bluuebunny/crossref_metadata_2025 huggingface dataset:
Habitat connectivity and local conditions shape taxonomic and functional diversity of arthropods on green roofs
Authors: Braaker Sonja , Obrist Martin Karl , Ghazoul Jaboury , Moretti Marco
Published: February 2017

Increasing development of urban environments creates high pressure on green spaces with potential negative impacts on biodiversity and ecosystem services. There is growing evidence that green roofs – rooftops covered with vegetation – can contribute mitigate the loss of urban green spaces by providing new habitats for numerous arthropod species.

Whether green roofs can contribute to enhance taxonomic and functional diversity and increase connectivity across urbanized areas remains, however, largely unknown. Furthermore, only limited information is available on how environmental conditions shape green roof arthropod communities.

We investigated the community composition of arthropods (Apidae, Curculionidae, Araneae and Carabidae) on 40 green roofs and 40 green sites at ground level in the city of Zurich, Switzerland. We assessed how the site's environmental variables (such as area, height, vegetation, substrate and connectivity among sites) affect species richness and functional diversity using generalized linear models. We used an extension of co‐inertia analysis (RLQ) and fourth‐corner analysis to highlight the mechanism underlying community assemblages across taxonomic groups on green roof and ground communities.

Species richness was higher at ground‐level sites, while no difference in functional diversity was found between green roofs and ground sites. Green roof arthropod diversity increased with higher connectivity and plant species richness, irrespective of substrate depth, height and area of green roofs. The species trait analysis reviewed the mechanisms related to the environmental predictors that shape the species assemblages of the different taxa at ground and roof sites.

Our study shows the important contribution of green roofs in maintaining high functional diversity of arthropod communities across different taxonomic groups, despite their lower species richness compared with ground sites. Species communities on green roofs revealed to be characterized by specific trait assemblages. The study also provides details on the environmental conditions that influence arthropod diversity and gives new perspectives on how the design of green roofs can be improved to increase their ecological value. Furthermore, the study highlights the importance of integrating green roofs in planning policies which aim to enhance urban habitat connectivity.
A review of the predictive role of functional imaging in patients with mucosal primary head and neck cancer treated with radiation therapy
Authors: Min Myo , Lin Peter , Liney Gary , Lee Mark , Forstner Dion , Fowler Allan , Holloway Lois
Published: February 2017

Advanced radiotherapy techniques, such as intensity‐modulated radiotherapy, have been reported to reduce toxicities by improving the dose conformity in mucosal primary head and neck cancer (MPHNC). However, to further optimize the therapeutic ratio, details on individual patient and disease characteristics may be necessary to tailor treatments. This is likely to include identifying poor responders for treatment intensification and good responders for de‐escalation strategies. Non‐invasive, repeatable imaging biomarkers are attractive modalities in both pre‐treatment and intra‐treatment response prediction with a view to individualized treatment options. This review has assessed the current literature on the prognostic/predictive role of widely available functional imaging (FI) studies such as fMRI(functional magnetic resonance imaging), functional computed tomography (fCT) and positron‐emission‐tomography(PET). A literature search was carried out using Medline, Embase and PubMed. Studies were included if imaging was undertaken pre and/or during radiotherapy (with or without the addition of chemotherapy and/or surgery). A total of 99 relevant studies were identified: 14 fMRI, 10 fCT, 59 FDG‐PET and 16 non‐FDG‐PET studies. These articles were reviewed to identify imaging parameters demonstrating a correlation with patient outcome or a factor considered to impact on patient outcome and thus likely to be of potential predictive value in MPHNC and associated future radiotherapy treatment directions. Several studies have demonstrated that both pre‐treatment and mid‐treatment FDG‐PET is predictive of outcomes. However, further studies are required to confirm the role of other imaging studies including fMRI and PET using other tracers. There is large heterogeneity within and between published studies, including tumour sites, treatment options, outcome endpoints and parameters assessed. We propose a minimum set of factors that should be reported and make recommendations for studies evaluating the predictive utility in MPHNC.
A comparison of ultrasound‐guided interscalene and supraclavicular blocks for post‐operative analgesia after shoulder surgery
Authors: Kim B. G. , Han J. U. , Song J. H. , Yang C. , Lee B. W. , Baek J. S.
Published: February 2017

Background

In contrast to interscalene block, there was little information regarding the analgesic efficacy of supraclavicular block for shoulder surgery. This study aimed to compare the analgesic efficacy and side effects of interscalene and supraclavicular blocks for shoulder surgery.

Methods

Patients scheduled for shoulder surgery were assigned to receive either ultrasound‐guided interscalene (n = 25) or supraclavicular block (n = 24) with 20 ml of 0.375% ropivacaine. We assessed the duration of post‐operative analgesia as a primary outcome and pain scores, supplemental analgesia, diaphragmatic excursion, motor block, fingertip numbness, side effects, and patient satisfaction as secondary outcomes.

Results

The duration of post‐operative analgesia was not statistically different between groups: 868 (800–1440) min for supraclavicular block vs. 800 (731–922) min for interscalene block (median difference −85 min, 95% CI, −283 to 3 min, P = 0.095). The incidence of diaphragmatic paresis was significantly lower in the supraclavicular block group compared with that in the interscalene block group, both at 30 min after the block (66.7% vs. 92%, P = 0.021) and in the post‐anaesthesia care unit (62.5% vs. 92%, P = 0.024). Motor block was higher in the supraclavicular block group in the post‐anaesthesia care unit, however, not at 24 h. Other secondary outcomes were similar for both groups.

Conclusions

This study showed no statistically significant difference in the duration of post‐operative analgesia between the supraclavicular and interscalene blocks. However, the supraclavicular block was associated with a lower incidence of diaphragmatic paresis compared with that of the interscalene block after shoulder surgery.
Emergency Physician Knowledge, Attitudes, and Behavior Regarding ACEP's Choosing Wisely Recommendations: A Survey Study
Authors: Lin Michelle P. , Nguyen Thomas , Probst Marc A. , Richardson Lynne D. , Schuur Jeremiah D.
Published: February 2017

Objective

In 2013, the American College of Emergency Physicians joined the Choosing Wisely campaign; however, its impact on emergency physician behavior is unknown. We assessed knowledge, attitudes, and self‐reported behaviors regarding the Choosing Wisely recommendations.

Methods

We performed a cross‐sectional survey of emergency physicians at a national meeting. We approached 819 physicians; 765 (93.4%) completed the survey.

Results

As a result of the Choosing Wisely campaign, most respondents (64.5%) felt more comfortable discussing low‐value services with patients, 54.5% reported reducing utilization, and 52.5% were aware of local efforts to promote the campaign. A majority (62.97%) of respondents were able to identify at least four of five recommendations. The most prevalent low‐value practices were computed tomography (CT) brain for minor head injury (29.9%) and antibiotics for acute sinusitis (26.9%). Few respondents reported performing lumbar radiograph for nontraumatic low back pain (7.8%) and Foley catheter for patients who can void (5.6%). Respondents reported patient/family expectations as the most important reason for ordering antibiotics for sinusitis (68%) and imaging for low back pain (56.8%). However, concern for serious diagnosis was the most important reason for performing CT chest for patients with normal D‐dimer (49.7%) and CT abdomen for recurrent uncomplicated renal colic (42.5%). A minority (3.8% to 26.7%) of respondents identified malpractice risk as the primary reason for performing low‐value services.

Conclusions

Despite familiarity with Choosing Wisely, many emergency physicians report performing low‐value services. Primary reasons for low‐value services differ: antibiotic prescribing was driven by patient/family expectations, while concern for serious diagnosis influenced advanced diagnostic imaging. Greater efforts are needed to promote effective dissemination and implementation; such efforts may be targeted based on differing reasons for low‐value services.
Nationwide surveys show that the incidence of recurrent Kawasaki disease in Japan has hardly changed over the last 30 years
Authors: Sudo Daisuke , Nakamura Yosikazu
Published: February 2017

Aim

Since Kawasaki disease (KD) was first reported in 1967, its aetiology has been intensively investigated, but remains unclear. We investigated the incidence of recurrent KD in Japan in 2003–2012, compared with previous data from our team, and assessed the potential risk factors for disease recurrence.

Methods

Data from nationwide KD surveys were retrospectively analysed and 81 310 patients were observed. Incidence rates were compared between different years.

Results

The incidence rates for recurrent KD were 3.89 per 1000 person‐years (January 2003 to December 2012), 4.95 (July 2003 to December 2010), 6.48 (January 2003 to December 2006) and 6.51 (January 2007 to December 2010). These rates were almost consistent with our previous data, which started in the 1980s. The incidence rate for recurrence was statistically higher among males, patients under the age of three years and those who received intravenous immunoglobulin or steroid therapy at the initial episode. The presence of cardiac sequelae during the initial episode did not affect the recurrence incidence.

Conclusion

Although the incidence of KD has increased, the incidence of recurrent KD has remained largely unchanged over the past 30 years. Risk factors for recurrence included male sex, young age and initial resistance to immunoglobulin therapy.
Liver fibrosis diagnosis by blood test and elastography in chronic hepatitis C: agreement or combination?
Authors: Calès P. , Boursier J. , Lebigot J. , de Ledinghen V. , Aubé C. , Hubert I. , Oberti F.
Published: February 2017

Background

In chronic hepatitis C, the European Association for the Study of the Liver and the Asociacion Latinoamericana para el Estudio del Higado recommend performing transient elastography plus a blood test to diagnose significant fibrosis; test concordance confirms the diagnosis.

Aim

To validate this rule and improve it by combining a blood test, FibroMeter (virus second generation, Echosens, Paris, France) and transient elastography (constitutive tests) into a single combined test, as suggested by the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America.

Methods

A total of 1199 patients were included in an exploratory set (HCV, n = 679) or in two validation sets (HCV ± HIV, HBV, n = 520). Accuracy was mainly evaluated by correct diagnosis rate for severe fibrosis (pathological Metavir F ≥ 3, primary outcome) by classical test scores or a fibrosis classification, reflecting Metavir staging, as a function of test concordance.

Results

Score accuracy: there were no significant differences between the blood test (75.7%), elastography (79.1%) and the combined test (79.4%) (P = 0.066); the score accuracy of each test was significantly (P < 0.001) decreased in discordant vs. concordant tests. Classification accuracy: combined test accuracy (91.7%) was significantly (P < 0.001) increased vs. the blood test (84.1%) and elastography (88.2%); accuracy of each constitutive test was significantly (P < 0.001) decreased in discordant vs. concordant tests but not with combined test: 89.0 vs. 92.7% (P = 0.118). Multivariate analysis for accuracy showed an interaction between concordance and fibrosis level: in the 1% of patients with full classification discordance and severe fibrosis, non‐invasive tests were unreliable. The advantage of combined test classification was confirmed in the validation sets.

Conclusions

The concordance recommendation is validated. A combined test, expressed in classification instead of score, improves this rule and validates the recommendation of a combined test, avoiding 99% of biopsies, and offering precise staging.
Dose de‐escalation to adalimumab 40 mg every 3 weeks in patients with Crohn's disease – a nested case–control study
Authors: Van Steenbergen S. , Bian S. , Vermeire S. , Van Assche G. , Gils A. , Ferrante M.
Published: February 2017

Summary

Background

Data on dose de‐escalation in patients with Crohn's disease (CD) are limited.

Aim

To evaluate outcomes of dose de‐escalation from adalimumab (ADM) every other week (EOW) to every three weeks (ETW).

Methods

We selected patients with CD receiving maintenance therapy with ADM 40 mg ETW with serum levels (SL) available before and after dose de‐escalation. Sex‐ and age‐matched controls continuing ADM 40 mg EOW were identified. Patient reported outcome, C‐reactive protein (CRP) and serum albumin were collected.

Results

Out of 898 patients, we identified 40 (11 male, median 37 years) who de‐escalated to ADM 40 mg ETW for ADM‐related adverse events (AE, n = 1), ADM SL >7 μg/mL (n = 8), or both (n = 31). Compared to controls, ADM SL dropped significantly within 4 months, without associated clinical or biochemical changes. In 53% of patients, dose de‐escalation was associated with disappearance of AE (8/16 skin manifestation, 3/6 arthralgia, 5/7 frequent infectious episodes). During a median follow‐up of 24 months, 65% of patients maintained clinical response, but 35% needed dose escalation back to ADM 40 mg EOW because of clinical relapse (n = 8), ADM SL <4 μg/mL (n = 2), or both (n = 4). CRP <3.5 mg/L at dose de‐escalation was independently associated with dose escalation‐free survival [odds ratio 6.28 (95% CI 1.83–21.59), P = 0.004]. We could not define a minimal ADM SL to consider or maintain dose de‐escalation.

Conclusions

Overall, 65% of patients who de‐escalated to adalimumab 40 mg every 3 weeks remained in clinical remission for a median of 24 months. In 53% of patients, adalimumab‐related adverse events disappeared after dose de‐escalation. Regardless of adalimumab SL, disease remission should be assessed objectively prior to dose de‐escalation.
Odense Pharmacoepidemiological Database: A Review of Use and Content
Authors: Hallas Jesper , Hellfritzsch Maja , Rix Morten , Olesen Morten , Reilev Mette , Pottegård Anton
Published: February 2017

The Odense University Pharmacoepidemiological Database (OPED) is a prescription database established in 1990 by the University of Southern Denmark, covering reimbursed prescriptions from the county of Funen in Denmark and the region of Southern Denmark (1.2 million inhabitants). It is still active and thereby has more than 25 years of continuous coverage. In this MiniReview, we review its history, content, quality, coverage, governance and some of its uses. OPED's data include the Danish Civil Registration Number (CPR), which enables unambiguous linkage with virtually all other health‐related registers in Denmark. Among its research uses, we review record linkage studies of drug effects, advanced drug utilization studies, some examples of method development and use of OPED as sampling frame to recruit patients for field studies or clinical trials. With the advent of other, more comprehensive sources of prescription data in Denmark, OPED may still play a role as in certain data‐intensive regional studies.
Impact of senescence‐associated secretory phenotype and its potential as a therapeutic target for senescence‐associated diseases
Authors: Watanabe Sugiko , Kawamoto Shimpei , Ohtani Naoko , Hara Eiji
Published: February 2017

“Cellular senescence” is a state in which cells undergo irreversible cell cycle arrest in response to a variety of cellular stresses. Once cells senesce, they are strongly resistant to any mitogens, including oncogenic stimuli. Therefore, cellular senescence has been assumed to be a potent anticancer mechanism. Although irreversible cell‐cycle arrest is traditionally considered the major characteristic of senescent cells, recent studies have revealed some additional functions. Most noteworthy is the increased secretion of various secretory proteins, such as inflammatory cytokines, chemokines, growth factors, and MMPs, into the surrounding extracellular fluid. These newly recognized senescent phenotypes, termed senescence‐associated secretory phenotypes (SASPs), reportedly contribute to tumor suppression, wound healing, embryonic development, and even tumorigenesis promotion. Thus, SASPs appear to be beneficial or deleterious, depending on the biological context. As senescent cells are known to accumulate during the aging process in vivo, it is quite possible that their accumulation in aged tissues promotes age‐associated functional decline and various diseases, including cancers, at least to some extent. Here, we focus on and discuss the functional and regulatory network of SASPs toward opening up new possibilities for controlling aging and aging‐associated diseases.
Identification of proteasomal catalytic subunit PSMA6 as a therapeutic target for lung cancer
Authors: Kakumu Tomohiko , Sato Mitsuo , Goto Daiki , Kato Toshio , Yogo Naoyuki , Hase Tetsunari , Morise Masahiro , Fukui Takayuki , Yokoi Kohei , Sekido Yoshitaka , Girard Luc , Minna John D. , Byers Lauren A. , Heymach John V. , Coombes Kevin R. , Kondo Masashi , Hasegawa Yoshinori
Published: February 2017

To identify potential therapeutic targets for lung cancer, we performed semi‐genome‐wide shRNA screening combined with the utilization of genome‐wide expression and copy number data. shRNA screening targeting 5043 genes in NCI‐H460 identified 51 genes as candidates. Pathway analysis revealed that the 51 genes were enriched for the five pathways, including ribosome, proteasome, RNA polymerase, pyrimidine metabolism and spliceosome pathways. We focused on the proteasome pathway that involved six candidate genes because its activation has been demonstrated in diverse human malignancies, including lung cancer. Microarray expression and array CGH data showed that PSMA6, a proteasomal subunit of a 20S catalytic core complex, was highly expressed in lung cancer cell lines, with recurrent gene amplifications in some cases. Therefore, we further examined the roles of PSMA6 in lung cancer. Silencing of PSMA6 induced apoptosis or G2/M cell cycle arrest in cancer cell lines but not in an immortalized normal lung cell line. These results suggested that PSMA6 serves as an attractive target with a high therapeutic index for lung cancer.
SOX2 is required to maintain cancer stem cells in ovarian cancer
Authors: Wen Yiping , Hou Yaya , Huang Zaiju , Cai Jing , Wang Zehua
Published: February 2017

Ovarian cancer cells can form spheroids under serum‐free suspension culture conditions. The spheroids, which are enriched in cancer stem cells, can result in tumor dissemination and relapse. To identify new targetable molecules in ovarian cancer spheroids, we investigated the differential expression of genes in spheroids compared with that under monolayer culture conditions by qPCR microarray. We identified that SOX2 is overexpressed in spheroids. We then proved that SOX2 expression was increased in successive spheroid generations. Besides, knockdown of SOX2 expression in SKOV3 or HO8910 ovarian cancer spheroid cells decreased spheroid formation, cell proliferation, cell migration, resistance to Cisplatin treatment, tumorigenicity, and the expression of stemness‐related genes and epithelial to mesenchymal transition‐related genes, whereas overexpression of SOX2 in SKOV3 or HO8910 ovarian cancer cells showed the opposite effects. In addition, we found that SOX2 expression was closely associated with chemo‐resistance and poor prognosis in EOC patients. These results strongly suggest that SOX2 is required to maintain cancer stem cells in ovarian cancer. Targeting SOX2 in ovarian cancer may be therapeutically beneficial.
Controlled release of an endostatin peptide using chitosan nanoparticles
Authors: Ebrahimi Samani Sanaz , Seraj Zahra , Naderimanesh Hossein , Khajeh Khosro , Esmaeili Rastaghi Ahmad Reza , Droudi Taher , Kolivand Peirhosein , Kazemi Hadi , Asghari S. Mohsen
Published: February 2017

Whereas several anticancer peptides are in different stages of clinical development, their administration is limited by the fast elimination from the systemic circulation. Peptide loading on nano‐carriers can pave the way for their future application. We have recently indicated that a disulfide loop rather than a Zn‐binding loop improves the anti‐angiogenic and antitumor activities of the N‐terminal fragment of endostatin. In this study, chitosan nanoparticles (CS NPs) are used for the controlled release of the engineered peptide. Loading of the peptide into CS NPs using the ionic gelation method was confirmed by FTIR and resulted in final particle size, poly‐dispersity index and surface charge of 186.5 ± 24.0 nm, 0.26 ± 0.02 and 20.1 ± 0.4 mV respectively. The SEM morphological analysis revealed spherical particles with an average size of 80 ± 5 nm. Peptide loading studies revealed that CS NPs are able to adsorb the peptide as ~70%. The release measurements indicated an initial burst release by 49% after 2 hr and complete release after 80 hr. According to in vitro studies, the loaded peptide was much more toxic for endothelial cells than different cancer cell lines. These results underscore the promise of CS NPs as therapeutics nanosystems and open a perspective for improving the clinical applications of peptide drugs.
The Child of the Common: Governing Children in the Freetown Christiania, Denmark
Authors: Wasshede Cathrin
Published: February 2017

Children in the intentional community of Christiania, Denmark, are seen as belonging to a flock. They experience a relatively high degree of freedom and autonomy as well as collective supervision/control. Departing from Foucault's conceptualisation of pastoral power and interviews conducted in Christiania, this article explores what the idea of the child as belonging to the common/collective may imply for the governance of children. A unique combination of freedom and supervision, individualism and collectivism, results in a form of responsibilisation that aims to strengthen the community, unlike neo‐liberal responsibilisation, which leaves the individual alone with the freedom to take care of herself.
Peri‐implant bleeding on probing: a cross‐sectional multilevel analysis of associated factors
Authors: Merli Mauro , Bernardelli Francesco , Giulianelli Erica , Toselli Ivano , Mariotti Giorgia , Nieri Michele
Published: February 2017

Objectives

The objective was to evaluate the association between peri‐implant bleeding on probing (BoP) and probing depth. Other factors regarding patients, implants, and sites were taken into consideration.

Material and methods

Consecutive adult patients with ≥1 dental implant were eligible. Two calibrated operators examined the patients. BoP was the outcome variable. The effects of patient, implant and site factors on BoP were assessed using a 3‐level logistic model.

Results

Fifty‐two patients for a total of 92 implants and 552 sites were included in the analysis. The BoP was observed in 217 sites (39%). The odds ratio increased by 1.81 (95% CI from 1.47 to 2.23; P < 0.0001) for each 1 mm increment in probing pocket depth. A significant higher risk was observed also for interproximal vs. approximal surfaces (OR = 1.55; 95% CI from 1.02 to 2.36; P = 0.0402).

Conclusions

Peri‐implant bleeding was associated with site‐specific factors.
Recombinant bone morphogenetic protein‐2 and platelet‐derived growth factor‐BB for localized bone regeneration. Histologic and radiographic outcomes of a rabbit study
Authors: Thoma Daniel S. , Lim Hyun‐Chang , Sapata Vitor M. , Yoon Sora R. , Jung Ronald E. , Jung Ui‐Won
Published: February 2017

Objectives

Improvement in localized bone regeneration is needed to avoid the use of autogenous tissue. For that purpose, the use biologic mediators was proposed. The aim was to test whether or not one of two biologic mediators, recombinant human bone morphogenetic protein‐2 (rhBMP‐2) or recombinant platelet‐derived growth factor (rhPDGF‐BB), is superior to the other and to control groups for localized bone regeneration.

Materials and Methods

Four cylinders (height: 5 mm; diameter: 7 mm) were screwed on the parietal and frontal bones at the cranium in 12 rabbits. The cylinders either received (i) deproteinized bovine bone mineral (DBBM) mixed rhBMP‐2 (DBBM/BMP‐2), (ii) DBBM mixed with rhPDGF‐BB (DBBM/PDGF), (iii) DBBM (DBBM), and (iv) empty control (control). Rabbits were euthanized at 2 and 8 weeks (n = 6, respectively). Conventional histomorphometric and micro‐CT analyses were performed. Parametric linear mixed models were applied for the analyses with Bonferroni correction for the multiple group comparisons.

Results

The area of bone regeneration (histology; AAHisto) at 2 weeks peaked for DBBM (41.91%) with statistically significantly greater values compared to DBBM/PDGF and the control group (P < 0.05). At 8 weeks, mean AAHisto values were 96.29% (DBBM/BMP‐2), 46.37% (DBBM/PDFG), 39.66% (DBBM), and 35.98% (control) (DBBM/BMP‐2 vs. all groups (P < 0.05)). At 8 weeks, bone regeneration was greatest for DBBM/BMP‐2 (35.62%) with statistically significant differences compared to all other groups (P < 0.05). The area of bone regeneration (micro‐CT; AAm‐CT) at 2 weeks amounted to 43.87% (DBBM/BMP‐2), 42.81% (DBBM/PDFG), 48.71% (DBBM), and 0.96% (control). The control group demonstrated statistically significantly less AAm‐CT compared to all groups (P < 0.05). At 8 weeks, mean AAm‐CT values were 63.65% (DBBM/BMP‐2), 50.21% (DBBM/PDFG), 44.81% (DBBM), and 4.57% (control) (P > 0.05).

Conclusions

The use of rhBMP‐2 significantly enhanced bone regeneration compared to all other groups including the group with rhPDGF‐BB.
The association of admission hyperglycaemia and adverse clinical outcome in medical emergencies: the multinational, prospective, observational TRIAGE study
Authors: Kutz A. , Struja T. , Hausfater P. , Amin D. , Amin A. , Haubitz S. , Bernard M. , Huber A. , Mueller B. , Schuetz P. ,   the TRIAGE study group
Published: February 2017

Aims

The clinical relevance of hyperglycaemia in an emergency department population remains incompletely understood. We investigated the association between admission blood glucose levels and adverse clinical outcomes in a large emergency department cohort.

Methods

We prospectively enrolled 7132 adult medical patients seeking emergency department care in three tertiary care hospitals in Switzerland, France and the USA. We used adjusted multivariable logistic regression models to examine the association between admission blood glucose levels and 30‐day mortality, as well as adverse clinical course stratified by pre‐existing diabetes and principal medical diagnoses.

Results

In 6044 people without diabetes (84.7%), severe hyperglycaemia, defined as a glucose level of > 11.1 mmol/l (200 mg/dl), was associated with a doubling in the risk of 30‐day mortality [adjusted odds ratio (OR) 1.9; 95% confidence interval (95% CI), 1.1 to 3.3; P = 0.018] and a three‐fold increase in the risk of intensive care unit admission (adjusted OR 3.0; 95% CI, 1.9 to 4.9; P < 0.001). These associations were similar among different diagnoses. In the population with diabetes (n = 1088), no association with 30‐day mortality was found (adjusted OR 1.0; 95% CI, 0.6 to 1.8; P for interaction = 0.001), whereas the association with intensive care unit admission was weaker (adjusted OR 2.4; 95% CI, 1.5 to 4.1; P for interaction = 0.011). Overall 30‐day mortality was higher in those with diabetes than in those without (6.1 vs. 4.4%, P = 0.015).

Conclusions

In this large medical emergency department patient cohort, admission hyperglycaemia was strongly associated with adverse clinical course in people without diabetes. (Clinical Trial Registry No: NCT01768494)
Impact of neighbourhood‐level inequity on paediatric diabetes care
Authors: Clarke A. B. M. , Daneman D. , Curtis J. R. , Mahmud F. H.
Published: February 2017

Aims

To evaluate the association between neighbourhood‐level inequity and glycaemic control in paediatric participants with Type 1 diabetes using the Neighbourhood Equity Index (NEI).

Methods

The NEI was linked to the clinical data of 519 children with diabetes followed at the Hospital for Sick Children (Toronto, Canada). The NEI is a composite measure of inequity developed using the World Health Organization's Urban Health Equity Assessment and Response Tool (HEART), which encompasses 15 weighted indicators evaluating economic, social, environmental and lifestyle factors. The geographic distribution of participants was determined using postal codes, and the relationship between HbA1c and NEI was evaluated using regression and spatial analysis techniques.

Results

Participants’ mean HbA1c was significantly correlated with NEI (R = −0.24, P < 0.0001). Regression analysis demonstrated that NEI was a strong predictor of mean HbA1c (P < 0.0001), accounting for differences in HbA1c as large as 1.0% (11 mmol/mol) when controlled for age, sex, diabetes duration, insulin pump therapy and number of annual clinic visits. Geo‐mapping using spatial scan testing revealed the presence of two clusters of low‐equity neighbourhoods containing 3.22 (P = 0.001) and 2.83 (P = 0.02) times more participants with HbA1c ≥ 9.5% (80 mmol/mol) than expected.

Conclusions

Our findings demonstrated that NEI was a significant predictor of HbA1c in our clinic population and a useful tool for investigating spatial trends related to inequities in health, providing evidence that a composite, area‐based measure of overall inequity is well suited to the study of glycaemic control in urban paediatric Type 1 diabetes populations.
Left ventricular diastolic dysfunction in patients with chronic obstructive pulmonary disease: Impact of methods of assessment
Authors: Farouk Heba , Albasmi Maged , El Chilali Karim , Mahmoud Kareem , Nasr Abdo , Heshmat Hussein , Abdel‐Moneim Samah , Baligh Essam
Published: February 2017

Background

The prevalence of left ventricular (LV) diastolic dysfunction in patients with chronic obstructive pulmonary disease (COPD), using different echocardiographic parameters, varies widely in the literature. The highest prevalence of LV diastolic dysfunction was detected using the mitral inflow indexes that are commonly altered in these patients due to the associated tachycardia, reduced preload, and ventricular septal shift. In this study, we aimed at evaluating the impact of the used echocardiographic method of assessment on the prevalence of LV diastolic dysfunction in patients with COPD and normal LV systolic function.

Methods

We studied 35 patients with COPD and 18 age‐matched controls. A comprehensive approach to diagnose and grade the LV diastolic dysfunction was performed in accordance with the recommendations of the American Society of Echocardiography published in 2009. The results were compared with those of mitral inflow indexes.

Results

LV diastolic dysfunction was reported in 20 patients using the mitral inflow indexes while in only 12 patients using the comprehensive approach (P=.021). Compared to the controls, LV diastolic dysfunction was significantly more common in patients using the mitral inflow indexes (P=.001), while no statistically significant difference was detected between both groups using the comprehensive approach (P=.1).

Conclusion

The prevalence of LV diastolic dysfunction in patients with COPD varies according to the used echocardiographic approach. Further studies are recommended to determine which approach is the most accurate in estimating the true prevalence of LV diastolic dysfunction among this group of patients.
Assessment of myocardial ischemia by strain dobutamine stress echocardiography and cardiac magnetic resonance perfusion imaging before and after coronary artery bypass grafting
Authors: Rösner Assami , Schirmer Henrik , Iqbal Amjid , Bijnens Bart , Avenarius Derk , Malm Siri
Published: February 2017

Background

Following coronary artery bypass grafting (CABG), testing for myocardial ischemia by noninvasive imaging is often hampered by false‐positive results. The aim of this study was to find test parameters with the best potential to identify myocardial ischemia in post‐CABG patients.

Methods

Fifty‐two consecutive patients scheduled for CABG, underwent both dobutamine stress echocardiography (DSE) and cardiac magnetic resonance first‐pass perfusion imaging (CMR‐FPPI) with adenosine vasodilation, before and 8–10 months after the surgical revascularization. A pathologic biphasic stress response (PBR) expresses the presence of contractile reserve during low‐dose dobutamine that decreases to hypo‐ or akinesia provoked by high‐dose dobutamine. During DSE, potential PBR, segmental wall‐motion score (WMS) as well as peak‐systolic longitudinal strain (PLS) at peak‐dose dobutamine were assessed.

Results

Post‐CABG, there was still a relatively high prevalence of ischemia‐positive segments evaluated by deformation imaging, but the number of such segments was significantly lower by PBR (20% and 22%) compared with peak‐dose strain and WMS (62% and 77%, respectively; P<.05). The use of PBR instead of peak‐dose WMS and strain could reduce the number of false‐positive test results post‐CABG.

Conclusion

Among all imaging modalities tested, PBR by WMS and strain may be useful parameters for identifying patients with the need for new revascularization. We furthermore found that DSE may be interpreted as positive when revealing at least three ischemia‐positive segments. The sensitivity of these test modalities for detecting coronary restenosis needs to be determined in further studies on a cohort of symptomatic post‐CABG patients.
Heterozygous truncation mutations of the SMC1A gene cause a severe early onset epilepsy with cluster seizures in females: Detailed phenotyping of 10 new cases
Authors: Symonds Joseph D. , Joss Shelagh , Metcalfe Kay A. , Somarathi Suresh , Cruden Jamie , Devlin Anita M. , Donaldson Alan , DiDonato Nataliya , Fitzpatrick David , Kaiser Frank J. , Lampe Anne K. , Lees Melissa M. , McLellan Ailsa , Montgomery Tara , Mundada Vivek , Nairn Lesley , Sarkar Ajoy , Schallner Jens , Pozojevic Jelena , Parenti Ilaria , Tan Jeen , Turnpenny Peter , Whitehouse William P. ,   The DDD Study, Zuberi Sameer M.
Published: February 2017

Objective

The phenotype of seizure clustering with febrile illnesses in infancy/early childhood is well recognized. To date the only genetic epilepsy consistently associated with this phenotype is PCDH19, an X‐linked disorder restricted to females, and males with mosaicism. The SMC1A gene, which encodes a structural component of the cohesin complex is also located on the X chromosome. Missense variants and small in‐frame deletions of SMC1A cause approximately 5% of Cornelia de Lange Syndrome (CdLS). Recently, protein truncating mutations in SMC1A have been reported in five females, all of whom have been affected by a drug‐resistant epilepsy, and severe developmental impairment. Our objective was to further delineate the phenotype of SMC1A truncation.

Method

Female cases with de novo truncation mutations in SMC1A were identified from the Deciphering Developmental Disorders (DDD) study (n = 8), from postmortem testing of an affected twin (n = 1), and from clinical testing with an epilepsy gene panel (n = 1). Detailed information on the phenotype in each case was obtained.

Results

Ten cases with heterozygous de novo mutations in the SMC1A gene are presented. All 10 mutations identified are predicted to result in premature truncation of the SMC1A protein. All cases are female, and none had a clinical diagnosis of CdLS. They presented with onset of epileptic seizures between <4 weeks and 28 months of age. In the majority of cases, a marked preponderance for seizures to occur in clusters was noted. Seizure clusters were associated with developmental regression. Moderate or severe developmental impairment was apparent in all cases.

Significance

Truncation mutations in SMC1A cause a severe epilepsy phenotype with cluster seizures in females. These mutations are likely to be nonviable in males.
Genomic patterns of diversity and divergence of two introduced salmonid species in Patagonia, South America
Authors: Narum Shawn R. , Gallardo Pablo , Correa Cristian , Matala Amanda , Hasselman Daniel , Sutherland Ben J. G. , Bernatchez Louis
Published: February 2017

Invasive species have become widespread in aquatic environments throughout the world, yet there are few studies that have examined genomic variation of multiple introduced species in newly colonized environments. In this study, we contrast genomic variation in two salmonid species (anadromous Chinook Salmon, Oncorhynchus tshawytscha, 11,579 SNPs and resident Brook Charr Salvelinus fontinalis, 13,522 SNPs) with differing invasion success after introduction to new environments in South America relative to populations from their native range in North America. Estimates of genetic diversity were not significantly different between introduced and source populations for either species, indicative of propagule pressure that has been shown to maintain diversity in founding populations relative to their native range. Introduced populations also demonstrated higher connectivity and gene flow than those in their native range. Evidence for candidate loci under divergent selection was observed, but was limited to specific introduced populations and was not widely evident. Patterns of genomic variation were consistent with general dispersal potential of each species and therefore also the notion that life history variation may contribute to both invasion success and subsequent genetic structure of these two salmonids in Patagonia.
Landscape‐scale life‐history gradients in New Zealand freshwater fish
Authors: Jones Peter E. , Augspurger Jason , Closs Gerard P.
Published: February 2017

Landscape‐scale clines in environmental parameters can lead to life‐history gradients. Study of interspecific life‐history differences can provide evidence of evolutionary adaptations in response to environmental cues, whereas examination of intraspecific life‐history variation can identify the ecological mechanisms driving trait evolution.

We examined egg size and fecundity variation in three species of closely related freshwater fish (Galaxiidae) which occur across a habitat gradient in South Island, New Zealand. Inter‐population trait variation was assessed in the species with the widest distribution to investigate the ecological mechanisms driving egg size evolution.

Substantial interspecific egg size and fecundity differences were observed. Galaxias paucispondylus, which generally occurs in high altitude headwater streams, showed an average egg size an order of magnitude larger, and fecundity an order of magnitude lower than G. brevipinnis, a species which rears in pelagic environments. Galaxias vulgaris, which rears fluvial environments but is generally distributed in lower catchment reaches than G. paucispondylus, showed intermediate fecundity and egg size traits. This interspecific trait variation is likely to be driven by differences in the larval rearing habitat, i.e. rearing in cold high altitude locations requires large well‐developed larvae (and therefore large eggs) but these come at the cost of maternal fecundity, whereas in rearing in warmer lower catchment watercourses, and pelagic habitats, does not require such large well‐developed larvae. Hence, fitness is maximised by progressively increasing fecundity by reducing egg size across this habitat cline.

Life history‐habitat trends were repeated when intraspecific patterns in the widely distributed G. vulgaris were assessed, with population egg size increasing, and fecundity decreasing, in relation to a suite of interrelated environmental variables up an approximate altitudinal cline.

The results highlight how inter‐ and intraspecific variation in egg size–fecundity trade‐offs in closely related species can interact to drive the evolution of landscape‐scale life‐history gradients. Egg size differences are likely to be driven by differences in the quality of the larval rearing habitat, i.e. rearing in a challenging habitat requires a larger egg whereas in relatively benign larval rearing habitat, fecundity can be maximised by reducing egg size. The interspecific variation observed provides evidence of trait adaptation in response to an environmental cue, while the intraspecific inter‐population differences indicate the potential ecological mechanisms driving trait evolution.
Transport biofuels in global energy–economy modelling – a review of comprehensive energy systems assessment approaches
Authors: Ahlgren Erik O. , Börjesson Hagberg Martin , Grahn Maria
Published: February 2017

The high oil dependence and the growth of energy use in the transport sector have increased the interest in alternative nonfossil fuels as a measure to mitigate climate change and improve energy security. More ambitious energy and environmental targets and larger use of nonfossil energy in the transport sector increase energy–transport interactions and system effects over sector boundaries. While the stationary energy sector (e.g., electricity and heat generation) and the transport sector earlier to large degree could be considered as separate systems with limited interaction, integrated analysis approaches and assessments of energy–transport interactions now grow in importance. In recent years, the scientific literature has presented an increasing number of global energy–economy future studies based on systems modelling treating the transport sector as an integral part of the overall energy system and/or economy. Many of these studies provide important insights regarding transport biofuels. To clarify similarities and differences in approaches and results, the present work reviews studies on transport biofuels in global energy–economy modelling and investigates what future role comprehensive global energy–economy modelling studies portray for transport biofuels in terms of their potential and competitiveness. The results vary widely between the studies, but the resulting transport biofuel market shares are mainly below 40% during the entire time periods analysed. Some of the reviewed studies show higher transport biofuel market shares in the medium (15–30 years) than in the long term (above 30 years), and, in the long‐term models, at the end of the modelling horizon, transport biofuels are often substituted by electric and hydrogen cars.
Mining the global diversity for bioenergy traits of barley straw: genomewide association study under varying plant water status
Authors: Naz Ali A. , Reinert Stephan , Bostanci Cihan , Seperi Bahare , Leon Jens , Böttger Christian , Südekum Karl‐Heinz , Frei Michael
Published: February 2017

Cereal straws constitute a considerable source of biomass that can be used for bioenergy applications. Its composition is crucial for the energy value in biological or thermochemical conversion processes. Therefore, this study aimed at (i) exploring the global diversity in the composition of barley (Hordeum vulgare L.) straw; (ii) testing the effect of drought on straw composition; (iii) correlating compositional traits with energy value; and (iv) identifying loci associated with straw composition through genomewide association study (GWAS). A population of 179 barley accessions was grown in control and drought conditions, and straw was analyzed for thioglycolic acid lignin (TGAL), total phenolics (TP), carbon, crude protein (CP), C/N ratio, and ash. Substantial variability was observed in all traits. Moreover, drought treatment affected all traits leading to significant decreases in carbon, CP, ash, TGAL and TP concentrations, and a significant increase in C/N ratio. In vitro incubations in rumen fluid were used to estimate the energy value in biological energy conversion, while calorimetry was used to estimate the energy yield in thermochemical energy conversion. Thioglycolic acid lignin was singled out as the most influential trait determining energy value, as it was negatively correlated with the digestibility of organic matter and metabolizable energy in in vitro incubations, but positively correlated with gross energy measured by calorimetry. The GWAS yielded four loci significantly associated with TGAL irrespective of plant water status, which explained between 22.5% and 38.7% of the phenotypic variation. In addition, three loci significantly affected the response of TGAL to plant water status, and explained between 11.2% and 16.6% of the phenotypic variation. These loci contained plausible candidate genes that could be associated with lignin biosynthesis based on their annotations. In conclusion, this study illustrated great potential for the molecular breeding of barley varieties with enhanced straw quality for bioenergy applications.
GNAS mutations are present in colorectal traditional serrated adenomas, serrated tubulovillous adenomas and serrated adenocarcinomas with adverse prognostic features
Authors: Liu Cheng , McKeone Diane M , Walker Neal I , Bettington Mark L , Leggett Barbara A , Whitehall Vicki L J
Published: February 2017

Aims

Activating mutations in GNAS are important in the development of a range of neoplasms, including a small proportion of conventional adenomas and colorectal carcinomas (CRCs). However, their contribution to serrated pathway neoplasia is unclear, as mutations have only been examined in small series of sessile serrated adenomas (SSAs) and traditional serrated adenomas (TSAs), and not in serrated tubulovillous adenomas (sTVAs). The aim of this study was to investigate the frequency and significance of GNAS mutations in colorectal adenomas and CRCs.

Methods and results

Using a large, well‐characterized series, we identified GNAS mutations in 9.2% (18 of 196) of TSAs, 7.1% (four of 56) of sTVAs and 2.0% (nine of 459) of CRCs. Mutations were absent in SSAs (none of 43), tubular adenomas (none of 50) and conventional tubulovillous adenomas (none of 50). A BRAF or KRAS mutation was seen in 77.4% of GNAS mutant lesions, suggesting a synergistic effect with the mitogen‐activated protein kinase pathway. In CRCs, GNAS mutations were associated with mucinous differentiation and serrated morphological features.

Conclusions

GNAS mutations contribute significantly to the development of a subset of serrated adenomas and CRCs.