bluuebunny/crossref_metadata_2025 huggingface dataset:
Alteration in gene expression profile of thymomas with or without myasthenia gravis linked with the nuclear factor‐kappaB/autoimmune regulator pathway to myasthenia gravis pathogenesis
Authors: Guo Feng , Wang Chun‐Yang , Wang Shuo , Zhang Jun , Yan Yi‐Jie , Guan Zhi‐Yu , Meng Fan‐Jie
Published: February 2019

Background

To investigate the gene expression profile of a set of candidate genes for a better understanding of the molecular mechanism underlying the pathogenesis of thymoma with or without myasthenia gravis.

Methods

Thymoma patients and thymoma patients with myasthenia gravis were analyzed using microarray profiling to identify significant changes in gene expression of autoimmune regulator pathway genes including AIRE, IL‐7R, CHRNA3, SYMD1, THRA, and CAV3.

Results

Across all of our samples, we found that 1484 mRNAs were upregulated and 770 were downregulated in thymoma patients compared with thymoma with myasthenia gravis patients. Gene ontology and pathway analysis revealed that a large number of genes participated in cellular functions for humoral immune response, sequence‐specific DNA binding RNA polymerase II transcription factor activity, positive regulation of gene expression, regulation of neuron projection development, extracellular ligand‐gated ion channel activity, positive regulation of striated muscle cell differentiation, and regulation of nuclear factor‐kappaB import into the nucleus.

Conclusion

Our results revealed genetic differences between thymomas and myasthenia gravis, and identified the key candidate genes/pathways for molecular mechanism.
C‐reactive protein to albumin ratio is a key indicator in a predictive model for anastomosis leakage after esophagectomy: Application of classification and regression tree analysis
Authors: Shao Chen‐Ye , Liu Kai‐Chao , Li Chu‐Ling , Cong Zhuang‐Zhuang , Hu Li‐Wen , Luo Jing , Diao Yi‐Fei , Xu Yang , Ji Sai‐Guang , Qiang Yong , Shen Yi
Published: February 2019

Background

Anastomotic leakage (AL), a serious complication after esophagectomy, might impair patient quality of life, prolong hospital stay, and even lead to surgery‐related death. The aim of this study was to show a novel decision model based on classification and regression tree (CART) analysis for the prediction of postoperative AL among patients who have undergone esophagectomy.

Methods

A total of 450 patients (training set: 356; test set: 94) with perioperative information were included. A decision tree model was established to identify the predictors of AL in the training set, which was validated in the test set. A receiver operating characteristic curve was also created to illustrate the diagnostic ability of the decision model.

Results

A total of 12.2% (55/450) of the 450 patients suffered AL, which was diagnosed at median postoperative day 7 (range: 6–16). The decision tree model, containing surgical duration, postoperative lymphocyte count, and postoperative C‐reactive protein to albumin ratio, was established by CART analysis. Among the three variables, the postoperative C‐reactive protein to albumin ratio was identified as the most important indicator in the CART model with normalized importance of 100%. According to the results validated in the test set, the sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy of the prediction model were 80%, 98.8%, 88.9%, 97.6%, and 96.8%, respectively. Moreover, the area under the receiver operating characteristic curve was 0.95.

Conclusion

The decision model based on CART analysis presented good performance for predicting AL, and might allow the early identification of patients at high risk.
Join the ant hunt: how accurately can the public recognise red imported fire ant Solenopsis invicta (Hymenoptera: Formicidae) in Australia?
Authors: McNaught Melinda K , Wylie Ross , Bell Robert
Published: February 2019

A national eradication program for the red imported fire ant, Solenopsis invicta, has been ongoing in Australia since 2001 when the pest was first officially identified in Brisbane, Queensland. Through a range of communication strategies, the program has encouraged the public to report suspect S. invicta and to submit ant samples for identification. There is now a 16‐year dataset of ant specimen submissions from the public and, in the last 5 years, digital ant photograph submissions. Analysis of this dataset shows that, at the end of 2017, the program has processed over 45 000 identifiable ant samples from 41 genus groups from the public in the greater Brisbane region, as well as viewed almost 7000 digital photo submissions. Of these submissions, 8486 were S. invicta samples, with 898 of these originating from a photo. The 10 most commonly submitted local ant genera represent 90% of non‐target ant samples received. Eight of these genera share two or more traits with S. invicta. Since photos were introduced, there has been a reduction in the average yearly non‐target samples received, along with an increase in the proportion of positive detections within public submissions. We conclude that the program's messaging about how to recognise S. invicta has been effective and that photo submissions are a cost‐effective and successful engagement tool. Our study shows that a high level of confidence can be placed on the ability of the public to recognise and report suspect S. invicta and demonstrates again the importance of awareness campaigns in enhancing the probability of passive detection of a target species.
Structure and function of the bird fovea
Authors: Bringmann Andreas
Published: February 2019

The cellular structure and functional relevance of the bird fovea are still incompletely understood. This review gives an overview of the cellular composition of the bird fovea, with special regard to Müller glial cells that provide the mechanical stability of the foveal tissue. A survey of previous data shows that the visual acuity of different bird groups (with the exception of owls) depends on the eye size, while the shape of the foveal pit does not correlate with the visual acuity. Among various bird groups, the foveal pit may have two depths, shallow (80‒120 µm) or deep (190‒240 µm). There is a long‐lasting debate whether the bird fovea acts as a local image enlarger or as a focus indicator and movement detector. These functions are supported by the refraction of the incoming light at the tissue surface. However, it was shown that Müller cells form highly refractive layers in the centre and walls of the deep avian fovea (Nature, 1978, 275, 127). Analysis of the light path through the tissue may suggest that Müller cell layers serve at least two optical functions: magnification of the image in the foveal centre and light focusing into a point within and/or a ring around the foveal centre. It is suggested that Müller glial cells contribute to various optical functions of the bird fovea.
Elevation‐richness pattern of vascular plants in wadis of the arid mountain Gebel Elba, Egypt
Authors: Abutaha Maged M. , El‐Khouly Ahmed A. , Jürgens Norbert , Morsy Amal A. , Oldeland Jens
Published: February 2019

Mountains provide a unique opportunity to study drivers of species richness across relatively short elevation gradients. However, few studies have reported elevational patterns for arid mountains. We studied elevation‐richness pattern along an elevational gradient at the arid mountain Gebel Elba, south‐east of Egypt, expecting a unimodal richness pattern. We sampled 133 vegetation plots (10 × 10 m) in four wadis along an elevational gradient from 130 to 680 m which represents the transition from desert to mountain wadi systems. We used generalised additive models to describe the relationship between elevation and plant species richness. We found a strong increase in species richness and Shannon diversity at low elevations followed by a plateau at mid‐ to high elevations. When we analysed each tributary as a single gradient, no pattern was found. The analysed elevational gradient seems to be a major stress gradient in terms of temperature and water availability, exhibiting a trend of increasing species richness that changes to a plateau pattern; a pattern rarely observed for wadi systems in arid mountains. We discuss the observed pattern with the climatic stress hypothesis and the environmental heterogeneity hypothesis as possible explanations for the pattern.
Implications of vaginal instrumental delivery for children's school achievement: A population‐based linked administrative data study
Authors: Hsieh David C. , Smithers Lisa G. , Black Mairead , Lynch John W. , Dekker Gustaff , Wilkinson Chris , Stark Michael J. , Mol Ben W.
Published: February 2019

Background

Vaginal instrumental delivery is a common obstetrical intervention, but its effect on children's later development is not well known.

Aims

To determine if vaginal instrumental delivery is associated with adverse neurodevelopment as measured by school achievement.

Material and methods

We performed a whole‐of‐population study involving linkage of routinely collected perinatal data with school assessments among children born in South Australia from 1999 to 2008. Participants were singleton children born by forceps (n = 5494), ventouse (n = 6988), or normal delivery (n = 80 803). School achievement was measured through performance on the National Assessment Program in Literacy and Numeracy (NAPLAN), at around eight years of age. This assessment involved five domains and scores were categorised according to performing at or above National Minimum Standards (NMS). Effects of instrumental versus normal vaginal delivery were analysed via augmented inverse probability weighting (AIPW), taking into account a variety of maternal, perinatal and sociodemographic characteristics.

Results

In unadjusted analyses, instrumental delivery was not associated with poor NAPLAN scores. AIPW analyses also suggested that instrumental delivery had minimal adverse effect on NAPLAN scores, with the largest difference being lower spelling scores among forceps‐delivered children (−0.022 (95% CI −0.0053–0.009)) compared with spontaneous vaginal births. The findings were consistent among exploratory subgroup analyses involving births in the absence of prolonged labour, with APGAR ≥ 9, and among normotensive and non‐diabetic mothers.

Conclusion

In singleton children born at term, instrumental delivery does not have an adverse effect on neurodevelopment as measured by NAPLAN performance at age eight.
Subcontracting Academia: Alienation, Exploitation and Disillusionment in theUKOverseas Syrian Refugee Research Industry
Authors: Sukarieh Mayssoun , Tannock Stuart
Published: February 2019

As the political economy of social science research has shifted, subcontracted research assistants have taken over an ever growing part of the research process. In this article, we report on a case study of the experiences of local research assistants employed onUK‐directed research projects on Syrian refugees in Lebanon. While refugee research is framed in theUKas a noble project of helping the world's most vulnerable, these assistants speak critically of their sense of alienation, exploitation and disillusionment with the research they work on. Such problems arise, we argue, not just from subcontracted labour relations in the workplace itself, but also the broader political economy of how overseas social science research is currently produced. Addressing these problems requires giving better recognition to the work, interests and concerns of research assistants, but also rethinking and restructuring the global production of social science research more generally.
The treatment outcomes in IgG4‐related orbital disease: a systematic review of the literature
Authors: Detiger Sanne E. , Karim A. Faiz , Verdijk Robert M. , van Hagen P. Martin , van Laar Jan A. M. , Paridaens Dion
Published: February 2019

IgG4‐related disease (IgG4‐RD) is an immune‐mediated systemic fibro inflammatory disease. Treatment of IgG4‐related orbital disease (IgG4‐ROD) is often indicated to relieve the symptoms and to prevent complications. For IgG4‐ROD, no international formal treatment guidelines are available and the optimal treatment strategy is uncertain. In this systematic review, we describe the efficacy of conventional and biologic disease‐modifying antirheumatic drugs (DMARDs) in IgG4‐ROD. A systematic search of Embase, Medline, Web‐of‐Science, PubMed publisher, Cochrane and Google Scholar was performed for treatment outcomes in IgG4‐ROD. Relevant articles on treatment of IgG4‐ROD were retrieved to last date of inclusion 3 January 2018. The following inclusion criteria were used: articles in English or English translation, studies evaluating the use of DMARDs (conventional and biologic) in the treatment of IgG4‐ROD. Meta‐analysis and review articles were excluded. A final selection after full‐text evaluation was made by independent reviewers, based on treatment of IgG4‐ROD with DMARDs and the availability of treatment outcomes. With this systematic review, we identified 35 studies and case reports/series on IgG4‐ROD, describing 95 patients, treated with conventional and/or biologic DMARDs. The success of conventional DMARDs varies between 36% and 75% in patients with IgG4‐ROD, while rituximab is successful in the majority (93%) of the patients. Based on this systematic review, rituximab is the most effective DMARD in IgG4‐ROD, while the efficacy of conventional DMARDs is limited. We propose early initiation of rituximab in case of refractory and organ‐ or life‐threatening disease.
Population/regional differences in efficacy of 3 drug categories (antidiabetic, respiratory and psychotropic agents) among East Asians: A retrospective study based on multiregional clinical trials
Authors: Sai Kimie , Yoshida Akiomi , Hanatani Tadaaki , Imatoh Takuya , Takeuchi Masahiro , Narukawa Mamoru , Watanabe Hiroshi , Uyama Yoshiaki , Saito Yoshiro
Published: February 2019

Aims

This study aimed to identify population/regional differences in drug efficacy and the influencing factors among East Asians to be considered when planning multiregional clinical trials (MRCTs) to facilitate rapid drug approval in Asians.

Methods

A retrospective analysis of efficacy (intergroup difference in endpoint between control and study drug treatment) among East Asian populations for 3 drug categories, antidiabetic, respiratory and psychotropic agents, was conducted in collaboration with pharmaceutical companies using their MRCT data. Common endpoints by drug category were selected; background factors that commonly affected the endpoints among regions were analysed first; then the population/regional differences were evaluated by the interaction term region‐by‐treatment using an analysis of covariance model after adjusting for background factors.

Results

Among 17 endpoints for eight pharmaceutical products from 3 drug categories, no substantial population/regional differences were detected in the 3 drug categories examined (P > .05), except for haemoglobin A1c change between Japan and Korea for an antidiabetic drug, insulin glulisine (P = .0068). However, no such regional differences were evident in patients with clinically important higher haemoglobin A1c baseline values (majority subgroup). Variability in disease severity at baseline and concomitant drugs were determined to be potential influencing factors for regional differences.

Conclusions

This study suggests that the regional variability in efficacy of these 3 drug categories is not large among East Asians, and reveals the importance of considering background factors when planning MRCTs. Further studies are needed to evaluate regional variability in the efficacy of other drug categories and clarify the factors leading to regional differences in East Asians.
The aims of expanded universal carrier screening: Autonomy, prevention, and responsible parenthood
Authors: van der Hout Sanne , Dondorp Wybo , de Wert Guido
Published: February 2019

Expanded universal carrier screening (EUCS) entails a population‐wide screening offer for multiple disease‐causing mutations simultaneously. Although there is much debate about the conditions under which EUCS can responsibly be introduced, there seems to be little discussion about its aim: providing carrier couples with options for autonomous reproductive choice. While this links in with current accounts of the aim of foetal anomaly screening, it is different from how the aim of ancestry‐based carrier screening has traditionally been understood: reducing the disease burden in the population. The reasons why the aim of EUCS is presented in terms of ‘autonomy’ rather than ‘prevention’ have not been spelled out in the literature. This paper seeks to fill this gap by considering the morally relevant similarities and dissimilarities between foetal anomaly screening, ancestry‐based carrier screening and EUCS. When carrier screening is performed in the prenatal period, enhancing autonomy appears the most appropriate aim of EUCS, as the alternative of ‘prevention through selective abortion’ would urge women to terminate wanted pregnancies. However, when screening is conducted in the preconception period, carrier couples can avoid the birth of affected children by other means than selective abortion, for instance preimplantation genetic diagnosis. To the extent that this increased control over passing on a genetic disorder raises questions of parental responsibility, it seems necessary that the account of the aims of EUCS is wider than only in terms of enhancing reproductive autonomy.
Bioethics and activism: A natural fit?
Authors: Rogers Wendy
Published: February 2019

Bioethics is a practically oriented discipline that developed to address pressing ethical issues arising from developments in the life sciences. Given this inherent practical bent, some form of advocacy or activism seems inherent to the nature of bioethics. However, there are potential tensions between being a bioethics activist, and academic ideals. In academic bioethics, scholarship involves reflection, rigour and the embrace of complexity and uncertainty. These values of scholarship seem to be in tension with being an activist, which requires pragmatism, simplicity, certainty and, above all, action. In this paper I explore this apparent dichotomy, using the case example of my own involvement in international efforts to end forced organ harvesting from prisoners of conscience in China. I conclude that these tensions can be managed and that academic bioethics requires a willingness to be activist.
Aquablation for benign prostatic hyperplasia in large prostates (80–150 mL): 6‐month results from the WATER II trial
Authors: Desai Mihir , Bidair Mo , Zorn Kevin C. , Trainer Andrew , Arther Andrew , Kramolowsky Eugene , Doumanian Leo , Elterman Dean , Kaufman Ronald P. , Lingeman James , Krambeck Amy , Eure Gregg , Badlani Gopal , Plante Mark , Uchio Edward , Gin Greg , Goldenberg Larry , Paterson Ryan , So Alan , Humphreys Mitch , Roehrborn Claus , Kaplan Steven , Motola Jay , Bhojani Naeem
Published: February 2019

Objective

To present 6‐month safety and effectiveness data from a multicentre prospective study of aquablation in men with lower urinary tract symptoms (LUTS) attributable to benign prostatic hyperplasia (BPH) with prostate volumes between 80 and 150 mL.

Methods

Between September and December 2017, 101 men with LUTSattributable to BPHwere prospectively enrolled at 16 centres in Canada and the USA.

Results

The mean prostate volume was 107 mL. The mean length of hospital stay after the aquablation procedure was 1.6 days (range: same day to 6 days). The primary safety endpoint (Clavien–Dindo grade 2 or higher or any grade 1 event resulting in persistent disability) at 3 months occurred in 45.5% of men, which met the study design goal of < 65% (P < 0.001). At 6 months, 22% of the patients had experienced a Clavien–Dindo grade 2, 14% a grade 3 and 5% a grade 4 adverse event. Bleeding complications requiring intervention and/or transfusion were recorded in eight patients prior to discharge and in six patients after discharge. The mean International Prostate Symptom Score improved from 23.2 ± 6.3 at baseline to 6.7 ± 5.1 at 3 months, meeting the study's primary efficacy endpoint goal (P < 0.001). The maximum urinary flow rate increased from 8.7 to 18.8 mL/s (P < 0.001) and post‐void residual urine volume decreased from 131 at baseline to 47 at 6 months (P < 0.0001). At 6 months, prostate‐specific antigen concentration reduced from 7.1 ± 5.9 ng/mL at baseline to 4.0 ± 3.9 ng/mL, a 44% reduction.

Conclusions

Aquablation is safe and effective in treating men with larger prostates (80–150 mL), without significant increase in procedure or resection time.
Cannabinoids differentially modulate cortical information transmission through the sensorimotor or medial prefrontal basal ganglia circuits
Authors: Antonazzo Mario , Gutierrez‐Ceballos Amaia , Bustinza Irati , Ugedo Luisa , Morera‐Herreras Teresa
Published: February 2019

Background and Purpose

In the sensorimotor (SM) and medial prefrontal (mPF) basal ganglia (BG) circuits, the cortical information is transferred to the substantia nigra pars reticulata (SNr) through the hyperdirect trans‐subthalamic pathway and through the direct and indirect trans‐striatal pathways. The cannabinoid CB1 receptor, which is highly expressed in both BG circuits, may participate in the regulation of motor and motivational behaviours. Here, we investigated the modulation of cortico‐nigral information transmission through the BG circuits by cannabinoids.

Experimental Approach

We used single‐unit recordings of SNr neurons along with simultaneous electrical stimulation of motor or mPF cortex in anaesthetized rats.

Key Results

Cortical stimulation elicited a triphasic response in the SNr neurons from both SM and mPF‐BG circuits, which consisted of an early excitation (hyperdirect transmission pathway), an inhibition (direct transmission pathway), and a late excitation (indirect transmission pathway). In the SM circuit, after Δ9‐tetrahydrocannabinol or WIN 55,212‐2 administration, the inhibition and the late excitation were decreased or completely lost, whereas the early excitation response remained unaltered. However, cannabinoid administration dramatically decreased all the responses in the mPF circuit. The CB1 receptor antagonist AM251 (2 mg·kg−1, i.v.) did not modify the triphasic response, but blocked the effects induced by cannabinoid agonists.

Conclusions and Implications

CB1 receptor activation modulates the SM information transmission through the trans‐striatal pathways and profoundly decreases the cortico‐BG transmission through the mPF circuit. These results may be relevant for elucidating the involvement of the cannabinoid system in motor performance and in decision making or goal‐directed behaviour.
Reducing risk of Type 2 diabetes in HIV: a mixed‐methods investigation of the STOP‐Diabetes diet and physical activity intervention
Authors: Duncan A. D. , Peters B. S. , Rivas C. , Goff L. M.
Published: February 2019

Aim

To conduct a mixed‐methods feasibility study of the effectiveness and acceptability of an individualized diet and physical activity intervention designed to reduce the risk of Type 2 diabetes experienced by people living with HIV.

Methods

Participants with impaired fasting glucose and HIV were invited to take part in a 6‐month diet and physical activity intervention. Individualized advice to achieve 10 lifestyle goals was delivered monthly. Diabetes risk was assessed pre‐ and post‐intervention by measurement of the glucose and insulin response to a 3‐h meal tolerance test. Six‐month change was analysed using paired t‐tests. Research interviews exploring the acceptability of the intervention and factors influencing behaviour change were conducted with those who participated in the intervention, and those who declined participation.

Results

The intervention (n=28) significantly reduced the following: glucose and insulin, both fasting and postprandial incremental area under the curve (glucose 7.9% and 17.6%; insulin 22.7% and 31.4%, respectively); weight (4.6%); waist circumference (6.2%); systolic blood pressure (7.4%); and triglycerides (36.7%). Interview data demonstrated the acceptability of the intervention. However, participants expressed concern that deliberate weight loss might lead to disclosure of HIV status or association with AIDS‐related illness. The belief that antiretroviral medications drove diabetes risk was associated with declining study participation or achieving fewer goals.

Conclusions

We have demonstrated the beneficial effects of a lifestyle intervention in mitigating the increased risk of Type 2 diabetes associated with HIV. Future interventions should be designed to further reduce the unique barriers that prevent successful outcomes in this cohort.
Text‐message responsiveness to blood glucose monitoring reminders is associated with HbA1c benefit in teenagers with Type 1 diabetes
Authors: McGill D. E. , Volkening L. K. , Butler D. A. , Wasserman R. M. , Anderson B. J. , Laffel L. M.
Published: February 2019

Aims

To evaluate an 18‐month text‐messaging intervention in teenagers with Type 1 diabetes and to assess factors associated with text responsiveness and glycaemic benefit.

Methods

Teenagers with diabetes (N = 147), aged 13–17 years, received two‐way text reminders at self‐selected times to check blood glucose levels and reply with blood glucose results.

Results

At baseline, the participants (48% boys, 78% white, 63% pump‐treated) had a mean ± sd age of 14.9 ± 1.3 years, diabetes duration of 7.1 ± 3.9 years and HbA1c concentration of 69 ± 12 mmol/mol (8.5 ± 1.1%). The mean proportion of days with ≥1 blood glucose response declined over time (0–6 months, 60 ± 26% of days, 7–12 months, 53 ± 31% of days, 13–18 months, 43 ± 33% of days). Over 18 months, 49% responded with ≥1 blood glucose result on ≥50% of days (high responders). Regression analysis controlling for baseline HbA1c revealed no significant change in HbA1c from baseline to 18 months in high responders (P = 0.54) compared with a significant HbA1c increase in low responders (+0.3%, P = 0.01). In participants with baseline HbA1c ≥64 mmol/mol (≥8%), high responders were 2.5 times more likely than low responders to have a clinically significant [≥5.5 mmol/mol (≥0.5%)] HbA1c decrease over 18 months (P < 0.05). In participants with baseline HbA1c <64 mmol/mol(<8%), high responders were 5.7 times more likely than low responders to have an 18‐month HbA1c <58 mmol/mol (<7.5%; P < 0.05).

Conclusions

Teenagers with Type 1 diabetes who responded to text reminders on ≥50% of days over 18 months experienced clinically significant glycaemic benefit. There remains a need to tailor interventions to maintain teenager engagement and optimize improvements.
How Important are Firms in Explaining Wage Changes During a Recession?
Authors: Doris Aedín , O'Neill Donal , Sweetman Olive
Published: February 2019

During the Great Recession, many Irish workers experienced nominal earnings reductions, with about 50% of private sector employees receiving pay cuts at the height of the crisis. However, at the same time, a substantial minority of workers continued to receive pay increases. In this paper we use a unique dataset containing earnings on every worker in Ireland to examine the relative roles of worker and firm characteristics in explaining this heterogeneity in earnings dynamics. Our results show that between‐firm effects play a small role in determining pay changes in Ireland. Although between‐firm effects became more important in the peak year of the economic crisis, the vast majority of earnings changes continued to be driven by within‐firm forces. These findings raise a number of important questions about the role of morale and fairness in the wage‐setting process.
Percutaneous closure of the left atrial appendage: The value of real time 3D transesophageal echocardiography and the intraoperative change in the size of the left atrial appendage
Authors: Zhang Lizi , Cong Tao , Liu Ansheng
Published: February 2019

Objective

The aim of this study was to investigate the value of real time three‐dimensional transesophageal echocardiography (RT3DTEE) in percutaneous closure of the left atrial appendage (LAAC). In addition, this study also explored the change in the size of the left atrial appendage (LAA) from 24 hours before the operation to just before implantation during the operation.

Methods and results

In a retrospective study, 32 patients underwent two‐dimensional transesophageal echocardiography (2DTEE) and RT3DTEE 24 hours prior to operation and during operation. The maximal LAA orifice diameter (by 2DTEE, 22.7 ± 2.7 vs 24.6 ± 2.2 mm, P < 0.01; by RT3DTEE, 24.2 ± 2.9 vs 25.8 ± 2.7 mm, P < 0.01), the maximal landing zone diameter (by 2DTEE, 19.0 ± 2.8 vs 20.4 ± 2.8 mm, P < 0.01; by RT3DTEE, 20.4 ± 2.7 vs 22.6 ± 3.0 mm, P < 0.01), and the maximal depth diameter (by 2DTEE, 25.2 ± 3.2 vs 26.5 ± 3.0 mm, P < 0.01; by RT3DTEE, 26.4 ± 3.2 vs 27.5 ± 3.7 mm, P < 0.01) all increased significantly during the operation. The highest correlation (R) between the maximal landing zone diameter and the compressed occluder diameter was determined for RT3DTEE measurements during the operation (R = 0.90), whereas the landing zone diameter (R = 0.80) measured by 2DTEE was less correlated. In addition, our study showed that RT3DTEE was of great value in discriminating the LAA orifice shape, allowing differentiation of the LAA morphology and identification of the number of LAA lobes.

Conclusions

A certain amount of intravenous rehydration just before and during operation increased the LAA size significantly. The measurements by RT3DTEE showed a closer correlation to LAA occluder size than those by 2DTEE. The LAA displayed by RT3DTEE was more visible than that by 2DTEE.
Fungaemia in haematological malignancies: SEIFEM‐2015 survey
Authors: Criscuolo Marianna , Marchesi Francesco , Candoni Anna , Cattaneo Chiara , Nosari Annamaria , Veggia Barbara , Verga Luisa , Fracchiolla Nicola , Vianelli Nicola , Del Principe Maria Ilaria , Picardi Marco , Tumbarello Mario , Aversa Franco , Busca Alessandro , Pagano Livio ,   the SEIFEM Group (Sorveglianza Epidemiologica Infezioni nelle Emopatie)
Published: February 2019

Background

Fungal infections are still a relevant challenge for clinicians involved in the cure of patients with cancer. We retrospectively reviewed charts of hospitalized patients with haematological malignancies (HMs), in which a documented fungaemia was diagnosed between January 2011 and December 2015 at 28 adult and 6 paediatric Italian Hematology Departments.

Methods

During the study period, we recorded 215 fungal bloodstream infections (BSI). Microbiological analyses documented that BSI was due to moulds in 17 patients (8%) and yeasts in 198 patients (92%), being Candida spp identified in 174 patients (81%).

Results

Mortality rates were 70% and 39% for mould and yeast infections, respectively. Infection was the main cause of death in 53% of the mould and 18% of the yeast groups. At the multivariate analysis, ECOG ≥ 2 and septic shock were significantly associated with increased mortality, and removal of central venous catheter (CVC) survival was found to be protective. When considering patients with candidemia only, ECOG ≥ 2 and removal of CVC were statistically associated with overall mortality.

Conclusions

Although candidemia represents a group of BSI with a good prognosis, its risk factors largely overlap with those identified for all fungaemias, even though the candidemia‐related mortality is lower when compared to other fungal BSI. Management of fungal BSI is still a complex issue, in which both patients and disease characteristics should be focused to address a personalized approach.
Latitudinal gradients of parasite richness: a review and new insights from helminths of cricetid rodents
Authors: Preisser Whitney
Published: February 2019

The latitudinal diversity gradient (LDG), or the trend of higher species richness at lower latitudes, has been well documented in multiple groups of free‐living organisms. Investigations of the LDG in parasitic organisms are comparatively scarce. Here, I investigated latitudinal patterns of parasite diversity by reviewing published studies and by conducting a novel investigation of the LDG of helminths (parasitic nematodes, trematodes and cestodes) of cricetid rodents (Rodentia: Cricetidae). Using host–parasite records from 175 parasite communities and 60 host species, I tested for the presence and direction of a latitudinal pattern of helminth richness. Additionally, I examined four abiotic factors (mean annual temperature, annual precipitation, annual temperature range and annual precipitation range) and two biotic variables (host body mass and host diet) as potential correlates of parasite richness. The analyses were performed with and without phylogenetic comparative methods, as necessary. In this system, helminths followed the traditional LDG, with increasing species richness with decreasing latitude. Nematode richness appeared to drive this pattern, as cestodes and trematodes exhibited a reverse LDG and no latitudinal pattern, respectively. Overall helminth richness and nematode richness were higher in areas with higher mean annual temperatures, annual precipitation and annual precipitation ranges and lower annual temperature ranges, characteristics that often typify lower latitudes. Cestode richness was higher in areas of lower mean annual temperatures, annual precipitation and annual precipitation ranges and higher annual temperature ranges, while trematode richness showed no relationship with climate variables when phylogenetic comparative methods were used. Host diet was significantly correlated with cestode and trematode species richness, while host body mass was significantly correlated with nematode species richness. Results of this study support a complex association between parasite richness and latitude, and indicate that researchers should carefully consider other factors when trying to understand diversity gradients in parasitic organisms.
Juvenile river residence and performance of Snake River fall Chinook salmon
Authors: Chittaro Paul M. , Hegg Jens C. , Kennedy Brian P. , Weitkamp Laurie A. , Johnson Lyndal L. , Bucher Cynthia , Zabel Richard W.
Published: February 2019

An animal's performance during its early life stage can greatly influence its survival to adulthood. Therefore, understanding aspects of early life history can be informative, particularly when designing management plans to rebuild a population. For a threatened population of fall Chinook salmon (Oncorhynchus tshawytscha) in the Snake River of Idaho, we reconstructed the early life history for 124 returning wild and hatchery adults using information recorded in their otoliths. Of our sampled wild adults (n = 61), 43% and 49% reared within the Snake River and Clearwater/Salmon rivers. We also found that only 21% of our sampled wild adults exhibited the historically common subyearling out‐migration strategy, in which juveniles exit freshwater shortly after hatching, while the remaining wild adults exhibited the yearling out‐migration strategy (i.e., individuals delay their freshwater exit). As expected, yearlings had, on average, a significantly larger body size than subyearlings at ocean entry. However, 35% of wild yearlings overlapped in size with wild subyearlings suggesting that spending more time in freshwater might not necessarily result in a larger body size. Lastly, we observed that variability in fork length at Snake River egress and ocean entry were best explained by migration strategy and where it reared, followed by hatch year and sex. Results from this study highlight the utility of adult otoliths in providing details about early life history, an understanding of which is critical to the conservation of Snake River fall Chinook salmon.
An investigation of dental students’ perceptions about the characteristics of effective instructors and their related factors
Authors: Nazir Muhammad Ashraf , Al‐Ansari Asim , Farooqi Faraz Ahmed
Published: February 2019

Background

The characteristics of effective teachers can be used to improve student learning, support their academic achievement outcomes and promote faculty development and career advancement.

Objectives

To assess dental students’ perceptions about the characteristics of effective instructors and related factors.

Materials and Methods

This cross‐sectional study analysed data collected from students at a dental college in Saudi Arabia. A pilot‐tested questionnaire with satisfactory internal consistency was distributed amongst all students. The questionnaire contained 21 items related to the characteristics of effective instructors on a 5‐point Likert‐type scale. Student's t test was performed to analyse the association of factors like gender, last year's GPA, academic year, paternal income, education and employment with three highly rated items of the characteristics of effective teachers.

Results

The response rate was 85.4%. There were 53.6% female and 46.4% male students in the study. The provision of learning resources (mean 4.3 ± 1.06), demonstration of honesty, ethics and integrity (mean 4.28 ± 0.99) and showing respect and caring attitude (mean 4.24 ± 0.94) were three most highly rated characteristics of effective instructors. Using the latest technology, acting as a role model and maintaining class discipline were the least rated traits of good teachers. A significantly higher percentage of female students considered these three items more important than male students (P < 0.05). The students with last year GPA > 4 considered providing learning material as an attribute of effective teacher significantly more important than the students with GPA ≤ 4 (P < 0.001). In addition, the characteristics of effective instructors (75.1%) were considered more important in providing students with rewarding learning experience than their teaching experience (15.4%) and educational attainment (9.5%).

Conclusion

The most important attributes of effective teachers included providing learning resources, demonstrating honesty/integrity and showing respect/care.
Assessment of hydraulic properties of technosols using Beerkan and multiple tension disc infiltration methods
Authors: Yilmaz Deniz , Bouarafa Sofia , Peyneau Pierre‐Emmanuel , Angulo‐Jaramillo Rafael , Lassabatere Laurent
Published: February 2019

The increasing global urban sprawl requires large amounts of materials, putting huge pressure on numerous natural resources. In particular, vast quantities of soils are used to create infrastructures or green spaces associated with new developments. Alternative solutions aimed at alleviating soil consumption are thus being encouraged. Creating urban soils by recycling waste from industrial and construction activities is feasible, but apart from their support function the resulting technosols should also be able to provide some ecosystem services such as the capacity to infiltrate water and filter contaminants. Various methods are routinely used for in situ characterization of the hydraulic behaviour of natural soils, but their ability to assess the hydraulic properties of technosols remains unclear. Indeed, technosols formed from recycled waste differ markedly from natural soil because they often contain a considerable proportion of coarse artefacts that affect their structure. In this study, results obtained by two distinct methods (ponding and tension infiltrometry), associated with two data processing methods (Beerkan estimation soil transfer (BEST) and numerical inversion), on a set of infiltration data measured on experimental plots made of technosols have been compared with each other. Both methods provided similar results and thus proved to be reliable when applied to technosols.

Highlights

Reuse of by‐products from anthropogenic activities is crucial to alleviate the consumption of natural soil.

Hydraulic properties of technosols must be monitored to assess some of the ecosystem services they can provide.

BEST and numerical inversion of multiple tension disc infiltration data gave consistent results.

Reliability of the hydraulic characterization methods used for technosols deserves further inquiry.
A multiperiod hybrid decision support model for medical diagnosis and treatment based on similarities and three‐way decision theory
Authors: Yang Yan , Hu Junhua , Liu Yongmei , Chen Xiaohong
Published: February 2019

Patients always want a precise diagnosis and appropriate treatment advice when they are diagnosed with a disease. Furthermore, the original information about certain features and symptoms appears in different forms, and the effect of time is always ignored in the process of diagnosis. To overcome these defects, this paper develops a systematic multiperiod hybrid decision support model, which combines the similarity measurement and three‐way decision theory to provide prediction and treatment advice for patients under the fuzzy environment. This multiperiod hybrid decision support model, which considers the effect of time, including transformation module, multiperiod integration module, similarity module, prediction module, and three‐way decision module, provides disease prediction and advice on treatment based on similarities and three‐way decision theory. To validate this model, we construct an illustration composed of four cases, and this ultimately shows that MPH‐SDM can effectively support patients' disease diagnoses and treatment.
Supporting Father Involvement: An Intervention With Community and Child Welfare–Referred Couples
Authors: Pruett Marsha Kline , Cowan Philip A. , Cowan Carolyn Pape , Gillette Peter , Pruett Kyle D.
Published: February 2019

Objective

To expand the evidence base of the Supporting Father Involvement (SFI) intervention to include child welfare families.

Background

Taking a preventive father‐inclusive approach, SFI aims to strengthen coparenting, parent–child relationships, and child outcomes. This study replicates 4 prior iterations of the program using the same 32‐hour curriculum facilitated by clinically trained staff, case managers, and onsite child care and family meals.

Method

Participants (N = 239) included low‐income (median = $24,000) coparenting pairs, typically mothers and fathers/father figures, half of whom were Mexican American, with toddlers (median age < 3 years). Questionnaires assessing multiple family domains were administered verbally over an 18‐month period. Intervention effectiveness was tested through a randomized control trial with immediate treatment or waitlist–control groups using a moderated mediator structural equation model.

Results

The model explained 49% to 56% of the variance in children's problem behaviors (intervention and autoregressive effects). The intervention reduced couple conflict, which reduced anxious and harsh parenting, leading to better child outcomes. The intervention was equally effective for community and child welfare–referred families and family dynamics pathways were similar across conditions.

Conclusion

With its intentional outreach and inclusion of fathers, SFI offers an effective intervention for lower risk child welfare–involved families.

Implications

Results argue for the utility of treating community and child welfare parents in mixed‐gender prevention groups that focus on strengthening multiple levels of family relationships.
The association of the ankle‐brachial index, the toe‐brachial index, and their difference, with mortality and limb outcomes in dialysis patients
Authors: Prasad Ritika , Kamath Thejas , Ginsberg Charles , Potok O. Alison , Ix Joachim H. , Garimella Pranav S. , Rifkin Dena E.
Published: February 2019

Introduction: The ankle‐brachial index (ABI) is the most common test to diagnose peripheral artery disease (PAD). In dialysis patients, the ABI may under‐diagnose PAD, due to a high prevalence of concomitant medial arterial calcification (MAC). The toe‐brachial index (TBI) is not as susceptible to misclassification by MAC. Taking the ABI and TBI together in the form of their difference, the ABI‐TBI, may provide a single measure for assessing both atherosclerosis and calcification. The relationship of these variables in dialysis patients has not been well studied.

Methods: We identified 37 dialysis patients referred for vascular studies between 2009 and 2017 in the San Diego Veterans Administration Medical Center (SDVAMC). The ABI and TBI were performed systematically for each patient, and TBI was performed regardless of ABI or waveform. We examined associations between ABI, TBI, and the difference between them (ABI‐TBI) with all‐cause mortality and major adverse limb events (MALE), which includes revascularizations and amputations.

Findings: The mean age was 65 years and 30% were African American. All patients were men, reflecting the Veterans Administration population. There were 26 deaths during follow‐up and mortality was highest in patients who had low ABI and low TBI and least in those with high ABI and high TBI. Persons with TBI < 0.7 had an increased risk of all‐cause mortality. The ABI‐TBI, and the ABI itself, were not significantly associated with all‐cause mortality although the patterns were similar.

Discussion: Although ABI may be an important initial risk stratification tool, the TBI may be a more informative predictor of mortality in dialysis patients. Strengths of this study include a high rate of MALE and deaths. The TBI, and the difference between ABI and TBI, should be studied further in a larger cohort of persons with advanced kidney disease.
Atypical posterior reversible encephalopathy syndrome in a noncompliant hemodialysis patient: Case report and literature review
Authors: Chiang Wen‐Fang , Chen Pei‐Ti , Chen Yen‐Lin , Chen Ming‐Hua
Published: February 2019

Posterior reversible encephalopathy syndrome (PRES) is a reversible vasogenic brain edema in patients who present with seizure, headache, visual disturbance, and altered mental status, and a characteristic neuroimaging profile. Although PRES predominantly affects the bilateral parieto‐occipital areas, involvement of the frontal and temporal lobes, basal ganglia, brainstem, and cerebellum is not uncommon. Isolated involvement of the brainstem and cerebellum sparing the parieto‐occipital lobe is rarely reported. Here, we describe a 47‐year‐old man with end‐stage renal disease on chronic hemodialysis who presented with prominent hypertension and coma after missing three dialysis sessions. On examination, there was paucity of focal neurologic signs. Diagnosis of PRES was based on brain magnetic resonance imaging findings that were consistent with vasogenic edema of the pons and cerebellum without involvement of other areas. With antihypertensive therapy and intense ultrafiltration during hemodialysis, the patient's blood pressure and consciousness returned to normal, along with complete resolution of the abnormal imaging findings. This case stresses that noncompliance with dialysis should be considered a risk factor for PRES. This case is considered relative to the available literature on three patients with brainstem variant of PRES.