bluuebunny/crossref_metadata_2025 huggingface dataset:
Emotional indicators and anxiety levels of immigrant children who have been exposed to warfare
Authors: Celik Rukiye , Altay Naime , Yurttutan Selverhan , Toruner Ebru K.
Published: April 2019

Problem

Little is known about the emotional reactions of children who have migrated to another country fleeing a war in their home.

Purpose

This descriptive study was conducted to compare the emotional indicators and anxiety levels of Syrian children who have migrated to Turkey following the war with anxiety levels of Turkish children.

Methods

The study has been completed with 125 children who migrated from Syria and 168 children who are living in Turkey. The demographic data form, the Spielberger state and trait anxiety inventory (STAI) and Koppitz Draw‐A‐Person test were used for data collection.

Findings

The average ages of Syrian and Turkish children who participated in the study are 9.14 ± 1.11; 8.89 ± 0.76, respectively. Emotional indicators such as impulsivity, anxiety, and anger appear more frequently in Syrian children's drawings compared to the drawings of Turkish children. State anxiety scores were 47.44 ± 8.09 in Syrian children and 32.16 ± 10.46 in Turkish children. Trait anxiety scores were 49.08 ± 7.98 in Syrian children and 39.76 ± 8.58 in Turkish children. The STAI score of Syrian children was higher compared to the score of Turkish children.

Conclusions

Anxiety scores of children who have migrated are significantly higher than those of children residing in their country of origin. The physical and psychological evaluation of children who have witnessed warfare and have migrated is an important nursing initiative.
Electrophysiological and clinical characteristics of catheter ablation for isolated left side atrial tachycardia over a 10‐year period
Authors: Vicera Jennifer J. B. , Lin Yenn‐Jiang , Lin Chin‐Yu , Lu Dai‐Yin , Chang Shih‐Lin , Lo Li‐Wei , Chung Fa‐Po , Chao Tze‐Fan , Hu Yu‐Feng , Tuan Ta‐Chuan , Liao Jo‐Nan , Chen Yun‐Yu , Sukardi Rubiana , Salim Simon , Wu Cheng‐I , Liu Chih‐Min , Hoang Quang‐Minh , Ba Vu Van , Huang Ting‐Chun , Chuang Chieh‐Mao , Chen Chun‐Chao , Chin Chye‐Gen , Kuo Ling , Chen Shih‐Ann
Published: April 2019

Aims

Most left atrial tachycardia (LAT) is associated with atrial fibrillation (AF). The clinical and electrophysiological characteristics and outcomes of LAT without AF have not been investigated. This study sought to determine the long‐term ablation outcomes and predictors of recurrence of isolated LAT.

Methods

This is a single‐center study of consecutive patients with isolated LAT. Atrial arrhythmia recurrence was determined from follow‐up records of patients who underwent LAT ablation from 2008 to 2017. Clinical and electrophysiologic characteristics associated with atrial arrhythmia recurrence were identified.

Results

A total of 50 patients (53 ± 19 years, 46% male) with 59 LAT (1.16 ± 0.47 per patient) were enrolled. Over a mean follow‐up of 37 ± 33 months, atrial arrhythmia recurrence occurred in 22 (44%) patients, 11 with atrial tachycardia (AT) only, five with AF only, and six with concurrent AT and AF. The incidence of pulmonary vein (PV) origins increased significantly in the repeat procedure (P = 0.036). Multivariate analysis identified left ventricular ejection fraction (LVEF) as the only predictor of any atrial arrhythmia recurrence and LAT recurrence, while smoking and identified macroreentrant LAT in the index procedure predicted AF recurrence.

Conclusion

This study demonstrated a higher rate of atrial arrhythmia recurrence, including AF, among patients with initially isolated LAT. A lower LVEF predicted any atrial arrhythmia and LAT recurrence, whereas smoking and index macroreentrant AT mechanism predicted long‐term AF. PV ATs were frequently observed in recurrent patients irrespective of index procedure origin.
Predictors of successful complex catheter ablation for persistent atrial fibrillation despite failure of targeted procedural arrhythmia termination
Authors: Spittler Raphael , Bahlke Fabian , Hoffmann Boris A. , Theis Cathrin , Mollnau Hanke , Marx Alexandra , Ocete Blanca Quesada , Ilioska Pamela , Lange Björn , Konrad Torsten , Rostock Thomas
Published: April 2019

Introduction

Procedural atrial fibrillation (AF) termination is considered as a predictor of long‐term success after catheter ablation for persistent AF (persAF). However, some patients remain free of arrhythmia recurrences despite failure to achieve AF termination. The objective of this study was to assess long‐term outcome and prognostic factors in patients undergoing complex ablation without procedural AF termination.

Methods and Results

This study comprised 419 patients (63.8 ± 10.2 years, 63.4% male) undergoing complex ablation for persAF. Patients without procedural AF termination (n = 137, 64.2 ± 9.7 years, 63.5% male) were categorized into patients who remained in sinus rhythm (SR) in long‐term outcome (SR‐group) and patients with recurrence of AF or atrial tachycardia (AT) (AR‐group). During a follow‐up (FU) of 19.6 ± 14.6 months, the SR‐group consisted of 65 (47.5%) and the AR‐group of 69 (50.4%) patients. Three patients (2.2%) were lost to FU. Left atrial appendage (LAA) flow velocity and left atrium volume index (LAVI) could be identified as predictors for long‐term success. LAA flow velocity and baseline AF cycle length (AFCL) were significantly associated with the type of arrhythmia recurrence (AF vs AT), ie, higher values of both are predictive for AT rather than AF recurrences. Patients with a LAVI < 34.4 mL/m² and significant AFCL increase during the ablation procedure had rather AT than AF recurrences.

Conclusion

Patients with an arrhythmia‐free outcome despite failure of procedural AF termination during complex ablation for persAF are characterized by specific morphological and functional properties that are easy to obtain.
Concomitant overexpression of triple antioxidant enzymes selectively increases circulating endothelial progenitor cells in mice with limb ischaemia
Authors: Liu Lingjuan , Cui Yuqi , Li Xin , Que Xingyi , Xiao Yuan , Yang Chunlin , Zhang Jia , Xie Xiaoyun , Cowan Peter J. , Tian Jie , Hao Hong , Liu Zhenguo
Published: April 2019

Endothelial progenitor cells (EPCs) are a group of heterogeneous cells in bone marrow (BM) and blood. Ischaemia increases reactive oxygen species (ROS) production that regulates EPC number and function. The present study was conducted to determine if ischaemia‐induced ROS differentially regulated individual EPC subpopulations using a mouse model concomitantly overexpressing superoxide dismutase (SOD)1, SOD3 and glutathione peroxidase. Limb ischaemia was induced by femoral artery ligation in male transgenic mice with their wild‐type littermate as control. BM and blood cells were collected for EPCs analysis and mononuclear cell intracellular ROS production, apoptosis and proliferation at baseline, day 3 and day 21 after ischaemia. Cells positive for c‐Kit+/CD31+ or Sca‐1+/Flk‐1+ or CD34+/CD133+ or CD34+/Flk‐1+ were identified as EPCs. ischaemia significantly increased ROS production and cell apoptosis and decreased proliferation of circulating and BM mononuclear cells and increased BM and circulating EPCs levels. Overexpression of triple antioxidant enzymes effectively prevented ischaemia‐induced ROS production with significantly decreased cell apoptosis and preserved proliferation and significantly increased circulating EPCs level without significant changes in BM EPC populations, associated with enhanced recovery of blood flow and function of the ischemic limb. These data suggested that ischaemia‐induced ROS was differentially involved in the regulation of circulating EPC population.
Somatic mutations in kinetochore gene KNSTRN are associated with basal proliferating actinic keratoses and cutaneous squamous cell carcinoma
Authors: Schmitz L. , Grinblat B. , Novak B. , Hoeh A.‐K. , Händschke K. , von Dobbeler C. , Bierhoff E. , Szeimies R.‐M. , Gambichler T. , Torezan L. , Festa‐Neto C. , Stockfleth E. , Dirschka T.
Published: April 2019

Background

Mutations in kinetochore gene KNSTRN accelerate the development of cutaneous squamous cell carcinoma (SCC) and may correlate with different histological classifications of actinic keratosis (AKs).

Objective

To determine KNSTRN gene mutation frequency in healthy skin (HS), actinically damaged skin (ADS), in AKs with different histomorphological gradings and invasive SCCs.

Methods

All samples were histologically evaluated. AK lesions were additionally classified according to their upwards (AK I–III) and downwards (PRO I–III) directed growth pattern. Mutation analyses of all samples were performed using the Sanger method.

Results

With one exception, all detected mutations in KNSTRN gene showed an alanine‐to‐glutamate substitution at codon 40 (p.Ala40Glu). p.Ala40Glu mutation was found in 6.9% (2/29) of HS, in 16.1% (5/31) of ADS, in 18.3% (20/109) of AKs and in 30.0% (9/30) of invasive SCCs. Further stratification of AKs using the common AK classification of Röwert‐Huber revealed the p.Ala40Glu mutation in 14.7% (5/43), 13.3% (4/30) and 24.4% (11/45) (AK I, II and III). In contrast, the new PRO classification showed a distribution of 3.6% (1/28) in PRO I, 21.7% (13/60) in PRO II and 28.6% (6/21) in PRO III. Mutation frequency in HS showed significant differences compared to AKs classified as PRO III and invasive SCCs (P < 0.05). In contrast, there were no statistically significant differences between HS and AKs when classified according to Röwert‐Huber.

Conclusions

Recurrent somatic mutation p.Ala40Glu in KNSTRN gene is associated with basal proliferating AKs in accordance with invasive SCCs. This supports the impact of basal proliferative pattern in terms of progression.
AOFOG survey for the status of minimally invasive gynecologic surgery in the Asia/Oceania region
Authors: Mandai Masaki ,   on behalf of the AOFOG MIGS Committee
Published: April 2019

Aim

To clarify the status of minimally invasive gynecologic surgery (MIGS) in the Asia/Oceania region.

Methods

Survey questionnaires were sent out to the representative of AOFOG countries. They consisted of questions on the general status of MIGS, the clinical indication of MIGS, cost coverage, company support, training and certification for MIGS, patient preference for MIGS and requirements for the AOFOG.

Results

Developmental stage of MIGS in this region was roughly divided into three categories: fully developed countries, countries in the developmental stage and countries in the rudimentary stage. Clinical indication of MIGS and training opportunity of young doctors were correlated with the developmental stage.

Conclusion

Support by AOFOG should be considered according to the developmental stage of each country. Collecting updated information on MIGS in each member country is important to provide adequate support.
Case of decidual discharge from the nonpregnant uterine cavity of the bicorporeal uterus before onset of delivery
Authors: Obata Soichiro , Noguchi Takashi , Chiba Sawako , Miyagi Etsuko , Aoki Shigeru
Published: April 2019

A 30‐year‐old woman with a bicorporeal uterus complained of abdominal pain and vaginal hemorrhage at 28 weeks and 5 days of gestation. There were no signs of placenta previa with echography in the second trimester; however, the echography showed a highly echoic area (91 × 85 mm), indicating placenta previa. Thereafter, abdominal pain and vaginal bleeding increased. Thus, we suspected placental abruption and performed cesarean section. After cesarean section, discharge of placenta‐like tissue into the vagina was confirmed and pathological examination of the tissue showed only the decidua. In cases of uterine malformations, in which the uterine cavity is divided into pregnant and nonpregnant sides, the decidua on the nonpregnant side can be discharged before the onset of delivery. In addition, at the time of decidual discharge, echography findings are similar to those of placenta previa and the clinical symptoms are similar to those of placental abruption.
Fat talk: A citizen sociolinguistic approach
Authors: SturtzSreetharan Cindi L. , Agostini Gina , Brewis Alexandra A. , Wutich Amber
Published: April 2019

Fat talk, or self‐disparaging talk about the body, is common among US women and increasingly reported for men. Despite its commonality, this unique genre of talk is difficult to access using traditional sociolinguistic methods both because it is brief and because it arises spontaneously in casual conversation. Here we present a new method of data collection accomplished by collaborating with citizen sociolinguists to collect spontaneous fat talk in public spaces. We compare fat talk exchanges captured by citizen sociolinguists against those collected in a vignette‐based discourse completion task. Our results show redundancy both in how fat talk is initiated and in the manner of the reply across both forms of data collection. However, the citizen sociolinguistic method produced greater variety in fat talk utterances, was less methodologically taxing, and revealed that fat talk occurs differently in same‐sex interactions than mixed‐sex ones.
Does low body fat percentage in neonates greater than the 5th percentile birthweight increase the risk of hypoglycaemia and neonatal morbidity?
Authors: Shaw Mark , Lutz Tracey , Gordon Adrienne
Published: April 2019

Aim

Low body fat percentage (BF%) has been shown to predict morbidity and possible hypoglycaemia in newborns. Hypoglycaemia in neonates is associated with significant neonatal morbidity. Early detection and prevention are critical. To identify if low BF% (>1 standard deviation below the mean) in non‐small‐for‐gestational‐age neonates (>5th percentile body weight) increases the risk of short‐term morbidity, with specific attention to hypoglycaemia.

Methods

All term neonates who had their BF% measured as part of the Newborn Early Assessment Programme between 28 January 2014 and 9 August 2016 were included in the study. Neonates whose weight was below the 5th percentile and neonates of diabetic mothers were excluded as blood sugar level monitoring is routinely performed on these babies. Neonatal morbidity and blood sugar levels were obtained from electronic records, and the individual patient's paper records were reviewed. A composite score for neonatal morbidity (poor feeding AND hypothermia AND prolonged length of stay) was calculated. Statistics were analysed using SPSS.

Results

A total of 247 neonates met the inclusion criteria (3.3% of total births). Hypoglycaemia was found in 8.5% of the study population. The risk of hypoglycaemia did not change significantly in neonates with birthweight of the 5th–10th percentile and >10th percentile (8 vs. 8.8%); 4.9% of babies met the combined morbidity criteria.

Conclusions

Non‐small‐for‐gestational‐age babies (>5th percentile) with low BF% are at risk of hypoglycaemia and short‐term morbidity. These infants will not be identified by current hypoglycaemia screening methods in centres that do not measure BF%.
A snapshot of virological presentation and outcome of immunosuppression‐driven HBV reactivation from real clinical practice: Evidence of a relevant risk of death and evolution from silent to chronic infection
Authors: Salpini Romina , Battisti Arianna , Colagrossi Luna , Di Carlo Domenico , Fabeni Lavinia , Piermatteo Lorenzo , Cerva Carlotta , Lichtner Miriam , Mastroianni Claudio , Marignani Massimo , Maylin Sarah , Delaugerre Constance , Morisco Filomena , Coppola Nicola , Marrone Aldo , Angelico Mario , Sarmati Loredana , Andreoni Massimo , Perno Carlo‐Federico , Ceccherini‐Silberstein Francesca , Svicher Valentina
Published: April 2019

The study was undertaken in order to provide a snapshot from real clinical practice of virological presentation and outcome of patients developing immunosuppression‐driven HBV reactivation. Seventy patients with HBV reactivation were included (66.2% treated with rituximab, 10% with corticosteroids and 23.8% with other immunosuppressive drugs). Following HBV reactivation, patients received anti‐HBV treatment for a median (IQR) follow‐up of 31(13‐47) months. At baseline‐screening, 72.9% of patients were HBsAg‐negative and 27.1% HBsAg‐positive. About 71.4% had a diagnosis of biochemical reactivation [median (IQR) HBV DNA and ALT: 6.9 (5.4‐7.8) log IU/mL and 359 (102‐775) U/L]. Moreover, 10% of patients died from hepatic failure. Antiviral prophylaxis was documented in 57.9% and 15.7% of HBsAg‐positive and HBsAg‐negative patients at baseline‐screening (median [IQR] prophylaxis duration: 24[15‐33] and 25[17‐36] months, respectively). Notably, HBV reactivation occurred 2‐24 months after completing the recommended course of anti‐HBV prophylaxis in 35.3% of patients. By analysing treatment outcome, the cumulative probability of ALT normalization and of virological suppression was 97% and 69%, respectively. Nevertheless, in patients negative to HBsAg at baseline‐screening, only 27% returned to HBsAg‐negative status during prolonged follow‐up, suggesting the establishment of chronic infection. In conclusion, most patients received a diagnosis of HBV reactivation accompanied by high ALT and 10% died for hepatic failure, supporting the importance of strict monitoring for an early HBV reactivation diagnosis. Furthermore, HBV reactivation correlates with high risk of HBV chronicity in patients negative for HBsAg at baseline‐screening, converting a silent into a chronic infection, requiring long‐term antiviral treatment. Finally, a relevant proportion of patients experienced HBV reactivation after completing the recommended course of anti‐HBV prophylaxis, suggesting the need to reconsider proper duration of prophylaxis particularly in profound immunosuppression.
Risk assessment of hepatocellular carcinoma development by magnetic resonance elastography in chronic hepatitis C patients who achieved sustained virological responses by direct‐acting antivirals
Authors: Tamaki Nobuharu , Higuchi Mayu , Kurosaki Masayuki , Kirino Sakura , Osawa Leona , Watakabe Keiya , Wang Wan , Okada Mao , Shimizu Takao , Takaura Kenta , Takada Hitomi , Kaneko Shun , Yasui Yutaka , Tsuchiya Kaoru , Nakanishi Hiroyuki , Itakura Jun , Takahashi Yuka , Enomoto Nobuyuki , Izumi Namiki
Published: April 2019

Prediction of hepatocellular carcinoma (HCC) development after sustained virological response (SVR) is clinically important, and the usefulness of noninvasive markers for prediction HCC have been reported. The aim of this study was to compare the prediction accuracy for HCC development by noninvasive markers. A total of 346 patients with chronic hepatitis C without history of HCC who achieved SVR through direct‐acting antivirals were included. Magnetic resonance elastography (MRE) and serum fibrosis markers were measured 12 weeks after the end of treatment, and the subsequent HCC development was examined. The mean observation period was 26.4 ± 7.9 months, and 24 patients developed HCC. Area under the receiver operating characteristic curve of liver stiffness by MRE, Wisteria floribunda agglutinin‐positive mac‐2 binding protein and FIB‐4 for predicting HCC within 3 years was 0.743, 0.697 and 0.647, respectively. The 1/2/3‐year rates of HCC development in patients with liver stiffness ≥3.75 KPa were 6.6%, 11.9% and 14.5%, whereas they were 1.4%, 2.5% and 2.5% in patients with liver stiffness <3.75 KPa (P < 0.001). Multivariate analysis revealed that liver stiffness ≥3.75 was an independent predictive factor for HCC development (hazard ratio, 3.51; 95% confidence interval, 1.24‐9.99). In subgroup analysis, there were 132 patients who were <73 years old and had liver stiffness <3.75 KPa, and no HCC development was observed in these patients. Diagnostic accuracy for predicting HCC development was higher in MRE than serum fibrosis markers and measurement of liver stiffness by MRE could identify patients with high and low risk of HCC development after SVR.
HBV coinfection with HCV alters circulating Tfh cell distribution and impairs HCV neutralizing antibody responses
Authors: Wen Bo , Zhang Jian , Liu Wenpei , Tang Ping , Xie Ting , Huang Liyan , Hu Yabin , Jin Kun , Zhang Ping , Liu Ziyan , Niu Ling , Qu Xiaowang
Published: April 2019

Hepatitis C virus (HCV) and hepatitis B virus (HBV) coinfection reciprocally influences viral replication and host defence responses. This study aimed to investigate the impact of HBV coinfection on circulating T follicular helper cell (cTfh) distribution and the HCV neutralizing antibody (nAb) response. HCV neutralizing antibody responses were measured in individuals with HCV monoinfection (n = 83) and HBV/HCV coinfection (n = 78) using the HCV pseudoparticle neutralization assay. The frequencies of cTfh cells and their subsets in HCV monoinfection (n = 34) and HBV/HCV coinfection (n = 30) were analysed by flow cytometry. The correlations of clinical parameters, cTfh cells and neutralizing antibody responses were analysed. Compared with HCV monoinfection, the HBV coinfection group showed significantly lower HCV neutralizing antibody responses (P < 0.001) and a decreased frequency of circulating Th1‐like Tfh cells (Tfh1) (P = 0.004). In HCV monoinfection, the frequency of the Tfh1 subset was positively correlated with HCV neutralizing antibody responses (R = 0.378, P = 0.03), but this correlation was lost under HBV/HCV coinfection (R = 0.115, P = 0.551). In contrast, the frequency of circulating Th2‐like Tfh cells (Tfh2) was negatively correlated with the HCV neutralizing antibody responses (R = 0.404, P = 0.003). Further analysis showed that HBV coinfection enhanced the Tfh2 subset composition within cTfh cells (P < 0.001), which was associated with serum HBsAg in HBV/HCV coinfection (R = 0.521, P = 0.003). As expected, HBsAg also exhibited an inverse association with HCV neutralizing antibody responses in HBV/HCV coinfection (R = 0.59, P < 0.001). In contrast to HCV monoinfection, HBV/HCV coinfection leads to altered cTfh cell distribution and impaired HCV neutralizing antibody responses, which are associated with HBsAg. These findings will be helpful for better understanding the immunopathogenesis of HBV/HCV coinfection.
Efficacy and safety of glecaprevir/pibrentasvir in patients with chronic HCV infection and psychiatric disorders: An integrated analysis
Authors: Back David , Belperio Pamela , Bondin Mark , Negro Francesco , Talal Andrew H. , Park Caroline , Zhang ZhenZhen , Pinsky Brett , Crown Eric , Mensa Federico J. , Marra Fiona
Published: April 2019

Although direct‐acting antivirals (DAAs) for chronic hepatitis C virus (HCV) infection are highly efficacious and safe, treatment initiation is often limited in patients with neuropsychiatric disorders due to concerns over reduced treatment adherence and drug–drug interactions. Here, we report adherence, efficacy, safety and patient‐reported outcomes (PROs) from an integrated analysis of registrational studies using the pangenotypic DAA regimen of glecaprevir and pibrentasvir (G/P). Patients with chronic HCV genotypes 1‐6 infection with compensated liver disease (with or without cirrhosis) receiving G/P for 8, 12 or 16 weeks were included in this analysis. Patients were classified as having a psychiatric disorder based on medical history and/or co‐medications. Primary analyses assessed treatment adherence, efficacy (sustained virologic response at post‐treatment week 12; SVR12), safety and PROs. Among 2522 patients receiving G/P, 789 (31%) had a psychiatric disorder with the most common diagnoses being depression (64%; 506/789) and anxiety disorders (27%; 216/789). Treatment adherence was comparably high (>95%) in patients with and without psychiatric disorders. SVR12 rates were 97.3% (768/789; 95% CI = 96.2‐98.5) and 97.5% (1689/1733; 95% CI = 96.7‐98.2) in patients with and without psychiatric disorders, respectively. Among patients with psychiatric disorders, SVR12 rates remained >96% by individual psychiatric diagnoses and co‐medication classes. Overall, most adverse events (AEs) were mild‐to‐moderate in severity with serious AEs and AEs leading to G/P discontinuation occurring at similarly low rates in both patient populations. In conclusion, G/P treatment was highly efficacious, well‐tolerated and demonstrated high adherence rates in patients with chronic HCV infection and psychiatric disorders.
ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs
Authors: Keene Bruce W. , Atkins Clarke E. , Bonagura John D. , Fox Philip R. , Häggström Jens , Fuentes Virginia Luis , Oyama Mark A. , Rush John E. , Stepien Rebecca , Uechi Masami
Published: April 2019

This report, issued by the ACVIM Specialty of Cardiology consensus panel, revises guidelines for the diagnosis and treatment of myxomatous mitral valve disease (MMVD, also known as endocardiosis and degenerative or chronic valvular heart disease) in dogs, originally published in 2009. Updates were made to diagnostic, as well as medical, surgical, and dietary treatment recommendations. The strength of these recommendations was based on both the quantity and quality of available evidence supporting diagnostic and therapeutic decisions. Management of MMVD before the onset of clinical signs of heart failure has changed substantially compared with the 2009 guidelines, and new strategies to diagnose and treat advanced heart failure and pulmonary hypertension are reviewed.
Clues for our missing respiration model
Authors: Ryan Michael G. , Asao Shinichi
Published: April 2019

This article is a Commentary on Drake et al. (2019a), 222: 1298–1312 and Drake et al. (2019b), 222: 1313–1324.
A simple genetic architecture and low constraint allow rapid floral evolution in a diverse and recently radiating plant genus
Authors: Kostyun Jamie L. , Gibson Matthew J. S. , King Christian M. , Moyle Leonie C.
Published: April 2019

Genetic correlations among different components of phenotypes, especially those resulting from pleiotropy, can constrain or facilitate trait evolution. These factors could especially influence the evolution of traits that are functionally integrated, such as those comprising the flower. Indeed, pleiotropy is proposed as a main driver of repeated convergent trait transitions, including the evolution of phenotypically similar pollinator syndromes.

We assessed the role of pleiotropy in the differentiation of floral and other reproductive traits between two species – Jaltomata sinuosa and J. umbellata (Solanaceae) – that have divergent suites of floral traits consistent with bee and hummingbird pollination, respectively. To do so, we generated a hybrid population and examined the genetic architecture (trait segregation and quantitative trait locus (QTL) distribution) underlying 25 floral and fertility traits.

We found that most floral traits had a relatively simple genetic basis (few, predominantly additive, QTLs of moderate to large effect), as well as little evidence of antagonistic pleiotropy (few trait correlations and QTL colocalization, particularly between traits of different classes). However, we did detect a potential case of adaptive pleiotropy among floral size and nectar traits.

These mechanisms may have facilitated the rapid floral trait evolution observed within Jaltomata, and may be a common component of rapid phenotypic change more broadly.
PeSTZ1, a C2H2‐type zinc finger transcription factor from Populus euphratica, enhances freezing tolerance through modulation of ROS scavenging by directly regulating PeAPX2
Authors: He Fang , Li Hui‐Guang , Wang Jing‐Jing , Su Yanyan , Wang Hou‐Ling , Feng Cong‐Hua , Yang Yanli , Niu Meng‐Xue , Liu Chao , Yin Weilun , Xia Xinli
Published: April 2019

In the present study, PeSTZ1, a cysteine‐2/histidine‐2‐type zinc finger transcription factor, was isolated from the desert poplar, Populus euphratica, which serves as a model stress adaptation system for trees. PeSTZ1 was preferentially expressed in the young stems and was significantly up‐regulated during chilling and freezing treatments. PeSTZ1 was localized to the nucleus and bound specifically to the PeAPX2 promoter. To examine the potential functions of PeSTZ1, we overexpressed it in poplar 84K hybrids (Populus alba × Populus glandulosa), which are known to be stress‐sensitive. Upon exposure to freezing stress, transgenic poplars maintained higher photosynthetic activity and dissipated more excess light energy (in the form of heat) than wild‐type poplars. Thus, PeSTZ1 functions as a transcription activator to enhance freezing tolerance without sacrificing growth. Under freezing stress, PeSTZ1 acts upstream of ASCORBATE PEROXIDASE2 (PeAPX2) and directly regulates its expression by binding to its promoter. Activated PeAPX2 promotes cytosolic APX that scavenges reactive oxygen species (ROS) under cold stress. PeSTZ1 may operate in parallel with C‐REPEAT‐BINDING FACTORS to regulate COLD‐REGULATED gene expression. Moreover, PeSTZ1 up‐regulation reduces malondialdehyde and ROS accumulation by activating the antioxidant system. Taken together, these results suggested that overexpressing PeSTZ1 in 84K poplar enhances freezing tolerance through the modulation of ROS scavenging via the direct regulation of PeAPX2 expression.
Killer‐cell immunoglobulin‐like receptor ligand mismatch cord blood transplantation in high‐risk neuroblastoma
Authors: Matsuno Ryosuke , Toyama Daisuke , Akiyama Kosuke , Isoyama Keiichi , Shiozawa Eisuke , Yamamoto Shohei
Published: April 2019

Background

The prognosis of high‐risk neuroblastoma stage 4 with bone marrow metastasis, MYCN amplified, or refractory neuroblastoma is poor. To date, no standard treatment has been established. In four selected cases, we challenged the killer‐cell immunoglobulin‐like receptor ligand mismatch cord blood transplantation in graft‐versus‐host disease (GVHD) with reduced‐intensity conditioning.

Methods

Prior to this study, conventional chemotherapy, autologous peripheral blood stem cell transplantation with high‐dose chemotherapy (busulfan and melphalan), surgery and radiation therapy were completed in every case. The status before cord blood transplantation in two cases was not complete remission (CR) and in the others it was CR. The primary site was the mediastinum, two adrenal glands and a retroperitoneum, respectively. Three patients had bone and bone marrow metastasis and one had MYCN amplification. In all cases, international neuroblastoma pathology classification was unfavorable histology. All patients were >2 years of age.

Results

Relapse occurred only in one patient 17 months after the last transplantation, and the other three patients maintained disease‐free survival for 74, 36, and 24 months, respectively. In one case of relapse the disease could be controlled by conventional chemotherapy. Except one, all patients had no severe complications, such as acute or chronic GVHD. One patient had gastric antral vascular ectasia and hemorrhagic cystitis.

Conclusion

This strategy might be feasible and should be investigated for efficacy in the future. No definite conclusion can be made, however, due to the very small number of patients. Further prospective studies are required to determine its efficacy.
Use of geographic information systems for aquaculture and recommendations for development of spatial tools
Authors: Falconer Lynne , Middelboe Anne Lise , Kaas Hanne , Ross Lindsay G. , Telfer Trevor C.
Published: April 2019

There are many spatial issues associated with aquaculture which must be understood in order to support sustainable development and mitigate other potential issues. Geographic Information Systems (GIS) are used for investigation, analysis and modelling of aquaculture and there have been a considerable number of studies since the late 1980s. However, despite the range of applications, GIS is still often underutilized and stakeholders have requested more GIS‐based tools to support management and regulation of the sector. Consequently, there is a need to establish a knowledge base of existing applications and identify the challenges and opportunities to encourage development of tools that address user needs. This study presents a quantitative analysis of primary scientific literature, focusing on over 200 studies, to enable a comprehensive overview of the application of GIS and the trends associated with its use for aquaculture. Furthermore, there is a detailed assessment of the considerations when developing GIS‐based tools for aquaculture which culminates in five key recommendations regarding (i) usability of the tool; (ii) data requirements; (iii) accessibility to end user; (iv) capabilities and training requirements; and (v) longevity of the tool. These recommendations can guide future development and application of tools to support aquaculture planning and management and assess spatial issues relevant for the sector.
MicroRNA‐145 regulates immune cytokines via targeting FSCN1 in Staphylococcus aureus‐induced mastitis in dairy cows
Authors: Chen Zhi , Xu Xin , Tan Taoling , Chen Daijie , Liang Huanjie , Sun Kaidi , Li Mingxun , Zhang Huimin , Mao Yongjiang , Yang Zhangping
Published: April 2019

Dairy cow mastitis is a detrimental factor in milk quality and food safety. Mastitis generally refers to inflammation caused by infection by pathogenic microorganisms. Our studies in recent years have revealed the role of miRNA regulation in Staphylococcus aureus‐induced mastitis. In the present study, we overexpressed and suppressed miR‐145 to investigate the function of miR‐145 in Mac‐T cells. Flow cytometry, ELISA and EdU staining were used to detect changes in the secretion of several Mac‐T cytokines and in cell proliferation. We found that overexpression of miR‐145 in Mac‐T cells significantly reduced the secretion of IL‐12 and TNF‐α, but increased the secretion of IFN‐γ; the proliferation of bovine mammary epithelial cells was also inhibited. Using quantitative real‐time PCR (qRT‐PCR), Western blotting and luciferase multiplex verification techniques, we found that miR‐145 targeted and regulated FSCN1. Knock‐down of FSCN1 significantly increased the secretion of IL‐12, while the secretion of TNF‐α was significantly downregulated in Mac‐T cells. Upon S. aureus infection of mammary gland tissue, the body initiated inflammatory responses; Bta‐miR‐145 expression was downregulated, which reduced the inhibitory effect on the FSCN1 gene; and upregulation of FSCN1 expression promoted mammary epithelial cell proliferation to allow the recovery of damaged tissue. The results of the present study will aid in understanding the immune mechanism opposing S. aureus infection in dairy cows and will provide a laboratory research basis for the prevention and treatment of mastitis.
BMPR2‐expressing bone marrow‐derived endothelial‐like progenitor cells alleviate pulmonary arterial hypertension in vivo
Authors: Harper Rebecca L. , Maiolo Suzanne , Ward Rebekah J. , Seyfang Jemma , Cockshell Michaelia P. , Bonder Claudine S. , Reynolds Paul N.
Published: April 2019

Background and objective

Pulmonary arterial hypertension (PAH) is characterized by increased resistance in the distal pulmonary arteries, ultimately leading to right heart failure and, despite the available therapeutics, survival remains poor. Reduced expression of bone morphogenetic protein receptor type 2 (BMPR2) is strongly associated with PAH. Cell therapies are of interest in PAH, but whether this approach can upregulate BMPR2 is not known. Our objective was to evaluate a preclinical cell therapy approach based on upregulation of BMPR2.

Methods

We assessed the therapeutic effect of intravenously injected BMPR2‐augmented rat bone marrow‐derived endothelial‐like progenitor cells (BMPR2‐BM‐ELPC) on PAH in the rat monocrotaline (MCT) model.

Results

The cells accumulate in the lungs with negligible systemic distribution, but the vast majority are lost from the lungs by 24 h. Lungs from rats treated with BMPR2‐BM‐ELPC exhibited an immediate increase in BMPR2 and related intracellular signalling proteins. Treatment with BMPR2‐BM‐ELPC attenuated PAH as demonstrated by a reduction in right ventricular hypertrophy as well as right ventricular systolic and mean pulmonary arterial pressures. In addition, this treatment reversed PAH‐induced vascular remodelling with a significant reduction in vessel thickness and muscularization. In view of the short retention time of injected cells in the lungs, the mechanism for the effects seen may be intracellular communication via exosomes. In support of this hypothesis, we demonstrate that BMPR2‐transduced outgrowth endothelial progenitor cells (OECs) release BMPR2‐expressing exosomes.

Conclusion

BMPR2‐augmented ELPC demonstrate therapeutic benefits in the rat model and may have clinical translation potential.
Capital market integration and gender inequality
Authors: Komura Mizuki , Ogawa Hikaru
Published: April 2019

This study explores the effects of globalization on gender inequality. Specifically, we describe how, in terms of capital market integration, globalization alters the gender gap in wage rates through changes in labor demand for capital‐intensive sectors. Consequently, via changes in the bargaining positions of men and women, globalization leads to opposite effects on the couple's labor supply and fertility decisions in capital‐importing and capital‐exporting countries. Moreover, by considering the properties of the industrial structures of capital‐importing and capital‐exporting countries, we show that globalization induces empirically observed declines in fertility rates throughout the world.
Are dialysis patients too frail to exercise?
Authors: Wang Connie J. , Johansen Kirsten L.
Published: April 2019

Clinical manifestations of functional and morphological muscular abnormalities in dialysis patients are muscle weakness and low exercise capacity, possibly leading to a sedentary life style with low physical activity. Low cardiorespiratory fitness and muscle atrophy and weakness contribute to the development of frailty and affect patients’ ability to physically navigate their environment. While many dialysis patients may appear too frail to participate in moderate‐to‐vigorous aerobic exercise training, those who can complete such programs appear to derive substantial benefit. Less vigorous aerobic exercise, resistance training, and alternative forms of exercise can also be beneficial. Most patients on dialysis are not too frail to perform resistance exercise of adequate intensity to achieve increases in muscle size and strength, therefore, frailty should not be considered a contraindication to exercise.
The Symbiosis of Sectarianism, Authoritarianism, and Rentierism in the Saudi State
Authors: Freer Courtney
Published: April 2019

Saudi Arabia provides a compelling example of how sectarianism sustains the dynamics of authoritarianism, especially when bolstered by a rentier political economy. In this paper, I investigate three claims about the link between Saudi authoritarianism and sectarianism, as follows: (1) Governing with a sectarian ideology impedes political reform, since it disrupts cross‐sectarian reform coalitions by attacking the sectarian outgroup. (2) The presence of multiple sects, as well as hydrocarbon wealth, allows regimes like that of al‐Saʿud to use divide‐and‐rule tactics to maintain control; it also enables the funding of media and education outlets with the purpose of perpetuating authoritarianism, especially when the authoritarian dynamics are underpinned by a rentier political economy. (3) Despite the authoritarian and rentier dynamics in play, the Saudi government has at times sought at least a degree of inclusion of the Shia minority, depending on the political economy and the relative influence of Shia and Sunni Islamists. Using the existing literature on the Saudi state and historical examples, I aim to clarify the link between sectarianism and authoritarianism in a state in which the Sunni/Shia division, bolstered by a rentier political economy, has emerged as a powerful means of maintaining the political status quo.
Civic Space and Sectarianism in the Gulf States: The Dynamics of Informal Civil Society in Kuwait and Bahrain beyond State Institutions
Authors: Hafidh Hasan , Fibiger Thomas
Published: April 2019

The two small, multi‐sectarian Arab Gulf countries of Kuwait and Bahrain present two cases of the relationship between regimes and the everyday dynamics of sectarianism, offering both significant similarities and differences. In this article we focus on the role of informal spaces in amplifying or negating regime narratives of sectarianism. Both countries have a tradition of parliaments, which in both cases, however, have lost credibility among their citizens. Instead, informal spaces have become important, but they have come to be so in different ways in relation to the specific regime rhetoric of sectarianism: in Bahrain the regime promotes a sectarian narrative of political conflict, which is countered at the societal level, whereas in Kuwait, while the regime sees itself as cross‐sectarian, Kuwaiti society has become increasingly sectarianized. Relating this focus on informal spaces to a discussion of the ideological state apparatus (ISA), we provide a theoretical model for how this can be analyzed on a more general level, contributing to recent discussions of grassroots and non‐formal activism.
Interleukin‐21 enhances Toll‐like receptor 2/4‐mediated cytokine production via phosphorylation in the STAT3, Akt and p38 MAPK signalling pathways in human monocytic THP‐1 cells
Authors: Jian Leilei , Sun Lin , Li Changhong , Yu Ruohan , Ma Zhenzhen , Wang Xinyu , Zhao Jinxia , Liu Xiangyuan
Published: April 2019

Interleukin‐21 (IL‐21) is a type I cytokine produced by activated T cells that promotes cytokine production in monocytes. Monocytes are activated by Toll‐like receptors (TLRs) to produce pro‐inflammatory mediators. However, little is known about the regulatory effect of IL‐21 on TLR‐mediated inflammation in human monocytes. This study investigated the potential association between IL‐21 and TLR2/4‐mediated inflammation in human monocytic THP‐1 cells. First, the expression of the IL‐21 receptor (IL‐21R) in human monocytic THP‐1 cells was examined by flow cytometry. Then, THP‐1 cells were treated with either the TLR2 ligand peptidoglycan (PGN) or the TLR4 ligand lipopolysaccharide (LPS) with or without IL‐21. Then, the production of several cytokines (IL‐6, IL‐8, TNF‐α, IFN‐γ and IL‐10), expression of TLR2/4, and activation of the downstream signaling pathways of mitogen‐activated protein kinase (MAPK), Janus kinase (JAK)/signal transducer and activator of transcription 3 (STAT3), phosphatidylinositol 3‐kinase (PI3K)/protein kinase B (Akt), and nuclear factor‐kappa B (NF‐κB) were determined. We found that IL‐21R was highly expressed in human monocytic THP‐1 cells and that IL‐21 induced TLR2 and TLR4 expression and further enhanced PGN/LPS‐mediated TLR2/4 expression. In addition, IL‐21 also upregulated the expression of IL‐6, IL‐8, TNF‐α, IFN‐γ and IL‐10 and enhanced TLR2/4‐mediated cytokine production in THP‐1 cells via phosphorylation of the STAT3, Akt and p38 MAPK signalling pathways. Our study suggests, for the first time that IL‐21 enhances TLR2/4‐mediated cytokine production in human monocytic THP‐1 cells by activating the STAT3, PI3K/Akt and p38 MAPK signalling pathways.
Staffing in hospital transfusion laboratories: UKTLC surveys show cause for concern
Authors: Bolton‐Maggs P. , Mistry H. , Glencross H. , Rook R. ,   on behalf of the UK Transfusion Laboratory Collaborative
Published: April 2019

Objectives

To monitor minimum standards in hospital transfusion laboratories in relation to qualifications, training, competency and the use of information technology over time against published recommendations.

Background

The United Kingdom Transfusion Laboratory Collaborative was formed in 2006 with representatives from relevant organisations and has published standards for transfusion laboratory practice. The standards are set to ensure safe transfusion laboratory practice. Regular surveys are performed to see the extent to which laboratories are able to meet these standards and where any problems lie.

Methods

An electronic survey is sent to hospital transfusion laboratories on a single mid‐week day in the spring and is repeated every 2 years from 2011, to be completed by the lead in transfusion for the day. The questions cover staffing, training, funding and workload.

Results

Transfusion laboratories are having difficulty with staffing, particularly recruitment of suitably trained biomedical scientists, and with funding and time for training and education. Laboratory errors reported to the Serious Hazards of Transfusion haemovigilance scheme (SHOT) have not decreased with time, related to the under‐resourced workforce.

Conclusion

Problems in laboratory staffing and expertise in hospital transfusion laboratories need to be urgently addressed. The transfusion laboratory provides a key service to hospitals. The Blood Services in England and Wales are developing supportive strategies.
Genotyping of human neutrophil antigens 1, 3, 4 and 5 using a novel multiplex polymerase chain reaction
Authors: Grabowski C. , Jorks S. , Kroll H.
Published: April 2019

Objectives

Our study aimed to establish a novel multiplex polymerase chain reaction (PCR) for rapid simultaneous detection of all relevant human neutrophil antigen (HNA)‐1, ‐3, ‐4 and ‐5 alleles.

Background

Granulocyte‐reactive antibodies are involved in several diseases, such as neonatal alloimmune neutropenia, autoimmune neutropenia and transfusion‐related acute lung injury. A panel of well‐defined test granulocytes is required for diagnostic antibody detection and prospective blood donor screening. Several genotyping methods for the detection of HNA alleles have been described, but most approaches require separate amplification of each HNA allele or at least a separate amplification of the HNA‐1 alleles.

Methods

The new method is based on simultaneous detection in one reaction tube, where each HNA‐1 allele is amplified by two allele‐specific primers, one primer of which is labelled with a fluorescent dye (HEX, FAM). Allelic polymorphisms for HNA‐3, ‐4 and ‐5 were amplified with one common unlabelled primer and two fluorescence‐labelled (HEX, FAM) allele‐specific primers. DNA fragments of HNA alleles are analysed on a Genetic Analyser 3130xl by amplicon size and fluorescent dye. A total of 110 blood donors with known genotypes were studied.

Results

In the 110 DNA samples studied, all HNA‐1, ‐3, ‐4 and ‐5 alleles could be detected precisely. All results matched perfectly with those from reference typing by PCR‐sequence‐specific primer. Amplification performed well even at low DNA concentrations (10 ng μL−1).

Conclusion

Our method enables fast and easy genotyping of all relevant HNA‐alleles in one PCR reaction. Results are easy to analyse due to different amplicon sizes and fluorescent dyes. Furthermore, the method is suitable for high sample throughput.