bluuebunny/crossref_metadata_2025 huggingface dataset:
Occurrence and Safety Evaluation of Ochratoxin A in Cereal‐based Baby Foods Collected from Iranian Retail Market
Authors: Khoshnamvand Zeinab , Nazari Firouzeh , Mehrasebi Mohammad Reza , Hosseini Mir‐Jamal
Published: February 2019

Contamination of agricultural commodities with ochratoxin A (OTA) is a worldwide concern in recent decades. Consumption of OTA‐contaminated baby foods exerts health implications especially in children as the most vulnerable subpopulations. In the current study, for the first time in Iran, 64 baby foods (rice, wheat, and multigrain) samples from five different brands available in the Iranian market were analyzed to determine OTA level, using a HPLC with fluorescence detector. Overall, OTA was observed in 41% of analyzed samples with a mean and maximum level of 0.42 ± 0.27 and 1.1 μg/kg, respectively. OTA levels in five of 64 samples (7.8 %) were higher than the permissible limit recommended by European Commission (permissible limit: 0.5 μg/kg) and OTA levels in two of 64 samples (3.1%) were higher than the standard set by Iranian standard organization (1 μg/kg). The highest OTA contamination was observed in rice‐based baby food cereals (1.1 μg/kg; 57% of the samples), followed by wheat‐based (23%) and multigrain (20%) samples. OTA intake in infants (≥9 months old) was more than established provisional tolerable weekly intake by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) and the European Food Safety Authority (EFSA) (100 and 120 ng OTA per kg of body weight, respectively). OTA content in baby food and cereals, as well as other raw foodstuff should be investigated comprehensively to reduce the exposure rate of young children to OTA.
A UK survey of the use and management of cover crops
Authors: Storr Tom , Simmons Robert W. , Hannam Jacqueline A.
Published: February 2019

There is a growing trend in the use of cover crops in the United Kingdom, and whilst research shows there are many soil and environmental benefits, little is known about the farmer's perspective of cover cropping. A survey was designed and distributed to ask farmers about their use and management of cover crops. The online survey received 117 usable responses between January and March 2017, following distribution through social media in the United Kingdom. The survey highlighted that 66% of respondents used cover crops following harvest in 2016. Respondents observed benefits to soil structure, soil erosion control and water infiltration in addition to reductions in the use of chemical fertilisers, herbicide and fuel use. Of those not using cover crops, 90% would consider their use in the future if additional information on their use and benefits were known in a UK context. Changes to the 2016 Basic Payment Scheme guidelines for cover crops would have been welcomed by 71% of respondents using cover crops.
‘Small cost to pay for peace of mind’: Women's experiences with non‐invasive prenatal testing
Authors: Bowman‐Smart Hilary , Savulescu Julian , Mand Cara , Gyngell Christopher , Pertile Mark D. , Lewis Sharon , Delatycki Martin B.
Published: February 2019

Background

Non‐invasive prenatal testing (NIPT) has been available in Australia on a user‐pays basis since 2012. Since its introduction, it has grown in popularity as a screening method for fetal aneuploidy and may become publicly funded.

Aims

To assess the motivations and experiences of women who have undergone NIPT in a user‐pays system in Australia.

Materials and methods

One thousand women who had undergone NIPT through the Victorian Clinical Genetics Services in Melbourne, Australia were contacted and asked to complete a mixed‐methods survey. The number of eligible responses received was 235. Quantitative data analysis was performed in STATA IC 15.1, and qualitative data were examined using content analysis.

Results

Women reported generally positive experiences with NIPT and 95% of respondents indicated they would undergo NIPT in a future pregnancy. Most respondents received a low‐risk result, with 2.2% receiving a high‐risk result. Respondents viewed NIPT favourably compared to invasive testing and cited reassurance as a key reason they sought it. However, a small minority of women reported negative experiences with the testing process. Women were also supportive of NIPT becoming publicly funded, with 93% of respondents indicating support. Pre‐ and post‐test counselling were identified as possible areas for improvement to ensure informed consent.

Conclusion

In support of the existing literature, these results indicate that Australian women generally report positive experiences with NIPT. As NIPT becomes more common, with possible integration into public healthcare, further qualitative research would be valuable to examine the motivations and experiences of women undergoing NIPT.
How clinically important are non‐D Rh antibodies?
Authors: Healsmith Susan , Savoia Helen , Kane Stefan C.
Published: February 2019

Introduction

The advent of RhD immunoglobulin prophylaxis to prevent maternal RhD alloimmunization has reduced the incidence of this condition and its associated poor outcomes. Consequently, non‐D Rh antibodies now account for a greater proportion of alloimmunized pregnancies. These antibodies have been the subject of comparatively little research. This study investigated the incidence and clinical outcome of pregnancies affected by non‐D Rh alloimmunization at an Australian tertiary maternity service.

Material and methods

This was a retrospective study of all pregnancies with non‐D Rh antibodies (namely anti‐C, ‐E, ‐c, ‐e, ‐Cw as well as the compound antibodies anti‐CD, ‐cE and ‐ce) managed at the Royal Women's Hospital, Victoria, Australia, from 2009 to 2013 inclusive. Information collected included maternal demographics, details of the antibodies, course of the pregnancy and neonatal outcomes.

Results

During the study period, 115 non‐D Rh alloimmunized pregnancies were identified in 102 mothers. Forty‐nine pregnancies reached the critical titer (> 16) from non‐D Rh alone and 11 fetuses received intrauterine red blood cell transfusion. Labor was induced or cesarean section performed in 38 cases. Forty‐three neonates were admitted to the special care nursery and 59 received phototherapy. Nine received treatment for anemia and 10 neonates received intravenous immunoglobulin.

Conclusions

Non‐D Rh alloimmunization is a relatively uncommon complication of pregnancy, occurring in only .33% of pregnancies in the study period. It can lead to significant fetal/neonatal morbidity (and may lead to mortality). The most severe outcomes (including perinatal deaths) were mostly associated with the compound antibodies anti‐CD and anti‐cE, or a non‐D Rh antibody in conjunction with anti‐D.
Seroreversion of positive anti‐hepatitis C virus antibodies in left ventricular assist device recipients: Now you see them, now you don’t
Authors: Sims Daniel B. , Kataria Rachna , Rangasamy Sabarivinoth , Jorde Ulrich P.
Published: February 2019

The clinical significance of positive anti‐hepatitis C virus (anti‐HCV) antibody tests in recipients of left ventricular assist devices remains unclear. In light of emerging evidence suggesting the possibility of persistent low‐level HCV infection in patients with positive anti‐HCV antibody test but negative HCV ribonucleic acid, it is very important to distinguish the truly false positive HCV antibodies, in recipients of continuous flow left ventricular assist devices, from those suggestive of a prior clinically resolved infection or one where a low‐level viremia may have persisted. We conducted a retrospective analysis of left ventricular assist device recipients at our institution. While the total incidence of positive HCV antibody with concomitantly negative HCV ribonucleic acid test (19.2%) was in keeping with the incidences reported in prior cross‐sectional studies, we longitudinally followed our patients and observed a 100% seroreversion. Seroreversion, which has not been reported in other studies, occurred either during continued left ventricular assist device support (10 out of 26) or after heart transplant (7 out of 26). Hundred percent seroreversion strongly suggested that the anti‐HCV antibodies were truly false positive.
The Association of Psychological Well‐Being with Disablement Processes in a National Sample
Authors: Mishra Aura Ankita , Friedman Elliot M. , Christ Sharon L. , Denning Madison
Published: February 2019

Objective

Objectives were to explore subgroups of individuals with differential disability trajectories and evaluate the protective effects of psychological well‐being (i.e. hedonic and eudaimonic) in the presence of multiple disease conditions (or multimorbidity) and sociodemographic disadvantages.

Methods

Data come from the prospective longitudinal cohort study the Midlife Development in the United States (n = 3,904). Three waves of data spanning a 20‐year period were used to identify subgroups with different disability trajectories. Subgroup membership was then modelled as a function of psychological well‐being assessed at wave 1 of the study using multinomial logistic regression.

Results

Three unique groups were identified: a normative group with initially low and slowly increasing levels of disability; a group with high levels of disability that was stable over time; and a group with moderate initial levels of disability that increased over time. Hedonic well‐being at wave 1 was associated with membership in the risk groups relative to the normative group.

Conclusion

Individuals may follow one of three disability pathways mostly as a function of multimorbidity. However, hedonic well‐being was associated with having an advantageous disability trajectory regardless of multimorbidity status. Cultivating psychological well‐being may improve disability outcomes in aging individuals.
Environment or management? Relative importance for floristic composition of sub‐Mediterranean hay meadows in Central Italy
Authors: Giallonardo Tommaso , Angiolini Claudia , Ciaschetti Giampiero , Landi Marco , Pirone Gianfranco , Frattaroli Anna Rita
Published: February 2019

Questions

What are the separate and combined effects of natural and management factors on floristic assemblage in sub‐Mediterranean hay meadows? How are hay meadow dynamics affected by the environment excluding management?

Location

Central Apennines, Italy.

Methods

Vegetation was studied in 66 hay meadows by random plots, recording four groups of explanatory variables: management, soil, topography, and space. Using partial ordinations, the explanatory variables of the variation in floristic composition and plant traits were divided into sets. Then, to emphasize the relationship between purely environmental variables and vegetation, we considered only the partial ordination executed with soil and topographic variables using management and spatial data as covariables.

Results

The soil variables had the highest marginal explanatory power. Organic matter was the main driver of floristic composition, indicating a gradient associated also with soil moisture. The pure effect of spatial variables was very important, reflecting historical processes. On the contrary, management and topography variables sets were relatively weak predictors. Partial ordination showed that two topographic variables, slope and height above the plain, had an important weight in the hay meadow floristic assemblage, influencing soil fertility.

Conclusions

This analysis (a) confirms the determining function of soil fertility and moisture in driving plant species composition and traits; (b) focuses on the marginal power of current management when past traditional agro‐pastoral activity undergoes changes in mode and intensity; (c) highlights the role of spatial variables and site history; and (d) improves knowledge about topographical factors as drivers of species composition. The maintenance of hay meadow mosaics requires preservation of grasslands in complete topographical catenae and prevention of the abandonment of parcels on steep slopes. Considering the spatial variability of the studied communities, it is necessary to include a high number of geographically and ecologically different areas in a conservation network.
The skeletal impact of cancer therapies
Authors: Bedatsova Lucia , Drake Matthew T.
Published: February 2019

Both cancer and therapies used in the treatment of cancer can have significant deleterious effects on the skeleton, increasing the risks for both bone loss and fracture development. While advancements in cancer therapies have resulted in enhanced cancer survivorship for patients with many types of malignancies, it is increasingly recognized that efforts to reduce bone loss and limit fractures must be considered for nearly all patients undergoing cancer therapy in order to diminish the anticipated future skeletal consequences. To date, most studies examining the impact of cancer therapies on skeletal outcomes have focused on endocrine‐associated cancers of the breast and prostate, with more recent advances in our understanding of bone loss and fracture risk in other malignancies. Pharmacologic efforts to limit the adverse effects of cancer therapies on bone have nearly universally employed anti‐resorptive approaches, although studies have frequently relied on surrogate outcomes such as changes in bone mineral density or bone turnover markers, rather than on fractures or other skeletal‐related events, as primary study endpoints. Compounding current deficiencies for the provision of optimal care is the recognition that despite clearly written and straightforward society‐based guidelines, vulnerable eligible patients are very often neither identified nor provided with appropriate treatments to limit the skeletal impact of their cancer therapies.
A dynamic stakeholder model: An Other‐oriented ethical approach
Authors: Hatami Akram , Firoozi Naser
Published: February 2019

In this paper, we reflect on the role of the Other in ethical decision‐making in corporations. The Other, in the form of a corporation's stakeholders, has already been discussed in the scientific literature, but there are still some Others that remain unconsidered and that call on corporations to be responsible. Drawing on the philosophy of Levinas, we wish to highlight a green earth and future generations as two non‐immediate Others within a corporation's group of stakeholders whose voices are silenced. We argue that Levinasian ethics can be used as a framework to extend traditional stakeholder theory in a dynamic sphere. With this model, corporations can understand the vital role that both a green earth and future generations play in their existence and can respond to contingencies by considering delays. We enrich our paper with illustrative cases to present some serious environmental disasters that have occurred as a result of ignoring the Other. Finally, we show that understanding the Other as a part of a corporation's identity can create new avenues for “infinite responsibility” towards Others. We contribute to the relevant literature by highlighting that both a green earth and future generations are important but ignored stakeholder parties whose claims urgently need to be addressed.
Learning technology and disability—Overcoming barriers to inclusion: Evidence from a multicountry study
Authors: Hersh Marion , Mouroutsou Stella
Published: February 2019

The paper uses data from a 15‐country study to discuss the factors which affect the use of information and communication technologies (ICT) and learning technologies by disabled people and consequently their access to education. Significant differences were found both between and within countries: income and language were the main factors affecting availability. Thus, the greatest availability was in the higher income English‐speaking countries and the richer European countries. The main barriers to technology use included cost, lack of funding and lack of information. A particular disparity in technology access was found between the English‐speaking European population and Aboriginal speakers of indigenous languages in Australia, with considerably greater access by the former than the latter group. A number of recommendations are presented to increase access to learning and assistive technologies by disabled people. They include encouragement for developers to produce free of charge (minority language) technologies, research on more effective provision of technologies and personal assistance, assistive technology centres in all learning institutions, simple funding mechanisms and a fund to support technology provision in poorer countries.
The Structure of the Wage Gap for Temporary Workers: Evidence from Australian Panel Data
Authors: Laß Inga , Wooden Mark
Published: February 2019

This study uses panel data for Australia to estimate the wage differential between workers in temporary jobs and workers in permanent jobs. It is the first study to use unconditional quantile regression methods in combination with fixed effects to examine how this gap varies over the entire wage distribution. While the wages of fixed‐term contract workers are found to be similar to those of permanent workers, low‐paid casual workers experience a wage penalty and high‐paid casual workers a wage premium compared to their permanent counterparts. Temporary agency workers also usually receive a wage premium, which is particularly large for the most well paid.
An empirical Q‐matrix validation method for the sequential generalized DINA model
Authors: Ma Wenchao , de la Torre Jimmy
Published: February 2019

As a core component of most cognitive diagnosis models, the Q‐matrix, or item and attribute association matrix, is typically developed by domain experts, and tends to be subjective. It is critical to validate the Q‐matrix empirically because a misspecified Q‐matrix could result in erroneous attribute estimation. Most existing Q‐matrix validation procedures are developed for dichotomous responses. However, in this paper, we propose a method to empirically detect and correct the misspecifications in the Q‐matrix for graded response data based on the sequential generalized deterministic inputs, noisy ‘and’ gate (G‐DINA) model. The proposed Q‐matrix validation procedure is implemented in a stepwise manner based on the Wald test and an effect size measure. The feasibility of the proposed method is examined using simulation studies. Also, a set of data from the Trends in International Mathematics and Science Study (TIMSS) 2011 mathematics assessment is analysed for illustration.
Biodiversity and ecosystem functioning in naturally assembled communities
Authors: van der Plas Fons
Published: February 2019

Approximately 25 years ago, ecologists became increasingly interested in the question of whether ongoing biodiversity loss matters for the functioning of ecosystems. As such, a new ecological subfield on Biodiversity and Ecosystem Functioning (BEF) was born. This subfield was initially dominated by theoretical studies and by experiments in which biodiversity was manipulated, and responses of ecosystem functions such as biomass production, decomposition rates, carbon sequestration, trophic interactions and pollination were assessed. More recently, an increasing number of studies have investigated BEF relationships in non‐manipulated ecosystems, but reviews synthesizing our knowledge on the importance of real‐world biodiversity are still largely missing.

I performed a systematic review in order to assess how biodiversity drives ecosystem functioning in both terrestrial and aquatic, naturally assembled communities, and on how important biodiversity is compared to other factors, including other aspects of community composition and abiotic conditions. The outcomes of 258 published studies, which reported 726 BEF relationships, revealed that in many cases, biodiversity promotes average biomass production and its temporal stability, and pollination success. For decomposition rates and ecosystem multifunctionality, positive effects of biodiversity outnumbered negative effects, but neutral relationships were even more common. Similarly, negative effects of prey biodiversity on pathogen and herbivore damage outnumbered positive effects, but were less common than neutral relationships. Finally, there was no evidence that biodiversity is related to soil carbon storage.

Most BEF studies focused on the effects of taxonomic diversity, however, metrics of functional diversity were generally stronger predictors of ecosystem functioning. Furthermore, in most studies, abiotic factors and functional composition (e.g. the presence of a certain functional group) were stronger drivers of ecosystem functioning than biodiversityper se. While experiments suggest that positive biodiversity effects become stronger at larger spatial scales, in naturally assembled communities this idea is too poorly studied to draw general conclusions.

In summary, a high biodiversity in naturally assembled communities positively drives various ecosystem functions. At the same time, the strength and direction of these effects vary highly among studies, and factors other than biodiversity can be even more important in driving ecosystem functioning. Thus, to promote those ecosystem functions that underpin human well‐being, conservation should not only promote biodiversityper se, but also the abiotic conditions favouring species with suitable trait combinations.
Preclinical characterization of SHR6390, a novel CDK 4/6 inhibitor, in vitro and in human tumor xenograft models
Authors: Long Fei , He Ye , Fu Haoyu , Li Yun , Bao Xubin , Wang Quanren , Wang Yigang , Xie Chengying , Lou Liguang
Published: February 2019

Inhibition of the cyclin‐dependent kinase (CDK) 4/6‐retinoblastoma (RB) pathway is an effective therapeutic strategy against cancer. Here, we performed a preclinical investigation of the antitumor activity of SHR6390, a novel CDK4/6 inhibitor. SHR6390 exhibited potent antiproliferative activity against a wide range of human RB‐positive tumor cells in vitro, and exclusively induced G1 arrest as well as cellular senescence, with a concomitant reduction in the levels of Ser780‐phosphorylated RB protein. Compared with the well‐known CDK4/6 inhibitor palbociclib, orally administered SHR6390 led to equivalent or improved tumor efficacy against a panel of carcinoma xenografts, and produced marked tumor regression in some models, in association with sustained target inhibition in tumor tissues. Furthermore, SHR6390 overcame resistance to endocrine therapy and HER2‐targeting antibody in ER‐positive and HER2‐positive breast cancer, respectively. Moreover, SHR6390 combined with endocrine therapy exerted remarkable synergistic antitumor activity in ER‐positive breast cancer. Taken together, our findings indicate that SHR6390 is a novel CDK4/6 inhibitor with favorable pharmaceutical properties for use as an anticancer agent.
Schistosoma mansoni PCR+-infected individuals in the Sudan present elevated systemic levels of chemokines when compared to uninfected and egg+ cohorts
Authors: Arndts K , Elfaki T E M , Jelden N , Ritter M , Wiszniewsky A , Katawa G , Goreish I A , Atti El Mekki M E Y A , Doenhoff M J , Hoerauf A , Layland L E
Published: February 2019

Infections with Schistosoma mansoni remain a major health problem in the Sudan where endemic communities, such as those in Kassala and Khartoum states, continue to face severe social–economic difficulties. Our previous immunoepidemiological findings revealed different immune [cytokine and S. mansoni egg (SEA) antibody] profiles in individuals with active infections (eggs in stool n = 110), individuals positive for S. mansoni via polymerase chain reaction (PCR) using sera (SmPCR+  n = 63) and those uninfected (Sm uninf). As antibody responses to eggs and worms are known to change during infection, we have expanded the profiling further by determining levels of adult worm (SWA) antibodies and nine chemokines in the serum of each individual in the three different cohorts. With the exception of C-C motif chemokine ligand (CCL)2, all measured chemokines were significantly higher in SmPCR+ individuals when compared to the egg+ group and in addition they also presented elevated levels of SWA-specific immunoglobulin (Ig)G2. Multivariable regression analysis further revealed that infection per se was strongly linked to SWA-specific IgG3 levels and CCL5 was strongly associated with a SmPCR+ diagnostic state. In the absence of PCR diagnostics that recognize juvenile worms or schistosomulae motives, identifying schistosome-specific traits should provide better insights into current prevalence rates in endemic communities and, in doing so, take into consideration PCR+ non-egg+ individuals in current treatment programmes.
British Society for Immunology/United Kingdom Primary Immunodeficiency Network consensus statement on managing non-infectious complications of common variable immunodeficiency disorders
Authors: Bethune C , Egner W , Garcez T , Huissoon A , Jolles S , Karim Y , Jain R , Savic S , Kelley K , Grosse-Kreul D , Grigoriadou S
Published: February 2019

Common variable immunodeficiency (CVID) represents a heterogeneous group of rare disorders. There is considerable morbidity and mortality as a result of non-infectious complications, and this presents clinicians with management challenges. Clinical guidelines to support the management of CVID are urgently required. The UK Primary Immunodeficiency Network and the British Society for Immunology funded a joint project to address this. A modified Delphi Survey was conducted for the assessment, diagnosis and treatment of the non-infectious blood, respiratory, gut and liver complications of CVID. A steering group of 10 consultant immunologists and one nurse specialist developed and reviewed the survey statements and agreed the final recommendations. In total, 22 recommendations and three areas for research were developed.
Serum polyamine metabolic profile in autoimmune thyroid disease patients
Authors: Song Jing , Shan Zhongyan , Mao Jinyuan , Teng Weiping
Published: February 2019

Objective

Polyamines are indispensable polycations and play important physiological roles in living cells. Some polyamine metabolites have been associated with autoimmune disorders. The aims of this study were to profile polyamine metabolites in autoimmune thyroid disease (AITD) and predict whether polyamine metabolites are associated with thyroid hormone, thyroid autoantibodies or disease progression.

Design, patients and measurements

A total of 136 participants were recruited, including Graves’ disease (GD) (n = 36), Hashimoto's thyroiditis (HT) (n = 33) and thyroid autoantibody‐positive (pTAb) (n = 29) patients and 38 age‐ and sex‐matched healthy controls (HCs). Fourteen polyamine metabolites, including polyamine precursors, polyamines and polyamine catabolite, were measured by UFLC‐MS/MS

Results

Both GD and HT patients had higher L‐arginine, L‐ornithine, lysine and agmatine levels and lower putrescine, 1,3‐diaminopropane, spermine, N‐acetylputrescine levels than HCs. Some polyamine metabolite levels were different only in GD or HT patients compared to HCs: GD patients had significantly higher spermidine, N‐acetylspermidine and γ‐aminobutyric acid and lower cadaverine, whereas HT patients had significantly decreased N‐acetylspermine. Only spermine and N‐acetylspermine were significantly lower in pTAb than HCs. The spermine:spermidine ratio was significantly reduced in all AITD patients. In addition, spermine was negatively correlated with thyroid‐specific antibodies grade. N‐acetylspermidine might be a risk factor for pTAb progression to overt hypothyroidism.

Conclusions

Compared with the HCs, most metabolites of GD and HT showed similar patterns, suggesting the possibility of a common pathophysiological basis or metabolic pathway. Moreover, pTAb progression to overt hypothyroidism may be related to high N‐acetylspermidine. Thyroid autoimmunity was associated with low spermine.
Real microgravity condition promoted regeneration capacity of induced pluripotent stem cells during the TZ‐1 space mission
Authors: Zhou Jin , Dong Xiao‐Hui , Zhang Feng‐Zhi , Zhu Hui‐Min , Hao Tong , Jiang Xiao‐Xia , Zheng Wei‐Bo , Zhang Tao , Wang Pei‐Zhe , Li Hong , Na Jie , Wang Chang‐Yong
Published: February 2019

Induced pluripotent stem cells (iPSCs) are reprogrammed somatic cells that gained self‐renewal and differentiation capacity similar to embryonic stem cells. Taking the precious opportunity of the TianZhou‐1 spacecraft mission, we studied the effect of space microgravity (µg) on the self‐renewal capacity of iPSCs. Murine iPSCs carrying pluripotency reporter Oct4‐GFP were used. The Oct4‐EGFP‐iPSCs clones were loaded into the bioreactor and exposed to μg in outer space for 14 days. The control experiment was performed in identical device but on the ground in earth gravity (1 g). iPSCs clones were compact and highly expressed Oct4 before launch. In μg condition, cells in iPSC clones spread out more rapidly than those in ground 1 g condition during the first 3 days after launch. However, in 1 g condition, as the cell density increases, the Oct4‐GFP signal dropped significantly during the following 3 days. Interestingly, in μg condition, iPSCs originated from the spread‐out clones during the first 3 days appeared to cluster together and reform colonies that activated strong Oct4 expression. On the other hand, iPSC clones in 1 g condition were not able to recover Oct4 expression after overgrown. Our study for the first time performed real‐time imaging on the proliferation process of iPSCs in space and found that in μg condition, cell behaviour appeared to be more dynamic than on the ground.
Mucosal incision‐assisted biopsy versus endoscopic ultrasound‐guided fine‐needle aspiration with a rapid on‐site evaluation for gastric subepithelial lesions: A randomized cross‐over study
Authors: Osoegawa Takashi , Minoda Yosuke , Ihara Eikichi , Komori Keishi , Aso Akira , Goto Ayako , Itaba Soichi , Ogino Haruei , Nakamura Kazuhiko , Harada Naohiko , Makihara Kosuke , Tsuruta Shinichi , Yamamoto Hidetaka , Ogawa Yoshihiro
Published: February 2019

Objectives

This study aimed to compare the diagnostic yield of mucosal incision‐assisted biopsy (MIAB) and endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) with a rapid on‐site evaluation (ROSE) for gastric subepithelial lesions (SEL) suspected of being gastrointestinal stromal tumors (GIST) with an intraluminal growth pattern.

Methods

This was a prospective randomized, cross‐over multicenter study. The primary outcome was the diagnostic yield of EUS‐FNA and MIAB. The secondary outcomes were the technical success rate, complication rate, procedure time and biopsy frequency.

Results

A total of 47 patients were randomized to the MIAB group (n = 23) and EUS‐FNA group (n = 24). There was no significant difference in the diagnostic yield of MIAB and EUS‐FNA (91.3% vs 70.8%, P = 0.0746). The complication rates of MIAB and EUS‐FNA did not differ to a statistically significant extent. The mean procedure time in the MIAB group was significantly longer than that in the EUS‐FNA group (34 vs 26 min, P = 0.0011).

Conclusions

The diagnostic yield of MIAB was satisfactorily as high as EUS‐FNA with ROSE for gastric SEL with an intraluminal growth pattern.
Women's views on lifestyle changes to reduce the risk of developing Type 2 diabetes after gestational diabetes: a systematic review, qualitative synthesis and recommendations for practice
Authors: Dennison R. A. , Ward R. J. , Griffin S. J. , Usher‐Smith J. A.
Published: February 2019

Aims

After gestational diabetes, many women exhibit behaviours that increase their risk of developing Type 2 diabetes. We aimed to systematically synthesize the literature that focuses on the views of women with a history of gestational diabetes on reducing their risk of developing diabetes postpartum through lifestyle and behaviour changes.

Methods

We identified qualitative studies that examined the views of women with a history of gestational diabetes towards healthy eating and physical activity, Type 2 diabetes risk management or their experience of a diabetes prevention programme, and conducted a thematic synthesis to develop descriptive and then analytical themes. We also evaluated the quality of each study and the confidence that we had in our findings.

Results

We included 21 articles after screening 23 160 citations and 129 full texts. We identified six themes of interacting influences on postpartum behaviour: role as mother and priorities; social support; demands of life; personal preferences and experiences; risk perception and information; and finances and resources (plus preferred format of interventions). These factors inhibited many women from addressing their own health, while they motivated others to persevere. We also developed 20 recommendations, most with high or moderate confidence, for effective promotion of healthy lifestyles in this population.

Conclusions

Many factors hinder healthy lifestyles after gestational diabetes, yet how women interpret them can motivate or prevent changes that reduce diabetes risk. As our recommendations emphasize, women's experiences and needs should be considered when designing strategies to promote healthier lifestyles in this population.
Lorcaserin treatment decreases body weight and reduces cardiometabolic risk factors in obese adults: A six‐month, randomized, placebo‐controlled, double‐blind clinical trial
Authors: Tuccinardi Dario , Farr Olivia M. , Upadhyay Jagriti , Oussaada Sabrina M. , Mathew Hannah , Paschou Stavroula A. , Perakakis Nikolaos , Koniaris Anastasia , Kelesidis Theodoros , Mantzoros Christos S.
Published: February 2019

Lorcaserin is a serotonin 2c receptor agonist that promotes weight loss while contributing to the prevention and improvement of type 2 diabetes and improvement of atherogenic lipid profiles, without higher rates of major cardiovascular events. The full spectrum of possible lorcaserin‐induced improvements in cardiometabolic health remains to be clarified. Thus, we investigated the way in which lorcaserin treatment may alter cardiovascular disease risk, either independently or through changes in body weight. We measured, for the first time, lipid particle quantification, lipid peroxidation, appetite‐regulating hormones and mRNA expression of the 5‐hydroxytryptamine 2c receptor (5‐HT2c receptor). A total of 48 obese participants were enrolled in this six‐month, randomized (1:1), placebo‐controlled, double‐blinded clinical trial. Lorcaserin treatment reduced fat mass (P < 0.001), the fatty liver index (P < 0.0001) and energy intake (P < 0.03) without affecting energy expenditure or lean mass. Total low‐density lipoprotein (LDL) (P < 0.04) and small LDL particles (P < 0.03) decreased, while total high‐density lipoprotein (HDL) P < 0.02) increased and heart rate significantly decreased with lorcaserin treatment. No mRNA expression of the 5‐HT2c receptor was observed in peripheral organs. These data suggest that lorcaserin treatment for six months improves cardiometabolic health in obese individuals, acting mainly through the brain.
Left atrial strain and distensibility in relation to left ventricular dysfunction and prognosis in aortic stenosis
Authors: Meimoun Patrick , Djebali Manel , Botoro Thierry , Djou MD Urbain , Bidounga Honorine , Elmkies Frederic , Martis Sonia , Clerc Jérome
Published: February 2019

Objective

To test the relationship between left atrial (LA) distensibility (LAD), LA strain (LAS), and left ventricular (LV) dysfunction and prognosis in aortic stenosis (AS).

Methods

Transthoracic Doppler echocardiography was performed prospectively in 102 consecutive patients with AS (77 with severe, 25 with moderate, mean age 77 years). LA volume was calculated by the area‐length method in apical four‐ and two‐chamber views, immediately before mitral valve opening (Volmax) and at mitral valve closure (Volmin). LAD was defined as (Volmax – Volmin) × 100%/Volmin. LAS (mean of maximal strain from the 4–2 chamber views) was conducted using a dedicated software package. The endpoint was hospitalization for heart failure and death from any cause.

Results

Left atrial strain, LAD, and LA vol/m² were significantly correlated with LV diastolic parameters, and PASP (all, P < 0.05). However, LAD and LAS but not LA vol/m² were significantly correlated with Charlson score, LV global longitudinal strain, and to transaortic mean gradient (all, P < 0.05). At a median follow‐up of 25 months, 53 patients had an event. LAS, LAD, LA vol/m², and Charlson index were associated with events (all, P < 0.05). In multivariate analysis, LAD, LAS, and Charlson index (all, P < 0.01) remained independently associated with events. Using a ROC curve analysis, LAD ≤ 69% and LAS ≤ 17% were the best cutoffs associated with an event.

Conclusion

In patients with moderate to severe AS, LAD and LAS are associated with LV dysfunction, AS severity, and are independently linked to events.
Impact of T‐inversion on the outcome of Takotsubo syndrome as compared to acute coronary syndrome
Authors: Gietzen Thorsten , El‐Battrawy Ibrahim , Lang Siegfried , Zhou Xiao‐Bo , Ansari Uzair , Behnes Michael , Borggrefe Martin , Akin Ibrahim
Published: February 2019

Background

Previous studies revealed that patients with Takotsubo syndrome (TTS) have a higher mortality rate than the general population and a comparable mortality to acute coronary syndrome (ACS). Repolarisation abnormalities, namely T‐wave amplitude, may provide incremental prognostic information, in addition to traditional risk factors in ACS. This study was performed to determine the short‐ and long‐term prognostic impact of inverted T‐waves in TTS patients, as compared to ACS patients.

Methods and results

Our institutional database constituted a collective of 138 patients diagnosed with TTS from 2003 to 2017, as well as 532 patients suffering from ACS. Patients with TTS or with ACS (n = 138 per group) were matched for age and sex and assessed retrospectively and prospectively and divided into two groups, TTS with inverted T‐waves (n = 123) and ACS with inverted T‐waves (n = 80). In‐hospital complications such as respiratory failure with the need of respiratory support (60.2% vs 6.3%; P < 0.01), thromboembolic events (13.8% vs 2.5%; P < 0.01) and cardiogenic shock (18.9% vs 8.8%; P = 0.05) were significantly more presented in TTS as compared to ACS patients. Among cardiovascular risk factors diabetes mellitus (23.6% vs 45.0%; P < 0.01) and arterial hypertension (57.7% vs 78.8%; P < 0.01) were more presented in ACS patients as compared to TTS patients. Short‐term mortality was similar, however the long‐term mortality of 5 years was significantly higher in the TTS group (25.2% vs 7.5%; P < 0.01). In univariate analysis were male gender, EF < 35%, GFR < 60 mL/min, cardiogenic shock, inotropic drugs and history of cancer predictors of 5‐year mortality. The multivariate analysis showed only male gender (HR 2.7, 95% CI 1.1‐6.5; P = 0.02), GFR < 60 mL/min (HR 2.8, 95% CI 1.2‐6.0; P = 0.01) and history of cancer (HR 3.6, 95% CI 1.4‐9.3; P < 0.01) as independent predictors of 5‐year mortality.

Conclusion

Rates of long‐term mortality were significantly higher in TTS patients showing inverted T‐waves compared with patients diagnosed with ACS with inverted T‐waves. However, T‐inversion was not an independent predictor of 5‐year mortality in the multivariate analysis.
The limits to population density in birds and mammals
Authors: Stephens Philip A. , Vieira Marcus V. , Willis Stephen G. , Carbone Chris
Published: February 2019

We address two fundamental ecological questions: what are the limits to animal population density and what determines those limits? We develop simple alternative models to predict population limits in relation to body mass. A model assuming that within‐species area use increases with the square of daily travel distance broadly predicts the scaling of empirical extremes of minimum density across birds and mammals. Consistent with model predictions, the estimated density range for a given mass, ‘population scope’, is greater for birds than for mammals. However, unlike mammals and carnivorous birds, expected broad relationships between body mass and density extremes are not supported by data on herbivorous and omnivorous birds. Our results suggest that simple constraints on mobility and energy use/supply are major determinants of the scaling of density limits, but further understanding of interactions between dietary constraints and density limits are needed to predict future wildlife population responses to anthropogenic threats.
Second and higher moments of fundamentals: A literature review
Authors: Jia Yuecheng , Popova Ivilina , Simkins Betty , Emma Wang Qin
Published: February 2019

This literature review outlines the recent progress in fundamental second and higher moments of research. We survey the moments’ existence, formation, and financial market and macroeconomic implications. Research shows that time‐varying volatility and non‐Gaussian shocks exist throughout all measures of fundamentals at both the micro‐ and macro levels. In addition, the granular network among firms helps explain the origin of fundamental second and higher moments. Empirical evidence shows that the moments have strong predictive power on asset prices and macroeconomic variables. We also highlight several areas where more research is needed to better understand the moments.
Responses of microbial activity in hyporheic pore water to biogeochemical changes in a drying headwater stream
Authors: Harjung Astrid , Perujo Núria , Butturini Andrea , Romaní Anna M. , Sabater Francesc
Published: February 2019

Microbial heterotrophic activity is a major driver of nutrient and organic matter processing in the hyporheic zone of headwater streams. Additionally, the hyporheic zone might provide refuge for microbes when surface flow ceases during drought events.

We investigated chemical (organic and inorganic nutrients) and microbiological parameters (bacterial cell concentration, live–dead ratios, and extracellular enzyme activities) of surface and interstitial pore water in a period of progressive surface‐hyporheic disconnection due to summer drying. The special situation of the chosen study reach, where groundwater mixing is impeded by the bedrock forming a natural channel filled with sediment, allowed as to study the transformation of these parameters along hyporheic flow paths.

The chemical composition of the hyporheic pore water reflected the connectivity with the surface water, as expressed in the availability of nitrate and oxygen. Conversely, microbiological parameters in all hyporheic locations were different from the surface waters, suggesting that the microbial activity in the water changes rapidly once the water enters the hyporheic zone. This feature was principally manifested in higher live–dead ratios and lower leucine aminopeptidase (an activity related to nitrogen acquisition) in the hyporheic pore waters.

Overall, bacterial cell concentration and extracellular enzyme activities increased along hyporheic flow paths, with a congruent decrease in inorganic nutrients and dissolved organic matter quantity and apparent molecular size.

Our findings show two important functions of the hyporheic zone during drought: (1) deeper (−50 cm) water‐saturated layers can act as a refuge for microbial activity; and (2) the hyporheic zone shows high rates of carbon and nitrogen turnover when water residence times are longer during drought. These rates might be even enhanced by an increase in living microbes in the remaining moist locations of the hyporheic zone.
Decrease of variation in the grading of dysplasia in colorectal adenomas with a national e‐learning module
Authors: Madani Ariana , Kuijpers Chantal C H J , Sluijter Caro E , Von der Thüsen Jan H , Grünberg Katrien , Lemmens Valery E P P , Overbeek Lucy I H , Nagtegaal Iris D
Published: February 2019

Aims

Variation in health‐care is undesirable, as this is potentially harmful for patients. In the Netherlands, an e‐learning module was developed to standardise pathological evaluation of colorectal adenomas. We studied the effect of e‐learning on interlaboratory variability in grading of dysplasia in screened conventional colorectal adenomas.

Methods and results

A cross‐sectional retrospective study was performed, including all colorectal adenomas from the Dutch population‐based colorectal cancer screening programme, retrieved from the Dutch Pathology Registry (PALGA) from January 2014 to July 2015. The e‐learning tool, commissioned by the National Institute for Public Health, was implemented among screening pathologists from October 2014. Proportions of high‐grade dysplasia (HGD) were compared before (January–July 2014) and after implementation (October 2014–July 2015) of the e‐learning module. Interlaboratory variation was assessed by multilevel mixed‐effects analysis. In total, 20 713 colonoscopies (20 546 patients) were performed after a positive faecal immunochemical screening test, resulting in the inclusion of 56 355 conventional adenomas from 37 pathology laboratories. Before implementation, 12 614 adenomas were diagnosed, including 4.3% with HGD. After implementation, 43 741 adenomas were diagnosed, and the HGD proportion decreased to 3.9%. Univariable analysis showed less deviant proportions of HGD after implementation in 62% of the laboratories (P = 0.019). Multilevel analysis confirmed decreased variation in the risk of diagnosing HGD (P = 0.021).

Conclusions

Interlaboratory variability in grading HGD in colorectal adenomas after a positive screening test decreased after implementation of an e‐learning module for pathologists. We therefore conclude that e‐learning has a favourable influence on decreasing diagnostic variability, making this a relevant strategy for health‐care standardisation.
The prognostic significance of lysosomal protective protein (cathepsin A) in breast ductal carcinoma in situ
Authors: Toss Michael S , Miligy Islam M , Haj‐Ahmad Rita , Gorringe Kylie L , AlKawaz Abdulbaqi , Mittal Karuna , Ellis Ian O , Green Andrew R , Rakha Emad A
Published: February 2019

Aims

Cathepsin A (CTSA) is a key regulatory enzyme for galactoside metabolism. Additionally, it has a distinct proteolytic activity and plays a role in tumour progression. CTSA is differentially expressed at the mRNA level between breast ductal carcinoma in situ (DCIS) and invasive breast carcinoma (IBC). In this study, we aimed to characterise CTSA protein expression in DCIS and evaluate its prognostic significance.

Methods and results

A large cohort of DCIS [n = 776 for pure DCIS and n = 239 for DCIS associated with IBC (DCIS/IBC)] prepared as a tissue microarray was immunohistochemically stained for CTSA. High CTSA expression was observed in 48% of pure DCIS. High expression was associated with features of poor DCIS prognosis, including younger age at diagnosis (<50 years), higher nuclear grade, hormone receptor negativity, HER2 positivity, high proliferative index and high hypoxia inducible factor 1 alpha expression. High CTSA expression was associated with shorter recurrence‐free interval (RFI) (P = 0.0001). In multivariate survival analysis for patients treated with breast conserving surgery, CTSA was an independent predictor of shorter RFI (P = 0.015). DCIS associated with IBC showed higher CTSA expression than pure DCIS (P = 0.04). In the DCIS/IBC cohort, CTSA expression was higher in the invasive component than the DCIS component (P < 0.0001).

Conclusion

CTSA is not only associated with aggressive behaviour and poor outcome in DCIS but also a potential marker to predict co‐existing invasion in DCIS.