bluuebunny/crossref_metadata_2025 huggingface dataset:
Stock return autocorrelation, day of the week and volatility
Authors: Chowdhury Shah Saeed Hassan , Rahman M. Arifur , Sadique M. Shibley
Published: March 2017

Purpose

The main purpose of this paper is to investigate autocorrelation structure of stock and portfolio returns in a unique market setting of Saudi Arabia, where nearly all active traders are the retail individuals and the market operates under severe limits to arbitrage. Specifically, the authors examine how return autocorrelation of Saudi Arabian stock market is related to factors such as the day of the week, stock trading, performance on the preceding day and volatility.

Design/methodology/approach

The sample consists of the daily stock price and index data of 159 firms listed in Tadawul (Saudi Arabian Stock Exchange) for the period from January 2004 through December 2015. The methodology of Safvenblad (2000) is primarily used to investigate the autocorrelation structure of individual stock and index returns. The authors also use the Sentana and Wadhwani (1992) methodology to test for the presence of feedback traders in the Saudi stock market.

Findings

Results show that there is significantly positive autocorrelation in individual stock, size portfolio and market returns and that the last two are almost always larger than the first. Return autocorrelation is negatively related to firm size. Interestingly, return autocorrelation is positively related to trading frequency. For portfolios, autocorrelation of returns following a high absolute return day is significantly higher than that following a low absolute return day. Similarly, return autocorrelation during volatile periods is generally larger than that during tranquil periods. Return correlation between weekdays is usually larger than that between the first and last days of the week. Overall, the results suggest that the possible reason for positive autocorrelation in stock returns could be the presence of negative feedback traders who are engaged in frequent profit-taking activities.

Originality/value

This is the first paper that thoroughly investigates the autocorrelation structure of the returns of the Saudi stock market using both index and individual stock returns. As this US$583bn (as of August 21, 2014) market opened to foreign institutional investors in June 2015, the results of this paper should be of significant value for the potential uninformed foreign investors in this relatively lesser known and previously closed yet highly prospective market.
Factors behind support for harsher punishments for common and uncommon offenders
Authors: Palasinski Marek , Shortland Neil
Published: March 2017

Purpose

The purpose of this paper is to explore individual factors predicting support for harsher punishments for relatively common and uncommon serious offenders.

Design/methodology/approach

In Study 1, 120 UK participants (60 males and 60 females; mean age =37.31 SD=16.74) completed a survey exploring the extent to which they supported harsher punishments (SHP) for first time and repeat fraud, sexual and violent offenders. In Study 2, 131 participants (70 Britons and 61 Singaporeans; 69 females and 62 males; mean age=31.57; SD=10.87) completed a similar survey exploring their support for life sentence without the possibility of parole (SLSWP) for rather uncommon repeat offenders (i.e. drug traffickers, human traffickers, serious sexual offenders).

Findings

Study 1 found that right-wing authoritarianism (RWA) was an SHP predictor for first time and repeat fraud, violent and sex offenders. Study 2 found that national identity (i.e. how British or Singaporean participants felt) played a similar role to Study 1’s RWA in being a positive SLSWP predictor for repeat human traffickers and drug traffickers of both sexes, as well as male sex offenders. In contrast to the hypothesis, however, participants’ locations did not appear to play a statistically significant role.

Research limitations/implications

This survey-based research reveals a nuanced and quite consistent picture that could benefit from the inclusion of socio-economic factors and other cross-cultural comparisons.

Practical implications

The key message from this study is to inform the public on the role that right-wing authoritarianism and national identity play in their SHP and SLSWP.

Social implications

It is vital to increase the legislators’ and the public awareness of the role that national identity and RWA seem to play.

Originality/value

The paper offers insight into factors behind people’s punitive attitudes towards specific crimes regardless of geo-cultural location.
More than pictures: developing an accessible resource
Authors: Cameron Lois , Matthews Rhona
Published: March 2017

Purpose

The purpose of this paper is to describe the process of developing an accessible communication resource which enables people with a learning disability to reflect on their lives and raise issues of concern.

Design/methodology/approach

The process of making the resource and the facets that contribute to making it accessible are explored, e.g. design specification, the relationship between pictures and meaning, the order in which concepts are presented. The paper goes on to describe how the resource is put into practice using the format of a “Talking Mat”.® Talking Mats is a communication framework which has a strong evidence base that shows it improves the quality and quantity of information a person with a learning disability gives in a conversation. It provides practitioners with a consistent framework to support implementation. The impact of using the resource is explored through feedback from practitioners trained to use it and the stories that resulted.

Findings

A well-constructed resource can support people with a learning disability to express their views on what matters to them at a specific time and raise concerns they may have. The individual views that have emerged from people are varied. This resource enabled them to be genuinely included in planning the steps required to bring about positive change in their lives.

Originality/value

There is much emphasis on the development of accessible resources in the field of learning disability but little on the actual development process and the context of how resources are introduced. This paper aims to contribute to this knowledge base.
Retracted: Evaluation of antidiabetic activity of biologically synthesized silver nanoparticles usingPouteria sapotain streptozotocin‐induced diabetic rats
Authors: Prabhu Sathya , Vinodhini Shanmugam , Elanchezhiyan Chakravarthy , Rajeswari Devi
Published: March 2017

Background

Medicinal plants and green synthesis of silver nanoparticles (AgNPs) have proven to be good sources of agents effective in the treatment of diabetes mellitus. The present study focused on the green synthesis ofAgNPsfrom the aqueous leaf extract ofPouteria sapotain order to evaluate the in vitro and in vivo antidiabetic properties of this extract and the synthesizedAgNPs.

Methods

TheAgNPswere biologically synthesized under ambient conditions from an aqueous leaf extract ofP. sapotausing the hot percolation method and were characterized using spectroscopic methods, X‐ray diffraction, and scanning electron microscopy. The in vitro antidiabetic activity of the aqueous leaf extract andAgNPswas confirmed by non‐enzymatic glycosylation of hemoglobin, glucose uptake by yeast cells following exposure of cells to 5 or 10 mmol/L glucose solution, and inhibition of α‐amylase. Further, in vivo antidiabetic activity was assessed in streptozotocin‐induced rats. Rats were treated with aqueous leaf extract (100 mg/kg) orAgNPs(10 mg/kg) for 28 days. Following treatment, rats were killed for biochemical and histopathological analysis of kidney and liver samples.

Results

A significant reduction in blood sugar levels was noted in rats treated with leaf extract orAgNPs. Results of in vitro and in vivo analyses in rats treated with leaf extract orAgNPsshow that both the extract and the biologically synthesizedAgNPshave antidiabetic activity.

Conclusion

The aqueous leaf extract ofP. sapotaandAgNPsexhibited efficient antidiabetic activity in the rat model of diabetes and therefore could have potential for development for medical applications in the future.
Feeding preference as a main determinant of microscale patchiness among terrestrial nematodes
Authors: Quist Casper W. , Gort Gerrit , Mulder Christian , Wilbers Ruud H. P. , Termorshuizen Aad J. , Bakker Jaap , Helder Johannes
Published: March 2017

Soil biota are responsible for essential ecosystem services such as carbon storage, nutrient cycling and water retention. However, assessment of the condition of soil biota is hampered by an overwhelming level of diversity. With representatives in all trophic levels of the food web, nematode communities can be used as bioindicators. Accurate assessment of nematode assemblages requires insight into the distribution of specimens with distinct food preferences. With the availability of taxon‐specific quantitative PCR assays, distribution patterns of multiple nematode groups can be investigated simultaneously. Here, microscale patchiness of 45 nematode taxa was studied on 12 sampling sites (each with four adjacent microplots) located on arable fields or semi‐natural grasslands (‘system’), and on marine, river clay or sandy soils (‘soil type’). From each microplot, five composite samples were collected. Contrary to our expectations, an increase in the number of cores per composite sample did not result in more accurate measurements, and apparently the levels of microscale patchiness of the taxa are low compared to what has been reported for oligophagous plant‐parasites. System and soil type did not affect microscale distribution. To investigate the level of patchiness in more detail, detection probability (DP) and variability of abundances were calculated. Common and widespread bacterivorous and fungivorous taxa had DP ≥ 90%, confirming low level of microscale patchiness. With DPs of 40%–70%, predators and most omnivores showed degrees of local clustering. An overview of mean variabilities of abundances is presented that offers insight into how feeding preferences impact the microscale distribution both between and within trophic groups.
Clinicopathological and prognostic features of surgically resected pathological stage I lung adenocarcinoma harboring epidermal growth factor receptor and K‐ras mutation
Authors: Kaseda Kaoru , Asakura Keisuke , Kazama Akio , Ozawa Yukihiko
Published: March 2017

Background

This study aimed to evaluate mutations of the epidermal growth factor receptor (EGFR) and K‐ras genes and their clinicopathological and prognostic features in patients with resected pathological stage I adenocarcinoma.

Methods

We examined 224 patients with surgically resected lung adenocarcinoma and analyzed the prognostic and predictive value of these mutations in 162 patients with pathological stage I adenocarcinoma.

Results

Mutations of the EGFR and K‐ras genes were detected in 100 (44.6%) and 19 (8.5%) of all tumors, and in 81 (50.0%) and 17 (10.5%) of the pathological stage I tumors, respectively. EGFR mutations were significantly associated with female gender, smoking habit (never smoker), and low grade. By contrast, K‐ras mutations were significantly associated with male gender, smoking habit (ever smoker), and the presence of mucinous components. No significant differences were observed in recurrence‐free or overall survival between the EGFR‐mutant, K‐ras‐mutant, and wild‐type groups (five‐year recurrence‐free survival 77.8% vs. 87.8% vs. 79.5%; five‐year overall survival 82.8% vs. 82.4% vs. 79.2%, respectively). Multivariate analysis showed that neither EGFR nor K‐ras mutation was an independent prognostic factor.

Conclusions

The present study demonstrated that pathological stage I adenocarcinoma harboring EGFR and K‐ras gene mutations have distinct clinicopathological features. The presence of these mutations alone were not prognostic factors in patients with resected pathological stage I adenocarcinoma.
Analysis of Blood Flow Characteristics in a Model of a Mature Side‐to‐Side Arteriovenous Fistula
Authors: Javadzadegan Ashkan , Myo Lwin Nay , Asyraf Muhammad , Simmons Anne , Barber Tracie
Published: March 2017

The creation of an arteriovenous fistula (AVF) is a common surgical procedure in hemodialysis patients suffering from end‐stage renal disease (ESRD). However, several complications may occur after surgery, including thrombosis, stenosis, and aneurysm. These complications are attributed to hemodynamics perturbations including pathophysiological wall shear stress (WSS) and flow recirculation zones. In this study, we present a computational hemodynamic analysis in a model of a mature side‐to‐side AVF, which is then validated by experimental measurements. Both computational and experimental results confirmed the presence of complex flow patterns within the AVF with vortices initially developing at the center of the venous region and gradually moving downstream, such that at four characteristic anastomosis lengths downstream, the flow disturbances became minimum. A complex pattern was also observed in WSS distribution with regions of low and high WSS identified in proximal vein and feeding artery, respectively. In addition, the temporal distribution of WSS varied significantly along the venous wall where a large portion of it remained above normal levels of WSS during systole while the area was largely normal during diastole. Our findings support the hypothesis that high WSS is not detrimental to immediate patency of AVF; however, other factors including low WSS and temporal and spatial gradients of WSS increase the risk of vascular access complications.
Editorial: smoking status and 5‐year survival in patients with colorectal cancer
Authors: Ho N. , Lieberman D.
Published: March 2017

Linked Content

This article is linked to Sharp et al paper. To view this article visit https://doi.org/10.1111/apt.13944.
Letter: dose optimising infliximab in acute severe ulcerative colitis
Authors: Choy M. C. , De Cruz P.
Published: March 2017

Linked Content

This article is linked to Jairath et al and Hindryckx et al papers. To view these articles visit https://doi.org/10.1111/apt.14019 and https://doi.org/10.1111/apt.13913.
Editorial: co‐existing immune‐mediated disease in inflammatory bowel diseases – a new disease severity indicator?
Authors: Vegh Z. , Bessissow T. , Afif W. , Lakatos P. L.
Published: March 2017

Linked Content

This article is linked to Ananthakrishnan and Conway et al papers. To view these articles visit https://doi.org/10.1111/apt.13998 and https://doi.org/10.1111/apt.13940.
Editorial: scoring systems in primary biliary cholangitis – time to make a move. Authors’ reply
Authors: Yang F. , Yang Y. , Tang R. , Gershwin M. E. , Ma X.
Published: March 2017

Linked Content

This article is linked to Mells and Jones and Yang et al papers. To view these articles visit https://doi.org/10.1111/apt.13984 and https://doi.org/10.1111/apt.13927.
Functional dyspepsia is associated with duodenal eosinophilia in an Australian paediatric cohort
Authors: Wauters L. , Nightingale S. , Talley N. J. , Sulaiman B. , Walker M. M.
Published: March 2017

Background

The pathophysiology of functional dyspepsia (FD) remains unknown. Duodenal eosinophil infiltration has been reported.

Aim

To assess the association between dyspeptic symptoms and duodenal eosinophilia in children undergoing upper gastrointestinal endoscopy.

Methods

In this retrospective cohort study, children with normal upper endoscopy and routine histology at a single tertiary paediatric centre between 2010 and 2014 were included. FD was defined as epigastric pain or discomfort >2 months without response to acid suppression. Controls presented with nonerosive reflux disease, dysphagia or rumination syndrome. Intramucosal eosinophil counts were compared between the groups using uni‐ and multivariate regression analyses.

Results

Thirty‐six cases and 36 nonmatched controls were identified. Atopic history (39% vs. 25%) and psychological comorbidity (53% vs. 39%; both P = 0.2) were frequent in cases and controls. Self‐reported nausea (64% vs. 17%; P < 0.0001), lethargy (19% vs. 0%; P = 0.005) and family functional gastrointestinal disorder(FGID) (28% vs. 3%; P = 0.003) were more common in cases than controls. Duodenal eosinophil counts [median (IQR): 151 (118–207) vs. 76 (60–106) per mm2; P < 0.001] were significantly higher in cases than controls with >112 eosinophils per mm2 predictive for FD (OR: 33.6, 95% CI: 7.1–159.0; P < 0.001). Duodenal eosinophilia was associated with weight loss (OR: 7.1, 95% CI: 1.1–45.5; P = 0.04).

Conclusions

Functional dyspepsia in children is strongly associated with duodenal eosinophilia, in the absence of endoscopic or routine histological findings. Frequent atopic and psychological comorbidity illustrate likely multifactorial mechanisms.
Doing fieldwork the Chinese way: a returning researcher's insider/outsider status in her home town
Authors: Zhao Yawei
Published: March 2017

Insider/outsider status has been recognised in geographical literature as an important aspect of positionality on which researchers should reflect critically. Based on my fieldwork experience in Dali, southwest China, this paper articulates an account of the co‐existence of ‘insiderness’ and ‘outsiderness’ during the research process in a way that adds nuance to scholarly challenges to conceptions of insider/outsider status as an oppositional binary. I touch on several dilemmas that arose over the course of my fieldwork in my home town, such as working with local research assistants, ‘encountering’ a Western supervisor in the field and interviewing local people. I argue that interacting in the field with people from different ethnic, professional or socioeconomic characteristics dynamises a researcher's insider/outsider position, bringing his or her in‐between position to the fore. In this paper, I highlight the tensions and negotiations arising from my experience of in‐betweenness in Dali. I also point out several particularities of doing fieldwork in China by referring to Chinese ways of thinking and communication, and analyse how insiderness complicates the research process with particular regard to China. Finally, I conclude that working in the field is not only a process of data collection, but also a process of learning ‘who I am’.
Risk of myocardial infarction in patients with atrial fibrillation using vitamin K antagonists, aspirin or direct acting oral anticoagulants
Authors: Stolk Leo M. , de Vries Frank , Ebbelaar Chiel , de Boer Anthonius , Schalekamp Tom , Souverein Patrick , ten Cate‐Hoek Arina , Burden Andrea M.
Published: March 2017

Aim

Direct‐acting oral anticoagulants (DOACs) have become available for the prevention of stroke in patients with atrial fibrillation (AF). Conflicting results have been published on the risk of acute myocardial infarction (AMI) with the use of DOACs in comparison with vitamin K antagonists (VKAs). The objective of the present study was to evaluate the risk of AMI in patients with AF who are exposed to either VKAs, DOACs or low‐dose (< 325 mg) aspirin.

Methods

We conducted a population‐based cohort study using data from the Clinical Practice Research Datalink (2008–2014). The study population (n = 30 146) consisted of all patients ≥18 years with a diagnosis of AF who were new users of VKAs, DOACs (rivaroxaban and dabigatran) or aspirin. Cox proportional hazards models were used to estimate the hazard ratio (HR) of AMI for users of DOACs or aspirin vs. VKA. Adjustments were made for age, gender, lifestyle, risk factors, comorbidity and other drugs.

Results

The risk of AMI was doubled when we compared current use of DOACs with current use of VKAs [adjusted HR 2.11; 95% confidence interval (CI) 1.08, 4.12] and for current users of aspirin vs. current VKA users (adjusted HR 1.91; 95% CI 1.45, 2.51).

Conclusions

There is a twofold increase in the risk of AMI for users of DOACs, in comparison with VKAs, in AF therapy. In addition, the results suggested that in patients with AF, the incidence of AMI is higher during aspirin monotherapy than during the use of VKAs.
Adapting compassion focused therapy for an adult with a learning disability—A case study
Authors: Cooper Rosalind , Frearson Julia
Published: March 2017

Accessible summary

Compassion focused therapy is a talking therapy.

It helps people be kind to themselves.

We do not know whether this therapy can help people with learning disabilities.

Here, we talk about what happened when a man with a learning disability had the therapy.

We hope that other people will use the therapy too.

This will improve therapy for people with learning disabilities.

Background

Joe was referred to the Community Learning Disabilities Team (CLDT) for support around low mood and overeating. Initial formulation suggested compassion focused therapy (CFT) as an intervention. The evidence base for using CFT with people with learning disabilities is currently limited.

Materials and Methods

Adaptations were made to the CFT framework, accounting for Joe's learning disability. A case study design was used to investigate the effectiveness of intervention. Joe attended 13 sessions of assessment, formulation and intervention. Client feedback was incorporated to assess suitability of the CFT approach and adaptations made.

Results and Conclusions

Changes in scores on outcome measures were limited. However, findings from this exploratory study suggest that CFT can be meaningfully adapted for use within the field of learning disabilities. Implications for clinical practice and directions for future research are discussed.
Evaluation of the ECOSSE model to predict heterotrophic soil respiration by direct measurements
Authors: Dondini M. , Alberti G. , Delle Vedove G. , Ventura M. , Tonon G. , Viger M. , Harris Z. M. , Jenkins J. R. , Richards M. , Pogson M. , Taylor G. , Smith J. U. , Smith P.
Published: March 2017

This paper aims to evaluate the suitability of the ECOSSE model to estimate soil heterotrophic respiration (Rh) from arable land and short rotation coppices of poplar and willow. Between 2011 and 2013, we measured Rh with automatic closed dynamic chambers on root exclusion plots at one site in the UK (willow, mixed commercial genotypes of Salix spp.) and two sites in Italy (arable and poplar, Populus  ×  Canadensis Moench, Oudemberg genotype), and compared these measured fluxes to simulated values of Rh with the ECOSSE model. Correlation coefficients (r) between modelled and measured monthly Rh data were strong and significant, with a range between 0.81 and 0.96 for all three types of vegetation. There was no significant error and bias in the model for any site. The model was able to predict seasonal trends in Rh at all three sites even though it occasionally underestimated the flux values during warm weather in spring and summer. Because of the strong correlation between the measured and modelled values, it is unlikely that underestimation of the flux is the result of missing processes in the model. Therefore, further detailed monitoring of Rh is needed to modify the model. In this research, a limited set of input data was used to simulate Rh at the three sites. Nevertheless, overall results of the model evaluation suggest that the ECOSSE model simulates soil Rh adequately under all land uses tested and that continuous and direct measurements (such as automatic chambers installed on root‐exclusion plots) are a useful tool to test model performance to simulate Rh at the site level.

Highlights

Model evaluation is crucial to predict soil carbon balance accurately.

Modelled and measured heterotrophic respiration were compared for three land uses.

The model performed well statistically for all three vegetation types.

Modelled heterotrophic respiration should be evaluated by comparison to continuous measurements.
Opioid substitution therapy or hidden opioids are a minefield for nalmefene: an atypical case series of 11 patients in Lorraine
Authors: Yéléhé‐Okouma Melissa , Martini Hervé , Lemarié Jérémie , Labroca Pierre , Petitpain Nadine , Gibaja Valérie , Paille François , Gillet Pierre
Published: March 2017

Opioid antagonists such as naltrexone and nalmefene are used in drug therapy for alcoholism. Nalmefene, approved in Europe in February 2013 for the reduction of alcohol consumption, is used in patients with alcohol dependence. We report 11 cases of opioid withdrawal syndrome after a single dose of nalmefene in patients usually treated with methadone, buprenorphine, but also with fentanyl or loperamide. Nalmefene is both a partial agonist and an antagonist of opioid receptors. Regarding to its opioid antagonist activity, nalmefene is contraindicated in patients with an opioid treatment. Therefore, when prescribing or delivering nalmefene, healthcare professionals need to be vigilant about any type of opioid exposure, even masked or hidden, to avoid these potential life‐threatening syndromes.
Dapsone‐induced agranulocytosis—possible involvement of low‐activity N‐acetyltransferase 2
Authors: Potočnjak Ines , Likić Robert , Šimić Iveta , Juričić Nahal Danica , Čegec Ivana , Ganoci Lana , Božina Nada
Published: March 2017

Dapsone‐induced agranulocytosis is a rare but potentially fatal adverse drug reaction (ADR). A 45‐year‐old male Caucasian patient developed agranulocytosis caused by dapsone (diamino‐diphenyl sulfone), which he was prescribed for leukocytoclastic vasculitis. Patient's treatment consisted of termination of dapsone, antibiotic therapy, and granulocyte colony‐stimulating factor leading to prompt improvement of symptoms and normalization of laboratory blood values. Diagnostic evaluation revealed methemoglobinemia and excluded glucose‐6‐phosphate dehydrogenase deficiency. Pharmacogenetics testing showed that he was a carrier of NAT2 *5/*6 genotype, predisposing to low activity of the N‐acetyltransferase 2 enzyme. This was the first and only ADR to dapsone reported in Croatia. In total, there have been 73 ADR to dapsone recorded worldwide, including only four cases of agranulocytosis.
Prediction of recurrence following hepatectomy in patients with hepatitis C virus infection‐related hepatocellular carcinoma who achieved a sustained virological response
Authors: Okimoto Sho , Kobayashi Tsuyoshi , Kuroda Shintaro , Ishiyama Kohei , Ide Kentaro , Ohira Masahiro , Tahara Hiroyuki , Shimizu Seiichi , Iwako Hiroshi , Hamaoka Michinori , Honmyo Naruhiko , Yamaguchi Megumi , Ohdan Hideki
Published: March 2017

Aim

The risk of hepatitis C virus infection‐related hepatocellular carcinoma (HCC) is lower, with a better prognosis, in patients who achieve a sustained virological response (SVR) than in those who do not. We aimed to identify risk factors of post‐hepatectomy HCC recurrence in patients who achieved a SVR.

Methods

This retrospective study included 349 HCC patients who underwent an initial radical hepatectomy at our institution between January 2005 and December 2014. Sixty‐eight patients had achieved a SVR (the SVR group) and 281 patients had not (the non‐SVR group). Clinical characteristics and long‐term outcomes were compared between the two groups. Univariate and multivariate analyses identified variables associated with recurrence‐free survival in the SVR group.

Results

Post‐hepatectomy overall and recurrence‐free survival rates were significantly higher in the SVR group than the non‐SVR group (P < 0.01 and <0.05, respectively). Univariate analysis of post‐hepatectomy recurrence‐free survival in the SVR group revealed multiple significant factors: aspartate aminotransferase, 25 IU/L or more (P = 0.01); indocyanine green retention rate at 15 min, 20.0% or less (P < 0.05); hepatic vascular invasion (P < 0.05); and an interval of months or less between achieving a SVR and hepatectomy (P < 0.01). Multivariate analysis confirmed an interval of 30 months or less between achieving a SVR and hepatectomy as an independent prognostic factor of recurrence‐free survival (hazard ratio, 2.30; 95.0% confidence interval, 1.04–5.13; P < 0.05).

Conclusion

The interval between achieving a SVR and hepatectomy is an important predictor of recurrence in hepatitis C virus infection‐related HCC patients who achieved a SVR.
Current activities and future directions of comprehensive hepatitis control measures in Japan: The supportive role of the Hepatitis Information Center in building a solid foundation
Authors: Oza Noriko , Isoda Hiroshi , Ono Toshiki , Kanto Tatsuya
Published: March 2017

In Japan, hepatitis B or C virus infection has been a major health issue. For the prevention of liver‐related deaths, multifaceted strategies have been taken against hepatitis virus. In fiscal year (FY) 2002, nationwide screening for hepatitis was started as a part of health examinations provided by municipal governments. From FY2007, the hepatitis treatment network has been strengthened by the nationwide establishment of regional government‐based hepatitis treatment systems, comprising linked regional core centers, specialized institutions for hepatitis treatment, primary care physicians, and regional governments. Special subsidy program for patients with viral hepatitis was started at FY2008. The range of coverage has been expanding from patients treated with interferon to those on nucleotide analogs or interferon‐free therapies, including drug prices and examination expenses. The Basic Act on Hepatitis Measures was established in 2009. The Basic Guidelines for Promotion of Control Measures for hepatitis was issued in 2011, comprising nine principles in order to promote measures for hepatitis B and C. The Hepatitis Information Center was established in 2008. Its mission is to provide up‐to‐date hepatitis‐related information, supporting collaboration between regional core centers, and training medical personnel. The revision of the above‐mentioned Basic Guidelines in 2016 set the target as the reduction of patients progressing to cirrhosis and/or liver cancer. Achieving this goal definitely requires active collaboration among the national and local governments, regional core centers, and the Hepatitis Information Center, and participation by medical personnel, patients, and people with awareness.
Current status of clinical trials assessing oncolytic virus therapy for urological cancers
Authors: Taguchi Satoru , Fukuhara Hiroshi , Homma Yukio , Todo Tomoki
Published: March 2017

Oncolytic virus therapy has recently been recognized as a promising new option for cancer treatment. Oncolytic viruses replicate selectively in cancer cells, thus killing them without harming normal cells. Notably, T‐VEC (talimogene laherparepvec, formerly called OncoVEXGM‐CSF), an oncolytic herpes simplex virus type 1, was approved by the US Food and Drug Administration for the treatment of inoperable melanoma in October 2015, and was subsequently approved in Europe and Australia in 2016. The efficacies of many types of oncolytic viruses against urological cancers have been investigated in preclinical studies during the past decade, and some have already been tested in clinical trials. For example, a phase I trial of the third‐generation oncolytic Herpes simplex virus type 1, G47Δ, in patients with prostate cancer was completed in 2016. We summarize the current status of clinical trials of oncolytic virus therapy in patients with the three major urological cancers: prostate, bladder and renal cell cancers. In addition to Herpes simplex virus type 1, adenoviruses, reoviruses, vaccinia virus, Sendai virus and Newcastle disease virus have also been used as parental viruses in these trials. We believe that oncolytic virus therapy is likely to become an important and major treatment option for urological cancers in the near future.
Towards more disorganised decentralisation? Collective bargaining in the public sector under pay restraint
Authors: Grimshaw Damian , Johnson Mat , Marino Stefania , Rubery Jill
Published: March 2017

While sector‐level collective bargaining can provide the institutional leverage to sustain and improve employment standards, a proliferation of disorganised local settlements may reduce its effectiveness. This article examines this proposition for local government in the UK, highlights the risks of a ‘destructive’ disorganisation of employment relations and calls for a renewal of articulation mechanisms between sector and local levels of collective bargaining.
Austerity stabilised through European funds: the impact on Slovenian welfare administration and provision
Authors: Samaluk Barbara
Published: March 2017

The article explores how austerity stabilised through European funds affects institutional change, work organisation and employment relations within Slovenian welfare administration and provision. It shows that increasing dependence upon European funds turns the state into an intermediary characterised by project modes of work organisation that weaken human resource and financial capacities for domestic policy development and provision. It uncovers that project modes of organising, traditionally present within non‐governmental sector, are also entering the public sector. This shift increases the vulnerability of third and public sector workforce and frustrates young and excluded workers' transition into permanent jobs.
A life history approach to delineating how harsh environments and hawk temperament traits differentially shape children's problem‐solving skills
Authors: Suor Jennifer H. , Sturge‐Apple Melissa L. , Davies Patrick T. , Cicchetti Dante
Published: March 2017

Background

Harsh environments are known to predict deficits in children's cognitive abilities. Life history theory approaches challenge this interpretation, proposing stressed children's cognition becomes specialized to solve problems in fitness‐enhancing ways. The goal of this study was to examine associations between early environmental harshness and children's problem‐solving outcomes across tasks varying in ecological relevance. In addition, we utilize an evolutionary model of temperament toward further specifying whether hawk temperament traits moderate these associations.

Methods

Two hundred and one mother–child dyads participated in a prospective multimethod study when children were 2 and 4 years old. At age 2, environmental harshness was assessed via maternal report of earned income and observations of maternal disengagement during a parent–child interaction task. Children's hawk temperament traits were assessed from a series of unfamiliar episodes. At age 4, children's reward‐oriented and visual problem‐solving were measured.

Results

Path analyses revealed early environmental harshness and children's hawk temperament traits predicted worse visual problem‐solving. Results showed a significant two‐way interaction between children's hawk temperament traits and environmental harshness on reward‐oriented problem‐solving. Simple slope analyses revealed the effect of environmental harshness on reward‐oriented problem‐solving was specific to children with higher levels of hawk traits.

Conclusions

Results suggest early experiences of environmental harshness and child hawk temperament traits shape children's trajectories of problem‐solving in an environment‐fitting manner.
National Trends and Geographic Variation in Availability of Home Health Care: 2002–2015
Authors: Wang Yun , Leifheit‐Limson Erica C. , Fine Jonathan , Pandolfi Michelle M. , Gao Yan , Liu Fanglin , Eckenrode Sheila , Lichtman Judith H.
Published: March 2017

Objectives

To evaluate national trends and geographic variation in the availability of home health care from 2002 to 2015 and identify county‐specific characteristics associated with home health care.

Design

Observational study.

Setting

All counties in the United States.

Participants

All Medicare‐certified home health agencies included in the Centers for Medicare & Medicaid Services Home Health Compare system.

Measurements

County‐specific availability of home health care, defined as the number of available home health agencies that provided services to a given county per 100,000 population aged ≥18 years.

Results

The study included 15,184 Medicare‐certified home health agencies that served 97% of U.S. ZIP codes. Between 2002–2003 and 2014–2015, the county‐specific number of available home health agencies per 100,000 population aged ≥18 years increased from 14.7 to 21.8 and the median (inter‐quartile range) population that was serviced by at least one home health agency increased from 403,605 (890,329) to 455,488 (1,039,328). Considerable geographic variation in the availability of home health care was observed. The West, North East, and South Atlantic regions had lower home health care availability than the Central regions, and this pattern persisted over the study period. Counties with higher median income, a larger senior population, higher rates of households without a car and low access to stores, more obesity, greater inactivity, and higher proportions of non‐Hispanic white, non‐Hispanic black, and Hispanic populations were more likely to have higher availability of home health care.

Conclusion

The availability of home health care increased nationwide during the study period, but there was much geographic variation.
Preventing Hospitalization with Veterans Affairs Home‐Based Primary Care: Which Individuals Benefit Most?
Authors: Edwards Samuel T. , Saha Somnath , Prentice Julia C. , Pizer Steven D.
Published: March 2017

Objectives

To examine how medical complexity modifies the relationship between enrollment in Department of Veterans Affairs (VA) home‐based primary care (HBPC) and hospitalization for ambulatory care–sensitive conditions (ACSC) for veterans with diabetes mellitus and whether the effect of HBPC on hospitalizations varies according to clinical condition.

Design

Retrospective cohort study.

Setting

VA and non‐VA hospitals.

Participants

VA beneficiaries aged 67 and older with diabetes mellitus and enrolled in Medicare (N = 364,972).

Measurements

Instrumental variables regression models were used to estimate the effect of HBPC enrollment on hospitalization for ACSCs (defined according to the Agency for Healthcare Research and Quality Prevention Quality Indicators) overall and in subgroups stratified according to medical complexity. Models were also estimated for each ACSC to determine which conditions were most sensitive to HBPC. Distance from the veteran's residence to the nearest HBPC site was used as the instrumental variable.

Results

HBPC was associated with fewer ACSC hospitalizations (odds ratio (OR) = 0.35 per person‐month, 95% confidence interval (CI) = 0.30–0.42). For veterans in the highest quartile of medical complexity, HBPC enrollment was associated with fewer ACSC hospitalizations (OR = 0.43, 95% CI = 0.19–0.93), whereas for those in the lowest quartile, HBPC was associated with more ACSC hospitalizations (OR = 33.2, 95% CI = 4.6–240.1). HBPC enrollment was associated with fewer hospitalizations for a range of ACSCs.

Conclusion

HBPC enrollment was associated with fewer hospitalizations for a range of ACSCs in veterans with diabetes mellitus but only in the most medically complex individuals. This demonstrates the importance of appropriate targeting and suggests that the effect of HBPC is attributable to its comprehensive approach rather than condition‐specific interventions.
Observed Hearing Loss and Incident Dementia in a Multiethnic Cohort
Authors: Golub Justin S. , Luchsinger José A. , Manly Jennifer J. , Stern Yaakov , Mayeux Richard , Schupf Nicole
Published: March 2017

Objectives

To determine whether observed hearing loss (OHL) is associated with incident dementia in a multiethnic population.

Design

Prospective epidemiological cohort study.

Setting

Community in northern Manhattan.

Participants

Participants in the Washington Heights‐Inwood Columbia Aging Project, a longitudinal study on aging and dementia in an ethnically diverse community (n = 1,881).

Measurements

OHL was defined when the examiner observed it or according to self‐reported hearing aid use. A consensus panel diagnosed dementia using standard research criteria. A Cox proportional hazards model was used to examine the relationship between OHL at baseline and risk of incident dementia (mean 7.3 ± 4.4 years of longitudinal followup, range 0.9–20 years).

Results

OHL was associated with 1.69 (95% confidence interval (CI) = 1.3–2.3, P < .010) times the risk of incident dementia, adjusting for demographic characteristics, cardiovascular risk factors, apolipoprotein E4 genotype, and stroke. When stratified according to race, the association between OHL and incident dementia was high in all groups but was statistically significant only in blacks (hazard ratio = 2.62, 95% CI = 1.5–4.5, P < .010).

Conclusion

OHL was associated with greater risk of incident dementia in a multiethnic cohort. More study is needed to determine whether HL contributes to dementia and whether treating HL can reduce the risk of dementia.
Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study
Authors: Burks Collin E. , Jones Christopher W. , Braz Valerie A. , Swor Robert A. , Richmond Natalie L. , Hwang Kay S. , Hollowell Allison G. , Weaver Mark A. , Platts‐Mills Timothy F.
Published: March 2017

Background

Among older adults, malnutrition is common, often missed by healthcare providers, and influences recovery from illness or injury.

Objective

To identify modifiable risk factors associated with malnutrition in older patients.

Design

Prospective cross‐sectional multicenter study.

Setting

3 EDs in the South, Northeast, and Midwest.

Participants

Non‐critically ill, English‐speaking adults aged ≥65 years.

Measurements

Random time block sampling was used to enroll patients. The ED interview assessed malnutrition using the Mini Nutritional Assessment Short‐Form. Food insecurity and poor oral health were assessed using validated measures. Other risk factors examined included depressive symptoms, limited mobility, lack of transportation, loneliness, and medication side effects, qualified by whether the patient reported the risk factor affected their diet. The population attributable risk proportion (PARP) for malnutrition was estimated for each risk factor.

Results

In our sample (n = 252), the prevalence of malnutrition was 12%. Patient characteristics associated with malnutrition included not having a college degree, being admitted to the hospital, and residence in an assisted living facility. Of the risk factors examined, the PARPs for malnutrition were highest for poor oral health (54%; 95% CI 16%, 78%), food insecurity (14%; 95% CI 3%, 31%), and lack of transportation affecting diet (12%; 95% CI 3%, 28%).

Conclusion

Results of this observational study identify multiple modifiable factors associated with the problem of malnutrition in older adults.
A Longitudinal Study of the Mini‐Mental State Examination in Late Nonagenarians and Its Relationship with Dementia, Mortality, and Education
Authors: Skoog Johan , Backman Kristoffer , Ribbe Mats , Falk Hanna , Gudmundsson Pia , Thorvaldsson Valgeir , Borjesson‐Hanson Anne , Ostling Svante , Johansson Boo , Skoog Ingmar
Published: March 2017

Objectives

To examine level of and change in cognitive status using the Mini‐Mental State Examination (MMSE) in relation to dementia, mortality, education, and sex in late nonagenarians.

Design

Three‐year longitudinal study with examinations at ages 97, 99, and 100.

Setting

Trained psychiatric research nurses examined participants at their place of living.

Participants

A representative population‐based sample of 97‐year‐old Swedes (N = 591; 107 men, 484 women) living in Gothenburg, Sweden.

Measurements

A Swedish version of the MMSE was used to measure cognitive status. Geriatric psychiatrists diagnosed dementia according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Mixed models were fitted to the data to model the longitudinal relationship between MMSE score and explanatory variables.

Results

Individuals with dementia between age 97 and 100 had lower mean MMSE scores than those without dementia. Those who died during the 3‐year follow‐up had lower MMSE scores than those who survived. MMSE scores at baseline did not differ between those without dementia and those who developed dementia during the 3‐year follow‐up. Participants with more education had higher MMSE scores, but there was no association between education and linear change.

Conclusion

MMSE score is associated with dementia and subsequent mortality even in very old individuals, although the preclinical phase of dementia may be short in older age. Level of education is positively associated with MMSE score but not rate of decline in individuals approaching age 100.
Surgical Guidelines for Perioperative Management of Older Adults: What Geriatricians Need to Know
Authors: Colburn Jessica L. , Mohanty Sanjay , Burton John R.
Published: March 2017

A multidisciplinary panel of experts representing surgery, anesthesia, and geriatrics recently published guidelines for surgeons on the optimal perioperative management of older adults, including recommendations on postoperative recovery and posthospital transitions of care. Geriatricians have an important role in the care for older adults in the preoperative period as older adults consider surgical options and prepare for surgical procedures, during the perioperative period as inpatient consultants, and in the postoperative period as older adults transition to rehabilitation facilities or to home. This article outlines the perioperative surgical guidelines and describes how they apply to the role of the geriatrician in the care of older adults during the perioperative period.
The three‐finger toxin fold: a multifunctional structural scaffold able to modulate cholinergic functions
Authors: Kessler Pascal , Marchot Pascale , Silva Marcela , Servent Denis
Published: March 2017

Three‐finger fold toxins are miniproteins frequently found in Elapidae snake venoms. This fold is characterized by three distinct loops rich in β‐strands and emerging from a dense, globular core reticulated by four highly conserved disulfide bridges. The number and diversity of receptors, channels, and enzymes identified as targets of three‐finger fold toxins is increasing continuously. Such manifold diversity highlights the specific adaptability of this fold for generating pleiotropic functions. Although this toxin superfamily disturbs many biological functions by interacting with a large diversity of molecular targets, the most significant target is the cholinergic system. By blocking the activity of the nicotinic and muscarinic acetylcholine receptors or by inhibiting the enzyme acetylcholinesterase, three‐finger fold toxins interfere most drastically with neuromuscular junction functioning. Several of these toxins have become powerful pharmacological tools for studying the function and structure of their molecular targets. Most importantly, since dysfunction of these receptors/enzyme is involved in many diseases, exploiting the three‐finger scaffold to create novel, highly specific therapeutic agents may represent a major future endeavor.

This is an article for the special issue XVth International Symposium on Cholinergic Mechanisms.

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