bluuebunny/crossref_metadata_2025 huggingface dataset:
Utility of the combination of simple electrocardiographic parameters for identifying mid‐septal pacing
Authors: Matsuo Masanori , Shimeno Kenji , Yoshiyama Tomotaka , Matsumura Yoshiki , Matsumoto Ryo , Abe Yukio , Naruko Takahiko , Yoshiyama Minoru
Published: September 2019

Introduction

The electrocardiograms (ECG) criteria to anchor the lead to the right ventricular septum have not been established. This study aimed to identify ECG criteria of pacing at the right ventricular mid septum (RVMS) and investigate whether the paced QRS duration (pQRSd) from the RVMS was narrow.

Methods and results

In 42 patients, ECG pacing at the basal anterior wall (BA), mid‐anterior wall (MA), apex (AP), and mid septum (MS) was recorded. The pacing sites were validated by using right ventriculography and computed tomography. We estimated the ECG parameters and compared them among the four pacing sites. The combination of simple four paced‐ECG parameters could reliably confirm the pacing at the RVMS. The area under the receiver‐operating characteristics curve for the number of positive findings among the following: (a) positive QRS in lead aVL, (b) QRS notching in lead I, (c) precordial leads transition at less than V5, and (d) presence of isoelectric QRS in the inferior leads was 0.95 (95% confidence interval, 0.91‐0.98) and the number of positive findings (≥3) had a sensitivity of 83.3% and a specificity of 93.7% for discriminating MS from the other sites. The pQRSd with three or more positive findings was significantly narrower than that with less than three positive findings (≥3: 137.4 ± 9.2 ms, <3: 151.8 ± 13.1 ms, P ≤ .05).

Conclusion

The combination of ECG parameters can help identify right ventricular mid‐septal pacing. The use of these parameters may enable the implantation of the pacing lead in the RVMS accurately and obtain a narrower QRS duration.
Physicians’ perceptions of shared decision‐making for implantable cardioverter‐defibrillators: Results of a physician survey
Authors: Ali‐Ahmed Fatima , Matlock Daniel , Zeitler Emily P. , Thomas Kevin L. , Haines David E. , Al‐Khatib Sana M.
Published: September 2019

Background

Centers for Medicare and Medicaid Services has mandated the use of shared decision‐making (SDM) for implantable cardioverter‐defibrillator (ICD) implantation. SDM tools help facilitate quality SDM by presenting patients with balanced evidence‐based facts related to risk and benefits. Perceptions of ICD implantation may differ based on patients’ sex and race.

Objective

To determine if and how physicians are incorporating SDM in counseling patients about ICD and if they are aware of sex‐ and race‐based differences in patients’ perception of ICDs.

Methods

This was a pilot study involving an online survey targeting attending physicians who implant ICDs. Physicians were randomly selected by a computer‐based program; 350 surveys were sent.

Results

Of the 124 (35%) respondents to the survey, 102 (84%) met the inclusion criteria, and of those, 99 (97%) were adult electrophysiologists. Most physicians (90, 88%) stated they engaged in SDM during the general consent process. Sixty‐three (62%) physicians discuss end of life issues while obtaining general consent. Forty‐four (43%) physicians said they use an existing SDM tool with the Colorado SDM tool being the most common (39, 89%). The majority of physicians were unaware of sex‐ and race‐based differences in perceptions related to ICD implantation (sex 64, 63% and race 63, 62%).

Conclusion

A vast majority of physicians are engaging in SDM; however less than half are using a formal SDM tool, and a minority of physicians were aware of sex‐ and race‐based differences in patients’ perception of ICD implantation. Sex‐ and race‐based tools might help address this gap.
Gastroesophageal reflux disease and atrial fibrillation: Insight from autonomic cardiogastric neural interaction
Authors: Huang Ting‐Chun , Lo Li‐Wei , Yamada Shinya , Chou Yu‐Hui , Lin Wei‐Lun , Chang Shih‐Lin , Lin Yenn‐Jiang , Liu Shin‐Huei , Cheng Wen‐Han , Tsai Tsung‐Ying , Liu Ping‐Yen , Chen Shih‐Ann
Published: September 2019

Background

The relationship between gastroesophageal reflux disease (GERD) and atrial fibrillation (AF) has been previously reported. However, the detailed mechanism remains unknown. In this study, we investigated the effects of acid reflux on the intrinsic cardiac autonomic nervous system, atrial/ventricular electrophysiology, and AF inducibility.

Methods

Eighteen rabbits were randomized into three groups: acid reflux (group 1, n = 6), control (group 2, n = 6), and acid reflux with periesophageal vagal blockade (group 3, n = 6). Atrial and ventricular effective refractory periods (ERPs) and AF inducibility were checked at baseline and then hourly until 5 hours after the experiment.

Results

Three hours after the experiment, atrial ERP prolongation was noted in groups 2 and 3 (P < .05), whereas shortening of the atrial ERPs was observed in group 1, compared with the baseline. However, no changes were observed in ventricular ERPs in the three groups. The AF inducibility was higher in group 1 than in groups 2 and 3. Pathological examination showed clear esophageal mucosal breaks in groups 1 and 3.

Conclusions

In this study, we found that the antimuscarinic blockade prevents GERD induced changes to atrial electrophysiology and susceptibility to AF—making it highly likely that autonomic activity is important in mediating this effect.
Free thyroxine within the normal reference range predicts risk of atrial fibrillation
Authors: Anderson Jeffrey L. , Jacobs Victoria , May Heidi T. , Bair Tami L. , Benowitz Barry A. , Lappe Donald L. , Muhlestein Joseph B. , Knowlton Kirk U. , Bunch T. Jared
Published: September 2019

Introduction

Hyperthyroidism is a known precipitating factor for atrial fibrillation (AF). However, recent reports have suggested an increased risk of AF with free thyroxine (fT4) levels even within the upper reference (normal) range. We sought to test whether higher fT4 levels within the reference range are associated with an increased risk of AF.

Methods and Results

All patients in the Intermountain Healthcare electronic medical record database with an fT4 level not on thyroid medication were included. The reference range of fT4 was divided into quartiles (Q), and associations with prevalent and incident AF were assessed by multivariable regression. Similar analyses were performed for thyroid stimulating hormone (TSH) and total and free T3. A total of 174 914 patients were included and followed for 7.0 ± 4.9 years. Of these, 7.4%, 88.4%, and 4.2% had fT4 levels below, within, and above the reference range. As expected, prevalent AF was greater with elevated fT4. However, gradients also were noted within the reference range, comparing Q4 to Q1, for prevalent AF (adjusted odds ratio 1.4, P < .0001) and incident AF (adjusted hazard ratio 1.16, P < .0001). In contrast, no relationship with AF prevalence and incidence was noted for total and free T3 within their reference ranges, and the pattern for TSH was uninformative.

Conclusion

Higher fT4 levels within the reference range were associated with an increased prevalence and incidence of AF. These findings in a large dataset prospectively validate earlier reports and may have important implications, including a redefinition of the normal range and fT4 targets for replacement therapy.
Iron chelation and 2‐oxoglutarate‐dependent dioxygenase inhibition suppress mantle cell lymphoma's cyclin D1
Authors: Babosova Olga , Kapralova Katarina , Raskova Kafkova Leona , Korinek Vladimir , Divoky Vladimir , Prchal Josef T. , Lanikova Lucie
Published: September 2019

The patients with mantle cell lymphoma (MCL) have translocation t(11;14) associated with cyclin D1 overexpression. We observed that iron (an essential cofactor of dioxygenases including prolyl hydroxylases [PHDs]) depletion by deferoxamine blocked MCL cells’ proliferation, increased expression of DNA damage marker γH2AX, induced cell cycle arrest and decreased cyclin D1 level. Treatment of MCL cell lines with dimethyloxalylglycine, which blocks dioxygenases involving PHDs by competing with their substrate 2‐oxoglutarate, leads to their decreased proliferation and the decrease of cyclin D1 level. We then postulated that loss of EGLN2/PHD1 in MCL cells may lead to down‐regulation of cyclin D1 by blocking the degradation of FOXO3A, a cyclin D1 suppressor. However, the CRISPR/Cas9‐based loss‐of‐function of EGLN2/PHD1 did not affect cyclin D1 expression and the loss of FOXO3A did not restore cyclin D1 levels after iron chelation. These data suggest that expression of cyclin D1 in MCL is not controlled by ENGL2/PHD1‐FOXO3A pathway and that chelation‐ and 2‐oxoglutarate competition‐mediated down‐regulation of cyclin D1 in MCL cells is driven by yet unknown mechanism involving iron‐ and 2‐oxoglutarate‐dependent dioxygenases other than PHD1. These data support further exploration of the use of iron chelation and 2‐oxoglutarate‐dependent dioxygenase inhibitors as a novel therapy of MCL.
Biphasic effects of autophagy on decompression bubble‐induced endothelial injury
Authors: Wang Mengmeng , Zhang Kun , Nie Shaojie , Huang Guoyang , Yi Hongjie , He Chunyang , Buzzacott Peter , Xu Weigang
Published: September 2019

Endothelial dysfunction induced by bubbles plays an important role in decompression sickness (DCS), but the mechanism of which has not been clear. The present study was to investigate the role of autophagy in bubble‐induced endothelial injury. Human umbilical vein endothelial cells (HUVECs) were treated with bubbles, autophagy markers and endothelial injury indices were determined, and relationship strengths were quantified. Effects of autophagy inhibitor 3‐methyladenine (3‐MA) were observed. Bubble contact for 1, 5, 10, 20 or 30 minutes induced significant autophagy with increases in LC3‐II/I ratio and Beclin‐1, and a decrease in P62, which correlated with bubble contact duration. Apoptosis rate, cytochrome C and cleaved caspase‐3 increased, and cell viability decreased following bubble contact for 10, 20 or 30 minutes, but not for 1 or 5 minutes. Injuries in HUVECs were correlated with LC3‐II/I ratio and partially reversed by 3‐MA in 10, 20 or 30 minutes contact, but worsened in 1 or 5 minutes. Bubble pre‐conditioning for 1 minutes resulted in increased cell viability and decreased apoptosis rate compared with no pre‐conditioning, and 30‐minutes pre‐conditioning induced opposing changes, all of which were inhibited by 3‐MA. In conclusion, autophagy was involved and played a biphasic role in bubble‐induced endothelial injury.
From Containment to Realpolitik and Back Again: A Realist Constructivist Analysis of Turkey–EU Relations and the Migration Issue
Authors: Martin Natalie
Published: September 2019

The EU's reaction to the migration crisis of 2015–16 was to shower the Turkish government with gifts to secure their cooperation on the Aegean crossing. This led to accusations of realpolitik after Brussels made concessions to Turkey despite Ankara's liberal democratic deficit. This article examines EU policy before, during and after the migration crisis to argue that the situation is more nuanced than this suggests. Turkey–EU accession had been in a state of containment for nearly a decade before the migration issue. Brussels' reaction to it raised questions about the EU's liberal identity but Brussels backtracked quickly once the extent of illiberality following the attempted coup d'état emerged. Turkey–EU relations then returned to a pre‐migration state of containment whereby Turkey remains a candidate but progress towards accession depends on their liberal progress. Using realist constructivism, it concludes the EU's liberal democratic standards remain, but the liberal bar is pliable according to circumstances.
Clinical evaluation of injectable platelet‐rich fibrin with connective tissue graft for the treatment of deep gingival recession defects: A controlled randomized clinical trial
Authors: Ucak Turer Onur , Ozcan Mustafa , Alkaya Bahar , Surmeli Seren , Seydaoglu Gulsah , Haytac Mehmet Cenk
Published: September 2019

Aim

The aim of this study was to determine whether the combined connective tissue graft (CTG) with injectable platelet‐rich fibrin (i‐PRF) with coronally advanced flap (CAF) improved root coverage of deep Miller Class I or II gingival recessions compared with CTG alone with CAF.

Material and Methods

Seventy‐two patients with Miller class I and II gingival recessions were enrolled. Thirty‐six patients were randomly assigned to the test group (CAF+CTG+i‐PRF [700 rpm for 3 min]) or control group (CAF+CTG). Clinical evaluations were made at 6 months.

Results

At 6 months, complete root coverage was obtained at 88% of the sites treated with CAF+CTG+i‐PRF and 80% of the sites treated with CAF+CTG. Difference between the two groups was not statistically significant. At 6 months, the recession depth (RD) reduction and increase in keratinized tissue height (KTH) of the test sites were significantly better compared with the control sites.

Conclusions

According to the results, the addition of i‐PRF to the CAF+CTG treatment showed further development in terms of increasing the KTH and decreasing RD. However, this single trial is not sufficient to advocate the true clinical effect of i‐PRF on recession treatment with CAF+CTG and additional trials are needed.
Periodontal regeneration using bone morphogenetic protein 2 incorporated biomimetic calcium phosphate in conjunction with barrier membrane: A pre‐clinical study in dogs
Authors: Wei Lingfei , Teng Fei , Deng Liquan , Liu Gangfeng , Luan Mengyin , Jiang Jie , Liu Zhonghao , Liu Yuelian
Published: September 2019

Aim

To evaluate the effect of bone morphogenetic protein 2 (BMP‐2) incorporated biomimetic calcium phosphate (BMP‐2/BioCaP) in conjunction with barrier membrane on periodontal regeneration in chronic periodontitis experimental model.

Material and Methods

Chronic periodontitis experimental model with critical‐sized supra‐alveolar defects was created in 15 dogs’ mandibles. After the initial periodontal therapy, the defects were randomly assigned to the following groups: (a) control; (b) barrier membrane; (c) deproteinized bovine bone mineral + barrier membrane; (d) BioCaP + barrier membrane and (e) BMP‐2/BioCaP + barrier membrane (6 quadrants with 18 teeth per group). Eight weeks later, clinical examinations, micro‐CT, and histomorphometric analyses were performed.

Results

Clinical examinations, including plaque index, bleeding index, and probing depth, were similar for all groups. In contrast, the clinical attachment loss was significantly lower in defects grafted with BMP‐2/BioCaP and barrier membrane. The micro‐CT results showed that the height of mineralized tissue in defects grafted with BMP‐2/BioCaP and barrier membrane was significantly higher. For histometric analysis, the defects grafted with BMP‐2/BioCaP and barrier membrane exhibited significantly more connective tissue height, new cementum height, new bone height and area, as well as less down‐growth of junctional epithelium.

Conclusion

BMP‐2/BioCaP could be a promising bone substitute for periodontal regeneration.
Efficacy and safety of once‐weekly exenatide after switching from twice‐daily exenatide in patients with type 2 diabetes
Authors: Watanabe Yuusuke , Saisho Yoshifumi , Inaishi Jun , Kou Kinsei , Yamauchi Akira , Kanazawa Yasuhiko , Okubo Yoshiaki , Tokui Mikiya , Imai Takatoshi , Murakami Rie , Tsuchiya Tami , Sasaki Hironobu , Masaoka Tatsuhiro , Irie Junichiro , Meguro Shu , Itoh Hiroshi ,   for the Twin‐exenatide Study Group
Published: September 2019

Aims/Introduction

To evaluate the efficacy and safety of once‐weekly (q.w.) extended‐release exenatide after switching from twice‐daily (b.i.d.) exenatide in patients with type 2 diabetes.

Materials and Methods

This was an investigator‐initiated, prospective, single‐arm, multicenter study. Individuals with type 2 diabetes who had been treated with exenatide b.i.d. for at least 3 months were enrolled and switched to exenatide q.w. for 24 weeks. The primary end‐point was change in HbA1c at week 24 to test the glucose‐lowering effect of exenatide q.w. versus exenatide b.i.d.

Results

A total of 58 Japanese individuals with type 2 diabetes completed the study. Glycated hemoglobin was reduced by 0.2% at week 24 (7.2 ± 1.2% vs 7.0 ± 1.2% [56 ± 13 vs 53 ± 13 mmol/mol], 95% confidence interval −0.4 to −0.03%, P < 0.005 for non‐inferiority, P = 0.01 for superiority). Fasting plasma glucose was reduced by 12 mg/dL at week 24 (154 ± 46 vs 142 ± 46 mg/dL, P = 0.02). β‐Cell function assessed by homeostasis model assessment of β‐cell function and C‐peptide index was significantly improved at week 24. The incidence of self‐reported hypoglycemia was reduced, and treatment satisfaction assessed by the Diabetes Treatment Satisfaction Questionnaire and Diabetes Medication Satisfaction Questionnaire was improved at week 24, with no change in body weight. There was no serious adverse event related to the study drug.

Conclusions

Switching from exenatide b.i.d. to exenatide q.w. resulted in a reduction in glycated hemoglobin, fasting plasma glucose and the incidence of hypoglycemia, and improvement in β‐cell function and treatment satisfaction in patients with type 2 diabetes. These findings will be useful for selecting optimal treatment in individuals with type 2 diabetes.
Item Selection and Exposure Control Methods for Computerized Adaptive Testing with Multidimensional Ranking Items
Authors: Chen Chia‐Wen , Wang Wen‐Chung , Chiu Ming Ming , Ro Sage
Published: September 2019

The use of computerized adaptive testing algorithms for ranking items (e.g., college preferences, career choices) involves two major challenges: unacceptably high computation times (selecting from a large item pool with many dimensions) and biased results (enhanced preferences or intensified examinee responses because of repeated statements across items). To address these issues, we introduce subpool partition strategies for item selection and within‐person statement exposure control procedures. Simulations showed that the multinomial method reduces computation time while maintaining measurement precision. Both the freeze and revised Sympson‐Hetter online (RSHO) methods controlled the statement exposure rate; RSHO sacrificed some measurement precision but increased pool use. Furthermore, preventing a statement's repetition on consecutive items neither hindered the effectiveness of the freeze or RSHO method nor reduced measurement precision.
Layperson's preference of the transverse occlusal plane in asymmetric facial model
Authors: Silva Bruno P. , Tortora Sofia C. , Stanley Kyle , Mahn Gustavo , Coachman Christian , Mahn Eduardo
Published: September 2019

Objective

Facial asymmetries are common, especially deviated nose and chin. The clinician must consider these variables when establishing the smile, placement and angulation of the occlusal plane. The purpose of this article is to determine if nose and chin deviations affect the perception of laypeople towards different angulations of the occlusal plane cant.

Materials and Method

An asymmetric facial model was created from a symmetric facial model used in a previous study. Nose and chin were deviated 3 mm to the left and eight different pictures were created, each with different degrees of occlusal plane cant in both direction. Using a visual Likert scale delivered via Websurvey within the private practice setting, 120 randomly selected laypersons evaluated each image according to their own beauty preferences.

Results

In an asymmetric face, nose and chin deviated 3 mm to the left, a minor occlusal plane angulation of 2° can be perceptible regardless of the direction of the cant.

Conclusions

The occlusal plane should be as parallel to the interpupillary line as possible. If occlusal cant is present, less than 2° of angulation it is preferable, regardless of the direction of the nose and chin.

Clinical Significance

In the presence of an asymmetric face, the occlusal plane should be as parallel as possible to the interpupillary line. The direction of the deviation of the nose and the chin are irrelevant factors to determine the occlusal plane. An inclination of the occlusal plane can cause vertical discrepancy, which could subsequently create malocclusion. A complete dentofacial analysis can aim at assessing the angulation of the occlusal plane not only for esthetic outcomes, but for also allowing correct occlusal function.
In vitro propagation of tilapia lake virus in cell lines developed from Oreochromis mossambicus
Authors: Nanthini Ravi , Abdul Majeed Seepoo , Vimal Sugumar , Taju Gani , Sivakumar Selvam , Santhosh Kumar Shanmugam , Pillai Devika , Sneha Kalasseril Girijan , Rakesh Chakalaparambil Gokulan , Sahul Hameed Azeez Sait
Published: September 2019

Tilapia lake virus (TiLV)‐suspected samples of tilapia were collected from grow‐out ponds located with clinical signs and mortality ranged from 5% to 50%. The reverse transcription–polymerase chain reaction (RT‐PCR) assay revealed the presence of TiLV in the disease outbreak ponds. Cell lines were developed from heart, gill and eye of Mozambique tilapia and characterized. Morphologically, these cell lines are composed of epithelioid cells. The optimum growth of these cells was observed at 28°C and 20% concentration of FBS. After cryopreservation, 70%–90% of cells were found to be viable. The cells of all three cell lines were found to be positive to fibronectin and pancytokeratin. PCR amplification of 16S rRNA and COI of O. mossambicus confirmed the origin of these cell lines from O. mossambicus. Heart and gill cell lines were found to be highly susceptible to TiLV and found to be useful for its isolation from infected fish samples. The experimental infection was carried out in O. niloticus and O. mossambicus using the TiLV propagated in susceptible cell lines. The RT‐PCR results revealed the presence of TiLV in brain, gill, liver, kidney, spleen, eye, muscle, intestine and heart of experimentally infected O. niloticus and O. mossambicus.
Inactivation of Escherichia coli and Salmonella in liquid egg white by pulsed UV light and its effects on quality
Authors: Ouyang Beining , Demirci Ali , Patterson Paul H.
Published: September 2019

This study evaluated the pulsed UV light treatment for the inactivation of Escherichia coli K12 and Salmonella Enteritidis in liquid egg white. Three parameters (treatment time, volume of liquid egg white, and distance from the sample to the pulse UV strobe) have been optimized for log reductions of microorganisms using response surface methodology. The maximum log reductions obtained after 40 s of treatment time at a 5 cm of distance (the energy dose equals 45.6 J/cm2) were 1.28 log CFU/ml of E. coli K12 and 1.98 log CFU/ml of S. Enteritidis in 5 ml of fresh liquid egg white. A significant temperature increase of the egg white sample (from 24 to 70°C) was observed at the extreme treatment condition (5 cm, 40 s). Quality evaluations indicate that pulsed UV light does not change foaming ability or foam stability of liquid egg white. However, the changes in pH, lipid oxidation, turbidity, and color of the egg white were correlated with the intensity of the treatment.

Practical applications

Heat pasteurization is currently being used to decontaminate liquid egg white. However, alternative methods are desired to improve decontamination as well as maintain the quality of liquid egg white. This study demonstrated the potential of pulsed UV light for the inactivation of pathogens in liquid egg white.
Current management of Cushing's disease
Authors: Tritos N. A. , Biller B. M. K.
Published: September 2019

Cushing's disease (CD) is caused by a pituitary tumour that secretes adrenocorticotropin (ACTH) autonomously, leading to excess cortisol secretion from the adrenal glands. The condition is associated with increased morbidity and mortality that can be mitigated by treatments that result in sustained endocrine remission. Transsphenoidal pituitary surgery (TSS) remains the mainstay of treatment for CD but requires considerable neurosurgical expertise and experience in order to optimize patient outcomes. Up to 90% of patients with microadenomas (tumour below 1 cm in largest diameter) and 65% of patients with macroadenomas (tumour at or above 1 cm in greatest diameter) achieve endocrine remission after TSS by an experienced surgeon. Patients who are not in remission postoperatively or those who relapse may benefit from undergoing a second pituitary operation. Alternatively, radiation therapy to the sella with interim medical therapy, or bilateral adrenalectomy, can be effective as definitive treatments of CD. Medical therapy is currently adjunctive in most patients with CD and is generally prescribed to patients who are about to receive radiation therapy and will be awaiting its salutary effects to occur. Available treatment options include steroidogenesis inhibitors, centrally acting agents and glucocorticoid receptor antagonists. Several novel agents are in clinical trials and may eventually constitute additional treatment options for this serious condition.
Internalized Racism: A Systematic Review of the Psychological Literature on Racism's Most Insidious Consequence
Authors: David E. J. R. , Schroeder Tiera M. , Fernandez Jessicaanne
Published: September 2019

Racism is often thought of as existing and operating at the interpersonal and institutional levels. One aspect of racism that has been relatively forgotten, however, is its internalized component: racism that exists and operates at the internalized level. Surprisingly, even psychology—the field that is arguably best equipped to study the internalized component of racism—seems to have lagged in investigating and addressing this construct. Thus, we conducted a systematic literature review of psychological work on internalized racial oppression to better understand what is currently known, what the recent surge in scholarship has contributed, and where the research and service gaps are in order to identify areas for future growth. Overall, psychological attention on internalized racism seems to be increasing, and there have been some exciting conceptual (e.g., cognitive behavioral conceptualization, moving toward “appropriated racial oppression”) and empirical (e.g., development of scales, correlates with mental health variables) developments. However, our review also revealed a need for more work that: (1) utilizes qualitative or mixed methods; (2) focuses on the experiences of different racial and ethnic groups; (3) investigates how internalized racism intersects with other forms of internalized oppression; (4) clarifies the connection of internalized racism with other theoretically similar phenomena; and (5) incorporates social justice and advocacy in clinical and community services to balance unequal power dynamics that perpetuate racism—the root cause of internalized racism.
A systems‐centred approach to reducing medication error: Should pre‐hospital providers and emergency departments dose children by age during resuscitation?
Authors: Foster Mieke , Tagg Andrew
Published: September 2019

The high‐risk, high‐stress and high‐stakes environment of out‐of‐hospital or emergency department paediatric resuscitation is prone to human error, and medication errors are common. This could be contributing to the difference in survival rate of resuscitation in the out‐of‐hospital versus inpatient setting. Medication for children during resuscitation requires estimation of the child's weight and calculation of the corresponding drug dose. Whilst both of these steps can lead to error, calculation errors (including 10‐fold errors) are much more common and harmful than weight errors. Previous solutions aim to optimise each stage of the medication dosing process. Currently, Australian guidelines suggest using the highly inaccurate original advanced paediatric life support formula, weight = 2 × (age + 4), to dose medications in these settings. This means age is converted to weight, which is then converted to dose. There is no evidence that this is causing harm to patients. Therefore, it could be suggested that age could safely be converted straight to dose according to preset doses. This eliminates the need for any weight estimation or dose calculation, thus reducing the potential for error and harm.
Cellular Responses of Gelidium floridanum (Gelidiales, Rhodophyta) Tetraspores Under Heat Wave and Copper Pollution
Authors: Kreusch Marianne , Poltronieri Elisa , Bouvie Fernanda , Pereira Débora T. , Batista Deonir , Ramlov Fernanda , Maraschin Marcelo , Bouzon Zenilda L. , Simioni Carmen
Published: September 2019

Spore settlement and development are bottlenecks for resilience of habitat‐forming macroalgal species. These processes are directly related to temperature, a global stressor protagonist of ocean warming. The toxic effects of local pollutants such as copper may be worsened under a global warming scenario. Therefore, in this paper, we investigated the effects of increased temperature combined with elevated concentrations of copper on the viability, photosynthetic pigments, and ultrastructure of Gelidium floridanum tetraspores. Tetraspores were cultivated on slides with sterilized seawater or seawater enriched with CuCl2, and incubated under 24°C or 30°C for 24 h. Tetraspores cultivated with copper 3.0 μM under 30°C had lower viability. Both temperature and copper had a significant effect on phycocyanin and phycoerythrin concentrations. Samples cultivated with copper under 30°C presented a heavily altered cellular structure, with vesicles throughout the cytoplasm, chloroplasts with altered structure and cells with degenerated cytoplasm and cell walls. Our findings show that temperature and copper significantly affect the viability, photosynthetic pigments, and ultrastructure of G. floridanum tetraspores, presenting an additive interaction for the physiology of this seaweed's early stages.
Radiographic diagnosis of small intestinal obstruction in pet rabbits (Oryctolagus cuniculus): 63 cases
Authors: Debenham J. J. , Brinchmann T. , Sheen J. , Vella D.
Published: September 2019

Objectives

To identify radiographic features that can be used to aid in the diagnosis of small intestinal obstruction in pet rabbits.

Materials and Methods

Retrospective study comparing radiographic features of 63 cases of confirmed intestinal obstruction with 50 abdominal radiographs taken of rabbits without gastrointestinal disease. Abdominal radiographs were examined for gastric size, gastric contents, small intestinal dilatation and gas within the large intestine and caecum.

Results

Gastric size, gastric contents, small intestinal dilatation and gas within the large intestine and caecum were all features that differed between rabbits with small intestinal obstruction and rabbits without gastrointestinal disease. Radiographic features associated with small intestinal obstruction included severe gastric dilation, gastric contents primarily consisting of liquid and gas, small intestinal dilation and absence of large amounts of gas in the caecum and large intestine.

Clinical Significance

Observation on gastric size, small intestinal dilatation and gas within the large intestine and caecum aid in radiological diagnosis of small intestinal obstruction in rabbits and so can guide appropriate treatment.
Reduced structural connectivity in Insomnia Disorder
Authors: Jespersen Kira V. , Stevner Angus , Fernandes Henrique , Sørensen Stine D. , Van Someren Eus , Kringelbach Morten , Vuust Peter
Published: September 2019

Insomnia Disorder is the most prevalent sleep disorder, and it involves both sleep difficulties and daytime complaints. The neural underpinnings of Insomnia Disorder are poorly understood. Several existing neuroimaging studies focused on local measures and specific regions of interests, which makes it difficult to judge their whole‐brain significance. We therefore here applied a data‐driven approach to assess differences in whole‐brain structural connectivity between adults with Insomnia Disorder and matched controls without sleep complaints. We used diffusion tensor imaging and probabilistic tractography to assess whole‐brain structural connectivity, and examined group differences using network‐based statistics. The results revealed a significant difference in the structural connectivity of the two groups (p = .014). Participants with Insomnia Disorder showed reduced connectivity in a sub‐network that included mainly fronto‐subcortical connections with the insula as a key region. By taking a whole‐brain network perspective, our study enables the integration of previous inconsistent findings. Our results reveal that reduced structural connectivity of the left insula and the connections between frontal and subcortical regions are central neurobiological features of Insomnia Disorder. The importance of these areas for interoception, emotional processing, stress responses and the generation of slow‐wave sleep may help guide the development of neurobiology‐based models of the prevalent condition of Insomnia Disorder.
Longitudinal evolution of vertically HIV/HCV–co‐infected vs HCV–mono‐infected children
Authors: Sainz Talia , Fernández McPhee Carolina , Domínguez‐Rodríguez Sara , Hierro Loreto , Mellado María José , Fortuny Claudia , Falcón María Dolores , Soler‐Palacín Pere , Rojo Pablo , Ramos José Tomás , Gavilán César , Guerrero Carmelo , Díaz Maria del Carmen , Jara Paloma , Navarro María Luisa ,   on behalf of the Pediatric National AIDS Research Network of Spain (CORISPE) integrated in the Translational Research Network in Pediatric Infectious Diseases (RITIP)
Published: September 2019

HIV co‐infection has been suggested to play a deleterious role on the pathogenesis of liver fibrosis among vertically HCV‐infected children. The aim of this study was to describe the longitudinal evolution of vertically acquired HIV/HCV co‐infection in youths, in comparison with HCV infection alone. This was a retrospective, multicentre study including vertically HIV/HCV–co‐infected patients and age‐ and sex‐matched vertically HCV–mono‐infected patients. Progression to advanced liver fibrosis, defined as F3 or more by elastography or METAVIR biopsy staging, and response to treatment were compared by means of univariate and multivariate regression analyses and Cox regression models. Sixty‐seven co‐infected patients were compared with 67 matched HCV–mono‐infected patients. No progression to advanced liver disease was observed during the first decade. At a median age of 20.0 [19.0, 22.0] years, 26.7% co‐infected vs 20% mono‐infected had progressed to advanced fibrosis (P = .617). Peg‐IFN/RBV for HCV treatment was given to 37.9% vs 86.6% (P‐value < .001). At treatment initiation, co‐infected patients were older (16.9 ± 4.1 vs 11.7 ± 4.5 years, P < .001), and 47.1% vs 7.1% showed advanced fibrosis (P < .003), with no differences in hard‐to‐treat genotype distribution. Sustained viral response was comparable between groups (43.5% vs 44.0%, P = .122). In vertically HIV/HCV–co‐infected patients, the progression to liver fibrosis was rare during childhood. At the end of adolescence, over 25% of patients displayed advanced liver disease. Response to Peg‐IFN/RBV was poor and comparable in both groups, supporting the need for fast access to early treatment with direct‐acting antivirals against HCV for vertically co‐infected patients.
Ovarian HBV replication following ovulation induction in female hepatitis B carriers undergoing IVF treatment: A prospective observational study
Authors: Mak Jennifer Sze Man , Lao Terence T. , Leung Maran Bo Wah , Chung Cathy Hoi Sze , Chung Jacqueline Pui Wah , Cheung Lai Ping , Li Tin‐Chiu
Published: September 2019

Hepatitis B virus (HBV) can be found in ovarian tissues. This study compared HBV DNA levels in follicular fluid collected during oocyte retrieval with paired serum samples in HBV carriers after ovarian stimulation during IVF treatment for infertility. Sixty‐four HBV carrier women referred to the Assisted Reproductive Units of two Hong Kong hospitals were recruited. At oocyte retrieval, the follicular fluid aspirated from the first follicle was collected for study. In 22 women, the first follicular fluid sample from both ovaries was similarly collected and studied. These women were also tested for liver function test and HBeAg. In 28 (43.8%) women, HBV DNA was detected in follicular fluid and the level correlated with serum levels (Spearman's correlation P < .001). There was concordant detection of HBV DNA in both ovaries, and the levels were significantly correlated (Spearman's correlation P = .029). In 40% of women with FF HBV DNA, the follicular fluid:serum ratio was >1.0, suggesting stimulation of HBV replication. These women also had significantly different liver function test results. Increased HBV replication exists in 40% of women with HBV DNA detected in follicular undergoing ovarian stimulation during IVF treatment.
Self‐Processes of Acceptance, Compassion, and Regulation of Learning in University Students with Learning Disabilities and/or ADHD
Authors: Willoughby David , Evans Mary Ann
Published: September 2019

University students with a learning disability (LD) represent a growing fraction of the student population within North America. Although past research has focused on cognitive aspects of living with an LD and/or attention‐deficit/hyperactivity disorder (ADHD), social–emotional factors have received less attention. Such factors may play an important role in self‐regulation of learning. This study investigated the relations among self‐compassion, self‐acceptance of an LD, and self‐regulated learning in university students with an LD and/or ADHD. Participants were 78 university students who self‐identified as possessing an LD and/or ADHD. Variables were measured using an online questionnaire. These students had lower self‐compassion scores than found by researchers in other studies. Correlational analyses revealed significant associations among self‐acceptance of an LD, self‐compassion, and self‐regulated learning.
Relationship between nonalcoholic fatty liver disease and muscle quality as well as quantity evaluated by computed tomography
Authors: Tanaka Muhei , Okada Hiroshi , Hashimoto Yoshitaka , Kumagai Muneaki , Nishimura Hiromi , Oda Yohei , Fukui Michiaki
Published: September 2019

Background & Aims

Sarcopenia is reported to be associated with nonalcoholic fatty liver disease (NAFLD). Evaluation of skeletal muscle attenuation and area by computed tomography (CT) may represent a promising approach for evaluation of the risk of NAFLD. We examined the association between skeletal muscle characteristics and NAFLD and investigated the combined effect of these parameters on the prevalence of NAFLD.

Methods

In this cross‐sectional study, we analysed data from 632 middle‐aged Japanese subjects without daily alcohol intake (353 men and 279 women) from a cohort of employees undergoing annual health examinations. The cross‐sectional skeletal muscle area was evaluated on the basis of CT data at the level of the third lumbar vertebrae, and the skeletal muscle index (SMI) and density (SMD) were calculated. The subjects were divided into four study groups according to their SMI and SMD relative to median values.

Results

One hundred forty men and forty‐three women had NAFLD. Total SMI (odds ratio [OR] per 1.0 cm2/kg/m2increase 0.43, 95% confidence interval [CI] 0.29‐0.64 in men and OR 0.21, 95% CI 0.10‐0.42 in women) and total SMD (OR, per 1.0 Hounsfield Unit increase 0.88, 95% CI 0.83‐0.93 in men and 0.88, 0.82‐0.95 in women) were significantly associated with the prevalence of NAFLD after adjusting for covariates. The subgroup with simultaneous presence of low SMI and low SMD was associated with a significantly higher prevalence of NAFLD compared with other groups.

Conclusions

Both SMI and SMD are independently associated with the prevalence of NAFLD.
The Loz1 transcription factor from Schizosaccharomyces pombe binds to Loz1 response elements and represses gene expression when zinc is in excess
Authors: Wilson Stevin , Liu Yi‐Hsuan , Cardona‐Soto Carlos , Wadhwa Vibhuti , Foster Mark P. , Bird Amanda J.
Published: September 2019

In Schizosaccharomyces pombe, the expression of the zrt1 zinc uptake gene is tightly regulated by zinc status. When intracellular zinc levels are low, zrt1 is highly expressed. However, when zinc levels are high, transcription of zrt1 is blocked in a manner that is dependent upon the transcription factor Loz1. To gain additional insight into the mechanism by which Loz1 inhibits gene expression in high zinc, we used RNA‐seq to identify Loz1‐regulated genes, and ChIP‐seq to analyze the recruitment of Loz1 to target gene promoters. We find that Loz1 is recruited to the promoters of 27 genes that are also repressed in high zinc in a Loz1‐dependent manner. We also find that the recruitment of Loz1 to the majority of target gene promoters is dependent upon zinc and the motif 5ʹ‐CGN(A/C)GATCNTY‐3ʹ, which we have named the Loz1 response element (LRE). Using reporter assays, we show that LREs are both required and sufficient for Loz1‐mediated gene repression, and that the level of gene repression is dependent upon the number and sequence of LREs. Our results elucidate the Loz1 regulon in fission yeast and provide new insight into how eukaryotic cells are able to respond to changes in zinc availability in the environment.
Role of major facilitator superfamily transporter Qdr2p in biofilm formation by Candida glabrata
Authors: Widiasih Widiyanto Tria , Chen Xinyue , Iwatani Shun , Chibana Hiroji , Kajiwara Susumu
Published: September 2019

Candida glabrata represents the second‐most frequent cause of candidiasis infections of the mucosa, bloodstream and genito‐urinary tract in immunocompromised individuals. The incidence of C glabrata infection has increased significantly in the last two decades, mainly due to this species’ abilities to resist various antifungal drugs and to form biofilms. We focused on the relationship between biofilm formation and the product of QDR2, a C glabrata member of the major facilitator superfamily (MFS) gene family, given that fungal biofilm formation limits drug penetration and is associated with persistent infection. The fungal cells in biofilms were compared between a C glabrata ∆qdr2 mutant and its wild‐type strain. Cells were analysed for metabolism activity and drug susceptibility (using tetrazolium assay), adhesion activity, growth assay and intracellular pH (using flow cytometry). Compared to the wild type, the C glabrata ∆qdr2 showed lower adhesion activity and higher fluconazole susceptibility when assessed as a biofilm. The mutant also showed decreased metabolic activity during biofilm formation. Furthermore, the mutant grew more slowly under neutral‐basic pH conditions. The qdr2 deletion in C glabrata resulted in an impaired ability to maintain pH homeostasis, which led in turn to a reduction of cell growth and of adherence to an artificial matrix. These results suggested that the Qdr2p function is needed for proper biofilm formation and biofilm maintenance in C glabrata as well as biofilm drug resistance towards fluconazole. Qdr2p may play an important role in C glabrata's ability to form biofilms on implanted medical devices in human bodies.
Risk factors for absence of catch‐up growth in small for gestational age very low‐birthweight infants
Authors: Arai Sakiko , Sato Yoshiaki , Muramatsu Hideki , Yamamoto Hidenori , Aoki Fumiko , Okai Yu , Kataoka Shinsuke , Hanada Yu , Hamada Motoharu , Morimoto Yoshihito , Kojima Seiji , Natsume Jun , Takahashi Yoshiyuki ,   Nagoya Collaborative Clinical Research Team
Published: September 2019

Background

Many small for gestational age (SGA) infants have catch‐up growth during the first 2 years of life, but approximately 10% have no catch‐up growth, and short stature continues into adulthood. Identification of risk factors for absence of catch‐up growth at an early age may be useful for earlier diagnosis and earlier treatment.

Methods

This was a retrospective multicenter study. The subjects were SGA infants with very low‐birthweight (VLBW), who were followed up until the age of 3 years. The risk factors for absence of catch‐up growth were identified on statistical analysis.

Results

Of the 217 SGA infants in this study, 181 were in the catch‐up group and 36 were in the no catch‐up group. The catch‐up rate was 83%. On multivariate analysis adjusted for gestational age, birthweight, birth height, and birth head circumference, multipara, Z and ΔZ scores of length at 12 months of corrected age, and the Z score of height at 24 months of corrected age were risk factors for lack of catch‐up at 3 years.

Conclusions

The length Z and ΔZ scores at 12 months of corrected age may be useful for an earlier diagnosis and earlier initiation of growth hormone treatment in VLBW infants.
Nationwide survey of pediatric hypodiploid acute lymphoblastic leukemia in Japan
Authors: Ishimaru Sae , Okamoto Yasuhiro , Imai Chihaya , Sakaguchi Hirotoshi , Taki Tomohiko , Hasegawa Daisuke , Cho Yuko , Kakuda Harumi , Sano Hideki , Manabe Atsushi , Imamura Toshihiko , Kato Motohiro , Arakawa Yuki , Shimonodan Hidemi , Sato Atsushi , Suenobu Souichi , Inukai Takeshi , Watanabe Arata , Kawano Yoshifumi , Kikuta Atsushi , Horibe Keizo , Ohara Akira , Koh Katsuyoshi
Published: September 2019

Background

Ploidy is a highly significant prognostic factor for pediatric acute lymphoblastic leukemia (ALL). Children with hypodiploid ALL have poor outcomes despite current intensive chemotherapy. Little has been investigated with regard to hypodiploid ALL in Japanese children.

Methods

We retrospectively collected clinical data on hypodiploid ALL cases from the registries of prospective multicenter trials conducted by the four independent clinical study groups in Japan between 1997 and 2012.

Results

A total of 117 ALL patients with hypodiploidy were analyzed in this study. There were 101, eight, and eight patients with 45, 44, and fewer than 44 chromosomes, respectively. The 5 year overall survival rates differed significantly: 86.0%, 87.5%, and 62.5% for patients with 45, 44, and fewer than 44 chromosomes, respectively (P = 0.037). Of the eight patients with 44 chromosomes, seven were alive, including five patients who maintained complete remission without undergoing hematopoietic stem cell transplantation (HSCT). Of the eight patients with fewer than 44 chromosomes, six were good responders to prednisolone and none had induction failure, but the relapse rate was high (5/8). No patients had central nervous system relapse. Four patients underwent HSCT after relapse, but only one survived.

Conclusions

Outcomes of Japanese ALL patients with fewer than 44 chromosomes were poor, as previously reported in other countries. Although the sample size was small, patients with 44 chromosomes had better prognoses than those previously reported. Further studies including international collaboration are needed to improve outcomes for pediatric ALL patients with fewer than 44 chromosomes.