bluuebunny/crossref_metadata_2025 huggingface dataset:
Airway management in microgravity: A systematic review
Authors: Warnecke Tobias , Tochtermann Felix , Kerkhoff Steffen , Komorowski Matthieu , Neuhaus Christopher , Hinkelbein Jochen
Published: September 2018

Introduction

In the near future, space programs will shift their focus toward long‐duration interplanetary missions, in particular to the Moon and Mars. These exploration missions will be associated with an increased risk of acute medical problems, which will need to be handled by an autonomous crew operating in extreme isolation. An important skill in emergencies is represented by airway management. Many airway devices are available and it is unclear which one would be the most suitable in the context of a space mission. The aim of this systematic review was to analyze the existing literature on airway management in the special situation of weightlessness during space missions.

Material and methods

We performed a standardized review of published literature on airway management in spaceflight and analogue environments using the database PubMed.

Results

We identified a total of 3111 publications of which 3039 were initially excluded after evaluation. The screening identified three randomized comparative manikin studies, two of them in parabolic flights, one in a submerged setup. Under free‐floating conditions, the insertion success rate of supraglottic airway devices (SGA) was excellent (91%‐97%). The administration of artificial ventilation could be successfully achieved in weightlessness with SGA. The success rate of conventional laryngoscopy under free‐floating conditions fluctuated between 15% and 86%.

Conclusion

It appears possible to safely manage the airway in weightlessness, provided that certain conditions are ensured, such as restraining the patient and operator for conventional orotracheal intubation. If airway protection is required with endotracheal intubation, both the operator and the patient should be restrained.
Iatrogenic cerebral gas embolism–A systematic review of case reports
Authors: Hatling Dyveke , Høgset Anne , Guttormsen Anne Berit , Müller Bernd
Published: September 2018

Background

Cerebral gas embolism is a complication of several medical procedures and occurs when gas enters the cerebral circulation. Knowledge about etiology and outcome in affected patients is limited, and prospective trials on management and treatment are hardly feasible. Case reports are therefore an important source of information.

Methods

A systematic literature search was conducted in June 2016 and May 2018, supplemented by a manual search. Titles and abstracts were systematically assessed for eligibility, followed by full‐text screening for included papers. Screening and data extraction were performed independently by two researchers. Cases of cerebral gas embolism due to any iatrogenic cause were included. Criteria for exclusion were: animal studies, non‐cerebral localization, extravascular gas only, and non‐iatrogenic causes. 264 cases reported in 189 papers were included.

Results

A broad range of procedures leading to iatrogenic cerebral gas embolism (ICGE) were identified and a comprehensive list is presented in this article. Procedures were mostly reported as conducted correctly, but procedure related error, patient activity, or defective equipment were also reported as causes. Neurological, neuropsychological, and cardiopulmonary symptoms were common. The diagnosis was frequently based on or confirmed by radiology, usually CT. Hyperbaric oxygen therapy was applied in a large number of cases.

Conclusion

The reported causes, symptoms and signs, and outcomes of ICGE vary significantly, and awareness of the condition in the medical community is essential. A standardized method of reporting could facilitate higher quality research in the field.
Pulmonary haemodynamics and right ventricular function in cemented vs uncemented total hip arthroplasty—A randomized trial
Authors: Segerstad Mathias Hård af , Olsen Fredrik , Patel Arun , Houltz Erik , Nellgård Bengt , Ricksten Sven‐Erik
Published: September 2018

Background

Bone cement implantation syndrome (BCIS) is a feared complication in orthopaedic surgery with a huge impact on post‐operative morbidity. In this randomized trial, we evaluated the effects of bone cement on pulmonary and systemic haemodynamics in patients receiving either cemented or uncemented hip arthroplasty for isolated femoral neck fracture.

Methods

Twenty‐two patients were randomized to receive either cemented (n = 10) or uncemented (n = 12) total hip arthroplasty. Surgery was performed under total intravenous anaesthesia in the lateral position. All patients were catheterized with radial‐ and pulmonary artery catheters, for continuous measurements of mean arterial pressure (MAP), pulmonary arterial pressure (PAP), cardiac output, right ventricular (RV) end‐diastolic volume (RVEDV) and RV ejection fraction (RVEF). Haemodynamic measurements and blood gas analyses were performed after induction of anaesthesia, during surgery before and immediately after bone cementation and prosthesis insertion, 10 and 20 minutes after insertion and during skin closure.

Results

Pulmonary vascular resistance index (PVRI) increased during and after prosthesis insertion by 45% and 20% in the cemented and uncemented group, respectively (P < 0.005). Systolic and mean PAP increased by 18% and 17% in the cemented group, which was not seen in the uncemented group (P < 0.001). There was a trend for a more pronounced fall in RVEF in the cemented group, while there were no differences in cardiac output or stroke volume between groups.

Conclusion

The use of bone cement in total hip arthroplasty increases pulmonary vascular resistance and the afterload of the RV with potentially negative effects on RV performance.
The association of positive orientation with health and psychosocial adaption
Authors: Tisak Marie S.
Published: September 2018

In this commentary, major contributions of the conceptualization of positive orientation as a measure of a personal disposition to optimistically evaluate oneself, one's past, and one's future experiences, promoting growth and commitment to life (Caprara, Alessandri, & Caprara, 2019), were presented. The evidence includes psychometric properties demonstrating a unidimensional trait, as well as reliability and validity of the measure that is substantiated across developmental ages and at least 15 different cultures. The evidence also implies that positive orientation may influence outcomes of not only individuals but also groups. Furthermore, the significance of positivity in research across vast domains of research attests to the validity of the measure, including social relationships, health issues, coping strategies, job satisfaction, and job performance, to name a few.
Anal incontinence after vaginal delivery or cesarean section
Authors: Schei Berit , Johannessen Hege Hølmo , Rydning Astrid , Sultan Abdul , Mørkved Siv
Published: September 2018

Introduction

Uncertainties remain as to whether a cesarean section is protective for the short‐term and long‐term development of anal incontinence. Our aim was to explore whether women who had delivered only vaginally were at greater risk of anal incontinence than nulliparous women and women who had undergone cesarean sections only.

Material and methods

Background information, medical history, and data on anal incontinence (defined as fecal or flatus incontinence weekly or more) reported by women participating in a large population‐based health survey in Norway (the Nord‐Trøndelag Health Study 3) during the period October 2006 to June 2008 were collected and linked to data from the Medical Birth Registry of Norway. The prevalence of anal incontinence was calculated and multivariate logistic regression analyses were applied.

Results

The mean age of the 12 567 women was 49.9 years. The age and educational level of women who had cesarean sections only were similar to those who had a vaginal delivery and obstetric anal sphincter injuries (OASIS). Nulliparous women and those who had a vaginal delivery and no OASIS were older and had higher educational achievements than women who had delivered by cesarean section exclusively, and women with OASIS. One in four women with OASIS reported anal incontinence compared with one in six of the other women (P < .001). Age, educational level, diarrhea, constipation, birthweight, and OASIS increased the risk of anal incontinence in all women. Parity was associated with anal incontinence in parous women only. No differences were found for fecal urgency.

Conclusions

Women with vaginal deliveries complicated by OASIS are at increased risk of anal incontinence. However, no increased risk of anal incontinence was found in nulliparous women or women who had cesarean sections only or vaginal deliveries not complicated by OASIS.
Choroidal blood flow after the first intravitreal ranibizumab injection in neovascular age‐related macular degeneration patients
Authors: Mottet Benjamin , Aptel Florent , Geiser Martial Henri , Hera Ruxandra , Zhou Thierry , Almanjoumi Ahmed , Vinh Viviane , Chiquet Christophe
Published: September 2018

Purpose

To analyse choroidal blood flow (ChBF) changes after the first intravitreal ranibizumab injection in naïve, age‐related macular degeneration (ARMD) patients.

Methods

Subfoveal ChBF was assessed by laser Doppler flowmetry (LDF) in newly diagnosed ARMD patients. Both treated and untreated eyes were assessed in each subject at each visit before the first intravitreal ranibizumab injection as well as 24 hr (day 1) and 7 days after (day 7). Central macular thickness (CMT), best‐corrected visual acuity (BVCA), systemic haemodynamic parameters and LDF parameters were evaluated at each visit. Nonparametric tests were used to compare data between visits and between treated and untreated eyes.

Results

Seventeen ARMD patients were included (12 women and five men, 78 ± 8 years old). At day 7 postintravitreal ranibizumab injection, the normalized choroidal blood velocity (ChBVel) change in the treated eye group was significant (−10.2%; p = 0.006). The choroidal blood volume (ChBVol) did not change significantly after intravitreal injection of ranibizumab. There was a trend for a reduction in ChBF at day 7 (−9.1%, p = 0.08). The sensitivity of the experiment was 12% for ChBVel, 16% for ChBVol and 9% for ChBF.

Conclusion

In conclusion, the laser Doppler technique provides feasible and noninvasive measurements of blood flow parameters before and after intravitreal injection of antivascular endothelial growth factor (anti‐VEGF) in patients with exudative ARMD. Choroidal blood velocity decreased as early as 7 days after intravitreal ranibizumab injection, suggesting a vasoconstriction effect of anti‐VEGF in large choroidal vessels in front of choriocapillaris (the site of LDF measurement).
Comparison of corneal biomechanical changes after refractive surgery by noncontact tonometry: small‐incision lenticule extraction versus flap‐based refractive surgery – a systematic review
Authors: Rævdal Pernille , Grauslund Jakob , Vestergaard Anders Højslet
Published: September 2018

Corneal refractive surgery disrupts corneal integrity and reduces biomechanical stability in consequence of the beneficial refractive alteration. The minimal invasive cap‐based refractive procedure, small‐incision lenticule extraction (SMILE), has been proposed to affect corneal integrity less than flap‐based procedures, due to the fibre‐sparing incision of the strong anterior corneal lamellae. Flap‐based procedures include laser‐assisted in situ keratomileusis (LASIK), femtosecond laser‐assisted in situ keratomileusis (FS‐LASIK) and femtosecond lenticule extraction (FLEx). The purpose of this systematic review was to evaluate corneal biomechanical changes by noncontact air pulse tonometry after treatment of myopia/myopic astigmatism with SMILE compared to flap‐based refractive surgery. A total of 220 publications were identified through a systematic search in PubMed and Embase. Two levels of screening identified nine studies (three randomised controlled trials (RCT) and six nonrandomised clinical trials) eligible for the review. All the nonrandomised clinical trials were graded to have an overall serious risk of bias. Measurements with the Corvis ST were not included in any of the eligible studies. The RCTs found no statistical significant differences between SMILE or flap‐based procedures concerning corneal hysteresis (CH) or corneal resistance factor (CRF), as measured with the Ocular Response Analyzer. However, a greater reduction in CRF and CH was found in the flap‐based group in five and two of the nonrandomised studies, respectively. The findings in this review illustrate that the presumed biomechanical advantages of a cap‐based small incision could not be demonstrated in existing studies and by commercially available technology. However, studies with lower levels of evidence suggest less affection of corneal viscoelastic properties after SMILE when evaluating corneal stability by noncontact tonometry.
Dorsal hypothalamic dopaminergic neurons play an inhibitory role in the hypothalamic‐pituitary‐adrenal axis via activation of D2R in mice
Authors: Di Tingting , Chen Peipei , Yuan Zihao , Wang Ya , Sha Sha , Chen Ling
Published: September 2018

Aim

The present study investigated the effects of dorsal hypothalamic dopamine (dh‐DA) neurons on activation of hypothalamic‐pituitary‐adrenal (HPA) axis in adult male mice.

Methods

Tyrosine hydroxylase‐labelled DA neurons, DA content, c‐Fos immune‐positive (c‐Fos+) cells and CRH expression in paraventricular nuclei (PVN), serum CORT and ACTH were examined at 4‐, 8‐, and 12‐hour after a signal injection of MPTP (20 mg kg−1) respectively.

Results

The dh‐DA neurons and DA content in PVN at 4‐hour post‐MPTP were reduced with recovery at 12‐hour post‐MPTP, while decline of nigrostriatal DA neurons and DA content in striatum started from 12‐hour post‐MPTP. Number of c‐Fos+ cells, and CORT/ACTH levels increased at 4‐hour post‐MPTP, followed by recovery at 12‐hour post‐MPTP. The CRH mRNA was elevated at 4‐hour post‐MPTP, and sustained for over 12 hours. At 2‐hour post‐MPTP, PVN‐injection of D2R agonist quinpirole corrected the increases in c‐Fos+ cells, CORT/ACTH and CRH mRNA, but D1R agonist SKF38393 did not. PVN‐injection of D2R antagonist L‐sulpiride alone caused increases in c‐Fos+ cells, CORT/ACTH and CRH mRNA. Similarly, PVN‐injection of CB1R agonist WIN552,12 prevented the increases in c‐Fos+ cells and CORT/ACTH rather than CRH mRNA, which were blocked by CB1R antagonist AM251. Levels of PKA and CREB phosphorylation in PVN were increased at 4‐hour post‐MPTP, which were blocked by quinpirole, but not WIN552,12. PKA inhibitor H89 corrected the increase of CRH mRNA at 8‐hour post‐MPTP.

Conclusion

The activation of dh‐DA neurons regulates negatively HPA axis through targeting D2Rs of CRH neurons to enhance endocannabinoid release and inhibit PKA‐CREB pathway.
Power and Sample Size for Dose-Finding Studies with Survival Endpoints Under Model Uncertainty
Authors: Deng Qiqi , Bai Xiaofei , Liu Dacheng , Roy Dooti , Ying Zhiliang , Lin Dan-Yu
Published: September 2018

Multiple comparison procedures combined with modeling techniques (MCP-Mod) (Bretz et al., 2005) is an efficient and robust statistical methodology for the model-based design and analysis of dose-finding studies with an unknown dose–response model. With this approach, multiple comparison methods are used to identify statistically significant contrasts corresponding to a set of candidate dose–response models, and the best model is then used to estimate the target dose. Power and sample size calculations for this methodology require knowledge of the covariance matrix for the estimators of the (placebo-adjusted) mean responses among the dose groups. In this article, we consider survival endpoints and derive an analytic form of the covariance matrix for the estimators of the log hazard ratios as a function of the total number of events in the study. We then use this closed-form expression of the covariance matrix to derive the power and sample size formulas. We discuss practical considerations in the application of these formulas. In addition, we provide an illustration with a motivating example on chronic obstructive pulmonary disease. Finally, we demonstrate through simulation studies that the proposed formulas are accurate enough for practical use.
A professional development model to facilitate teacher adoption of interactive, immersive digital games for classroom learning
Authors: Stieler‐Hunt Colleen , Jones Christian
Published: September 2018

The benefits of using digital games in the curriculum are well documented in literature. Most teachers who use digital games use short‐form drill‐and‐practice learning games rather than the kinds of games most students would choose to play in their free time. The use of more interactive, immersive digital games (IDGs) in classrooms tends to be sporadic, dependent upon the enthusiasm and ingenuity of individual teachers. Previous studies have indicated that many teachers have concerns about using digital games in classrooms and have difficulties knowing how to best use digital games. This qualitative study presents a professional development model for teachers that was inductively derived through analysing in‐depth, semi‐structured interviews with 13 educators who have used digital games in the classroom. Implementing this model can help teachers develop attitudes and skills necessary to meaningfully use interactive, IDGs in their classrooms. Evidence suggests that a mentor should have a strong understanding of how to use digital games effectively in classrooms, work with small cohorts of teachers to collegially plan the use of digital games within a unit of class work, trial the unit of work with a small number of enthusiastic teachers, and then implement it with the remaining teachers. This approach is based on interviews with educators who have successfully mentored teachers in their schools to use interactive, IDGs in their classrooms. These educators encountered little resistance from their teaching colleagues. Their approach further supported teachers who were open to the possibilities of using digital games in their classrooms.
Gamifying programming education in K‐12: A review of programming curricula in seven countries and programming games
Authors: Lindberg Renny S. N. , Laine Teemu H. , Haaranen Lassi
Published: September 2018

An increasing number of countries have recently included programming education in their curricula. Similarly, utilizing programming concepts in gameplay has become popular in the videogame industry. Although many games have been developed for learning to program, their variety and their correspondence to national curricula remain an uncharted territory. Consequently, this paper has three objectives. Firstly, an investigation on the guidelines on programming education in K‐12 in seven countries was performed by collecting curricula and other relevant data official from governmental and non‐profit educational websites. Secondly, a review of existing acquirable games that utilize programming topics in their gameplay was conducted by searching popular game stores. Lastly, we compared the curricula and made suggestions as to which age group the identified games would be suitable. The results of this study can be useful to educators and curriculum designers who wish to gamify programming education.
The influence of extramural access to mainstream culture social media on ethnic minority students’ motivation for language learning
Authors: Lai Chun
Published: September 2018

The educational potentials of social media both in the formal and informal learning contexts have been widely acknowledged. However, how social media use in the informal contexts might influence students’ learning in the formal contexts is still underexplored. Path analysis of 141 survey responses from secondary school ethnic minority students in Hong Kong revealed that voluntary access to Chinese social media in daily life influenced these students’ ideal L2 self and motivated efforts in learning Chinese both directly and indirectly via bicultural integration identity and bicultural competence. The findings confirmed that social media practices in the informal contexts may influence students’ motivated efforts in learning in the formal contexts. The study suggests promoting ethnic minorities’ extramural use of mainstream culture social media to influence their acculturation into the dominant culture and motivation in learning the dominant culture’s language. It further highlights the importance of equipping ethnic minority students with the necessary socio‐cultural and communication skills to facilitate positive intercultural engagement on these sites so as to safeguard the positive influences of informal social media use on students’ motivation for learning.
Clinical value of automated fibrin generation markers in patients with septic shock: a SepsiCoag ancillary study
Authors: Gris Jean‐Christophe , Cochery‐Nouvellon Eva , Bouvier Sylvie , Jaber Samir , Albanese Jacques , Constantin Jean‐Michel , Orban Jean‐Christophe , Morel Jérôme , Leone Marc , Deras Pauline , Elotmani Loubna , Lavigne‐Lissalde Géraldine , Lefrant Jean‐Yves
Published: September 2018

An ancillary analysis to the SepsiCoag multicentric prospective observational study on patients entering an intensive care unit with septic shock evaluated the prognostic potential of fibrin generation markers (FGMs) tested at inclusion in the study, on survival at day 30. After centralization of samples, three automated FGMs were compared: D‐dimers (DDi), fibrin/fibrinogen degradation products (FDP) and fibrin monomers (FM). FM was the single FGM that was significantly higher in non‐surviving patients, area under the receiver‐operator characteristic curve (AUCROC): 0·617, P < 0·0001. Significantly higher International Society on Thrombosis and Haemostasis Disseminated Intravascular Coagulation (ISTH DIC) scores were calculated in non‐survivors using each of the three FGMs. A dose‐effect relationship was observed between ISTH DIC scores and non‐survival, with highest significance obtained using FM as the FGM. An overt DIC diagnosis using the ISTH DIC score calculated using FM was a predictor of non‐survival at day 30, independently from overt DIC diagnosis based on scores calculated using FDP or DDi. The AUCROC values testing the ability of the ISTH DIC score to predict non‐survival were 0·650, 0·624 and 0·602 using FM, DDi and FDP, respectively, as the FGM. In patients with septic shock, among the commercially‐available automated assays, automated FM is the FGM best related with late prognosis.
Relevance of low specific IgE levels to egg, milk and peanut in infancy
Authors: Nilsson Sara Fagerstedt , Lilja Gunnar , Järnbert‐Pettersson Hans , Alm Johan
Published: September 2018

Background

IgE sensitization is usually associated with allergy‐related diseases, but may also occur in asymptomatic individuals. The clinical importance of IgE antibody concentrations in the interval 0.1‐0.34 kU/L in early life in relation to allergy development is poorly evaluated.

Objective

To assess the relevance of low specific IgE (s‐IgE) to hen’s egg, cow’s milk and peanut at 6 months of age for development of sensitization and allergy‐related disease during early childhood.

Methods

s‐IgE concentrations to relevant allergens from blood samples taken at 6 months and 1, 2 and 5 years from children in the prospective ALADDIN cohort were divided into three categories: non‐sensitized (<0.1 kU/L), low sensitized (0.1‐0.34 kU/L) and sensitized (≥0.35 kU/L) and allergy‐related disease assessed.

Results

A total of 372 children were included in this study. Compared with non‐sensitized children at 6 months of age, children with low levels of allergen specific IgE (0.1‐0.34 kU/L) to food allergens, especially to egg, at 6 months of age were associated with development of sensitization to aeroallergens at 5 years of age (10/14 [71%] vs 39/250 [15%]). In addition, children with low levels to egg or milk at 6 months were more often sensitized to the respective allergen at 1 year of age and, regarding low levels to egg, also to the development of eczema (6/18 [33%] vs 29/292 [10%]).

Conclusion & Clinical Relevance

IgE antibody concentrations in the interval 0.1‐0.34 kU/L to food allergens in infancy seem to increase the probability of sensitization to aeroallergens and, regarding low levels to egg, also of eczema during early childhood. Thus, IgE levels during the first year of life, although below 0.35 kU/L, can provide additional allergy‐related prognostic information.
Association of dyslipidaemia and oral statin use, and dry eye disease symptoms in the Blue Mountains Eye Study
Authors: Ooi Kenneth G.‐J. , Lee Ming‐Han H. , Burlutsky George , Gopinath Bamini , Mitchell Paul , Watson Stephanie
Published: September 2018

Importance

There is limited literature on oral statin use and its association with dry eye.

Background

To analyse the association between dyslipidaemia, use of oral statin drugs, and symptoms of dry eye disease (DED) among older adults.

Design

Population‐based study.

Participants

Participants of the Blue Mountains Eye Study III (BMESIII), a large cohort study in suburban Sydney, aged 60 years or older (mean age = 74, range = 60–97, n = 1680) were analysed.

Methods

Information on DED symptoms and statin use were obtained from an interviewer‐administered questionnaire. Serum lipid profiles were determined from fasting blood tests.

Main Outcome Measures

The association of various DED symptoms, as well as their number and their severity, with dyslipidaemia and oral statin intake was evaluated.

Results

At least one DED symptom was reported in 52% (n = 1029) of the population. Patients with hypercholesterolaemia (>5.5 mmol/L) did not report more DED symptoms than those without hypercholesterolaemia. Neither serum high‐density lipoprotein nor low‐density lipoprotein levels were associated with any DED symptoms. Patients taking oral statins were more likely to report one or more moderate to severe symptoms of DED (odds ratio: 2.054, 95% confidence interval: 1.281–3.295).

Conclusions and Relevance

The association between oral statin use and presence of moderate to severe DED symptomatology is a novel finding that deserves further mechanistic and clinical correlation in order to determine its potential, or lack thereof, for the management of dry eye.
Distinguishing histopathologic features of acantholytic dermatoses and the pattern of acantholytic hypergranulosis
Authors: See Sharlene Helene C. , Peternel Sandra , Adams Derrick , North Jeffrey P.
Published: September 2018

Background

Acantholysis can be seen in multiple skin diseases. Adnexal acantholysis has been regarded as a feature distinguishing pemphigus vulgaris (PV) from acantholytic conditions.

Methods

A retrospective review of the histopathologic features of diseases with acantholysis including PV, pemphigus foliaceus (PF), Hailey‐Hailey disease (HHD), Darier disease (DD), Grover disease, and pityriasis rubra pilaris (PRP) was performed.

Results

Biopsies of PV (n = 49), HHD (n = 27), DD (n = 25), Grover disease (n = 65), and PRP (n = 33) showed suprabasilar acantholysis. Acantholysis was limited to the lower epidermis in PV and PRP, and involved all epidermal layers in HHD, DD, and Grover disease. Acantholysis in PF (n = 38) mainly involved the upper epidermis. Follicular acantholysis occurred more frequently in PV and PF (P < 0.0001). Eccrine acantholysis was found in PV (42%), HHD (18%), PF (13%), and DD (4%). Grover disease, DD, and HHD had greater dyskeratosis (P < 0.0001). Neutrophils were more common in PV, PF, and HHD, while eosinophils were more common in Grover disease and DD. A pattern termed acantholytic hypergranulosis occurred predominantly in PF.

Conclusion

Adnexal acantholysis does not reliably distinguish PV from PF. The level of acantholysis, degree of dyskeratosis, and acantholytic hypergranulosis are distinguishing features between the two types of pemphigus and other acantholytic disorders.
Rheological properties of sickle erythrocytes in patients with sickle‐cell anemia: The effect of hydroxyurea, fetal hemoglobin, and α‐thalassemia
Authors: Ballas Samir K. , Connes Philippe ,   the Investigators of the Multicenter Study of Hydroxyurea in Sickle Cell Anemia
Published: September 2018

Objective

Determine the effect of fetal hemoglobin (HbF) and α‐thalassemia on red blood cell (RBC) deformability of patients with sickle‐cell anemia (SCA) with and without hydroxyurea (HU).

Methods

Adult patients were enrolled in the Sickle Cell Program of the Cardeza Foundation (Thomas Jefferson University) and were followed up prospectively during the period in which the Multicenter Study of Hydroxyurea (MSH) in patients with SCA was conducted. Ninety‐one patients did not receive HU, 20 patients were enrolled in MSH, and 10 patients were enrolled in an open‐label study of HU in SCA. Of the 20 patients enrolled in MSH, 11 took HU and nine took placebo. Control group included 113 normal individuals. Red blood cell deformability index (DI) was measured by ektacytometry.

Results

Patients with SCA taking HU (n = 21) had higher DI than those taking placebo (n = 9) or who were not taking this therapy (n = 91). In patients without therapy, those with α‐thalassemia (n = 31) had higher DI than those without. We showed a significant positive correlation between the level of HbF and DI. SCA patients without α‐thalassemia and HbF <10% (n = 48) had lower DI than patients with α‐thalassemia and HbF <10% (n = 23) and patients with (n = 8) or without α‐thalassemia but with HbF >10% (n = 12). DI measured in patients without α‐thalassemia and HbF >10% was higher than in the three other subgroups.

Conclusion

Elevated levels of HbF with or without HU and α‐thalassemia improve sickle RBC rheology, which, in turn, improve the clinical picture of SCA.
Evolutionarily stable communities: a framework for understanding the role of trait evolution in the maintenance of diversity
Authors: Edwards Kyle F. , Kremer Colin T. , Miller Elizabeth T. , Osmond Matthew M. , Litchman Elena , Klausmeier Christopher A.
Published: September 2018

Biological diversity depends on the interplay between evolutionary diversification and ecological mechanisms allowing species to coexist. Current research increasingly integrates ecology and evolution over a range of timescales, but our common conceptual framework for understanding species coexistence requires better incorporation of evolutionary processes. Here, we focus on the idea ofevolutionarily stable communities(ESCs), which are theoretical endpoints of evolution in a community context. We useESCs as a unifying framework to highlight some important but under‐appreciated theoretical results, and we review empirical research relevant to these theoretical predictions. We explain how, in addition to generating diversity, evolution can also limit diversity by reducing the effectiveness of coexistence mechanisms. The coevolving traits of competing species may either diverge or converge, depending on whether the number of species in the community is low (undersaturated) or high (oversaturated) relative to theESC. Competition in oversaturated communities can lead to extinction or neutrally coexisting, ecologically equivalent species. It is critical to consider trait evolution when investigating fundamental ecological questions like the strength of different coexistence mechanisms, the feasibility of ecologically equivalent species, and the interpretation of different patterns of trait dispersion.
Male mate choice in the chameleon grasshopper (Kosciuscola tristis)
Authors: Muschett Giselle , Umbers Kate D. L. , Herberstein Marie E.
Published: September 2018

In many species, males can increase their fitness by mating with the highest quality females. Female quality can be indicated by cues, such as body size, age and mating status. In the alpine grasshopper Kosciuscola tristis, males can be found riding on subadult females early in the season, and as the season progresses, males engage in fights over ovipositing females. These observations suggest that males may be competing for females that are either unmated (early season) or sperm‐depleted (late season). We thus hypothesised that male K. tristis may be choosy in relation to female mating status, and specifically, we predicted that males prefer females that are unmated. We conducted behavioural experiments in which males were given the choice of two females, one mated and one unmated. Contrary to our prediction, males did not mate preferentially with unmated females. However, copulation duration with unmated females was, on average, 24 times the length of copulation with mated females. While female K. tristis can reject mates, we did not observe any evidence of overt female choice during our trials. Females may gain additional benefits from mating multiply and may therefore not readily reject males. While our experiment cannot definitively disentangle female from male control over copulation duration, we suggest that males choose to invest more time in copula with unmated females, perhaps for paternity assurance, and that male mate assessment occurs during copulation rather than beforehand.
Efficacy of inhaled budesonide for the treatment of severe equine asthma
Authors: Lavoie J. P. , Leclere M. , Rodrigues N. , Lemos K. R. , Bourzac C. , Lefebvre‐Lavoie J. , Beauchamp G. , Albrecht B.
Published: September 2018

Background

Corticosteroids are the most potent drugs for the control of severe equine asthma, but adverse effects limit their chronic systemic administration. Inhaled medications allow for drug delivery directly into the airways, reducing the harmful effects of these drugs.

Objectives

To evaluate the efficacy of inhaled budesonide specifically formulated for the equine use and administered by a novel inhalation device in horses with severe asthma.

Study design

Experimental studies in horses with naturally occurring asthma with cross‐over, randomised, blinded experimental designs.

Methods

In Study 1, budesonide (1800 μg twice daily) administered using a novel Respimat®based inhaler was compared to i.v. dexamethasone (0.04 mg/kg). In Study 2, 3 doses of budesonide (450, 900, and 1800 μg) were compared to oral dexamethasone (0.066 mg/kg). Lung function, bronchoalveolar fluid cytology (Study 1),CBC, serum chemistry, and serum cortisol and adrenocorticotropic hormone (ACTH) values were evaluated.

Results

In Study 1, there was a marked and significant improvement in the lung function of all horses treated with budesonide and dexamethasone. Neutrophil percentages in bronchoalveolar fluid decreased in all horses treated with dexamethasone and in four of six horses treated with budesonide. Serum cortisol and bloodACTHconcentrations decreased with both treatments. In Study 2, there was a significant improvement in the lung function with all dosages of budesonide, and the effects of higher dosages were comparable to those of dexamethasone. Dexamethasone and budesonide at the two higher dosages induced a significant decrease of cortisol concentrations.

Main limitations

The Respimat®based inhaler is not currently commercially available.

Conclusions

Administration of budesonide with the Respimat®based inhaler provided dose‐dependent relief of airway obstruction in horses with severe asthma, but also a suppression of serum cortisol.
Assessment of methane and carbon dioxide emissions in two sub‐basins of a small acidic bog lake artificially divided 30 years ago
Authors: Sepulveda‐Jauregui Armando , Martinez‐Cruz Karla , Lau Maximilian , Casper Peter
Published: September 2018

Although lakes are important sources of methane (CH4) and carbon dioxide (CO2) to the atmosphere contributing to global warming, their CH4 and CO2 emissions are rarely assessed. In particular, increasing inputs of terrestrial dissolved organic carbon (DOC) may affect gas dynamics and alter seasonal changes in gas production.

Here, we analysed variations in CH4 and CO2 dynamics in sub‐basins of an acidic bog lake, which was artificially divided into four quarters three decades ago, leading to divergence in water chemistry and biology. In the divided lake, only the south‐west basin (SW) received DOC inputs from an adjacent peat bog, while the north‐east basin (NE) was hydrologically disconnected. A year‐long determination of CH4 and CO2 production and emission patterns in the two contrasting basins exposed the indirect mechanisms by which DOC supply exercised control on greenhouse gas dynamics in this shallow lake.

In both basins, dissolved CH4 was negatively correlated with dissolved oxygen (O2) through the water column, suggesting that aerobic methanotrophy is an important regulator of CH4 emissions in this lake. In contrast, the amount of CO2 stored in oxic and anoxic layers was not significantly different between the basins, suggesting that O2 is not the most important driver of dissolved CO2.

Estimated total CH4 and CO2 emissions were 2.1 and 1.7 times lower in the NE basin than in the SW basin, with major CH4 and CO2 emissions occurring during the fall turnover. The differences in CH4 and CO2 emissions suggest that the hydro‐physical properties, namely seasonal temperature, the duration of stratification and O2 availability, are the main drivers of CH4 and CO2 emissions to the atmosphere from small shallow lakes under the influence of DOC inputs under global warming pressure.
Changes in macro‐ and micromineral concentrations in herbage during the harvesting and conservation processes
Authors: Schlegel Patrick , Wyss Ueli , Arrigo Yves , Hess Hans Dieter
Published: September 2018

The changes in macromineral (Ca, P, Mg, K, Na, Cl and S) and micromineral (Cu, Fe, Mn, Zn, Co and Se) concentrations in herbage were followed during the harvesting and conservation processes of barn‐ and field‐dried hay and silage. In total, 131 herbage samples originating from 50 harvests were collected in fresh form before mowing, in wilted form at harvest and in conserved form after storage. During the harvesting process, initial Ca, Mg and Zn concentrations in herbage decreased by 7–17% for barn‐dried hay, and initial Ca concentration decreased by 7% in herbage for silage (explained by losses of mineral‐rich and fragile plants or plant parts during the mechanical treatments). During the conservation process, mineral concentrations remained stable in barn‐dried hay, but macro‐ and micromineral concentrations increased on average by 6% and 31%, respectively, in silage (explained by loss of fermentable nutrients). Overall, in conserved hay (field‐ and barn‐dried hay), concentrations were decreased as follows: Ca 25%, Mg 15%, Cu 9% and Zn 12%; and in silage, concentrations increased as follows: Mg 12%, Na 33%, Mn 65%, Zn 13% and Se 27%, relative to the initial fresh form. During the harvesting process, ash, Fe and Co concentrations increased by factors of 0.29, 7.6 and 8.8 in wilted herbage for silage. Iron and Co concentrations in wilted and conserved herbage were linearly correlated with increasing ash concentration from a breakpoint of 100 g/kg dry matter, indicative of increasing soil contamination.
Forage sorghum quantity and quality as affected by biological phosphorous fertilization
Authors: Ehteshami Seyed MohammadReza , Khavazi Kazem , Asgharzadeh Ahmad
Published: September 2018

To investigate the effects of seed inoculation with phosphate affecting microorganisms on the quantitative and qualitative traits of two forage sorghum (Sorghum bicolor (L.)), genotypes were investigated during 2011 and 2012 field experiments. The experimental treatments consisted of chemical (triple super phosphate (TP)), and biological P fertilizers [mycorrhizal fungus (Rhizophagus intraradices) (AM) + Pseudomonas fluorescens strain 93 (PB)] as well as sorghum genotypes (Speedfed and Jumbo) factorially arranged on the basis of a randomized complete block design with three replications. The results revealed that seed inoculation by AM fungi and its combined inoculation with PB significantly influenced sorghum growth, P concentration and acid detergent fibre (ADF%). Rhizophagus intraradices appeared to be better adapted for association with sorghum than P. fluorescens strain 93 under the environmental conditions of the experiment. The significant differences in the quantity and quality of the two genotypes as affected by chemical and biological fertilization indicate the importance of selecting the right genotype, which results in higher growth and yields with a better forage quality. Although in most cases, the biological fertilization was the more recommendable, the use of chemical P fertilization up to some level was essential for the production of sorghum forage yield affecting crop quality. It is more beneficial to use the integrated beneficial microorganisms (AM + PB) instead of their single use to achieve better crop growth, yield and nutrient status for both plant and soil health.
NBA sweet spots: Distance‐based impacts on establishment‐level sales
Authors: Stitzel Brandli , Rogers Cynthia L.
Published: September 2018

This paper examines distance‐based effects of the introduction of a National Basketball Association (NBA) team on establishment‐level sales. Using a unique micro dataset with precise geographic location information and industry detail, we apply spatio‐temporal estimation strategies following Harger et al. and Ahlfeldt and Kavetsos. We build on the literature by focusing on sales activity, a broad measure of economic activity, for industries related to the NBA‐product. Our application considers the relocation of the NBA’s Seattle franchise (Supersonics) to Oklahoma City (Thunder). The results reveal spatially differentiated impacts that would be obscured using data aggregated over space or industry. Specifically, food establishments exhibit increased sales and entertainment establishments exhibit decreased sales relative to establishments in the outer most ring of the study area.
Other Helicobacters and the gastric microbiome
Authors: Kupcinskas Juozas , Hold Georgina L.
Published: September 2018

The current article is a review of the most important, accessible, and relevant literature published between April 2017 and March 2018 on other Helicobacters and the gastric microbiome. The first part of the review focuses on literature describing non‐Helicobacter pylori‐Helicobacter (NHPH) infections in humans and animals whilst the subsequent section focuses specifically on the human gastric microbiome. Novel diagnostic methods as well as new NHPHs species have been identified in recent studies. Furthermore, our knowledge about the pathogenesis of NHPH infections has been further enhanced by important fundamental studies in cell lines and animal models. Over the last year, additional insights over the prevalence and potential prevention strategies of NHPHs have also been reported. With regard to understanding the gastric microbiome, new information detailing the structure of the gastric microbiota at different stages of H. pylori infection, within different patient geographical locations, was documented. There was also a study detailing the impact of proton‐pump inhibitor usage and the effect on the gastric microbiome. Newer analysis approaches including defining the active microbiome through analysis of RNA rather than DNA‐based sequencing were also published allowing the first assessments of the functional capabilities of the gastric microbiome.
External quality assessment of p210 BCR‐ABL1 transcript quantification by RT‐qPCR: Findings and recommendations
Authors: Fu Yu , Zhang Rui , Wu Qisheng , Zhang Jiawei , Bao Lihua , Li Jinming
Published: September 2018

Introduction

External quality assessment (EQA) is an essential tool for quality assurance of analytical testing processes of p210 BCR‐ABL1 transcripts by RT‐qPCR. As an EQA provider, the National Center for Clinical Laboratories organized an EQA scheme of p210 BCR‐ABL1 testing in China for the first time to identify existing problems and ensure the reliability of p210 BCR‐ABL1 testing.

Methods

Using armored RNA technology, we first constructed pACYC‐MS2‐p210 and CG recombinant plasmids and expressed p210 and CG armored RNAs, with packaging segments of p210 BCR‐ABL1 fusion gene (FG) and four common control gene (CG) transcripts. Using these armored RNAs, we prepared lyophilized p210 quality control (QC) sample panels and evaluated detection performance of participating laboratories in China.

Results

Of the 66 participating laboratories, great variation was found with coefficient of variation (CV%) of raw p210 BCR‐ABL1 results basically ranging from 60.0% to 100.0%. In 24 International Scale (IS) laboratories, the CV% of results decreased from 82.4% to 61.6%, and the percentage of laboratories within 2‐, 3‐, and 5‐fold of the median values increased from 78.2%, 87.0%, and 92.1% to 80.1%, 89.4%, and 97.2%, respectively, after conversion with a laboratory‐specific conversion factor (CF); however, poorly converted results were also observed in laboratories resulting from changed components of RT‐qPCR procedures. False‐negative and false‐positive results were also found in the EQA.

Conclusions

Various problems were found for p210 BCR‐ABL1 detection in the EQA. By solving the existing problems, the performance of p210 BCR‐ABL1 detection can be improved, ensuring robust laboratory diagnostic capacities in China.
Review of advanced nursing practice in Denmark with an exemplar
Authors: Quallich Susanne A. , Grauengaard Jane , Ohl Dana A. , Sønksen Jens
Published: September 2018

Advances in independent nursing practice can expand the professional identity of nurses. Although there is no formal recognition for an advance practice nursing role in Denmark, there are clear examples of nursing expanding its scope to meet the meet of individual patients and larger community needs. Many Danish nurses work with expanded competencies in surgical settings, medical settings, psychiatric environments, and are instrumental in promoting continuity of care for patients who have chronic conditions. Expansion of the nursing role is an example of health care evolving to meet societal and patient needs, even within a controlled research environment, and will promote job satisfaction and retention among its most experienced nurses. This paper offers a review of expanded nursing roles in Denmark and offers further evidence of expanded autonomy for nurses in a clinical research environment.
Credit Cards: Transactional Convenience or Debt‐Trap?
Authors: Brown Stephen , Veld Chris , Veld‐Merkoulova Yulia
Published: September 2018

We survey individuals on their credit card usage. Contrary to popular press, most credit card holders use credit cards in a responsible manner. They tend to use credit cards for transaction convenience and pay little interest. Only a minor subset of people uses credit cards to access expensive credit, with only 7% of credit card holders in our sample never paying the balance in full. Credit card debt is more common among older, less financially literate, and less trusting respondents. Even individuals with credit card debt are well aware about its costs and are likely to make informed financial choices.