bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical association of Spirochaetes and Synergistetes with peri‐implantitis
Authors: Belibasakis Georgios N. , Mir‐Mari Javier , Sahrmann Philipp , Sanz‐Martin Ignacio , Schmidlin Patrick R. , Jung Ronald E.
Published: October 2015

Objectives

The microbial composition of peri‐implantitis‐associated biofilms may resemble that of periodontitis, with some distinctive differences, as identified by various conventional or molecular detection methods. Yet, the complete microbiome of peri‐implantitis awaits further characterization. The present clinical study was undertaken with the aim to investigate the association of Spirochaetes, and the more recently identified phylum Synergistetes, with peri‐implantitis.

Materials and Methods

Submucosal biofilms were obtained from single sites of patients with peri‐implantitis (n = 43) or individuals with peri‐implant health (n = 41). The samples were analysed by fluorescence in situ hybridization (FISH) and epifluorescence microscopy, using 16S rRNA‐based oligonucleotide probes for Synergistetes cluster A, subclusters A1 and A2, and Treponema groups I–III and IV.

Results

Treponema group IV was barely detectable, whereas Treponema groups I–III were detected at low prevalence in health, but their prevalence and numbers were significantly increased in peri‐implantitis by 48% and 2.4‐log, respectively. Synergistetes cluster A was detected in half of the healthy sites, and its prevalence and numbers were significantly increased in peri‐implantitis by 30% and 2.5‐log, respectively. No quantitative differences were found between Synergistetes subclusters A1 and A2 numbers, as both increased by 2.8‐log. Synergistetes cluster A displayed strong correlations with several clinical peri‐implant parameters, but Treponema groups I–III only with probing pocket depth.

Conclusion

The present clinical cross‐sectional study demonstrates that Spriochaetes of the Treponema groups I–III, but not group IV, and Synergistetes of the cluster A are highly associated with peri‐implantitis. Synergistetes cluster A appears to display a stronger association with peri‐implantitis than Spirochaetes.
Dynapenic obesity and the risk of incident Type 2 diabetes: the English Longitudinal Study of Ageing
Authors: Cuthbertson D. J. , Bell J. A. , Ng S. Y. , Kemp G. J. , Kivimaki M. , Hamer M.
Published: October 2015

Aim

Obesity is a well‐established risk factor for developing Type 2 diabetes. Evidence suggests that sarcopenia, the age‐related decline in muscle mass and strength, may exacerbate diabetes risk in obese individuals. The aim of this study was to determine the combined effect of obesity and low muscle strength, dynapenia, on the risk of incident Type 2 diabetes in older adults.

Methods

Participants were 5953 (1670 obese) men and women from the English Longitudinal Study of Ageing without known Type 2 diabetes at baseline and for whom handgrip strength, biochemical and other clinical data were collected. A diagnosis of Type 2 diabetes was recorded from self‐reported physician diagnosis over 6 years.

Results

For each unit increase in grip strength, there was a reduction in diabetes risk (age‐, sex‐ and BMI adjusted HR; 0.98; 95% CI 0.96–0.99). The risk of Type 2 diabetes was elevated in all obese participants, but was greatest in those with low handgrip strength (HR = 4.93, 95% CI 2.85, 8.53) compared with non‐obese individuals with high handgrip strength. Eleven per cent of the sample met the threshold for weakness (handgrip strength: men < 26 kg; women < 16 kg) that was associated with elevated Type 2 diabetes risk in obese (HR = 3.57, 95% CI 2.04, 6.24) but not in non‐obese (HR = 0.86, 95% CI, 0.44, 1.68) compared with normal/non‐obese participants.

Conclusion

Dynapenic obesity, determined by high BMI and low handgrip strength, is associated with increased risk of incident Type 2 diabetes in older people.
Glycaemic behaviour during breastfeeding in women with Type 1 diabetes
Authors: Achong N. , McIntyre H. D. , Callaway L. , Duncan E. L.
Published: October 2015

Aim

To describe glycaemia in both breastfeeding women and artificially feeding women with Type 1 diabetes, and the changes in glycaemia induced by suckling.

Methods

A blinded continuous glucose monitor was applied for up to 6 days in eight breastfeeding and eight artificially feeding women with Type 1 diabetes 2–4 months postpartum. Women recorded glucose levels, insulin dosages, oral intake and breastfeeding episodes. A standardized breakfast was consumed on 2 days. A third group (clinic controls) were identified from a historical database.

Results

Carbohydrate intake tended to be higher in breastfeeding than artificially feeding women (P = 0.09) despite similar insulin requirements. Compared with breastfeeding women, the high blood glucose index and standard deviation of glucose were higher in artificially feeding women (P = 0.02 and 0.06, respectively) and in the clinical control group (P = 0.02 and 0.05, respectively). The low blood glucose index and hypoglycaemia were similar. After suckling, the low blood glucose index increased compared with before (P < 0.01) and during (P < 0.01) suckling. Hypoglycaemia (blood glucose < 4.0 mmol/l) occurred within 3 h of suckling in 14% of suckling episodes, and was associated with time from last oral intake (P = 0.04) and last rapid‐acting insulin (P = 0.03). After a standardized breakfast, the area under the glucose curve was positive. In breastfeeding women the area under the glucose curve was positive if suckling was avoided for 1 h after eating and negative if suckling occurred within 30 min of eating.

Conclusions

Breastfeeding women with Type 1 diabetes had similar hypoglycaemia but lower glucose variability than artificially feeding women. Suckling reduced maternal glucose levels but did not cause hypoglycaemia in most episodes.
Different definition of microvascular angina
Authors: Suzuki Hiroshi
Published: October 2015

We sometimes encounter patients with microvascular angina (MVA), a disease characterized by anginal pain without abnormal coronary arteriographic findings or coronary spasm. More than 40 years have passed since MVA was first confirmed. The terms ‘syndrome X’, ‘cardiac syndrome X’ and ‘microvascular dysfunction’ have also been used to describe conditions similar to MVA, but all with slightly different definitions. The cause of MVA seems almost certain to be organic and functional abnormalities of the small arteries of the heart. Patients with MVA are likely to suffer from endothelial dysfunction and other microvascular abnormalities of both the coronary and peripheral arteries. The major treatment of MVA has been medication, most often calcium channel blockers. The prognosis of MVA is generally excellent, although symptoms remain in many studies. Some MVA patients with accompanying hypertensive heart disease have gone on to develop progressive left ventricular dysfunction, with poor prognosis. The different definitions applied to the terms used to describe this condition, what we refer to here as MVA, can confound issues involved in diagnosis, prognosis and proper treatment. Therefore, it is extremely important to distinguish primary MVA without underlying heart disease from secondary MVA to explore the disease mechanism and examine the clinical characteristics. It is more than 40 years since Likoff first confirmed this disease; therefore, all researchers know that strict diagnostic criteria for MVA should be immediately established.
Enhanced suicidal erythrocyte death in acute cardiac failure
Authors: Attanasio Philipp , Bissinger Rosi , Haverkamp Wilhelm , Pieske Burkert , Wutzler Alexander , Lang Florian
Published: October 2015

Background

A common complication of acute cardiac failure (AHF) is anaemia, which negatively influences the clinical outcome. Causes of anaemia include enhanced eryptosis, a suicidal erythrocyte death characterized by cell shrinkage and cell membrane scrambling with phosphatidylserine translocation. Signalling triggering eryptosis include oxidative stress, increase of cytosolic Ca2+‐activity ([Ca2+]i) and ceramide. The present study explored whether AHF is associated with accelerated eryptosis.

Materials and Methods

Erythrocytes were drawn from healthy volunteers (n = 10) and patients hospitalized for AHF (n = 22). Phosphatidylserine exposure was estimated from annexin‐V‐binding, cell volume from forward scatter, [Ca2+]i from Fluo3‐fluorescence, ceramide abundance utilizing specific antibodies and reactive oxygen species (ROS) abundance from 2′,7′‐dichlorodihydrofluorescein diacetate (DCFDA) fluorescence, as determined by flow cytometry.

Results

In AHF‐patients, haemoglobin concentration (11·5 ± 0·5 g/dL), and haematocrit (35·6 ± 1·2%) were significantly lower than haemoglobin concentration (14·1 ± 0·4 g/dL), and haematocrit (40·1 ± 1·0%) in healthy volunteers, even though reticulocyte number was significantly higher in AHF patients (2·3 ± 0·3%) than in healthy volunteers (1·1 ± 0·2%). The percentage of erythrocytes exposing phosphatidylserine was significantly higher in AHF patients (1·8 ± 0·1%) than in healthy volunteers (1·2 ± 0·2%). The forward scatter was significantly lower and the ROS abundance significantly larger in AHF patients than in healthy volunteers. In erythrocytes drawn from healthy volunteers, phosphatidylserine and ROS abundance was increased to significantly higher values following a 24 h treatment with plasma from AHF patients than with plasma from healthy volunteers.

Conclusion

AHF leads to anaemia despite increased reticulocyte number and at least partially due to enhanced eryptosis. Underlying mechanisms include oxidative stress imposed by a plasma borne component.
Global aerial flyways allow efficient travelling
Authors: Kranstauber B. , Weinzierl R. , Wikelski M. , Safi K.
Published: October 2015

Birds migrate over vast distances at substantial costs. The highly dynamic nature of the air makes the selection of the best travel route difficult. We investigated to what extent migratory birds may optimise migratory route choice with respect to wind, and if route choice can be subject to natural selection. Following the optimal route, calculated using 21 years of empirical global wind data, reduced median travel time by 26.5% compared to the spatially shortest route. When we used a time‐dependent survival model to quantify the adaptive benefit of choosing a fixed wind‐optimised route, 84.8% of pairs of locations yielded a route with a higher survival than the shortest route. This suggests that birds, even if incapable of predicting wind individually, could adjust their migratory routes at a population level. As a consequence, this may result in the emergence of low‐cost flyways representing a global network of aerial migratory pathways.
Bottom‐up regulation of malaria population dynamics in mice co‐infected with lung‐migratory nematodes
Authors: Griffiths Emily C. , Fairlie‐Clarke Karen , Allen Judith E. , Metcalf C. Jessica E. , Graham Andrea L.
Published: October 2015

When and how populations are regulated by bottom up vs. top down processes, and how those processes are affected by co‐occurring species, are poorly characterised across much of ecology. We are especially interested in the community ecology of parasites that must share a host. Here, we quantify how resources and immunity affect parasite propagation in experiments in near‐replicate ‘mesocosms’’ – i.e. mice infected with malaria (Plasmodium chabaudi) and nematodes (Nippostrongylus brasiliensis). Nematodes suppressed immune responses against malaria, and yet malaria populations were smaller in co‐infected hosts. Further analyses of within‐host epidemiology revealed that nematode co‐infection altered malaria propagation by suppressing target cell availability. This is the first demonstration that bottom‐up resource regulation may have earlier and stronger effects than top‐down immune mechanisms on within‐host community dynamics. Our findings demonstrate the potential power of experimental ecology to disentangle mechanisms of population regulation in complex communities.
Availability of antiepileptic drugs across Europe
Authors: Baftiu Arton , Johannessen Landmark Cecilie , Nikaj Valent , Neslein Inger‐Lise , Johannessen Svein I. , Perucca Emilio
Published: October 2015

Europe consists of 53 countries with widely different economic conditions and different political, educational, and health care systems. This study was aimed at determining the availability of antiepileptic drugs (AEDs) across Europe. An electronic questionnaire was submitted to all 43 European chapters of the International League Against Epilepsy (ILAE). Outcome measures were availability of older, newer, and newest AEDs, generic products, indications, reimbursement rules, and reasons for lack of availability of AEDs. Countries were divided according to economic status as defined by the World Bank. Thirty‐four chapters (79%) provided data. There were large differences in AED availability across countries, especially between high‐income countries and the other countries. The newest AEDs were not available in any of the 12 non–high‐income countries. Availability was higher in countries with public reimbursement systems. Reimbursement policies ranged from full reimbursement for all AEDs to complete lack of reimbursement. Main hurdles for poor access to AEDs included lack of regulatory approval, high prices and reimbursement restrictions. The availability of AEDs differs across European countries, with many hurdles hampering access to epilepsy medicines, particularly to new medications. These findings raise major concerns on the quality of epilepsy care in many countries.
One gene but different proteins and diseases: the complexity of dystonin and bullous pemphigoid antigen 1
Authors: Künzli Kseniia , Favre Bertrand , Chofflon Michel , Borradori Luca
Published: October 2015

Since the immunochemical identification of the bullous pemphigoid antigen 230 (BP230) as one of the major target autoantigens of bullous pemphigoid (BP) in 1981, our understanding of this protein has significantly increased. Cloning of its gene, development and characterization of animal models with engineered gene mutations or spontaneous mouse mutations have revealed an unexpected complexity of the gene encoding BP230. The latter, now called dystonin (DST), is composed of at least 100 exons and gives rise to three major isoforms, an epithelial, a neuronal and a muscular isoform, named BPAG1e (corresponding to the original BP230), BPAG1a and BPAG1b, respectively. The various BPAG1 isoforms play a key role in fundamental processes, such as cell adhesion, cytoskeleton organization, and cell migration. Genetic defects of BPAG1 isoforms are the culprits of epidermolysis bullosa and complex, devastating neurological diseases. In this review, we summarize recent advances of our knowledge about several BPAG1 isoforms, their role in various biological processes and in human diseases.
Medical treatments of elderly, French patients with type 2 diabetes: results at inclusion in the GERODIAB Cohort
Authors: Doucet Jean A. , Bauduceau Bernard , Le Floch Jean‐Pierre , Verny Christiane ,   The SFD/SFGG Intergroup
Published: October 2015

Prevalence of diabetes in the elderly increases, and half of the French diabetics are over the age of 75 years. The GERODIAB study is the first French multicentre, prospective, observational study designed to analyse over 5 years the influence of glycaemic control on morbidity–mortality in type 2 diabetics patients 70 years old and over. This study analysed the diabetic and geriatric factors associated with the treatment modalities, particularly insulin, at inclusion in the cohort. The cohort of 987 type 2 diabetics was divided into three groups according to the method of treatment. Slightly fewer than one‐third of these patients (26.4%) were treated with insulin alone, 31% received insulin and oral antidiabetic drugs, and 42.7% oral antidiabetic drugs alone. The patients that received insulin alone were significantly older, had poorer glycaemic control (HbA1c = 7.9 ± 1.4, 7.8 ± 1.0 and 7.1 ± 1.2%, respectively; P < 0.001) and had greater alterations of glomerular filtration rate (GFR). HbA1c was below 6.5% in 15% of patients and 37.3% of patients had a GFR below 60 mL/min. The patients treated with insulin alone had significantly more hypoglycaemic episodes (respectively 53.3, 36.3 and 19.5%, P < 0.001), retinopathy, cardiovascular involvement and more specific geriatric complications, such as cognitive disorders (respectively 34.1, 31.4 and 23.6%, P = 0.006). In this specific population of elderly type 2 diabetic patients, diabetic and geriatric conditions significantly differed between the types of drug treatments. Considering low values of HbA1c and GFR, some patients seemed overtreated and other patients received inappropriate drugs.
Quantifying the conservation value of seascape connectivity: a global synthesis
Authors: Olds Andrew D. , Connolly Rod M. , Pitt Kylie A. , Pittman Simon J. , Maxwell Paul S. , Huijbers Chantal M. , Moore Brad R. , Albert Simon , Rissik David , Babcock Russell C. , Schlacher Thomas A.
Published: October 2015

Aim

Connectivity structures populations, communities and ecosystems in the sea. The extent of connectivity is, therefore, predicted to also influence the outcomes of conservation initiatives, such as marine reserves. Here we review the published evidence about how important seascape connectivity (i.e. landscape connectivity in the sea) is for marine conservation outcomes.

Location

Global.

Methods

We analysed the global literature on the effects of seascape connectivity on reserve performance.

Results

In the majority of cases, greater seascape connectivity inside reserves translates into better conservation outcomes (i.e. enhanced productivity and diversity). Research on reserve performance is, however, most often conducted separately from research on connectivity, resulting in few studies (< 5% of all studies of seascape connectivity) that have quantified how connectivity modifies reserve effects on populations, assemblages or ecosystem functioning in seascapes. Nevertheless, evidence for positive effects of connectivity on reserve performance is geographically widespread, encompassing studies in the Caribbean Sea, Florida Keys and western Pacific Ocean.

Main conclusions

Given that research rarely connects the effects of connectivity and reserves, our thesis is that stronger linkages between landscape ecology and marine spatial planning are likely to improve conservation outcomes in the sea. The key science challenge is to identify the full range of ecological functions that are modulated by connectivity and the spatial scale over which these functions enhance conservation outcomes.
Power in numbers. Drivers of high population density in insular lizards
Authors: Novosolov Maria , Rodda Gordon H. , Feldman Anat , Kadison Amy E. , Dor Roi , Meiri Shai
Published: October 2015

Aim

Islands organisms usually have fewer predator and competitor species than mainland ones. This is thought to result in high population densities on islands. We hypothesize that insular lizards have denser populations than mainland species and that density, in general, is negatively correlated with competitor and predator richness.

Location

Global.

Methods

We compared densities of 346 lizard species on islands and the mainland while examining the relationship between density and, predator and competitor richness, primary productivity, seasonality and island area. We controlled for phylogenetic non‐independence, body mass and study area, which are known to strongly affect population density.

Results

Insular populations (especially on snake‐free islands) are denser than mainland ones. Mainland populations of lizard species that also inhabit islands were denser than those of species that do not inhabit islands. Population density was the highest on islands with low net primary productivity and was not significantly affected by competitor or predator richness. Moreover, insular populations show high density regardless of island area.

Main conclusions

We conclude that the ability of mainland species to reach high population densities may increase their chances in reaching and successfully colonizing islands. We postulate that population density may be affected by predator and competitor density rather than by their richness. Density increase on islands may result not from the environmental simplicity of island faunas but through propagule sorting or pressure.
The Godzilla Megamullion, the largest oceanic core complex on the earth: a historical review
Authors: Ohara Yasuhiko
Published: October 2015

The Godzilla Megamullion is the largest known oceanic core complex (OCC) on the Earth, located in the Parece Vela Basin in the Philippine Sea. In this article, the history of Godzilla Megamullion study is reviewed for the first time, dividing it into three major phases: (i) the early studies done before Japan's extended continental shelf survey program; (ii) the studies during Japan's extended continental shelf survey program that discovered the OCC; and (iii) the studies by the post‐discovery cruises. The early studies included an interpretation of US nautical chart of the southwestern Pacific and the site surveys for Deep Sea Drilling Project cruises (DSDP Legs 6, 31 and 59). The early studies recognized the presence of the Parece Vela Rift, the extinct spreading axis of the Parece Vela Basin, and established the currently accepted model that the Philippine Sea evolved with eastward progression of backarc spreading and arc migration. The modern understanding of the Parece Vela Basin comes from Japan's extended continental shelf survey program. The program revealed the ultramafic petrology as well as a two‐stage evolution model of the basin. Following these results, the discovery of the Godzilla Megamullion was made in 2001. The studies by the post‐discovery cruises further revealed important characteristics of the OCC, such as the presence of abundant plagioclase‐bearing peridotite and the systematic temporal changes in both deformation microstructures and composition of plagioclase and amphibole in gabbroic mylonites and ultramylonites. Zircon U–Pb ages of gabboric and leucocratic rocks indicate that the terminal phase of Parece Vela Basin spreading was with a significant decline in spreading rate and asymmetry accompanying formation of the Godzilla Megamullion. The estimated denudation rate of the OCC was approximately 2.5 cm/yr; significantly slower than the previous estimate based on poorly constrained magnetic data.
The association between chronic hepatitis C infection and cardiovascular risk
Authors: Pateria P. , Jeffrey G. P. , MacQuillan G. , Speers D. , Ching H. , Chinnaratha M. A. , Watts G. F. , Adams L. A.
Published: October 2015

Background

Vascular disease is a common cause of death in patients with chronic hepatitis C (CHC) infection; however, the association between CHC and atherosclerosis is unclear.

Aims

To determine whether patients with CHC have increased subclinical vascular disease and whether genotype or antiviral treatment modifies this risk.

Methods

Fifty CHC patients and 22 age‐matched and sex‐matched healthy controls underwent clinical and biochemical assessment for vascular risk factors. In addition, vascular risk was assessed by measuring arterial stiffness (aortic augmentation index and carotid‐femoral pulse wave velocity (PWV)), endothelial dysfunction (brachial artery flow‐mediated dilatation (FMD) and dilatation post‐glycerol trinitrate administration) and carotid intima‐media thickness (CIMT). Assessment was repeated in subset of CHC patients (n = 12) undergoing antiviral treatment 18 months after initiation of treatment.

Results

Baseline vascular risk factors and measures of arterial stiffness, endothelial dysfunction and CIMT were not different between cases and controls (P > 0.2 for all). Genotype 1 CHC patients had greater endothelial dysfunction with lower FMD (8.2 ± 3.5% vs 10.9 ± 5.2%, P = 0.03) and higher right CIMT (0.6 ± 0.1 mm vs 0.5 ± 0.07 mm, P = 0.04) compared with non‐genotype 1. Patients who achieved sustained virological response (7/12) showed significant improvement in insulin resistance (homeostasis model of assessment of insulin resistance 2.3 ± 1.2 vs 1.8 ± 0.8, P = 0.02) and arterial stiffness (PWV 7.4 ± 1.1 m/s vs 6.5 ± 0.6 m/s, P = 0.04).

Conclusions

Subclinical vascular disease is not greater in CHC subjects compared with controls. However, among CHC subjects, genotype 1 infection is associated with greater endothelial dysfunction and increased carotid‐intima medial thickness compared with non‐genotype 1 infection. Successful viral eradication may improve insulin resistance and arterial stiffness.
Synthesis and Oxidation Testing of MAX Phase Composites in the Cr–Ti–Al–C Quaternary System
Authors: Horlait Denis , Grasso Salvatore , Al Nasiri Nasrin , Burr Patrick A. , Lee William Edward
Published: October 2015

According to the properties determined for the ternary end‐members, MAX phases in the quaternary Cr–Ti–Al–C system could be of interest as protective coatings for nuclear fuel cladding in the case of severe accident conditions. In this study, syntheses of 211 and 312 MAX phase compositions were attempted using pressureless reactions starting from Cr, TiH2, Al, and C (graphite) powders. It was observed that both the Ti substitution by Cr in Ti3AlC2 and the mutual solubility of Ti2AlC and Cr2AlC are limited to a few atomic percent. In addition, the remarkable stability of the (Cr2/3Ti1/3)3AlC2 MAX phase composition was confirmed. Due to the low miscibility of MAX phases in the Cr–Ti–Al–C system, most samples contained substantial amounts of TiCx and Al–Cr alloys as secondary phases, thus forming composite materials. After sintering, all samples were submitted to a single oxidation test (12 h at 1400°C in air) to identify compositions potentially offering high‐temperature oxidation resistance and so warranting further investigation. In addition to (Cr0.95Ti0.05)2AlC, composite samples containing substantial quantities of Al8Cr5 and AlCr2 formed a stable and passivating Al2O3 scale, whereas the other samples were fully oxidized.
On the origin of endemic species in the Red Sea
Authors: DiBattista Joseph D. , Howard Choat J. , Gaither Michelle R. , Hobbs Jean‐Paul A. , Lozano‐Cortés Diego F. , Myers Robert F. , Paulay Gustav , Rocha Luiz A. , Toonen Robert J. , Westneat Mark W. , Berumen Michael L.
Published: October 2015

Aim

The geological and palaeo‐climatic forces that produced the unique biodiversity in the Red Sea are a subject of vigorous debate. Here, we review evidence for and against the hypotheses that: (1) Red Sea fauna was extirpated during glacial cycles of the Pleistocene and (2) coral reef fauna found refuge within or just outside the Red Sea during low sea level stands when conditions were inhospitable.

Location

Red Sea and Western Indian Ocean.

Methods

We review the literature on palaeontological, geological, biological and genetic evidence that allow us to explore competing hypotheses on the origins and maintenance of shallow‐water reef fauna in the Red Sea.

Results

Palaeontological (microfossil) evidence indicates that some areas of the central Red Sea were devoid of most plankton during low sea level stands due to hypersaline conditions caused by almost complete isolation from the Indian Ocean. However, two areas may have retained conditions adequate for survival: the Gulf of Aqaba and the southern Red Sea. In addition to isolation within the Red Sea, which separated the northern and southern faunas, a strong barrier may also operate in the region: the cold, nutrient‐rich water upwelling at the boundary of the Gulf of Aden and the Arabian Sea. Biological data are either inconclusive or support these putative barriers and refugia, but no data set, that we know of rejects them. Genetic evidence suggests that many endemic lineages diverged from their Indian Ocean counterparts long before the most recent glaciations and/or are restricted to narrow areas, especially in the northern Red Sea.

Main conclusions

High endemism observed in the Red Sea and Gulf of Aden appears to have multiple origins. A cold, nutrient‐rich water barrier separates the Gulf of Aden from the rest of the Arabian Sea, whereas a narrow strait separates the Red Sea from the Gulf of Aden, each providing potential isolating barriers. Additional barriers may arise from environmental gradients, circulation patterns and the constriction at the mouth of the Gulf of Aqaba. Endemics that evolved within the Red Sea basin had to survive glacial cycles in relatively low salinity refugia. It therefore appears that the unique conditions in the Red Sea, in addition to those characteristics of the Arabian Peninsula region as a whole, drive the divergence of populations via a combination of isolation and selection.
Termite mounds alter the spatial distribution of African savanna tree species
Authors: Davies Andrew B. , Baldeck Claire A. , Asner Gregory P.
Published: October 2015

Aim

Termite mounds form small islands of enhanced water and soil nutrient availability on otherwise dry and nutrient‐poor hill crests, which can have important impacts on the plant community. However, the way in which termite mounds alter the spatial distribution of particular tree species across broad savanna landscapes is poorly understood. We aimed to understand the nature and extent of the relationship between termite mounds and key woody savanna species at landscape scales through the use of airborne remote sensing.

Location

Kruger National Park, South Africa.

Methods

We mapped 9894 termite mounds and 666,679 savanna trees from 15 species across two landscapes with contrasting rainfall regimes using airborne imaging spectroscopy and LiDAR data. We then examined changes in tree species densities and community composition with respect to distance from termite mounds.

Results

In both landscapes, termite mounds reduced overall tree densities over distances up to 10 m from mound centres. However, the effect of termite mounds on tree density differed among species, with some species, typically associated with lowland and riparian habitats, showing increased density near termite mounds. Indeed, changes in overall tree community composition revealed that termite mounds harbour tree communities similar to lowland communities, with this similarity decreasing with increased distance from the nearest mound. Termite effects were more pronounced in the savanna landscape receiving higher annual rainfall, whereas a greater percentage of the landscape was affected in the drier landscape due to higher mound densities.

Main conclusions

Termite mounds mediate the spatial distribution of tree species in savanna landscapes, increasing the abundance of tree species typically associated with lowland habitats. This contributes to the spatial heterogeneity of savanna vegetation within landscapes and the maintenance of savanna biodiversity.
Prevalence estimation of halitosis and its association with oral health‐related parameters in an adult population of a city in North Italy
Authors: Aimetti Mario , Perotto Stefano , Castiglione Anna , Ercoli Elena , Romano Federica
Published: October 2015

Aim

No epidemiological data on halitosis are available from Italy. Thus, the aim of this population‐based cross‐sectional study was to estimate the prevalence of halitosis in an urban adult population from North Italy and to explore related oral risk indicators.

Materials and Methods

The survey used a two‐stage probability sampling method to collect a representative sample of inhabitants, aged between 20 and 75 years, in the city of Turin. Seven hundred and forty‐four adults were clinically examined (47% of sampled subjects) for oral malodor and periodontal conditions. Using a standardized questionnaire social, health and halitosis‐related parameters were collected. Logistic models with interaction terms between tongue coating scores (TCS) and periodontal status were used to explore halitosis risk indicators.

Results

The prevalence estimate of halitosis according to the organoleptic assessment was 53.51% (95% CI: 48.55–58.50). A statistically significant correlation was found between organoleptic and gas chromatography measurements (p < 0.0001). Stronger associations between halitosis and periodontitis were observed in people having higher TCS: adjusted odds ratio considering low and high TCS in individuals with severe periodontitis were 2.95 and 20.77 (p ≤ 0.003).

Conclusions

Due to the high prevalence of halitosis in the Turin population, its diagnosis and management should be incorporated in comprehensive dental care.
Cardiovascular autonomic neuropathy in patients with type 2 diabetes
Authors: Liu Yuan , Liu Sui‐xin , Zheng Fan , Cai Ying , Xie Kang‐ling , Zhang Wen‐liang
Published: October 2015

Aims/Introduction

Heart rate recovery (HRR) after exercise is considered to be a new index of autonomic dysfunction associated with cardiovascular disease and mortality. The present study aimed to investigate the risk factors of HRR and the effects of exercise on the abnormal HRR in type 2 diabetes.

Materials and Methods

A total of 123 type 2 diabetes patients were recruited, and the oral glucose tolerance test and exercise test were carried out to analyze the risk factors associated with abnormal HRR. Among these patients, 42 patients with abnormal HRR were further randomized to either the conventional therapy group (CT group; n = 20) or the intensive therapy group (IT group; n = 22). The CT group patients underwent metformin and diet control, whereas the IT group additionally underwent a combined moderate intensity aerobic and resistance training three times per week for 12 weeks. The results of blood sample analysis and HRR were recorded before and after the training.

Results

Abnormal HRR was related to fasting blood glucose, glycosylated hemoglobin, low‐density lipoprotein cholesterol, and resting and maximum heart rates (P < 0.05 for both). After training, the IT group had significantly lower levels of fasting blood glucose, glycosylated hemoglobin and resting heart rate than the CT group (all P < 0.01 or P < 0.005). Significant improvement in HRR and metabolic equivalents was observed in the IT group compared with the CT group (P < 0.05).

Conclusions

These data suggested that combined aerobic and resistance training improved cardiac autonomic dysfunction as measured by HRR in type 2 diabetes patients. This might be due to better improvement of glycemic control, resting heart rate and physical fitness.
Low osteocalcin level is a risk factor for impaired glucose metabolism in a Chinese male population
Authors: Liang Yaojie , Tan Aihua , Liang Danyan , Yang Xiaobo , Liao Ming , Gao Yong , Jiang Yonghua , Yao Ziting , Lin Xinggu , Lu Zheng , Wu Chunlei , Zhang Shijun , Hu Yanlin , Qin Xue , Mo Zengnan , Li Hong , Zhang Haiying
Published: October 2015

Aims/Introduction

This study was to assess the association between serum osteocalcin level and glucose metabolism in a Chinese male population.

Materials and Methods

We carried out a cross‐sectional study with a cohort of participants from the Fangchenggang Area Male Health and Examination Survey. The cross‐sectional study was carried out among 2,353 men, including 2,139 participants with normal glucose tolerance, 148 with impaired fasting glucose and 66 with type 2 diabetes. A subsample of 1,109 men with measurement of osteocalcin was observed in the cohort. After a 4‐year follow‐up period, 1,049 non‐diabetic and 983 participants with normal glucose tolerance who submitted the available information were enrolled in the cohort. Participants were divided into group‐H (≥23.33 ng/mL) and group‐L (<23.33 ng/mL) by osteocalcin level.

Results

In the cross‐sectional study, osteocalcin levels were highest in participants with normal glucose tolerance, followed by those with impaired fasting glucose and type 2 diabetes (P < 0.001). In partial correlation analysis adjusted for age, serum osteocalcin level was related to glucose level (r = −0.082, P < 0.001), insulin level (r = −0.079, P < 0.001) and insulin resistance (r = −0.065, P = 0.002). Compared with group‐H, group‐L was associated with an increased risk of type 2 diabetes (odds ratio 2.107, 95% confidence interval 1.123–3.955), impaired fasting glucose (odds ratio 2.106; 95% CI 1.528–2.902), and insulin resistance (odds ratio 1.359, 95% confidence interval 1.080–1.710) adjusted for age, education levels, cigarette smoking and lipid profiles. In the cohort study, the increased risk of impaired fasting glucose was significant in group‐L vs group‐H (3.3% vs 1.2%, P = 0.026).

Conclusions

Low serum osteocalcin level was a risk factor for impaired glucose metabolism and subsequent type 2 diabetes.
Application of imaging fusion combining contrast‐enhanced ultrasound and magnetic resonance imaging in detection of hepatic cellular carcinomas undetectable by conventional ultrasound
Authors: Dong Yi , Wang Wen‐Ping , Mao Feng , Ji Zheng‐Biao , Huang Bei‐Jian
Published: October 2015

Background and Aim:

The aim of this study is to explore the value of volume navigation image fusion‐assisted contrast‐enhanced ultrasound (CEUS) in detection for radiofrequency ablation guidance of hepatocellular carcinomas (HCCs), which were undetectable on conventional ultrasound.

Methods:

From May 2012 to May 2014, 41 patients with 49 HCCs were included in this study. All lesions were detected by dynamic magnetic resonance imaging (MRI) and planned for radiofrequency ablation but were undetectable on conventional ultrasound. After a bolus injection of 2.4 ml SonoVue® (Bracco, Italy), LOGIQ E9 ultrasound system with volume navigation system (version R1.0.5, GE Healthcare, Milwaukee, WI, USA) was used to fuse CEUS and MRI images. The fusion time, fusion success rate, lesion enhancement pattern, and detection rate were analyzed.

Results:

Image fusions were conducted successfully in 49 HCCs, the technical success rate was 100%. The average fusion time was (9.2 ± 2.1) min (6–12 min). The mean diameter of HCCs was 25.2 ± 5.3 mm (mean ± SD), and mean depth was 41.8 ± 17.2 mm. The detection rate of HCCs using CEUS/MRI imaging fusion (95.9%, 47/49) was significantly higher than CEUS (42.9%, 21/49) (P < 0.05). For small HCCs (diameter, 1–2 cm), the detection rate using imaging fusion (96.9%, 32/33) was also significantly higher than CEUS (18.2%, 6/33) (P < 0.01). All HCCs displayed a rapid wash‐in pattern in the arterial phase of CEUS.

Conclusions:

Imaging fusion combining CEUS and MRI is a promising technique to improve the detection, precise localization, and accurate diagnosis of undetectable HCCs on conventional ultrasound, especially small and atypical HCCs.
Factors affecting burnout in female nurses who have preschool‐age children
Authors: Maruyama Akiko , Suzuki Eiko , Takayama Yuko
Published: October 2015

Aim

This prospective cohort study aims to clarify the factors affecting burnout in female nurses who have preschool‐age children.

Methods

The subjects were 2151 female nurses who have preschool‐age children and work at 70 city hospitals acrossJapan. The questionnaires were completed by 1644 female nurses with preschool‐age children inOctober 2010, and they were divided into a cohort to observe the incidence of burnout, which was investigated inOctober 2011.

Results

At the baseline, the authors obtained responses from 1802 subjects (83.8%) who had agreed to join the study. The subjects the authors were able to investigate totaled 523, of whom 117 (22.4%) had experienced burnout. Multiple logistic regression analysis showed that influencing or predictive factors in burnout were years at the present workplace, will to continue work, assertiveness, overtime work, and spanking children.

Conclusion

Female nurses who have preschool‐age children tend to burnout easily if they have been at their present workplace for less than 3 years, wish to quit working, respond to a child's misbehavior with spanking, are “very low” in assertiveness, or work 4–6 h of overtime per week.
A regular yoga intervention for staff nurse sleep quality and work stress: a randomised controlled trial
Authors: Fang Ronghua , Li Xia
Published: October 2015

Aims and objectives

Although many studies have assessed the efficacy of yoga in older individuals, minimal research has focused on how nurses use yoga to improve sleep quality and to reduce work stress after work hours. We used the Pittsburgh Sleep Quality Index in Chinese and the Questionnaire on Medical Worker's Stress in Chinese to determine the impact of yoga on the quality of sleep and work stress of staff nurses employed by a general hospital in China.

Background

Disturbances in the circadian rhythm interrupt an individual's pattern of sleep.

Study design

Convenient sampling method.

Methods

One hundred and twenty nurses were randomised into two groups: a yoga group and a non‐yoga group. The yoga group performed yoga more than two times every week for 50–60 minutes each time after work hours. The NG group did not participate in yoga. After six months, self‐reported sleep quality and work stress were compared between the two groups, and then we used linear regression to confirm the independent factors related to sleep quality.

Results

Nurses in the yoga group had better sleep quality and lower work stress compared with nurses in the non‐yoga group. The linear regression model indicated that nursing experience, age and yoga intervention were significantly related to sleep quality.

Conclusion

Regular yoga can improve sleep quality and reduce work stress in staff nurses.

Relevance to clinical practice

This study provides evidence that hospital management should pay attention to nurse sleep quality and work stress, thereby taking corresponding measures to reduce work pressure and improve health outcomes.
Genetics of coronary heart disease: towards causal mechanisms, novel drug targets and more personalized prevention
Authors: Orho‐Melander M.
Published: October 2015

Coronary heart disease (CHD) is an archetypical multifactorial disorder that is influenced by genetic susceptibility as well as both modifiable and nonmodifiable risk factors, and their interactions. Advances during recent years in the field of multifactorial genetics, in particular genomewide association studies (GWASs) and their meta‐analyses, have provided the statistical power to identify and replicate genetic variants in more than 50 risk loci for CHD and in several hundreds of loci for cardiometabolic risk factors for CHD such as blood lipids and lipoproteins. Although for a great majority of these loci both the causal variants and mechanisms remain unknown, progress in identifying the causal variants and underlying mechanisms has already been made for several genetic loci. Furthermore, identification of rare loss‐of‐function variants in genes such as PCSK9, NPC1L1, APOC3 and APOA5, which cause a markedly decreased risk of CHD and no adverse side effects, illustrates the power of translating genetic findings into novel mechanistic information and provides some optimism for the future of developing novel drugs, given the many genes associated with CHD in GWASs. Finally, Mendelian randomization can be used to reveal or exclude causal relationships between heritable biomarkers and CHD, and such approaches have already provided evidence of causal relationships between CHD and LDL cholesterol, triglycerides/remnant particles and lipoprotein(a), and indicated a lack of causality for HDL cholesterol, C‐reactive protein and lipoprotein‐associated phospholipase A2. Together, these genetic findings are beginning to lead to promising new drug targets and novel interventional strategies and thus have great potential to improve prevention, prediction and therapy of CHD.
Low Quality of Life and Depressive Symptoms as an Independent Risk Factor for Erectile Dysfunction in Patients with Obstructive Sleep Apnea
Authors: Jeon Yung Jin , Yoon Dae Wui , Han Doo Hee , Won Tae-Bin , Kim Dong-Young , Shin Hyun-Woo
Published: October 2015

Introduction

Accumulating evidence indicates that obstructive sleep apnea (OSA) is associated with a high prevalence of erectile dysfunction (ED), but the factors that predict the risk of ED in OSA patients have yet to be defined clearly.

Aims

The aims of the present study were to investigate the clinical characteristics of OSA patients with ED and to identify plausible predictors of ED.

Methods

The present cross-sectional analysis included 713 male patients who visited Seoul National University Hospital for snoring and/or daytime sleepiness from 2006 to 2014. An in-laboratory polysomnography procedure was conducted to obtain objective recordings of OSA and other sleep parameters.

Main Outcome Measures

The demographic data of all patients were obtained, and each patient completed all requirements of the following questionnaires: the Calgary Sleep Apnea Quality of Life Index (SAQLI), the Korean version of the International Index of Erectile Function (KIIEF-5), the Beck Depression Inventory (BDI), and the Epworth Sleepiness Scale (ESS). ED and OSA were defined as a KIIEF-5 < 21 and a respiratory disturbance index (RDI) ≥ 5, respectively. Depressive symptoms were defined as a BDI ≥ 10.

Results

The frequency of ED did not differ significantly according to OSA severity. In Spearman's correlation analysis, the BDI and the ESS were inversely correlated with the KIIEF-5, whereas the SAQLI was positively correlated with the KIIEF-5. The RDI and the lowest oxygen saturation (SaO2) did not exhibit significant correlations with the KIIEF-5. A multivariate logistic regression analysis adjusted for possible confounding factors showed that ED was independently associated with the SAQLI and depressive symptoms, but there was no significant association of ED with either the RDI or the lowest SaO2.

Conclusions

The present study demonstrated that depressive symptoms and a low quality of life specific to sleep apnea are independent risk factors for ED in OSA patients.
Hepatitis C virus seroprevalence in adults in Africa: a systematic review and meta‐analysis
Authors: Riou J. , Aït Ahmed M. , Blake A. , Vozlinsky S. , Brichler S. , Eholié S. , Boëlle P.‐Y. , Fontanet A. ,   the HCV epidemiology in Africa group
Published: October 2015

With the introduction of more efficient treatments for hepatitis C virus (HCV), improved epidemiological information is required at the country level to allow evidence‐based policymaking for elaboration of national strategies and HCV resources planning. We present a systematic review with meta‐analysis of HCV seroprevalence data in adults in African countries. We conducted a systematic review of all HCV seroprevalence estimates reported in African countries from 2000 to 2014 in MEDLINE, AJOL and grey literature. We assessed studies performed in the general population and among blood donors, pregnant women and HIV‐positive patients. A meta‐regression analysis was used to provide adjusted estimates of HCV seroprevalence in the general adult population in each country, accounting for the heterogeneity in sample age structure and population types in the included studies. We identified 775 national‐level estimations, among which 184 were included. Estimates of HCV seroprevalence were produced for 38 countries, in addition to the results from nationwide representative surveys available in Egypt and Libya. Next to Egypt, which clearly stands out, the highest levels of seroprevalence were found in Middle Africa (e.g. Cameroon, Gabon and Angola) and some West African countries (e.g. Burkina Faso, Benin), and the largest absolute numbers of infected adults were found in Nigeria, Ethiopia and Democratic Republic of Congo. This study exposes the diversity of HCV epidemiology among African countries. Egypt and several countries of West and Middle Africa present a HCV burden that will require strong governmental commitment to promote efficient preventive and curative interventions.