bluuebunny/crossref_metadata_2025 huggingface dataset:
The mechanisms affecting seedling establishment in restored savanna understories are seasonally dependent
Authors: Sorenson Quinn M. , Damschen Ellen I.
Published: February 2019

Agricultural land is being increasingly abandoned on a global scale, with over 200 million hectares recovering from agricultural use. Plant community regeneration differs greatly in structure and composition after agricultural impacts, yet the mechanisms underpinning these dramatic changes are poorly understood. It is critical to determine the relative importance of abiotic and biotic factors that limit plant establishment and success during the recovery process. In particular, below‐ground competition for resources in soils affected by former agricultural uses may play an important role in limiting plant establishment. Yet, below‐ground competition is generally studied less than above‐ground, especially in the context of land‐use history.

We compare plant establishment with and without below‐ground competition in the context of a large‐scale experiment manipulating land‐use histories (i.e. with and without a history of agriculture) and restoration of historical vegetation structure (i.e. thinned and unthinned canopy trees) and determine how life stage and the local environment (e.g. soil water holding capacity, vegetation cover) influence this relationship.

For three of our four target species, below‐ground competition strongly limited establishment success, but did not interact with land‐use history and canopy thinning directly. Instead, land‐use history and canopy thinning interacted to affect establishment during germination and survival in spring, while below‐ground competition limited growth during the summer. The strength of below‐ground competition was affected by local resources, but the directionality of this relationship depended on agricultural history and canopy thinning.

Synthesis and applications. Because adding seeds increased establishment in all cases, we recommend confronting land‐use legacies by overcoming dispersal limitation with seed additions (even in degraded sites) and ensuring that below‐ground structures are managed during restoration, especially in summer. In addition, managers should consider how the relationship between local resources and below‐ground competition at individual sites might depend on land‐use history or canopy thinning.
Impacts of honeybee density on crop yield: A meta‐analysis
Authors: Rollin Orianne , Garibaldi Lucas A.
Published: February 2019

There is increasing recognition that pollination deficits are limiting crop yields world‐wide. However, management strategies for optimal insect pollination are still unclear for most crops. Current management focuses on providing high densities of honeybees, but recommended densities are highly variable, even within single crops and cultivars.

We performed an extensive literature search to record honeybee densities (colony density and/or flower visitation rates) and crop productivity (fruit set, seed set, fruit weight and/or yield). Effect sizes were represented as the difference in crop productivity between the two most extreme levels of honeybee densities.

Out of 795 reviewed studies, only 22 analysed the effect of at least two levels of honeybee densities on crop productivity (reporting 60 resulting effect sizes in total). Moreover, few recommendations for crop pollination management are based on results from controlled experimental designs, and with comparable methodology.

We found that both colony density and visitation rates increased all the productivity variables. However, effects were nonlinear for visitation rates, suggesting that there is an optimum (mean of 8–10 visits per flower) beyond which more honeybees are not beneficial (and can even be detrimental) for crop productivity.

Effect sizes for visitation rates were greater than that for colony densities, suggesting that visitation rates are a more direct measure of the pollination process. Data on the relation between colony density and visitation rates are lacking. Interestingly, effect sizes for visitation rates were greater for crops with separate sexes than those with hermaphroditic flowers; therefore, the benefits of honeybee pollination vary according to the crop biology.

Synthesis and applications. Current practices for crop pollination assume that more honeybees are always better for crop yield, even if the effect of this management on crop production still unclear. In contrast, our analyses suggest that there is an optimum for honeybee densities. Despite the importance of honeybees and pollinator‐dependent crops world‐wide, there is a lack of studies designed for finding such an optimal level of crop pollination. Our analyses further suggest that visitation rates could be used as a proxy to guide management recommendations such as colony density and spatial arrangement.
Metabolic syndrome and time to pregnancy: a retrospective study of nulliparous women
Authors: Grieger JA , Grzeskowiak LE , Smithers LG , Bianco‐Miotto T , Leemaqz SY , Andraweera P , Poston L , McCowan LM , Kenny LC , Myers J , Walker JJ , Norman RJ , Dekker GA , Roberts CT
Published: February 2019

Objective

To determine: (1) the association between metabolic syndrome (MetS), time to pregnancy (TTP), and infertility; (2) associations between individual and an increasing number of MetS components, TTP, and infertility; and (3) whether these relationships differ by body mass index (BMI < 30 kg/m2 versus BMI ≥ 30 kg/m2).

Design

Retrospective cohort study.

Setting

Multiple centres (in Australia, Ireland, New Zealand, and the UK).

Population

Five thousand five hundred and nineteen low‐risk nulliparous pregnant women.

Methods

Data on retrospectively reported TTP (number of months to conceive) and a blood sample to assess metabolic health were collected between 14 and 16 weeks of gestation. MetS was defined according to the International Diabetes Federation criteria. Accelerated failure time models with log‐normal distribution were conducted to estimate time ratios (TRs) and 95% CIs. Differences in MetS on infertility (TTP > 12 months) were compared using a generalised linear model (Poisson distribution) with robust variance estimates (relative risks, RRs; 95% CIs). All analyses (entire cohort and split by BMI) were controlled for a range of maternal and paternal confounding factors.

Main outcome measures

Time to pregnancy and infertility.

Results

Of the 5519 women included, 12.4% (n = 684) had MetS. Compared with women without MetS, women with MetS had a longer TTP (adjusted TR 1.30; 95% CI 1.15–1.46), which was similar in women who were obese and in women who were not obese. Marginal estimates for median TTP in women with MetS versus without MetS was 3.1 months (3.0–3.3 months) versus 4.1 months (3.6–4.5 months), respectively. Women with MetS were at a 62% greater risk for infertility and were at a greater risk for infertility whether they were obese (adjusted RR 1.62; 95% CI 1.15–2.29) or not (adjusted RR 1.73; 95% CI 1.33–2.23). Reduced high‐density lipoprotein cholesterol (HDL‐C) and raised triglycerides (TGs) were the main individual components associated with risk for infertility.

Conclusion

Metabolic syndrome is associated with longer TTP and infertility, independent of obesity. Additional studies, before pregnancy, are required to support our findings and to determine the applicability of which combinations of metabolic abnormalities pose the greatest risk to delayed fertility, or whether individual components are amenable to modification.

Tweetable abstract

Metabolic syndrome is associated with longer time to pregnancy and infertility, independent of obesity.
The Status of Forensic Anthropology in Europe and South Africa: Results of the 2016 FASE Questionnaire on Forensic Anthropology
Authors: Obertová Zuzana , Adalian Pascal , Baccino Eric , Cunha Eugenia , De Boer Hans H. , Fracasso Tony , Kranioti Elena , Lefévre Philippe , Lynnerup Niels , Petaros Anja , Ross Ann , Steyn Maryna , Cattaneo Cristina
Published: February 2019

One of the goals of the Forensic Anthropology Society of Europe (FASE) is to map the existing education and practice opportunities in the field of forensic anthropology in order to support the development of the discipline and to optimize the training courses provided by the Society. To address this goal, an online questionnaire was sent to European and South African practitioners of forensic anthropology and related disciplines in 2016. The results of the questionnaire showed that the status and roles of forensic anthropologists vary depending on the national legal systems, education, and employment status of the practitioners. Despite the fact that the expertise of forensic anthropologists has been increasingly requested in a variety of investigations and the spectrum of tasks has become broader, including identification of living persons, specialized education in forensic anthropology is still restricted to a few graduate and postgraduate programs in European countries and to annual FASE courses.
Natural language processing to identify ureteric stones in radiology reports
Authors: Li Andrew Yu , Elliot Nikki
Published: February 2019

Introduction

Natural language processing (NLP) is an emerging tool which has the ability to automate data extraction from large volumes of unstructured text. One of the main described uses of NLP in radiology is cohort building for epidemiological studies. This study aims to assess the accuracy of NLP in identifying a group of patients positive for ureteric stones on Computed Tomography – Kidneys, Ureter, Bladder (CT KUB) reports.

Methods

Retrospective review of all CT KUB reports in a single calendar year. A locally available NLP tool was used to automatically classify the reports based on positivity for ureteric stones. This was validated by manual review and refined to maximize the accuracy of stone detection.

Results

A total of 1874 CT KUB reports were identified. Manual classification of ureteric stone positivity was 36% compared with 27% using NLP. The accuracy of NLP was 85% with a sensitivity of 66% and specificity of 95%. Incorrect classification was due to misspellings, variable syntax, terminology, pluralization and the inability to exclude clinical request details from the search algorithm.

Conclusions

Our NLP tool demonstrated high specificity but low sensitivity at identifying CT KUB reports that are positive for ureteric stones. This was attributable to the lack of feature extraction tools tailored for analysing radiology text, incompleteness of the medical lexicon database and heterogeneity of unstructured reports. Improvements in these areas will help improve data extraction accuracy.
I can see clearly now: Reinterpreting statistical significance
Authors: Dushoff Jonathan , Kain Morgan P. , Bolker Benjamin M.
Published: February 2019

Null hypothesis significance testing (NHST) remains popular despite decades of concern about misuse and misinterpretation. There are many recent suggestions for mitigating problems arising from NHST, including calls for abandoning NHST in favour of Bayesian or information‐theoretic approaches. We believe that NHST will continue to be widely used, and can be most usefully interpreted as a guide to whether a certain effect can be seen clearly in a particular context (e.g. whether we can clearly see that a correlation or between‐group difference is positive or negative).

We believe that much misinterpretation of NHST is due to language: significance testing has little to do with other meanings of the word ‘significance’. We therefore suggest that researchers describe the conclusions of null‐hypothesis tests in terms of statistical ‘clarity’ rather than ‘significance’. We illustrate our point by rewriting common misinterpretations of the meaning of statistical tests found in the literature using the language of ‘clarity’.

The meaning of statistical tests become easier to interpret and explain when viewed through the lens of ‘statistical clarity’.

Our suggestion is mild, but practical: this simple semantic change could enhance clarity in statistical communication.
Epigenetic age is a cell‐intrinsic property in transplanted human hematopoietic cells
Authors: Søraas Arne , Matsuyama Mieko , de Lima Marcos , Wald David , Buechner Jochen , Gedde‐Dahl Tobias , Søraas Camilla Lund , Chen Brian , Ferrucci Luigi , Dahl John Arne , Horvath Steve , Matsuyama Shigemi
Published: February 2019

The age of tissues and cells can be accurately estimated by DNA methylation analysis. The multitissue DNA methylation (DNAm) age predictor combines the DNAm levels of 353 CpG dinucleotides to arrive at an age estimate referred to as DNAm age. Recent studies based on short‐term observations showed that the DNAm age of reconstituted blood following allogeneic hematopoietic stem cell transplantation (HSCT) reflects the age of the donor. However, it is not known whether the DNAm age of donor blood remains independent of the recipient's age over the long term. Importantly, long‐term studies including child recipients have the potential to clearly reveal whether DNAm age is cell‐intrinsic or whether it is modulated by extracellular cues in vivo. Here, we address this question by analyzing blood methylation data from HSCT donor and recipient pairs who greatly differed in chronological age (age differences between 1 and 49 years). We found that the DNAm age of the reconstituted blood was not influenced by the recipient's age, even 17 years after HSCT, in individuals without relapse of their hematologic disorder. However, the DNAm age of recipients with relapse of leukemia was unstable. These data are consistent with our previous findings concerning the abnormal DNAm age of cancer cells, and it can potentially be exploited to monitor the health of HSCT recipients. Our data demonstrate that transplanted human hematopoietic stem cells have an intrinsic DNAm age that is unaffected by the environment in a recipient of a different age.
Medication adherence in first episode psychosis: the role of pre‐onset subthreshold symptoms
Authors: Daneault J.‐G. , Maraj A. , Lepage M. , Malla A. , Schmitz N. , Iyer S. N. , Joober R. , Shah J. L.
Published: February 2019

Objective

The experience of pre‐onset subthreshold psychotic symptoms (STPS, signifying a clinical high‐risk state) in first episode psychosis (FEP) predicts poorer outcomes during treatment, possibly through differential adherence to medication. We explored whether adherence differs between FEP patients with and without pre‐onset STPS.

Methods

Antipsychotic medication adherence was compared in 263 STPS+ and 158 STPS− subjects in a specialized early intervention program for FEP. Data were gathered from a larger observational study conducted between 2003 and 2016. STPS status, sociodemographic, and baseline clinical variables were tested as predictors of non‐adherence using univariate and multivariate logistic regressions. Time to onset of non‐adherence was analyzed using Kaplan–Meier curves. The same predictors were tested as predictors of time to onset of non‐adherence using Cox regression models.

Results

Medication non‐adherence was higher in STPS+ participants (78.9% vs. 68.9%). STPS status (OR 1.709), substance use disorder (OR 1.767), and milder positive symptoms (OR 0.972) were significant baseline predictors of non‐adherence. Substance use disorder (HR 1.410), milder positive symptoms (HR 0.990), and lack of contact between the clinical team and relatives (HR 1.356) were significant baseline predictors of time to non‐adherence.

Conclusion

FEP patients who experience pre‐onset STPS are more likely to be non‐adherent to antipsychotic medication over 2 years of intervention. FEP programs should routinely evaluate pre‐onset symptomatology to deliver more personalized treatments, with emphasis on engaging both patients and family members from the beginning of care.
Hallucinations in patients with borderline personality disorder: characteristics, severity, and relationship with schizotypy and loneliness
Authors: Slotema C. W. , Bayrak H. , Linszen M. M. J. , Deen M. , Sommer I. E. C.
Published: February 2019

Objective

In patients with borderline personality disorder (BPD), data are lacking on characteristics and severity of hallucinations in modalities other than the auditory (verbal) type. The same applies to relationships between hallucinations and the severity of depression, anxiety, schizotypy, and loneliness.

Methods

In 60 female patients withBPD(37 also with hallucinations), this cross‐sectional study explored characteristics and severity of (i) hallucinations and (ii) schizotypal features, (iii) severity of depression and anxiety, and (iv) loneliness, and the relationships between hallucinations and the other characteristics.

Results

In patients with hallucinations, 80% experienced hallucinations in more than one modality; in the different modalities, the characteristics of the hallucinations were similar. The criteria for loneliness were fulfilled in 81% and 48% of patients with and without hallucinations. Compared to patients withBPDwithout hallucinations, the presence of hallucinations was associated with higher scores for depression, anxiety, loneliness, and schizotypy. Furthermore, the severity of hallucinations showed a positive correlation with the severity of loneliness and schizotypy.

Conclusion

Patients withBPDexperienced hallucinations with characteristics similar to the more frequently studied auditory (verbal) hallucinations. Higher scores for schizotypy and loneliness indicate that patients with hallucinations had more characteristics of cluster A personality disorders.
Cocaine'omics: Genome‐wide and transcriptome‐wide analyses provide biological insight into cocaine use and dependence
Authors: Huggett Spencer B. , Stallings Michael C.
Published: February 2019

We investigated the genetic and molecular architecture of cocaine dependence (CD) and cocaine use by integrating genome‐/transcriptome‐wide analyses. To prioritize candidates for follow‐up investigation, we also sought to translate gene expression findings across species. Using data from the largest genome‐wide association study (GWAS) of CD to date (n = 3176, 74% with CD), we assessed genomic heritability, gene‐based associations, and tissue enrichment. We detected a significant single‐nucleotide polymorphism heritability of 28% for CD and identified three genes (two loci) underlying this predisposition: the C1qL2 (complement component C1 q like 2), KCTD20 (potassium channel tetramerization domain containing 20), and STK38 (serine/threonine kinase 38) genes. Tissue enrichment analyses indicated robust enrichment in numerous brain regions, including the hippocampus. We used postmortem human hippocampal RNA‐sequencing data from previous study (n = 15, seven chronic cocaine users) to follow up genome‐wide results and to identify differentially expressed genes/transcripts and gene networks underlying cocaine use. Cross‐species analyses utilized hippocampal gene expression from a mouse model of cocaine use. Differentially expressed genes/transcripts in humans were enriched for the genes nominally associated with CD via GWAS (P < 0.05) and for differentially expressed genes in the hippocampus of cocaine‐exposed mice. We identified KCTD20 as a central component of a hippocampal gene network strongly associated with human cocaine use, and this gene network was conserved in the mouse hippocampus. We outline a framework to map and translate genome‐wide findings onto tissue‐specific gene expression, which provided biological insight into cocaine use/dependence.
A multiple‐method analysis of appraisal–emotion relationships: The case of the prosocial intergroup emotions
Authors: Fernando Julian W. , Kashima Yoshihisa , Laham Simon M.
Published: February 2019

Despite its status as a prominent set of theories for explaining the elicitation and differentiation of emotions, much appraisal theory and research offer little indication of the nature of the relationship expected between appraisals and emotions. Here, we present a three‐study, multiple‐method analysis in which we examine numerous ways of testing appraisal–emotion relationships using the “prosocial” intergroup emotions—sympathy, anger, and guilt—as an example. Results show that the set of appraisal dimensions that appears strongly characteristic of an emotion varies depending on the kind of appraisal—emotion relationship hypothesised and the experimental methodology/statistical analysis used. These findings demonstrate the utility of explicit theorising about the nature of the relationship between emotions and appraisals, and show how the hypothesised appraisal–emotion relationship and choice of methodology can affect the structure of appraisal theories. We recommend an analysis across multiple methods to provide a more complete picture of a given set of appraisal–emotion relationships.
Housing Squats as “Educational Sites of Resistance”: The Process of Movement Social Base Formation in the Struggle for the House
Authors: Caciagli Carlotta
Published: February 2019

This paper aims to contribute to the scholarly work on the internal dynamics of contemporary housing movements. In particular, it explores the spatial strategies through which squat inhabitants change the configuration of the squat to turn an abandoned building into a house for multiple families. The main argument is that these strategies, requiring horizontal participation and solidarity, catalyse the transformation of a sum of people dispossessed of the house into a collective, political subject. Therefore, the author proposes to analyse housing squats as “educational sites of resistance”. The findings come from the author's participant observation of Rome's housing movement organisation Coordinamento Cittadino di Lotta per la casa. In addition to providing empirical knowledge, the paper aims to offer inputs for investigating to what extent the process of politicisation is shaped by the space and what constitute the peculiarities of a so‐recomposed collective subject.
SITUPS: a new tool for oral case presentation in the paediatric emergency department
Authors: Sofou Kalliopi , Bry Kristina
Published: February 2019

Aim

We developed a new case presentation technique, SITUPS, and studied its impact on the patient presentations by medical students at a paediatric emergency department. The students’ opinions about the usefulness of the technique were also assessed.

Methods

The students saw patients both before and after introduction to SITUPS. Their presentations were analysed by the clinical instructor using a student assessment form. The students filled in a 15‐item questionnaire about their opinion of SITUPS as a learning tool.

Results

Twenty‐eight students were evaluated both without and with SITUPS in a total of 78 presentations. Using SITUPS, the students gave more complete case presentations without increasing the presentation time. The main areas of improvement were discussing differential diagnoses, proposing a management plan, and identifying where they lacked knowledge and needed to ask the instructor questions. The students found SITUPS particularly helpful in identifying family and social issues of significance, thinking of relevant questions to ask the patient and the family, and thinking through differential diagnoses.

Conclusion

We propose a new case presentation technique, SITUPS, for use at the paediatric emergency department. With the help of SITUPS, the medical students gave more complete case presentations in a time‐effective manner.
Adjuvant potential of selegiline in treating acute toxicity of aluminium phosphide in rats
Authors: Maleki Adeleh , Hosseini Mir‐Jamal , Rahimi Nastaran , Abdollahi Alireza , Akbarfakhrabadi Amir , Javadian Nina , Amiri Shayan , Behnoush Behnam , Dehpour Ahmad Reza
Published: February 2019

Aluminium phosphide (AlP) is a highly toxic substance with a high mortality rate and no effective antidote. Once exposed to the moisture and acidic conditions of the stomach, AlP releases toxic phosphine (PH3) gas, which results in severe toxicity in poisoned subjects. Selegiline is a monoamine oxidase inhibitor with antioxidant and anti‐apoptotic properties, which is mostly prescribed for the treatment of mood disorders and Parkinson's disease. Since AlP has detrimental effects on cardiac physiology and mitochondrial function, we tested the protective effects of acute selegiline treatment on cardiac mitochondrial function, redox status and electrocardiographic parameters in rats after AlP poisoning. To do this, AlP was given to rats by gavage to induce toxicity. Selegiline was injected intraperitoneally in the treatment groups 1 hour after AlP poisoning. Selegiline treatment after AlP intoxication was not associated with a significant difference in the mortality rate of animals. However, selegiline reduced oxidative stress (decreased the reactive oxygen species and malondialdehyde) and increased glutathione in the cardiac tissue of rats exposed to AlP. Further, the mitochondrial membrane potential (ΔΨm) collapse reversed after treatment with selegiline. Selegiline also improved the electrocardiographic (ECG) parameters and enhanced heart rate. The histopathological evaluation revealed that selegiline eliminated the inflammation and injuries induced by AlP in the stomach and duodenum, as well as cardiac tissue. In conclusion, selegiline treatment can ameliorate the AlP‐induced cardiac and gastrointestinal injuries in rats via boosting redox status and mitochondrial function with no significant effect on survival. We suggest that using selegiline, apart from other clinical treatments, may improve the quality of treatment process for AlP toxicity.
Hospital‐based maternity care practitioners’ perceptions of doulas
Authors: Neel Kira , Goldman Roberta , Marte Denise , Bello Gisel , Nothnagle Melissa B.
Published: February 2019

Introduction

A birth doula provides continuous informational, physical, and emotional support during pregnancy, labor, and immediately postpartum. Existing data on the benefits of doulas, especially for low‐resource, high‐need patients, do not address how and why individual practitioners decide to recommend this model of care. This project aims to describe best practices of integrating doulas into hospital‐based maternity care teams to facilitate access to this evidence‐based service for improving maternal health outcomes.

Methods

Semi‐structured interviews using open‐ended questions were conducted in person with 47 maternity care practitioners—OB/GYNs, family medicine physicians, RNs, and nurse‐midwives—across three hospitals. Interview analysis was conducted using the Template Organizing Style qualitative analysis approach.

Results

Results demonstrated varied support for doula care given practitioners’ experiences. Positive experiences centered on doulas’ supportive role and strong relationships with patients. Some conflicts between practitioners and doulas may stem from a cross‐cultural divide between mainstream obstetric/physician culture and a natural birth “counter culture.” Suggestions to facilitate good working relationships centered on three overlapping themes: mutual respect between doulas and hospital staff, education about doulas’ training, and clarification of roles on maternity care teams especially among staff with overlapping roles.

Conclusions

Among maternity care practitioners, some frustration, anger, and resentment persist with respect to work with doulas. Adequate staff training in the doula model of care, explicit role definition, and increasing practitioner exposure to doulas may promote effective integration of doulas into hospital maternity care teams.
Identification of novel oncogenic events occurring early in prostate carcinogenesis using purified autologous malignant and non‐malignant prostate epithelial cells
Authors: Sluka Pavel , Pezaro Carmel , Wardan Hady , Sengupta Shomik , Davis Ian D.
Published: February 2019

Objective

To interrogate enriched prostate cancer cells and autologous non‐malignant prostate epithelial cells from men with localized prostate cancer, in order to identify early oncogenic pathways.

Patients and Methods

We collected malignant and matched non‐malignant prostatectomy samples from men with adenocarcinoma involving two or more contiguous areas in only one lobe of the prostate. Tissue samples from both lobes were subjected to digestion and single‐cell suspensions were prepared. Epithelial cell adhesion molecule‐positive cells from cancerous and contralateral non‐malignant (control) samples were isolated using magnetic beads, ensuring uniform populations were obtained for each donor. Unbiased RNA sequencing analysis was used to measure gene expression and for detection of transcribed mutations or splice variants that were over‐ or under‐represented in malignant prostate epithelial cells relative to autologous control prostate epithelial cells.

Results

From five patient samples we identified 17 genes that were altered in prostate cancer epithelial cells, with 82% of genes being downregulated. Three genes, TDRD1, ANGTL4, and CLDN3, were consistently upregulated in malignant tissue. Malignant cells from three of the five patients showed evidence of upregulated ERG signalling, however, only one of these contained a TMPRSS2‐ERG rearrangement. We did not identify mutations, gene rearrangements, or splice variants that were consistent amongst the patients.

Conclusions

Events occurring early in prostate cancer oncogenesis in these samples were characterized by a predominant downregulation of gene expression along with upregulation of TDRD1, ANGTL4 and CLDN3. No consistent mutations or splice variants were observed, but upregulation of ERG signalling was seen both in the presence and absence of the classic TMPRSS2‐ERG rearrangement.
Segmental resection of distal ureter with termino‐terminal ureteric anastomosis vs bladder cuff removal and ureteric re‐implantation for upper tract urothelial carcinoma: results of a multicentre study
Authors: Abrate Alberto , Sessa Francesco , Sebastianelli Arcangelo , Preto Mirko , Olivero Alberto , Varca Virginia , Benelli Andrea , Campi Riccardo , Sessa Maurizio , Pavone Carlo , Serretta Vincenzo , Vella Marco , Brunocilla Eugenio , Serni Sergio , Trombetta Carlo , Terrone Carlo , Gregori Andrea , Lissiani Andrea , Gontero Paolo , Schiavina Riccardo , Gacci Mauro , Simonato Alchiede
Published: February 2019

Objectives

To compare overall (OS), cancer‐specific (CSS), recurrence‐free survival (RFS) and postoperative renal function amongst patients with upper tract urothelial carcinoma (UTUC) of the distal (lower lumbar and pelvic) ureter, electively treated with segmental resection and termino‐terminal anastomosis (TT) vs bladder cuff removal and ureteric re‐implantation (RR).

Patients and methods

A multicentre retrospective study, including 84 patients diagnosed with UTUC of the distal ureter and treated with TT or RR, is presented. The primary endpoint was to compare TT and RR in terms of OS, CSS and RFS. As a secondary outcome, we compared the postoperative creatinine values as an index of renal function in the two groups.

Results

Of 521 patients with UTUC, 65 (77.4%) and 19 (22.6%) patients underwent RR and TT, respectively. Pre‐ and postoperative characteristics were not statistically different between the two groups. The median follow‐up period was 22.7 months. Patients treated with TT and those treated with RR did not have significantly different 5‐year OS, CSS or RFS (73.7% vs 92.3%, P = 0.052; 94.7% vs 95.4%, P = 0.970: and 63.2% vs 53.9%, P = 0.489, respectively). No difference in postoperative creatinine variation emerged in association with the surgical technique (P = 0.411).

Conclusion

Patients treated with TT or RR for UTUC showed comparable OS, CSS, RFS and postoperative renal function. Our data suggest that bladder cuff removal is not imperative in the treatment of distal ureteric UTUC, and TT can be a safe solution in selected cases.
Ciliary kinesins beyond IFT: Cilium length, disassembly, cargo transport and signalling
Authors: Reilly Madeline Louise , Benmerah Alexandre
Published: February 2019

Cilia and flagella are microtubule‐based antenna which are highly conserved among eukaryotes. In vertebrates, primary and motile cilia have evolved to exert several key functions during development and tissue homoeostasis. Ciliary dysfunction in humans causes a highly heterogeneous group of diseases called ciliopathies, a class of genetic multisystemic disorders primarily affecting kidney, skeleton, retina, lung and the central nervous system. Among key ciliary proteins, kinesin family members (KIF) are microtubule‐interacting proteins involved in many diverse cellular functions, including transport of cargo (organelles, proteins and lipids) along microtubules and regulating the dynamics of cytoplasmic and spindle microtubules through their depolymerising activity. Many KIFs are also involved in diverse ciliary functions including assembly/disassembly, motility and signalling. We here review these ciliary kinesins in vertebrates and focus on their involvement in ciliopathy‐related disorders.
Forward stratigraphic modelling of sediment pathways and depocentres in salt‐influenced passive‐margin basins: Lower Cretaceous, central Scotian Basin
Authors: Sangster Christopher , Piper David J. W. , Hawie Nicolas , Pe‐Piper Georgia , Saint‐Ange Francky
Published: February 2019

Source‐to‐sink studies and numerical modelling software are increasingly used to better understand sedimentary basins, and to predict sediment distributions. However, predictive modelling remains problematic in basins dominated by salt tectonics. The Lower Cretaceous delta system of the Scotian Basin is well suited for source‐to‐sink studies and provides an opportunity to apply this approach to a region experiencing active salt tectonism. This study uses forward stratigraphic modelling software and statistical analysis software to produce predictive stratigraphic models of the central Scotian Basin, test their sensitivity to different input parameters, assess proposed provenance pathways, and determine the distribution of sand and factors that control sedimentation in the basin. Models have been calibrated against reference wells and seismic surfaces, and implement a multidisciplinary approach to define simulation parameters. Simulation results show that previously proposed provenance pathways for the Early Cretaceous can be used to generate predictive stratigraphic models, which simulate the overall sediment distribution for the central Scotian Basin. Modelling confirms that the shaly nature of the Naskapi Member is the result of tectonic diversion of the Sable and Banquereau rivers and suggests additional episodic diversion during the deposition of the Cree Member. Sand is dominantly trapped on the shelf in all units, with transport into the basin along salt corridors and as a result of turbidity current flows occurring in the Upper Missisauga Formation and Cree Member. This led to sand accumulation in minibasins with a large deposit seawards of the Tantallon M‐41 well. Sand also appears to bypass the basin via salt corridors which lead to the down‐slope edge of the study area. Sensitivity analysis suggests that the grain size of source sediments to the system is the controlling factor of sand distribution. The methodology applied to this basin has applications to other regions complicated by salt tectonics, and where sediment distribution and transport from source‐to‐sink remain unclear.
Food avoidance strategies in eosinophilic oesophagitis
Authors: Cianferoni Antonella , Shuker Michelle , Brown‐Whitehorn Terri , Hunter Hannah , Venter Carina , Spergel Jonathan M.
Published: February 2019

Eosinophilic oesophagitis (EoE) is a chronic disease associated with significant morbidity that can result in permanent fibrosis and stricture formation. Given the complexity, a multidisciplinary approach is recommended to manage these patients. In the majority of children with EoE not responsive to proton‐pump inhibitor (PPI), inflammation is driven by sensitivity to foods and treatment with an elimination diet can be effective. Foods most commonly identified to trigger EoE in children are milk and wheat, but egg, soy, meats and grains can also be triggers. Foods can be eliminated using a step‐down or step‐up approach. If the goal is to achieve quick remission, elemental diet or six food elimination diets are the most effective. A step‐up approach starting from a 1‐2 food elimination diet and increasing the number of foods based on a personalized dietary approach is recommended if the goal is to achieve remission using the least number of endoscopies and with increased acceptability to the patient. Children with EoE on elimination diets require frequent monitoring of growth and nutrition, as well as screening for symptoms of EoE, allergy and mindfulness regarding psychosocial impact of chronic disease on the family and child. Current research focused on tools to select patients who mostly will benefit from dietary treatment, identify relevant food allergens, obtain oesophageal tissue non‐invasively and induce tolerance will greatly improve the treatment of EoE.
Rapid spread of mannan to the immune system, skin and joints within 6 hours after local exposure
Authors: Hagert C , Siitonen R , Li X-G , Liljenbäck H , Roivainen A , Holmdahl R
Published: February 2019

Psoriasis (Ps), psoriatic arthritis (PsA) and rheumatoid arthritis (RA) are common diseases dependent on environmental factors that activate the immune system in unknown ways. Mannan is a group of polysaccharides common in the environment; they are potentially pathogenic, because at least some of them induce Ps-, PsA- and RA-like inflammation in mice. Here, we used positron emission tomography/computed tomography to examine in-vivo transport and spread of mannan labelled with fluorine-18 [18F]. The results showed that mannan was transported to joints (knee) and bone marrow (tibia) of mice within 6 h after intraperitoneal injection. The time it took to transport mannan, and its presence in blood, indicated cellular transport of mannan within the circulatory system. In addition, mannan was filtered mainly through the spleen and liver. [18F]fluoromannan was excreted via kidneys, small intestine and, to some extent, the mouth. In conclusion, mannan reaches joints rapidly after injection, which may explain why mannan-induced inflammatory disease is targeted to these tissues.
Presence of intragraft B cells during acute renal allograft rejection is accompanied by changes in peripheral blood B cell subsets
Authors: Heidt S , Vergunst M , Anholts J D H , Swings G M J S , Gielis E M J , Groeneweg K E , Witkamp M J , de Fijter J W , Reinders M E J , Roelen D L , Eikmans M , Claas F H J
Published: February 2019

B cells have various functions, besides being plasma cell precursors. We determined the presence of intragraft B cells at time of acute rejection (AR) and looked for correlates of B cell involvement in peripheral blood. Renal biopsies at time of AR or stable graft function were analysed for the presence of B cells and B cell-related gene expression, as well as C4d staining. Peripheral blood B cell subset distribution was analysed at various time-points in patients with AR and controls, alongside serum human leucocyte antigen (HLA) antibodies. AR was accompanied by intragraft CD20+ B cells, as well as elevated CD20 (MS4A1) and CD19 gene expression compared to controls. B cell infiltrates were proportional to T cells, and accompanied by the chemokine pair C-X-C motif chemokine ligand 13 (CXCL13)–C-X-C motif chemokine receptor 5 (CXCR5) and B cell activating factor (BAFF). Peripheral blood memory B cells were decreased and naive B cells increased at AR, in contrast to controls. While 22% of patients with AR and 5% of controls showed de-novo donor-specific antibodies (DSA), all biopsies were C4d-negative. These results suggest a role for B cells in AR by infiltrating the graft alongside T cells. We hypothesize that the shift in peripheral blood B cell composition is related to the graft infiltration at time of AR.
The predictive value of plasma osmolality for in‐hospital mortality in patients with acute pulmonary embolism
Authors: Öz Ahmet , Çınar Tufan , Hayıroğlu Mert İlker , Avşar Şahin , Keskin Muhammed , Orhan Ahmet Lütfüllah
Published: February 2019

Introduction and Objectives

Prior studies demonstrated that plasma osmolality may have a predictive value for in‐hospital mortality in patients with heart failure and acute coronary syndrome. In addition, plasma glucose and blood urea nitrogen (BUN) levels, the components of plasma osmolality, have been shown to be an important contributor for in‐hospital mortality in acute pulmonary embolism (APE) patients. Hence, the objective of the current study is to evaluate the effect of plasma osmolality upon admission with in‐hospital mortality in patients with APE.

Methods

A total of 245 consecutive intermediate or high risk APE patients were enrolled into the study. The study population was divided into three tertile groups (T1, T2 and T3) based on the increased plasma osmolality. The in‐hospital mortality was the primary end‐point.

Results

After adjusting for all risk factors, in‐hospital mortality was significantly higher in the T3 group compared to T1 and T2 groups (OR: 3.6, 95% CI: 1.3 to 18.8, P < .001). In addition, the incidence of asystolia, hypotension and cardiogenic shock were significantly higher in the T3 group. An area under the receiver operating characteristic curve value of plasma osmolality for the in‐hospital mortality was 0.76 with sensitivity 67.2% and specificity 74.1% 95% CI: (0.66‐0.87, P < .001).

Conclusion

This is the first study to demonstrate that elevated levels of plasma osmolality may have a predictive value for in‐hospital mortality in APE patients. Our findings are novel and deserve further studies whether the treatment of higher plasma osmolality may reduce the risk of in‐hospital mortality in APE patients.
Plasmacytoid dendritic cells in granulomatous variant of mycosis fungoides
Authors: Fernandez‐Flores Angel , Cassarino David S.
Published: February 2019

Introduction

Granulomatous mycosis fungoides (MF) is a rare variant in which granulomas are associated with other typical signs of MF. Its prognosis is worse than that of classical MF. Plasmacytoid dendritic cells (PDCs) are a subset of interferon‐producing dendritic cells that link the innate and the adaptative immune responses. They have also been related to tolerance to certain tumors such as melanoma.

Materials and methods

In this article, we examined for the presence of CD123+ PDC in six cases of granulomatous MF from our archives.

Results

We found clusters of 10 or more positive cells in three of six cases of granulomatous MF (two women and a man, in their sixth and seventh decade). Although in two of these three cases the granulomatous response was extensive, in the other, it only represented 10% of the infiltrate of the biopsy. In all three cases, the granulomas were epithelioid, sarcoidal type.

Conclusions

CD123+ PDC can be identified in granulomatous MF. The pathogenic and prognostic role of this finding requires further clarification.
Plasmacytoid morphology of poorly differentiated thyroid carcinoma: Diagnostic approach with a brief review of the literature
Authors: Gochhait Debasis , Edura Praveena , Ganesh Nachiappa Rajesh , Siddaraju Neelaiah , Rangarajan Vidhyalakshmi , Keloth Thara
Published: February 2019

Poorly differentiated thyroid carcinoma (PDTC) are unusual tumours which are rarely diagnosed with accuracy in cytology. Plasmacytoid morphology of the tumour cells can cause diagnostic difficulty as it mimics many other primary thyroid tumours: however it can be accurately diagnosed if certain fine morphological clues are identified while reporting.
The additive role of echocardiography in the screening for sudden death
Authors: Tamariz Leonardo , Goldberger Jeffrey J. , Palacio Ana , Chen Gordon , Dawkins Elissa , Forbes Emancia , Tajiri Thiago , Ghany Reyan
Published: February 2019

Background

A clinically based sudden cardiac death (SCD) risk score has predictive value. Echocardiographic parameters predict SCD. Our aim was to evaluate the effect of adding echocardiographic parameters to the clinical SCD risk score for the prediction of all‐cause mortality.

Methods

We conducted a retrospective cohort of screening echocardiograms performed on primary care patients. We calculated the SCD risk score and added the left ventricular (LV) mass index, LV hypertrophy, diastolic dysfunction, and LV ejection fraction (EF). We calculated the c‐statistic, net reclassification index (NRI), and Hosmer‐Lemeshow chi‐square for the SCD score alone or combined with each echocardiographic parameter in predicting all‐cause mortality.

Results

We included 6447 primary care patients who underwent a screening echocardiogram and had a SCD score. The c‐statistic of the SCD score for mortality was 0.61; 95% CI 0.58–0.62 and the c‐statistic for the score combined with LV mass index increased to 0.64; 95% CI 0.63–0.65 and for the score combined with LVEF, the c‐statistic was 0.64;95% CI 0.63–0.67. When diastolic dysfunction and LV hypertrophy were added to the SCD score, the c‐statistic did not significantly change (P > 0.05). The NRI for the addition of LV mass index and LVEF was 0.52 ± 0.02, and the Hosmer‐Lemeshow statistic was nonsignificant (P > 0.05).

Conclusions

Adding LV mass index or LVEF to the SCD risk score improves the ability to predict mortality, but in the primary care setting, the improvement is small and underscores the challenge of SCD prediction and prevention in the community.
Structural signature of sporadic Creutzfeldt–Jakob disease
Authors: Navid J. , Day G. S. , Strain J. , Perrin R. J. , Bucelli R. C. , Dincer A. , Wisch J. K. , Soleimani‐Meigooni D. , Morris J. C. , Benzinger T. L. S. , Ances B. M.
Published: February 2019

Background and purpose

Sporadic Creutzfeldt–Jakob disease (sCJD) is a rapidly progressive neurodegenerative disease caused by an abnormal isoform of the human prion protein. Structural magnetic resonance imaging in patients with pathologically confirmed sCJD was compared with cognitively normal individuals to identify a cortical thickness signature of sCJD.

Methods

This retrospective cross‐sectional study compared patients with autopsy‐confirmed sCJD with dementia (n = 11) with age‐ and sex‐matched cognitively normal individuals (n = 22). We identified regions of interest (ROIs) in which cortical thickness was most affected by sCJD. Within patients with sCJD, the relationship between ROI cortical thickness and clinical measures (disease duration, cerebrospinal fluid tau and diffusion‐weighted imaging abnormalities) was evaluated.

Results

Compared with cognitively normal individuals, patients with sCJD had significantly reduced cortical thickness in multiple ROIs, including the fusiform gyrus, precentral gyrus, precuneus and superior temporal gyrus bilaterally; the caudal middle frontal gyrus, superior frontal gyrus, postcentral gyrus, inferior temporal gyrus and transverse temporal gyrus in the left hemisphere; and the superior parietal lobule in the right hemisphere. Only one patient with sCJD had co‐pathology consistent with Alzheimer's disease. Reduced cortical thickness did not correlate with disease duration, presence of diffusion restriction or elevated cerebrospinal fluid tau.

Conclusion

Cortical signature changes in sCJD may reflect brain changes not captured by standard clinical measures. This information may be used with clinical measures to inform the progression of sCJD and patterns of prion protein spread throughout the brain. These results may have implications for prediction of symptomatic progression and plausibly for development of therapeutic strategies.
Primary ossifying fibroma of the proximal phalanx in a horse
Authors: Balducci J. , Selberg K. , Pool R. , Radue R. P.
Published: February 2019

A primary ossifying fibroma was found at necropsy in a 5‐year‐old Welsh pony cross mare that was humanely subjected to euthanasia for an intractable severe left hindlimb lameness. Antemortem radiographs of the left hind pastern were characterised by articular, subchondral and cortical areas of lysis. Primary ossifying fibroma is a rare lesion of the distal limb but should be considered when there is extensive lysis extending into the medulla and proximal cortical bone.