bluuebunny/crossref_metadata_2025 huggingface dataset:
Perverse Market Outcomes from Biodiversity Conservation Interventions
Authors: Lim Felix K. S. , Carrasco L. Roman , McHardy Jolian , Edwards David P.
Published: November 2016

Conservation interventions are being implemented at various spatial scales to reduce the impacts of rising global population and affluence on biodiversity and ecosystems. While the direct impacts of these conservation efforts are considered, the unintended consequences brought about by market feedback effects are often overlooked. Perverse market outcomes could result in reduced or even reversed net impacts of conservation efforts. We develop an economic framework to describe how the intended impacts of conservation interventions could be compromised due to unanticipated reactions to regulations in the market: policies aimed at restricting supply could potentially result in leakage effects through external or unregulated markets. Using this framework, we review how various intervention methods could result in negative feedback impacts on biodiversity, including legal restrictions like protected areas, market‐based approaches, and agricultural intensification. Finally, we discuss how conservation management and planning can be designed to ensure the risks of perverse market outcomes are detected, if not overcome, and we address some knowledge gaps that affect our understanding of how market feedbacks vary across spatial and temporal scales, especially with teleconnectedness and increased international trade.
Spectroscopic evaluation of the colour play effect of thermochromic liquid crystal printing inks
Authors: Jakovljević Maja , Lozo Branka , Klanjšek Gunde Marta
Published: November 2016

Colour changes of a thermochromic liquid crystal (TLC) ink printed on a black substrate are clearly observed by the naked eye, and therefore it is reasonable to expect that every approach recommended for colour measurements of samples with solid colour would be appropriate. In addition, the published spectroscopic analyses of TLC inks do not provide any guidance or limitations for the measurement geometry. On the other hand, our study demonstrates that spectroscopic measurements of such samples are not so straightforward. When using the most simple and commonly used measurement equipment with a directional illumination and viewing approach, the temperature‐dependent spectral features resolve in a narrow spectral region that gives only a small part of the colour play effect. Detection of the entire effect requires the use of integrating spheres, which spatially integrate the radiant flux reflected on a sample in any direction; better results are obtained by spheres of larger diameter. The comparision of spectroscopic and colorimetric results obtained when different measurement geometries are applied on the same sample may demonstrate certain properties of the liquid crystal material inside microcapsules and help in understanding some details of the optical properties of the ink layer.
p38 MAPK pathway is essential for self‐renewal of mouse male germline stem cells (mGSCs)
Authors: Niu Zhiwei , Mu Hailong , Zhu Haijing , Wu Jiang , Hua Jinlian
Published: November 2016

Objectives

Male germline stem cells (mGSCs), also called spermatogonial stem cells (SSCs), constantly generate spermatozoa in male animals. A number of preliminary studies on mechanisms of mGSC self‐renewal have previously been conducted, revealing that several factors are involved in this regulated process. The p38 MAPK pathway is widely conserved in multiple cell types in vivo, and plays an important role in cell proliferation, differentiation, inflammation and apoptosis. However, its role in self‐renewal of mGSCs has not hitherto been determined.

Materials and methods

Here, the mouse mGSCs were cultured and their identity was verified by semi‐RT‐PCR, alkaline phosphatase (AP) staining and immunofluorescence staining. Then, the p38 MAPK pathway was blocked by p38 MAPK‐specific inhibitor SB202190. mGSC self‐renewal ability was then analysed by observation of morphology, cell number, cell growth analysis, TUNEL incorporation assay and cell cycle analysis.

Results

Results showed that mouse mGSC self‐renewal ability was significantly inhibited by SB202190.

Conclusions

This study showed for the first time that the p38 MAPK pathway plays a key role in maintaining self‐renewal capacity of mouse mGSCs, which offers a new self‐renewal pathway for these cells and contributes to overall knowledge of the mechanisms of mGSC self‐renewal.
838. ACONITUM JAPONICUM subsp. JAPONICUM
Authors: Kadota Yuichi
Published: November 2016

The name Aconitum japonicum Thunb. subsp. japonicum (syn. A. japonicum var. montanum Nakai; Japanese name, Yama‐torikabuto) is well known to botanists and horticulturists as a representative of Japanese monkshoods and is occasionally found even in the suburbs of Tokyo. However, this aconite is restricted to the mountains on the Pacific Ocean side of Honshu Island, central Japan. Although the geographical range of A. japonicum is rather narrow, it shows a wide range of morphological variation as a member of a tetraploid species group (2n = 4x = 32).
839. EUTREMA JAPONICUM
Authors: Iwashina Tsukasa
Published: November 2016

Eutrema japonicum (Miq.) Koidz. (syn. Wasabia japonica (Miq.) Matsum.) the rhizomes of which are known as the herb wasabi in Japanese restaurants, is described and illustrated. Its distribution, chemistry and cultivation are also discussed. A description of the genus Eutrema R. Br. is given, and the second Japanese species E. tenue (Miq.) Makino is illustrated.
841. ILEX DIMORPHOPHYLLA
Authors: Nagamasu Hidetoshi
Published: November 2016

The holly, Ilex dimorphophylla Koidz., an endangered endemic from the Ryukyu Islands, is illustrated and described. The habit of leaf dimorphy, between spiny and spineless leaves, is discussed.
842. ACER MICRANTHUM
Authors: Rix Martyn
Published: November 2016

Acer micranthum, a small‐leaved maple from the mountains of Japan, is illustrated. Its position in the genus and cultivation are discussed.
843. GAULTHERIA ADENOTHRIX
Authors: Yonekura Koji
Published: November 2016

Gaultheria adenothrix (Miq.) Maxim. is one of three species of Gaultheria L. growing in Japan, and one of two endemic Gaultheria species in this country having vicarious species in North America. The taxonomic history, affinities, description of morphology and the ecology of the species are described.
845. KINUGASA JAPONICA
Authors: Tamura Minoru
Published: November 2016

Kinugasa is a monotypic genus of the family Melanthiaceae, consisting only of K. japonica, endemic to Japan. It grows in subalpine forests, often along the valleys where snow covers in winter, and is conspicuous by its large white or yellowish white petaloid outer tepals.
Rosazea‐Management: Update über allgemeine Maßnahmen und topische Therapieoptionen
Authors: Schaller M , Schöfer H , Homey B , Hofmann M , Gieler U , Lehmann P , Luger TA , Ruzicka T , Steinhoff M
Published: November 2016

Obwohl bislang für die Rosazea keine kurative Therapie besteht, können verschiedene Optionen zur Behandlung der Symptome und zur Vorbeugung von Exazerbationen empfohlen werden. Neben Selbsthilfemaßnahme wie der Vermeidung von Triggerfaktoren und einer geeigneten Hautpflege sollte das Rosazea‐Management bei Patienten mit erythematöser und leichter bis schwerer papulopustulöser Rosazea die Anwendung topischer Präparate als First‐Line‐Therapie umfassen. Da Überlappungen der charakteristischen Rosazea‐Symptome im klinischen Alltag die Regel sind, sollte die medikamentöse Therapie auf die individuellen Symptome zugeschnitten werden; auch eine Kombinationstherapie kann erforderlich sein. Zu den für die Behandlung der Hauptsymptome der Rosazea zugelassenen Wirkstoffen gehören Brimonidin gegen das Erythem sowie Ivermectin, Metronidazol oder Azelainsäure gegen entzündliche Läsionen. Ihre Wirksamkeit wurde in zahlreichen validen, gut kontrollierten Studien belegt. Darüber hinaus existieren verschiedene nicht zugelassene topische Behandlungsmöglichkeiten, deren Wirksamkeit und Sicherheit noch in größeren, kontrollierten Studien zu untersuchen ist.
A single‐algorithm ensemble approach to estimating suitability and uncertainty: cross‐time projections for four Malagasy tenrecs
Authors: Boria Robert A. , Olson Link E. , Goodman Steven M. , Anderson Robert P.
Published: November 2016

Aim

Ecological niche models (ENMs) are used widely in ecology, evolution, global change biology, but model uncertainty remains an underappreciated issue. Generally, either a single model from one algorithm or an ensemble of single models from different algorithms is used to provide a prediction. In addition to variability among algorithms, recent studies have shown the need to consider variability within a single algorithm, for example optimizing model complexity by tuning model settings. We present an ensemble ENM using a single‐algorithm approach, while adjusting model settings to maximize performance.

Location

Madagascar.

Methods

We used maxent, bioclimatic variables and occurrence records of four species of Malagasy tenrecs (Family Tenrecidae). We calibrated and evaluated preliminary models using a jackknife approach, tuning two model settings to estimate optimal model complexity. We chose a suite of top‐performing preliminary models and then generated a consensus prediction. Furthermore, we calculated the variability among predictions of the co‐optimal models to indicate variation in geography (i.e. uncertainty). We then did the same after projecting the predictions to climatic estimates for the Last Glacial Maximum and the year 2070.

Results

The default settings were never identified as optimal for any of the four species. The model settings considered as the co‐optimal solutions essentially led to the same evaluation statistics; however, they showed high variation in their geographic predictions for three of the four species. Additionally, variation among such models was greater when transferred across time.

Main conclusions

This approach likely can provide better predictions for a single algorithm as well as quantifications of within‐algorithm uncertainty, qualities that are highly useful in interpreting reconstructed suitable areas or forecasts of potential range shifts under future climate change. Finally, this within‐algorithm uncertainty can be integrated into a larger framework that considers variability due to other factors (e.g. related to input data, alternate algorithms or various Global circulation models).
Four‐month‐old infants individuate and track simple tools following functional demonstrations
Authors: Stavans Maayan , Baillargeon Renée
Published: November 2016

Two experiments examined whether 4‐month‐olds (n = 120) who were induced to assign two objects to different categories would then be able to take advantage of these contrastive categorical encodings to individuate and track the objects. In each experiment, infants first watched functional demonstrations of two tools, a masher and tongs (Experiment 1) or a marker and a knife (Experiment 2). Next, half the infants saw the two tools brought out alternately from behind a screen, which was then lowered to reveal only one of the tools (different‐objects condition); the other infants saw similar events except that the same tool was shown on either side of the screen (same‐object condition). In both experiments, infants in the different‐objects condition looked reliably longer than those in the same‐object condition, and this effect was eliminated if the demonstrations involved similar but non‐functional actions. Together, these results indicate that infants (a) were led by the functional demonstrations they observed to assign the two tools to distinct categories, (b) recruited these categorical encodings to individuate and track the tools, and hence (c) detected a violation in the different‐objects condition when the screen was lowered to reveal only one tool. Categorical information thus plays a privileged role in individuation and identity tracking from a very young age.
Liraglutide as adjunct to insulin treatment in type 1 diabetes does not interfere with glycaemic recovery or gastric emptying rate during hypoglycaemia: A randomized, placebo‐controlled, double‐blind, parallel‐group study
Authors: Frandsen Christian S. , Dejgaard Thomas F. , Andersen Henrik U. , Holst Jens J. , Hartmann Bolette , Thorsteinsson Birger , Madsbad Sten
Published: November 2016

Aim

Glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) therapy is a potential treatment as adjunct to insulin in type 1 diabetes (T1D). However, GLP‐1RAs inhibit glucagon secretion and delay the gastric emptying (GE) rate and may impair recovery from hypoglycaemia. We evaluated the effect of the GLP‐1RA liraglutide on counterregulatory responses and GE rate during hypoglycaemia in persons with T1D.

Materials and methods

In a 12‐week, randomized, double‐blind, placebo‐controlled study, 20 patients aged >18 years with T1D and HbA1c ≥8% (64 mmol/mol) were randomly assigned (1:1) to liraglutide 1.2 mg once daily or placebo as add‐on to insulin treatment. Before and at end of treatment a hypoglycaemic clamp (plasma glucose target 2.5 mmol/L) was carried out, followed by a liquid meal. Primary endpoint was change in GE rate (evaluated by area under the paracetamol curve and time to peak). Secondary endpoints included changes in glycaemic recovery, counter‐regulatory hormones, pancreatic polypeptide (PP), GLP‐1, blood pressure and heart rate.

Results

During the period June 2013 to October 2014, 20 patients were enrolled. After 12 weeks of treatment, changes in GE rates did not differ significantly between groups (
P
 = .96), with no significant changes from baseline, whether evaluated from AUCs or time to peak. The secondary endpoints, glycaemic recovery, counter‐regulatory hormone responses, systolic blood pressure and GLP‐1 and PP responses, were also similar. Heart rate increased with liraglutide from 69 ± 4 to 80 ± 5 beats/min (
P
 = .02).

Conclusions

Liraglutide does not compromise glycaemic recovery, GE rate or counter‐regulatory hormone responses in T1D patients during hypoglycaemia. No treatment‐related safety issues were identified.
Effects of gemigliptin, a dipeptidyl peptidase‐4 inhibitor, on lipid metabolism and endotoxemia after a high‐fat meal in patients with type 2 diabetes
Authors: Ahn Chang Ho , Kim Eun Ky , Min Se Hee , Oh Tae Jung , Cho Young Min
Published: November 2016

We aimed to investigate the effects of gemigliptin, a dipeptidyl peptidase‐4 inhibitor, on postprandial lipoprotein levels and endotoxemia in a randomized, double‐blind, placebo‐controlled, crossover study. Ten people with type 2 diabetes mellitus (T2DM), inadequately controlled with oral antidiabetic medications and/or lifestyle modification, were randomized to gemigliptin or placebo for 4 weeks. At the end of each treatment phase, the study participants underwent a high‐fat meal tolerance test and needle aspiration of abdominal subcutaneous adipose tissue. The median (range) fasting and total area under the curve of apolipoprotein B48 (ApoB48) were significantly lower with gemigliptin than with placebo (2.9 [1.5‐15.8] µg/mL vs 4.2 [1.3‐23.4] µg/mL; P = .020; 35.3 [14.4‐87.4] µg/mL × hour vs 42.2 [17.5‐109.0] µg/mL × hour; P = .020, respectively), whereas apolipoprotein B100 showed no significant difference. Serum endotoxin levels were undetectable in 70% of the samples, so we were not able to evaluate the effect of gemigliptin on endotoxemia. The gene expression of inflammatory cytokines in subcutaneous adipose tissue was not affected by gemigliptin. Gemigliptin reduced ApoB48 levels after a high‐fat meal in participants with T2DM. Whether systemic endotoxin levels can be reduced by gemigliptin requires further investigation.
Skeletogenesis of Myiopsitta monachus (Psittaciformes) and sequence heterochronies in Aves
Authors: Carril Julieta , Tambussi Claudia P.
Published: November 2016

The ossification sequence of Myiopsitta monachus was determined. Myiopsitta has a similar sequence to other altricial birds, with delayed skeletons compared to precocial species. The hindlimbs ossify before the forelimbs, a condition that could be linked to altriciality. To determine the stability of the sequences of ossification across birds, we selected species of different groups of Aves and used event‐pairing method and character mapping on a phylogeny. Our results show that the homogeneity in the development of birds was supported by 56.77% of the character states. Event‐pair cracking phylogenetic method was applied to identify sequence heterochronies. Results reveal a high number of heterochronies and show that the long bones in limbs may behave as modules. In Myiopsitta, the ossa ectethmoidale and mesethmoidale ossify early. These bones provide the origin site of the Psittaciformes’ novel adductor m. ethmomandibularis, associated with strong bite forces, and its acceleration in the sequence may correspond to the functional hypothesis. Also, the early appearance of some hyoid apparatus elements occurs, and could be related to the development of tongue in Psittaciformes and its role in handling food, and is in concordance with the functional and size hypothesis.
The unpopularity of the hearth tax and the social geography of London in 1666
Authors: Wareham Andrew
Published: November 2016

This article presents a new evaluation of the Restoration hearth tax and the social geography of London, first, by comparing the 1666 London hearth tax return with unpublished collectors’ accounts; second, by analysing the huge amount of extraneous data in these records on the social conditions in London; and third, by considering how different forms of tax avoidance and tax evasion operated on the streets of London. The article discusses wealth distribution by location and social status, and shows how privileged groups used diplomatic, ecclesiastical, and military rank to avoid the hearth tax, while ordinary householders turned to doorstep opposition, especially in the outer and poorer suburbs, in expressing their hostility towards the heath tax. The article demonstrates that in Metropolitan London the assessment and collection of the hearth tax depended not only upon the enforcement of the parliamentary legislation, but also upon negotiation and give‐and‐take between tax collectors and tax payers, sometimes in consultation with the Crown. As a result the hearth tax failed to fill the king's purse, was unpopular in the capital and in the country, and created onerous work for both auditors and hearth tax collectors, which contributed to the short life of the hearth tax (1662–89).
Morbidity and mortality following poliomyelitis – a lifelong follow‐up
Authors: Kay L. , Nielsen N. M. , Wanscher B. , Ibsen R. , Kjellberg J. , Jennum P.
Published: November 2016

Background and purpose

In the world today 10–20 million people are still living with late effects of poliomyelitis (PM), but the long‐term consequences of the disease are not well known. The aim of this study was to describe lifelong morbidity and mortality among Danes who survived PM.

Methods

Data from official registers for a cohort of 3606 Danes hospitalized for PM in the period 1940–1954 were compared with 13 762 age‐ and gender‐matched controls.

Results

Compared with controls, mortality was moderately increased for both paralytic as well as non‐paralytic PM cases; Hazard Ratio, 1.31 (95% confidence interval, 1.18–1.44) and 1.09 (95% confidence interval, 1.00–1.19), respectively. Hospitalization rates were approximately 1.5 times higher among both paralytic and non‐paralytic PM cases as compared with controls. Discharge diagnoses showed a broad spectrum of diseases. There were no major differences in morbidities between paralytic and non‐paralytic PM cases.

Conclusions

Poliomyelitis has significant long‐term consequences on morbidity and mortality of both paralytic and non‐paralytic cases.
The role of type II transmembrane serine protease‐mediated signaling in cancer
Authors: Tanabe Lauren M. , List Karin
Published: November 2016

Pericellular proteases have long been implicated in carcinogenesis. Previous research focused on these proteins, primarily as extracellular matrix (ECM) protein‐degrading enzymes which allowed cancer cells to breach the basement membrane and invade surrounding tissue. However, recently, there has been a shift in the view of cell surface proteases, including serine proteases, as proteolytic modifiers of particular targets, including growth factors and protease‐activated receptors, which are critical for the activation of oncogenic signaling pathways. Of the 176 human serine proteases currently identified, a subset of 17, known as type II transmembrane serine proteases (TTSPs). Many have been shown to be relevant to cancer progression since they were first identified as a family around the turn of the century. To this end, altered expression of TTSPs appeared as a trademark of several tumor types. However, the substrates and underlying signaling pathways remained unclear. Localization of these proteins to the cell surface places them in the unique position to mediate signal transduction between the cell and its surrounding environment. Many of the TTSPs have already been shown to play key roles in processes such as postnatal development, tissue homeostasis, and tumor progression, which share overlapping molecular mechanisms. In this review, we summarize the current knowledge regarding the role of the TTSP family in pro‐oncogenic signaling.
Hypothalamic‐specific proopiomelanocortin deficiency reduces alcohol drinking in male and female mice
Authors: Zhou Y. , Rubinstein M. , Low M. J. , Kreek M. J.
Published: November 2016

Opioid receptor antagonist naltrexone reduces alcohol consumption and relapse in both humans and rodents. This study investigated whether hypothalamic proopiomelanocortin (POMC) neurons (producing beta‐endorphin and melanocortins) play a role in alcohol drinking behaviors. Both male and female mice with targeted deletion of two neuronal Pomc enhancers nPE1 and nPE2 (nPE−/−), resulting in hypothalamic‐specific POMC deficiency, were studied in short‐access (4‐h/day) drinking‐in‐the‐dark (DID, alcohol in one bottle, intermittent access (IA, 24‐h cycles of alcohol access every other day, alcohol vs. water in a two‐bottle choice) and alcohol deprivation effect (ADE) models. Wild‐type nPE+/+ exposed to 1‐week DID rapidly established stable alcohol drinking behavior with more intake in females, whereas nPE−/− mice of both sexes had less intake and less preference. Although nPE−/− showed less saccharin intake and preference than nPE+/+, there was no genotype difference in sucrose intake or preference in the DID paradigm. After 3‐week IA, nPE+/+ gradually escalated to high alcohol intake and preference, with more intake in females, whereas nPE−/− showed less escalation. Pharmacological blockade of mu‐opioid receptors with naltrexone reduced intake in nPE+/+ in a dose‐dependent manner, but had blunted effects in nPE−/− of both sexes. When alcohol was presented again after 1‐week abstinence from IA, nPE+/+ of both sexes displayed significant increases in alcohol intake (ADE or relapse‐like drinking), with more pronounced ADE in females, whereas nPE−/− did not show ADE in either sex. Our results suggest that neuronal POMC is involved in modulation of alcohol ‘binge’ drinking, escalation and ‘relapse’, probably via hypothalamic‐mediated mechanisms, with sex differences.
Nutrient‐dependent increased dendritic arborization of somatosensory neurons
Authors: Watanabe Kaori , Furumizo Yuki , Usui Tadao , Hattori Yukako , Uemura Tadashi
Published: November 2016

Suboptimal nutrition imposes developmental constraints on infant animals, which marshal adaptive responses to eventually become mature adults. Such responses are mounted at multiple levels from systemic to cellular. At the cellular level, the underlying mechanisms of cell proliferation control have been intensively studied. However, less is known about how growth of postmitotic and morphologically complex cells, such as neurons, is controlled by nutritional status. We address this question using Class I and Class IV dendritic arborization neurons in Drosophila larvae. Class IV neurons have been shown to sense nociceptive thermal, mechanical and light stimuli, whereas Class I neurons are proprioceptors. We reared larvae on diets with different protein and carbohydrate content throughout larval stages and examined how morphologies of Class I or Class IV neurons were affected. Dendritic arbors of Class IV neurons became more complex when larvae were reared on a low‐yeast diet, which contains lower amounts of amino acids and other ingredients, compared to a high‐yeast diet. In contrast, such low‐yeast‐dependent hyperarborization was not seen in Class I neurons. The physiological and metabolic implications of the hyperarborization phenotype are discussed in relation to a recent hypothesis that Class IV neurons sense protein‐deficient stress and to our characterization of how the dietary yeast contents impacted larval metabolism.
Structural and functional analysis of cyclophilin PpiB mutants supports an in vivo function not limited to prolyl isomerization activity
Authors: Skagia Aggeliki , Vezyri Eleni , Sigala Markezina , Kokkinou Areti , Karpusas Michael , Venieraki Anastasia , Katinakis Panagiotis , Dimou Maria
Published: November 2016

Escherichia coli cyclophilin PpiB is a peptidyl‐prolyl cis/trans isomerase (PPIase, EC: 5.2.1.8), involved in the negative modulation of various bacterial processes, such as swimming and swarming motility and biofilm formation ability. In this study, we show that PpiB possesses also a chaperone function as it can prevent the thermal denaturation of citrate synthase even with essentially eliminated PPIase activity. We demonstrate, using active site mutations, that the PPIase activity of PpiB is required in all processes, except for the negative effect on swimming, indicating a possible isomerase‐independent function. Additionally, we show that the reduced PPIase activity of PpiB does not prevent the association with all prey proteins tested and that the PPIase active site is not involved necessarily in each association. We also used a random mutagenesis approach, to identify amino acid residues apart from the catalytic site, which are necessary for PpiB function. The combination of enzymatic studies concerning the PPIase and chaperone activities of each mutant protein, with structural analyses based on 3D models, provided further insights into the effects of the mutations on the function of PpiB and showed the importance of structural features in addition to the catalytic site, for its in vivo role.
Evaluation of the utility of the ISTH‐BAT in haemophilia carriers: a multinational study
Authors: James P. D. , Mahlangu J. , Bidlingmaier C. , Mingot‐Castellano M. E. , Chitlur M. , Fogarty P. F. , Cuker A. , Mancuso M. E. , Holme P. A. , Grabell J. , Satkunam N. , Hopman W. M. , Mathew P. ,   Global Emerging HEmostasis Experts Panel (GEHEP)
Published: November 2016

Introduction

There has been increasing recognition in recent years that female carriers of haemophilia manifest abnormal bleeding; however, data on the use of bleeding assessment tools in this population are lacking.

Aim

Our objective was to validate the ISTH‐BAT in haemophilia carriers to describe bleeding symptoms and allow for comparisons with factor levels and other patient groups.

Methods

This was a prospective, observational, cross‐sectional study performed by members of Global Emerging HEmostasis Panel (GEHEP). Unselected consecutive haemophilia carriers were recruited and a CRF and the ISTH‐BAT were completed by study personnel.

Results

A total of 168 haemophilia carriers were enrolled: 155 haemophilia A and 13 haemophilia B. The mean age was 40 years (range: 20–82). Carriers had higher mean bleeding scores (BS) compared with age‐matched controls (n = 46; 5.7 vs. 1.43; P < 0.0001) and Type 3 VWD OC (n = 32; 3.0; P = 0.009), but lower BS compared with women with Type 1 VWD (n = 83; 8.7; P < 0.0001). Fifteen carriers reported haemarthrosis, and of those six had normal FVIII/FIX levels. There was a significant but weak negative correlation between BS and factor level (Spearman's r2 = −0.36, P < 0.001).

Conclusion

Our results show that haemophilia carriers experience abnormal bleeding, including haemarthrosis. Overall, BS in women with Type 1 VWD > haemophilia carriers > Type 3 VWD OC > controls. Understanding the performance of the ISTH‐BAT in this population is a critical step in future research aimed at investigating the underlying pathophysiology of abnormal bleeding, with the ultimate goal of optimizing treatment.
Unusual cause of hypercalcaemia in end stage renal failure patients
Authors: Teo Hooi Khee , Wong Jiunn
Published: November 2016

Immobility‐induced hypercalcaemia is rarely considered in patients on dialysis and is a challenging diagnosis to make. This is especially so due to the lack of biomarkers as well as the notion that calcium metabolism is mostly related to chronic kidney disease‐metabolic bone disorder due to the role of iPTH. We present two cases of our dialysis patients, who were clinically unwell from hypercalcemia. We were initially uncertain of the cause of hypercalcemia as despite our attempts to adjust treatment based on their biochemical findings, we were unable to correct the hypercalcemia. We did not have appropriate bone turnover markers to guide us and out of desperation, anti‐resorptives—calcitonin and bisphosphonate were given with good clinical response. We concluded that the hypercalcemia was related to immobility‐induced hypercalcemia and the inappropriately low iPTH was a red herring. Immobility‐induced hypercalcaemia should be considered in patients with end stage renal failure on renal replacement therapy, especially in those with recent and significant immobility. In these patients, pamidronate can be considered should the hypercalcaemia persist.
Potentially pathogenic circulating autoantibodies to cardiac troponin are present in hemodialysis patients
Authors: Jefferies Helen J. , Tertti Risto , Wittfooth Saara , Burton James O. , Metsärinne Kaj , Pettersson Kim , McIntyre Christopher W.
Published: November 2016

Introduction: Repetitive dialysis‐induced cardiac injury is associated with elevated troponin levels, inflammation, and longitudinal reduction in cardiac function. Pathogenic autoantibodies to cardiac troponins (cTnAAb) produce inflammatory cardiomyopathy in murine models. This study aimed to explore the possibility that analogous autoimmune processes might occur in hemodialysis (HD) patients, by initially investigating cTnAAb prevalence, and exploring potential links with HD‐induced myocardial stunning.

Methods: In 130 prevalent HD patients from two centers (Derby, UK; Turku, Finland), cTnAAb (immunoassay) and cardiac troponins were quantified. Sixty‐four patients underwent serial echocardiography to assess myocardial stunning.

Findings: cTnAAb were present in 7% of patients. Dual positivity to cTnAAb and elevated cTn occurred in 3% and 6% for cTnI and cTnT, respectively. Patients with cTnAAb had significantly longer dialysis vintage (82 vs. 30 months, P = 0.024), higher cTnT (0.1 vs. 0.05 pg/mL, P = 0.04), cTnI (0.02 vs. 0.01 pg/mL, P = 0.029), and free PAPP‐A (6.4 vs. 3.3 mIU/L, P = 0.038).

Discussion: This is the first description of cTnAAb in HD patients, which raises the possibility that longitudinal exposure to repetitive HD‐induced cardiac injury may lead to further autoimmune‐based myocardial insult.
Oral health status of six‐year‐old children in Qatar: findings from the national oral health survey
Authors: Al‐Thani MH , Al‐Thani AA , Al‐Emadi AA , Al‐Chetachi WF , Akram H , Poovelil BV
Published: November 2016

Introduction

Oral health has a significant impact on physical, social and mental well‐being of an individual. Qatar, like the rest of the world, is experiencing higher prevalence of oral health‐related problems.

Objectives

To examine the oral health status and extent of preventive and curative needs among six‐year‐old school children in Qatar by key demographic indicators.

Methods

Secondary data analysis of 1124 six‐year‐old private and government primary school children from the 2011 Qatar National Oral Health Survey was performed. Dental caries lesions status of primary dentition was assessed according to the WHO criteria. Descriptive statistics were carried out, and comparison among groups was executed by running t statistics. Logistic regression was performed to interpret the impact of various predictors.

Results

Overall, 71.4% children presented with dental caries lesions with a higher prevalence among girls versus boys (73.8% versus 68.9%). The mean overall dmft was recorded as 4.2 with ±4.2 SD. Qatari children had 3.8 time odds of having dental caries lesions compared with non‐Qatari children (P < 0.001). Overall, 18.9% of children showed signs of poor periodontal health. Odds of having more periodontal disease were significant in Qatari boys (OR = 3.1 CI = 2.0, 4.7, P < 0.001) compared to non‐Qatari boys. On average, 3.6 teeth per student were in need of any treatment.

Conclusion

This study indicated that only 28.6% of children aged six were free from caries lesions. The results urge to further strengthen the strategies and to improve oral hygiene by various evidence‐based interventions.
Microwave–hot air drying applied to selected cassava cultivars: drying kinetics and sensory acceptance
Authors: Gonçalves Leticia Tinoco , Pereira Nádia Rosa , Almeida Selma Bergara , Freitas Silvio de Jesus , Waldman Walter Ruggeri
Published: November 2016

The effects of three cassava cultivars produced in Brazil were assessed (IAC Espeto, IAC 14 and IAC Caapora) in order to obtain chips by precooking and hot air–microwave drying (70 °C, 95 W). The difference in the composition of cultivars has not influenced the drying of cassava slices. The drying kinetics presented a constant drying rate period followed by a decreasing drying rate with effective diffusion coefficient of 2.8–3.0 × 10−10 m2s−1. The hedonic means of all attributes ranged from ‘neither like nor dislike’ to ‘like moderately’. Therefore, the choice of the more suitable cultivar can be based on plant productivity and product yield. The IAC 14 cultivar resulted in the highest root production per plant, product mass per roots and chips yield.
Genetic diagnosis in Hemophilia A from southern China: five novel mutations and one preimplantation genetic analysis
Authors: Chen J. , Wang J. , Lin X. Y. , Xu Y. W. , He Z. H. , Li H. Y. , Chen S. Q. , Jiang W. Y.
Published: November 2016

Introduction

As there is currently no complete cure for hemophilia A (HA), the identification of pathogenic mutations in factor VIII (FVIII) gene from HA patients and carriers, which can contribute to genetic counseling prenatal diagnosis, and preimplantation genetic diagnosis (PGD), is an important step to prevent HA.

Methods

A total of 14 unrelated Chinese HA subjects (FVIII activity <40%), 20 carrier subjects, three fetuses, and one PGD were included in this study. We first screened for the presence of FVIII intron 22 and intron 1 inversions. Second, the coding region of the FVIII gene was sequenced. For the novel mutations, FVIII mRNA expression was detected by real‐time PCR and the protein structures were analyzed by bioinformatic tools.

Results

Five novel mutations (c.1A>C, c.304_305insA, c.1594T>A, c.6045G>A, and c.2645_2646insG) were found. The real‐time PCR showed that the expression of FVIII mRNAs was lower in HA patients than in normal subjects. Prenatal diagnosis and PGD were successfully performed: Two of three fetuses and four of eight blastomeres were confirmed to be normal.

Conclusion

In conclusion, genetic diagnosis of 14 unrelated HA subjects, 20 carrier subjects, three fetuses, and one PGD was successfully performed in our study.
Skewed, Persistent and High before Death: Medical Spending in Germany
Authors: Karlsson Martin , Klein Tobias J. , Ziebarth Nicolas R.
Published: November 2016

We use claims panel data from a big German private health insurer to provide detailed individual‐level evidence on medical spending between 2005 and 2011. This includes evidence on the distribution of medical spending, the dependence of medical spending on age and other demographic characteristics, its persistence, and how medical spending evolves in the years before death. Our main findings are that health care spending more than doubles between ages 50 and 80 and that spending is very concentrated: the top 10 per cent of all spenders are responsible for 53 per cent of all medical spending in a given year. There is a 50 per cent probability that individual expenditures lie in the same quintile of the distribution after five years, for both very‐high‐ and very‐low‐cost individuals. Medical spending in the year of death is six times higher for the deceased than for everybody else in that year and accounts for 7.9 per cent of lifetime spending. Females use more office‐based care and have higher spending at younger ages, whereas males have higher spending at older ages, particularly for hospital care, and die younger. The presentation of these empirical facts is framed by an institutional discussion of the German health care system, a comparison between publicly‐ and privately‐insured individuals, and a discussion of medical spending trends in aggregate‐level data.
Socio‐Economic Inequalities in Health Care in England
Authors: Cookson Richard , Propper Carol , Asaria Miqdad , Raine Rosalind
Published: November 2016

This paper reviews what is known about socio‐economic inequalities in health care in England, with particular attention to inequalities relative to need that may be considered unfair (‘inequities’). We call inequalities of 5 per cent or less between the most and least deprived socio‐economic quintile groups ‘slight’, inequalities of 5–15 per cent ‘moderate’ and inequalities of more than 15 per cent ‘substantial’. Overall public health care expenditure is substantially concentrated on poorer people. At any given age, poorer people are more likely to see their family doctor, have a public outpatient appointment, visit accident and emergency, and stay in hospital for publicly‐funded inpatient treatment. After allowing for current self‐assessed health and morbidity, there is slight pro‐rich inequity in combined public and private medical specialist visits but not in family doctor visits. There are also slight pro‐rich inequities in overall indicators of clinical process quality and patient experience from public health care, substantial pro‐rich inequalities in bereaved people's experiences of health and social care for recently deceased relatives, and mostly slight but occasionally substantial pro‐rich inequities in the use of preventive care (for example, dental check‐ups, eye tests, screening and vaccination) and a few specific treatments (for example, hip and knee replacement). Studies of population health care outcomes (for example, avoidable emergency hospitalisation) find substantial pro‐rich inequality after adjusting for age and sex only. These findings are all consistent with a broad economic framework that sees health care as just one input into the production of health over the life course, alongside many other socio‐economically patterned inputs including environmental factors (for example, living and working conditions), consumption (for example, diet and smoking), self‐care (for example, seeking medical information) and informal care (for example, support from family and friends).
Medical Spending in Japan: An Analysis Using Administrative Data from a Citizen's Health Insurance Plan
Authors: Ibuka Yoko , Chen Stacey H. , Ohtsu Yui , Izumida Nobuyuki
Published: November 2016

Health care spending growth in Japan has accelerated in recent years, unlike in most OECD countries. It is thus important to characterise the structure of recent medical spending using individual‐level data. We use medical claim bill data from a citizen's health insurance plan in Japan to examine the concentration in and persistence of medical spending. We find that medical spending is disproportionately distributed across individuals, with the top 10 per cent of spenders responsible for over 60 per cent of total expenditures. We also find a high correlation in spending over time: the top 20 per cent of spenders have a probability of over 60 per cent of remaining in the same rank in the following year. Further, medical spending is more concentrated among those aged 0–64 years than among the older age group. The results also show a difference in income gradient of health expenditures across age groups. Specifically, individuals aged 25–64 in low‐income families spend more on medical care than those in high‐income families, whereas there is no clear association between income and health expenditures among the elderly. Finally, consistent with previous studies, we find increased medical expenses in the year of death, accounting for 17 per cent of total expenditures among those aged 65 and over.
Recent Trends in Taiwanese Medical Spending
Authors: Chen Stacey H. , Chuang Hongwei
Published: November 2016

Since the creation of National Health Insurance (NHI) in 1995, Taiwan's medical spending has been increasing rapidly, as has been the case in most countries worldwide. This paper follows international standards in documenting recent trends in Taiwan's medical spending by category, relying on official statistics, Surveys of Family Income and Expenditure (SFIE) data and administrative reimbursement panel data from the NHI Universal Database (NHIUD). Two findings are noteworthy. First, we find a rapidly widening gap since 1996 between rich and poor in terms of out‐of‐pocket payments and those by private health insurance; meanwhile, the gap between them in terms of NHI expenditure has remained roughly constant. This trend can be attributed mainly to a positive income gradient in personal health care expenditure among elderly individuals (aged 65 or older). Second, end‐of‐life hospital spending is large in both magnitude and proportion. Average end‐of‐life hospital spending is more than 30 times average hospital spending by the total population, and it accounts for 15.9 per cent of total hospital care expenditure (or 5.0 per cent of overall medical spending), even though the population near death accounts for only 0.51 per cent of the overall population. Two‐thirds of end‐of‐life hospital spending is on the elderly, who also constitute two‐thirds of the population near death. For both the elderly and working‐age adults, the share of end‐of‐life hospital spending strikingly aligns with the share of deaths.
Medical Spending in Denmark
Authors: Christensen Bent Jesper , Gørtz Mette , Kallestrup‐Lamb Malene
Published: November 2016

Using full population longitudinal data from merged administrative registers for Denmark, we document that medical spending is highly concentrated in the population and is persistent through time at the individual level. In addition, we provide overviews of institutional details of the Danish health care system, aggregate trends in health care expenditures and the relevant register data. Nearly two‐thirds of expenditures are on hospitals and one‐fifth on long‐term care, with the remainder roughly equally split between primary care and prescription drugs. Health expenditures are higher for men than for women from ages 61 to 78, and otherwise higher for women. Between ages 50 and 80, hospital expenditures more than triple for men while more than doubling for women, and total health expenditures quadruple for men while tripling for women. The top 1 per cent of all spenders account for nearly one‐quarter of total spending in a given year, and averaging over three years only reduces this fraction to one‐fifth. The top 20 per cent of spenders in a given year are more likely to remain in that category two years later than not. The poorest fifth of the population aged 25 and above are responsible for more than twice as much spending on health as the richest, and this reverse social gradient is even stronger for long‐term care and is stronger among men than among women, especially in hospital expenses. Expenditures in the year (over the three years) before death are nearly 12 times (respectively nine times) higher than average, but nevertheless are only 11 per cent (respectively a quarter) of lifetime spending. Out‐of‐pocket expenses on prescription drugs only amount to 3 per cent of total health expenditures and are less concentrated than these.
Speciation in a keystone plant genus is driven by elevation: a case study in New Guinean Ficus
Authors: Segar S. T. , Volf M. , Zima Jnr J. , Isua B. , Sisol M. , Sam L. , Sam K. , Souto‐Vilarós D. , Novotny V.
Published: November 2016

Much of the world's insect and plant biodiversity is found in tropical and subtropical ‘hotspots’, which often include long elevational gradients. These gradients may function as ‘diversity pumps’ and contribute to both regional and local species richness. Climactic conditions on such gradients often change rapidly along short vertical distances and may result in local adaptation and high levels of population genetic structure in plants and insects. We investigated the population genetic structure of two species of Ficus (Moraceae) along a continuously forested elevational gradient in Papua New Guinea. This speciose plant genus is pollinated by tiny, species‐specific and highly coevolved chalcid wasps (Agaonidae) and represented by at least 73 species at our study gradient. We present results from two species of Ficus sampled from six elevations between 200 m and 2700 m a.s.l. (almost the entire elevational range of the genus) and 10 polymorphic microsatellite loci. These results show that strong barriers to gene flow exist between 1200 m and 1700 m a.s.l. Whereas lowland populations are panmictic across distances over 70 km, montane populations can be disjunct over 4 km, despite continuous forest cover. We suggest that the limited gene flow between populations of these two species of montane Ficus may be driven by environmental limitations on pollinator or seed dispersal in combination with local adaptation of Ficus populations. Such a mechanism may have wider implications for plant and pollinator speciation across long and continuously forested elevational gradients if generalist insect pollinators and vertebrate seed dispersers also form populations based on elevation.