Real-Life Experience of mTOR Inhibitors in Liver Transplant Recipients in a Region Where Living Donation Is Predominant

Background: Mammalian target of rapamycin (mTOR) inhibitors, such as everolimus and sirolimus, may be efficacious in preserving renal function in liver transplantation (LT) recipients while preventing hepatocellular carcinoma (HCC) recurrence.Materials and Methods: In this study, we retrospectively evaluated the safety, efficacy, and renoprotective effects of mTOR inhibitors in LT recipients. Among the 84 patients enrolled, mTOR inhibitor was commenced during the first year after LT. Renal function was measured by estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease equation.Results: Regarding the type of mTOR inhibitor, everolimus was used in 71 patients and sirolimus in 13 patients. Concomitant tacrolimus was used in 63 patients (75.0%). For total enrolled patients, kidney function did not significantly change during 12 months after initiation of mTOR inhibitors, although tacrolimus-withdrawn patients (n = 21) showed better kidney function compared to tacrolimus-minimized patients (n = 63) after conversion. However, a significant improvement in kidney function was observed in the eGFR <60 ml/min/1.73 m2 group (n = 19) 12 months after initiation of mTOR inhibitors, for both patient groups with early + mid starters (n = 7, stating within 1 year after LT) and late starters (n = 12, starting over 1 year after LT). mTOR inhibitors were safely administered without serious adverse events that led to drug discontinuation.Conclusion: We demonstrated that patients with renal impairment showed significant improvement in renal function regardless of the timing of mTOR inhibitor start, suggesting that switch to mTOR inhibitors may be beneficial when renal function declines.

Investigating the Influences of Starting Age on Pronunciation: a Comparative Study of Chinese Learners of English As a Second Language

This study aims to test the validity of Critical Period Hypothesis (CPH) by investigating the influence of starting age on Chinese English learners’ pronunciation. The study compares the degree of foreign accent of native Chinese English learners with different starting ages in learning English, in an attempt to determine whether early Chinese English learners could outperform late ones in terms of English pronunciation when exposed to an English-speaking setting. Furthermore, this research also proposes to investigate other possible factors that affect Chinese English learners’ pronunciation. Participants were asked to provide spontaneous speech samples through semi-structured interviews conducted face-to-face or via Skype. In addition, an additional read-aloud task was required to ensure a more thorough and in-depth interpretation. The final results run counter to the Critical Period Hypothesis as there appeared to be late starters who also achieved native-like pronunciation, and there was no significant difference between early starters and late ones in terms of pronunciation. However, the study also yielded some results suggesting that greater efforts and stronger motivations were required for late starters in order to achieve the same pronunciation levels as early starters’, indicating that starting age can be a sensitive rather than critical factor for second language (L2) pronunciation acquisition.

Patterns of Romantic Relationship Experiences and Psychosocial Adjustment From Adolescence to Young Adulthood

Engaging in a romantic relationship is a key developmental task of adolescence and adolescents differ greatly in both the age at which they start dating and in how romantically active they are. These differences in romantic relationship experiences could be relevant for adolescents’ short- and long-term psychosocial adjustment. The present study describes the diversity of relationship experiences during adolescence and examines their connection to psychosocial adjustment in adolescence and young adulthood. N = 2457 adolescents (49.3% female) from a German representative longitudinal study provided information on their relationship experiences between the ages 10 and 20, as well as on their psychosocial adjustment. Data were collected via annual assessments starting in 2008 at age M = 16.50 years (SD = 0.88) through young adulthood (M = 25.46, SD = 0.87). Latent profile analysis identified three romantic involvement groups: late starters, moderate daters, and frequent changers, which were further compared to adolescents without any romantic experiences (continuous singles). Growth curve analyses indicated that continuous singles reported lower life satisfaction and higher loneliness than the moderate daters in adolescence and young adulthood. The continuous singles were also less satisfied with their life in young adulthood and felt more lonely in both adolescence and young adulthood compared to the late starters. The findings of the study suggest great variability in adolescents’ romantic relationship experiences and point toward the developmental significance of these experiences for short- and long-term well-being.

Lifelong smoking trajectories of Northern Finns are characterized by sociodemographic and lifestyle differences in a 46-year follow-up

Smoking remains among the leading causes of mortality worldwide. Obtaining a comprehensive understanding of a population’s smoking behaviour is essential for tobacco control. Here, we aim to characterize lifelong smoking patterns and explore underlying sociodemographic and lifestyle factors in a population-based birth cohort population followed up for 46 years. Our analysis is based on 5797 individuals from the Northern Finland Birth Cohort 1966 who self-reported their tobacco smoking behaviour at the ages of 14, 31 and 46. Data on sex, education, employment, body mass index, physical activity, alcohol consumption, and substance addiction were also collected at the follow-ups. We profile each individual’s annual smoking history from the age of 5 to 47, and conduct a latent class trajectory analysis on the data. We then characterize the identified smoking trajectory classes in terms of the background variables, and compare the heaviest smokers with other classes in order to reveal specific predictors of non-smoking and discontinued smoking. Six smoking trajectories are identified in our sample: never-smokers (class size 41.0%), youth smokers (12.6%), young adult quitters (10.8%), late adult quitters (10.5%), late starters (4.3%), and lifetime smokers (20.7%). Smoking is generally associated with male sex, lower socioeconomic status and unhealthier lifestyle. Multivariable between-class comparisons identify unemployment (odds ratio [OR] 1.28–1.45) and physical inactivity (OR 1.20–1.52) as significant predictors of lifetime smoking relative to any other class. Female sex increases the odds of never-smoking and youth smoking (OR 1.29–1.33), and male sex increases the odds of adult quitting (OR 1.30–1.41), relative to lifetime smoking. We expect future initiatives to benefit from our data by exploiting the identified predictors as direct targets of intervention, or as a means of identifying individuals who may benefit from such interventions.

On Constructing Typologies of Young People’s Cosmopolitanism

This paper addresses a number of fundamental epistemological obstacles faced by researchers interested in studying young people’s cosmopolitanism, more specifically, the normative temptation and “first experience” obstacles. It goes on to tackle the inherent temporality of cosmopolitan behaviour, seeing how it is a fundamentally dynamic phenomenon that entails itineraries, trajectories and pathways through young people’s life cycles. As such, the text proposes six typical trajectories. In terms of temporalities: “the confirmed cosmopolitan,” “late starters,” “cosmopolitan and uncosmopolitan at the same time,” and “disengagement from cosmopolitanism”; in terms of moving through social space: “focusing on social space close to home,” “the ordinary tourist.”

Does younger mean better? Age of onset, learning rate and shortterm L2 proficiency in young Danish learners of English

This paper reports the results of a semi-longitudinal study investigating the role of age of onset in early foreign language (English) learning. We compared two groups of Danish school children (N = 276) who, following an educational reform in 2014, started their first English classes the same year but at different ages. One group (the early starters) was introduced to English in the 1st grade (age 7-8) and the other group (the late starters) in the 3rd grade (age 9-10). Children’s receptive vocabulary, receptive grammar, and phonetic discrimination skills were followed for three years, allowing comparisons across groups and time and tracking learning rate and shortterm proficiency (after one and two years of instruction). Results showed that the late starters outperformed the early starters in most tests. With respect to learning rate, the tests also revealed that the late starters had an advantage in the receptive grammar test, whereas the phonetic discrimination test showed a more diffuse picture with the late starters seemingly halting in development and the early starters advancing. The results also showed gender differences with boys achieving a higher level of proficiency and exhibiting a faster learning rate than girls. The pedagogical implications of the results are discussed.

Exploring determinants of internationalisation: the case of late starters

Purpose The purpose of this paper is to explore the determinants of internationalisation among late starters in the wine sector. Strategic implications for small and medium enterprises (SMEs) in a young wine producing region are derived based on the findings. Design/methodology/approach Data were collected through a quantitative survey among 38 wineries that are engaged in export activity in the Romagna wine producing area (Italy). Both multivariate analysis of cardinal company data through multiple and fractional regression models as well as nonparametric analysis of Likert-type survey elements were carried out. Findings The study identifies several determinants that affect the export intensity of businesses in the sample: Resources within the business turn out to be important, as well as the choice of distribution partners. Characteristics of exported goods were found to differ on comparing intra- and extra-EU exports. Practical implications Competitiveness in the international marketplace is closely linked to the product quality, distribution network and productivity of a firm. Regional networks can help businesses to develop these factors, overcome export barriers and strengthen the competitiveness of a region as a whole. Originality/value This study investigated the determinants of internationalisation in a wine producing region which is considered a late starter of internationalisation in the wine industry and it is the first one spotlighting on a regional firm-level in the Italian wine industry.