bluuebunny/crossref_metadata_2025 huggingface dataset:
Ringer's lactate versus normal saline in acute pancreatitis: A systematic review and meta‐analysis
Authors: Iqbal Umair , Anwar Hafsa , Scribani Melissa
Published: May 2018

OBJECTIVE

Aggressive i.v. hydration with crystalloids is the first step in managing acute pancreatitis (AP) and is associated with improved survival. Guidelines about the choice of crystalloids to use are unclear. This systematic review and meta‐analysis was aimed to discern whether the choice of fluids in managing pancreatitis was associated with patients' outcomes.

METHODS

A comprehensive literature review was conducted by searching the Embase, MEDLINE, PubMed and Google Scholar databases to December 2017 to identify all studies that compared normal saline (NS) with Ringer's lactate (RL) for managing AP. The characteristics of the participants, outcome measurements (including mortality, the development of systemic inflammatory response syndrome [SIRS] on admission and at 24 h, and pancreatic necrosis) were analyzed.

RESULTS

Five studies (three randomized controlled trials and two retrospective cohort studies) with 428 patients were included in this analysis. Mortality trended lower in the RL group but this was not statistically significant (pooled odds ratio [OR] 0.61, 95% CI 0.28–1.29, P = 0.20). Patients in the RL group had significantly decreased odds of developing SIRS at 24 h (pooled OR 0.38, 95% CI 0.15–0.98, P = 0.05).

CONCLUSIONS

RL has anti‐inflammatory effects and is associated with decreased odds of persistent SIRS at 24 h, which is a marker of severe disease in AP patients. Although mortality trended lower in the RL group this did not achieve statistical significance and hence larger randomized controlled trials are needed to evaluate this association.
Clinical significance of calcium‐binding protein S100A8 and S100A9 expression in non‐small cell lung cancer
Authors: Huang He , Huang Qingdong , Tang Tingyu , Gu Liang , Du Jianzong , Li Zhijun , Lu Xiaoling , Zhou Xiaoxi
Published: May 2018

Background

The purpose of this study was to evaluate the correlation between calcium‐binding protein S100A8 and S100A9 expression in non‐small cell lung cancer (NSCLC) and patients’ clinical features.

Methods

Fifty‐two NSCLC patients who underwent surgery at Zhejiang Hospital from February 2014 to January 2016 were included in this study. Calcium‐binding protein S100A8 and S100A9 expression patterns in cancer and para‐cancer tissues were examined by immunohistochemistry assay. The correlation between calcium‐binding protein S100A8 and S100A9 expression patterns and NSCLC patients’ clinical characteristics, including age, gender, tumor node metastasis stage, and pathology type, were evaluated.

Results

S100A8 and S100A9 were generally expressed on the cytoplasm and nucleus of NSCLC cells, mainly located in the cytoplasm, stained with brown particles, and distributed evenly. The positive expression rates of S100A8 and S100A9 in cancer tissues were 71.2% and 76.9%, respectively, which were significantly higher than in para‐cancer tissues at 11.5% and 19.2%, respectively, with statistical significance (P < 0.05). S100A8 and S100A9 positive expression was associated with tumor differentiation degree (P < 0.05) but were not correlated with age, gender, smoking history, tumor diameter, pathology type, tumor node metastasis stage, or pleural effusion (Pall > 0.05).

Conclusion

S100A8 and S100A9 positive expression in cancer tissues was significantly higher than in para‐cancer tissues and was correlated with tumor differentiation, which may be a potential marker for poor prognosis.
Overexpression of S100A14 contributes to malignant progression and predicts poor prognosis of lung adenocarcinoma
Authors: Ding Fang , Wang Di , Li Xu‐Kun , Yang Lin , Liu Hui‐Ying , Cui Wei , Liu Zhi‐Hua , Che Yi‐Qun
Published: May 2018

Background

S100A14 is a member of the S100 calcium‐binding protein family that exerts important phenotypic effects on cell proliferation, apoptosis, differentiation, and motility. However, the functional role and potential clinical significance of S100A14 in lung adenocarcinoma has not yet been clarified.

Methods

We analyzed genomic alterations of S100A14 using The Cancer Genome Atlas lung adenocarcinoma genomic dataset. S100A14 displayed significant copy number amplification in lung adenocarcinoma. We detected S100A14 expression in lung adenocarcinoma and analyzed the correlation between S100A14 expression and clinicopathological characteristics.

Results

Immunohistochemical analysis showed that S100A14 expression was obviously upregulated in lung adenocarcinoma tissues compared to matched normal counterparts. Statistical analysis revealed that S100A14 expression strongly correlated with poor differentiation, metastasis, stage, smoking, and EGFR mutation. Furthermore, our data indicated that S100A14 serum levels were higher in lung adenocarcinoma patients than healthy controls. Intriguingly, S100A14 serum levels were related to distant metastasis (P = 0.028). High S100A14 expression was significantly associated with overall (P = 0.0016) and post progression (P = 0.039) survival. In addition, we investigated the biological functions of S100A14 in lung adenocarcinoma cell lines. The results demonstrated that S100A14 promoted cell migration and invasion of SPCA1 and Glc‐82 cells.

Conclusions

S100A14 increases the motility of lung adenocarcinoma cells, and might be a diagnostic and prognostic serum biomarker and potential therapeutic target for lung adenocarcinoma.
Australian recommendations for the integration of emergency care for older people: Consensus Statement
Authors: Lowthian Judy A , Arendts Glenn , Strivens Edward
Published: May 2018

Objectives

Management of older patients during acute illness or injury does not occur in isolation in emergency departments. We aimed to develop a collaborative Consensus Statement to enunciate principles of integrated emergency care.

Methods

Briefing notes, informed by research and evidence reviews, were developed and evaluated by a Consensus Working Party comprising cross‐specialty representation from clinical experts, service providers, consumers and policymakers. The Consensus Working Party then convened to discuss and develop the statement's content. A subcommittee produced a draft, which was reviewed and edited by the Consensus Working Party.

Results

Consensus was reached after three rounds of discussion, with 12 principles and six recommendations for how to follow these principles, including an integrated care framework for action.

Conclusion

Dissemination will encourage stakeholders and associated policy bodies to embrace the principles and priorities for action, potentially leading to collaborative work practices and improvement of care during and after acute illness or injury.
Food knowledge and psychological state predict adherence to a gluten‐free diet in a survey of 5310 Australians and New Zealanders with coeliac disease
Authors: Halmos E. P. , Deng M. , Knowles S. R. , Sainsbury K. , Mullan B. , Tye‐Din J. A.
Published: May 2018

Background

A gluten‐free diet treats coeliac disease, but its efficacy depends on strict adherence. A variety of patient factors may influence adherence but have not been well described at a population level.

Aim

To comprehensively assess the patient factors that influence gluten‐free diet adherence in patients with coeliac disease.

Methods

Patients with coeliac disease completed an online survey comprising the validated Celiac Dietary Adherence Test in addition to data on demographics, details of diagnosis and management and assessment of diet knowledge, quality of life and psychological distress. Survey data were analysed for predictors of adherence and quality of life.

Results

Of 7393 responses, 5310 completed the Celiac Dietary Adherence Test and 3230 (61%) were adherent to a gluten‐free diet. Multivariate regression showed older age, being male, symptoms after gluten ingestion, better food knowledge and lower risk of psychological distress were independent predictors of adherence (each P ≤ 0.008). Additionally, dietary adherence was associated with better quality of life (P < 0.001; multiple regression). Respondents who considered themselves to have poor food knowledge were more likely to incorrectly identify gluten‐free foods, but could still recognise gluten‐containing foods, suggesting that poor knowledge may lead to over‐restriction of diet.

Conclusions

Poor knowledge of a gluten‐free diet and psychological wellbeing were independent modifiable risk factors for inadequate adherence to a gluten‐free diet in patients with coeliac disease. Involvement of both a dietitian and mental health care professional, in the presence of psychological distress, is likely to be necessary to improve adherence and health outcomes.
Oral Immunosuppressive Treatment of Myasthenia Gravis in Denmark: A Nationwide Drug Utilization Study, 1996–2013
Authors: Pedersen Emil Greve , Hallas Jesper , Pottegård Anton , Hald Stine Munk , Jensen Poul Erik Hyldgaard , Gaist David
Published: May 2018

Although immunosuppressants in the treatment of myasthenia have been available for several decades, population‐based studies describing drug utilization in myasthenia patients are scarce. We aimed in this study to describe the treatment of myasthenia in Denmark in more recent years with emphasis on use of oral immunosuppressant agents. We identified a nationwide cohort of incident myasthenia patients in Denmark from 1996 to 2013 and tracked their use of drugs over the entire period using data from nationwide registers. Patients with myasthenia were classified according to utilization of specific immunosuppressants (e.g. prednisolone) as ‘never user’ or ‘ever user’. We used Kaplan–Meier (K‐M) and proportion of patients covered (PPC) curves to describe treatment onset and termination. We identified 928 patients (52% female) with incident myasthenia in the study period. Overall, 638 (69%) were treated with prednisolone and 506 (55%) with azathioprine. Treatment with prednisolone and azathioprine within 2 years of myasthenia diagnosis was initiated in 462 (56%) and 366 (45%). Only one of four myasthenia patients (n = 231) did not receive oral immunosuppressive treatment at any time in the study period. Prednisolone was stopped in most patients, whereas treatment with azathioprine was often continued throughout follow‐up. In conclusion, we found that treatment of myasthenia in Denmark in recent years corresponded well to the expected clinical course of myasthenia and that most patients underwent long‐term immunosuppression.
Cognitive training for technical and non‐technical skills in robotic surgery: a randomised controlled trial
Authors: Raison Nicholas , Ahmed Kamran , Abe Takashige , Brunckhorst Oliver , Novara Giacomo , Buffi Nicolò , McIlhenny Craig , van der Poel Henk , van Hemelrijck Mieke , Gavazzi Andrea , Dasgupta Prokar
Published: May 2018

Objective

To investigate the effectiveness of motor imagery (MI) for technical skill and non‐technical skill (NTS) training in minimally invasive surgery (MIS).

Subjects and Methods

A single‐blind, parallel‐group randomised controlled trial was conducted at the Vattikuti Institute of Robotic Surgery, King's College London. Novice surgeons were recruited by open invitation in 2015. After basic robotic skills training, participants underwent simple randomisation to either MI training or standard training. All participants completed a robotic urethrovesical anastomosis task within a simulated operating room. In addition to the technical task, participants were required to manage three scripted NTS scenarios. Assessment was performed by five blinded expert surgeons and a NTS expert using validated tools for evaluating technical skills [Global Evaluative Assessment of Robotic Skills (GEARS)] and NTS [Non‐Technical Skills for Surgeons (NOTSS)]. Quality of MI was assessed using a revised Movement Imagery Questionnaire (MIQ).

Results

In all, 33 participants underwent MI training and 29 underwent standard training. Interrater reliability was high, Krippendorff's α = 0.85. After MI training, the mean (sd) GEARS score was significantly higher than after standard training, at 13.1 (3.25) vs 11.4 (2.97) (P = 0.03). There was no difference in mean NOTSS scores, at 25.8 vs 26.4 (P = 0.77). MI training was successful with significantly higher imagery scores than standard training (mean MIQ score 5.1 vs 4.5, P = 0.04).

Conclusions

Motor imagery is an effective training tool for improving technical skill in MIS even in novice participants. No beneficial effect for NTS was found.
Architecture, deformation style and petrophysical properties of growth fault systems: the Late Triassic deltaic succession of southern Edgeøya (East Svalbard)
Authors: Ogata Kei , Mulrooney Mark J. , Braathen Alvar , Maher Harmon , Osmundsen Per Terje , Anell Ingrid , Smyrak‐Sikora Aleksandra Anna , Balsamo Fabrizio
Published: May 2018

The Late Triassic outcrops on southern Edgeøya, East Svalbard, allow a multiscale study of syn‐sedimentary listric growth faults located in the prodelta region of a regional prograding system. At least three hierarchical orders of growth faults have been recognized, each showing different deformation mechanisms, styles and stratigraphic locations of the associated detachment interval. The faults, characterized by mutually influencing deformation envelopes over space‐time, generally show SW‐ to SE‐dipping directions, indicating a counter‐regional trend with respect to the inferred W‐NW directed progradation of the associated delta system. The down‐dip movement is accommodated by polyphase deformation, with the different fault architectural elements recording a time‐dependent transition from fluidal‐hydroplastic to ductile‐brittle deformation, which is also conceptually scale‐dependent, from the smaller‐ (3rd order) to the larger‐scale (1st order) end‐member faults respectively. A shift from distributed strain to strain localization towards the fault cores is observed at the meso to microscale (<1 mm), and in the variation in petrophysical parameters of the litho‐structural facies across and along the fault envelope, with bulk porosity, density, pore size and microcrack intensity varying accordingly to deformation and reworking intensity of inherited structural fabrics. The second‐ and third‐order listric fault nucleation points appear to be located above blind fault tip‐related monoclines involving cemented organic shales. Close to planar, through‐going, first‐order faults cut across this boundary, eventually connecting with other favourable lower‐hierarchy fault to create seismic‐scale fault zones similar to those imaged in the nearby offshore areas. The inferred large‐scale driving mechanisms for the first‐order faults are related to the combined effect of tectonic reactivation of deeper Palaeozoic structures in a far field stress regime due to the Uralide orogeny, and differential compaction associated with increased sand sedimentary input in a fine‐grained, water‐saturated, low‐accommodation, prodeltaic depositional environment. In synergy to this large‐scale picture, small‐scale causative factors favouring second‐ and third‐order faulting seem to be related to mechanical‐rheological instabilities related to localized shallow diagenesis and liquidization fronts.
Community composition and diversity of Neotropical root‐associated fungi in common and rare trees
Authors: Schroeder John W. , Martin Jessica T. , Angulo Diego F. , Barbosa Jomar M. , Perea Ramón , Arias‐Del Razo Itzel , Sebastián‐González Esther , Dirzo Rodolfo
Published: May 2018

Interactions between plants and root‐associated fungi can affect the assembly, diversity, and relative abundances of tropical plant species. Host–symbiont compatibility and some degree of host specificity are prerequisites for these processes to occur, and these prerequisites may vary with host abundance. However, direct assessments of whether specificity of root‐associated fungi varies with host abundance are lacking. Here, in a diverse tropical forest in Los Tuxtlas, Mexico, we couple DNA metabarcoding with a sampling design that controls for host phylogeny, host age, and habitat variation, to characterize fungal communities associated with the roots of three confamilial pairs of host species that exhibit contrasting (high and low) relative abundances. We uncovered a functionally and phylogenetically diverse fungal community composed of 1,038 OTUs (operational taxonomic units with 97% genetic similarity), only 14 of which exhibited host specificity. Host species was a significant predictor of fungal community composition only for the subset of OTUs composed of putatively pathogenic fungi. We found no significant difference in the number of specialists associating with common versus rare trees, but we found that host abundance was negatively correlated with the diversity of root fungal communities. This latter result was significant for symbiotrophs (mostly arbuscular mycorrhizal fungi) and, to a lesser extent, for pathotrophs (mostly plant pathogens). Thus, root fungal communities differ between common and rare trees, which may impact the strength of conspecific negative density dependence. Further studies from other tropical sites and host lineages are warranted, given the role of root‐associated fungi in biodiversity maintenance.
There is no place like @home!: The value of home consultations in paediatric rehabilitation
Authors: van Maren‐Suir I. , Ketelaar M. , Brouns B. , van der Sanden K. , Verhoef M.
Published: May 2018

Background

Family‐centred services (FCS) is widely regarded as the best practice approach in early interventions. Creating a therapeutic environment, which also stimulates collaboration between parents and service professionals, is a way to conform to the principles of FCS. The present paper describes the project entitled @home, involving the implementation of home consultations by a specialized team working with children aged 0–5 years at our rehabilitation centre in the Netherlands. The objectives of this article are to (a) describe the development and implementation of home consultations as part of regular care and (b) share the experiences of parents and service providers with home consultations.

Method

The implementation process was divided into 3 steps: (1) interviewing experts, (2) adjusting current rehabilitation trajectories, and (3) service providers offering consultations to children at home. The experiences with the home consultations were immediately incorporated in the system, making the implementation an iterative process.

Results

In 82% of the 133 home conducted consultations, the service professionals reported that it was more valuable to offer home consultations than seeing the child at the rehabilitation centre. The semistructured interviews revealed that parents and service providers found that they received and provided more tailored advice, perceived a more equal partnership between service professionals and parents, and reported that the home consultations provided a good natural therapeutic environment where a child can be itself and where the child performs best.

Conclusion

By using the @home system based on the 3 service models, home consultations are now part of the regular paediatric rehabilitation system at our rehabilitation centre.
Effects of treatment with an angiotensin 2 receptor blocker and/or vitamin D3 on parathyroid hormone and aldosterone: A randomized, placebo‐controlled trial
Authors: Bislev Lise Sofie , Langagergaard Rødbro Lene , Nørgaard Bech Jesper , Bjerregaard Pedersen Erling , Rolighed Lars , Sikjær Tanja , Rejnmark Lars
Published: May 2018

Objective

Emerging evidence supports a positive, bidirectional and clinical relevant interaction between parathyroid hormone (PTH) and the renin‐angiotensin‐aldosterone‐system (RAAS). A beneficial effect of the widely used RAAS inhibitors might include a PTH‐lowering effect, as high PTH levels may be harmful to cardiovascular health. We aimed to investigate whether PTH levels are lowered by short‐term treatment with an angiotensin 2 receptor blocker (valsartan) independently of coadministration of vitamin D3. Secondary end‐points included effects on blood pressure, cardiac conduction and concentrations of renin and aldosterone.

Design and Methods

In a double‐blind placebo‐controlled trial, we included 81 otherwise healthy postmenopausal women with high PTH levels (>6.9 pmol/L) and vitamin D insufficiency (25(OH)D < 50 nmol/L). Participants received 2 weeks of treatment with valsartan 80 mg/d, vitamin D3 70 μg/d, valsartan plus vitamin D3 or double placebo.

Results

Valsartan treatment did not affect plasma PTH, although treatment reduced diastolic blood pressure (P = .01) and the aldosterone/renin ratio (P < .001). We found no associations between calciotropic hormones and RAAS markers. Vitamin D3 supplementation reduced PTH by 3.4% (25th, 75th −9.0 to 8.7) compared to a 7.1% increase (25th, 75th −2.4 to 30.9) in the placebo group (P = .01), but did not affect blood pressure, cardiac conduction or concentrations of renin and aldosterone.

Conclusions

Independently of vitamin D3, short‐term valsartan treatment did not reduce PTH. Vitamin D3 reduced PTH but did not affect blood pressure, cardiac conduction or the RAAS. The study does not support a direct association between PTH and aldosterone or a blood pressure‐lowering effect of vitamin D3.
Dento‐alveolar measurements and histomorphometric parameters of maxillary and mandibular first molars, using micro‐CT
Authors: Theye Charlotte E. G. , Hattingh André , Cracknell Tamsin J. , Oettlé Anna C. , Steyn Maryna , Vandeweghe Stefan
Published: May 2018

Background

Micro‐CT is a high‐resolution, non‐invasive, and non‐destructive imaging technique, currently acknowledged as a gold standard modality for assessing quantitatively and objectively dental morphology and bone microarchitecture parameters.

Purpose

The aim of this study was to analyze critical dental and periodontal measurements characterizing the mandibular (MandFM) and maxillary (MaxFM) first molar architecture, as well as the corresponding bony socket, using micro‐CT.

Materials and Methods

Thirty‐eight human dried skulls (22‐76 years) were scanned to enable the virtual analysis of 61 first molars. Depending on the type of measurement, the parameters were recorded on two‐dimensional sections or directly on three‐dimensional models. Tooth morphology was described by four aspects (e.g., tooth width, trunk length, root length, and root span), while the socket architecture was assessed by buccal plate thicknesses and bone density measurements.

Results

Minimum, maximum, and mean distances as well as cortical and trabecular bone densities were recorded in MandFM and MaxFM. It is noteworthy that the buccal plate thickness was found to be less than 1 mm in more than 55% of cases in MaxFM, whereas only in 20.8% of cases in MandFM (and even 0% at two sites). A wide range of bone densities was observed and the comparison between MandFM and MaxFM did not show a significant difference. Furthermore, cortical densities were negatively correlated with aging, while trabecular densities were not influenced.

Conclusions

Using micro‐CT, three‐dimensional aspects of the human first molar morphology and microstructural parameters of the surrounding bone were evaluated in the mandible and in the maxilla. These comprehensive measurements and their correlation with aging may be of great importance for the use of immediate implant placement in molar extraction sockets and thus the potential long‐term success of this treatment modality.
Novel electrical conductivity device for osteotomy preparation for dental implants placement: A cadaver study
Authors: Lorean Adi , Barer Noa , Barbu Horia , Levin Liran
Published: May 2018

Objectives

To evaluate the accuracy, safety, and anticipation effect of a novel electrical conductivity device (SG) in maxillary osteotomy preparation for placement of dental implants.

Materials and Methods

Thirty‐seven osteotomies were prepared by three operators with different levels of expertise, using the SG protocol in the maxilla of six fresh frozen cadavers. A pre‐op CT measurement of the length of bone in the desired implant location was taken and compared with the final length of the osteotomy created using SG during surgery. A comparison was made between the results of the different operators.

Results

The pre‐op CT bone length measurements and the final depth assessment of the osteotomy with SG had a very high correlation level (0.977) with a significant mean difference of 0.639 mm (P < .0001), with the pre‐op CT measurements being longer. The least experienced operator had placed the implants 0.924 mm less deep than the pre‐op CT length measurements while the most experienced operator had placed the implants 0.244 mm less deep than the pre op CT length measurements. All implants were placed in the correct position and no breach of the sinus/nasal floor or buccal/palatine bone plates was detected.

Conclusions

The SG electrical conductivity device offers the operator real‐time monitoring during the surgical procedure. It provides a simple, safe, and sensitive method of detecting breaches, making it simple and safe for oral surgeons with different levels of expertise to use, with promising results.
Predicting the impacts of anthropogenic disturbances on marine populations
Authors: Nabe‐Nielsen Jacob , van Beest Floris M , Grimm Volker , Sibly Richard M , Teilmann Jonas , Thompson Paul M
Published: May 2018

Marine ecosystems are increasingly exposed to anthropogenic disturbances that cause animals to change behavior and move away from potential foraging grounds. Here we present a process‐based modeling framework for assessing population consequences of such sub‐lethal behavioral effects. It builds directly on how disturbances influence animal movements, foraging and energetics, and is therefore applicable to a wide range of species. To demonstrate the model we assess the impact of wind farm construction noise on the North Sea harbor porpoise population. Subsequently, we demonstrate how the model can be used to minimize population impacts of disturbances through spatial planning. Population models that build on the fundamental processes that determine animal fitness have a high predictive power in novel environments, making them ideal for marine management.
Ignoring spatial heterogeneity in social conditions overestimates extinction risk of aquatic macrophytes
Authors: Toyama Fumiya , Akasaka Munemitsu
Published: May 2018

Aim

Abandoned lands are expanding globally due to depopulation in rural areas; biodiversity is declining due to the cessation of traditional management practices. However, the awareness of abandonment as a serious threat is still limited. Knowledge of the influence of the responsible factors on the assessment of regional extinction risk of species due to abandonment is sparse although it is indispensable for conservation decision‐making. This study aimed to clarify the influence of the heterogeneity in abandonment risk and interspecies differences in sensitivity to abandonment on regional species extinction risk and to identify the attributes of the species whose extinction risk is prone to be assessed inaccurately by ignoring the abandonment risk.

Location

Awaji Island, Hyogo, Western Japan.

Methods

We assessed the extinction risk of 64 species of macrophytes under four scenarios: 2 × 2 combinations whether to incorporate interspecies differences in sensitivity to abandonment and the abandonment risk, respectively.

Results

Ignoring the abandonment risk overestimated the extinction risk of most species by 10%, whereas ignoring interspecies differences in sensitivity did not significantly affect the extinction risk. Ignoring the abandonment risk overestimated the extinction risk of emergent plants by 12%, whereas it underestimated that of free‐floating plants or threatened plants by 5%. Spatial bias in abandonment risk markedly reduced the correlation between the extinction risk and the frequency of species occurrence.

Main conclusions

The abandonment risk was more effective in accurately assessing the extinction risk due to abandonment than interspecies differences in sensitivity. Extinction risk of emergent, free‐floating or threatened species were assessed inaccurately by ignoring the abandonment risk. Focusing only on the area of occurrence or the extent of occurrence of a species as a surrogate for its extinction risk is likely to produce inaccurate assessments, and thus should be avoided.
Guidelines for Gastroenterological Endoscopy in Patients Undergoing Antithrombotic Treatment: 2017 Appendix on Anticoagulants Including Direct Oral Anticoagulants
Authors: Kato Mototsugu , Uedo Noriya , Hokimoto Seiji , Ieko Masahiro , Higuchi Kazuhide , Murakami Kazunari , Fujimoto Kazuma
Published: May 2018

In 2012, the Japan Gastroenterological Endoscopy Society published “Guidelines for Gastroenterological Endoscopy in Patients Undergoing Antithrombotic Treatment” concerning thromboembolism associated with antithrombotic therapy withdrawal. Since then, physicians have started prescribing oral anticoagulants, creating a need for standards reflecting their use in clinical practice. Therefore, new findings regarding anticoagulants are included in this appendix. However, the evidence levels are low for many statements contained herein and these appended guidelines still need to be verified in clinical settings.
Proximal versus distal femoral derotation osteotomy in bilateral cerebral palsy
Authors: Niklasch Mirjam , Boyer Elizabeth R , Novacheck Tom , Dreher Thomas , Schwartz Michael
Published: May 2018

Aim

Femoral derotation osteotomy (FDO) can be conducted either proximally or distally to correct internal rotation gait (IRG) and increased anteversion in children with cerebral palsy (CP). Previous studies with limited numbers of participants have presented comparable short‐term static and kinematic outcomes for both techniques. The objective of this retrospective multicentre study was to verify this thesis with a larger number of patients.

Method

In total, 119 children with CP and IRG were included after matching the groups on preoperative mean stance hip rotation: 67 intertrochanteric (proximal group) FDO (average age at surgery 9y [SD 3y]); 52 supracondylar (distal group) FDO (average age at surgery 12y [SD 3y]). One random limb of each child was analyzed. Both transverse plane kinematic gait data and torsional parameters of clinical examination were assessed preoperatively and postoperatively.

Results

On average, both groups’ mean hip rotation and midpoint of hip rotation improved postoperatively, and groups did not differ preoperatively or postoperatively for these variables (p>0.05).

Interpretation

The osteotomy location does not influence short‐term gait kinematics nor static measurements. Therefore, the choice of performing proximal or distal FDO in children with CP for treatment of IRG and increased anteversion should be motivated by considerations other than these outcome parameters.

What this paper adds

Femoral derotation osteotomy (FDO) location does not influence mean stance hip rotation in cerebral palsy (CP).

FDO location does not influence mid‐point hip rotation in CP.

FDO location should be motivated by concomitant procedures performed.
Impact of treatment with pioglitazone on stroke outcomes: A real‐world database analysis
Authors: Morgan Christopher Ll , Inzucchi Silvio E. , Puelles Jorge , Jenkins‐Jones Sara , Currie Craig J.
Published: May 2018

Aims

Randomized controlled trials have reported an association between pioglitazone and reduced incidence of stroke in type 2 diabetic (T2DM) and insulin‐resistant populations. We investigated this association within a real‐world database.

Materials and methods

T2DM patients who initiated pioglitazone between 2000 and 2012 were extracted from the Clinical Practice Research Datalink (CPRD), a UK routine data source. Two non‐exposed control cohorts were matched according to age, gender, HbA1c, diabetes duration, stroke history, co‐morbidities and prior T2DM regimen. Control cohort‐1 comprised patients initiating a new T2DM therapy as their respective case initiated pioglitazone. Control cohort‐2 maintained the same T2DM regimen as their respective case prior to the case initiating pioglitazone. Primary outcome was incident stroke; other outcomes included mortality, length of hospital stay and stroke recurrence.

Results

A total of 4234 patients initiating pioglitazone were matched to controls in cohort‐1 and 3604 in cohort‐2. For the primary outcome there were significantly reduced hazard ratios (HRs) for cases: controls. For cohort 1, the HR was 0.666 (95% CI, 0.466‐0.952) during the therapy period and was 0.750 (0.612‐0.919) over the entire observation period; for cohort 2, respective HRs were 0.516 (0.336‐0.794) and 0.773 (0.611‐0.978). There was no significant difference in 30‐day mortality rate or rate of recurrent stroke. For stroke events that required hospitalization, there was a significant difference in length of stay for patients discharged to usual residence (median, 3.0 days vs 7.0 days; P = .008) for control cohort‐2 while undergoing treatment.

Conclusions

In support of evidence from 2 large randomized trials, these observational data show that pioglitazone has a potent effect in reducing stroke events in patients with type 2 diabetes.
Time trends and geographical variation in prescribing of drugs for diabetes in England from 1998 to 2017
Authors: Curtis Helen J. , Dennis John M. , Shields Beverley M. , Walker Alex J. , Bacon Seb , Hattersley Andrew T. , Jones Angus G. , Goldacre Ben
Published: May 2018

Aims

To measure the variation in prescribing of second‐line non‐insulin diabetes drugs.

Materials and Methods

We evaluated time trends for the period 1998 to 2016, using England's publicly available prescribing datasets, and stratified these by the order in which they were prescribed to patients using the Clinical Practice Research Datalink. We calculated the proportion of each class of diabetes drug as a percentage of the total per year. We evaluated geographical variation in prescribing using general practice‐level data for the latest 12 months (to August 2017), with aggregation to Clinical Commissioning Groups. We calculated percentiles and ranges, and plotted maps.

Results

Prescribing of therapy after metformin is changing rapidly. Dipeptidyl peptidase‐4 (DPP‐4) inhibitor use has increased markedly, with DPP‐4 inhibitors now the most common second‐line drug (43% prescriptions in 2016). The use of sodium‐glucose co‐transporter‐2 (SGLT‐2) inhibitors also increased rapidly (14% new second‐line, 27% new third‐line prescriptions in 2016). There was wide geographical variation in choice of therapies and average spend per patient. In contrast, metformin was consistently used as a first‐line treatment in accordance with guidelines.

Conclusions

In England there is extensive geographical variation in the prescribing of diabetes drugs after metformin, and increasing use of higher‐cost DPP‐4 inhibitors and SGLT‐2 inhibitors compared with low‐cost sulphonylureas. Our findings strongly support the case for comparative effectiveness trials of current diabetes drugs.
Remediation of sandy soil contaminated by heavy metals with Na2EDTA washing enhanced with organic reducing agents: element distribution and spectroscopic analysis
Authors: Wei M. , Chen J. , Wang Q.
Published: May 2018

Washing with Na2EDTA is insufficient to remove both cationic and anionic metal species in contaminated soil. Therefore, washing with Na2EDTA enhanced with organic reducing agents was tested as a means to improve the efficiency of removal of heavy metals and to investigate its effect on the spectroscopic characteristics of contaminated soil. The results indicated that washing with Na2EDTA enhanced with organic reducing agents was effective in removing both arsenic and cationic metals from contaminated soil at the initial pH of the mixed washing agents. The increase in removal efficiencies (compared with a single Na2EDTA washing) under this washing regime was 19–31% for arsenic, 6–19% for cadmium, 3–12% for copper and 6–21% for lead in two samples. The results of metal fractionation indicated that the addition of either oxalic or ascorbic acids could increase the relative proportion of the residual fraction to varying degrees. The spectroscopic analysis demonstrated that these acids were effective in removing metals by dissolving soil minerals, such as amorphous iron oxides, and reducing mineral oxides. The X‐ray photoelectron spectroscopy (XPS) study showed that more Fe(III) was transformed to Fe(II) under Na2EDTA washing enhanced with oxalic acid than with ascorbic acid, and the dissolution of silicon oxides was very limited in the presence of either of these acids. Washing with Na2EDTA enhanced by both oxalic and ascorbic acid of the sampled soils improved removal efficiencies; properties of the washing agent, the physicochemical properties of samples and the pollution characteristics (e.g. the amounts of contamination and metal fractions) combined to influence the effect of washing.

Highlights

Washing with Na2EDTA and oxalic or ascorbic acids was effective in extracting arsenic and cationic metals.

Oxalic acid was more effective than ascorbic acid in transforming Fe(III) to Fe(II).

Addition of organic reducing acids increased the relative proportion of the residual fraction of metals.

Metal removal was affected by dissolution of minerals such as scorodite, muscovite and feldspar.
Combined use of two defensive traits in pupae of Scymnus posticalis ladybirds
Authors: Mizuno Takafumi , Hayashi Masayuki , Akino Toshiharu
Published: May 2018

Coccinellid pupae have various defensive traits, such as keeping their final‐instar larval exuviae and secreting droplets containing defensive chemicals at the tips of glandular hairs. Although each of these traits has been described separately in different species, it is unclear how each defensive trait functions when more than one trait coexists. We found that pupae of the ladybird Scymnus posticalis have two different types of traits; they were partially covered with their own final‐instar larval exuviae, with thick wax structures, and had many glandular hairs secreting transparent droplets on the exposed parts of the body without waxy exuviae (head and medial parts of thoracic and abdominal dorsum). In this study, the defensive effects of these two traits were evaluated against two ant species, Tetramorium tsushimae and Lasius japonicus, which are potential predators. When encountering a pupa, neither ant species were able to make frequent physical contact with the exposed parts of the pupa because of the presence of the waxy exuviae. When touching the exposed body part that was covered with droplets, both ant species immediately stepped backward and then swept their antennae. The droplets suppressed ant feeding when mixed with sucrose solution, suggesting that the droplets contain repellent chemicals. These results indicate that the two traits of S. posticalis pupae (the larval waxy exuviae and the droplets) effectively play defensive roles against ants, functioning as a physical obstruction and a chemical repellent, respectively.
Subsocial spiders in space and time: A fine scale approach to the dynamics of dispersal
Authors: Aceves‐Aparicio Alfonso , Tapia‐McClung Horacio , Macías‐Ordóñez Rogelio , Rao Dinesh
Published: May 2018

Less than 0.2% of all spider species live in close associations with conspecifics. Among these, subsocial spiders show characteristics of both solitary spiders (e.g., individuals disperse for breeding) and social spiders (e.g., prolonged cooperative behaviours at least prior to independent reproduction). Dispersing individuals build small webs, usually with one inhabitant, whereas colonies are large webs with plant debris and harbouring multiple females. We studied the spatiotemporal dynamics of dispersal in the subsocial spider Anelosimus baeza. We followed the occupancy of all colonies and dispersal webs over the breeding season by mapping the number and sex of spiders with respect to their location in three dimensions. We studied the settlement patterns of new webs and fluctuation in web occupancy through movement between occupied and abandoned webs of colonies and dispersal webs. The occupancy of webs was highly dynamic with changes occurring at small time scales. The similarity in the patterns of web occupancy by females among dispersal webs was partially explained by their spatial and their temporal proximity. Our results suggest that dispersal webs may be used by spiders as a temporary refuge by both sexes during the breeding season. Patterns described here suggest new approaches to dispersal studies in group living spiders.
Evaluating the potential for prezygotic isolation and hybridization between landlocked and anadromous alewife (Alosa pseudoharengus) following secondary contact
Authors: Littrell Katherine A. , Ellis David , Gephard Stephen R. , MacDonald Andrew D. , Palkovacs Eric P. , Scranton Katherine , Post David M.
Published: May 2018

The recent increase in river restoration projects is altering habitat connectivity for many aquatic species, increasing the chance that previously isolated populations will come into secondary contact. Anadromous and landlocked alewife (Alosa pseudoharengus) are currently undergoing secondary contact as a result of a fishway installation at Rogers Lake in Old Lyme, Connecticut. To determine the degree of prezygotic isolation and potential for hybridization between alewife life history forms, we constructed spawning time distributions for two anadromous and three landlocked alewife populations using otolith‐derived age estimates. In addition, we analyzed long‐term data from anadromous alewife migratory spawning runs to look for trends in arrival date and spawning time. Our results indicated that anadromous alewife spawned earlier and over a shorter duration than landlocked alewife, but 3%–13% of landlocked alewife spawning overlapped with the anadromous alewife spawning period. The degree of spawning time overlap was primarily driven by annual and population‐level variation in the timing of spawning by landlocked alewife, whereas the timing and duration of spawning for anadromous alewife were found to be relatively invariant among years in our study system. For alewife and many other anadromous fish species, the increase in fish passage river restoration projects in the coming decades will re‐establish habitat connectivity and may bring isolated populations into contact. Hybridization between life history forms may occur when prezygotic isolating mechanisms are minimal, leading to potentially rapid ecological and evolutionary changes in restored habitats.
Topical application of quercetin improves wound healing in pressure ulcer lesions
Authors: Yin Guimei , Wang Zhijing , Wang Zhaoxia , Wang Xirui
Published: May 2018

The ischaemia‐reperfusion (I/R)–induced skin lesion has been identified as primary cause of pressure ulcers. To date, attempts to prevent pressure ulcers have not produced a significant improvement. Quercetin, one of the most widely distributed flavonoids in fruits and vegetables, exhibits its antioxidant and anti‐inflammatory properties against many diseases, including ischaemic heart disease, atherosclerosis and renal injury. In vitro wound scratch assay was first used to assess the function of quercetin in wounding cell model. Next, animal pressure ulcers model was established with two cycles of I/R. The impact of quercetin in the wound recovery, immune cell infiltration and pro‐inflammatory cytokines production was investigated in this model. Mechanistic regulation of quercetin at the wound site was also studied. Quercetin accelerated wound closure in cell scratch assay. Dose‐response study suggested 1 μmol/L quercetin for in vivo study. In I/R injury model, quercetin treatment significantly accelerated wound closure, reduced immune cell infiltration and pro‐inflammatory cytokines production. Signalling study showed quercetin treatment inhibited MAPK but not NFĸB activation. Quercetin treatment improved the wound healing process in I/R lesions by suppressing MAPK pathway. Our results supported that quercetin could be a potential therapeutic agent for pressure ulcers.
Solar‐induced chlorophyll fluorescence is strongly correlated with terrestrial photosynthesis for a wide variety of biomes: First global analysis based on OCO‐2 and flux tower observations
Authors: Li Xing , Xiao Jingfeng , He Binbin , Altaf Arain M. , Beringer Jason , Desai Ankur R. , Emmel Carmen , Hollinger David Y. , Krasnova Alisa , Mammarella Ivan , Noe Steffen M. , Ortiz Penélope Serrano , Rey‐Sanchez A. Camilo , Rocha Adrian V. , Varlagin Andrej
Published: May 2018

Solar‐induced chlorophyll fluorescence (SIF) has been increasingly used as a proxy for terrestrial gross primary productivity (GPP). Previous work mainly evaluated the relationship between satellite‐observed SIF and gridded GPP products both based on coarse spatial resolutions. Finer resolution SIF (1.3 km × 2.25 km) measured from the Orbiting Carbon Observatory‐2 (OCO‐2) provides the first opportunity to examine the SIF–GPP relationship at the ecosystem scale using flux tower GPP data. However, it remains unclear how strong the relationship is for each biome and whether a robust, universal relationship exists across a variety of biomes. Here we conducted the first global analysis of the relationship between OCO‐2 SIF and tower GPP for a total of 64 flux sites across the globe encompassing eight major biomes. OCO‐2 SIF showed strong correlations with tower GPP at both midday and daily timescales, with the strongest relationship observed for daily SIF at the 757 nm (R2 = 0.72,p < 0.0001). Strong linear relationships between SIF and GPP were consistently found for all biomes (R2 = 0.57–0.79,p < 0.0001) except evergreen broadleaf forests (R2 = 0.16,p < 0.05) at the daily timescale. A higher slope was found for C4grasslands and croplands than for C3ecosystems. The generally consistent slope of the relationship among biomes suggests a nearly universal rather than biome‐specific SIF–GPP relationship, and this finding is an important distinction and simplification compared to previous results. SIF was mainly driven by absorbed photosynthetically active radiation and was also influenced by environmental stresses (temperature and water stresses) that determine photosynthetic light use efficiency. OCO‐2 SIF generally had a better performance for predicting GPP than satellite‐derived vegetation indices and a light use efficiency model. The universal SIF–GPP relationship can potentially lead to more accurate GPP estimates regionally or globally. Our findings revealed the remarkable ability of finer resolution SIF observations from OCO‐2 and other new or future missions (e.g., TROPOMI, FLEX) for estimating terrestrial photosynthesis across a wide variety of biomes and identified their potential and limitations for ecosystem functioning and carbon cycle studies.