bluuebunny/crossref_metadata_2025 huggingface dataset:
Gut mucosal virome alterations in ulcerative colitis
Authors: Zuo Tao , Lu Xiao-Juan , Zhang Yu , Cheung Chun Pan , Lam Siu , Zhang Fen , Tang Whitney , Ching Jessica Y L , Zhao Risheng , Chan Paul K S , Sung Joseph J Y , Yu Jun , Chan Francis K L , Cao Qian , Sheng Jian-Qiu , Ng Siew C
Published: March 2019

Objective

The pathogenesis of UC relates to gut microbiota dysbiosis. We postulate that alterations in the viral community populating the intestinal mucosa play an important role in UC pathogenesis. This study aims to characterise the mucosal virome and their functions in health and UC.

Design

Deep metagenomics sequencing of virus-like particle preparations and bacterial 16S rRNA sequencing were performed on the rectal mucosa of 167 subjects from three different geographical regions in China (UC=91; healthy controls=76). Virome and bacteriome alterations in UC mucosa were assessed and correlated with patient metadata. We applied partition around medoids clustering algorithm and classified mucosa viral communities into two clusters, referred to as mucosal virome metacommunities 1 and 2.

Results

In UC, there was an expansion of mucosa viruses, particularly Caudovirales bacteriophages, and a decrease in mucosa Caudovirales diversity, richness and evenness compared with healthy controls. Altered mucosal virome correlated with intestinal inflammation. Interindividual dissimilarity between mucosal viromes was higher in UC than controls. Escherichia phage and Enterobacteria phage were more abundant in the mucosa of UC than controls. Compared with metacommunity 1, metacommunity 2 was predominated by UC subjects and displayed a significant loss of various viral species. Patients with UC showed substantial abrogation of diverse viral functions, whereas multiple viral functions, particularly functions of bacteriophages associated with host bacteria fitness and pathogenicity, were markedly enriched in UC mucosa. Intensive transkingdom correlations between mucosa viruses and bacteria were significantly depleted in UC.

Conclusion

We demonstrated for the first time that UC is characterised by substantial alterations of the mucosa virobiota with functional distortion. Enrichment of Caudovirales bacteriophages, increased phage/bacteria virulence functions and loss of viral-bacterial correlations in the UC mucosa highlight that mucosal virome may play an important role in UC pathogenesis.
Proprotein convertase subtilisin/kexin 9 inhibitors in reducing cardiovascular outcomes: a systematic review and meta-analysis
Authors: Du Heyue , Li Xiaodan , Su Na , Li Ling , Hao Xiaoting , Gao Haihui , Kwong Joey Sum-Wing , Vandvik Per Olav , Yang Xueli , Nemeth Imola , Mordi Ify R , Li Qianrui , Zhang Longhao , Rao Li , Lang Chim C , Li Jianshu , Tian Haoming , Li Sheyu
Published: March 2019

Background

To evaluate the effects of proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors on major adverse cardiovascular events (MACE).

Methods

Our systematic review included randomised controlled trials if they studied PCSK9 inhibitors in patients for primary and/or secondary prevention of cardiovascular diseases or with hypercholesterolaemia/hyperlipidaemia. Dichotomous variables from individual studies were pooled by relative risks (RR) and their 95% CIs using the random-effect model. Risk difference (RD) in the 10-year frame was also estimated using the pooled RR and the estimated baseline risk using the control group. Grading of Recommendation Assessment, Development and Evaluation was used to assess the quality of evidence.

Results

We included 54 trials with 97 910 patients in the analysis. Compared with controls, PCSK9 inhibitors significantly reduced the risk of MACE by 16% (RR, 0.84; 95% CI 0.79 to 0.89; RD: 47 fewer per 1000 vs 286 as the baseline risk; 95% CI 32 to 59 fewer), non-fatal myocardial infarction (MI) by 17% (RR, 0.83; 95% CI 0.74 to 0.93; RD, 35 fewer per 1000 vs 207 as the baseline; 95% CI 13 to 53 fewer) and any stroke by 25% (RR, 0.75; 95% CI 0.65 to 0.85; RD, 16 fewer per 1000 vs 61 as the baseline; 95% CI 9 to 21 fewer) with moderate quality evidence. No significant differences were found between PCSK9 inhibitors and control groups in all-cause mortality, cardiovascular death, heart failure or unstable angina with low-quality evidence.

Conclusions

This study demonstrated that PCSK9 inhibitors could significantly reduce the risk of MACE, non-fatal MI and stroke.

Trial registration

PROSPERO; CRD42017073904.
Whole-body positron emission tomography and positron emission tomography/computed tomography in gynecologic oncology
Authors: Kim E. E.
Published: March 2019

The advent of positron emission tomography (PET) and PET/computed tomography (CT) now enables us to detect metabolically active gynecologic cancers with greater accuracy than was possible with anatomic imagings. Fluorine-18 fluorodeoxyglucose PET has been useful in differentiation of malignant from benign lymph nodes, and residual or recurrent cancers from post-treatment changes. PET/CT produces additional information for the diagnosis and tissue biopsy as well as radiotherapy planning. This paper reviews the principle and clinical utility of PET and PET/CT in the diagnosis, staging, recurrence, therapeutic response as well as prognosis of gynecologic cancers.
The relative importance of surgical training and laboratory research in a gynecologic oncology fellowship
Authors: Eisenkop S. M. , Spirtos N. M.
Published: March 2019

The objective was to determine trends of surgical skill acquisition during fellowships, and the consensus amongst gynecologic oncologists about the relative importance of surgical training and laboratory research in fellowships. A survey addressing surgical capability at the time of fellowship completion, and relative priorities that should be given to surgical training and laboratory research was mailed to gynecologic oncologists and fellows in the Society of Gynecologic Oncologists directory. Of 820 surveyed, 454 (55.4%) of provided utilizable data, of whom 56 (12.5%) were fellows, and 398 (87.5%) in practice (49.5% university-based and 50.5% community hospital-based). Relative to past graduates, recent ones report and current fellows anticipate alowerprobability of being able toindependentlyperform some procedures applicable to cervical and ovarian cancer, as well as others necessary to manage complications at the time of fellowship completion. 69.8% of all respondents think that greater emphasis should be placed on surgical training at the expense of doing less laboratory research. There is wide variation of opinion among respondents concerning the value of and most appropriate length of time that should be dedicated to laboratory research in a fellowship. There is an indication of a trend for more recent fellows to graduate having acquired less surgical skill and a prevalent opinion that surgical training should be more heavily emphasized in fellowships.
Preoperative predictors of suboptimal primary surgical cytoreduction in women with clinical evidence of advanced primary epithelial ovarian cancer
Authors: Brockbank E. C. , Ind T. E. J. , Barton D. P. J. , Shepherd J. H. , Gore M. E. , A'HERN R. , Bridges J. E.
Published: March 2019

Introduction

Women with epithelial ovarian cancer (EOC) are conventionally treated with primary cytoreductive surgery. For those with a low probability of optimal primary surgical debulking, an alternative management option is primary chemotherapy with delayed primary surgery. Selection criteria are required to identify women who may benefit from this approach.

Patients and methods

Patient age, presence of ascites, preoperative serum CA-125 level, surgical procedures performed, postoperative residual disease, FIGO stage, and histology data were collected on 97 women with preoperative clinical evidence of advanced EOC. Univariate and multivariate analysis was performed to identify which preoperative factors predict disease that will be suboptimally debulked. Receiver–operator curves were constructed for CA-125 level as a predictor for residual disease.

Results

The best predictor of disease suboptimally cytoreduced was serum CA-125 level (OR = 22.76, 95% CI = 7.13–72.69). Other predictive factors included age over 60 years (OR = 3.16, 95% CI = 1.04–9.56) and clinical evidence of ascites (OR = 3.30, 95% CI = 1.03–10.62). The optimal cut-off for serum CA-125 as a predictor of suboptimal debulking was 586 IU (sensitivity 80.0%, specificity 88.5%, PPV 85.7%).

Conclusion

Serum CA-125 level is a reliable component of the preoperative assessment of women with EOC.
The influence of splenic metastases on survival in FIGO stage IIIC epithelial ovarian cancer
Authors: Ayhan A. , Al R. A. , Baykal C. , Demirtas E. , Ayhan A. , YÜCE K.
Published: March 2019

The purposes of this study were to compare the survival of ovarian cancer patients with splenic metastasis to patients without it and to evaluate the complications of the procedure.

A retrospective study was performed on 34 patients with ovarian cancer who underwent splenectomy for initial cytoreduction at gynecologic oncology unit of Hacettepe University Hospitals between 1989 and 2001. All patients had FIGO stage IIIC disease and were left with <1 cm residual tumor after surgery. Eighteen patients (52.9%) had splenic metastasis. Patients with splenic metastasis tended poorer survival. Median survivals were 28.9 and 41.3 months for patients with splenic disease and for patients without it, respectively (P> 0.05). Univariate analysis revealed that performance status and histologic type influenced survival. Histologic type and performance status were identified as independent risk factors by multivariate analysis. Postoperative complications were developed in ten (29.4%) patients and three of these (8.8%) died in 1 month after operation. None of the complications was attributed directly to the splenectomy procedure.

Complete surgical cytoreduction confers a survival benefit whether the parenchyma was involved or not. The splenectomy should be considered with its acceptable morbidity in selected patients who have a chance to achieve optimal debulking.
Gene–gene and gene–environmental interactions of p53, p21, and IRF-1 polymorphisms in Korean women with cervix cancer
Authors: Lee J. E. , Lee S. J. , Namkoong S. E. , Um S. J. , Sull J. W. , Jee S. H. , You Y. K. , Park J. S.
Published: March 2019

Background

The aim of this study was to identify gene–gene and gene–environmental factors affecting cervix carcinogenesis in Korean women.

Methods

We evaluated 530 subjects composed of 185 female cervix cancer patients and 345 normal healthy women. The single nucleotide polymorphisms (SNPs) of p53 codon 72, p21 codon 31, and interferon regulatory factor-1 (IRF-1) intron 6 were evaluated from extracted DNA of peripheral blood with an automatic DNA sequencer. The differences of each SNP, gene–gene and gene–environmental interactions between normal controls and patients were evaluated in the adjusted environmental background.

Results

In the environmental aspect, the rate of cervix cancer increased in the women with a lower level of education, a younger age at first sexual intercourse and more childbearing. The women who had p53 (Arg/Arg), IRF-1 (T/T), and <6 years of education showed a 14.7-fold increased risk of cervix cancer compared to the women who had p53 (∼Pro), IRF-1 (∼C), and >15 years of education. The women who had p53 (Arg/Arg), p21 (Ser/Ser), and >3 children showed a 6.4-fold increased risk of cervix cancer compared to the women who had p53 (∼Pro), p21 (∼Arg), and no children. The women who had p53 (Arg/Arg), IRF-1 (T/T), and first sexual intercourse before 22 years old showed a 5.5-fold increased risk of cervix cancer compared to the women who had p53 (∼Pro), IRF-1 (∼C), and first sexual intercourse after 26 years old.

Conclusions

We found that the level of education, the age at first intercourse, and the number of children were independent risk factors in cervix carcinogenesis. The specific combinations of p53, p21, and IRF-1 gene–gene and gene–environmental interactions were significantly noted in the cervix carcinogenesis of Korean women.
Nuclear and cytoplasmic c-myc staining in endometrial carcinoma and their relationship to survival
Authors: Geisler J. P. , Geisler H. E. , Manahan K. J. , Miller G. A. , Wiemann M. C. , Zhou Z. , Crabtree W.
Published: March 2019

Objective

The role of the c-myc proto-oncogene in genomic instability is just becoming more fully understood. However, its role in endometrial cancer is essentially unknown. The objective of this study was to determine the relationship between cytoplasmic and nuclear c-myc staining, DNA index, and survival in patients with endometrial carcinoma.

Methods

One hundred and twenty-one patients with endometrial carcinoma were studied. Image analysis was used to determine DNA index. In addition to cytoplasmic and nuclear c-myc staining and DNA index, histologic type, stage, grade, depth of invasion, lymphvascular space invasion, and peritoneal cytology were evaluated as prognostic indicators. Univariate and multivariate analyses were performed.

Results

One hundred and twenty-one patients were followed for over 5 years. c-myc cytoplasmic staining was present in 75.2% of the patients' tumors, and nuclear staining was present in 66.9% (P= 0.99). DNA index was significantly higher in patients with nuclear c-myc staining and no cytoplasmic staining (DNA index 1.38) as compared to those patients whose tumors displayed cytoplasmic c-myc staining but no nuclear c-myc staining (1.18) (P= 0.016). Patients whose tumors stained positively for nuclear c-myc and negatively for cytoplasmic c-myc had significantly worse survival by Kaplan–Meier analysis (P< 0.0001). Seventeen patients died during the follow-up period of this study. By multivariate analysis, positive cytoplasmic c-myc staining with negative nuclear staining (P= 0.0076), negative cytoplasmic c-myc staining with positive nuclear staining (P= 0.011) and FIGO stage (P< 0.0001) were shown to be independent prognostic indicators predictive of survival.

Conclusion

Nuclear and cytoplasmic c-myc staining, as well as FIGO stage, when assessed by multivariate analysis, were demonstrated to be important factors in predicting survival in the 121 patients in this study. While increasing FIGO stage was prognostic of decreased survival, the specific location of c-myc staining was also associated with prognosis. The expression of the c-myc protein is related to survival in patients with adenocarcinoma of the endometrium.
Effect of Acute Exercise on Postprandial Endothelial Function in Postmenopausal Women: A Randomized Cross-Over Study
Authors: Shah Meena , Bailey Sarah , Gloeckner Adam , Kreutzer Andreas , Adams-Huet Beverley , Cheek Dennis , Mitchell Joel
Published: March 2019

High-sugar intake may cause endothelial dysfunction. It is unknown if a bout of aerobic exercise improves endothelial dysfunction caused by a high-sugar meal in postmenopausal women. This study evaluated if prior aerobic exercise attenuates postprandial endothelial dysfunction in postmenopausal women. Twenty-two postmenopausal women (age [mean±SD]: 60.4±6.5 years; % body fat: 40.3%±7.5%) underwent an exercise (EX) or no exercise (NE) condition, in a random order, 13–16 hours prior to the high-sugar meal consumption. The EX condition included a 60 min bout of supervised aerobic exercise at 75% of age-predicted maximum heart rate. The high-sugar meal, consumed after a 12-hour fast, contained 33% of the subjects’ daily energy needs, and 75.6% energy from carbohydrates. Flow-mediated dilation (FMD) and blood concentrations of glucose, insulin, endothelin-1 (ET-1), and nitric oxide (NO) were assessed at baseline and 60 min, 120 min, and 180 min postprandially. Repeated measures analysis test showed that there were no condition by time interaction or condition effects for FMD, glucose, insulin, or NO. There was a significant condition by time interaction but no condition effect for ET-1. Area under the curve was also not different by condition for insulin sensitivity or the above variables. In conclusion, prior aerobic exercise compared with NE did not affect FMD, blood glucose, insulin, ET-1 or NO concentrations, or insulin sensitivity following a high-sugar meal in postmenopausal women. Future studies should look at the effect of different EX intensities on meal-induced endothelial dysfunction in this population.

Trial Registration: ClinicalTrials.gov Identifier: NCT02919488
We don’t need unilateral DNRs: taking informed non-dissent one step further
Authors: Real de Asúa Diego , Lee Katarina , Koch Peter , de Melo-Martín Inmaculada , Bibler Trevor
Published: March 2019

Although shared decision-making is a standard in medical care, unilateral decisions through process-based conflict resolution policies have been defended in certain cases. In patients who do not stand to receive proportional clinical benefits, the harms involved in interventions such as cardiopulmonary resuscitation seem to run contrary to the principle of non-maleficence, and provision of such interventions may cause clinicians significant moral distress. However, because the application of these policies involves taking choices out of the domain of shared decision-making, they face important ethical and legal problems, including a recent challenge to their constitutionality. In light of these concerns, we suggest a re-conceptualization of informed non-dissent as an alternative approach in cases where the application of process-based policies is being considered. This clinician-directed communication model still preserves what is valuable in such policies and salvages professional integrity, while minimising ethical and legal challenges.
Volumetric T2-weighted MRI improves the diagnostic accuracy of spinal vascular malformations: comparative analysis with a conventional MR study
Authors: Kannath Santhosh Kumar , Rajendran Adhithyan , Thomas Bejoy , Rajan Jayadevan Enakshy
Published: March 2019

Background

To date, very little study of the importance of a volumetric T2-weighted MR sequence in the evaluation of spinal vascular malformations (SVMs) has been carried out.

Objective

To determine the utility and accuracy of a volumetric T2 MR sequence compared with conventional T2 in the diagnosis of SVMs.

Methods

Retrospective analysis of all patients who underwent spinal DSA for suspected SVMs was conducted. Conventional T2 and volumetric T2 MR images were analysed for the presence of flow voids and parenchymal changes, and SVMs were characterized. The sensitivity, specificity, and overall diagnostic accuracy of these MRI diagnoses were calculated.

Results

Of 89 subjects included in the final analysis, 70 patients had angiographically proved SVMs (38 patients with spinal cord arteriovenous malformations [SCAVM—intramedullary or perimedullary] and 32 cases of spinal dural arteriovenous fistula (SDAVF)) and the remaining 19 subjects were normal. The sensitivity and specificity for identification of SVMs were 98.1% and 90% for volumetric T2 sequences, compared with 82.8% and 89.4% for conventional T2 MRI, respectively. For characterization of spinal vascular lesions, volumetric MRI showed high sensitivity, specificity, and accuracy for SDAVF (100%, 90%, 97%, respectively) compared with conventional T2 MRI (71.8%, 89%, 79%, respectively). The positive likelihood ratio was high and negative likelihood ratio was zero for volumetric MRI evaluation of SDAVF, while these ratios were comparable between the two sequences for SCAVM.

Conclusion

Volumetric T2 MRI is highly sensitive for the detection of SVMs, especially for SDAVF. Volumetric T2 MRI could be introduced into routine clinical practice in the screening of suspected SVMs.
Effect of extracranial lesion severity on outcome of endovascular thrombectomy in patients with anterior circulation tandem occlusion: analysis of the TITAN registry
Authors: Anadani Mohammad , Spiotta Alejandro , Alawieh Ali , Turjman Francis , Piotin Michel , Steglich-Arnholm Henrik , Holtmannspötter Markus , Taschner Christian , Eiden Sebastian , Haussen Diogo C , Nogueira Raul , Papanagiotou Panagiotis , Boutchakova Maria , Siddiqui Adnan H , Lapergue Bertrand , Dorn Franziska , Cognard Christophe , Killer-Oberpfalzer Monika , Mangiafico Salvatore , Ribo Marc , Psychogios Marios-Nikos , Labeyrie Marc-Antoine , Mazighi Mikael , Biondi Alessandra , Anxionnat René , Bracard Serge , Richard Sébastien , Gory Benjamin
Published: March 2019

Introduction

Endovascular treatment (EVT) for tandem occlusion (TO) of the anterior circulation is complex but effective. The effect of extracranial internal carotid artery (EICA) lesion severity on the outcomes of EVT is unknown. In this study we investigated the effect of EICA lesion severity on the outcomes of tandem occlusion EVT.

Methods

A multicenter retrospective TITAN (Thrombectomy In TANdem lesions) study that included 18 international endovascular capable centers was performed. Patients who received EVT for atherosclerotic TO with or without EICA lesion intervention were included. Patients were divided into two groups based on the EICA lesion severity (high-grade stenosis (≥90% North American Symptomatic Carotid Endarterectomy Trial) vs complete occlusion). Outcome measures included the 90-day clinical outcome (modified Rankin Scale score (mRS)), angiographic reperfusion (modified Thrombolysis In Cerebral Ischemia (mTICI) at the end of the procedure), procedural complications, and intracranial hemorrhage at 24 hours follow-up.

Results

A total of 305 patients were included in the study, of whom 135 had complete EICA occlusion and 170 had severe EICA stenosis. The EICA occlusion group had shorter mean onset-to-groin time (259±120 min vs 305±202 min; p=0.037), more patients with diabetes, and fewer with hyperlipidemia. With respect to the outcome, mTICI 2b–3 reperfusion was lower in the EICA occlusion group (70% vs 81%; p=0.03). The favorable outcome (90-day mRS 0–2), intracerebral hemorrhage and procedural complications were similar in both groups.

Conclusion

Atherosclerotic occlusion of the EICA in acute tandem strokes was associated with a lower rate of mTICI 2b–3 reperfusion but similar functional and safety outcomes when compared with high-grade EICA stenosis.
Syphilis associated with recreational drug use, depression and high-risk sexual behaviour in men who have sex with men: a case–control study in China
Authors: Wu Huichao , Xiu Cuizhen , Fu Xiaojing , Li Menglong , Wang Zhenhong , Li Xiufang , Wu Jing , Vermund Sten H , Hu Yifei
Published: March 2019

Objective

We investigated syphilis prevalence among men who have sex with men (MSM) in China, as well as potential risk factors. Our principal hypothesis was that syphilis would be associated with the use of recreational drugs such as methamphetamines.

Methods

From April to October 2013, we used several methods to recruit MSM in Qingdao, collecting demographic/behavioural information via self-administrated questionnaires. Trained health workers collected blood for theTreponema pallidumparticle assay (TPPA) with positives confirmed by a toluidine red unheated serum test. We used an unmatched case–control study to identify factors that might predict syphilis infection using multivariable logistic regression.

Results

We recruited 447 MSM who agreed to participate and who completed syphilis testing. Of 71 (15.9%) syphilis-positive MSM, 44 (62.0%) used drugs. Of 376 (84.1%) syphilis-negative MSM, 186 (49.5%) used drugs. We found a positive association with syphilis for any recreational drug use (crude OR (cOR) 1.7, 95 % CI 1.0 to 2.8), frequent methamphetamine use (cOR 2.4, 95% CI 1.1 to 5.3) and multiple drug use (adjusted OR (aOR) 3.4, 95% CI 1.3 to 9.2). Syphilis-positive men were more likely to have a higher physical depression score (aOR 5.2, 95% CI 1.1 to 24.4), be > 30 years old (aOR 2.7, 95% CI 1.5 to 4.8), report a prior STI (aOR 4.1, 95% CI 2.3 to 7.3) and report a sex party experience (aOR 2.2, 95% CI 1.1 to 4.4).

Conclusions

Recreational drug use, depression and high-risk sexual behaviours were associated with syphilis infection among MSM in China. Only a multifaceted approach is likely be effective in control of both syphilis and HIV .
Is the cardioprotective effect of the ACE2 activator diminazene aceturate more potent than the ACE inhibitor enalapril on acute myocardial infarction in rats?
Authors: Badae Noha Mohamed , El Naggar Asmaa Samy , El Sayed Samiha Mahmoud
Published: March 2019

Myocardial infarction is a major cause of cardiac dysfunction. All components of the cardiac renin–angiotensin system (RAS) are upregulated in myocardial infarction. Angiotensin-converting enzyme (ACE) and ACE2 are key enzymes involved in synthesis of components of RAS and provide a counter-regulatory mechanism within RAS. We compared the cardioprotective effect of the ACE2 activator diminazene aceturate (DIZE) versus the ACE inhibitor enalapril on post acute myocardial infarction (AMI) ventricular dysfunction in rats. Adult male rats received subcutaneous injections of either saline (control) or isoproterenol (85 mg/kg) to induce AMI. Rats with AMI confirmed biochemically and by ECG, were either left untreated (AMI) or administered DIZE (AMI + DIZE) or enalapril (AMI + enalapril) daily for 4 weeks. DIZE caused a significant activation of cardiac ACE2 compared with enalapril. DIZE caused a significantly greater enhancement of cardiac hemodynamics. DIZE also caused greater reductions in heart-type fatty acid binding protein (H-FABP), β-myosin heavy chain (β-MYH), and in heart mass to total body mass ratio. These results indicated that activation of cardiac ACE2 by DIZE enhanced the protective axis of RAS and improved myocardial function following AMI, whereas enalapril was not sufficient to restore all cardiac parameters back to normal.
Tree Swallow (Tachycineta bicolor) nest success and nestling growth near oil sands mining operations in northeastern Alberta, Canada
Authors: Godwin Christine M. , Barclay Robert M.R. , Smits Judit E.G.
Published: March 2019

Industrial development and contaminant exposure may affect reproductive success and food quality for birds. Tree Swallows (Tachycineta bicolor (Vieillot, 1808)) nesting near oil sands development in northern Alberta (Canada) potentially experience elevated environmental stressors that could influence reproduction. We measured reproductive and growth endpoints in Tree Swallows, predicting reduced reproductive success and nestling growth near oil sands operations compared with reference sites. We also identified the invertebrate prey in the stomach contents of nestlings to understand variability in the diet and its potential effect on growth and survival of nestlings. From 2012 to 2015, clutch initiation varied among years but was not influenced by proximity to oil sands operations. Hatching and fledging success decreased in response to increased precipitation, regardless of location. Measurements of nestling growth reflected the variation associated with nestling sex and possibly asynchronous hatching. The composition of the nestling diet was significantly different; birds near oil sands development consumed Odonata, whereas birds at reference sites consumed Ephemeroptera. Nestlings from all sites consumed relatively high quantities of terrestrial insects. Our results demonstrate that factors such as weather conditions, diet, hatching order, and nestling sex are important when interpreting the potential effects of oil sands development on nest success and nestling growth.
The Place of In Vitro Maturation in Assisted Reproductive Technology
Authors: Vuong Lan N. , Ho Tuong M. , Gilchrist Robert B. , Smitz Johan
Published: March 2019

In vitro maturation (IVM) is an assisted reproductive technology (ART) whereby immature cumulus-oocyte complexes are collected and matured in vitro, without need for controlled ovarian stimulation and ovulation triggering. Advantages of IVM over in vitro fertilization (IVF) include mild or no stimulation, lower medication costs and less patient burden. However, early clinical outcomes with IVM were suboptimal. More recently, clinical studies reported live birth rates after IVM of about 40%. New IVM culture systems are being used to improve the efficacy of IVM. These have been in widespread use for animals for many years and are now showing promise in the clinical setting. Patients more likely to benefit from IVM over IVF include those at risk of OHSS (e.g. women with polycystic ovary syndrome), when the time for ovarian stimulation is limited, or where sustained elevations of estradiol are contraindicated (e.g. oncofertility indications). The main barrier to use of IVM to date was its relative efficacy compared with IVF, and there have also been concerns over the health of infants born following IVM. However, no differences in congenital abnormalities between IVM and other ARTs have been identified. In addition, there is a lack of both experience and standardized protocols. Strategies to overcome barriers to the use of IVM include better training for clinicians, more and better funded research in the field, and improved recognition of IVM by fertility specialists. Overall, IVM offers a valuable alternative for ART in select patient populations. New approaches to IVM appear to have the potential to achieve pregnancy outcomes equivalent to those after IVF. Increasing the use of IVM in the future can be achieved with improved training and education for fertility specialists, and increased funding for IVM research, with the ultimate goal of improving fertility outcomes.
Age-dependent pulmonary reactivity to house dust mite allergen: a model of adult-onset asthma?
Authors: Mack Savannah , Shin Jinho , Ahn Yoomin , Castaneda Alejandro R. , Peake Janice , Fulgar Ciara , Zhang JingJing , Cho Yoon Hee , Pinkerton Kent E.
Published: March 2019

Asthma is a heterogeneous disease differentiated by factors like allergen sensitivity, inflammation, sex, and age at onset. The mouse model is widely used to study the early-life development of allergic asthma. However, age-dependent allergen responses later in life remain relatively understudied and lack a widely accepted model. To differentiate age-dependent responses to the ubiquitous house dust mite (HDM), 3- and 9-mo-old female C57BL/6 mice were randomized into two groups each and exposed to HDM or phosphate-buffered saline (control) via intranasal instillation for sensitization and challenge phases. At 24 h after challenge, all mice underwent pulmonary function testing and methacholine challenge. Bronchoalveolar lavage fluid (BALF) was collected for assessment of cell differentials, and right lung lobes were fixed, sectioned, and stained for histopathology and immunohistochemistry. Both age groups demonstrated strong inflammatory/allergic responses to HDM exposure. However, only 9-mo-old HDM-exposed mice demonstrated significant airway hyperresponsiveness compared with age-matched controls. These HDM-exposed mice also had 1) statistically significant increases in tissue bronchiolitis, perivasculitis, and BALF neutrophilia relative to their younger counterparts and 2) significantly increased extent of immunostaining compared with all other groups. This study presents a potential model for adult-onset asthma, focusing specifically on the atopic, perimenopausal female phenotype. Our findings suggest that lung function declines with age and that the inflammatory profile of this adult subgroup is a mixed, rather than a simple, atopic, Th2 response. This model may enhance our understanding of how age influences the development of asthmic-like symptoms in older subgroups.
Surfactant plus budesonide decreases lung and systemic inflammation in mechanically ventilated preterm sheep
Authors: Kothe T. Brett , Kemp Matthew W. , Schmidt Augusto , Royse Emily , Salomone Fabrizio , Clarke Michael W. , Musk Gabrielle C. , Jobe Alan H. , Hillman Noah H.
Published: March 2019

Mechanical ventilation with normal tidal volumes (VT) causes lung and systemic inflammation in preterm sheep. Mechanical ventilation is associated with bronchopulmonary dysplasia (BPD) in preterm infants, and the addition of budesonide to surfactant decreases BPD in clinical trials. Budesonide with surfactant will decrease the lung injury from mechanical ventilation for 24 h in preterm sheep. Lambs at 126 ± 1 day gestational age were delivered and randomized to either: 1) surfactant (200 mg/kg) or 2) surfactant mixed with budesonide (0.25 mg/kg) before mechanical ventilation with VT of 7–8 ml/kg for 2, 6, or 24 h ( n = 6 or 7/group). Lung physiology and budesonide levels in the plasma and the lung were measured. Lung tissue, bronchoalveolar lavage fluid (BALF), liver, and brain tissues were evaluated for indicators of injury. High initial budesonide plasma levels of 170 ng/ml decreased to 3 ng/ml at 24 h. Lung tissue budesonide levels were less than 1% of initial dose by 24 h. Although physiological variables were generally similar, budesonide-exposed lambs required lower mean airway pressures, had higher hyperoxia responses, and had more stable blood pressures. Budesonide decreased proinflammatory mRNA in the lung, liver, and brain. Budesonide also decreased total protein and proinflammatory cytokines in BALF, and decreased inducible nitric oxide synthase activation at 24 h. In ventilated preterm lambs, most of the budesonide left the lung within 24 h. The addition of budesonide to surfactant improved physiology, decreased markers of lung injury, and decreased systemic responses in liver and brain.
Time course of decompensation after angiotensin II and high-salt diet in Balb/CJ mice suggests pulmonary hypertension-induced cardiorenal syndrome
Authors: Becirovic-Agic Mediha , Jönsson Sofia , Tveitarås Maria K. , Skogstrand Trude , Karlsen Tine V. , Lidén Åsa , Leh Sabine , Ericsson Madelene , Nilsson Stefan K. , Reed Rolf K. , Hultström Michael
Published: March 2019

The genetic background of a mouse strain determines its susceptibility to disease. C57BL/6J and Balb/CJ are two widely used inbred mouse strains that we found react dramatically differently to angiotensin II and high-salt diet (ANG II + Salt). Balb/CJ show increased mortality associated with anuria and edema formation while C57BL/6J develop arterial hypertension but do not decompensate and die. Clinical symptoms of heart failure in Balb/CJ mice gave the hypothesis that ANG II + Salt impairs cardiac function and induces cardiac remodeling in male Balb/CJ but not in male C57BL/6J mice. To test this hypothesis, we measured cardiac function using echocardiography before treatment and every day for 7 days during treatment with ANG II + Salt. Interestingly, pulsed wave Doppler of pulmonary artery flow indicated increased pulmonary vascular resistance and right ventricle systolic pressure in Balb/CJ mice, already 24 h after ANG II + Salt treatment was started. In addition, Balb/CJ mice showed abnormal diastolic filling indicated by reduced early and late filling and increased isovolumic relaxation time. Furthermore, Balb/CJ exhibited lower cardiac output compared with C57BL/6J even though they retained more sodium and water, as assessed using metabolic cages. Left posterior wall thickness increased during ANG II + Salt treatment but did not differ between the strains. In conclusion, ANG II + Salt treatment causes early restriction of pulmonary flow and reduced left ventricular filling and cardiac output in Balb/CJ, which results in fluid retention and peripheral edema. This makes Balb/CJ a potential model to study the adaptive capacity of the heart for identifying new disease mechanisms and drug targets.
Tubule-vascular feedback in renal autoregulation
Authors: Romero Cesar A. , Carretero Oscar A.
Published: March 2019

Afferent arteriole (Af-Art) diameter regulates pressure and flow into the glomerulus, which are the main determinants of the glomerular filtration rate. Thus, Af-Art resistance is crucial for Na+ filtration. Af-Arts play a role as integrative centers, where systemic and local systems interact to determine the final degree of resistance. The tubule of a single nephron contacts an Af-Art of the same nephron at two locations: in the transition of the thick ascending limb to the distal tubule (macula densa) and again in the connecting tubule. These two sites are the anatomic basis of two intrinsic feedback mechanisms: tubule-glomerular feedback and connecting tubule-glomerular feedback. The cross communications between the tubules and Af-Arts integrate tubular Na+ and water processing with the hemodynamic conditions of the kidneys. Tubule-glomerular feedback provides negative feedback that tends to avoid salt loss, and connecting tubule-glomerular feedback provides positive feedback that favors salt excretion by modulating tubule-glomerular feedback (resetting it) and increasing glomerular filtration rate. These feedback mechanisms are also exposed to systemic modulators (hormones and the nervous system); however, they can work in isolated kidneys or nephrons. The exaggerated activation or absence of any of these mechanisms may lead to disequilibrium in salt and water homeostasis, especially in extreme conditions (e.g., high-salt diet/low-salt diet) and may be part of the pathogenesis of some diseases. In this review, we focus on molecular signaling, feedback interactions, and the physiological roles of these two feedback mechanisms.
Paracellular calcium transport in the proximal tubule and the formation of kidney stones
Authors: Curry Joshua N. , Yu Alan S. L.
Published: March 2019

The proximal tubule (PT) is responsible for the majority of calcium reabsorption by the kidney. Most PT calcium transport appears to be passive, although the molecular facilitators have not been well established. Emerging evidence supports a major role for PT calcium transport in idiopathic hypercalciuria and the development of kidney stones. This review will cover recent developments in our understanding of PT calcium transport and the role of the PT in kidney stone formation.
Motion integration is anisotropic during smooth pursuit eye movements
Authors: Souto David , Chudasama Jayesha , Kerzel Dirk , Johnston Alan
Published: March 2019

Smooth pursuit eye movements (pursuit) are used to minimize the retinal motion of moving objects. During pursuit, the pattern of motion on the retina carries not only information about the object movement but also reafferent information about the eye movement itself. The latter arises from the retinal flow of the stationary world in the direction opposite to the eye movement. To extract the global direction of motion of the tracked object and stationary world, the visual system needs to integrate ambiguous local motion measurements (i.e., the aperture problem). Unlike the tracked object, the stationary world’s global motion is entirely determined by the eye movement and thus can be approximately derived from motor commands sent to the eye (i.e., from an efference copy). Because retinal motion opposite to the eye movement is dominant during pursuit, different motion integration mechanisms might be used for retinal motion in the same direction and opposite to pursuit. To investigate motion integration during pursuit, we tested direction discrimination of a brief change in global object motion. The global motion stimulus was a circular array of small static apertures within which one-dimensional gratings moved. We found increased coherence thresholds and a qualitatively different reflexive ocular tracking for global motion opposite to pursuit. Both effects suggest reduced sampling of motion opposite to pursuit, which results in an impaired ability to extract coherence in motion signals in the reafferent direction. We suggest that anisotropic motion integration is an adaptation to asymmetric retinal motion patterns experienced during pursuit eye movements.

NEW & NOTEWORTHY This study provides a new understanding of how the visual system achieves coherent perception of an object’s motion while the eyes themselves are moving. The visual system integrates local motion measurements to create a coherent percept of object motion. An analysis of perceptual judgments and reflexive eye movements to a brief change in an object’s global motion confirms that the visual and oculomotor systems pick fewer samples to extract global motion opposite to the eye movement.
Integrity Audit of Shared Cloud Data with Identity Tracking
Authors: Yan Yun Xue , Wu Lei , Xu Wen Yu , Wang Hao , Liu Zhao Man
Published: March 2019

More and more users are uploading their data to the cloud without storing any copies locally. Under the premise that cloud users cannot fully trust cloud service providers, how to ensure the integrity of users’ shared data in the cloud storage environment is one of the current research hotspots. In this paper, we propose a secure and effective data sharing scheme for dynamic user groups. (1) In order to realize the user identity tracking and the addition and deletion of dynamic group users, we add a new role called Rights Distribution Center (RDC) in our scheme. (2) To protect the privacy of user identity, when performing third party audit to verify data integrity, it is not possible to determine which user is a specific user. Therefore, the fairness of the audit can be promoted. (3) Define a new integrity audit model for shared cloud data. In this scheme, the user sends the encrypted data to the cloud and the data tag to the Rights Distribution Center (RDC) by using data blindness technology. Finally, we prove the security of the scheme through provable security theory. In addition, the experimental data shows that our proposed scheme is more efficient and scalable than the state-of-the-art solution.
Gastric Heterotopic Pancreas Presenting as Abdominal Pain with Acute and Chronic Pancreatitis in the Resected Specimen
Authors: Wawrzynski Joseph , Leon Lauren De , Shah Samir A. , Adrain Alyn , Goldstein Lisa J. , Feller Edward
Published: March 2019

Heterotopic pancreas, also known as ectopic pancreas, is pancreatic tissue located outside the pancreatic parenchyma without vascular or ductal communication with the gland. Ectopic pancreas is rarely symptomatic, typically detected incidentally at surgery or autopsy. Eighty-five to 90% are in the upper GI tract, especially the gastric antrum. We report a 54-year-old man with symptomatic gastric heterotopic pancreas presenting as recurrent, initially undiagnosed, abdominal pain. Surgery revealed heterotopic pancreas including excretory ducts, acini, and islet cells. Evidence of acute pancreatitis was present, marked by inflammation and abscess formation. Chronic pancreatitis was diagnosed by fibrosis and dilated ducts containing proteinaceous material. Submucosal location with normal overlying mucosa on endoscopy increases risks of delayed or missed diagnosis. Complications include GI bleeding, acute or chronic pancreatitis, pancreatic necrosis, pseudocyst, gastric outlet obstruction, perforation, and, rarely, pancreatic carcinoma. This rare disorder mimics more common diseases. Low suspicion, nondiagnostic imaging or endoscopy contribute to frequent diagnostic delay.
Product Module Network Modeling and Evolution Analysis
Authors: Qiao Hu , Xu Zhaohui , He Jiang , Xiang Ying
Published: March 2019

Modular technology for product design and manufacturing is an effective way to solve mass customization problems. One difficulty in the application of modular technology is that the characteristics of mass customization, such as multi batch and small batch, easily increase the complexity of the module structure of the enterprise products. To address this problem, based on complex network theory, the enterprise products module is mapped as the vertex of the network, the number of modules used is mapped as the node weight, the dependency between the modules is mapped to the edge, and the product module network is established. The brittleness risk entropy of the product module network is put forward by considering the internal and external factors that influence the application of the enterprise module to determine the rationality of the required modules' organizational structures. Then, the stability uncertainty of the product module network can be determined by calculating the brittleness risk entropy, in which the subsystem that is the most brittle risk entropy can be identified. And the evolution of the product module network can be promoted by changing factors of the entropy maximum subsystem. To analyze the change in the product module network caused by module evolution, a BBV (Barrat–Barthelemy–Vespignani) model of the product module network is established to dynamically determine the brittle risk of the product module network. Finally, the modularity structure of a series of special vehicles is used as an example to verify the presented method, and the results confirm the rationality and effectiveness of the method.
Novel Design Method for Bus Approach Lanes with Bus Guidance and Priority Controls for Prioritizing Through and Left-Turn Buses
Authors: Shu Shijie , Zhao Jing , Han Yin
Published: March 2019

Transit priority is a useful way of improving transit operations in urban networks. However, the through and left-turn buses are rarely prioritized simultaneously at isolated intersections in the existing studies. This paper presents a variable bus approach lane design with a bus guidance and priority control model, which can reduce the delay of both the through and left-turn buses. The variable bus approach lanes can be dynamically used for the through and left-turn buses during the various periods of a signal cycle by the integrated design of geometric layouts and signal timing. A detailed bus guidance and priority control optimization model is formulated to guide the buses entering the appropriate bus approach lanes, and it provides optimal signal priorities for buses. The effectiveness of the proposed method is validated by a case study and numerical experiments. The results show that, on average, the total passenger delay can be reduced by 5% for every 30 veh/h and 40 veh/h increase in the volume of through buses and left-turn buses, respectively. Moreover, a comparison between the proposed method and the conventional transit priority method reveals that significant improvements can be made in reducing delays using the proposed method even at intersections with high degree of the saturation.