bluuebunny/crossref_metadata_2025 huggingface dataset:
Multidimensional ecological analyses demonstrate how interactions between functional traits shape fitness and life history strategies
Authors: Pistón Nuria , de Bello Francesco , Dias André T. C. , Götzenberger Lars , Rosado Bruno H. P. , de Mattos Eduardo A. , Salguero‐Gómez Roberto , Carmona Carlos P.
Published: April 2019

Traditionally, trait‐based studies have explored single‐trait‐fitness relationships. However, this approximation in the study of fitness components is often too simplistic, given that fitness is determined by the interplay of multiple traits, which could even lead to multiple functional strategies with comparable fitness (i.e. alternative designs).

Here we suggest that an analytical framework using boosted regression trees (BRT) can prove more informative to test hypotheses on trait combinations compared to standard linear models. We use two published datasets for comparisons: a botanical garden dataset with 557 plant species (Herben, 2012, Journal of Ecology, 100, 1522) and an observational dataset with 83 plant species (Adler, 2014, Proceedings of the National Academy of Sciences, 111, 740).

Using the observational dataset, we found that BRTs predict the role of traits on the relative importance of survival, growth and reproduction for population growth rate better than linear models do. Moreover, we split species cultivated in different habitats within the botanical garden and observed that seed and vegetative reproduction depended on trait combinations in most habitats. Our analyses suggest that, while not all traits impact fitness components to the same degree, it is crucial to consider traits that represent different ecological dimensions.

Synthesis. The analysis of trait combinations, and corresponding alternative designs via BRTs, represent a promising approach for understanding and managing functional changes in vegetation composition through measurement of suites of relatively easily measurable traits.
Functional diversity promotes phytoplankton resource use efficiency
Authors: Ye Lin , Chang Chun‐Wei , Matsuzaki Shin‐ichiro S. , Takamura Noriko , Widdicombe Claire E. , Hsieh Chih‐hao
Published: April 2019

Understanding the relationship between biodiversity and ecosystem functioning (BEF) is a central topic in ecology. Multi‐trait–based functional diversity has been proposed to improve mechanistic understanding of the BEF relationship; however, how trait‐based functional diversity affects ecosystem functioning and processes has rarely been addressed in aquatic ecosystems.

Here, we examined the causal relationships between three phytoplankton functional diversity indices (FAD2, functional diversity based on dendrograms [FDc], FRic) and Shannon diversity index versus resource use efficiency for nitrogen (RUEN), phosphorus (RUEP) and silicate (RUESi), with monthly long‐term datasets from the marine (Western English Channel, 2000–2014) and freshwater (Lake Kasumigaura, 1984–2012) ecosystems.

We employed Convergent Cross Mapping (CCM), a novel method developed for identifying causality for nonlinear dynamical systems; this is in contrast to linear approaches that cannot distinguish causality from correlation. CCM found that FDc is the most robust functional diversity index among the selected functional diversity indices (FAD2, FDc, FRic) in predicting phytoplankton resource use efficiency and exhibited a much stronger causal effect than the Shannon index.

Furthermore, scenario exploration analysis indicates that most causal effects from phytoplankton diversity indices on resource use efficiency (RUEN, RUEPand RUESi) are on average positive, and FDc exhibited the most consistent positive causal effects on phytoplankton resource efficiency in both marine and freshwater ecosystems. Thus, increasing FDc can enhance phytoplankton resource use efficiency in aquatic ecosystems.

Synthesis.Our results show significant causal effects of functional diversity on phytoplankton resource use efficiency in both marine and freshwater ecosystems. Among all selected functional diversity indices, functional diversity based on dendrogram is the most robust functional diversity index in promoting phytoplankton resource efficiency. Our study provides empirical evidences in natural aquatic systems that trait‐based functional diversity represents better species niche partitioning than the Shannon index and thereafter enhances resource use efficiency. This finding can improve our understanding on trophic transfer and nutrient cycling in aquatic ecosystems.
‘You certainly don't go back to the doctor once you've been told, “I'll never understand women like you.”’ Seeking candidacy and structural competency in the dynamics of domestic abuse disclosure
Authors: Mackenzie Mhairi , Gannon Maria , Stanley Nicky , Cosgrove Katie , Feder Gene
Published: April 2019

A reticence on the part of women to disclose domestic abuse (DA) to family doctors, allied to front‐line responses that do not always reflect an understanding of the structure and dynamics of DA, hampers the provision of professional support. Using data from 20 qualitative interviews with women who have experienced DA, this paper explores their discourse about interacting with family doctors. It is the first study to explore firsthand accounts of these interactions through Dixon Woods’ lens of candidacy. It finds disclosure to be inherently dynamic as a process and expands the candidacy lens by considering the: (i) conflicting candidacies of victims and perpetrators; (ii) diversionary disclosure tactics deployed by perpetrators and, (iii) the potential role of General Practitioner (GPs) in imagining candidacies from a structural perspective. By exploring the dynamics of disclosure through the concept of ‘structural competency’ it finds that in encounters with women who have experienced abuse GPs ineluctably communicate their views on the legitimacy of women's claims for support; these in turn shape future candidacy and help‐seeking. Greater GP awareness of the factors creating and sustaining abuse offers the potential for better care and reduced stigmatisation of abused women.
Prospective study of gestational diabetes and fatty liver scores 9 to 16 years after pregnancy
Authors: Donnelly Sarah R. , Hinkle Stefanie N. , Rawal Shristi , Grunnet Louise G. , Chavarro Jorge E. , Vaag Allan , Wu Jing , Damm Peter , Mills James L. , Li Mengying , Bjerregaard Anne A. , Thuesen Anne Cathrine B. , Gore‐Langton Robert E. , Francis Ellen C. , Ley Sylvia H. , Hu Frank B. , Tsai Michael Y. , Olsen Sjurdur F. , Zhang Cuilin
Published: April 2019

Background

Women with gestational diabetes mellitus (GDM) may be at an increased risk of liver complications because chronic hyperglycemia is a risk factor for liver fat accumulation and potential liver dysfunction. Large prospective studies examining liver fat accumulation following a GDM pregnancy are lacking.

Methods

The Diabetes & Women's Health Study (2012‐2014) examined the association between GDM and subsequent fatty liver scores among 607 women with and 619 women without GDM in the Danish National Birth Cohort. Nine to 16 years postpartum, a clinical examination was performed, with measurement of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ‐glutamyl transferase, from which fatty liver scoring indices were calculated to assess liver fat score, fatty liver index, hepatic steatosis index, and liver fat percentage. Relative risks (RR) with 95% confidence intervals (CI) for elevated liver scoring indices by GDM status were assessed adjusting for major risk factors, including prepregnancy body mass index.

Results

Women with prior GDM had higher adjusted ALT and AST levels than women without GDM (by 6.7% [95% CI 1.7‐12.0] and 4.8% [95% CI 0.6‐9.1], respectively). Women with GDM also had adjusted increased risks for elevated liver fat score (RR 2.34; 95% CI 1.68‐3.27), fatty liver index (RR 1.59; 95% CI 1.27‐1.99), and hepatic steatosis index (RR 1.44; 95% CI 1.21‐1.71).

Conclusions

Women with GDM during pregnancy were at an increased risk for fatty liver 9 to 16 years postpartum. Gestational diabetes mellitus may serve as another risk indicator for the early identification and prevention of liver fat accumulation.
A binomial N‐mixture model for estimating arrival and departure timing
Authors: Mizel Jeremy D. , Schmidt Joshua H. , Phillips Laura M. , Mcintyre Carol L.
Published: April 2019

The timing of life cycle events has strong fitness consequences, suggesting that monitoring of arrival and departure timing may help understand spatial and population dynamics. Several existing models with inference to arrival and departure in unmarked populations are applicable to detection/non‐detection data which is a reduced information summary of the underlying population and phenological dynamics. These models also do not directly address the dependence of seasonal variation in availability (e.g. song rate) on arrival timing, often treating the seasonal distribution of availability as fixed across years despite allowing variation in arrival. Model development in an abundance framework has largely occurred in the context of stopover populations, rather than populations that exhibit some period of closure between arrival and departure phases.

We developed an N‐mixture model that accommodates the dependence of seasonal availability on arrival timing, providing inference about abundance and both arrival and departure timing based on repeated count data. The model is applicable to populations in which there exists some period of closure between the arrival and departure phases. We developed two general formulations of the model, both of which include a model for the arrival process, but differ in the model for seasonal availability. The first formulation is applicable to cases in which seasonal availability is a function of cue production. The other is applicable to situations where seasonal availability is a function of departure of individuals or their transition to a state in which they remain unavailable for detection.

We demonstrated through simulation that both versions provide unbiased and precise estimates of phenology and abundance and illustrated the cue production formulation using data collected in Denali National Park, Alaska for three passerine species.

We expect that our inference framework will be broadly applicable in studies of unmarked populations where joint assessment of population, spatial and phenological dynamics is of interest.
Class Monopoly Rent and the Redevelopment of Portland's Pearl District
Authors: Anderson Matthew B.
Published: April 2019

This study examines the role of class monopoly rent in shaping the spatial form and pattern of urban redevelopment processes in the contemporary neoliberal city. Since an initial flourishing literature during the 1970s and 1980s, urban land rent theory has fallen from the analytic radar of critical urban studies since the early 1990s, with the influence of class monopoly rent often considered an aberration of how capitalist real estate markets normally operate, if not rejected. Consequently, class monopoly rent has never been systematically elaborated. Based on an empirical analysis of Portland's Pearl District, this study suggests that the influence of class monopoly rent in contemporary processes of urban redevelopment is far more pervasive than often recognised, representing a “standard institutional practice” that is endemic (rather than aberrational) to the working of neoliberal urban governing regimes, and embeds in the social and physical landscape in a multiplicity of ways.
Contraception after pregnancy
Authors: Glasier Anna , Bhattacharya Siladitya , Evers Hans , Gemzell‐Danielsson Kristina , Hardman Sarah , Heikinheimo Oskari , La Vecchia Carlo , Somigliana Edgardo
Published: April 2019

Whatever the outcome, pregnancy provides the opportunity to offer effective contraception to couples motivated to avoid another pregnancy. This narrative review summarizes the evidence for health providers, drawing attention to current guidelines on which contraceptive methods can be used, and when they should be started after pregnancy, whatever its outcome. Fertility returns within 1 month of the end of pregnancy unless breastfeeding occurs. Breastfeeding, which itself suppresses fertility after childbirth, influences both when contraception should start and what methods can be used. Without breastfeeding, effective contraception should be started as soon as possible if another pregnancy is to be avoided. Interpregnancy intervals of at least 6 months after miscarriage and 1‐2 years after childbirth have long been recommended by the World Health Organization in order to reduce the chance of adverse pregnancy outcome. Recent research suggests that this may not be necessary, at least for healthy women <35 years old. Most contraceptive methods can be used after pregnancy regardless of the outcome. Because of an increased risk of venous thromboembolism associated with estrogen‐containing contraceptives, initiation of these methods should be delayed until 6 weeks after childbirth. More research is required to settle the questions over the use of combined hormonal contraception during breastfeeding, the use of injectable progestin‐only contraceptives before 6 weeks after childbirth, and the use of both hormonal and intrauterine contraception after gestational trophoblastic disease. The potential impact on the risk of ectopic pregnancy of certain contraceptive methods often confuses healthcare providers. The challenges involved in providing effective, seamless service provision of contraception after pregnancy are numerous, even in industrialized countries. Nevertheless, the clear benefits demonstrate that it is worth the effort.
Process of selecting and educating HCV‐uninfected kidney waiting‐list candidates for HCV‐infected kidney transplantation
Authors: Sise Meghan E. , Wojciechowski David , Chute Donald F. , Gustafson Jenna , Chung Raymond T. , Williams Winfred W. , Elias Nahel
Published: April 2019

Long waiting times for kidney transplant (KT) and the high risk of mortality on dialysis have prompted investigation into strategies to utilize hepatitis C virus (HCV)‐infected organs to decrease discard rates of potentially viable kidneys. Due the opioid epidemic, the number of HCV‐infected donors has increased significantly. With the development of direct‐acting antiviral therapies for HCV infection, now more than 95% of patients who received treatment are cured. Experimental trials have used direct‐acting antiviral therapy to treat HCV infection in HCV‐uninfected transplant recipients of kidneys from HCV‐viremic donors. To date, HCV has been eradicated in all cases. Though these strategies will potentially increase the donor pool of available kidneys, shorten waitlist times, and ultimately decrease mortality in patients waiting for KT, identifying the ideal candidates and educating them about a protocol to utilize direct‐acting antiviral therapy to cure HCV after it is transmitted is essential. We present our approach to patient selection and education for a clinical trial in transplantation of HCV viremic kidneys into uninfected recipients.
Parental height modifies the association between linear growth and neurodevelopment in infancy
Authors: Upadhyay Ravi P. , Chandyo Ram K. , Kvestad Ingrid , Hysing Mari , Ulak Manjeswori , Ranjitkar Suman , Shrestha Merina , Shrestha Laxman , Strand Tor A.
Published: April 2019

Aim

To estimate the extent to which maternal and paternal height modify the association between length‐for‐age Z‐score (LAZ) and neurodevelopmental outcomes assessed by the Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley‐III).

Methods

Baseline data from a clinical trial in 600 Nepalese infants aged six to 11 months with LAZ less than −1 were utilised. The primary exposure was the LAZ score, interaction variables were maternal and paternal height, and the outcomes were Bayley‐III cognitive, language and motor scaled scores. Linear regression and generalised additive model (GAM) were used to identify potential interactions.

Results

Linear regression analysis stratified by parental height categories showed that association between unit increase in LAZ and cognitive scaled score differed across maternal (normal height: ß 1.16, 95% CI; 0.75, 1.57 and short height: ß 0.67, 95% CI; 0.28, 1.05) and paternal (normal height: ß 1.32, 95% CI; 0.91, 1.72 and short height: ß 0.61, 95% CI; 0.03, 1.18) height categories. Maternal height also modified the association between LAZ and fine motor scaled score.

Conclusion

The association between LAZ and neurodevelopmental outcomes was attenuated when maternal and paternal height was taken into account. Parental stature should be considered when using LAZ as a proxy for neurodevelopment among infants.
Long‐term oncological outcomes of patients with paratesticular sarcoma
Authors: Goldberg Hanan , Wong Lih‐Ming , Dickson Brendan , Catton Charles , Yap Stanley A. , Alkasab Thamir , Evans Andrew , van der Kwast Theodorus , Jewett Michael A. S. , Hamilton Robert J.
Published: April 2019

Objectives

To present long‐term oncological outcomes of patients with paratesticular sarcoma treated by a multidisciplinary team.

Patients and methods

Patients managed at the Princess Margaret Cancer Centre, between 1990 and 2012, were analysed. A sarcoma expert performed central pathology review. Kaplan–Meier graphs compared local recurrence (LR), metastasis, and overall survival (OS) of patients treated with hemiscrotectomy vs those who did not. Univariable Cox proportional hazards analysis was performed to delineate predictors of LR, metastasis, and OS.

Results

Overall, 51 patients with a median (interquartile range) follow‐up of 132 (51.6–226.8) months were analysed. At presentation, 92.2% (47 patients) had localised disease. Only five patients (9.8%) had undergone initially planned hemiscrotectomy. Completion and salvage hemiscrotectomy was performed in 25 (54.3%) and seven (15.2%) patients, respectively. Recurrence and metastasis occurred in 12 (25.5%) and 10 patients (19.6%), respectively. At the last follow‐up, 21.6% (11 patients) had died, with eight dying from their disease. Kaplan–Meyer graphs demonstrated that hemiscrotectomy improved LR (median not reached vs 62.4 months, log‐rank P = 0.008) and OS (median not reached vs 168 months, log‐rank P = 0.081). Univariable analysis found hemiscrotectomy to be associated with a lower LR rate (hazard ratio [HR] 0.21, P = 0.02), whilst positive margins at initial surgery were associated with increased LR (HR 4.81, P = 0.047). No metastasis predictors were found, but age (HR 1.04, 95% confidence interval [CI] 1.0–1.08; P = 0.02) and non‐localised disease at presentation (HR5.17, 95% CI 1.33–20.06; P = 0.017) were associated with worse OS.

Conclusion

Paratesticular sarcoma is a rare tumour, predominantly manifesting as localised disease. Most patients receive an initial suboptimal oncological surgery. Improved long‐term outcomes are demonstrated following early hemiscrotectomy.
Idiopathic anaphylaxis
Authors: Bilò Maria Beatrice , Martini Matteo , Tontini Chiara , Mohamed Omar E. , Krishna Mamidipudi T.
Published: April 2019

Idiopathic anaphylaxis (IA) or spontaneous anaphylaxis is a diagnosis of exclusion when no cause can be identified. The exact incidence and prevalence of IA are not known. The clinical manifestations of IA are similar to other known causes of anaphylaxis. A typical attack is usually acute in onset and can worsen over minutes to a few hours. The pathophysiology of IA has not yet been fully elucidated, although an IgE‐mediated pathway by hitherto unidentified trigger/s might be the main underlying mechanism. Elevated concentrations of urinary histamine and its metabolite, methylimidazole acetic acid, plasma histamine and serum tryptase have been reported, consistent with mast cell activation. There is some evidence that corticosteroids reduce the frequency and severity of episodes of IA, consistent with a steroid‐responsive condition. Important differential diagnoses of IA include galactose alpha‐1,3 galactose (a carbohydrate contained in red meat) allergy, pigeon tick bite (Argax reflexus), wheat‐dependent exercise‐induced anaphylaxis, Anisakis simplex allergy and mast cell disorders. Other differential diagnoses include “allergy‐mimics” such as asthma masquerading as anaphylaxis, undifferentiated somatoform disorder, panic attacks, globus hystericus, vocal cord dysfunction, scombroid poisoning, vasoactive amine intolerance, carcinoid syndrome and phaeochromocytoma. Acute treatment of IA is the same as for other forms of anaphylaxis. Long‐term management is individualized and dictated by frequency and severity of symptoms and involves treatment with H1 and H2 receptor blockers, leukotriene receptor antagonist and consideration for prolonged reducing courses of oral corticosteroids. Patients should possess an epinephrine autoinjector with an anaphylaxis self‐management plan. There are anecdotal reports regarding the use of omalizumab. For reasons that remain unclear, the prognosis of IA is generally favourable with appropriate treatment and patient education. If remission cannot be achieved, the diagnosis should be reconsidered.
A multicentre validation study for the EU‐TIRADS using histological diagnosis as a gold standard
Authors: Trimboli Pierpaolo , Ngu Rose , Royer Benedicte , Giovanella Luca , Bigorgne Claude , Simo Ricard , Carroll Paul , Russ Gilles
Published: April 2019

Objective

Many systems for risk stratification of thyroid nodule with ultrasound (US) have been proposed and the EU‐TIRADS issued by the ETA in 2017 was the last to have been published. The present study was undertaken to evaluate whether the malignancy risk of each category corresponded to the given range of the guidelines and assess the diagnostic value of EU‐TIRADS in a multi‐institutional trial with histology as gold standard.

Design

Three institutions in Switzerland, France and United Kingdom shared this retrospective study. Enrolment period was 2013‐2017. Included were patients who had undergone surgery with a detailed preoperative thyroid US.

Methods

Cancer risk was calculated for each EU‐TIRADS score. Predictivity tests were estimated. Nonparametric statistical analysis was used.

Results

The final series included 1058 nodules of which 257 (24.3%) carcinomas. Nodules were classified as EU‐TIRADS 2, 3, 4 and 5 in 6.7, 46.4, 26.2 and 20.7%, respectively. Cancer prevalence was 1.4, 3.5, 17 and 87.7% in classes 2‐5, respectively (P < 0.0001). EU‐TIRADS 5 had a significantly higher cancer rate than the other summed categories (7.7%;P < 0.0001) with OR 84.7. When EU‐TIRADS 4 and 5 were combined, 93% sensitivity and 97% NPV were found and findings of the three institutions were quite similar. Using the recommended criteria for FNA negative predictive value was 90.9%.

Conclusions

The cancer rate was within or close to the given range described in the EU‐TIRADS guidelines. The diagnostic value was satisfactory. The results were similar in the three institutions participating in the study.
Management of Clostridioides (formerly Clostridium) difficile infection (CDI) in solid organ transplant recipients: Guidelines from the American Society of Transplantation Community of Practice
Authors: Mullane Kathleen M. , Dubberke Erik R. ,   on behalf of the AST ID Community of Practice
Published: April 2019

These updated guidelines from the American Society of Transplantation Infectious Diseases Community of Practice address the prevention and management of Clostridium difficile infection in solid organ transplant (SOT) recipients. Clostridioides (formerly Clostridium) difficile infection (CDI) is among the most common hospital acquired infections. In SOT recipients, the incidence of CDI varies by type and number or organs transplanted. While a meta‐analysis of published literature found the prevalence of postoperative CDI in the general surgical population to be approximately 0.51%, the prevalence of CDI that is seen in the solid organ transplant population ranges from a low of 3.2% in the pancreatic transplant population to 12.7% in those receiving multiple organ transplants. There are no randomized, controlled trials evaluating the management of CDI in the SOT population. Herein is a review and summary of the currently available literature that has been synthesized into updated treatment guidelines for the management of CDI in the SOT population.
Substance use in kidney transplant candidates and its impact on access to kidney transplantation
Authors: Tang Evan , Bansal Aarushi , Famure Olusegun , Keszei Andras , Novak Marta , Kim S. Joseph , Mucsi Istvan
Published: April 2019

Background

Due to the increasing public acceptance of substance use, it is important to understand the association between substance use and access to kidney transplant and its outcomes. Here, we assess the sociodemographic predictors of substance use and the association between substance use and KT access.

Methods

Predictors of substance use were examined using a multivariable‐adjusted multinomial logistic regression. The association between current substance use (tobacco and drug) and time from referral to listing or receipt of a KT was examined using Cox proportional hazards models.

Results

Of 2346 patients, the prevalence of current substance use was 17%. Predictors of current tobacco use were younger age, male sex, Caucasian ethnicity, being unemployed, and unmarried. Predictors of current drug use were younger age, male sex, Caucasian ethnicity, a history of non‐adherence, and a history of mental health disorder. Patients with tobacco use had a decreased likelihood of being cleared for KT (hazard ratio [HR]:0.83[0.70, 0.99]) and receiving a KT (HR:0.80 [0.66, 0.96]). No association was seen in this sample for patients with drug use (HR:0.88 [0.69, 1.11] for being cleared for KT and 0.88 [0.69, 1.14] for KT, respectively).

Conclusions

Tobacco use was associated with a decreased likelihood of access to KT whereas there was no statistically significant difference in access to KT between patients with or without drug use.
Nutrition‐related factors associated with waiting list mortality in patients with interstitial lung disease: A retrospective cohort study
Authors: Oshima Ayako , Nishimura Akiko , Chen‐Yoshikawa Toyofumi F. , Harashima Shin‐ichi , Komatsu Teruya , Handa Tomohiro , Aoyama Akihiro , Takahashi Koji , Ikeda Masaki , Oshima Yohei , Ikezoe Kohei , Sato Susumu , Isomi Maki , Shide Kenichiro , Date Hiroshi , Inagaki Nobuya
Published: April 2019

Japanese patients with interstitial lung disease (ILD) sometimes die waiting for lung transplantation (LTx) because it takes about 2 years to receive it in Japan. We evaluated nutrition‐related factors associated with waiting list mortality. Seventy‐six ILD patients were hospitalized in Kyoto University Hospital at registration for LTx from 2013 to 2015. Among them, 40 patients were included and analyzed. Patient background was as follows: female, 30%; age, 50.3 ± 6.9 years; body mass index, 21.1 ± 4.0 kg/m2; 6‐minute walk distance (6MWD), 356 ± 172 m; serum albumin, 3.8 ± 0.4 g/dL; serum transthyretin (TTR), 25.3 ± 7.5 mg/dL; and C‐reactive protein, 0.5 ± 0.5 mg/dL. Median observational period was 497 (range 97‐1015) days, and median survival time was 550 (95% CI 414‐686) days. Survival rate was 47.5%, and mortality rate was 38.7/100 person‐years. Cox analyses showed that TTR (HR 0.791, 95% CI 0.633‐0.988) and 6MWD (HR 0.795, 95% CI 0.674‐0.938) were independently correlated with mortality and were influenced by body fat mass and leg skeletal muscle mass, respectively. It is suggested that nutritional markers and exercise capacity are important prognostic markers in waitlisted patients, but further study is needed to determine whether nutritional intervention or exercise can change outcomes.
Closed‐loop insulin delivery in end‐of‐life care: a case report
Authors: Boughton C. K. , Bally L. , Hartnell S. , Wilinska M. , Coll A. P. , Evans M. , Stettler C. , Hovorka R.
Published: April 2019

Background

Glucose management for people with diabetes approaching the end of life can be very challenging. The aim is to balance a minimally invasive approach with avoidance of symptomatic hypo‐ and hyperglycaemia.

Case report

We present a case of a hospitalized individual whose glucose was managed with closed‐loop insulin delivery within a randomized controlled trial setting during a period of terminal illness. During the time in which closed‐loop insulin delivery was used, glucose control was safe, with no glucose‐related harm. The mean ± sd sensor glucose for this individual was 11.3 ± 4.3 mmol/l, percentage of time spent in target glucose range between 6 and 15 mmol/l was 70.5%, time spent in hypoglycaemia was 2.0% and time spent in significant hyperglycaemia >20 mmol/l was 2.6%.

Conclusion

Closed‐loop systems can accommodate personalized glucose targets and highly variable insulin requirements. Factory‐calibrated continuous glucose sensors and insulin pump therapy are less intrusive than finger‐stick glucose measurements and insulin injections, respectively. Closed‐loop systems may provide a safer and less burdensome approach to glucose management towards the end of life.
Residual cardiovascular risk among people with diabetes
Authors: Dash Satya , Leiter Lawrence A.
Published: April 2019

Type 2 diabetes (T2D) is a growing health concern across both developed and developing countries. Cardiovascular disease (CVD) remains the major cause of increased mortality in this patient population. In recent years, effective low density lipoprotein lowering treatments and other risk reduction strategies have substantially reduced the risk of atherosclerotic CVD, yet patients with T2D continue to remain at increased risk for atherosclerotic CVD. Here, we will briefly review various proposed underlying mechanisms for this residual risk with a more in‐depth focus on the potential role of triglyceride‐rich lipoproteins in residual risk and potential avenues to target this pharmacologically.
Prenatal diagnosis of fetal isolated right coronary artery to left ventricle fistula
Authors: Zhao Leisheng , Wang Yu , Wang Meilian , Sun Xue , Ma Jianing , Li Jingjing , Zhang Ying
Published: April 2019

Coronary artery fistula (CAF) is a rare malformation and is seldom reported during pregnancy. Right coronary artery fistula commonly drains into the right ventricle, right atrium, or pulmonary artery. We describe here a rare case of fetal CAF draining into the left ventricle using cross‐sectional and color Doppler echocardiography. We also summarized our experience in the diagnosis of this uncommon malformation, in which tracing the origin, course, and outlet of the abnormal intra‐cardiac flow played a key role.
More distance, more remittance? Remitting behavior, travel cost, and the size of the informal channel
Authors: Ferriani Fabrizio , Oddo Giacomo
Published: April 2019

The rising number of foreign workers in Italy during the last 15 years has led to a conspicuous increase in the amount of remittances sent abroad. In this paper, we examine the determinants of remittance outflows originated in Italy and transferred abroad through registered financial intermediaries. After controlling for a wide set of socioeconomic regressors, we document a strong positive relation between remittances and the cost of travel between Italy and the migrants' respective home countries. We interpret this result as indirect evidence of unrecorded flows, since the relation between remittances and travel cost should be non‐significant unless geographical proximity permits remitters to switch to informal (non‐observable) transmission mechanisms. Moreover, using data on temporal and monetary costs for a subset of bilateral corridors, we also find remittances to be negatively correlated with high transaction costs and low speed of transfer. We rely on this empirical evidence and on a model of migrants' remitting behavior to present new strategies for estimating the size of the informal outflow.
Developmental changes in the excitatory short‐term plasticity at input synapses in the rat inferior colliculus
Authors: Kitagawa Mako , Sakaba Takeshi
Published: April 2019

The inferior colliculus (IC) is the primal center of convergence and integration in the auditory pathway. Although extensive functional changes are known to occur at the relay synapses in the auditory brainstem during development, the changes in the IC remain to be investigated. Here, we have measured excitatory postsynaptic currents (EPSCs) of the neurons in the central nucleus of the IC in response to stimulation of either the lateral lemniscus or the commissure of the inferior colliculus. Before hearing onset, the lemniscus inputs exhibited short‐term depression, whereas commissural inputs showed facilitation. After hearing onset, the N‐methyl‐d‐aspartate‐EPSCs exhibited faster decay for both pathways, whereas the decay of the AMPA‐EPSCs were unaltered. Furthermore, the EPSCs showed more constant responses during repetitive stimulation in both pathways. These developmental changes ensure faster and more reliable signal transmission to the inferior colliculus after onset of hearing.
Selection, optimization and characterization of molecular tests for the detection of Tobacco ringspot virus (TRSV)
Authors: Renvoisé J. P. , Chambon F. , Gleize M. , Pradeilles N. , Garnier S. , Rolland M.
Published: April 2019

The aim of the study was to select, optimize and characterize RT‐PCR tests for the detection of Tobacco ringspot virus (TRSV) in post‐entry quarantine. Among five different tests, the Poojari et al. (Journal of Virological Methods 235, 112–118) and Jossey & Babadoost (Plant Disease 90, 1361) conventionnal RT‐PCR tests were chosen and optimized for this purpose. Ten TRSV isolates, 17 healthy plants from the genera Vitis, Prunus and Malus, four other Nepoviruses or Secoviridae isolates and serial dilutions of three TRSV isolates were used for the complete characterization of the optimized tests. In the tested conditions, the Poojari and Jossey & Babadoost tests respectively showed 100% and 95% inclusivity, 100% and 100% exclusivity, 100% and 96.4% analytical specificity, 100% and 100% diagnostic specificity, [10−7; 10−1] and [10−8; 10−2] limit of detection dilution factors (analytical sensitivity), 91.1% and 90.0% repeatability, 90.3% and 91.1% reproducibility and 100% and 100% selectivity. Due to its higher inclusivity, the optimized Poojari test is recommended for the detection of TRSV isolates for post‐entry quarantine purposes, but can also be used for global surveys. The optimized Jossey & Babadoost test showed the best analytical sensitivity, suggesting that combining both tests can further enhance detection.
Trophic level and host specialisation affect beta‐diversity in plant–herbivore–parasitoid assemblages
Authors: Pereira Martins Lucas , Matos Medina Anderson , Lewinsohn Thomas M. , Almeida‐Neto Mário
Published: April 2019

Herbivorous insects that feed internally on plant tissues depend on their host plants as food resource and immediate habitat. The parasitoids of these herbivores, in turn, depend both on their host herbivores and on the herbivores' host plants. Thus, we may suppose that herbivores and parasitoids must be more affected by biotic interactions (the biotic filter) than their host plants. Also, resource specialisation can mediate the importance of hosts as biotic filters, since the distribution of specialised consumers is limited to sites occupied by their few host species.

Plants and insects were sampled in remnants of the Brazilian Cerrado to address three questions: (i) Does beta‐diversity increase at higher trophic levels? (ii) Is host plant specialisation positively related to the beta‐diversity? (iii) Are trophic level effects on beta‐diversity mediated by host plant specialisation? Appropriate null models were employed to explore the importance of biotic filters associated with resources in explaining the beta‐diversity of higher trophic levels.

Beta‐diversity and host plant specialisation were lower for parasitoids than for herbivores, and total beta‐diversity did not differ between herbivores and plants. Null models revealed that the presence of host plants did not constrain overall beta‐diversity patterns. Beta‐diversity of herbivores and parasitoids, however, increased with host specialisation.

Our findings indicate that low beta‐diversity of basal trophic levels decreases the effect of biotic filters, allowing consumers to occupy several sites. We also show that the severity of biotic filters is higher for host specialists, which might explain the higher beta‐diversity of herbivores compared to parasitoids.
Heparin–LL37 complexes are less cytotoxic for human dental pulp cells and have undiminished antimicrobial and LPS‐neutralizing abilities
Authors: Yoshida K. , Suzuki S. , Kawada‐Matsuo M. , Nakanishi J. , Hirata‐Tsuchiya S. , Komatsuzawa H. , Yamada S. , Shiba H.
Published: April 2019

Aim

To investigate whether glycosaminoglycans (GAGs) binding to high‐dose LL37 eliminates its cytotoxicity to dental pulp cells (hDPCs) whilst retaining undiminished antimicrobial and LPS‐neutralizing abilities.

Methodology

hDPCs were stimulated with varying concentrations of LL37, and their cell viability was analysed by MTT. Then, high‐dose LL37 (10 μmol L−1) was bound to varying concentrations of three GAGs, heparin, chondroitin sulphate and hyaluronic acid, and their cytotoxic effects on hDPCs and antimicrobial effects were evaluated and compared. Furthermore, the LPS‐neutralizing ability of heparin (5 μg mL−1)–LL37 (10 μmol L−1) complexes, which were found to be less cytotoxic for hDPCs with undiminished antimicrobial ability, was investigated. Statistical analysis was performed using one‐way analysis of variance (anova), followed by Dunnett's test. P values below 0.05 were considered significant.

Results

LL37 significantly reduced the cell viability of hDPCs in a dose‐dependent manner (P < 0.01). LL37 (10 μmol L−1) binding to heparin within a limited concentration range (2~6 μg mL−1) eliminated the cytotoxicity for hDPCs (P < 0.01) whilst exerting potent antimicrobial effects against Streptococcus mutans, Streptococcus sobrinus, Streptococcus salivarius, Aggegatibacter actinomycetemcomitans and Escherichia coli. LL37 (10 μmol L−1) binding to chondroitin sulphate exhibited similar functions (P < 0.01); however, the effective chondroitin sulphate concentration was highly restricted (3 μg mL−1). LL37 (10 μmol L−1) binding to hyaluronic acid was unable to abrogate the cytotoxicity of LL37 even at higher concentrations (10 and 100 μg mL−1). Moreover, exogenous addition of LPS dose‐dependently reduced the amount of LL37 precipitated with the heparin–LL37 agarose beads (P < 0.01), and the released LL37 simultaneously neutralized the pro‐inflammatory ability of LPS in macrophages (P < 0.01).

Conclusions

Heparin–LL37 complexes generated at suitable concentration ratios are easy to make, are less cytotoxic and are broad‐range antimicrobial materials that can neutralize LPS by providing LL37 in accordance with the amount of free LPS. They may be a potential treatment to save dental pulp tissue from the acute inflammation exacerbated by invading bacteria and the LPS they release.
Flexible antiferroelectric thick film deposited on nickel foils for high energy‐storage capacitor
Authors: Zhang Ying , Li Yong , Hao Xihong , Jiang Haitao , Zhai Jiwei
Published: April 2019

Flexible antiferroelectric (AFE) Pb0.94La0.04Zr0.97Ti0.03O3 (PLZT) thick‐film capacitors were fabricated on nickel foil substrates using sol‐gel method. The thick PLZT film shows pure perovskite phase with dense microstructure. The discharge energy‐storage properties of the thick PLZT film are directly evaluated by the resistance‐inductance‐capacitance (RLC) circuit. The maximum value of the discharge energy‐storage density (Wdis) is 15.8 J/cm3 at 1400 kV/cm and 90% of the corresponding energy is released in a short time of about 250 ns. In addition, the Wdis and discharge time could be adjusted by the bent radius of the film, which provides a simple and feasible solution for the regulation of the electrical performance. Furthermore, the flexible AFE film exhibits good mechanical properties under cycling tests with bending radii down to 2.5 mm and 1500 rounds. This work shows a critical significance in fabricating flexible AFE capacitors for application in modern electronics and electrical power systems.
Partial cation substitution of tunable blue‐cyan‐emitting Ba2B2O5:Ce3+ for near‐UV white LEDs
Authors: Bai Qiongyu , Zhao Suling , Xu Zheng , Li Panlai
Published: April 2019

In this study, Sr2+, Ca2+, Zn2+, and Mg2+ ions act to tune the emission band to the blue‐cyan region in BaxSryB2O5:Ce3+ (BSBO), BaxCazB2O5:Ce3+ (BCBO), BaxZnuB2O5:Ce3+ (BZBO), and BaxMgvB2O5:Ce3+ (BMBO) phosphors. A red shift occurs with the increase of Sr2+, Ca2+, Zn2+, and Mg2+ concentration, and a blue shift occurs when the concentrations of Sr2+, Ca2+, Zn2+, and Mg2+ exceed the critical value. The emission color can be tuned from deep blue (0.15, 0.12) to cyan (0.16, 0.27) upon 365 nm UV lamp excitation due to the crystal field splitting and centroid shifts. The excitation band shift to long wavelength by introducing ions, so that the synthesized phosphor can be better matched with the n‐UV chip. The emission intensity slowly decreases with the temperature increasing. Therefore, the BMBO:Ce3+, BZBO:Ce3+, BCBO:Ce3+, and BSBO:Ce3+ phosphors with relatively good thermal stability were synthesized, which could have potential applications in the n‐UV white LEDs.
Sufficiency and Satiable Values
Authors: Nielsen Lasse
Published: April 2019

This article identifies value‐satiability sufficientarianism as a distinctive version of the sufficiency view, which has been ignored in the literature on distributive justice. This is unfortunate because value‐satiability sufficientarianism is much better equipped than alternative sufficiency views to cope with the standard objections against sufficiency. Most often, sufficientarianism refers to satiability as a feature of moral principles and reasons. But value‐satiability sufficientarianism also invokes satiability in the space of value‐theory, as it determines the sufficiency threshold at the point where justice‐relevant values have been completely fulfilled. The article gives examples of how this view is widely apparent in the literature, and it provides some reasons in its favour. It then presents the two standard objections against sufficientarianism – the threshold objection and the indifference objection – and argues that these critiques do not apply to value‐satiability sufficientarianism. The general argument of the article therefore proves sufficientarianism more difficult to refute than is commonly credited.
The utility of Guillain‐Barré syndrome prognostic models in Malaysian patients
Authors: Tan Cheng‐Yin , Razali Siti N. O. , Goh Khean‐Jin , Shahrizaila Nortina
Published: April 2019

Guillain‐Barré syndrome (GBS) is an acute immune‐mediated neuropathy that has variable disease course and outcome. The Erasmus GBS outcome score (EGOS), modified EGOS (mEGOS), and Erasmus GBS respiratory insufficiency score (EGRIS) are prognostic models designed to predict the functional outcome of GBS patients at 6 months (EGOS and mEGOS) and the need for mechanical ventilation within a week of admission (EGRIS). The models were primarily developed in the Dutch GBS population, and thus the usefulness of these models in other GBS cohorts is less clear. In the current study, we aimed to validate mEGOS, EGOS, and EGRIS in Malaysian GBS patients. A total of 107 patients with GBS and its variants were consecutively recruited. Patients with GBS and Miller Fisher syndrome (MFS) were analysed separately. In the GBS cohort, high mEGOS and EGOS scores were significantly correlated with poor outcome at 6 months (mEGOS on admission: r = .381, P = .005; mEGOS at day 7 of admission: r = .507, P < .001; EGOS: r = .484, P < .001). However, there were no significant correlations between mEGOS or EGOS and outcome in patients with MFS (mEGOS on admission: r = .152, P = .523; mEGOS at day 7 of admission: r = .008, P = .973; EGOS: r = .110; P = .644). The score of EGRIS for GBS patients with mechanical ventilation was significantly higher than those patients without mechanical ventilation (4 ± 2 vs 3 ± 1; P < .001). We conclude that mEGOS and EGOS are clinically useful and relevant to the Malaysian GBS population but not in patients with classic MFS. EGRIS could be used to predict the need for mechanical ventilation in our local GBS patients.
Nonvascular uses of pulsed dye laser in clinical dermatology
Authors: Forbat Emily , Al‐Niaimi Firas
Published: April 2019

Lasers are fast becoming the vogue of dermatology ranging from ablative, nonablative, fractional photothermolysis to vascular lasers. There are a range of vascular lasers including potassium titanyl phosphate (KTP 532 nm), pulsed dye laser (PDL −595 nm), diode (810 nm), and Nd:YAG (1064 nm). PDL is a laser that emits yellow light using Rhodamine dye as it is lasing medium. Typical vascular lesions which are treated by PDL include port wine stain, hemangioma, telangiectasia, spider angioma, and rosacea. This article focuses on the use of PDL beyond primary vascular conditions. We review the evidence, or lack thereof, of the use of PDL in acne vulgaris, scars, striae, warts, molluscum, psoriasis, rejuvenation, basal cell carcinoma (BCC), and miscellaneous dermatological sequelae.
Associations between fatigue, sleep disturbance and eating style in adults with type 2 diabetes: A correlational study
Authors: Zhu Bingqian , Martyn‐Nemeth Pamela , Ruggiero Laurie , Park Chang G. , Zhang Yaqing , Fritschi Cynthia
Published: April 2019

Aims and objectives

To test the hypothesis that fatigue and sleep disturbance account for a significant amount of variation in eating styles among people with type 2 diabetes (T2D).

Background

Healthy eating is an important component of diabetes self‐care but remains a major challenge. In people with T2D, symptoms of fatigue and sleep disturbance are pervasive. However, there is limited understanding of whether fatigue and sleep disturbance are associated with eating style in people with T2D.

Design

Correlational design.

Methods

This study was reported following the STROBE checklist. Data were collected between February 2017 and January 2018. A convenience sample of 64 T2D adults completed the Three‐Factor Eating Questionnaire‐R18V2 to measure eating style (e.g., emotional eating, cognitive restraint and uncontrolled eating). Diabetes distress, fatigue and sleep disturbance were measured using validated questionnaires. Hierarchical regression analyses were performed.

Results

Only age was a significant predictor (β = −0.344) of cognitive restraint. Participant demographics, psychological factor and health‐related factors contribute significantly to the model predicting emotional eating, but only diabetes distress was a significant predictor (β = 0.433). Introducing fatigue and poor sleep quality explained an additional 12.0% of the variation in emotional eating. The final model explained 24.9% of the variation in emotional eating; both diabetes distress (β = 0.294) and fatigue (β = 0.360) were significant predictors.

Conclusion

There is a strong, independent relationship of fatigue and diabetes distress with emotional eating T2D patients. The effect of improving fatigue and diabetes distress on eating style should be explored.

Relevance to clinical practice

In clinical practice, nurses are recommended to include a detailed assessment of fatigue and distress in patients with diabetes. Additional to the conventional nutrition therapy focusing on diet advice, eating style should also be incorporated in diet education by diabetes nurses.