bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors influencing Turkish parents’ intentions towards anti-consumption of junk food
Authors: Yarimoglu Emel , Kazancoglu Ipek , Bulut Zeki Atıl
Published: March 2019

Purpose

The purpose of this paper is to analyze parents’ intentions toward the anti-consumption of junk food for their children. The paper incorporated the theory of planned behavior (TPB) using two external factors, which previously have not been investigated together.

Design/methodology/approach

A questionnaire was designed from previous studies consisting of the constructs of the TPB (intention, attitude, subjective norm, perceived behavioral control) and two external factors (anticipated regret and perceived risk). An online survey was conducted among 392 participants. Confirmatory factor analysis and structural equation modeling were used to test the hypotheses.

Findings

All hypotheses were supported. Attitudes, subjective norms and perceived behavioral control affected parental intentions toward the anti-consumption of junk food. The two external factors of the model also affected parental intentions toward the anti-consumption of junk food.

Research limitations/implications

There were four limitations regarding participants, the research model and product type.

Practical implications

Junk food producers, sellers, fast food restaurants and public policies should encourage healthy lifestyles, particularly for children. Junk food producers and fast food restaurants should offer healthier nutritional options. Governmental policies should include legal regulations to restrict marketing strategies for unhealthy products. Parents, as the primary influencers of children, should be educated regarding the anti-consumption of junk food.

Originality/value

The study contributed to the anti-consumption literature by analyzing buying intentions toward junk food within the concept of anti-consumption, analyzing intentions by adding anticipated regret and perceived risk to the TPB model and analyzing the effects of perceived risk on anticipated regret.
Co-designing integrated care for high-needs clients: the Help Team for school-aged children
Authors: Tuominen Tuula , Harju Mari , Oksman Erja , Hujala Anneli
Published: March 2019

Purpose

The purpose of this paper is to describe a Finnish pilot project aiming to support high-needs clients in their everyday lives by developing an integrated care approach based on the multi-sectoral collaboration of care professionals. The Help Team for school-aged children will be described as an example of the integrative practices developed on the project.

Design/methodology/approach

Altogether 250 professionals from primary and secondary health care and social care and from the education sector were designated to collaborate in 37 local, multi-sectoral teams, aiming to develop integrated care practices for high-needs clients. Teamwork was supported by coaches and project seminars, the Breakthrough method and other LEAN methods. The project was evaluated internally by means of a survey and interviews with the participants.

Findings

As a result of the project, all 37 teams developed a specific collaboration model for their selected target group comprising different kinds of high-needs clients.

Research limitations/implications

The sustainability of the outcomes of the project depends on how managers and decision-makers are committed to applying the collaboration models in future.

Practical implications

Many of the collaboration models developed in the project will be implemented in practice in a wider area.

Social implications

The project highlighted the need to pay attention to the problems of people with multiple care needs and the challenges they pose for integrated care.

Originality/value

The project was based on the client-centered development work done by frontline professionals. Due to the high level of involvement of the professionals themselves, the project proved highly instructive for them. It is extremely important to engage frontline level professionals in development work and support them in collaborating beyond the traditional “silos”.
To Invest or Not to Invest?: The Roles of Product Information, Attitudes Towards Finance and Life Variables in Retail Investor Propensity to Engage with Financial Products
Authors: Hillenbrand Carola , Saraeva Anastasiya , Money Kevin , Brooks Chris
Published: March 2019

Little is known in the current literature about the factors affecting retail investor (RI) propensity to engage with financial products other than their attitude towards financial risk (ATFR). This study explores the role of a number of variables, thematically grouped into domain‐specific (product information and attitudes towards finance) and general impact factors (life variables). Data from 970 UK‐based RIs, collected in 2017 across a variant of products, suggest that when analysed thematically, variables related to product information emerge as the most important group of influence factors. While the relevance of ATFR is also vindicated in the findings of this study, the results bring a dose of life context to situations of financial decision‐making by illustrating that information about the product as well as life variables matter significantly, in particular negative emotions and sensation‐seeking, thereby highlighting a duty of care towards potentially vulnerable people. The study discusses implications arising from the findings in relation to research, practice and policy.
Diabetes news
Authors: Kurian Martin J. , Rentzepis Peter J. , Carracher Ann M. , Close Kelly L.
Published: March 2019

Martin J. Kurian, Peter J. Rentzepis, Ann M. Carracher, and Kelly L. Close are of Close Concerns (http://www.closeconcerns.com), a healthcare information company focused exclusively on diabetes and obesity care. Close Concerns publishes Closer Look, a periodical that brings together news and insights in these areas. Each month, the Journal of Diabetes includes this News feature, in which Kurian, Rentzepis, Carracher, and Close review the latest developments relevant to researchers and clinicians.
Barbara Johnson's Album: Material Literacy and Consumer Practice, 1746‐1823
Authors: Dyer Serena
Published: March 2019

This article examines Barbara Johnson's Album, a prolific record of the dress consumption of a vicar's daughter. The album contains over a hundred samples of dress fabrics acquired by Johnson between the ages of eight and eighty‐five. Interrogated alongside the Johnson family correspondence and didactic tools produced by Johnson's mother, this article argues that the album acted as a material form of account book, conceived as a moral, financial and material regulator. Considered within the emerging framework of material knowledge and consumer skill, the album provides important evidence of how consumers maintained and developed their material literacy.
Demand for temperature and rainfall index insurance in India
Authors: Matsuda Ayako , Kurosaki Takashi
Published: March 2019

Weather index insurance has been attracting considerable attention from academics and policymakers. This study investigates the demand for two types of index insurance sold in India: temperature index insurance for dry season and rainfall index insurance for subsequent monsoon season. Using data from randomized subsidy experiments, we separate purchase and quantity decisions and investigate how demand for rainfall insurance is correlated with demand for temperature insurance sold in the previous season. We find that the price (premium) does not influence purchase decisions per se but does significantly influence quantity decisions. The quantity demanded is less price‐sensitive for subsequent rainfall insurance than it is for temperature insurance. We also find that purchasers of temperature insurance tend to buy rainfall insurance more often than nonpurchasers do. However, a one‐time subsidy does not influence on subsequent demand, suggesting no price‐anchoring effect.
Two novel variants in the ATM gene causing ataxia‐telangiectasia, including a duplication of 90 kb: Utility of targeted next‐generation sequencing in detection of copy number variation
Authors: Martin‐Rodriguez Samuel , Calvo‐Ferrer Alicia , Ortega‐Unanue Nerea , Samaniego‐Jimenez Laura , Sanz‐Izquierdo Maria Pilar , Bernardo‐Gonzalez Ivan
Published: March 2019

Ataxia‐telangiectasia (A‐T) is a rare autosomal recessive neurodegenerative disorder characterized by progressive cerebellar ataxia, ocular apraxia, immunodeficiency, telangiectasia, elevated serum α‐fetoprotein concentration, radiosensitivity and cancer predisposition. Classical A‐T is caused by biallelic variants on ATM (ataxia telangiectasia mutated) gene, leading to a loss of function of the protein kinase ATM, involved in DNA damage repair. Atypical presentations can be found in A‐T‐like disease or in Nijmegen breakage syndrome, caused by deficiency of mre11 or nibrin proteins, respectively. In this report, we present the genetic characterization of a 4‐year‐old female with clinical diagnosis of A‐T. Next‐generation sequencing (NGS) revealed two novel heterozygous mutations in the ATM gene: a single‐nucleotide variant (SNV) at exon 47 (NM_000051.3:c.6899G > C; p.Trp2300Ser) and ∼90 kb genomic duplication spanning exons 17–61, NG_009830.1:g.(41245_49339)_(137044_147250)dup. These findings were validated by Sanger sequencing and MLPA (multiplex ligation‐dependent probe amplification) analysis respectively. Familial segregation study confirmed that the two variants are inherited, and the infant is a compound heterozygote. Thus, our study expands the spectrum of ATM pathogenic variants and demonstrates the utility of targeted NGS in the detection of copy number variation.
The Powers in PowerPoint: Embedded Authorities, Documentary Tastes, and Institutional (Second) Orders in Corporate Korea
Authors: Prentice Michael M.
Published: March 2019

Microsoft PowerPoint is both the bane and banality of contemporary South Korean office work. Corporate workers spend countless hours refining and crafting plans, proposals, and reports in PowerPoint that often lead to conflicts with coworkers and overtime work. This article theorizes the excessive attention to documents in modern office contexts. Where scholars have been under the impression that institutional documents align with institutional purposes, I describe a context in which making documents for individual purposes and making them for work exist under a basic tension. Based on fieldwork in corporate Korea between 2013 and 2015, I describe how Korean office workers calibrate documents to the tastes of superiors who populate the managerial chain. These practices leave little trace of real “work” on paper, but they are productive for navigating complex internal labor markets and demonstrating a higher order value of attention toward others. These findings suggest that institutional and individual authorities are not competing projects inside organizations but become entangled in increasingly complex participatory encounters, even as they are channeled through a seemingly simple software like PowerPoint. [documents, expertise, authority, technology, South Korea]
In commemoration of the 2018 Mataro Nagayo Prize: A road to early diagnosis and monitoring of asbestos‐related mesothelioma
Authors: Hino Okio , Abe Masaaki , Han Bo , Yan Yan
Published: March 2019

Primarily caused by exposure to asbestos, mesothelioma is a typical occupational disease. The latency of mesothelioma is as long as 20‐40 years, and the cancer initially progresses mainly along the surfaces of pleura or peritoneum without forming masses. As symptoms do not develop until late stages, it has been challenging to diagnose this disease in its early stages and to carry out complete surgical removal. In responding to Japan's asbestos crisis in the mid‐2000s, we have developed and improved ERC/MSLN‐based serum and radiological markers and pioneered the use of an N‐ERC ELISA kit for screening populations at risk for asbestos exposure. In the present article, we review our research toward early diagnosis of asbestos‐related mesothelioma before symptoms develop and share our clinical experience of screening, diagnosing and monitoring of this disease. This paper is dedicated to the author (Dr Okio Hino) to commemorate the honor bestowed upon him as the recipient of the Mataro Nagayo Prize in 2018.
Tolerability and efficacy of durvalumab in Japanese patients with advanced solid tumors
Authors: Fujiwara Yutaka , Iguchi Haruo , Yamamoto Noboru , Hayama Manabu , Nii Masahiro , Ueda Shinya , Komuro Keiko , Sugimoto Mariko , Vlahovic Gordana , Kozuki Toshiyuki
Published: March 2019

Blockade of programmed cell death ligand‐1 with durvalumab has shown efficacy and safety in large, international studies of patients with advanced solid tumors. A phase 1, non‐randomized, open‐label multicenter study was initiated to evaluate durvalumab in a Japanese population. The first part of this study used a standard 3 + 3 dose‐escalation design to determine the optimal dosing schedule of durvalumab. Primary objective was evaluation of safety and tolerability of durvalumab monotherapy. Secondary objectives were to evaluate maximum tolerated dose (MTD), immunogenicity, pharmacokinetics, and efficacy. Twenty‐two patients (median age, 61.5 years; range, 41‐76; 64% male) received durvalumab at doses of 1, 3, or 10 mg/kg every 2 weeks (q2w), 15 mg/kg q3w, or 20 mg/kg q4w. Twenty patients discontinued before completing 12 months of treatment as a result of progressive disease and two due to adverse events (AE). The most common treatment‐related AE (trAE) were rash (18%) and pruritus (14%); two patients had grade ≥3 trAE including one patient each with hyponatremia and hypothyroidism. No patient experienced a dose‐limiting toxicity (DLT) during the DLT evaluation period and the MTD was not identified. There were no AE leading to a fatal outcome during study treatment. Durvalumab showed dose‐proportional pharmacokinetics across the 1‐20 mg/kg dose range; incidence of positive titers for antidrug antibodies was 9%. One patient with lung cancer had a partial response and disease control rate at 12 weeks was 36%. In conclusion, durvalumab at the doses and regimens evaluated was safe and well tolerated in Japanese patients with advanced solid tumors.
Ecological spillover from a marine protected area replenishes an over‐exploited population across an island chain
Authors: Kough Andrew S. , Belak Carolyn A. , Paris Claire B. , Lundy Agnessa , Cronin Heather , Gnanalingam Gaya , Hagedorn Sam , Skubel Rachel , Weiler Amanda C. , Stoner Allan W.
Published: March 2019

Quantifying successful ecological spillover from marine protected areas (MPAs) is challenging yet crucial for conservation planning. The queen conch (Lobatus gigas) supports an iconic Bahamian fishery, but populations are declining. Here we provide evidence for MPAs as a solution: showing that a well‐enforced MPA supplies ecological spillover through larval supply. Dive surveys throughout the Exuma Cays, including a centrally‐located MPA, provided information on abundance, size, and age. Data showed higher‐adult abundance within the MPA and positive associations between enforcement and conch size and age. A biophysical model estimated that MPA larvae settled in unprotected areas, and that MPA larval sources included unprotected sites with densities too low for reproduction. The MPA is currently sustaining nearby populations, yet its future is in jeopardy without upstream larval sources. Our results and consultations with stakeholders regarding management of the Bahamian conch fishery support creating a network of MPAs that exchange larvae for a sustainable future.
Healthcare professionals as gatekeepers in research involving refugee survivors of sexual torture: An examination of the ethical issues
Authors: Dehghan Roghieh , Wilson James
Published: March 2019

This paper examines the ethical issues that arise when healthcare providers act as gatekeepers to research involving vulnerable populations. Traumatised refugees serve as an example of this subset of research participants. Highlighting the particular vulnerabilities of this group, we argue that specific ethical considerations are required that go beyond the conventional research approaches. While gatekeeping responds to some of those vulnerabilities, it risks wronging through unwarranted paternalism. Instead, we will propose that a relational ethics of justice and care serves as a more appropriate framework for responding to the challenges of research involving traumatised refugees. Specifically, such a framework allows us to reflect more deeply on the role of the gatekeeper. In conclusion, we recommend that clinicians and researchers collaborate with survivors’ advisory groups in the development of specific research ethical guidelines.
Lower rates of hypoglycaemia in older individuals with type 2 diabetes using insulin degludec versus insulin glargine U100: Results from SWITCH 2
Authors: Heller Simon R. , DeVries J. Hans , Wysham Carol , Hansen Charlotte T. , Hansen Melissa V. , Frier Brian M.
Published: March 2019

Aim

This study aimed to investigate the safety of insulin degludec (degludec) in relation to age and risk of hypoglycaemia post hoc in individuals with type 2 diabetes (T2D) (SWITCH 2 trial).

Methods

In this crossover study, individuals with T2D who were at risk of hypoglycaemia were randomized to double‐blind treatment with degludec or insulin glargine 100 units/mL (glargine U100) ± oral antidiabetic drugs. After 32 weeks, patients crossed over to the other treatment. Primary endpoint was number of overall severe (positively adjudicated) or glucose‐confirmed (plasma glucose <56 mg/dL; 3.1 mmol/L) symptomatic hypoglycaemia events during the two 16‐week maintenance periods.

Results

For individuals ≤65 (n = 450) and >65 (n = 270) years, baseline median (range) duration of diabetes was 12 (1–40) vs 15 (1–54) years, mean HbA1c was 7.7% vs 7.4% and mean estimated glomerular filtration rate was 87.0 vs 63.7 mL/min/1.73 m2, respectively. No significant differences in HbA1c reduction were seen in individuals ≤65 or >65 years. During both maintenance periods, treatment with degludec lowered rates of hypoglycaemia (overall/nocturnal symptomatic) vs those with glargine U100 in individuals ≤65 (31% vs 43%) and >65 (30% vs 41%) years. With degludec and glargine U100, respectively, six vs nine severe hypoglycaemic events occurred in individuals ≤65 years and four vs eight events occurred in those >65 years. Adverse event rates were 3.2 and 3.3 events/patient‐year for individuals ≤65 years and were 3.5 and 4.1 events/patient‐year for individuals >65 years with degludec and glargine U100, respectively.

Conclusion

Treatment with degludec was safe and effective, with a frequency of hypoglycaemia lower than that with glargine U100 in both younger and older individuals (>65 years) with T2D.
Restoration potential of threatened ecosystem engineers increases with aridity: broad scale effects on soil nutrients and function
Authors: Decker Orsi , Eldridge David J. , Gibb Heloise
Published: March 2019

Species extinctions alter ecosystem services, and the magnitude of this impact is likely to change across environmental gradients. In Australia, soil‐disturbing mammals that are now considered ecologically extinct are thought to be important ecosystem engineers. Previous studies have demonstrated microsite‐level impacts of reintroduced soil‐disturbing mammals on soil functions, but effects are yet to be tested across larger scales. Further, it is unclear how impacts vary across environmental gradients and if the restoration potential of reintroductions changes with climate. We examined the effects of soil‐disturbing mammal reintroductions across a large rainfall gradient in Australia to test the hypothesis that ecosystem engineering effects on soil function depend on climate. We compared soil labile carbon, available nitrogen and the activity of four enzymes associated with nutrient cycling in three microsite types with and without soil‐disturbing mammals in five sites along a large rainfall gradient (166–870 mm). Soil enzyme activity was greatest in the presence of soil‐disturbing mammals and increased with rainfall, but soil available carbon and nitrogen varied across the gradient and among microsites. Microsite effects were often stronger than any effects of soil‐disturbing mammals, with soil beneath vegetated patches (shrubs and trees) having greater enzyme activity, carbon and nitrogen than bare soils. However, soil‐disturbing mammals homogenised nutrient distributions across microsites. The impacts of soil‐disturbing mammals on soil function previously detected at micro‐scales was detected at a landscape‐scale. However, the overall effects of soil‐disturbing mammals on soil functions varied with productivity (rainfall). The context of soil‐disturbing mammal reintroductions is thus likely to be critical in determining their effectiveness in restoring soil function.
A weighting method to improve habitat association analysis: tested on British carabids
Authors: Chetcuti Jordan , Kunin William E. , Bullock James M.
Published: March 2019

Analysis of species’ habitat associations is important for biodiversity conservation and spatial ecology. The original phi coefficient of association is a simple method that gives both positive and negative associations of individual species with habitats. The method originates in assessing the association of plant species with habitats, sampled by quadrats. Using this method for mobile animals creates problems as records often have imprecise locations, and would require either using only records related to a single habitat or arbitrarily choosing a single habitat to assign.

We propose and test a new weighted version of the index that retains more records, which improves association estimates and allows assessment of more species. It weights habitats that lie within the area covered by the species record with their certainty level, in our case study, the proportion of the grid cell covered by that habitat.

We used carabid beetle data from the National Biodiversity Network atlas and CEH Land Cover Map 2015 across Great Britain to compare the original method with the weighted version. We used presence‐only data, assigning species absences using a threshold based on the number of other species found at a location, and conducted a sensitivity analysis of this threshold. Qualitative descriptions of habitat associations were used as independent validation data.

The weighted index allowed the analysis of 52 additional species (19% more) and gave results with as few as 50 records. For the species we could analyse using both indices, the weighted index explained 70% of the qualitative validation data compared to 68% for the original, indicating no accuracy loss.

The weighted phi coefficient of association provides an improved method for habitat analysis giving information on preferred and avoided habitats for mobile species that have limited records, and can be used in modelling and analysis that directs conservation policy and practice.
Testimony, epistemic egoism, and epistemic credit
Authors: Kawall Jason
Published: March 2019

It is generally acknowledged that testifiers can play a central role in the production of knowledge and other valuable epistemic states in others. But does such a role warrant any form of epistemic credit and is an agent more successful qua epistemic agent insofar as she is a successful testifier? I here propose an affirmative answer to both questions. The core of the current paper consists in a sustained defense of this proposal against a series of objections. I further argue that the proposal allows us to recognize an important additional epistemic harm that arises in cases of testimonial injustice beyond those described by Miranda Fricker. Finally, I conclude by distinguishing between four kinds of credit—distinctions that allow us to avoid inappropriately attributing epistemic credit in problematic cases. If the current proposal is correct, our understanding of successful epistemic agents needs to be significantly modified in order to take into account their role in producing epistemically valuable states in others.
Seeds tend to disperse further in the tropics
Authors: Chen Si‐Chong , Tamme Riin , Thomson Fiona J. , Moles Angela T.
Published: March 2019

Despite the importance of seed dispersal in a plant's life cycle, global patterns in seed dispersal distance have seldom been studied. This paper presents the first geographically and taxonomically broad quantification of the latitudinal gradient in seed dispersal distance. Although there is substantial variation in the seed dispersal distances of different species at a given latitude, seeds disperse on average more than an order of magnitude further at the equator than towards the poles. This pattern is partially explained by plant life‐history traits that simultaneously associate with seed dispersal distance and latitude, including dispersal mode and plant height. The extended seed shadow of tropical plants could increase the distance between conspecific individuals. This could facilitate species coexistence and contribute to the maintenance of high plant diversity in tropical communities. The latitudinal gradient in dispersal distance also has implications for species’ persistence in the face of habitat fragmentation and climate change.
Refinement of the Micro‐Distillation Technique for Isotopic Analysis of Geological Samples with pg‐Level Osmium Contents
Authors: Nakanishi Nao , Yokoyama Tetsuya , Ishikawa Akira
Published: March 2019

In recent years, the 187Re–187Os isotope system has been increasingly used to study samples containing very small quantities of Os. For such samples, optimisation of measurement procedures is essential to minimise the loss of Os before mass spectrometric measurements. Micro‐distillation is a necessary purification step that is applied after the main Os chemical separation procedure, prior to Os isotope ratio measurements by negative‐thermal ionisation mass spectrometry (N‐TIMS). However, unlike the other separation steps, this procedure has not yet been optimised for small samples. In this study, we present a refined micro‐distillation method that achieved higher yields and allowed high‐precision R(187Os/188Os) expressed as 187Os/188Os measurements for small‐sized geological samples that contain only a few pg Os. The Os recovery in the micro‐distillation step was tested by changing the operating conditions including heating time and temperature, and amounts of oxidant and reductant. Recoveries were measured by the isotope dilution ICP‐MS method after the addition of 190Os‐enriched spike solution. We found that the most critical factor controlling the chemical yield of Os during micro‐distillation is the extent of dilution of the reductant (HBr) by H2O evaporated from the oxidant. A refined micro‐distillation method, in which the amount of oxidant solution is reduced from the conventional method, achieved an improved chemical yield of Os (~ 90%). This refined method was applied to the measurement of 187Os/188Os by N‐TIMS of varying test portions of the geological reference material BIR‐1a. The resulting 187Os/188Os ratios of BIR‐1a matched the literature data, with propagated uncertainties of 0.2, 1.1 and 11% digested sample quantities containing 150, 10 and 1 pg of Os, respectively.
Effect of milling on the anisotropic grain growth in a sintered Ba5Nb4O15 specimen and its effect on microwave dielectric properties
Authors: Tsao Chung‐Ya , Tuan Wei‐Hsing , Feng Kuei‐Chih
Published: March 2019

In this study, relationships between the processing, microstructure, and properties of barium niobate (Ba5Nb4O15) are investigated. The milling of a Ba5Nb4O15 powder in water is effective with respect to size reduction. However, after milling in water, BaCO3 is formed within the slurry. With the increase in the amount of BaCO3 formed, the aspect ratio of the elongated Ba5Nb4O15 grains increases. The formation of the elongated Ba5Nb4O15 grains prohibits the densification. Hence, the microwave dielectric properties, including permittivity and quality factor, are poor because of the low density. In addition, milling in ethanol is carried out for comparison: A lower amount of BaCO3 is formed after milling in ethanol; the extent of anisotropic grain growth is thus reduced.
Dermatology inpatient consultations in Latin America: 3‐year experience in our University Hospital setting
Authors: Chavez‐Alvarez Sonia , Herz‐Ruelas Maira , Ocampo‐Candiani Jorge , Ayala‐Cortes Ana S. , Gomez‐Flores Minerva
Published: March 2019

Background

Dermatology patients are mostly seen in outpatient clinics; however, there is a significant need for consultations within the hospital setting.

Methods

Here we describe the hospital consultations received by the Dermatology Service during a 3‐year period.

Results

Most of the requested consultations came from the Internal Medicine Department and the surgical departments. The most common encountered dermatoses were drug eruptions and adnexal diseases, followed by viral dermatoses.

Conclusions

In hospital dermatology may pose a challenge for other clinicians; therefore, dermatologists should be adequately trained to confront a wide variety of clinical scenarios.
Dermatological manifestations in patients with human T‐cell lymphotropic virus at a reference service in Amazon
Authors: Andrade de Sousa Brena , dos Santos Laisa V. , Oliveira Tamires R. , Dias Aline L. , Araújo da Costa Carlos , Medeiros Sousa Rita C. , de Sousa Maisa S. , Xavier Marília B.
Published: March 2019

Introduction

Individuals infected with the human T‐cell lymphotropic virus type 1 (HTLV‐1) commonly present skin lesions, which may be a warning sign for the diagnosis of infection. This study describes the most prevalent skin manifestations in HTLV carriers attended at the clinic of Núcleo de Medicina Tropical (NMT) of the Universidade Federal do Pará (UFPA) in Belém, Pará, Brazil.

Methods

This is a study of a series of cases of patients infected with human T‐cell lymphotropic virus types 1 and 2 (HTLV‐1/2) treated at NMT UFPA between 1999 and 2016. A descriptive analysis of data was applied.

Results

Among 788 surveyed medical records in the service, 15.10% (n = 119) were referred to the dermatology clinic. From the series of cases that presented with skin lesions, 66.39% were female and 33.61% were male, and the average age of this group was 48 years. There was a predominance of patients with noninfectious inflammatory manifestations (64.2%), followed by infectious ones (24.6%), and 1.58% with lymphoproliferative diseases. As for the group of lesions, 45.26% of the erythematous‐squamous type were observed, followed by dyschromia (24.21%), and eczematous (14.74%). One patient with a diagnosis of adult T‐cell leukemia/lymphoma, another with parapsoriasis, and four with infective dermatitis are highlighted.

Conclusion

Skin disorders in the HLTV positive patient are important causes of referral to the dermatologist with etiological and skin lesions groups diversity. In the series of cases studied, lymphoproliferatives diseases and infective dermatitis associated with HTLV‐1 were presented as a challenge for the diagnosis and clinical management of these patients.
Time to acute stroke treatment in‐hours was more than halved after the introduction of the Helsinki Model at Westmead Hospital
Authors: Silsby Matthew , Duma Stephen R. , Fois Alessandro F. , Yin Y. W. Katie , Koryzna Joanna , Mahant Neil , Evans Andrew , Fung Victor S. C.
Published: March 2019

Background

Management of acute ischaemic stroke is time critical. Reducing time to treatment with thrombolysis is strongly associated with improved outcomes in properly selected patients. However, there are barriers to ensuring timely treatment in the hospital setting.

Aim

To determine if simple, no‐cost protocol changes could improve time to treatment for acute ischaemic stroke at a busy tertiary hospital.

Methods

Prospectively collected routine clinical data were compared retrospectively before and after a protocol change designed to mirror the successful model from Helsinki University Central Hospital. Consecutive patients who activated a ‘code stroke’ (presentation consistent with acute stroke, eligible for acute stroke therapy) during working hours were included.

Results

Prior to the protocol change, 143 patients activated a code stroke, and 30 patients received thrombolysis. Following the protocol change, 134 patients activated a code stroke, and 14 patients received thrombolysis. The median time to administer thrombolysis was reduced from 76 min (interquartile range 54–91) to 33 min (27–44), P < 0.01. The median time to perform diagnostic computed tomography was unchanged between the two groups, 23 (14–54) min versus 22 (9–49) min, P = 0.12. However, this was reduced on subgroup analysis of patients whose arrival was pre‐notified by the ambulance service, 16 (9–22) min versus 8 (4–14) min, P < 0.01.

Conclusion

Time to treatment in acute stroke was dramatically improved with a simple intervention. This was achieved without a large stroke team or additional funding, making it highly accessible to other health services also seeking to improve their stroke service.
Number of neighbors instead of group size significantly affects individual vigilance levels in large animal aggregations
Authors: Zhao Jin‐Ming , Lyu Nan , Sun Yue‐Hua , Zhou Li‐Zhi
Published: March 2019

The group size effect states that animals living in groups gain anti‐predator benefits through reducing vigilance levels as group size increases. A basic assumption of group size effect is that all individuals are equally important for a focal individual, who may adjust its vigilance levels according to social information acquired from them. However, some studies have indicated that neighbors pose greater influences on an individual's vigilance decisions than other group members, especially in large aggregations. Vigilance has also been found to be directed to both predators (anti‐predation vigilance) and conspecifics (social vigilance). Central individuals might rely more on social vigilance than peripheral individuals. To test these hypotheses, we examined the effects of flock size, number of neighbors and position within a flock on vigilance and competition of greater white‐fronted gooseAnser albifronsthat form large foraging flocks in winter, controlling the effects of other variables (group identity, winter period and site). We found that individual vigilance levels were significantly affected by number of neighbors and position within a flock, whereas flock size showed no effect. Individuals devoted a large component of vigilance to nearby flock mates. Central individuals directed a relatively larger proportion of vigilance to monitor neighbors than peripheral ones, indicating that central individuals more relied on social information acquired from neighbors, possibly caused by the more blocked visual field of central individuals. Moreover, some social vigilance may function as conducting or preventing agonistic interactions since competition intensity was positively correlated with number of neighbors. Our study therefore demonstrate that the number of neighbors is more important than group size in determining individual vigilance in large animal groups. Further studies are still needed to unravel which neighbors pose greater influence on individual vigilance, and the factors that influence individuals to acquire information from their neighbors to adjust vigilance behaviors.
Pace capture and adenosine triphosphate provocation are complementary rather than mutually exclusive methods to ensure durable pulmonary vein isolation
Authors: Zeng Li‐Jun , Shi Liang , Tian Ying , Wang Yan‐Jiang , Yin Xian‐Dong , Liu Xiao‐Qing , Yang Xin‐Chun , Liu Xing‐Peng
Published: March 2019

Introduction

Adenosine triphosphate (ATP)‐provoked dormant conduction (DC) and pacing for unexcitability are used to identify conduction gaps along the ablation lines after circumferential pulmonary vein isolation (CPVI). We aim to determine whether ATP provocation and pacing are interchangeable as endpoints for ablation of paroxysmal atrial fibrillation (PAF).

Methods and Results

A total of 107 patients with PAF were randomly divided into two groups after completion of CPVI. In group I (A‐P group, n = 53), ATP was administered first. If DC was uncovered, additional ablation was performed until ATP tests were negative. Bipolar pacing along the ablation line was performed subsequently. In group II (P‐A group, n = 54), the same protocol was used, but the pacing and the ATP tests were performed in the opposite sequence. The 12‐month ablation outcomes of all patients were compared with those of a historical control group of 107 patients with PAF in whom only ATP test was performed. Regardless of which test was performed first, the other modality still identified conduction gaps. In group I, pacing maneuvers identified gaps in 49% (n = 26) of patients who had negative ATP tests. In group II, ATP tests uncovered DC in 18.5% (n = 10) of patients in whom pacing identified no gaps. After 12 months, a higher proportion of patients (91.6%) were free from atrial tachyarrhythmias compared with the historical control group (81.3%; P = 0.031).

Conclusion

Pacing along the ablation lines and ATP provocation are complementary tests for evaluating the durability of CPVI and can lead to better long‐term outcomes when used in combination.
FAM3C‐YY1 axis is essential for TGFβ‐promoted proliferation and migration of human breast cancer MDA‐MB‐231 cells via the activation of HSF1
Authors: Yang Weili , Feng Biaoqi , Meng Yuhong , Wang Junpei , Geng Bin , Cui Qinghua , Zhang Hongquan , Yang Yang , Yang Jichun
Published: March 2019

Family with sequence similarity three member C (FAM3C) (interleukin‐like EMT inducer [ILEI]), heat shock factor 1 (HSF1) and Ying‐Yang 1 (YY1) have been independently reported to be involved in the pathogenesis of various cancers. However, whether they are coordinated to trigger the development of cancer remains unknown. This study determined the role and mechanism of YY1 and HSF1 in FAM3C‐induced proliferation and migration of breast cancer cells. In human MDA‐MB‐231 breast cancer cell line, transforming growth factor‐β (TGFβ) up‐regulated FAM3C, HSF1 and YY1 expressions. FAM3C overexpression promoted the proliferation and migration of MDA‐MB‐231 cells with YY1 and HSF1 up‐regulation, whereas FAM3C silencing exerted the opposite effects. FAM3C inhibition repressed TGFβ‐induced HSF1 activation, and proliferation and migration of breast cancer cells. YY1 was shown to directly activate HSF1 transcription to promote the proliferation and migration of breast cancer cells. YY1 silencing blunted FAM3C‐ and TGFβ‐triggered activation of HSF1‐Akt‐Cyclin D1 pathway, and proliferation and migration of breast cancer cells. Inhibition of HSF1 blocked TGFβ‐, FAM3C‐ and YY1‐induced proliferation and migration of breast cancer cells. YY1 and HSF1 had little effect on FAM3C expression. Similarly, inhibition of HSF1 also blunted FAM3C‐ and TGFβ‐promoted proliferation and migration of human breast cancer BT‐549 cells. In human breast cancer tissues, FAM3C, YY1 and HSF1 protein expressions were increased. In conclusion, FAM3C activated YY1‐HSF1 signalling axis to promote the proliferation and migration of breast cancer cells. Furthermore, novel FAM3C‐YY1‐HSF1 pathway plays an important role in TGFβ‐triggered proliferation and migration of human breast cancer MDA‐MB‐231 cells.
Genes or environment: what counts most in basal cell carcinoma?
Authors: Argenziano G. , Brancaccio G.
Published: March 2019

Linked article: This is a commentary on J.A.C. Verkouteren et al., pp. 533–540 in this issue. To view this article visit https://doi.org/10.1111/jdv.15389.
Terrestriality constrains salamander limb diversification: Implications for the evolution of pentadactyly
Authors: Ledbetter Nicholus M. , Bonett Ronald M.
Published: March 2019

Patterns of phenotypic evolution can abruptly shift as species move between adaptive zones. Extant salamanders display three distinct life cycle strategies that range from aquatic to terrestrial (biphasic), to fully aquatic (paedomorphic) and to fully terrestrial (direct development). Life cycle variation is associated with changes in body form such as loss of digits, limb reduction or body elongation. However, the relationships among these traits and life cycle strategy remain unresolved. Here, we use a Bayesian modelling approach to test whether life cycle transitions by salamanders have influenced rates, optima and integration of primary locomotory structures (limbs and trunk). We show that paedomorphic salamanders have elevated rates of limb evolution with optima shifted towards smaller size and fewer digits compared to all other salamanders. Rate of hindlimb digit evolution is shown to decrease in a gradient as life cycles become more terrestrial. Paedomorphs have a higher correlation between hindlimb digit loss and increases in vertebral number, as well as reduced correlations between limb lengths. Our results support the idea that terrestrial plantigrade locomotion constrains limb evolution and, when lifted, leads to higher rates of trait diversification and shifts in optima and integration. The basic tetrapod body form of most salamanders and the independent losses of terrestrial life stages provide an important framework for understanding the evolutionary and developmental mechanisms behind major shifts in ecological zones as seen among early tetrapods during their transition from water to land.
Reply to: Comment on: Serum Cholesterol and Incident Alzheimer's Disease: Findings From the Adult Changes in Thought Study
Authors: Marcum Zachary A. , Walker Rod , Bobb Jennifer F. , Sin Mo‐Kyung , Gray Shelly L. , Bowen James D. , McCormick Wayne , McCurry Susan M. , Crane Paul K. , Larson Eric B.
Published: March 2019

This letter comments on the letter by Naharci et al.
Finding Someone Like Me: The Secret to Successfully Mentoring Specialists in Aging Research
Authors: High Kevin , Kritchevsky Stephen
Published: March 2019

This editorial comments on the articles by Carpenter et al. and Masterson Creber et al. in this issue.
Coeliac disease in Caucasian and South Asian patients in the North West of England
Authors: Adam U. U. , Melgies M. , Kadir S. , Henriksen L. , Lynch D.
Published: March 2019

Background

Coeliac disease is an autoimmune enteropathy characterised by mucosal inflammation subsequent to gluten exposure, leading to malabsorption. Treatment is strict dietary control, relying on the patient's ability to maintain lifestyle modifications. The present study aimed to compare clinical presentation and adherence to a gluten‐free diet between South Asian and Caucasian patients with coeliac disease in East Lancashire

Methods

In total, 33 South Asian and 113 Caucasian adult patients diagnosed with coeliac disease under the care of the Dietetics Department at East Lancashire Hospitals NHS Trust were selected using a convenience sampling method and then allocated to the South Asian or Caucasian group. A subjective assessment of dietetic notes from follow‐up visits within 1 year of the first appointment was undertaken by two investigators who subsequently allocated the patients to one of the three categories: (i) fully‐adherent; (ii) partly‐adherent; and (iii) non‐adherent. Presenting complaint, vitamin D, vitamin B12, folate and ferritin levels were also compared.

Results

There was a significant difference in adherence to gluten‐free diet between the groups, with a larger proportion of Caucasian patients being fully adherent to gluten‐free diet compared to South Asian patients (64.6% versus 12.1%, P < 0.001). In addition, a significantly higher proportion of South Asian patients were vitamin D deficient compared with Caucasian patients (70.8% versus 32.8%, P = 0.002).

Conclusions

The rates of strict adherence to gluten‐free diet and vitamin D levels were significantly lower in South Asian patients with coeliac disease compared to the Caucasian coeliac population. Further studies are required to investigate the causes and improve adherence in the South Asian population.
The Impact of MRI T1 Hypointense Brain Lesions on Cerebral Deep Gray Matter Volume Measures in Multiple Sclerosis
Authors: Buyukturkoglu Korhan , Mormina Enricomaria , De Jager Philip L. , Riley Claire S. , Leavitt Victoria M.
Published: March 2019

BACKGROUND AND PURPOSE

Deep gray matter (DGM) atrophy has been shown at early stages of multiple sclerosis (MS) and reported as an informative marker of cognitive dysfunction and clinical progression. Therefore, accurate measurement of DGM structure volume is a key priority in MS research. Findings from prior studies have shown that hypointense T1 lesions may impact the accuracy of global brain volume measures; however, literature on the effects of hypointense T1 lesions on DGM structure volumes is sparse.

METHODS

We explored the effects of hypointense T1 lesions on data from 54 relapsing remitting MS patients. Lesions were segmented both manually and with a freely available automatic lesion segmentation/in‐painting algorithm (Lesion Segmentation Tool‐LST). Volumes of 14 DGM structures were calculated from non‐in‐painted and in‐painted images and compared via paired t‐tests, intraclass correlation coefficient, and Dice similarity coefficient.

RESULTS

There were no significant differences in DGM structural volumes between non‐in‐painted and in‐painted images. Automatic lesion‐segmentation/in‐painting tool provided similar results to manual segmentation/in‐painting.

CONCLUSIONS

Our results suggest that lesion in‐painting has a negligible impact on DGM structure volume measurement although some regions are more vulnerable to the impact of lesions than others. Furthermore, manual lesion segmentation/in‐painting can be replaced by an automatic segmentation/in‐painting process.
Hemodynamic Differences Between Recurrent and Nonrecurrent Intracranial Aneurysms: Fluid Dynamics Simulations Based on MR Angiography
Authors: Schönfeld Michael Hinrich , Forkert Nils Daniel , Fiehler Jens , Cho Young Dae , Han Moon Hee , Kang Hyun‐Seung , Peach Thomas William , Byrne James Vincent
Published: March 2019

BACKGROUND AND PURPOSE

Although the role of wall shear stress (WSS) in the initiation, growth, and rupture of intracranial aneurysms has been well studied, its influence on aneurysm recurrence after endovascular treatment requires further investigation. We aimed to compare WSS at necks of recurrent and nonrecurrent aneurysms.

METHODS

Nine recurrent coil‐embolized aneurysms were identified and matched with nine nonrecurrent aneurysms. Patient‐specific vessel geometries reconstructed from follow‐up 3‐D time‐of‐flight magnetic resonance angiography were analyzed using computational fluid dynamics (CFD) simulations. Absolute WSS and the percentage of abnormally low and high WSS at the aneurysm neck compared to the near artery were measured.

RESULTS

The median percentage of abnormal WSS at the aneurysm neck was 49.3% for recurrent and 34.7% for nonrecurrent aneurysms (P = .011). The area under the receiver‐operating‐characteristic curve for distinguishing these aneurysms according to the percentage of abnormal WSS was .86 (95% CI .62 to .98). The optimal cut‐off value of 45.1% resulted in a sensitivity and a specificity of 88.89% (95% CI 51.8% to 99.7%).

CONCLUSION

Our findings indicate that necks of recurrent aneurysms are exposed to abnormal WSS to a larger extent. Abnormal WSS may serve as a metric to distinguish them from nonrecurrent aneurysms with CFD simulations a priori.