bluuebunny/crossref_metadata_2025 huggingface dataset:
Measures of biologically relevant environmental heterogeneity improve prediction of regional plant species richness
Authors: Cramer Michael D. , Verboom G. Anthony
Published: December 2016

Aim

Relatively few models of species richness explicitly consider aspects of environmental heterogeneity, other than topographic heterogeneity. We hypothesized that environmental heterogeneity is an important determinant of species richness, especially in ancient climatically stable environments.

Location

South Africa, which accommodates a range of biomes that differ strongly in species richness.

Methods

We included measures of climatic, edaphic and biotic variables and their spatial heterogeneities in boosted regression tree models of vascular plant species richness. Species richness was assessed using herbarium records per quarter degree square (QDS). To avoid autocorrelation and problems of variable collection rates we iteratively randomly subsampled 20% of the available QDS. We also verified estimates of species richness using an independent data source.

Results

The models predicted 68% of QDS species richness and 95% of biome richness. Spatial variability in diurnal temperature range was the strongest predictor of species richness, and inclusion of edaphic and biotic terms as well as spatial heterogeneities increased the explanatory power of the model considerably. Heterogeneity variables featured strongly (8 of 13) as predictors of species richness, but several resource variables (e.g. precipitation, seasonality and evapotranspiration) were also important. The spatial heterogeneities of some variables (e.g. water availability, fire) were related to their mean values, possibly explaining why some global models that have not explicitly included heterogeneity (other than topographic) perform well.

Main conclusions

Environmental heterogeneities are important predictors of species richness, yielding accurate predictions even in the absence of any consideration of diversification rates or environmental stability. Greater heterogeneity of some resource variables when limiting, contributed to modelled species richness, adding to understanding of why species richness of some resource‐poor Mediterranean‐ecosystems is high. We suggest that species richness in ancient, climatically stable Mediterranean‐ecosystems is contingent on resource and environmental heterogeneity that has enabled both the diversification and maintenance of regional species richness.
Gecko phylogeography in the Western Indian Ocean region: the oldest clade of Ebenavia inunguis lives on the youngest island
Authors: Hawlitschek Oliver , Toussaint Emmanuel F. A. , Gehring Philip‐Sebastian , Ratsoavina Fanomezana M. , Cole Nik , Crottini Angelica , Nopper Joachim , Lam Athena W. , Vences Miguel , Glaw Frank
Published: December 2016

Aim

We studied the gecko genus Ebenavia to reconstruct its colonization history, test for anthropogenic versus natural dispersal out of Madagascar, and correlate divergence date estimates of our phylogeny with geological age estimates of islands in the region.

Location

Madagascar and surrounding islands of the Western Indian Ocean (Comoros, Mayotte, Mauritius, Pemba).

Methods

We reconstructed the phylogeny of Ebenavia covering its entire geographical range using a molecular data set of three mitochondrial and two nuclear markers. We estimated divergence times based on calibrations using (1) previously calculated mutation rates of mitochondrial markers, (2) a combination of these rates with old or (3) young geological age estimates for some of the islands inhabited by the genus, and (4) an independent data set with fossil outgroup calibration points.

Results

Ebenavia inunguis, one of two recognized species of the genus, comprises multiple ancient evolutionary lineages. The earliest divergence within this complex (Miocene, 13–20 Ma; 95% credibility interval [CI]: 4–29 Ma) separates the population of the Comoros Islands, excluding Mayotte, from all other lineages. The age estimates for island lineages coincide with the geological age estimates of the islands except for Grand Comoro, where the age of the local clade (3–5 Ma; 95% CI: 2–7 Ma) significantly predates the estimated island age (0·5 Ma). A clade from north Madagascar + Mayotte + Pemba is estimated to have diverged from an eastern Malagasy clade in the Miocene.

Main Conclusions

Our results suggest that Grand Comoro Island is geologically older than previously estimated. The islands of the Comoros and Pemba were probably colonized via natural dispersal out of Madagascar (> 1000 km in the case of Pemba). Mauritius was most likely colonized only recently from eastern Madagascar via human translocation.
Lineage splitting, secondary contacts and genetic admixture of a widely distributed marine invertebrate
Authors: Pérez‐Portela R. , Rius M. , Villamor A.
Published: December 2016

Aim

We explore the genetic structure of the widespread starfish, Marthasterias spp., in order to: (1) identify historical causes of genetic divergence, (2) test the effect of past climatic events on populations’ demography and (3) explore main barriers to gene flow.

Location

North‐ and south‐east Atlantic Ocean and Mediterranean Sea.

Methods

We amplified and sequenced three mitochondrial genes and one nuclear intron, and genotyped five nuclear microsatellite loci from 337 specimens. We reconstructed the phylogeny and phylogeography of Marthasterias spp. using the obtained DNA sequences, and used the microsatellite loci to explore major genetic discontinuities along the European coast.

Results

Our results suggested the existence of two allopatric species, one in the Northern Hemisphere (M. glacialis) and another in the Southern Hemisphere (Marthasterias sp.). This allopatric split could be attributed to recent changes in oceanographic circulation of the eastern Atlantic Ocean that may have acted as barrier to gene flow. Mitochondrial divergence between European lineages could be attributed to potential vicariance during Pleistocene glacial periods, but was not supported by nuclear markers, which may be indicative of recent genetic admixture. Secondary contact after glacial periods and gene flow across the Gibraltar Strait may explain this pattern. Genetic structure of M. glacialis based on nuclear markers did not show much divergence among geographical areas although most populations were significantly differentiated.

Main conclusions

The phylogeography of the widely distributed genus Marthasterias has most likely been shaped by recent changes in climate and oceanographic patterns. Major changes of ocean current patterns initially resulted in splitting between Northern and Southern Hemisphere lineages. Subsequently, glacial periods most likely enhanced vicariance of European lineages, followed by a post‐glacial expansion facilitating secondary contacts and genetic admixture.
Nd:YAG and pulsed dye laser therapy in infantile haemangiomas: a retrospective analysis of 271 treated haemangiomas in 149 children
Authors: Hartmann F. , Lockmann A. , Grönemeyer L.‐L. , Haenssle H.A. , Zutt M. , von Fintel H. , Kühnle I. , Schön M.P. , Thoms K.‐M.
Published: December 2016

Background

Infantile haemangiomas (IH) are common benign tumours in infancy. Most IH resolve spontaneously, but some require treatment due to ulceration, functional impairment or cosmetic disfiguration. While systemic propranolol is effective in many cases, laser therapy may be a safe topical alternative.

Objective

To assess the efficacy of combined Nd:YAG/pulsed dye laser (PDL) or PDL alone for therapy of IH.

Patients and methods

A total of 271 IH in 149 infants were treated with combined Nd:YAG/PDL or PDL alone. Based on photographs before and 4–6 weeks after the last treatment, the results were evaluated independently by three physicians. Remissions were categorized as 0–25% (I), 26–50% (II), 51–75% (III) and 76–100% (IV).

Results

In total, 472 laser treatments were performed. In 137 of 149 infants (91.9%) laser therapy was performed during a short sevoflurane mask anaesthesia, while 12 of 149 infants (8.1%) received topical anaesthetic gel. Combined Nd:YAG/PDL was applied in 187 of 271 IH (69.0%), while PDL alone in 84 of 271 IH (31.0%). On average, 1.74 treatments per IH were necessary (Nd:YAG/PDL: 1.95, PDL: 1.26). Moderate or strong (III/IV) improvement was observed in 92.4% of all IH treated. No serious adverse effects were observed.

Conclusion

Combined Nd:YAG/PDL therapy is an effective and well‐tolerated local treatment option for IH of any classification, in any phase of development and at any age. With regard to the systemic use of propranolol, combined Nd:YAG/PDL therapy seems a safe and promising alternative in many cases.
Positive impact of omalizumab on angioedema and quality of life in patients with refractory chronic idiopathic/spontaneous urticaria: analyses according to the presence or absence of angioedema
Authors: Maurer M. , Sofen H. , Ortiz B. , Kianifard F. , Gabriel S. , Bernstein J.A.
Published: December 2016

Background

Approximately 50% of patients with chronic idiopathic/spontaneous urticaria (CIU/CSU) report hives and angioedema; some experience hives/angioedema only.

Objective

Assess omalizumab's effect on angioedema and quality of life (QoL) in subgroups with refractory CIU/CSU: those with and without angioedema.

Methods

Patients received omalizumab (75, 150 or 300 mg) or placebo every 4 weeks for 12/24 weeks. Angioedema and QoL were assessed [Urticaria Patient Daily Diary and Dermatology Quality of Life Index (DLQI)]. Subgroups were based on the presence/absence of baseline angioedema 7 days prior to randomization.

Results

Patients with baseline angioedema randomized to omalizumab 300 mg had a greater reduction in mean weekly incidence of angioedema and mean number of days/week with angioedema vs. placebo at 12 and 24 weeks. A 3.3‐ to 4.5‐point greater mean reduction in DLQI score was achieved with omalizumab 300 mg treatment vs. placebo, above the minimal clinically important difference threshold. Results with lower doses vs. placebo were variable.

Conclusion

Compared with placebo, omalizumab 300 mg treatment over 12–24 weeks resulted in marked reduction in incidence and number of days/week with angioedema accompanied by clinically relevant improvement in QoL.
New Concept in Reduced‐Calorie Sponge Cake Production by Xylitol and Oligofructose
Authors: Nourmohammadi Elham , Peighambardoust Seyed Hadi
Published: December 2016

In the present study, the influence of sucrose replacement with xylitol and oligofructose on volume, apparent and solid density, porosity, water activity, crust color, texture and sensory properties of reduced‐calorie sponge cakes was investigated (control: 100% sucrose, X1: 100% xylitol, X2: 77% xylitol‐23% oligofructose, X3: 23% xylitol‐57% sucrose‐20% oligofructose and X4: 25% xylitol‐75% sucrose). Based on the results X3 indicated the highest volume and porosity and the lowest apparent density. X3 also possessed the same firmness with sucrose cakes, while other reduced‐calorie samples showed lower firmness compared to control. In terms of crust color, all reduced‐calorie samples excluding X1 had darker crust than control. Control cakes showed the highest water activity than other samples. The sensory scores of all reduced‐calorie cakes were similar to control at the 1st and 7th days of evaluation, while dietetic samples got higher scores than sucrose cakes at the 14th day after production. Xylitol had no significant effect on solid density (P > 0.05).

Practical Applications

Due to high level of sucrose in cake formulation, and problems such as obesity and increased blood sugar as the result of over consumption of these products, it is necessary to find a way to eliminate or reduce sucrose in cake formulation. Bulking agents are allowed for low calorie and diabetic diets, since their metabolism is slow and incomplete. The purpose of this research is using different concentrations of xylitol and oligofructose as bulking agents in reduced‐calorie cakes. Based on our findings, partial substitution of sucrose with xylitol and oligofructose (X3: xylitol‐sucrose‐oligofructose) showed the best results. On the other hand, complete substitution of sucrose with xylitol (X1) did not provide suitable physical and sensory properties.
Modification of Foaming Properties of Commercial Soy Protein Isolates and Concentrates by Heat Treatments
Authors: Shao Yi‐Yuan , Lin Kuan‐Hung , Kao Yu‐Ju
Published: December 2016

Commercial soy protein isolates (SPIs; China 980A, China 880, ISP 974 and ADM 974) and soy protein concentrates (SPCs; SPC 700 and ARCON S) were used for comparing the effects of heat treatment (55C and 85C for 10–30 min) on the surface tension, surface hydrophobicity, viscosity, solubility at pH 3–8 and foaming properties. The foam capacity was highly positively correlated with the surface hydrophobicity, but negatively related to the surface tension, liquid percentage and foam maximum density. Heating commercial SPIs and SPCs improved the foam capacity, changed the surface hydrophobicity, solubility, foam maximum density and foam stability, and decreased the surface tension and viscosity. The heating temperatures had a greater influence on protein properties than did the heating time. Among soy protein products, heat‐modified China 980A had the best foam capacity and foam stability.

Practical Applications

Simple heating treatments improved foaming properties of commercial soy products with low level of surface tension and high level of surface hydrophobicity and solubility. In particular, heating improved surface tension, foaming capacity, liquid percentage, foam maximum density and not damaged foaming stability in most of samples. These results indicate that a relatively inexpensive, high quality foaming properties was obtained by the action of heating process that benefits the application of using commercial soy proteins as foaming agents in aerated food systems. Therefore, the foaming properties of heated soy proteins were dramatically different, showing great potential for improving tailor‐made proteins for various applications.
Management of Atrial Fibrillation in Elderly Adults
Authors: Desai Yaanik , El‐Chami Mikhael F. , Leon Angel R. , Merchant Faisal M.
Published: December 2016

Driven in large part by the aging of the population and the increasing prevalence of cardiovascular comorbidities associated with atrial fibrillation (AF), there is a burgeoning epidemic of AF in elderly adults. Although there is a large body of literature to guide management of people with AF, elderly adults with AF are frequently underrepresented in clinical trials. This review provides a contemporary update on management of elderly adults with AF with a particular focus on the two main clinical challenges that AF poses: stroke risk reduction and control of symptoms. The evidence to support novel AF treatment strategies in elderly adults is reviewed, including novel oral anticoagulants and left atrial appendage closure for stroke risk reduction and catheter ablation for control of symptoms.
A Dyadic Perspective on Engagement in Advance Care Planning
Authors: Fried Terri , Zenoni Maria , Iannone Lynne
Published: December 2016

Objectives

To understand the perspectives of both patients and the person who would make medical decisions for them if they were unable (surrogates) on their participation in advance care planning (ACP).

Design

Qualitative cross‐sectional study.

Setting

Community.

Participants

Thirty‐one veterans age 55 years and older and their surrogates.

Measurements

In interviews conducted with both the veteran and surrogate, they were asked to discuss their participation in four ACP activities: communication about life‐sustaining treatment, communication about views on quality of life, completion of a living will, and appointment of a healthcare proxy. They were asked about barriers to and facilitators of ACP engagement. When they did not agree about engagement, they each provided their perspective on what they believed had or had not occurred.

Results

Many of the same barriers to and facilitators of engagement were discussed by both patients and surrogates. These included difficulty thinking about dying, differences in values, and experiences with others that demonstrated the ability of ACP to decrease burden or avoid conflict. Reasons for disagreements in perceptions about whether communication had occurred included surrogates’ need for more detailed information, surrogates’ lack of readiness to hear what the patient was saying, and surrogates’ reliance on what they know about the patient. For some dyads, participation in the study prompted additional communication, resulting in a better shared understanding of ACP engagement.

Conclusion

Surrogates can both impede and facilitate engagement in ACP, and they can hold different perceptions from patients regarding this engagement. Efforts to promote ACP may be most successful if they assess and address both patients’ and surrogates’ attitudes and help to facilitate clear communication between them.
Effectiveness of Handmade “Jacky‐Like Catheter” As a Single Multipurpose Catheter in Transradial Coronary Angiography: A Randomized Comparison With Conventional Two‐Catheter Strategy
Authors: Erden Ismail , Golcuk Ebru , Bozyel Serdar , Erden Emine Cakcak , Balaban Yakup , Yalın Kivanc , Turan Burak
Published: December 2016

Objective

To investigate safety and efficacy of specialized hand‐modified “Jacky‐Like” catheter (JLC) as a single dual‐purpose catheter in transradial coronary angiography.

Methods

Patients over 18 years undergoing diagnostic CAG through right radial artery (RRA) were prospectively enrolled. Procedures were performed with a single JLC modified from a left Judkins (JL) 3.5 catheter or by using 2‐catheter approach (2C). Procedures with coronary artery bypass grafts or ventricular angiographies were excluded from the study. Three hundred and eighty‐seven transradial procedures were performed successfully. One hundred and ninety‐four procedures were performed with 2C and 193 procedures with a JLC. Inability to use intended catheters, total fluoroscopic time in minutes, the consumption of contrast medium in milliliter, development of radial artery spasm (RAS), and radial artery occlusion (RAO) were evaluated.

Results

In the 2C group, angiography was successfully performed on the RCA of 191 patients (98.9%) and on LCA in 192 patients (99.4%). In the JLC group, angiography was successfully performed on the RCA and LCA of 193 (99.4%) and 174 (89.6%) patients, respectively. Utilization of supplemental catheters was significantly greater in the JLC group (21; 10.8%) versus the 2C group (3; 1.5% P = 0.001). Mean fluoroscopy time was shorter in the JLC group (2.0 ± 2.3 min vs. 2.3 ± 1.5 min; P = 0.043). Mean procedure time was also decreased with JLC but did not reach statistical significance (5.7 ± 3.1 min vs. 6.2 ± 2.5 min; P = 0.081). When additional time for reshaping the JLC was not taken into account, mean procedure time was significantly decreased in the JLC group (5.6 ± 2.9 min vs. 6.2 ± 2.4 min; P = 0.031). There was a trend toward lower incidence of consumption of contrast medium in the 2C group (49 ± 13 mL vs. 52 ± 18 mL; P = 0.061). RAS was observed more frequently in the 2C group (11.3% vs. 21.7%, P = 0.005). There was a trend toward high incidence of RAO in the 2C group (4.1 vs. 8.3% P = 0.064).

Conclusion

In transradial procedures from RRA, a JLC catheter can be very effective when dedicated dual‐purpose catheter is not available.
Drug‐Eluting Balloon Angioplasty for Below the Knee Lesions in End Stage Renal Disease Patients with Critical Limb Ischemia: Midterm Results
Authors: Teymen Burak , Aktürk Süleyman
Published: December 2016

Background

The 1‐year restenosis rate after standard balloon angioplasty (BA) of long lesions in below‐the‐knee arteries may be as high as 70%. Our aim was to investigate the efficacy and safety of paclitaxel drug‐eluting balloon (DEB) for treatment of below the knee lesions in end stage renal disease patients (ESRD) with critical limb ischemia (CLI).

Methods

Our study is a retrospective, single‐center study. Inclusion criteria were ESRD, critical limb ischemia (Rutherford class 4 or higher) and significant stenosis or occlusion of at least 1 below‐the‐knee vessel. Target vessel restenosis and reocclusion at 1‐year follow‐up was the primary end point. Major amputation, was the secondary end point.

Results

From July 2012 to February 2015, 50 patients identified with ESRD, with CLI, treated with DEB angioplasty. Six patients were lost to follow‐up, leaving 44 patients with 55 vessels (mean age, 58.0 ± 6.9 years; 54.5% male). The mean lesion length was 113.4 ± 55.4 mm. BA confined to the infra‐popliteal segment alone in 81.8% of cases. Primary patency was 90.4% at 6 months and 62.2% at 12 months. At a mean follow‐up of 13.9 ± 3.5 months all cause mortality was 8.1% (N = 3). The ankle brachial index increased from 0.45 ± 0.04 preoperative to 0.88 ± 0.07 postoperative. There was one major amputation (2.7%) and 5 minor amputations at one year (13.5%).

Conclusion

DEB is effective in the treatment of below the knee critical stenosis and occlusions in ESRD patients with critical limb ischemia.
Niche Housing as Social Prosthetic for Lesbian, Gay, Bisexual, and Transgender Seniors: Resident Motivations and Perceptions
Authors: Matthews Carl , Hill Caroline , Frederiksen Debbie
Published: December 2016

Niche housing is one of the fastest growing segments of housing projects for elders in the United States. Folks select housing for many reasons including finances, social connections, safety, comfort, style, and services provided. This paper explores one of the latest developments, Town Hall Apartments, Chicago, created specifically to meet the needs of lesbian, gay, bisexual, and transgender (LGBT) seniors with limited income. Senior housing precedents and theories are explained and interviews with residents of the complex are analyzed. Findings provide ideas and directions for other designers to pursue when creating housing not only for LGBT seniors but other niche markets as well.
Verticillium dahliae LysM effectors differentially contribute to virulence on plant hosts
Authors: Kombrink Anja , Rovenich Hanna , Shi‐Kunne Xiaoqian , Rojas‐Padilla Eduardo , van den Berg Grardy C. M. , Domazakis Emmanouil , de Jonge Ronnie , Valkenburg Dirk‐Jan , Sánchez‐Vallet Andrea , Seidl Michael F. , Thomma Bart P. H. J.
Published: December 2016

Chitin‐binding lysin motif (LysM) effectors contribute to the virulence of various plant‐pathogenic fungi that are causal agents of foliar diseases. Here, we report the LysM effectors of the soil‐borne fungal vascular wilt pathogen Verticillium dahliae. Comparative genomics revealed three core LysM effectors that are conserved in a collection of V. dahliae strains. Remarkably, and in contrast with the previously studied LysM effectors of other plant pathogens, no expression of core LysM effectors was monitored in planta in a taxonomically diverse panel of host plants. Moreover, targeted deletion of the individual LysM effector genes in V. dahliae strain JR2 did not compromise virulence in infections on Arabidopsis, tomato or Nicotiana benthamiana. Interestingly, an additional lineage‐specific LysM effector is encoded in the genome of V. dahliae strain VdLs17, but not in any other V. dahliae strain sequenced to date. Remarkably, this lineage‐specific effector is expressed in planta and contributes to the virulence of V. dahliae strain VdLs17 on tomato, but not on Arabidopsis or N. benthamiana. Functional analysis revealed that this LysM effector binds chitin, is able to suppress chitin‐induced immune responses and protects fungal hyphae against hydrolysis by plant hydrolytic enzymes. Thus, in contrast with the core LysM effectors of V. dahliae, this lineage‐specific LysM effector of strain VdLs17 contributes to virulence in planta.
Identification of semiochemicals attractive toSimulium vittatum(IS‐7)
Authors: VEROCAI G. G. , McGAHA T. W. , IBURG J. P. , KATHOLI C. R. , CUPP E. W. , NOBLET R. , UNNASCH T. R.
Published: December 2016

Many blackfly species (Diptera:Simuliidae) are economically important insect pests, both as nuisance biters and as vectors of pathogens of medical and veterinary relevance. Among the important blackfly pest species inNorthAmerica isSimulium vittatumZetterstedtsensu lato. The objective of this study was to identify compounds excreted by mammalian hosts that are attractive to host‐seekingS. vittatumfemales. The attractiveness of putative compounds to colonizedS. vittatumwas tested through electrophysiological (electroantennography;n = 58 compounds) and behavioural (Y‐tube assays;n = 7 compounds in three concentrations) bioassays. Five compounds were significantly attractive to host‐seekingS. vittatumfemales: 1‐octen‐3‐ol; 2‐heptanone; acetophenone; 1‐octanol, and naphthalene. These candidate compounds might be useful as attractants in traps that could be developed for use in alternative or complementary management tactics in programmes to suppress nuisance blackfly populations, or for the collection of samples in which to study the transmission ecology of pathogens transmitted by blackflies of theS. vittatumcomplex.
Characterization of patients with chronic pulmonary aspergillosis according to the new ESCMID/ERS/ECMM and IDSA guidelines
Authors: Salzer Helmut J. F. , Heyckendorf Jan , Kalsdorf Barbara , Rolling Thierry , Lange Christoph
Published: December 2016

Recently, the Infectious Diseases Society of America (IDSA) and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) in cooperation with the European Respiratory Society (ERS) and the European Confederation of Medical Mycology (ECMM) published guidelines for the diagnosis of chronic pulmonary aspergillosis (CPA). Both guidelines, however, carry significant differences. We retrospectively applied the diagnostic recommendations on a patient cohort of 71 previously diagnosed CPA patients in order to compare both guidelines. In 50 patients (70%) the diagnosis was confirmed by the diagnostic criteria of both guidelines, while nine patients (13%) fulfilled neither the ESCMID/ERS/ECMM nor the IDSA criteria. Reasons were lack of mycological evidence in respiratory samples. These patients were not tested for the presence of Aspergillus‐specific IgG antibodies, which is strongly recommended by both guidelines. Seven patients did not fulfil the diagnostic criteria of the IDSA guideline, because of severe immunosuppression, while five patients didn't fulfil the diagnostic criteria of the ESCMID/ERS/ECMM guideline, because of uncommon image findings. The comparison of both guidelines highlight that the combination of a chest CT scan with the performance of an Aspergillus‐specific IgG antibody assay are key diagnostic features to establish a guideline‐based diagnosis of CPA.
Luminal contents from the gut of colicky infants induce visceral hypersensitivity in mice
Authors: Eutamène H. , Garcia‐Rodenas C. L. , Yvon S. , d'Aldebert E. , Foata F. , Berger B. , Sauser J. , Theodorou V. , Bergonzelli G. , Mas E.
Published: December 2016

Background

The pathophysiology of infantile colic is poorly understood, though various studies report gut microbiota dysbiosis in colicky infants. We aimed to test the hypothesis that colic‐related dysbiosis is associated with visceral hypersensitivity triggered by an altered luminal milieu.

Methods

Fecal samples from seven colicky and seven non‐colicky infants were studied. Fecal supernatants (FS) were infused into the colons of C57/Bl6 mice (n=10/specimen). Visceral sensitivity was subsequently assessed in the animals by recording their abdominal muscle response to colorectal distension (CRD) by electromyography (EMG). Serine and cysteine protease activities were assessed in FS with specific substrates. Infant fecal microbiota composition was analyzed by DNA extraction and 16S rRNA gene pyrosequencing.

Key Results

FS from colicky infants triggered higher EMG activity than FS from non‐colicky infants in response to both the largest CRD volumes and overall, as assessed by the area under the curve of the EMG across all CRD volumes. Infant crying time strongly correlated with mouse EMG activity. Microbiota richness and phylogenetic diversity were increased in the colicky group, without showing prominent microbial composition alterations. Only Bacteroides vulgatus and Bilophila wadsworthia were increased in the colicky group. Bacteroides vulgatus abundance positively correlated with visceral sensitivity. No differences were found in protease activities.

Conclusions & Inferences

Luminal contents from colicky infants trigger visceral hypersensitivity, which may explain the excessive crying behavior of these infants. Additional studies are required to determine the nature of the compounds involved, their mechanism of action, and the potential implications of intestinal microbiota in their generation.
Postanesthesia evaluation of emotional and psychological satisfaction in a Hispanic population
Authors: Zauner Angela , Pinilla Alvaro , Benitez Daniel , Tellez Alejandra , Romero David , Suarez Ana , López Vanessa , Hermida Eduardo
Published: December 2016

Background

Patient satisfaction has a positive impact on clinical care. Different strategies, such as questionnaires, have been developed to evaluate and improve patient satisfaction. A validated pediatric anesthesia questionnaire previously showed the importance of perioperative care built upon a relationship of trust between healthcare providers and children and parents, and a comfortable environment in which satisfactory answers are provided. However, the questionnaire was validated in English, and no research exists on the use of satisfaction questionnaires in Spanish. Given that there are 559 million Spanish speakers in the world, of which 53 million live in the United States, we intended to validate a Spanish version of this questionnaire to measure parental and pediatric satisfaction after anesthesia, and facilitate the provision and quality management of anesthesia care in Hispanic populations.

Methods

A questionnaire validated in English was translated to Spanish. Subsequently, it was administered to children who had undergone surgery and their parents to determine reliability, validity, acceptability, and reproducibility.

Results

Of the 228 recruited parents, a total of 221 agreed to participate, and 77 questionnaires were filled out completely by both parents and children. Overall response rates of 97% for parents and 90% for children were achieved. The reliability, test–retest reliability, and internal consistency were examined, and a McNemar coefficient of 0.97 and a Cronbach's alpha coefficient of 0.82 were obtained. Construct validity was obtained through comparisons of the following items: the child′s perception of serenity imparted by the medical staff with the parent′s satisfaction with conversations between the anesthesiologist and child, the nurse′s ability to make the child feel better with the parent′s satisfaction with the nurse′s professionalism, and the nurse′s kindness toward the child with the parent′s perception of the care provided.

Conclusion

This questionnaire proved to be simple and easy to understand within the literate Spanish‐speaking population. It had adequate content validity and high reliability, acceptability, reproducibility, and construct validity. We believe that this Spanish questionnaire can be used with success among Hispanic populations resulting in improved care for those undergoing anesthesia, and therefore, patient satisfaction.
Neurostimulation for Postsurgical Analgesia: A Novel System Enabling Ultrasound‐Guided Percutaneous Peripheral Nerve Stimulation
Authors: Ilfeld Brian M. , Grant Stuart A. , Gilmore Christopher A. , Chae John , Wilson Richard D. , Wongsarnpigoon Amorn , Boggs Joseph W.
Published: December 2016

While neurostimulation—stimulation of the nervous system using electrical current—has been used to treat chronic pain, its use treating postsurgical pain has been limited. Here, we report on the clinical application of a novel investigational lead to provide analgesia following total knee arthroplasty. In 5 subjects, leads were inserted percutaneously using ultrasound guidance within 0.5 to 3.0 cm of the femoral and/or sciatic nerve(s). With the delivery of current, pain decreased an average of 63% at rest, with 4 of 5 subjects having relief of > 50%. During passive and active knee flexion, pain decreased an average of 14% and 50%, with 0/3 and 1/2 subjects attaining > 50% relief, respectively. Ultrasound‐guided percutaneous peripheral nerve stimulation may be a practical modality for the treatment of postsurgical pain.
Successful Treatment of Postdural Puncture Headache Using Epidural Fibrin Glue Patch after Persistent Failure of Epidural Blood Patches
Authors: Wong Kevin , Monroe Brian R.
Published: December 2016

Objectives

Epidural blood patch is the gold standard for the treatment of postdural puncture headache (PDPH) when conservative treatments have failed to provide any relief. However, alternative therapies are lacking when epidural blood patch persistently fails to improve symptoms. Failure to treat PDPH may lead to significant functional impairment of daily living. Alternative therapies should be sought to accelerate recovery from PDPH.

Case Report

This case describes a woman who developed PDPH secondary to accidental dural puncture during a spinal cord stimulator trial. She was successfully treated with epidural fibrin glue patch after multiple trials of epidural blood patches.

Conclusion

Percutaneous injection of fibrin glue to seal the dural defect demonstrated promising outcomes for both immediate and long‐lasting resolution of persistent PDPH in our patient. In the event of epidural blood patch failure, epidural fibrin glue patch may be a reasonable alternative for the treatment of persistent PDPH.
The significance of meaningful and enjoyable activities for nursing home resident's experiences of dignity
Authors: Slettebø Åshild , Sæteren Berit , Caspari Synnøve , Lohne Vibeke , Rehnsfeldt Arne Wilhelm , Heggestad Anne Kari Tolo , Lillestø Britt , Høy Bente , Råholm Maj‐Britt , Lindwall Lillemor , Aasgaard Trygve , Nåden Dagfinn
Published: December 2016

Background

Living in a nursing home may be challenging to the residents’ experience of dignity. Residents’ perception of how their dignity is respected in everyday care is important.

Aim

To examine how nursing home residents experience dignity through the provision of activities that foster meaning and joy in their daily life.

Method

A qualitative design was used and 28 individual semistructured interviews conducted with nursing home residents from six nursing homes in Denmark, Norway and Sweden. The data were analysed with qualitative content analysis. Independent ethical committees in all participating countries granted their approval for the study.

Findings

The participants highlight two dimensions of the activities that foster experiences of dignity in nursing homes in Scandinavia. These two categories were (i) fostering dignity through meaningful participation and (ii) fostering dignity through experiencing enjoyable individualised activities.

Conclusion

Activities are important for residents to experience dignity in their daily life in nursing homes. However, it is important to tailor the activities to the individual and to enable the residents to take part actively. Nurses should collect information about the resident's preferences for participation in activities at the nursing home.
The HLA‐A, ‐B and ‐DRB1 polymorphism in a large dataset of South Brazil bone marrow donors from Rio Grande do Sul
Authors: Boquett J. A. , Nunes J. M. , Buhler S. , de Oliveira M. Z. , Jobim L. F. , Jobim M. , Fagundes N. J. R. , Schüler‐Faccini L. , Sanchez‐Mazas A.
Published: December 2016

Human leukocyte antigen (HLA) genes are very informative in population genetics studies and their variability has been widely used to reconstruct the history of geographic and/or demographic expansions of human populations. The characterization of HLA diversity at the population level is also fundamental in clinical studies, particularly for bone marrow transplantation programs. In this study, we investigated the HLA molecular variation in Rio Grande do Sul, South Brazil, in order to identify possible regional differences across this state. More than 97,000 bone marrow donors were typed at the HLA‐ A, ‐B and ‐DRB1 loci and analyzed by considering two kinds of subdivisions based on both self‐identified ethnicity and place of residence: (a) the official geographic subdivision defined by the Brazilian Institute of Geography and Statistics and (b) known information about the colonization history of the state. HLA allele and haplotype frequencies were estimated and compared among the defined subgroups. The results indicate a lack of correlation between genetic variation and geography and thus no clear HLA genetic structure based on geographic criteria. On the other hand, major differences were observed regarding ethnicity. In addition, local populations from Rio Grande do Sul were found to be genetically similar to their corresponding parental European populations from Germany, Italy and Portugal, as documented by historical data. Overall, this study provides a thorough characterization of the HLA genetic variation in Rio Grande do Sul and a better understanding of its demographic history, being most useful for the development of more efficient strategies in bone marrow donors' recruitment.
Multidisciplinary inferences on a newly recognized active east‐dipping extensional system in Central Italy
Authors: Lavecchia Giusy , Adinolfi Guido Maria , de Nardis Rita , Ferrarini Federica , Cirillo Daniele , Brozzetti Francesco , De Matteis Raffaella , Festa Gaetano , Zollo Aldo
Published: December 2016

We use a multidisciplinary approach to gather preliminary evidence for a Quaternary east‐dipping extensional detachment in Central Italy. This structure crops out in the Sabini‐Eastern Simbruini (SES) and would be hidden at mid‐crustal depths beneath the L'Aquila 2009 (Mw6.3) epicentral area. TheSESgeometry is reconstructed through geological mapping, structural analysis and seismic line interpretation. The geometry of the mid‐crustal segment, referred to as the Ocre Segment (OS), is interpreted through seismological analyses of the largest aftershock (Mw5.4) of the L'Aquila 2009 sequence. The kinematic compatibility between theSESand theOSunder a commonSW–NEtensional field is tested through stress inversion of both geological and seismological data. The reliability ofOSactivation is tested through slip tendency analysis. Like other Italian cases, theSESand theOSare preliminarily interpreted as expressions at different depths of the same unknown east‐dipping extensional detachment, characterized by a ramp–flat–ramp geometry.
The Consequential Conception of Doxastic Responsibility
Authors: Meylan Anne
Published: December 2016

We are occasionally responsible for our beliefs. But is this doxastic responsibility analogous to any non‐attitudinal form of responsibility? What I shall call the consequential conception of doxastic responsibility holds that the kind of responsibility that we have for our beliefs is indeed analogous to the kind of responsibility that we have for the consequences of our actions. This article does two things, both with the aim of defending this somewhat unsophisticated but intuitive view of doxastic responsibility. First, it emphasizes the advantage of preserving, as the consequential conception does, the analogy with the non‐attitudinal realm, i.e., with the realm of actions and their consequences. Second, this article regiments the most important objections to the consequential conception and answers them. The upshot is that there are no serious drawbacks to the consequential conception. There is, therefore, no reason not to favour it over accounts of doxastic responsibility that do not preserve the analogy with the non‐attitudinal realm.
Use of organs from donors with bloodstream infection, pneumonia, and influenza: Results of a survey of infectious diseases practitioners
Authors: Mehta Sanjay R. , Logan Cathy , Kotton Camille N. , Kumar Deepali , Aslam Saima
Published: December 2016

Background

Potential organ donors may be admitted with an infection to an intensive care unit, or contract a nosocomial infection during their stay, increasing the risk of potential transmission to the recipient. Because of a lack of practice guidelines and large‐scale data on this topic, we undertook a survey to assess the willingness of transplant infectious diseases (ID) physicians to accept such organs.

Methods

We performed a 10‐question survey of ID providers from the American Society of Transplantation Infectious Disease Community of Practice to determine the scope of practice regarding acceptance of organs from donors with bloodstream infection, pneumonia, and influenza prior to organ procurement, as well as management of such infections following transplantation.

Results

Among 60 respondents to our survey, a majority indicated that organs would be accepted from donors bacteremic with streptococci (76%) or Enterobacteriaceae (73%) without evidence of drug resistance. Acceptance rates varied based on infecting organism, type of organ, and center size. Ten percent of respondents would accept an organ from a donor bacteremic with a carbapenem‐resistant organism. Over 90% of respondents would accept an organ other than a lung from a donor with influenza on treatment, compared with 52% that would accept a lung in the same setting.

Conclusions

This study is the first to our knowledge to survey transplant ID providers regarding acceptance of organs based on specific infections in the donor. These decisions are often based on limited published data and experience. Better characterization of the outcomes from donors with specific types of infection could lead to liberalization of organ acceptance practices across centers.
West Nile Virus preparedness plan to ensure safe blood components in Switzerland: a risk‐based approach
Authors: Niederhauser C. , Fontana S. , Glauser A. , Steinemann C. , Koller A.
Published: December 2016

Background

In 2012, the Swiss Transfusion SRC founded a working group to develop a WNV preparedness plan for Switzerland in order to deal with expanding spread of WNV epidemics in Europe.

Materials and Methods

The risk estimates were computed for various presumptive incidence scenarios and brought into relation to cost estimates for the introduction of a routine WNV‐NAT screening programme. The costs to prevent one case per year and the number of donations which need to be tested to detect a WNV‐RNA‐positive donation were calculated.

Results

With a theoretical postulated incidence of one West Nile virus meningoencephalitis (WNVME) case in Switzerland per year, approximately one WNV‐RNA‐positive case would be detected every 11 years. With 100 WNVME cases per year, approximately 8·8 donations would be detected every year. The additional cost burden of introducing WNV‐NAT in Switzerland is 2·6 million euros per year. Costs to prevent one case per year are thus between 27 million and 0·28 million euros, depending on the incidence assumption.

Due to the geographical situation in Switzerland, it was decided to determine two potential risk regions, the southern part of the country and the remaining northern part. In addition, two risk levels and respective measures were defined.

Conclusions

The risk for WNV transmission through blood products is low even when 100 autochthonous WNV cases would be detected. With this in mind, the blood transfusion services and the national health authorities established a cost‐efficient WNV preparedness plan to prevent WNV transfusion–transmission and maintain self‐sufficiency in the blood supply.
HLA typing in diverse populations
Authors: Holdsworth R. , Diviney M.
Published: December 2016

The human leucocyte antigens (HLA) genes are part of the major histocompatibility complex and are the most polymorphic gene complex in the human genome. The HLA genes are hyperpolymorphic, that is many forms of the genes (alleles) at each locus. The HLA molecules play a critical role in our immune defence, and the extreme diversity ensures a robust immune response. Over many generations, HLA types are retained through immune advantage which may be the basis of the high frequency of some HLA alleles in specific regions. Geographical, language or religious influences can further influence regional HLA allele frequency. The HLA gene hyperpolymorphism can make typing protocols very complex. HLA typing requires DNA‐based testing methods to identify the hundreds of nucleotide differences throughout the introns and exons of the HLA genes for each allele. The level of resolution of the HLA result depends on the type of assay used. Assay design and testing can be time‐consuming, and manufacturers may use ‘smart’ software with population reference data to estimate the most likely HLA alleles in the allele assignment. Other methods have utilized haplotype data for HLA typing assignment, but the identification of haplotypes by inference rather than direct sequencing of alleles may generate ambiguous results. Next‐generation sequencing assays are designed to detect the entire nucleotide sequence of the HLA gene and accurately assign HLA alleles without ambiguity. Diverse populations will have a wide range of HLA types, and this can lead to challenges in assigning HLA alleles.
IMAGING DIAGNOSIS—IMAGING AND HISTOPATHOLOGIC CHARACTERISTICS OF A VERTEBRAL HAMARTOMA IN A CAT
Authors: Taylor‐Brown Frances E. , Lamb Christopher R. , Martineau Henny , Muir Clare , Beltran Elsa
Published: December 2016

A 9‐month‐old domestic shorthair cat had progressive ambulatory paraparesis, proprioceptive ataxia, and thoracolumbar hyperesthesia. An extradural mass affecting the left pedicle and lamina of the second lumbar vertebra (L2) causing marked spinal cord impingement was identified in magnetic resonance (MR) images. The mass was predominantly calcified in computed tomographic (CT) images. A hemilaminectomy was performed to resect the mass. Clinical signs were greatly improved at 12‐month follow‐up. The histopathologic diagnosis was vascular hamartoma. To our knowledge, this is the first report describing the MR characteristics of a vascular hamartoma associated with the vertebral column.
Molecular diversity and distribution of eastern Atlantic and Mediterranean dogfishes Squalus highlight taxonomic issues in the genus
Authors: Veríssimo Ana , Zaera‐Perez Diana , Leslie Rob , Iglésias Samuel P. , Séret Bernard , Grigoriou Panagiotis , Sterioti Aspasia , Gubili Chrysoula , Barría Claudio , Duffy Clinton , Hernández Sebastián , Batjakas Ioannis E. , Griffiths Andrew M.
Published: December 2016

The alpha taxonomy of the globally distributed shark genus Squalus has been under intense investigation recently, and many new species have been described over the last decade. However, taxonomic uncertainty remains about several taxa. Without consistent nomenclature and the ability to reliably distinguish between the different Squalus species, basic data collection, downstream conservation and management efforts are seriously compromised. To aid in clarifying the taxonomic status of Squalus species in the eastern Atlantic and Mediterranean, we assessed species diversity at the molecular level and evaluated the consistency in species identification in the region. Samples from all nominal Squalus species recognized in the above regions were collected in an international effort and sequenced for regions of the mitochondrial COI and ND2 genes. These data were further analysed alongside publicly available sequences, including 19 of the 26 Squalus species globally recognized, to compare the regional genus‐level diversity with that found elsewhere. Our results confirm inconsistent species identification in the eastern Atlantic and Mediterranean Squalus, particularly concerning S. blainville and S. megalops, and reinforce the need to revise the status of S. megalops and S. mitsukurii as they may include several distinct species distributed around the world. The status of S. blainville is also discussed in the light of the current findings and its problematic taxonomic history.