health utilities between the two study groups were not significant.

Conclusion

CHEconstitutes a considerable burden from the perspective of healthcare employees. Effective control ofCHEconstitutes an important public health goal.
Colour gamuts arising from absorber–dielectric–metal optical resonators
Authors: Oller Declan , He De , Kim Jin Ho , Pacifici Domenico , Xu Jimmy , Fernandes Gustavo E.
Published: August 2017

Structural coloration is a quickly growing field, encompassing physical and photonic processes such as interference, diffraction, and scattering. In this study, we investigated the optical effects in the visible wavelength range, and in particular, the colour gamuts achievable with absorber–dielectric–metal sandwich structures. These chemical‐free layered structures are highly tunable, easily scaled, optical cavities that are capable of generating remarkable colours whose properties are determined completely by material and structural parameters. We employed experimental and numerical strategies to demonstrate that each absorber spans a unique colour gamut, i.e. a subset of the full chromaticity space. While gamut overlap is observed between different absorber types, the gamut areas unique to each absorber occur at different hues of high excitation purity. A comprehensive understanding of how these colour gamuts develop and how different materials may be combined to expand larger subsets of the chromaticity space is required in order to maximize the variety of colours achievable with this system and elevate it into a ‘structural coloration technology’.
Psoriasis or not? Review of 51 clinically confirmed cases reveals an expanded histopathologic spectrum of psoriasis
Authors: Chau Thinh , Parsi Kory K. , Ogawa Toru , Kiuru Maija , Konia Thomas , Li Chin‐Shang , Fung Maxwell A.
Published: August 2017

Background

Psoriasis is usually diagnosed clinically, so only non‐classic or refractory cases tend to be biopsied. Diagnostic uncertainty persists when dermatopathologists encounter features regarded as non‐classic for psoriasis.

Objective

Define and document classic and non‐classic histologic features in skin biopsies from patients with clinically confirmed psoriasis.

Methods

Minimal clinical diagnostic criteria were informally validated and applied to a consecutive series of biopsies histologically consistent with psoriasis. Clinical confirmation required 2 of the following criteria: (1) classic morphology, (2) classic distribution, (3) nail pitting, and (4) family history, with #1 and/or #2 as 1 criterion in every case

Results

Fifty‐one biopsies from 46 patients were examined. Classic features of psoriasis included hypogranulosis (96%), club‐shaped rete ridges (96%), dermal papilla capillary ectasia (90%), Munro microabscess (78%), suprapapillary plate thinning (63%), spongiform pustules (53%), and regular acanthosis (14%). Non‐classic features included irregular acanthosis (84%), junctional vacuolar alteration (76%), spongiosis (76%), dermal neutrophils (69%), necrotic keratinocytes (67%), hypergranulosis (65%), neutrophilic spongiosis (61%), dermal eosinophils (49%), compact orthokeratosis (37%), papillary dermal fibrosis (35%), lichenoid infiltrate (25%), plasma cells (16%), and eosinophilic spongiosis (8%).

Conclusions

Psoriasis exhibits a broader histopathologic spectrum. The presence of some non‐classic features does not necessarily exclude the possibility of psoriasis.
Examination of associations between early life victimisation and alcohol's harm from others
Authors: Kaplan Lauren M. , Greenfield Thomas K. , Karriker‐Jaffe Katherine J.
Published: August 2017

Introduction and Aims. Study aims were to examine: (i) how physical and sexual victimisation in early life are associated with alcohol's harm from others; and (ii) whether respondents' current drinking is a mediator of the association between early life victimisation and alcohol's harm from others among men and women. Design and Methods. Data were from national computer‐assisted telephone interviews, using the landline sample (3335 men and 3520 women ages ≥18) from the 2010 US National Alcohol Survey. Harms from someone else's drinking included family/marital problems, financial troubles, assault and vandalism in the past 12 months. Victimisation was measured with severe physical abuse or sexual assault before age 18. Results. Severe physical or sexual victimisation before age 18 was reported by 3.4% of men and 8.1% of women. Significantly more men (5.2%) than women (2.4%) reported assault by other drinkers, and significantly more women reported family/marital (5.3%) and financial problems (2.8%) than did men (2.6 and 1% respectively). Severe early life victimisation was robustly associated with a greater likelihood of experiencing past‐year harms from other drinkers for both men and women. Men's drinking partially mediated associations between early life victimisation and recent assaults and vandalism by other drinkers. Discussion and Conclusions. Early life victimisation may increase risk of harms from someone else's drinking. Health services and interventions that screen for histories of victimisation may help decrease risk of later harms from others' drinking. Reductions in drinking among men with histories of victimisation also could help reduce their exposure to such harms. [Kaplan LM, Greenfield TK, Karriker‐Jaffe KJ. Examination of associations between early life victimisation and alcohol's harm from others.
BAD REPUTATION UNDER BOUNDED AND FADING MEMORY
Authors: Sperisen Benjamin
Published: August 2017

I relax the full memory assumption in Ely and Välimäki's (2003) mechanic game, where reputation is bad. Under bounded memory (only recent periods are observed), long memory still yields bad reputation due to an “echo” where bad signals cause future motorists to not hire, causing further lack of hiring, and so on. Short memory avoids bad reputation by making it “useless,” because consumers never learn enough information to change their decisions. No “happy middle” exists under bounded memory where consumers learn valuable information without tempting the mechanic into harmful signaling and thereby unraveling the market. By contrast, “fading memory” (past periods are randomly sampled with “fading” probabilities) achieves this happy middle by offering valuable information in a way that bounds the probabilities of these reputational echoes. Possible fading memory implementations (e.g., for review websites) are described and generalized to a broader class of games. (JEL C73, D8)
Illegal quays: Elizabethan customs reforms and suppression of the coastal trade of Christchurch, Hampshire
Authors: Gadd Stephen
Published: August 2017

This article considers deficiencies in the designation and reassessment of Legal Quays (those authorized for foreign trade), and the detrimental impact of these and other Elizabethan customs reforms from the perspective of Christchurch, a small coastal town then in Hampshire. Throttling the flow of merchandise through such places drove trade, and consequently economic growth, to those other places that enjoyed a convenient Legal Quay. In places without such quays, regulation and the farming of customs caused (and also facilitated) the suppression not only of international trade but also of domestic maritime trade. Though otherwise encouraged by Crown policy, entrepreneurial endeavour in Christchurch was stifled by customs regulation, in particular by the logistical burden introduced with remote record‐keeping for coastal trade in the port books. The town seemed unable to break free of Southampton's controlling influence in order to realize its own apparent economic potential.
Distinct patterns of discrimination and orienting for temporal processing of speech and nonspeech in Chinese children with autism: an event‐related potential study
Authors: Huang Dan , Yu Luodi , Wang Xiaoyue , Fan Yuebo , Wang Suiping , Zhang Yang
Published: August 2017

Although many studies have reported domain‐general impaired duration perception for speech and nonspeech sounds in children with autism, it remained unclear whether this phenomenon is universally applicable regardless of language background. In some languages such as Finnish and Japanese, vowel duration serves a phonemic role that can signify semantic distinction, and in others (e.g., Mandarin Chinese), vowel duration does not carry this phonemic function. The present event‐related potential study investigated neural sensitivity to duration contrasts in speech and nonspeech contexts in Mandarin‐speaking children with autism and a control group of age‐matched typically developing (TD) children. A passive oddball paradigm was adopted to elicit the mismatch negativity (MMN) and involuntary orienting response (P3a) for change detection. A pure tone condition and a vowel condition were used. The MMN results showed that the autism group had diminished response amplitude and delayed latency in the pure tone condition compared to the TD group, whereas no group difference was found in the vowel condition. The P3a results showed no significant between‐group MMN difference in the pure tone condition. In the vowel condition, the autism group had smaller P3a than the TD group. Together, the distinct patterns of discrimination and orienting responses for duration contrasts in pure tones and vowels are consistent with the ‘allophonic perception’ theory for autism, which may reflect a compromised perceptual weighting system for speech learning.
A tug of war: antagonistic effective connectivity patterns over the motor cortex and the severity of motor symptoms in Gilles de la Tourette syndrome
Authors: Zapparoli Laura , Tettamanti Marco , Porta Mauro , Zerbi Alberto , Servello Domenico , Banfi Giuseppe , Paulesu Eraldo
Published: August 2017

We tested the hypothesis that Gilles de la Tourette syndrome (GTS) is characterized by perturbed connectivity within cortico–subcortical motor networks. To this end, we performed a dynamic causal modelling (DCM) analysis of fMRI data collected during a finger opposition task in 24 normal controls and 24 GTS patients. The DCM analysis allowed us to assess whether any GTS‐specific patterns of brain activity were related to intrinsic and/or to task‐dependent connectivity. While no abnormalities were found for task‐dependent connectivity, intrinsic connectivity was abnormally increased in the premotor network, with stronger connections from the supplementary motor area (SMA), from the dorsolateral premotor cortex and from the putamen to the right superior frontal gyrus, an area where GTS showed over‐activation in a previous univariate analysis. We also found a positive correlation between the connectivity strength from the right basal ganglia to the right primary motor cortex (M1) and disease severity measured by the Yale Global Tic Severity Scale (YGTSS). This pattern was mirrored by a negative correlation between the connection strength from the right SMA to the right area M1 and the YGTSS score. These two reverse correlation effects showed a specific relationship with individual disease severity: the greater the imbalance between subcortical and premotor connectivity towards area M1, the higher the YGTSS score. These results reveal the existence of perturbed intrinsic connectivity patterns in the motor networks of GTS patients with two competing forces operating in a tug of war‐like mechanism: aberrant subcortical afferents to M1, compensated for by inputs from the premotor cortex.
The subthalamic nucleus‐external globus pallidus loop biases exploratory decisions towards known alternatives: a neuro‐computational study
Authors: Baladron Javier , Nambu Atsushi , Hamker Fred H.
Published: August 2017

Theories and models of the basal ganglia have mainly focused on the role of three different corticothalamic pathways: direct, indirect and hyperdirect. Although the indirect and the hyperdirect pathways are linked through the bidirectional connections between the subthalamic nucleus (STN) and the external globus pallidus (GPe), the role of their interactions has been mainly discussed in the context of a dysfunction (abnormal oscillations in Parkinson's disease) and not of its function. We here propose a novel role for the loop formed by the STN and the GPe. We show, through a neuro‐computational model, that this loop can bias the selection of actions during the exploratory period after a change in the environmental conditions towards alternative responses. Testing well‐known alternative solutions before completely random actions can reduce the time required for the search of a new response after a rule change. Our simulations further show that the knowledge acquired by the indirect pathway can be transferred into a stable memory via learning in the hyperdirect pathway to establish the blocking of unwanted responses. After a rule switch, first the indirect pathway learns to inhibit the previously correct actions. Once the new correct association is learned, the inhibition is transferred to the hyperdirect pathway through synaptic plasticity.
Drebrin E regulates neuroblast proliferation and chain migration in the adult brain
Authors: Kajita Yuki , Kojima Nobuhiko , Koganezawa Noriko , Yamazaki Hiroyuki , Sakimura Kenji , Shirao Tomoaki
Published: August 2017

F‐actin‐binding protein drebrin has two major isoforms: drebrin A and drebrin E. Drebrin A is the major isoform in the adult brain and is highly concentrated in dendritic spines, regulating spine morphology and synaptic plasticity. Conversely, drebrin E is the major isoform in the embryonic brain and regulates neuronal morphological differentiation, but it is also expressed in neurogenic regions of the adult brain. The subventricular zone (SVZ) is one of the brain regions where adult neurogenesis occurs. Neuroblasts migrate to the olfactory bulb (OB) and integrate into existing neuronal networks, after which drebrin expression changes from E to A, suggesting that drebrin E plays a specific role in neuroblasts in the adult brain. Therefore, to understand the role of drebrin E in the adult brain, we immunohistochemically analyzed adult neurogenesis using drebrin‐null‐mutant (DXKO) mice. In DXKO mice, the number of neuroblasts and cell proliferation decreased, although cell death remained unchanged. These results suggest that drebrin E regulates cell proliferation in the adult SVZ. Surprisingly, the decreased number of neuroblasts in the SVZ did not result in less neurons in the OB. This was because the survival rate of newly generated neurons in the OB increased in DXKO mice. Additionally, when neuroblasts reached the OB, the change in the migratory pathway from tangential to radial was partly disturbed in DXKO mice. These results suggest that drebrin E is involved in a chain migration of neuroblasts.
Ventral striatal dopaminergic defect is associated with hallucinations in Parkinson's disease
Authors: Jaakkola E. , Joutsa J. , Mäkinen E. , Johansson J. , Kaasinen V.
Published: August 2017

Background and purpose

Visual hallucinations (VHs) are a common complication of Parkinson's disease (PD). The pathogenesis of VHs in PD is still largely unclear. The aim of this study was to investigate the dopaminergic mechanisms of VHs and specifically whether the degree of striatal dopamine transporter (DAT) function or extrastriatal serotonin transporter (SERT) function can predict the appearance of VHs in patients with PD.

Methods

Twenty‐two PD patients scanned with [123I]FP‐CIT single photon emission computed tomography at an early stage of their disease who later developed VHs were identified and compared with 48 non‐hallucinating PD patients. The groups were matched for age, medication, disease duration and motor symptom severity. Clinical follow‐up after the scan was a median (range) of 6.9 (3.8–9.6) years. Imaging analyses were performed with both regions‐of‐interest‐based and voxel‐based (Statistical Parametric Mapping) methods for the striatal and extrastriatal regions.

Results

The median interval between the scan and the emergence of VHs was 4.8 years. Patients who developed VHs had 18.4% lower DAT binding in the right ventral striatum (P = 0.009), 16.7% lower binding in the left ventral striatum (P = 0.02) and 18.8% lower binding in the right putamen (P = 0.03) compared to patients who did not develop VHs.

Conclusions

Low striatal DAT function may predispose PD patients to VHs, and the regional distribution of the findings suggests a particular role of the ventral striatum. This is in line with non‐PD research that has implicated ventral striatal dysfunction in psychosis.
Ecosystem modelling to quantify the impact of historical whaling on Southern Hemisphere baleen whales
Authors: Tulloch Vivitskaia J D , Plagányi Éva E , Matear Richard , Brown Christopher J , Richardson Anthony J
Published: August 2017

Many baleen whales were commercially harvested during the 20th century almost to extinction. Reliable assessments of how this mass depletion impacted whale populations, and projections of their recovery, are crucial but there are uncertainties regarding the status of Southern Hemisphere whale populations. We developed a Southern Hemisphere spatial “Model of Intermediate Complexity for Ecosystem Assessments” (MICE) for phytoplankton, krill (Euphausia superba) and five baleen whale species, to estimate whale population trajectories from 1890 to present. To forward project to 2100, we couple the predator–prey model to a global climate model. We used the most up to date catch records, fitted to survey data and accounted for key uncertainties. We predict Antarctic blue (Balaenoptera musculus intermedia), fin (Balaenoptera physalus) and southern right (Eubalaena australis) whales will be at less than half their pre‐exploitation numbers (K) even given 100 years of future protection from whaling, because of slow growth rates. Some species have benefited greatly from cessation of harvesting, particularly humpbacks (Megaptera novaeangliae), currently at 32% of K, with full recovery predicted by 2050. We highlight spatial differences in the recovery of whale species between oceanic areas, with current estimates of Atlantic/Indian area blue (1,890, <1% of K) and fin (16,950, <4% of K) whales suggesting slower recovery from harvesting, whilst Pacific southern right numbers are <7% of K (2,680). Antarctic minke (Balaenoptera bonaerensis) population trajectories track future expected increases in primary productivity. Population estimates and plausible future predicted trajectories for Southern Hemisphere baleen whales are key requirements for management and conservation.
Fatigue crack propagation under in‐phase and out‐of‐phase biaxial loading
Authors: Neerukatti R.K. , Datta S. , Chattopadhyay A. , Iyyer N. , Phan N.
Published: August 2017

Fatigue damage characteristics of aluminium alloy under complex biaxial loads such as in‐phase and out‐of‐phase loading conditions and different biaxiality ratios have been investigated. The effects of microscale phenomena on macroscale crack growth were studied to develop an in‐depth understanding of crack nucleation and growth. Material characterization was conducted to study the microstructure variability. Scanning electron microscopy was used to identify the second phase particles, and energy dispersive X‐ray spectroscopy was performed to analyse their phases and elements. Extensive quasi‐static and fatigue tests were conducted on Al7075‐T651 cruciform specimens over a wide range of load ratios and phases. Detailed fractography analysis was conducted to understand the crack growth behaviour observed during the fatigue tests. Significant differences in crack initiation and propagation behaviour were observed when a phase difference was applied. Primarily, crack retardation and splitting were observed because of the constantly varying mode mixity caused by phase difference. The crack growth behaviour and fatigue lives under out‐of‐phase loading were compared with those under in‐phase loading to understand the effect of mixed‐mode fracture.
Fatigue resistance investigation of warm‐mix recycled asphalt binder, mastic, and fine aggregate matrix
Authors: Li Q. , Chen X. , Li G. , Zhang S.
Published: August 2017

Fatigue cracking is one of the primary distresses in warm‐mix recycled asphalt pavements. This paper evaluates the fatigue resistance evolution of warm‐mix recycled asphalt materials in different scales during the service period. The strain sweep test and time sweep test were performed, respectively, by dynamic shear rheometer to determine the linear viscoelastic limits and to characterize the fatigue behavior of warm‐mix recycled asphalt binder, mastic, and fine aggregate matrix with different ageing levels and recycling plans. The dissipated energy method was used to define the failure criterion and to construct the fatigue model. Effects of ageing levels and recycling plans on stiffness and fatigue resistance were investigated. Performance correlations among warm‐mix recycled asphalt binder, mastic, and fine aggregate matrix were developed, respectively, by the statistical method to determine the critical material scale for stiffness and fatigue resistance.
Heterogeneous stock rats: a model to study the genetics of despair‐like behavior in adolescence
Authors: Holl K. , He H. , Wedemeyer M. , Clopton L. , Wert S. , Meckes J. K. , Cheng R. , Kastner A. , Palmer A. A. , Redei E. E. , Solberg Woods L. C.
Published: August 2017

Major depressive disorder (MDD) is a complex illness caused by both genetic and environmental factors. Antidepressant resistance also has a genetic component. To date, however, very few genes have been identified for major depression or antidepressant resistance. In this study, we investigated whether outbred heterogeneous stock (HS) rats would be a suitable model to uncover the genetics of depression and its connection to antidepressant resistance. The Wistar Kyoto (WKY) rat, one of the eight founders of the HS, is a recognized animal model of juvenile depression and is resistant to fluoxetine antidepressant treatment. We therefore hypothesized that adolescent HS rats would exhibit variation in both despair‐like behavior and response to fluoxetine treatment. We assessed heritability of despair‐like behavior and response to sub‐acute fluoxetine using a modified forced swim test (FST) in 4‐week‐old HS rats. We also tested whether blood transcript levels previously identified as depression biomarkers in adolescent human subjects are differentially expressed in HS rats with high vs. low FST immobility. We demonstrate heritability of despair‐like behavior in 4‐week‐old HS rats and show that many HS rats are resistant to fluoxetine treatment. In addition, blood transcript levels of Amfr, Cdr2 and Kiaa1539, genes previously identified in human adolescents with MDD, are differentially expressed between HS rats with high vs. low immobility. These data demonstrate that FST despair‐like behavior will be amenable to genetic fine‐mapping in adolescent HS rats. The overlap between human and HS blood biomarkers suggest that these studies may translate to depression in humans.
Are educating and promoting interventions effective in oral health?: A systematic review
Authors: Ghaffari M , Rakhshanderou S , Ramezankhani A , Buunk‐Werkhoven YAB , Noroozi M , Armoon B
Published: August 2017

Objective

It is estimated that about 20%‐25% of the world's population are suffering from periodontal diseases or severe gum diseases. This requires appropriate interventions. For the development of effective and evidence‐based programmes tailored to the target group, the aim of this review was to survey to the effectiveness of oral health education and promotion interventions in the relevant groups of people.

Methods

The electronic databases including PubMed, EMBASE, Web of science and Cochrane Library were searched for English language studies between 2010 and (January‐December) 2016. To assess the quality of articles, the checklist was used that includes 19 items. Studies were selected based on PICOs criteria, and finally, 16 studies were entered in our study.

Results

A total of 16 articles were selected, classified into two groups (A and B groups), so that group A with short‐term effects includes improving knowledge, attitudes, self‐efficacy, oral health behaviour (toothbrushing and flossing), theoretical constructs (perceived susceptibility, perceived severity and perceived behavioural control) which consists of 15 articles and group B with long‐term effects includes improving decayed teeth, plaque, calculus and bleeding which consists of six articles.

Conclusion

Approximately, this study supports effectiveness of all oral health education and promotion interventions, especially in short‐term outcomes. Regarding the importance of long‐term and short‐term outcomes for oral health education and promotion programmes, These interventions could be performed in the future with several target groups including family and teachers.
Development of a strategy and computational application to select candidate protein analogues with reduced HLA binding and immunogenicity
Authors: Dhanda Sandeep Kumar , Grifoni Alba , Pham John , Vaughan Kerrie , Sidney John , Peters Bjoern , Sette Alessandro
Published: August 2017

Unwanted immune responses against protein therapeutics can reduce efficacy or lead to adverse reactions. T‐cell responses are key in the development of such responses, and are directed against immunodominant regions within the protein sequence, often associated with binding to several allelic variants of HLA class II molecules (promiscuous binders). Herein, we report a novel computational strategy to predict ‘de‐immunized’ peptides, based on previous studies of erythropoietin protein immunogenicity. This algorithm (or method) first predicts promiscuous binding regions within the target protein sequence and then identifies residue substitutions predicted to reduce HLA binding. Further, this method anticipates the effect of any given substitution on flanking peptides, thereby circumventing the creation of nascent HLA‐binding regions. As a proof‐of‐principle, the algorithm was applied to Vatreptacog α, an engineered Factor VII molecule associated with unintended immunogenicity. The algorithm correctly predicted the two immunogenic peptides containing the engineered residues. As a further validation, we selected and evaluated the immunogenicity of seven substitutions predicted to simultaneously reduce HLA binding for both peptides, five control substitutions with no predicted reduction in HLA‐binding capacity, and additional flanking region controls. In vitro immunogenicity was detected in 21·4% of the cultures of peptides predicted to have reduced HLA binding and 11·4% of the flanking regions, compared with 46% for the cultures of the peptides predicted to be immunogenic. This method has been implemented as an interactive application, freely available online at http://tools.iedb.org/deimmunization/.
Near‐field impedance accurately distinguishes among pericardial, intracavitary, and anterior mediastinal position
Authors: Burkland David A. , Ganapathy Anand V. , John Mathews , Greet Brian D. , Saeed Mohammad , Rasekh Abdi , Razavi Mehdi
Published: August 2017

Introduction

Epicardial catheter ablation is increasingly used to treat arrhythmias with an epicardial component. Nevertheless, percutaneous epicardial access remains associated with a significant risk of major complications. Developing a technology capable of confirming proper placement within the pericardial space could decrease complication rates. The purpose of this study was to examine differences in bioimpedance among the pericardial space, anterior mediastinum, and right ventricle.

Methods

An ovine model (n = 3) was used in this proof‐of‐concept study. A decapolar catheter was used to collect bipolar impedance readings; data were collected between each of five electrode pairs of varying distances. Data were collected from three test regions: the pericardial space, anterior mediastinum, and right ventricle. A control region in the inferior vena cava was used to normalize the data from the test regions. Analysis of variance was used to test for differences among regions.

Results

A total of 10 impedance values were collected in each animal between each of the five electrode pairs in the three test regions (n = 340) and the control region (n = 145). The average normalized impedance values were significantly different among the pericardial space (1.760 ± 0.370), anterior mediastinum (3.209 ± 0.227), and right ventricle (1.024 ± 0.207; P < 0.0001). In post hoc testing, the differences between each pair of regions were significant, as well (P < 0.001 for all).

Conclusion

Impedance values are significantly different among these three anatomical compartments. Therefore, impedance can be potentially used as a means to guide percutaneous epicardial access.
Human Rights on the Losing end of EU Enlargement: The Case of Serbia
Authors: Huszka Beáta
Published: August 2017

By scrutinizing the effectiveness of EU human rights conditionality through the case of freedom of expression and media freedom in Serbia, the present study argues that Serbia has pursued the strategy of introducing some reforms that fall short of implementation. While the inconsistency of the EU's conditionality policy partially explains Serbia's under‐performance, Serbian authorities also lacked the incentives for compliance. As Serbia was willing to compromise on its perceived national interests concerning international war crimes prosecution and Kosovo, both highly significant issues for its national identity, the real threat now as perceived by the authorities is well functioning independent institutions and free media that can put constraints on their power. Considering that the EU assigned a key role to human rights in its conditionality policy, the Serbian case demonstrates how geopolitics can interfere to limit the EU's capacity to achieve compliance even from a candidate country.
Inside the EU Commission: Evidence on the Perceived Relevance of the Secretariat General in Climate Policy‐Making
Authors: Hustedt Thurid , Seyfried Markus
Published: August 2017

This article studies the perception of the EU Commission's Secretariat General in policy‐making. Recently, research on EU institutions devotes increasing attention to analyzing structures and procedures of decision‐making in EU institutions, most notably the EU Commission. Conventionally, the EU Commission is portrayed as a fragmented organization, divided along the lines of staff nationality, sectoral responsibilities and cabinets and General Directorates (DGs). The Secretariat General has long been viewed a weak actor that is hardly able or motivated to steer internal decision‐making. However, recent research indicates a changing role of the Secretariat General as a pro‐active broker and last arbiter. This article studies how the Secretariat General is perceived by the DGs in policy coordination and argues that this perception depends on the pattern of political authority, bureaucratic roles and the relevance and the alternatives prevailing in the policy field. The article is based on data from a survey among Commission officials.
Language impairment and comorbid vulnerabilities among young people in custody
Authors: Hughes Nathan , Chitsabesan Prathiba , Bryan Karen , Borschmann Rohan , Swain Nathaniel , Lennox Charlotte , Shaw Jennifer
Published: August 2017

Background

While the prevalence of language and communication difficulties among young people in custody is well established, holistic understanding of the complexity and co‐occurrence of additional vulnerabilities among this population are rare.

Methods

Ninety‐three young people in a young offenders institution in England were assessed using the Comprehensive Health Assessment Tool, the Test of Word Knowledge, and a range of additional assessments of communication, cognition, and neurodevelopmental difficulties.

Results

Forty‐seven percent of the young people demonstrated an aspect of language skills significantly below the population average, with more than one in four identified as having impairment. Only one in four of those with an impairment had previously accessed speech and language services. Language needs were associated with difficulties with social communication and nonverbal cognition, as well as higher risk of self‐harm and substance misuse.

Conclusions

Earlier identification of language difficulties requires routine assessment of young people at risk of engagement in offending behavior. Where language difficulties are identified, holistic assessments of needs should be undertaken. There is a need for speech and language therapy provision within youth justice services, as well as in other services accessed by young people at risk of engagement in offending.
The Case for Insurance Reimbursement of Couple Therapy
Authors: Clawson Robb E. , Davis Stephanie Y. , Miller Richard B. , Webster Tabitha N.
Published: August 2017

A case is made for why it may now be in the best interest of insurance companies to reimburse for marital therapy to treat marital distress. Relevant literature is reviewed with a considerable focus on the reasons that insurance companies would benefit from reimbursing marital therapy – the high costs of marital distress, the growing link between marital distress and a host of related physical and mental health problems, as well as the availability of empirically supported treatments for marital distress. This is followed by a focus on the major reasons insurance companies cite for not reimbursing marital therapy, along with a discussion of advances in several growing bodies of research to address these concerns. Main arguments include the direct medical offset costs of couple and family therapy (including for high utilizers of health insurance), and the fact that insurance companies already find it cost effective to reimburse for prevention of other health and psychological problems. This is followed by implications for practitioners and researchers.
Effect of patent foramen ovale closure for prevention on recurrent stroke or transient ischemic attack in selected patients with cryptogenic stroke
Authors: Kim Minsu , Kim Sihoon , Moon Jeonggeun , Oh Pyung Chun , Park Yae Min , Shin Dong Hoon , Lee Yeong‐Bae , Lee Ji Yeon , Hwang Hee Young , Kang Woong Chol
Published: August 2017

Objectives

This study was sought to evaluate the effectiveness of patent foramen ovale (PFO) closure in selected patients (PFO shunt grade more than moderate) with cryptogenic stroke (CS).

Background

Whether closure of PFO is an effective treatment for prevention of CS is still unclear.

Methods

Consecutive 158 patients (mean age: 49.9 years old, closure group: 67 patients, medication group: 91 patients) were enrolled. The primary end point was a composite of recurrent stroke and transient ischemic attack.

Results

Baseline characteristics were similar between the two groups, except age which was younger in the closure group (47.7 ± 10.8 vs 51.9 ± 9.9, P = 0.013), and the presence of shunt at rest was more common in the closure group (35.8% vs 10.4%, P = 0.000). Procedural success was 94.0%. Over a mean follow‐up of 27.8 months, a total of six primary end point, all of which were strokes, occurred only in the medication group (6.6% vs 0%, P = 0.039). Stroke‐free survival rate was significantly higher in the closure group (P = 0.026)

Conclusions

Our study showed that PFO closure may be an effective treatment strategy to prevent recurrent stroke or TIA for patients with CS if it is conducted in selective patients who have PFO shunt more than moderate grade.