bluuebunny/crossref_metadata_2025 huggingface dataset:
Metacognitive deficits and social functioning in schizophrenia across symptom profiles: A latent class analysis
Authors: Gagen Emily C. , Zalzala Aieyat B. , Hochheiser Jesse , Martin Ashley Schnakenberg , Lysaker Paul H.
Published: June 2019

Functional deficits are a hallmark of schizophrenia spectrum disorders, but much debate still exists over why and how they originate. One model suggests that disturbances in social functioning are a result of metacognitive deficits or a failure to integrate information to form more complex ideas of themselves and others. It is unclear if this social dysfunction is present across different symptom presentations. We examined the relationship of metacognition, symptoms, and social functioning among a sample of adults with schizophrenia spectrum disorders ( N = 334). A latent class analysis produced a four-class model. Groups were classified as follows: diffuse symptoms/moderately impaired social functioning (Class 1), positive and hostility symptoms/mildly impaired social functioning (Class 2), minimal symptoms/good social functioning (Class 3), and negative and cognitive symptoms/severely impaired social functioning (Class 4). Class 3 demonstrated better overall metacognitive capacity than both Classes 1 and 4 but did not differ significantly from Class 2. Classes 2 and 3 both demonstrated better interpersonal functioning than Classes 1 and 4. Together, these findings provide support for models of poor functioning that stem from fragmentation of an individual’s experience, leading to diminished abilities to form meaningful connections with others. Additional interpretations, limitations, and research implications are discussed.
Out with the old and in with the new: The role of intolerance of uncertainty in reversal of threat and safety
Authors: Morriss Jayne , Saldarini Francesco , Chapman Catherine , Pollard Miriam , van Reekum Carien M.
Published: June 2019

Intolerance of uncertainty (IU) is associated with difficulty in updating contingencies from threatening to safe during extinction learning. However, it is unknown whether high IU individuals have difficulty (1) generally with updating threat to safe associations when contingencies change or (2) specifically with updating threat to safe associations during extinction learning, where direct threat is omitted. To address this question, we recorded IU, expectancy ratings, and skin conductance in 44 healthy participants during an associative learning paradigm, where threat and safety contingencies were reversed. During acquisition and reversal, we observed larger skin conductance response (SCR) magnitude and expectancy ratings for threat versus safety cues. However, during reversal, higher IU was associated with larger SCR magnitude to new threat versus new safety cues, compared with lower IU. These results were specific to IU-related variance, over shared variance with trait anxiety (State-Trait Anxiety Inventory, Trait Version). Overall, these findings suggest that individuals high in IU are able to reverse threat and safety associations in the presence of direct threat. Such findings help us understand the recently revealed link between IU and threat extinction, where direct threat is absent. Moreover, these findings highlight the potential relevance of IU in clinical intervention and treatment for anxiety disorders.
Greater body appreciation moderates the association between maladaptive attentional biases and body dissatisfaction in undergraduate women
Authors: Tobin Leah N. , Barron Amy H. , Sears Christopher R. , von Ranson Kristin M.
Published: June 2019

Attentional biases for weight-related information are thought to contribute to maintenance of body dissatisfaction and eating disorders. Women with greater body appreciation may pay less attention to thin-ideal cues if body appreciation protects them from negative effects of thin-ideal media, and if so, they may be less susceptible to development of maladaptive attentional biases. The present study used eye-gaze tracking to measure attention to weight-related words/images in 167 body-dissatisfied undergraduate women (aged 17–39 years) to examine the associations among body dissatisfaction, body appreciation, and attentional biases. Participants viewed displays of thin-related, fat-related, and neutral words/images while their eye fixations were tracked over 8-s intervals. We hypothesized body appreciation (as measured by the Body Appreciation Scale) would moderate the documented association between body dissatisfaction and attentional biases for thin-related information only, such that as body appreciation increased, the strength of the relationship between body dissatisfaction and attentional biases would decrease. Results indicated that body appreciation moderated the association between body dissatisfaction and attentional biases for thin-related words only. With low body appreciation, body dissatisfaction was positively associated with attention to thin-related words. With high body appreciation, there was an inverse association between body dissatisfaction and attention to thin-related words. Results suggest that body appreciation may be an effective prevention target for reducing maladaptive attentional biases.
BMS consensus statement for primary prevention of coronary heart disease in women
Authors: Stevenson John C
Published: June 2019

The British Menopause Society Council is committed to provide up to date authoritative reviews to aid health professionals to inform and advise women about key issues in postreproductive health. Coronary heart disease is a leading cause of death in women. Observational studies have consistently shown estrogen to help prevent coronary heart disease in postmenopausal women. The large randomized controlled Women’s Health Initiative trial initially did not confirm these observational findings. However, further analyses of the Women’s Health Initiative study as well as meta-analyses of randomized clinical trials of hormone replacement therapy and of the observational Nurses’ Health Study have now found that the timing of onset of hormone replacement therapy use is important and that estrogen may have an important protective role in coronary heart disease, particularly in women initiating treatment below age 60 years. This consensus statement will examine the evidence regarding hormone replacement therapy and non-estrogen therapies (lipid-lowering agents, aspirin, antihypertensives, anti-diabetic medications, selective estrogen receptor modulators) as well as diet, lifestyle and smoking cessation in the primary prevention of coronary heart disease in women.
No differential gene expression for CD4+ T cells of MS patients and healthy controls
Authors: Brorson Ina S , Eriksson Anna , Leikfoss Ingvild S , Celius Elisabeth G , Berg-Hansen Pål , Barcellos Lisa F , Berge Tone , Harbo Hanne F , Bos Steffan D
Published: June 2019

Background

Multiple sclerosis-associated genetic variants indicate that the adaptive immune system plays an important role in the risk of developing multiple sclerosis. It is currently not well understood how these multiple sclerosis-associated genetic variants contribute to multiple sclerosis risk. CD4+ T cells are suggested to be involved in multiple sclerosis disease processes.

Objective

We aim to identify CD4+ T cell differential gene expression between multiple sclerosis patients and healthy controls in order to understand better the role of these cells in multiple sclerosis.

Methods

We applied RNA sequencing on CD4+ T cells from multiple sclerosis patients and healthy controls.

Results

We did not identify significantly differentially expressed genes in CD4+ T cells from multiple sclerosis patients. Furthermore, pathway analyses did not identify enrichment for specific pathways in multiple sclerosis. When we investigated genes near multiple sclerosis-associated genetic variants, we did not observe significant enrichment of differentially expressed genes.

Conclusion

We conclude that CD4+ T cells from multiple sclerosis patients do not show significant differential gene expression. Therefore, gene expression studies of all circulating CD4+ T cells may not result in viable biomarkers. Gene expression studies of more specific subsets of CD4+ T cells remain justified to understand better which CD4+ T cell subsets contribute to multiple sclerosis pathology.
Audit Opinions: Are They Really Different for Family Businesses?
Authors: Mareque Mercedes , Rivo-López Elena , Villanueva-Villar Mónica , Lago-Peñas Santiago
Published: June 2019

The article poses a dual research question: What are the determining factors of the type of audit opinion in a stressed economic environment and do these factors differ between family and nonfamily firms? Our results show that auditor tenure and return on assets (ROA) raise the probability of receiving a favorable opinion. On the contrary, losses during the previous year, high financial leverage, and hiring a “Big 4” firm increase the probability of receiving an unfavorable opinion. Although the sign and the statistical significance are similar, the size of such effects differs between family and nonfamily firms. Finally, the probability of receiving a report with a favorable opinion increases as the economic situation improves.
The “Geopolitical” Factor in the Syrian Civil War: A Corpus-Based Thematic Analysis
Authors: Tan Kim Hua , Perudin Alirupendi
Published: June 2019

This study analyzes the key attributions of the Assad regime’s failure to end the protracted Syrian Civil War. It analyzes why it has taken the Assad regime so long to win back most of its territory despite tremendous support from Iran and Russia against fragmented oppositions who received jaded, half-hearted Western assistance. The article adopts a corpus-based, thematic analysis approach and uses primary and predominantly secondary data to examine Syrian domestic politics, as well as regional and global geopolitics. It explores how the three main geopolitically related themes contribute to the state of Syria as of mid-2018. The findings point toward several issues, including the regime’s dire manpower shortage, a severe lack of economic and social wherewithal, and Assad’s hard, inflexible stance on negotiations in addition to his corruption and brutality, which are among the key reasons for the current state of the Syrian conflict.
Early promising result of bicompartmental knee replacement in middle-aged patients
Authors: Tang Bruce Yan Ho , Cheung Chi Nok , Tsui Hon For , Wong Hok Leung
Published: June 2019

Introduction:

Partial knee replacement (PKR) is one of the treatment options in middle-aged patients with less extensive knee osteoarthritis, with unicompartmental knee replacement (UKR) most commonly done for medial osteoarthritis. There are numerous advantages like bone/ligament preserving and faster recovery. However, the indications of UKR remain controversial, as most patients have some patellofemoral joint (PFJ) osteoarthritis. We performed modular bicruciate-retaining bicompartmental knee replacement (BKR) in this group of patients and compared the outcome with total knee replacement (TKR).

Materials and Methods:

From 2016 to 2017, 14 BKR were performed in patients with medial and PFJ osteoarthritis. They were retrospectively compared with 14 TKR performed in patients with similar age and severity. The incision length, operative time, blood loss (in terms of hemoglobin drop), and length of stay were recorded. Pre- and postoperative range of motion and Knee Society knee score at 1-year follow-up were compared.

Results:

The mean incision length for BKR was shorter than TKR (130.1 vs. 185.1 mm), but the mean operative time was also longer (152.6 vs. 88.1 min). There was also less mean hemoglobin drop (1.8 vs. 2.6 g/dL) and shorter length of stay (7.4 vs. 9.2 days). The mean postoperative function score is better in BKR group (90.4 vs. 77.5), and the mean postoperative knee score (87.2 vs 88.9) and flexion (115.7° vs. 111.4°) were similar for both groups.

Discussion:

In selected patients, BKR is a good alternative to TKR. It preserves advantages of UKR while also tackle the PFJ which is the most controversial aspect of UKR. The early clinical outcome in our study is promising. However, there is a learning curve. Longer follow-up is necessary to study on the performance and survivorship as compared with UKR and TKR.
One-Step Autologous Minced Cartilage Procedure for the Treatment of Knee Joint Chondral and Osteochondral Lesions: A Series of 27 Patients With 2-Year Follow-up
Authors: Massen Felix Kurt , Inauen Cyril Raphael , Harder Laurent Pascale , Runer Armin , Preiss Stefan , Salzmann Gian Max
Published: June 2019

Background:

Chondral and osteochondral lesions are being detected with increasing frequency. For large-diameter lesions, cell-based treatment modalities are speculated to result in the best possible outcome.

Purpose:

To prospectively evaluate the 2-year clinical and radiological results after the treatment of chondral and osteochondral knee joint lesions by a single-step autologous minced cartilage procedure.

Study Design:

Case series; Level of evidence, 4.

Methods:

From February 2015 to June 2016, a total of 27 consecutive patients suffering from chondral or osteochondral lesions of the knee joint were treated using a single-step autologous minced cartilage procedure. All patients underwent preoperative and postoperative magnetic resonance imaging for the collection of AMADEUS (Area Measurement and Depth and Underlying Structures) and MOCART (magnetic resonance observation of cartilage repair tissue) scores. Clinical analysis was conducted by a numeric analog scale (NAS) for pain and knee function before the intervention and at 12 and 24 months postoperatively.

Results:

A total of 12 female and 15 male patients (mean age, 28.7 years) were evaluated for a mean of 28.2 ± 3.8 months. The mean cartilage defect size encountered intraoperatively was 3.1 ± 1.6 cm2. There was a significant decrease in pain from 7.2 ± 1.9 preoperatively to 1.8 ± 1.6 ( P < .001) at 2-year follow-up. Knee function improved from a mean of 7.2 ± 2.0 preoperatively to 2.1 ± 2.3 ( P < .001) at 2 years after surgery. The mean preoperative AMADEUS score was 57.4 ± 21.4. Postoperatively, the mean MOCART score was 40.6 ± 21.1 at 6-month follow-up. No correlation was observed between the clinical data and the MOCART or AMADEUS scores.

Conclusion:

Overall, the findings of this study demonstrated that patients undergoing a single-step autologous minced cartilage procedure had a satisfactory outcome at 2-year follow-up. As a result, the single-step autologous minced cartilage procedure does represent a possible alternative to standard autologous chondrocyte implantation. Longer follow-up and larger cohorts are required to define the benefits of this procedure.
Effect of Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT) on Compensatory Articulation in Children With Cleft Palate/Lip
Authors: Herreras Mercado Raúl , Simpson Kenneth , Bellom-Rohrbacher Kristen H.
Published: June 2019

Objective. This investigation researched the effectiveness of the PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets) method to address compensatory articulation errors in children with cleft palate. Design. Single-subject AB multiple baselines across participants and behaviors. Setting. Pediatric outpatient rehabilitation department in a local hospital in a metropolitan city. Participants. The investigation consisted of 3 participants (ages = 4:4 to 12:8) born with bilateral complete cleft lip and palate. All participants underwent several reconstructive surgeries to repair their lips and palates. Interventions. The PROMPT treatment was provided for 45 minutes 3 times a week for 4 weeks (3 weeks for Participant 2). Main Outcome Measure. Therapy sessions addressed anterior lingual speech motor phonemes across 3 tiers (syllables, words, and phrases). Results. Direct visual observation of data obtained throughout this investigation indicate potential positive effects and significant correlation between improvements in sound production at 3 tiers and the implementation of the PROMPT technique. Speech intelligibility was judged by 3 blinded listeners who were unfamiliar with children with speech disorders or with cleft palate speech. All listeners identified and judged improvement in overall speech intelligibility over the course of this investigation. Listeners examined speech samples selected from sessions 3, 6, 9, and 12. Conclusion. The findings in this investigation provide a potential relationship on the effectiveness of the PROMPT method and attainment of accurate speech productions in children with cleft palate producing compensatory articulation errors, resulting in improvement in overall speech intelligibility.
Earlier IV thrombolysis and mechanical thrombectomy in acute ischemic stroke are associated with a better recanalization
Authors: Nicastro Nicolas , Eger Antoine F , Boukrid Iman I , Mueller Hubertus FG , Machi Paolo , Vargas Maria Isabel , Poletti Pierre-Alexandre , Platon Alexandra , Sztajzel Roman F
Published: June 2019

Introduction:

Combined intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are the recommended treatment options for acute ischemic stroke (AIS). It is unclear whether earlier IVT and MT management can predict complete vessel recanalization.

Methods:

In this single-center retrospective observational study, we included 81 consecutive subjects with proximal middle cerebral artery AIS (age 70.5 ± 14.2 years, 53% female) who had both IVT and MT. We assessed recanalization after mechanical procedure according to modified thrombolysis in cerebral infarction (TICI) score as well as the National Institute of Health Stroke Scale (NIHSS) score at 24 h. Outcomes were modified Rankin Scale (mRS) at discharge, mRS at 3 months, death at 3 months, and prevalence of intracerebral hemorrhage during hospitalization.

Results:

Multinomial logistic regression ( χ 2 = 49.4, p = 0.0075, pseudo- R 2 = 0.26) showed that complete recanalization (TICI score = 3) was predicted by lower door-to-MT time ( p = 0.014, 95% confidence interval (CI) = −0.09 to −0.01) and lower symptoms-to-IVT time ( p = 0.045, 95% CI = −0.038 to −0.0004). An NIHSS score ≥10 at 24 h was predicted by higher baseline NIHSS ( p < 0.0001) and lower TICI score ( p = 0.009). Lower NIHSS at 24 h predicted a good outcome according to mRS at 3 months ( p = 0.006). Similarly, higher NIHSS at 24 h was a predictor of death at 3 months ( p = 0.013).

Conclusions:

The present study suggests that bridging therapy may improve vascular recanalization when both IVT and MT are performed earlier.
Correcting for Bias in Psychology: A Comparison of Meta-Analytic Methods
Authors: Carter Evan C. , Schönbrodt Felix D. , Gervais Will M. , Hilgard Joseph
Published: June 2019

Publication bias and questionable research practices in primary research can lead to badly overestimated effects in meta-analysis. Methodologists have proposed a variety of statistical approaches to correct for such overestimation. However, it is not clear which methods work best for data typically seen in psychology. Here, we present a comprehensive simulation study in which we examined how some of the most promising meta-analytic methods perform on data that might realistically be produced by research in psychology. We simulated several levels of questionable research practices, publication bias, and heterogeneity, and used study sample sizes empirically derived from the literature. Our results clearly indicated that no single meta-analytic method consistently outperformed all the others. Therefore, we recommend that meta-analysts in psychology focus on sensitivity analyses—that is, report on a variety of methods, consider the conditions under which these methods fail (as indicated by simulation studies such as ours), and then report how conclusions might change depending on which conditions are most plausible. Moreover, given the dependence of meta-analytic methods on untestable assumptions, we strongly recommend that researchers in psychology continue their efforts to improve the primary literature and conduct large-scale, preregistered replications. We provide detailed results and simulation code at https://osf.io/rf3ys and interactive figures at http://www.shinyapps.org/apps/metaExplorer/ .
Full-waveform inversion of salt models using shape optimization and simulated annealing
Authors: Datta Debanjan , Sen Mrinal K. , Liu Faqi , Morton Scott
Published: June 2019

A good starting model is imperative in full-waveform inversion (FWI) because it solves a least-squares inversion problem using a local gradient-based optimization method. A suboptimal starting model can result in cycle skipping leading to poor convergence and incorrect estimation of subsurface properties. This problem is especially crucial for salt models because the strong velocity contrasts create substantial time shifts in the modeled seismogram. Incorrect estimation of salt bodies leads to velocity inaccuracies in the sediments because the least-squares gradient aims to reduce traveltime differences without considering the sharp velocity jump between sediments and salt. We have developed a technique to estimate velocity models containing salt bodies using a combination of global and local optimization techniques. To stabilize the global optimization algorithm and keep it computationally tractable, we reduce the number of model parameters by using sparse parameterization formulations. The sparse formulation represents sediments using a set of interfaces and velocities across them, whereas a set of ellipses represents the salt body. We use very fast simulated annealing (VFSA) to minimize the misfit between the observed and synthetic data and estimate an optimal model in the sparsely parameterized space. The VFSA inverted model is then used as a starting model in FWI in which the sediments and salt body are updated in the least-squares sense. We partition model updates into sediment and salt updates in which the sediments are updated like conventional FWI, whereas the shape of the salt is updated by taking the zero crossing of an evolving level set surface. Our algorithm is tested on two 2D synthetic salt models, namely, the Sigsbee 2A model and a modified SEG Advanced Modeling Program (SEAM) Phase I model while fixing the top of the salt. We determine the efficiency of the VFSA inversion and imaging improvements from the level set FWI approach and evaluate a few sources of uncertainty in the estimation of salt shapes.
Introduction to this special section: Full-waveform inversion
Authors: Zimmer Ulrich
Published: June 2019

Full-waveform inversion (FWI) is often the method of choice for addressing the most challenging scenarios in seismic imaging. While FWI has been around for quite some time, the workflows are continuously developed and more case studies are becoming available to illustrate the power of the method. This special section of The Leading Edge presents seven papers that not only provide an overview of the progress of the method but also suggest new tweaks to the algorithm and several new case studies.
How to twist and turn a fiber: Performance modeling for optimal DAS acquisitions
Authors: Wuestefeld Andreas , Wilks Matt
Published: June 2019

The success of a distributed acoustic sensing (DAS) survey depends on strain energy impeding at favorable angles at most sections of the fiber. Although constrained to the path of the wellbore, there are various design parameters that can influence the recorded DAS amplitude. We present here a method to model the performance of DAS installations. We use precise raypath modeling in complex velocity models to determine ray incidence angles and show variations between different wrapping angles and detection thresholds. We then propose a way to evaluate the performance of the DAS acquisition design, and how to optimize processing, based on the percentage of DAS channels above a chosen amplitude threshold. For microseismic studies, the best wrapping angle of the fiber can be determined, which may be defined as covering the target area most homogeneously. For vertical seismic profiling projects, surface shot positions can be evaluated for their predicted recorded energy.
Advance decisions to refuse treatment and suicidal behaviour in emergency care: ‘it's very much a step into the unknown’
Authors: Quinlivan Leah , Nowland Rebecca , Steeg Sarah , Cooper Jayne , Meehan Declan , Godfrey Joseph , Robertson Duncan , Longson Damien , Potokar John , Davies Rosie , Allen Neil , Huxtable Richard , Mackway-Jones Kevin , Hawton Keith , Gunnell David , Kapur Nav
Published: June 2019

Background

Complex challenges may arise when patients present to emergency services with an advance decision to refuse life-saving treatment following suicidal behaviour.

Aims

To investigate the use of advance decisions to refuse treatment in the context of suicidal behaviour from the perspective of clinicians and people with lived experience of self-harm and/or psychiatric services.

Method

Forty-one participants aged 18 or over from hospital services (emergency departments, liaison psychiatry and ambulance services) and groups of individuals with experience of psychiatric services and/or self-harm were recruited to six focus groups in a multisite study in England. Data were collected in 2016 using a structured topic guide and included a fictional vignette. They were analysed using thematic framework analysis.

Results

Advance decisions to refuse treatment for suicidal behaviour were contentious across groups. Three main themes emerged from the data: (a) they may enhance patient autonomy and aid clarity in acute emergencies, but also create legal and ethical uncertainty over treatment following self-harm; (b) they are anxiety provoking for clinicians; and (c) in practice, there are challenges in validation (for example, validating the patient’s mental capacity at the time of writing), time constraints and significant legal/ethical complexities.

Conclusions

The potential for patients to refuse life-saving treatment following suicidal behaviour in a legal document was challenging and anxiety provoking for participants. Clinicians should act with caution given the potential for recovery and fluctuations in suicidal ideation. Currently, advance decisions to refuse treatment have questionable use in the context of suicidal behaviour given the challenges in validation. Discussion and further patient research are needed in this area.

Declaration of interest

D.G., K.H. and N.K. are members of the Department of Health's (England) National Suicide Prevention Advisory Group. N.K. chaired the National Institute for Health and Care Excellence (NICE) guideline development group for the longer-term management of self-harm and the NICE Topic Expert Group (which developed the quality standards for self-harm services). He is currently chair of the updated NICE guideline for Depression. K.H. and D.G. are NIHR Senior Investigators. K.H. is also supported by the Oxford Health NHS Foundation Trust and N.K. by the Greater Manchester Mental Health NHS Foundation Trust.
Pathology Image Exchange: The Dutch Digital Pathology Platform for Exchange of Whole-Slide Images for Efficient Teleconsultation, Telerevision, and Virtual Expert Panels
Authors: van Diest Paul J. , Huisman André , van Ekris Jaap , Meijer Jos , Willems Stefan , Hofhuis Hannelore , Verbeek Xander , van der Wel Myrtle , Vos Shoko , Leguit Roos , van den Brand Michiel , Hebeda Konnie , Grünberg Katrien
Published: June 2019

Among the many uses of digital pathology, remote consultation, remote revision, and virtual slide panels may be the most important ones. This requires basic slide scanner infrastructure in participating laboratories to produce whole-slide images. More importantly, a software platform is needed for exchange of these images and functionality to support the processes around discussing and reporting on these images without breaching patient privacy. This poses high demands on the setup of such a platform, given the inherent complexity of the handling of digital pathology images. In this article, we describe the setup and validation of the Pathology Image Exchange project, which aimed to create a vendor-independent platform for exchange of whole-slide images between Dutch pathology laboratories to facilitate efficient teleconsultation, telerevision, and virtual slide panels. Pathology Image Exchange was released in April 2018 after technical validation, and a first successful validation in real life has been performed for hematopathology cases.
Safety and Efficacy of Nivolumab in Brain Metastases From Renal Cell Carcinoma: Results of the GETUG-AFU 26 NIVOREN Multicenter Phase II Study
Authors: Flippot Ronan , Dalban Cécile , Laguerre Brigitte , Borchiellini Delphine , Gravis Gwénaelle , Négrier Sylvie , Chevreau Christine , Joly Florence , Geoffrois Lionnel , Ladoire Sylvain , Mahammedi Hakim , Rolland Frédéric , Gross-Goupil Marine , Deluche Elise , Priou Frank , Laramas Mathieu , Barthélémy Philippe , Narciso Bérengère , Houedé Nadine , Culine Stéphane , Oudard Stéphane , Chenot Marina , Tantot Florence , Chabaud Sylvie , Escudier Bernard , Albiges Laurence
Published: June 2019

PURPOSE

Nivolumab is standard of care for patients with metastatic clear cell renal cell carcinoma (ccRCC) after failure of antiangiogenic therapies, but its activity on brain metastases from ccRCC remains unknown, because these patients were excluded from pivotal studies. We aimed to assess the activity of nivolumab in this population.

METHODS

The GETUG-AFU 26 NIVOREN phase II trial assessed the activity and safety of nivolumab in patients with metastatic ccRCC who failed vascular endothelial growth factor–directed therapies ( ClinicalTrials.gov identifier: NCT03013335 ). Patients with asymptomatic brain metastases were prospectively identified and underwent dedicated brain evaluation. Two cohorts were constituted: cohort A comprised patients with previously untreated brain metastases, and cohort B comprised patients whose brain metastases underwent prior therapy. The primary end point was intracranial response rate in cohort A.

RESULTS

Seventy-three patients with brain metastases were included: 39 in cohort A and 34 in cohort B. Intracranial response rate was 12% in cohort A; no objective response was reported in patients with brain lesions that were multiple or larger than 1 cm. Median intracranial progression-free survival was 2.7 months (95% CI, 2.3 to 4.6 months) in cohort A and 4.8 months (95% CI, 3.0 to 8.0 months) in cohort B, with adjusted hazard ratio of 2.04 (95% CI, 1.08 to 3.83). Overall survival rate at 12 months was 67% (95% CI, 49.6% to 79.1%) in cohort A and 59% (95% CI, 40.6% to 73.2%) in cohort B. Most patients in cohort A (72%) needed subsequent focal brain therapy. Nivolumab was well tolerated, with no unexpected toxicity.

CONCLUSION

Nivolumab activity is limited in patients with untreated brain metastases from ccRCC. Brain imaging and focal therapy should be considered before immune checkpoint inhibitors in patients with metastatic ccRCC.
Effects of the Timing of Sex-Steroid Exposure in Adolescence on Adult Health Outcomes
Authors: Chan Yee-Ming , Feld Amalia , Jonsdottir-Lewis Elfa
Published: June 2019

Context

Variation in pubertal timing is associated with a wide range of adult risks and outcomes, but it is unclear whether these associations are causal, and it is largely unknown whether these associations can be modified by treatment.

Evidence Acquisition

We conducted PubMed searches to identify Mendelian randomization (MR) studies on the influence of pubertal timing on adult health and studies on sex-steroid treatment of the following conditions associated with reduced reproductive endocrine function in adolescence: constitutional delay, Turner syndrome, and Klinefelter syndrome.

Evidence Synthesis

Results of MR studies suggest that earlier pubertal timing increases body mass index; increases risk for breast, ovarian, endometrial, and prostate cancers; elevates fasting glucose levels and blood pressure; impairs lung capacity and increases risk for asthma; leads to earlier sexual intercourse and first birth; decreases time spent in education; and increases depressive symptoms in adolescence. Later pubertal timing appears to lower bone mineral density (BMD). Although studies of constitutional delay have not shown that sex-steroid treatment alters adult height or BMD, studies of girls with Turner syndrome and boys with Klinefelter syndrome suggest that earlier initiation of sex-steroid treatment improves physical and neurocognitive outcomes.

Conclusions

Despite having some limitations, MR studies suggest that pubertal timing causally influences many adult conditions and disease risks. Studies of Turner syndrome and Klinefelter syndrome suggest that earlier sex-steroid exposure may have short- and long-term benefits. The mechanisms underlying these findings and the effects of trends and treatments affecting pubertal timing remain to be determined.
Autism seminary for public engagement: evaluation of knowledge and attitudes of traditional medical practitioners in Mali
Authors: Sangare Modibo , Dembele Bakary , Toure Amadou , Diakite Seidina , Awandare Gordon , Kouyate Modibo , Doumbia Seydou , Diakite Mahamadou , Togora Arouna , Coulibaly Souleymane , Dolo Housseini
Published: June 2019

Background: Autism spectrum disorders (ASD) are stigmatizing in Africa and traditional medical practitioners occupy the first line of diagnosis and treatment due to the cultural perception of ASD, and the scarcity of conventional health services in Mali. We aimed to assess the knowledge, attitudes, and practices (KAP) concerning autism among traditional medical practitioners in Bamako, Mali.

Methods: We conducted a 6-week cross-sectional survey following a 1-day autism awareness seminary on September 9th, 2017 in Bamako. A questionnaire was designed to assess the KAP regarding autism. To assess their practices, parents of autistic children were asked about their experiences with traditional medical practitioners.

Results: Of the 37 study participants 67.60% were males and 56.8% had not heard about autism before the seminary. After the seminary, 73% claimed to understand the diagnosis criteria of autism, but only 16.2% could recall symptoms from all the three domains (reciprocal social interaction, verbal and nonverbal communication, and stereotyped behaviors/restricted interests) of a child development impaired by autism. Of traditional medical practitioners, 73% believed autism was caused by devils, God’s will, bad luck and divine punishment of maternal misbehavior; 65% were used to treating mental illness, and 78.4% felt traditional healing was the only treatment option in autism. Negative attitudes towards autistic children were present in 18.9%, suggesting a very strong cultural mindset on autism.

Conclusion: Knowledge on autism was poor among traditional medical practitioners. A culturally tailored autism public engagement strategy is necessary to positively change the mindset of Malian traditional medical practitioners.
Cost-effectiveness of invasive devices versus non-invasive devices for screening of anemia in field settings in India: A study protocol
Authors: Neogi Sutapa Bandyopadhyay , John Denny , Sharma Jyoti , Kar Rakhee , Kar Sitanshu Sekhar , Bhattacharya Maitreyee , Tiwari Kartavya , Saxena Renu
Published: June 2019

In India, an estimated 53% of women and 58% of children are anemic.  The accuracy of Sahli’s hemoglobinometer, commonly used for detecting anemia in public health settings, is questionable. This study presents the protocol for assessment of cost and cost effectiveness of devices for screening of anemia using invasive devices (HemoCue 301 and True Hb), and non-invasive devices (AJO Spectroscopic Test and Masimo Pulse Oximetery test) compared to automated auto-analyser (reference test). The study population will include all adult patients attending the outpatient department in urban/rural health centres for routine investigations. Each included patient will undergo either one or two index tests apart from the reference test, on a predefined weekly schedule to avoid bias. The total and incremental costs of the intervention will be measured prospectively by measuring both screening and provider costs.  Since the priority of the national program is detection of severe anemia, detection rates of anemia and severe anemia will be considered to calculate effectiveness. Cost comparisons of median, average and range of costs across the invasive and non-invasive devices will be calculated. Cost-effectiveness analysis will be compared for four devices within time horizon of 1 year. Ethics approval for the study has been obtained from the institutional ethics committees of the hospitals. The study protocol will generate evidence on the use of cost effectiveness of medical devices to influence policy decisions.
Espiritualidade, religiosidade e malformação congênita: uma revisão integrativa de literatura
Authors: Viana Ana Claudia Gomes , Lopes Maria Emília Limeira , Vasconcelos Mônica Ferreira de , Evangelista Carla Braz , Lima Débora Rodrigues Alves de , Alves Adriana Marques Pereira de Melo
Published: June 2019

Objetivo: investigar a produção científica sobre a espiritualidade e religiosidade no contexto da malformação congênita. Método: revisão integrativa da literatura, realizada na base de dados Pubmed, Lilacs e Scielo, a qual incluiu artigos de 2007 a 2017. Resultados: foram incluídas 28 publicações, cujas análises textuais permitiram a construção de duas categorias: práticas espirituais e religiosas e o enfrentamento do diagnóstico e nascimento pelos familiares; espiritualidade, religiosidade e cuidado com a criança malformada. Conclusão: mesmo possuindo significados diferentes, os estudos revelaram que a espiritualidade em saúde é, com frequência, associada à religiosidade. Essa dimensão humana mostrou-se relevante diante do enfrentamento do diagnóstico de malformação congênita e serviu como fonte de sustento para o enfrentamento do cuidado com seus portadores.
Short Communication: Seed germination of twelve Indonesian begonias for conservation
Authors: EFENDI MUHAMMAD , HANDAYANI AISYAH , LAILATY INTANI QUARTA
Published: June 2019

Abstract. Efendi M, Handayani A, Lailaty IQ. 2019. Short Communication: Seed germination of twelve Indonesian begonias for conservation. Biodiversitas 20: 1192-1197. Knowledge of seed quality is essential when seeds are stored for the long term. A preliminary study on Begonia seed conservation was conducted, to characterize morphology and germination testing on native Begonia from Indonesia. As many as 12 species of Indonesian Begonia were observed for the characteristics of fruit and seeds. Later, we tested the level of seed viability at different levels of fruit maturity. The experimental design used a Completely Randomized Design (CRD) with two factors. Data analysis was performed using the Statistical Tool for Agricultural Research (STAR) program and further testing the Duncan Multiple Range Test (DMRT) at a 5% significance level. Generally, all seeds were barrel-like in shape, the smallest size in B. muricata (252.42 µm length), and the largest size in B. areolata (up to 451.42µm length, while the operculum 28.48 µm-104.9 µm length). Most Begonia seeds start germinating in the second and third weeks after sowing. B. scottii, and B. verecunda, as well as B. longifolia, showed germination in the second week, while other species tended not to be simultaneous. Dry seed germination was higher than seed wet for eight weeks. B. longifolia and B. scottii had the highest germination in wet seed treatment: while in the dry seed treatment, the highest germination was showed by B. areolata and B. muricata.
The evaluation of potato virus Y transfer by some beneficial bugs (Hemiptera: Heteroptera)
Authors: PAZYUK IRINA M , FOMINYKH TATYANA S
Published: June 2019

Abstract. Pazyuk IM, Fominykh TS. 2019. The evaluation of potato virus Y transfer by some beneficial bugs (Hemiptera: Heteroptera). Biodiversitas 20: 1222-1227.  The predatory bugs Podisus maculiventris, Orius majusculus, Nesidiocoris tenuis, and Macrolophus pygmaeus were commonly used for control of pests in potato meristem culture in greenhouses. In this study, the risk of transmission of potato virus Y (PVY) by entomophagous bugs was estimated in cage experiments. It has been shown that none of the bugs tested was capable of transmitting the PVY. However, N. tenuis and M. pygmaeus have been shown to damage potato seedlings in the absence of animal food (pests or factitious food). The bug N. tenuis caused severer damage to potato plants than did the bug M. pygmaeus. Therefore, we can recommend only P. maculiventris and O. majusculus for pest control in potato meristem culture in greenhouses.
Diversity and inheritance in cowpea (Vigna unguiculata) on protein and yield components characters
Authors: PURNAMASARI INDAH , SOBIR SOBIR , SYUKUR MUHAMAD
Published: June 2019

Abstract. Purnamasari I, Sobir, Syukur M. 2019. Diversity and inheritance in cowpea (Vigna unguiculata) on protein and yield components characters. Biodiversitas 20: 1294-1298.  Diallel was a method that can be used to see inheritance and diversity character of plants. The objective of this study has evaluated the inheritance and diversity of the yield component characters and seed protein content. This study used genetic material from five homozygous cowpeas (Vigna unguiculata (L.) Walp) genotypes (KM1, KM2, KM4, KM5, and TG2) and 20 F1. Genotypes were planted using a randomized complete block design with three replications. The character observed were the yield components (weight of 100 seed, number of seeds per pod, number of pods per bunch, number of pods per plant and yield) and seeds protein content. Characters that were influenced by general combining ability (GCA) consist of weight of 100 seeds, number of pods per bunch, number of seeds per pod and seed protein content. The variance of GCA has a greater value than the variance of specific combining ability (SCA). Narrow sense and broad sense heritability values were high category consist of weight 100 seed, number seeds per pod, number pods per bunch and seed protein content. That characters were inherited additively. Characters were influenced by additive gene action and have high diversity make it possible to select in F2 generation using the pedigree selection method.
Mass production of the entomopathogenic nematode, Steinernema carpocapsae on Tenebrio molitor and Spodoptera litura
Authors: PRABOWO HERI , ADIKADARSIH SRI , DAMAIYANI JANIS
Published: June 2019

Abstract. Authors. 2019. Mass production of the entomopathogenic nematode, Steinernema carpocapsae on Tenebrio Molitor and Spodoptera litura. Biodiversitas 20: 1344-1349. Steinernema carpocapsae is the most developed biological agents to control pests nowadays, to support this nematode as a biological agent mass production technique is required. S. carpocapsae can be produced via in vivo methods. In vivo production has some advantages, such as cheap, easy, and sustainable to be developed in small farm agriculture. The purpose of this research was to evaluate the mass production of S. carpocapsae using Tenebrio molitor and Spodoptera litura larvae as hosts. Twenty-five last instar larvae were inoculated with different concentrations of infective juvenile (IJ) (e.g., 100, 200, 300 and 400 IJ/larvae) of S. carpocapsae Asembagus. The production of S. carpocapsae with concentrations of 100, 200, 300 and 400 IJ/larvae on T. molitor and S. litura showed 3.62x103; 6.29x103; 1.13x104; 1.52x104; 1.13x104; 1.46x104; 1.54x104; and 1.94x104 IJ/larvae, respectively. The IJ harvest from T. molitor and S. litura shows the longest body length for IJ at a concentration of 400 IJ/larva of 437.48µm and 591.42µm, respectively. This study indicates that T. molitor and S. litura can be used to produce S. carpocapsae. The production of S. carpocapsae with a concentration of 400 IJ / larvae on T. molitor and S. litura showed the highest total yield and body length of IJ.
Evaluation of agronomic performances of rainfed barley double-haploids (DHs) lines under semi-arid conditions
Authors: KARKOUR LARBI , FENNI MOHAMMED , RAMLA DALILA , GAAD DJOUHER , BENBELKACEM ABDELKADER
Published: June 2019

Abstract. Karkour L, Fenni M, Ramla D, Gaad D, Benbelkacem A. 2019. Evaluation of agronomic performances of rainfed barley double-haploids (DHs) lines under semi-arid conditions. Biodiversitas 20: 1398-1408. Sixty-six doubled-haploid (DHs) barley lines derived from F2 plants of three bi-parental single crosses, between the local variety (Tichdrett) and three introduced genotypes (Express, Plaisant, and Exito) were evaluated in 2017 for agronomic performance. The experiment was undertaken at two locations under rainfed conditions in semi-arid zone of Algeria in a randomized block design with three replications. Each line was scored for fifteen quantitative traits: number of days to heading, thousand grains weight, number of grains per spike, spikes number per m2, plant height, spike length, leaf relative water content, awn length, peduncle length, spike weight, grain weight per spike, leaf area, specific leaf weight, grain yield and harvest index. The results indicated that the presence of highly significant genotype effect for all traits except for leaf area and highly significant environment effect for all characters, except spikes number per m2and awns length. Genotype x environment interaction was highly significant for all traits, except specific leaf weight and leaf area. Significant positive correlation between the twelve agronomic traits, ranging from 0.45 to 0.87, were observed among the number of grains per spike, thousand grains weight, the number of spikes per m2, yield of grains and harvest index. The principal component analysis showed that four components could describe 72% of total variances. Cluster analysis divided all genotypes studied into three cluster groups. Overall, results of agronomic parameters and those related to the biotic and abiotic stresses will be used for better identifying this germplasm and better-directing studies of genetic improvement.
The impact of herbivorous insect on leaves of mangrove species Rhizophora stylosa and its relation to leaf nutrient level
Authors: TRISNAWATI INDAH , MURYONO MUKHAMMAD , DESMAWATI ISKA
Published: June 2019

Abstract. Trisnawati I, Muryono M, Desmawati I. 2019. The impact of herbivorous insect on leaves of mangrove species Rhizophora stylosa and its relation to leaf nutrient level. Biodiversitas 20: 1409-1415. Intertidal mangrove ecosystem is a very unique ecosystem which is under threat due to anthropogenic disturbances like land conversion to promote paddy cultivation and aquaculture and pollution. Increased nutrient loading from human activities is expected to have stronger responses to both mangroves and their associated herbivores. This research is aimed to investigate vulnerability of mangroves caused by herbivory of herbivorous insects, focusing on the diversity and abundance of herbivorous insects, the level of mangrove leaf damage and its relation to nutrient levels within leaves in term of nitrogen, phosphorus, potassium and water content. We observed mangrove habitats located around Institut Teknologi Sepuluh November (ITS) Campus in Surabaya, East Java dominated by Rhizophora vegetation. Herbivorous insects showed individual abundance of 15.15% of the total insects found in mangroves around the studied areas. The area of relative leaf damage in Rhizophora stylosa leaves tended to be high in sapling habitus (11.96-24.56%) compared to tree habitus (6.97-16.71%). One way ANOVA showed non-significant difference in leaf area damaged between sapling and tree habitus (F = 0.099, p-0.75), and percentage of herbivory between saplings and trees (F = 0.0007, p-0.98). Concentrations of potassium (K) was significantly higher in tree than sapling habitus, whereas leaf nutrient phosporous was significantly higher in sapling than tree habitus. Other leaf nutrients (total nitrogen and water) were relatively the same in both habitus. However, saplings contained more feeding deterrent tannins than trees. Leaf age is thought to be related to higher leaf palatability and insect herbivore nutrition in younger leaves, represented by sapling habitus.