bluuebunny/crossref_metadata_2025 huggingface dataset:
Spanish primary care survey on the management of Helicobacter pylori infection and dyspepsia: Information, attitudes, and decisions
Authors: McNicholl Adrian G. , Amador Javier , Ricote Mercedes , Cañones‐Garzón Pedro J. , Gene Emili , Calvet Xavier , Gisbert Javier P. ,   the Spanish Primary Care Societies SEMFyC,   SEMERGEN and SEMG, the Spanish Association of Gastroenterology,   the OPTICARE Long‐Term Educational Project
Published: May 2019

Introduction

Dyspepsia and Helicobacter pylori are two of the most relevant digestive conditions in primary care. Several consensuses on the subject have been published, but the assimilation/implementation of these guidelines is uncertain.

Aims and Methods

To evaluate the attitudes, perceptions, limitations, and adherence to recommendations of Spanish primary care physicians using an open online survey. Responses were anonymously codified. Estimated margin of error was 3.4%. Responses were weighted by province, gender, age, and type of practice. Survey was performed using the AEG‐REDCap platform.

Results

A total of 1445 responses, received between December 2017 and April 2018, were analyzed. Women represented 54%, and the average age was 48 years; 59% were from urban context, 20% from semi‐urban, and 21% from rural; 93% provided public practice. Over 40% had read at least one Maastricht consensus (24% Maastricht V), and 34% had attended a course related to H. pylori. 16% reported no direct access to any validated diagnostic method, only 44% to urea breath test, and 33% did not systematically refer to eradication confirmation test. The first‐line treatment of choice was standard triple therapy in 56%, followed by concomitant therapy (28%). Only 20% of physicians had optimal adherence to recommendations.

Conclusion

Even though some improvements from guidelines have been partially incorporated, the level of penetration of recommendations is still poor and delayed. To provide optimal primary care, the barriers for implementation, access to diagnostic tests and to continuous medical education, should be removed. Rigorous dissemination, implementation, and evaluation programs are desired in future consensuses.
High‐dose PPI‐amoxicillin dual therapy with or without bismuth for first‐line Helicobacter pylori therapy: A randomized trial
Authors: Yu Lou , Luo Laisheng , Long Xiaohua , Liang Xiao , Ji Yingjie , Graham David Y. , Lu Hong
Published: May 2019

Background

A reliably highly effective high‐dose proton‐pump inhibitor plus amoxicillin (dual Helicobacter pylori therapy) has remained elusive. We compared whether the addition of bismuth to high‐dose dual therapy would improve the efficacy of high‐dose dual therapy as first‐line treatment.

Methods

This was an open‐label, randomized single‐center study of 160 treatment‐naive patients with H. pylori infection who were randomly assigned to 14‐day therapy with esomeprazole 40 mg twice a day plus amoxicillin 1 g three times a day with or without bismuth potassium citrate 600 mg (elemental bismuth 220 mg) twice a day. Antibiotic resistance was determined by agar dilution method and eradication by 13C‐urea breath test.

Results

The per‐protocol eradication rates were 96.1%; 95% CI = 88.9%‐99.2% (73/76) without bismuth vs 93.3%; 95% CI = 85.1%‐97.8% (70/75) with bismuth (P = 0.494). The intention‐to‐treat eradication rates were 92.5%; 95% CI = 84.4%‐97.2% (74/80) without bismuth and 88.8%; 95% CI = 79.7%‐94.7% (71/80) with bismuth (P = 0.416). Resistance to amoxicillin, clarithromycin, metronidazole, and levofloxacin was 0%, 31.7%, 81.4%, and 40.7%, respectively. Smoking reduced treatment effectiveness limited to those not receiving bismuth. The per‐protocol eradication rates were 70% (7/10) vs 100% (66/66) in smokers vs non‐smokers without bismuth (P = 0.002), and 100% (10/10) in smokers vs 92.3% (60/65) in non‐smokers with bismuth (P = 1.0). The adverse event rates were 7.5% (6/80) without bismuth vs 11.3% (9/80) with bismuth (P = 0.416).

Conclusions

Fourteen‐day high‐dose dual therapy was both effective and safe for first‐line treatment in a region of high prevalence antibiotic resistance. Adding bismuth only improved treatment effectiveness among smokers.
Guidelines for the management of Helicobacter pylori infection in Japan: 2016 Revised Edition
Authors: Kato Mototsugu , Ota Hiroyoshi , Okuda Masumi , Kikuchi Shogo , Satoh Kiichi , Shimoyama Tadashi , Suzuki Hidekazu , Handa Osamu , Furuta Takahisa , Mabe Katsuhiro , Murakami Kazunari , Sugiyama Toshiro , Uemura Naomi , Takahashi Shin'ichi
Published: May 2019

Background

Since “Helicobacter pylori (H. pylori) infection” was set as the indication in the Japanese Society for Helicobacter Research (JSHR) Guidelines 2009, eradication treatment for H. pylori gastritis is covered under insurance since 2013 in Japan, and the number of H. pylori eradication has rapidly increased. Under such circumstances, JSHR has made the third revision to the “Guidelines for diagnosis and treatment of H. pylori infection” for the first time in 7 years.

Methods

The Guideline Committee held 10 meetings. Articles published between the establishment of the 2009 Guidelines and March 2016 were reviewed and classified according to the evidence level; the statements were revised on the basis of this review. After inviting public comments, the revised statements were finalized using the Delphi method.

Results

There was no change in the basic policy that H. pylori infectious disease is an indication for eradication. Other diseases presumed to be associated with H. pylori infection were added as indications. Serum pepsinogen level, endoscopic examination, and X‐ray examination were added to the diagnostic methods. The effects of 1‐week triple therapy consisting of potassium‐competitive acid blocker (P‐CAB), amoxicillin, and clarithromycin have improved, and high eradication rates can also be expected with proton pump inhibitors (PPI) or P‐CAB combined with amoxicillin and metronidazole. If the susceptibility test is not performed, the triple PPI or P‐CAB/amoxicillin/metronidazole therapy should be chosen, because the PPI/amoxicillin/metronidazole combination demonstrated a significantly higher eradication rate than PPI/amoxicillin/clarithromycin. In the proposal for gastric cancer prevention, we divided gastric cancer prevention measures by age from adolescent to elderly, who are at an increased gastric cancer risk, and presented measures for gastric cancer prevention primarily based on H. pylori eradication.

Conclusion

We expect the revised guidelines to facilitate appropriate interventions for patients with H. pylori infection and accomplish its eradication and prevention of gastric cancer.
Care Ethics and Obligations to Future Generations
Authors: Randall Thomas
Published: May 2019

A dominant area of inquiry within intergenerational ethics concerns how goods (and bads) ought to be justly distributed between noncontemporaries. Contractualist theories of justice that have broached these discussions have often centered on the concepts of mutual advantage and (indirect) reciprocal cooperation between rational, self‐interested beings. However, another prominent reason that many in the present feel that they have obligations toward future generations is not due to self‐interested reciprocity, but simply because they care about what happens to them. Care ethics promises to be conceptually well‐suited for articulating this latter reason: given that future generations are in a perpetual condition of dependency on present‐day people's actions, this is precisely the kind of relational structure that care theorists should be interested in morally evaluating. Unfortunately, the care literature has been largely silent on intergenerational ethics. This article aims to advance this literature, offering the blueprints of what a care ethic concerning future generations—a “future care ethic”—should look like. The resultant ethic defends a sufficientarian theory of obligation: people in the present ought to ensure the conditions needed to encourage and sustain a world that enables good caring relations to flourish.
Root canal configuration and its relation with endodontic technical errors in premolar teeth: a CBCT analysis
Authors: Nascimento E. H. L. , Nascimento M. C. C. , Gaêta‐Araujo H. , Fontenele R. C. , Freitas D. Q.
Published: May 2019

Aim

To evaluate the association between endodontic technical errors and the root canal configuration (RCC) of human premolars, as well as their relationship with periapical lesions through cone‐beam computed tomography (CBCT) images.

Methodology

The sample consisted of CBCT scans belonging to 136 patients, totalling 152 root filled premolars (185 roots). CBCT images were evaluated by two oral radiologists. RCC was recorded according to Vertucci's classification, and the endodontic treatment quality was judged on the presence and type of technical endodontic errors (underfilling, overfilling, nonhomogeneous filling, nonfilled canal, fractured instruments, root deviation and absence of coronal restoration). In addition, the presence of periapical lesions associated with each RCC was recorded. Data were expressed by frequencies and percentages, and intraobserver agreement was calculated using the Kappa test.

Results

The most common RCC was type I (71%), followed by type IV (15%), type II (8%), type V (3%), type VI (1%) and type III (1%). Types VII and VIII were not observed in the sample. Underfilling was the most frequent endodontic technical error for most RCCs, except for types IV, V and ‘other’, whose most frequent error was a nonfilled canal. The presence of technical errors was greater with an increase in the proportion of the periapical lesions. The intraobserver agreement was excellent.

Conclusions

There was an increase in the prevalence of endodontic technical errors and in the presence of periapical lesions as the anatomical complexity of the root canals increased. Underfilled and nonfilled canal were the most frequent endodontic technical errors.
Performance evaluation of the prototype Abbott Alinity hq hematology analyzer
Authors: Van der Beken Yolien , Van Dalem Annelien , Van Moer Guy , Segers Eddy , Damiaens Serge , Hoffmann Johannes , Lakos Gabriella , Jochmans Kristin
Published: May 2019

Introduction

The analytical and clinical performance as well as the workflow efficiency of the novel, prototype Alinity hq hematology analyzer was evaluated in the clinical laboratory of Universitair Ziekenhuis Brussel, Department of Hematology, Brussels, Belgium.

Methods

Within‐run and within‐laboratory imprecision, linearity, and carryover were assessed using clinical blood samples and commercial blood products. Four hundred and seventeen samples were selected for method comparison with Abbott CELL‐DYN Sapphire, and for flagging performance analysis in comparison with smear review and manual microscopic white blood cell (WBC) differential.

Results

Within‐run and within‐laboratory imprecision verification demonstrated low %CV for complete blood count and WBC differential results within the normal ranges (0.1%‐10.4%), except for basophil granulocytes. The linearity of the analytical measuring ranges was verified for WBCs, red blood cells, hemoglobin, and platelets. Alinity hq results showed strong agreement with those of CELL‐DYN Sapphire. Good correlation was demonstrated with manual WBC differential results, with negative bias for neutrophil (NEU) granulocytes, and positive bias for lymphocytes and monocytes. Blasts were detected with 75% sensitivity and 96% specificity at 1% blast threshold, and 100% sensitivity at 5% blast threshold. Immature granulocyte detection was more sensitive (81% vs 76%, P = 0.086) and specific (88% vs 78%, P = 0.0002) than with CELL‐DYN Sapphire. Nucleated red blood cell detection was more sensitive (89% vs 63%, P < 0.001) and just slightly less specific (96% vs 99%, P = 0.0067) than with CELL‐DYN Sapphire. Re‐run and reflex testing rates were lower with Alinity hq.

Conclusion

The Alinity hq hematology analyzer is suitable for clinical use.
Chromosomal microarray analysis is superior in identifying cryptic aberrations in patients with acute lymphoblastic leukemia at diagnosis/relapse as a single assay
Authors: Chen Chuanfei , Heng Evelyn Yee Hsieh , Lim Alvin Soon Tiong , Lau Lai Ching , Lim Tse Hui , Wong Gee Chuan , Tien Sim Leng
Published: May 2019

Introduction

Conventional cytogenetics (CC) is important in diagnosis, therapy, monitoring of post‐transplant bone marrow, and prognosis assessment of acute lymphoblastic leukemia (ALL). However, due to the nature of ALL, CC often encounters difficulties of complex karyotype, poor chromosome morphology, low mitotic index, or normal cells dividing only. In contrast, chromosomal microarray analysis (CMA) showed a specificity >99% and a sensitivity of 100% in chronic lymphocytic leukemia (CLL) patients. Here, we report our experience with CMA on adult ALL patients.

Methods

Thirty‐three bone marrow/blood samples from ALL patients (aged 18‐79 years, median 44) at diagnosis/relapse, analyzed by CC and/or fluorescence in situ hybridization (FISH), were recruited. Chromosomal microarray analysis results were compared with CC. Fluorescence in situ hybridization analysis, if available, was applied when there was a discrepancy.

Results

Copy‐neutral loss‐of‐heterozygosity (CN‐LOH) was found in 8 cases (24.2%). Only CN‐LOH at 9p was recurrent (3 cases, 9.1%). Copy number alterations (CNAs) were detected in 6 of 9 cases (66.7%) with normal karyotypes, in 3 of 5 cases (60.0%) with sole “balanced” translocations, and in 18 of 19 cases (94.7%) with complex karyotypes. Common CNAs involved CDKN2A/2B (30.3%), IKZF1 (27.3%), PAX5 (9.1%), RB1 (9.1%), BTG1 (6.7%), and ETV6 (6.7%), which regulate cell cycle, B lymphopoiesis, or act as tumor suppressors in ALL. Copy number alteration detection rate by CMA was 81.8% (27 of 33 cases) as compared to 57.6% (19 of 33 cases) by CC.

Conclusion

Incorporation of CMA as a routine clinical test at the time of diagnosis/relapse, in conjunction with CC and/or FISH, is highly recommended.
Impaired wound healing secondary to bevacizumab
Authors: Ahn Ji W. , Shalabi Doaa , Correa‐Selm Lilia M. , Dasgeb Bahar , Nikbakht Neda , Cha Jisun
Published: May 2019

Bevacizumab is a monoclonal antibody that exerts its antitumor activity by inhibiting vascular endothelial growth factor. Consequently, it suppresses endothelial cell proliferation, vascular permeability, and angiogenesis. This inhibitory effect contributes to tumour size reduction but causes wound‐healing delay, specifically during the proliferative phase, in patients receiving bevacizumab. Although surgical wound‐healing complications (WHC) associated with bevacizumab have been extensively reported, there is limited literature on peripheral WHC. More importantly, the histopathology of bevacizumab‐associated WHC has not been described. We present the histopathology findings of a non‐healing ulcer in a patient receiving bevacizumab, providing insight into the possible aetiology of this drug's adverse reaction. Furthermore, our patient's positive response to hyperbaric oxygen suggests its possible use for treatment of bevacizumab‐associated non‐healing wounds.
Progressive resistance training for persons with intellectual disabilities and visual impairment
Authors: Dijkhuizen Annemarie , Waninge Aly , Hermans Seph , van der Schans Cees P. , Krijnen Wim P.
Published: May 2019

Background

Knowledge concerning the feasibility and effects of progressive resistance training (PRT) for persons with intellectual disabilities and visual impairment who are categorized in Gross Motor Function Classification System (GMFCS) Level 1 is limited. The aim of our study was to evaluate feasibility and effect of PRT on participants' Quadriceps strength and personal goals.

Methods

Eight Participants followed a PRT program for 10 weeks. Feasibility was determined by percentage of attendance and compliance. The effect of PRT was analyzed with a linear mixed model (p < 0.05) and by normalized bootstrap (95% CI).

Results

Participants attended 87.8% of the sessions and trained according to the PRT program, indicating sufficient compliance. Quadriceps strength increased significantly by 69%, and participants' personal goals were achieved.

Conclusion

PRT is a feasible and potentially effective method for increasing Quadriceps strength as well as achieving personal goals in persons with intellectual disabilities and visual impairment with GMFCS Level 1.
“A Song of Ice and Fire”—another verse from the world of ablation
Authors: Saul J. Philip , LaPage Martin J.
Published: May 2019

The debate between the use of radiofrequency (RF) or cryoenergy for ablation near the atrioventricular (AV) conducting system or small coronaries has been fueled by the relative efficacies and risks of the two technologies, particularly in smaller hearts. The manuscript by Schneider et al adds another chapter to that ongoing debate.
Electrophysiologic and anatomic factors predictive of a need for touch‐up radiofrequency application for complete pulmonary vein isolation: Comparison between hot balloon‐ and cryoballoon‐based ablation
Authors: Wakamatsu Yuji , Nagashima Koichi , Nakahara Shiro , Iso Kazuki , Watanabe Ryuta , Arai Masaru , Otsuka Naoto , Yagyu Seina , Kurokawa Sayaka , Ohkubo Kimie , Nakai Toshiko , Okumura Yasuo
Published: May 2019

Introduction

Although electrophysiologic and anatomic factors associated with the need for touch‐up radiofrequency (RF) applications after cryoballoon ablation (CBA) for atrial fibrillation (AF) have been well described, those associated with the need for such touch‐up after hot balloon ablation (HBA) have not. We aimed to identify factors predictive of the need for touch‐up applications following HBA.

Methods

Anatomic and electrophysiologic factors predictive of the need for touch‐up RF ablation were compared between 46 propensity score‐matched pairs of patients who underwent HBA or CBA for AF.

Results

Touch‐up RF ablation was more frequently required after HBA than after CBA (57% vs 30%, respectively; P = .01), and mostly at the anterior aspect of the left superior pulmonary vein (LSPV) carina after HBA (35%) but at the inferior aspect of the right inferior PV (RIPV) after CBA (71%). Post HBA touch‐up was associated with male gender, a CHA
2DS
2‐VASc score ≤ 2, PV‐left atrial bipolar voltage ≥ 1.35 mV, and PV trunk length ≥ 24.0 mm; post CBA touch‐up associated with a history of heart failure.

Conclusion

Following balloon ablation for AF, there may be a need for touch‐up applications, especially at the LSPV ridge after HBA but at the RIPV after CBA. It may behoove operators to expect a need for touch‐up following HBA when patients are male, have a CHA2DS
2‐VASc score ≤ 2 points, when PV‐LA bipolar voltage is ≥ 1.35 mV, or when the PV trunk is ≥ 24.0 mm or following CBA when there is a history of heart failure.
Left atrial effective conducting size predicts atrial fibrillation vulnerability in persistent but not paroxysmal atrial fibrillation
Authors: Williams Steven E. , O’Neill Louisa , Roney Caroline H. , Julia Justo , Metzner Andreas , Reißmann Bruno , Mukherjee Rahul K. , Sim Iain , Whitaker John , Wright Matthew , Niederer Steven , Sohns Christian , O’Neill Mark
Published: May 2019

Background

The multiple wavelets and functional re‐entry hypotheses are mechanistic theories to explain atrial fibrillation (AF). If valid, a chamber's ability to support AF should depend upon the left atrial size, conduction velocity (CV), and refractoriness. Measurement of these parameters could provide a new therapeutic target for AF. We investigated the relationship between left atrial effective conducting size (LAECS), a function of area, CV and refractoriness, and AF vulnerability in patients undergoing AF ablation.

Methods and Results

Activation mapping was performed in patients with paroxysmal (n = 21) and persistent AF (n = 18) undergoing pulmonary vein isolation. Parameters used for calculating LAECS were: (a) left atrial body area (A); (b) effective refractory period (ERP); and (c) total activation time (T). Global CV was estimated as . Effective atrial conducting size was calculated as . Post ablation, AF inducibility testing was performed. The critical LAECS required for multiple wavelet termination was determined from computational modeling. LAECS was greater in patients with persistent vs paroxysmal AF (4.4 ± 2.0 cm vs 3.2 ± 1.4 cm; P = .049). AF was inducible in 14/39 patients. LAECS was greater in AF‐inducible patients (4.4 ± 1.8 cm vs 3.3 ± 1.7 cm; P = .035, respectively). The difference in LAECS between inducible and noninducible patients was significant in patients with persistent (P = .0046) but not paroxysmal AF (P = .6359). Computational modeling confirmed that LAECS > 4 cm was required for continuation of AF.

Conclusions

LAECS measured post ablation was associated with AF inducibility in patients with persistent, but not paroxysmal AF. These data support a role for this method in electrical substrate assessment in AF patients.
Double cryoenergy application (freeze‐thaw‐freeze) at growing myocardium: Lesion volume and effects on coronary arteries late after energy application. Implications for efficacy and safety in pediatric patients
Authors: Schneider Heike E. , Stahl Maja , Schillinger Wolfgang , Müller Matthias , Backhoff David , Schill Manfred , Groene Nehle , Krause Ulrich , Sigler Matthias , Paul Thomas
Published: May 2019

Introduction

Cryoenergy is accepted as an alternative to radiofrequency ablation (RFA) in childen for ablation of supraventricular tachycardia substrates. Single cryoenergy application has been shown to be inferior to RFA. Double cryoenergy application has therefore been introduced into clinical practice, but experience concerning efficacy is limited. Coronary artery stenosis has been reported as serious complication after RFA for arrhythmia substrates but not after single cryoablation. The purpose of the study was to assess lesion volume (efficacy) and risk of coronary artery damage (safety), late, that is, 6 months, after double cryoenergy application in a piglet model.

Methods

Two sequential cycles of cryoenergy were delivered at −75°C for 4 minutes at the atrioventricular groove in five piglets. Animals were restudied after 6 months by coronary angiography and intracoronary ultrasound (ICUS). Ablation lesions were examined histologically and lesion volume was determined by three‐dimensional morphometric analysis.

Results

Cryolesion volume was 174.04 ± 67.18 mm3 for atrial and 238.69 ± 112.1 mm3 for ventricular lesions (P > .05). Ventricular lesions, 4.06 ± 1.05 mm, were significantly deeper than atrial lesions, 3.58 ± 0.78 mm, (P < .05). In two of the 29 lesions, cryoenergy induced minor coronary artery injury with mild medial and adventitial thickening as well as minimal intimal proliferation, which had neither been detected by coronary angiography nor by ICUS.

Conclusion

Late after double cryoenergy application at growing myocardium, subclinical minor affection of the coronary artery wall could be detected with minimal intimal proliferation. As lifetime sequelae of this finding remains unknown, further studies are warranted to address safety of repeated cycles of cryoenergy application for tachycardia substrates in children.
Long term follow‐up after ventricular tachycardia ablation in patients with congenital heart disease
Authors: Yang Jiandu , Brunnquell Michael , Liang Jackson J. , Callans David J. , Garcia Fermin C. , Lin David , Frankel David S. , Kay Joseph , Marchlinski Francis E. , Tzou Wendy , Sauer William H. , Liu Bolun , Ruckdeschel Emily S. , Collins Kathryn , Santangeli Pasquale , Nguyen Duy T.
Published: May 2019

Background

Ventricular tachycardia (VT) is frequently encountered in patients with repaired and unrepaired congenital heart disease (CHD), causing significant morbidity and sudden cardiac death. Data regarding underlying VT mechanisms and optimal ablation strategies in these patients remain limited.

Objective

To describe the electrophysiologic mechanisms, ablation strategies, and long‐term outcomes in patients with CHD undergoing VT ablation.

Methods

Forty‐eight patients (mean age 41.3 ± 13.3 years, 77.1% male) with CHD underwent a total of 57 VT ablation procedures at two centers from 2000 to 2017. Electrophysiologic and follow‐up data were analyzed.

Results

Of the 77 different VTs induced at initial or repeat ablation, the underlying mechanism in 62 (81.0%) was due to scar‐related re‐entry; the remaining included four His‐Purkinje system–related macrore‐entry VTs and focal VTs mainly originating from the outflow tract region (8 of 11, 72.7%). VT‐free survival after a single procedure was 72.9% (35 of 48) at a median follow‐up of 53 months. VT‐free survival after multiple procedures was 85.4% (41 of 48) at a median follow‐up of 52 months. There were no major complications. Three patients died during the follow‐up period from nonarrhythmic causes, including heart failure and cardiac surgery complication.

Conclusion

While scar‐related re‐entry is the most common VT mechanism in patients with CHD, importantly, nonscar‐related VT may also be present. In experienced tertiary care centers, ablation of both scar‐related and nonscar‐related VT in patients with CHD is safe, feasible, and effective over long‐term follow‐up.
Dihydromyricetin protects HUVECs of oxidative damage induced by sodium nitroprusside through activating PI3K/Akt/FoxO3a signalling pathway
Authors: Zhang Xiaoying , Wang Lifang , Peng Lizhi , Tian Xiaoying , Qiu Xiaoyuan , Cao Huan , Yang Qiaohong , Liao Rifang , Yan Fengxia
Published: May 2019

The damage of vascular endothelial cells induced by oxidative stress plays an important role in the pathogenesis of atherosclerosis. Dihydromyricetin (DMY) is considered as a natural antioxidant. However, the mechanism of DMY on endothelial cell injury induced by oxidative stress remains unclear. In this study, we found that DMY could reduce the oxidative damage of HUVECs induced by sodium nitroprusside (SNP), HUVECs pre‐treated with DMY suppressed SNP‐induced apoptosis by reduced ROS overproduction of intracellular, decreased MDA level and elevated the superoxide dismutase activity. Meanwhile, we found that DMY could promote the expression of phosphorylated FoxO3a and Akt, and affect the nuclear localization of FoxO3a, when treated with the PI3K inhibitor LY294002, the effect of DMY was blocked. These data suggest that DMY protects HUVECs from oxidative stress by activating PI3K/Akt/FoxO3a signalling pathway. Therefore, DMY may have great therapeutic potential as a new drug for atherosclerosis.
Impact of hip fracture on all‐cause mortality in Japanese patients with type 2 diabetes mellitus: The Fukuoka Diabetes Registry
Authors: Komorita Yuji , Iwase Masanori , Idewaki Yasuhiro , Fujii Hiroki , Ohkuma Toshiaki , Ide Hitoshi , Jodai‐Kitamura Tamaki , Yoshinari Masahito , Murao‐Kimura Ai , Oku Yutaro , Nakamura Udai , Kitazono Takanari
Published: May 2019

Aims/Introduction

Patients with type 2 diabetes mellitus have an increased hip fracture risk. We investigated the relationship between hip fracture and all‐cause death in patients with type 2 diabetes in comparison with cardiovascular disease (CVD) or end‐stage renal disease (ERSD).

Materials and Methods

In total, 4,923 Japanese participants with type 2 diabetes (mean age 65 years, 2,790 men, 2,133 women) were followed for a median of 5.3 years (follow‐up rate 99.5%). We evaluated the associations between the presence of hip fracture (n = 110), upper limb fracture (n = 801), CVD (n = 1,344), ESRD (n = 104) and all‐cause death by logistic regression analysis.

Results

A total of 309 participants died during follow up. Multivariate‐adjusted odds ratios (ORs) for all‐cause mortality were significantly higher in participants with hip fractures than those without hip fractures (OR 2.67, 95% confidence interval [CI] 1.54–4.41), whereas the ORs for upper limb fracture were not significant. The ORs for all‐cause mortality were significantly higher in participants with CVD than those without CVD (OR 1.78, 95% CI, 1.39–2.70) and ESRD (OR 2.36, 95% CI 1.32–4.05). The ORs for all‐cause mortality of hip fracture were not affected by further adjustment for CVD and ESRD (OR 2.74, 95% CI 1.58–4.54). The cause of death was infection (40.0%), malignant neoplasm (25.0%) and CVD (15.0%) among participants with hip fracture.

Conclusions

Hip fractures were associated with an increased risk of death among Japanese patients with type 2 diabetes, independently of CVD and ESRD.
Causes of death and estimated life expectancy among people with diabetes: A retrospective cohort study in a diabetes clinic
Authors: Goto Atsushi , Takao Toshiko , Yoshida Yoko , Kawazu Shoji , Iwamoto Yasuhiko , Terauchi Yasuo
Published: May 2019

We sought to estimate the exact causes of death, mortality rate and life expectancy of diabetes patients by analyzing death records in a diabetes specialist clinic in Japan. Of the 6,140 participants included in our analysis, the average age was 58.1 years and 77% were men. A total of 261 deaths were recorded during the total follow‐up period of 24,079 total person‐years. The leading causes of death were cancer, heart diseases and cerebrovascular diseases. Using a life table prepared from the mortality rates estimated with the exponential distribution model, a life expectancy at 40 years was 39.2 years (95% confidence interval 37.9–40.2 years) for men and 43.6 years (95% confidence interval 41.8–45.3 years) for women. Although the present results must be interpreted with caution, compared with populations with diabetes surveyed during similar periods by the Japan Diabetes Society, our diabetes patients had similar ranking of the causes of death.
Impacts of acidification on brown trout Salmo trutta populations and the contribution of stocking to population recovery and genetic diversity
Authors: Prodöhl Paulo A. , Ferguson Andrew , Bradley Caroline R. , Ade Robin , Roberts Colin , Keay E. J. , Costa Artur R. , Hynes Rosaleen
Published: May 2019

Anthropogenic acidification in SW‐Scotland, from the early 19th Century onwards, led to the extinction of several loch (lake) brown trout (Salmo trutta) populations and substantial reductions in numbers in many others. Higher altitude populations with no stocking influence, which are isolated above natural and artificial barriers and subjected to the greatest effect of acidification, exhibited the least intrapopulation genetic diversity (34% of the allelic richness of the populations accessible to anadromous S. trutta). These, however, were characterised by the greatest interpopulation divergence (highest pairwise DEST 0.61 and FST 0.53 in contemporary samples) based on 16 microsatellite loci and are among the most differentiated S. trutta populations in NW‐Europe. Five lochs above impassable waterfalls, where S. trutta were thought to be extinct, are documented as having been stocked in the late 1980s or 1990s. All five lochs now support self‐sustaining S. trutta populations; three as a direct result of restoration stocking and two adjoining lochs largely arising from a small remnant wild population in one, but with some stocking input. The genetically unique Loch Grannoch S. trutta, which has been shown to have a heritable increased tolerance to acid conditions, was successfully used as a donor stock to restore populations in two acidic lochs. Loch Fleet S. trutta, which were re‐established from four separate donor sources in the late 1980s, showed differential contribution from these ancestors and a higher genetic diversity than all 17 natural loch populations examined in the area. Genetically distinct inlet and outlet spawning S. trutta populations were found in this loch. Three genetically distinct sympatric populations of S. trutta were identified in Loch Grannoch, most likely representing recruitment from the three main spawning rivers. A distinct genetic signature of Loch Leven S. trutta, the progenitor of many Scottish farm strains, facilitated detection of stocking with these strains. One artificially created loch was shown to have a population genetically very similar to Loch Leven S. trutta. In spite of recorded historical supplemental stocking with Loch Leven derived farm strains, much of the indigenous S. trutta genetic diversity in the area remains intact, aside from the effects of acidification induced bottlenecks. Overall genetic diversity and extant populations have been increased by allochthonous stocking.
Efficacy and safety of radiofrequency ablation for treatment of chronic radiation proctitis: A systematic review and meta‐analysis
Authors: McCarty Thomas R , Garg Rajat , Rustagi Tarun
Published: May 2019

Background and Aim

Although argon plasma coagulation is the current standard endoscopic treatment for chronic radiation proctitis (CRP), radiofrequency ablation (RFA) has emerged as an attractive alternative. The aim of this study is to evaluate the efficacy and safety of RFA for the treatment of CRP.

Methods

Searches of PubMed, EMBASE, Web of Science, and Cochrane Library databases were performed from 2004 through March 2018. Review and data abstraction were performed independently by two authors. Measured outcomes included hemoglobin, transfusion dependence, number of treatment sessions, RFA settings, and serious adverse events.

Results

Six studies (n = 71; mean age 73.41 ± 1.88 years; 90.14% male) were included. Thirty‐eight percent of patients failed prior treatment with argon plasma coagulation. Patients underwent a mean of 1.71 ± 0.34 RFA sessions with 24.54 ± 16.47 RFA applications per session. Pooled clinical and endoscopic success of RFA was 99% (95% confidence interval [CI]: 90–100; P < 0.001) and 100% (95% CI: 94–100; P < 0.001), respectively. Serious adverse events were reported in one patient—pooled rate of 0% (95% CI: 0–3; P < 0.001). Mean pre‐procedure hemoglobin was 10.38 ± 1.82 g/dL with significant improvement observed post‐RFA [weighted mean difference 2.49 g/dL (95% CI: 2.16–2.82; P < 0.001)]. Among transfusion‐dependent patients, 85% (95% CI: 68–97; P < 0.001) became transfusion‐free post‐RFA. Pooled mean follow‐up was 19.73 ± 9.72 months.

Conclusion

Despite limited long‐term data on RFA for CRP, available evidence suggests RFA is an effective and safe treatment.
Monetary Policy and the Asset Risk‐Taking Channel
Authors: ABBATE ANGELA , THALER DOMINIK
Published: May 2019

How important is the risk‐taking channel for monetary policy? To answer this question, we develop and estimate a quantitative monetary DSGE model where banks choose excessively risky investments, due to an agency problem that distorts banks' incentives. As the real interest rate declines, these distortions become more important and excessive risk taking increases, lowering the efficiency of investment. We show theoretically that this novel transmission channel generates a new monetary policy trade‐off between inflation and real interest rate stabilization, whereby the central bank may prefer to tolerate greater inflation volatility in order to lower excessive risk taking.
Measuring Inflation Anchoring and Uncertainty: A U.S. and Euro Area Comparison
Authors: GRISHCHENKO OLESYA , MOUABBI SARAH , RENNE JEAN‐PAUL
Published: May 2019

We use several U.S. and euro‐area surveys of professional forecasters to estimate a dynamic factor model of inflation featuring time‐varying uncertainty. We obtain survey‐consistent distributions of future inflation at any horizon, both in the U.S. and the euro area. Equipped with this model, we propose a novel measure of the anchoring of inflation expectations that accounts for inflation uncertainty. Our results suggest that following the Great Recession, inflation anchoring improved in the United States, while mild de‐anchoring occurred in the euro area. As of our sample end, both areas appear to be almost equally anchored.
Legal Design for Practice, Activism, Policy, and Research
Authors: Perry‐Kessaris Amanda
Published: May 2019

This article offers an original integrated introduction to how to think about what design can do for law; where to find examples of legal design; and how to assess it. It identifies clear points of contact between lawyerly concerns and designerly skills, knowledge, and attitudes. It proposes that designerly ways can directly improve lawyerly communication; and that they can also generate new structured‐yet‐free spaces in which lawyers can be at once practical, critical, and imaginative. The article foregrounds the, hitherto unrecognized, diversity of existing legal design practice by drawing examples from across four fields of lawyering: legal practice, legal activism, policy making, and legal research. Emphasis is placed throughout on the need for a critical approach to legal design – that is, for legal design to be thought about and done with a commitment to avoiding, exposing, and remedying biases and inequalities.
Infarct Pattern, Perfusion Mismatch Thresholds, and Recurrent Cerebrovascular Events in Symptomatic Intracranial Stenosis
Authors: Yaghi Shadi , Grory Brian Mac , Prabhakaran Shyam , Yeatts Sharon D. , Cutting Shawna , Jayaraman Mahesh , Sacchetti Daniel , Furie Karen , Zaidat Osama O. , Liebeskind David S. , Khatri Pooja
Published: May 2019

BACKGROUND AND PURPOSE

Studies have shown an association between infarct patterns and recurrent stroke in patients with symptomatic intracranial stenosis (sICAS) but there are limited data on associations with perfusion imaging mismatch profile. We aim to determine the association between infarct pattern, optimal mismatch profile definition, and recurrent cerebrovascular events (RCVE) in patients with anterior circulation sICAS.

METHODS

This is a retrospective study of consecutive patients with acutely sICAS admitted to a comprehensive stroke center over 18 month's period. Patients with sICAS underwent magnetic resonance perfusion (MRP) imaging within 24 hours from admission. Infarct patterns (internal BZ [IBZ], cortical BZ [CBZ], and core/perforator [C/P]) and RCVE within 90 days, were independently adjudicated by two reviewers. We compared mismatch profiles and recurrent event rates across infarct patterns.

RESULTS

Twenty‐five patients met inclusion criteria; 28% had IBZ infarcts and overall RCVE rate was 32.0%. When compared to patients without IBZ infarcts, those with IBZ infarcts were more likely to have a target mismatch profile using Tmax > 6 seconds (60% vs. 6.7%, P = .007) and RCVE (62.5% vs. 11.8%, P = .01). There were no associations between CBZ and C/P infarcts and target mismatch profiles and RCVE.

CONCLUSION

IBZ infarcts may be a surrogate marker of distal perfusion status and RCVE risk. Larger multicenter, prospective, core‐lab blindly adjudicated studies are needed to confirm our findings.
Molecular characterization of phytoplasma diseases of pepper in Turkey
Authors: Yilmaz Salih , Caglar Behcet Kemal , Djelouah Khaled
Published: May 2019

During autumn, an extensive survey was conducted in pepper (Capsicum annum L.) in intensive cultivation areas of four provinces in southeastern Turkey (Adana, Kahramanmaraş, Mersin and Şanlıurfa) in order to identify the causal agent (s) of phytoplasma‐like symptoms (chlorosis, little‐leaf, short internodes and stunting). DNA amplification by PCR and RFLP analysis using EcoRI restriction enzyme confirmed the presence of phytoplasmas in Şanlıurfa and Mersin, and consequently their possible association with the symptoms. Sequencing and phylogenetic analysis revealed that the isolate from Şanlıurfa had 99% sequence identity with “Candidatus Phytoplasma trifolii” (16SrVI) and is a member of the clover proliferation group (16SrVI‐A). Additionally, the isolate from Mersin had 96% sequence identity with “Candidatus Phytoplasma asteris” (16SrI). Importantly, gene sequence of the Mersin isolate shared <97.5% similarity to previously discovered “Ca. Phytoplasma” species. Consequently, the phytoplasma detected from Mersin could represent a new “Ca. Phytoplasma” species and to our knowledge, this is the first report of asteris‐like phytoplasmas infecting pepper in Turkey.
Precipitation reduction alters herbaceous community structure and composition in a savanna
Authors: Jin Yanqiang , Li Jing , Liu Chenggang , Liu Yuntong , Zhang Yiping , Song Qinghai , Sha Liqing , Balasubramanian Durairaj , Chen Aiguo , Yang Daxin , Li Peiguang
Published: May 2019

Questions

In the changing climate scenario, the decline in precipitation is expected to alter water availability for plants, which in turn affects plant community structure and composition. The responses of community composition and structure to declines in precipitation are well documented in other biomes but remain understudied in water‐limited savannas.

Location

A savanna ecosystem in southwest China.

Methods

We used a four‐year (2014–2017) precipitation manipulation experiment to examine changes in herbaceous community composition and structure across the species, functional group and community levels under precipitation reduction.

Results

Precipitation reduction significantly decreased the average height and percentage cover of the herbaceous community, while increasing species richness and the Pielou evenness index. Precipitation reduction significantly decreased average height, percentage cover and relative abundance of graminoids and perennials, but increased those of forbs and annuals. Precipitation reduction prompted a shift in the dominant species of the herbaceous community towards Fimbristylis monostachya.

Conclusions

The results show that precipitation reduction changed the composition and structure of the herbaceous community of this savanna. Furthermore, they provide strong evidence that changes in herbaceous community structure and composition in response to the intensity and duration of precipitation reduction in this savanna exhibited relatively low thresholds, which suggests that the herbaceous community's response to a decline in precipitation was essentially nonlinear. These findings imply that even relatively small declines in precipitation may stimulate shifts in plant community structure and composition and affect the function and stability of savanna ecosystems.
Broad‐headed spiny rats (Clyomys laticeps) as ecosystem engineers in the Brazilian savannah
Authors: Lamberto J. , Leiner N. O.
Published: May 2019

Soil disturbances promoted by the construction of subterranean systems are a classic example of ecosystem engineering. The broad‐headed spiny rat Clyomys laticeps caches seeds in subterranean systems excavated and occupied by its individuals, thus acting as potential ecosystem engineers in the Brazilian savannah. However, the effects of their activities on soil nutrient content and animal communities are still unknown. Here, we assessed the role of C. laticeps as an allogenic ecosystem engineer in a shrub savannah site. Our results demonstrated that C. laticeps subterranean systems, which contain three to seven burrow openings, provide a stable microclimate with lower temperatures and higher humidity than the outside environment, thus providing suitable habitat for several species. However, we found few animals associated with burrow systems, although previous studies recorded snakes, frogs, lizards and rodents using burrows as shelter. Both burrow architecture and methodological issues might explain the lack of a richer fauna using C. laticeps burrows. Arthropod abundance and diversity were similar between sites close to and away from C. laticeps burrow openings. Finally, mounds of soil accumulated surrounding burrow openings presented higher nutrient content (K, Ca, Mg) than soils collected inside burrow openings and control sites. Overall, our results support the hypothesis that C. laticeps acts as an ecosystem engineer, especially by modulating soil nutrient availability. Soil enrichment provided by C. laticeps burrowing activity may be particularly important in the Cerrado, due to low nutrient availability of soils and the contribution of edaphic factors on plant population dynamics in this biome, although future studies should focus on this issue. Given the accelerated habitat loss in the Cerrado and its effect on population decline of mammals, future studies should uncover the magnitude of engineering effects played by C. laticeps and pinpoint conservation actions to maintain their populations and their functional roles on ecosystems.
Particle Placement in Learner Language
Authors: Wulff Stefanie , Gries Stefan Th.
Published: May 2019

This study presents the first multifactorial corpus‐based analysis of verb–particle constructions in a data sample comprising spoken and written productions by intermediate‐level learners of English as a second language from 17 language backgrounds. We annotated 4,911 attestations retrieved from native speaker and language learner corpora for 14 predictors, including syntactic complexity, rhythmic and segment alternation, and the verb framing of the speaker's native language. A multifactorial prediction and deviation analysis using regression (Gries & Deshors, 2014), which stacks multiple regression analyses to compare native speaker and learner productions in identical contexts, revealed a complex picture in which processing demands, input effects, and native language typology jointly shape the degree to which learners’ choices of constructions are nativelike or not.
Flux towers in the sky: global ecology from space
Authors: Schimel David , Schneider Fabian D. ,   JPL Carbon and Ecosystem Participants
Published: May 2019

Global ecology – the study of the interactions among the Earth's ecosystems, land, atmosphere and oceans – depends crucially on global observations: this paper focuses on space‐based observations of global terrestrial ecosystems. Early global ecology relied on an extrapolation of detailed site‐level observations, using models of increasing complexity. Modern global ecology has been enabled largely by vegetation indices (greenness) from operational space‐based imagery but current capabilities greatly expand scientific possibilities. New observations from spacecraft in orbit allowed an estimation of gross carbon fluxes, photosynthesis, biomass burning, evapotranspiration and biomass, to create virtual eddy covariance sites in the sky. Planned missions will reveal the dimensions of the diversity of life itself. These observations will improve our understanding of the global productivity and carbon storage, land use, carbon cycle−climate feedback, diversity−productivity relationships and enable improved climate forecasts. Advances in remote sensing challenge ecologists to relate information organised by biome and species to new data arrayed by pixels and develop theory to address previously unobserved scales.
Updates on molecular mechanisms in the development of branched trichome in Arabidopsis and nonbranched in cotton
Authors: Wang Zhi , Yang Zuoren , Li Fuguang
Published: May 2019

Trichomes are specialized epidermal cells and a vital plant organ that protect plants from various harms and provide valuable resources for plant development and use. Some key genes related to trichomes have been identified in the model plant Arabidopsis thaliana through glabrous mutants and gene cloning, and the hub MYB‐bHLH‐WD40, consisting of several factors including GLABRA1 (GL1), GL3, TRANSPARENT TESTA GLABRA1 (TTG1), and ENHANCER OF GLABRA3 (EGL3), has been established. Subsequently, some upstream transcription factors, phytohormones and epigenetic modification factors have also been studied in depth. In cotton, a very important fibre and oil crop globally, in addition to the key MYB‐like factors, more important regulators and potential molecular mechanisms (e.g. epigenetic modifiers, distinct metabolic pathways) are being exploited during different fibre developmental stages. This occurs due to increased cotton research, resulting in the discovery of more complex regulation mechanisms from the allotetraploid genome of cotton. In addition, some conservative as well as specific mediators are involved in trichome development in other species. This study summarizes molecular mechanisms in trichome development and provides a detailed comparison of the similarities and differences between Arabidopsis and cotton, analyses the possible reasons for the discrepancy in identification of regulators, and raises future questions and foci for understanding trichome development in more detail.