bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatiotemporal heterogeneity decouples infection parameters of amphibian chytridiomycosis
Authors: McMillan Kirsten M. , Lesbarrères David , Harrison Xavier A. , Garner Trenton W. J.
Published: December 2019

Emerging infectious diseases are responsible for declines in wildlife populations around the globe. Mass mortality events associated with emerging infectious diseases are often associated with high number of infected individuals (prevalence) and high pathogen loads within individuals (intensity). At the landscape scale, spatial and temporal variation in environmental conditions can alter the relationship between these infection parameters and blur the overall picture of disease dynamics.

Quantitative estimates of how infection parameters covary with environmental heterogeneity at the landscape scale are scarce. If we are to identify wild populations at risk of disease epidemics, we must elucidate the factors that shape, and potentially decouple, the link between pathogen prevalence and intensity of infection over complex ecological landscapes.

Using a network of 41 populations of the amphibian host Rana pipiens in Ontario, Canada, we present the spatial and temporal heterogeneity in pathogen prevalence and intensity of infection of the chytrid fungus Batrachochytrium dendrobatidis (Bd), across a 3‐year period. We then quantify how covariation between both infection parameters measured during late summer is modified by previously experienced spatiotemporal environmental heterogeneity across 14 repeat sampled populations.

Late summer Bd infection parameters are governed, at least in part, by different environmental factors operating during separate host life‐history events. Our results provide evidence for a relationship between Bd prevalence and thermal regimes prior to host breeding at the site level, and a relationship between intensity of infection and aquatic conditions (precipitation, hydroshed size and river density) throughout host breeding period at the site level. This demonstrates that microclimatic variation within temporal windows can drive divergent patterns of pathogen dynamics within and across years, by effecting changes in host behaviour which interfere with the pathogen's ability to infect and re‐infect hosts.

A clearer understanding of the role that spatiotemporal heterogeneity has upon infection parameters will provide valuable insights into host–pathogen epidemiology, as well as more fundamental aspects of the ecology and evolution of interspecific interactions.
Agriculture and Brexit Britain's ‘No‐deal’ Tariff Plans
Authors: Swinbank Alan
Published: December 2019

In March 2019 the UK government published details of the import tariffs it planned to apply in the event of a ‘no‐deal’ Brexit from the EU. Some 88 per cent of the UK's imports – including many agri‐food products – would enter tariff‐free. This proposed unilateral reduction in border protection promoted few protests from the UK's farm lobby, in marked contrast to the reaction voiced by EU farmers to the planned trade agreement with Mercosur. Trade diplomats are often loath to contemplate unilateral tariff cuts, as these could later form a crucial part of a bargain in multilateral or bilateral trade deals. Indeed, the UK's ‘no‐deal’ tariff plan could undermine its objective of concluding ambitious Free Trade Agreements (FTAs) with the likes of Australia and the USA. Despite these developments in agri‐trade policy, UK politicians continued to express concern about the viability of UK agriculture in a ‘no‐deal’ scenario, and some promised to lavish tax‐payer‐funded support on the sector. Thus both free (or freer) trade and agricultural exceptionalism were canvassed cheek by jowl.
Low‐flow apnoeic oxygenation for laryngeal surgery: a prospective observational study
Authors: O'Loughlin C. J. , Phyland D. J. , Vallance N. A. , Giddings C. , Malkoutzis E. , Gunasekera E. , Webb A. , Barnes R.
Published: December 2019

Laryngeal surgery requires a shared airway and close collaboration between surgeon and anaesthetist in order to optimise operating conditions. Apnoeic oxygenation uses the principle of aventilatory mass flow to maintain oxygenation of pulmonary capillary blood under apnoeic conditions while minimising laryngeal movement. Concerns regarding accumulation of carbon dioxide and resultant acidaemia have limited the use of the technique. We performed a prospective study of low‐flow apnoeic oxygenation for patients undergoing microlaryngoscopy under general anaesthesia in order to evaluate the ability of the technique to maintain oxygenation and determine the resultant rate of carbon dioxide accumulation. Sixty‐four patients undergoing microlaryngoscopy under general anaesthesia were studied between November 2016 and December 2018. Intra‐operative oxygenation was provided via a 10‐French oxygen catheter placed into the trachea delivering oxygen at 0.5–1.0 l.min−1. Data regarding apnoea time, peripheral oxygen saturation and venous blood gas concentrations were recorded. The mean (SD) duration of apnoea was 18.7 (7.2) min. Apnoeic oxygenation allowed successful completion of the surgical procedure in 62/64 patients. Mean (SD) rate of rise of the venous partial pressure of carbon dioxide was 0.15 (0.10) kPa.min−1. Operating conditions were recorded qualitatively as being adequate in all cases. No adverse effects were reported. Low‐flow intra‐tracheal apnoeic oxygenation is a simple, effective and inexpensive technique to maintain oxygenation for laryngeal surgery.
Psychiatric Advance Directives and their relevance to improving psychiatric care in Asian countries
Authors: Poremski Daniel , Alexander Mark , Fang Tina , Tan Giles Ming‐Yee , Ong Samantha , Su Alex , Fung Daniel , Chua Hong Choon
Published: December 2019

People with mental illness may be unable to provide critical input about the care they wish to receive during a psychiatric crisis because of altered mental states. It is therefore imperative that clinicians seek to understand service users' wishes for care while they are well and able to provide meaningful input into the discussion. Achieving such an end may be done by discussing and completing a psychiatric advance directive. However, very few Asian countries have legislation that supports such advance directives. The present article seeks to give physicians more information about advance psychiatric directives and the potential role they could play to improve the healthcare provided in Asia to people at risk of losing capacity due to a mental illness. The degree to which mental health legislation supports psychiatric advance directives is documented for each country of South East Asia and Eastern Asia.
Personal Belief in a Just World and Conscientiousness: A meta‐analysis, facet‐level examination, and mediation model
Authors: Nudelman Gabriel , Otto Kathleen
Published: December 2019

Extensive research efforts have been devoted to understanding the nature of Conscientiousness, the only Big Five personality trait that has been robustly linked to professional achievement and longevity. We proposed that Conscientiousness is associated with Personal Belief in a Just World (PBJW), that is, the extent to which an individual believes that her or his efforts will be rewarded. To investigate this proposition, we undertook a meta‐analysis synthesizing past findings regarding the relationship between PBJW and Conscientiousness; we confirmed a positive relationship between the two constructs (r = .16) based on 17 samples and 5,810 individuals. We further proposed a theoretical framework linking PBJW to specific facets of Conscientiousness. A survey of a representative sample of the US population (n = 311) confirmed that PBJW is positively correlated with the specific facets of Self‐efficacy, Achievement‐striving, and Self‐discipline. Internal Locus of Control mediated these associations, elucidating the underlying processes linking PBJW and Conscientiousness.
Low prevalence of maternal microchimerism in peripheral blood of Japanese children with type 1 diabetes
Authors: Ushijima K. , Okuno M. , Ayabe T. , Kikuchi N. , Kawamura T. , Urakami T. , Yokota I. , Amemiya S. , Uchiyama T. , Kikuchi T. , Ogata T. , Sugihara S. , Fukami M. ,   The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes
Published: December 2019

Aim

To clarify the prevalence and degree of maternal microchimerism in Japanese children with type 1 diabetes, as well as its effect on phenotypic variation.

Methods

We studied 153 Japanese children with type 1 diabetes, including 124 children positive for β‐cell autoantibodies, and their 71 unaffected siblings. The number of circulating microchimeric cells per 105 host cells was estimated by the use of quantitative‐polymerase chain reaction targeting non‐transmitted maternal human leukocyte antigen alleles. The results were compared to previous data from white European people. Phenotypic comparison was performed between maternal microchimerism carriers and non‐carriers with diabetes.

Results

Maternal microchimerism was detected in 15% of children with autoantibody‐positive type 1 diabetes, 28% of children with autoantibody‐negative type 1 diabetes, and 16% of unaffected siblings. There were no differences in the prevalence or levels of maternal microchimerism among the three groups or between the children with type 1 diabetes and their unaffected siblings. Furthermore, maternal microchimerism carriers and non‐carriers exhibited similar phenotypes.

Conclusions

Maternal microchimerism appears to be less common in Japanese children with type 1 diabetes than in white European people. Our data indicate that maternal microchimerism is unlikely to be a major trigger or a phenotypic determinant of type 1 diabetes in Japanese children and that the biological significance of maternal microchimerism in type 1 diabetes may differ among ethnic groups.
The prognostic role of myocardial strain indices and dipyridamole stress test in renal transplantation patients
Authors: Lakkas Lampros , Naka Katerina K , Bechlioulis Aris , Girdis Ioannis , Duni Anila , Koutlas Vasileios , Moustakli Maria , Katsouras Christos S , Dounousi Evangelia , Michalis Lampros K
Published: December 2019

Introduction

Renal transplantation (RT) increases survival in end‐stage kidney disease patients but cardiovascular diseases remain the leading cause of morbidity and mortality. We evaluated the role of myocardial strain (2DSTE) indices and dipyridamole‐induced (DIPSE) changes in echocardiographic parameters at baseline for the prediction of clinical events and echocardiographically assessed deterioration of cardiac function in a RT population.

Methods

Forty‐five RT patients underwent an echocardiographic study at baseline including 2DSTE and DIPSE. If no cardiovascular/renal event occurred, patients were investigated at 3‐year follow‐up; eight patients presented a clinical event while 37 patients were re‐evaluated.

Results

Coronary flow reserve (CFR) was abnormal in 24% of the population. DIPSE induced improvements in classic and 2DSTE systolic and diastolic echocardiographic indices including TWIST, UNTWIST, global longitudinal strain (GLS), and circumferential strain (P < .05 for all). Compared to baseline, deteriorations in E/E’, LVEF, E’, and TWIST were observed at follow‐up (P < .05 for all). DIPSE‐induced changes in GLS, global radial strain, and LVEF were associated with changes in these indices at follow‐up (P < .05 for all). Higher LV mass index, E/E’, and lower MAPSE, E’, and CFR at baseline were associated with the occurrence of clinical events at follow‐up (P < .05 for all).

Conclusions

In RT patients, coronary vascular dysfunction (ie, low CFR) was associated with the occurrence of adverse events. DIPSE‐induced changes in myocardial strain and classic echocardiographic indices could identify individuals with a subclinical deterioration in cardiac function at follow‐up. This may indicate that DIPSE could serve as a means to assess myocardial reserve in this population.
Assessment of the quality of fetal heart standard views using the FAST, STAR, and FINE four‐dimensional ultrasound techniques in the screening of congenital heart diseases
Authors: Carrilho Milene Carvalho , Rolo Liliam Cristine , Tonni Gabriele , Araujo Júnior Edward
Published: December 2019

Objective

To compare the quality of standard fetal echocardiographic views obtained by four‐dimensional ultrasound with those obtained by the simple targeted arterial rendering (STAR) technique, four‐chamber view swing technique (FAST), and fetal intelligent navigation echocardiography (FINE/5D Heart®) technique.

Methods

This was a cross‐sectional prospective study that included pregnant women between 22 and 34 weeks of gestation, with normal fetuses. Fetal heart volumes were acquired using spatio‐temporal image correlation (STIC) with the fetal spine between 2 and 9 o'clock. The FAST/STAR techniques consist of the manipulation of STIC volumes by drawing OmniView™ lines to obtain echocardiographic views. The FINE/5D Heart® technique uses intelligent navigation to automatically generate echocardiographic views. The quality of the images was classified as excellent, good, acceptable, and unacceptable. The analysis was performed using the Bonferroni multiple comparisons test.

Results

The study included 101 pregnant women aged between 16 and 44 years. There was no mean difference in image quality between the techniques regarding fetal spine position in all echocardiographic views (P > .05). However, in the five‐chamber, left ventricular outflow tract, right ventricular outflow tract, ductal arch, superior vena cava/inferior vena cava, and abdomen/stomach views, there was a statistically significant mean difference quality between the techniques, regardless of the spine position (P < .05). The best mean image quality was obtained by the FINE technique (P ≤ .016 for all fetal echocardiographic views).

Conclusion

The quality of the echocardiographic views obtained using the FINE technique was superior to that of those generated by the FAST/STAR techniques in normal fetuses.
Prevalence and cardiovascular risk factors of asymptomatic intracranial arterial stenosis: the Kongcun Town Study in Shandong, China
Authors: Sun Q. , Wang Q. , Wang X. , Ji X. , Sang S. , Shao S. , Zhao Y. , Xiang Y. , Xue Y. , Li J. , Wang G. , Lv M. , Xue F. , Qiu C. , Du Y.
Published: December 2019

Background and purpose

This study was to investigate the prevalence and cardiovascular risk factors (CRFs) of asymptomatic intracranial atherosclerotic stenosis (aICAS) amongst middle‐aged and older adults living in rural communities in China.

Methods

This population‐based study included 2019 subjects (aged ≥40 years, 52.3% women) who were free of stroke and living in rural communities in China. From October 2017 to May 2018, data on demographics, CRFs and health conditions were collected through face‐to‐face interviews, physical examination and laboratory tests. Asymptomatic ICAS was detected through a two‐phase procedure: a screening phase with transcranial Doppler ultrasound, followed by a diagnostic phase with magnetic resonance angiography examination. Multivariable logistic regression models were used to analyse CRFs associated with aICAS.

Results

Of the 2019 participants, aICAS was detected in 153 persons. The overall prevalence of aICAS was 7.6%, and the prevalence of moderate‐to‐severe aICAS was 5.0%. The multi‐adjusted odds ratio (95% confidence interval) of aICAS associated with CRFs was 2.40 (1.56–3.69) for hypertension, 1.91 (1.32–2.76) for high hypersensitive C‐reactive protein, 1.68 (1.14–2.49) for diabetes and 1.61 (1.08–2.41) for overweight or obesity. When these four CRFs were aggregated, compared with participants without any of these factors, the multi‐adjusted odds ratios (95% confidence interval) of aICAS for persons concurrently having one, two and three or more of these factors were 1.14 (0.52–2.48), 2.91 (1.42–5.99) and 5.51 (2.64–11.50), respectively (P for linear trend <0.001).

Conclusions

Asymptomatic ICAS is common amongst rural‐dwelling middle‐aged and older Chinese people. Hypertension, diabetes, overweight or obesity and high hypersensitive C‐reactive protein, especially when coexisting, are strongly associated with aICAS.
How do we overcome abrupt degradation of marine ecosystems and meet the challenge of heat waves and climate extremes?
Authors: Ainsworth Tracy D. , Hurd Catriona L. , Gates Ruth D. , Boyd Philip W.
Published: December 2019

Extreme heat wave events are now causing ecosystem degradation across marine ecosystems. The consequences of this heat‐induced damage range from the rapid loss of habitat‐forming organisms, through to a reduction in the services that ecosystems support, and ultimately to impacts on human health and society. How we tackle the sudden emergence of ecosystem‐wide degradation has not yet been addressed in the context of marine heat waves. An examination of recent marine heat waves from around Australia points to the potential important role that respite or refuge from environmental extremes can play in enabling organismal survival. However, most ecological interventions are being devised with a target of mid to late‐century implementation, at which time many of the ecosystems, that the interventions are targeted towards, will have already undergone repeated and widespread heat wave induced degradation. Here, our assessment of the merits of proposed ecological interventions, across a spectrum of approaches, to counter marine environmental extremes, reveals a lack preparedness to counter the effects of extreme conditions on marine ecosystems. The ecological influence of these extremes are projected to continue to impact marine ecosystems in the coming years, long before these interventions can be developed. Our assessment reveals that approaches which are technologically ready and likely to be socially acceptable are locally deployable only, whereas those which are scalable—for example to features as large as major reef systems—are not close to being testable, and are unlikely to obtain social licence for deployment. Knowledge of the environmental timescales for survival of extremes, via respite or refuge, inferred from field observations will help test such intervention tools. The growing frequency of extreme events such as marine heat waves increases the urgency to consider mitigation and intervention tools that support organismal and ecosystem survival in the immediate future, while global climate mitigation and/or intervention are formulated.
Variation and evolution of C:N ratio among different organs enable plants to adapt to N‐limited environments
Authors: Zhang Jiahui , He Nianpeng , Liu Congcong , Xu Li , Chen Zhi , Li Ying , Wang Ruomeng , Yu Guirui , Sun Wei , Xiao Chunwang , Chen Han Y. H. , Reich Peter B.
Published: December 2019

Carbon (C) and nitrogen (N) are the primary elements involved in the growth and development of plants. The C:N ratio is an indicator of nitrogen use efficiency (NUE) and an input parameter for some ecological and ecosystem models. However, knowledge remains limited about the convergent or divergent variation in the C:N ratios among different plant organs (e.g., leaf, branch, trunk, and root) and how evolution and environment affect the coefficient shifts. Using systematic measurements of the leaf–branch–trunk–root of 2,139 species from tropical to cold‐temperate forests, we comprehensively evaluated variation in C:N ratio in different organs in different taxa and forest types. The ratios showed convergence in the direction of change but divergence in the rate of change. Plants evolved toward lower C:N ratios in the leaf and branch, with N playing a more important role than C. The C:N ratio of plant organs (except for the leaf) was constrained by phylogeny, but not strongly. Both the change of C:N during evolution and its spatial variation (lower C:N ratio at midlatitudes) help develop the adaptive growth hypothesis. That is, plants with a higher C:N ratio promote NUE under strong N‐limited conditions to ensure survival priority, whereas plants with a lower C:N ratio under less N‐limited environments benefit growth priority. In nature, larger proportion of species with a high C:N ratio enabled communities to inhabit more N‐limited conditions. Our results provide new insights on the evolution and drivers of C:N ratio among different plant organs, as well as provide a quantitative basis to optimize land surface process models.
Factors influencing the success of knowledge management process in health care organisations: a literature review
Authors: Ayatollahi Haleh , Zeraatkar Kimia
Published: December 2019

Introduction

Knowledge is a strategic resource in health care organisations and knowledge management (KM) is applied as an effective solution to overcome challenges, such as rising health care cost and increasing demands for improving quality of care. The aim of this review was to identify factors influencing the success of KM process in health care organisations of developed and developing countries.

Methods

This review was conducted in 2018. The sources used for searching relevant papers were PubMed, Scopus, Science Direct, Web of Knowledge, EMBASE and Google Scholar, and the time frame was between 1980 and 2017. The search terms were KM, health care services administration, health care organisation, hospital and clinic which were combined by using AND/OR Boolean operators.

Results

In this review, 13 papers were included. The main success factors influencing KM implementation in health care organisations were organisational culture, information technology, organisational structure, and performance evaluation and measurement. In developed countries, organisational culture was the most frequent factor, while in developing countries, organisational culture and information technology were the most frequent ones.

Conclusion

It seems that in developed and developing countries, organisational factors are the most frequent factors influencing successful KM in health care organisations.
Consumers' perception of and attitudes towards organic food in Galicia (Northern Spain)
Authors: Rodríguez‐Bermúdez Ruth , Miranda Marta , Orjales Inmaculada , Ginzo‐Villamayor María José , Al‐Soufi Wajih , López‐Alonso Marta
Published: December 2019

Although the organic sector is still relatively small, the demand for organic food is increasing throughout the world. The characterization of consumers' perception of and attitudes towards organic food is important to enable the development of marketing policies aimed at attracting conventional consumers to the sector. Consumers' behaviour studies must be conducted specifically for different regions and countries as perceptions and attitudes vary across the world. In the present study, a questionnaire was designed for administration to consumers in Galicia (Northern Spain). The questionnaire was administered to 830 consumers in 200 establishments to obtain data about the consumers' perception of and attitudes towards organic food. The survey results showed that one‐third of responders consume organic food and that the typical profile of a consumer of organic food is a middle‐aged, medium‐high class, university‐educated female living in a large village, who shops in supermarkets and preferably consume vegetables, fruits and eggs. Most people who declared that they consume organic products confuse these with home and locally produced food, indicating the potential for growth of the organic sector by providing such consumers with appropriate information. Most consumers (including conventional consumers) have a good opinion of organic food and consider that it is better for health, is of better quality than conventional food and avoid pesticide residues. However, price continues to be a barrier to the consumption of organic produce. Most respondents stated that they would consume more organic food if the price was only between 10% and 30% higher than the conventional equivalent. Finally, organic consumers in Galicia showed positive attitudes towards using local breeds in organic agriculture, both for producing food and for ecotourism and educational activities. Such activities could contribute to conserving breed biodiversity and adding value to organic farming.
Distinct patterns of socio‐economic disparities in child‐to‐adolescent BMI trajectories across UK ethnic groups: A prospective longitudinal study
Authors: Lu Yi , Pearce Anna , Li Leah
Published: December 2019

Background

In many high‐income countries, body mass index (BMI)/obesity levels are inversely associated with socio‐economic position (SEP). Little is known whether socio‐economic patterns in BMI trajectories throughout childhood differ by ethnicity, especially in the United Kingdom.

Objectives

To investigate socio‐economic disparities in child‐to‐adolescent BMI trajectories and risks of overweight and obesity during adolescence across ethnic groups.

Methods

Mixed‐effects fractional polynomial and multinomial regression models were applied to estimate socio‐economic differences in BMI trajectories (3‐14 years) and risk of overweight/obesity at 14 years, respectively, in the UK Millennium Cohort Study (n = 15 996). Analysis was stratified by ethnicity.

Result

Poverty was associated with higher BMI in children of White and South Asian origins, with a small difference at 3 years, which widened with age to 0.75 kg/m2 (95% CI, 0.59‐0.91) and 0.77 kg/m2 (0.26‐1.27) at 14 years for the White and South Asian groups, respectively. There was a reverse income‐BMI association in children of Black (African‐Caribbean) origin with the poverty group having a lower BMI (−0.37 kg/m2 [−0.71 to ‐0.04] at 5 years; −0.95 kg/m2 [−1.79 to −0.11] at 14 years). These patterns also presented with maternal education as a SEP indicator and for obesity at 14 years.

Conclusions

Socio‐economic advantage may not be universally associated with lower BMI, which should be considered when planning obesity interventions. The positive SEP‐BMI association in children of Black origin requires replication and merits further investigation into underpinning mechanisms.
Microvascular function in non‐dippers: Potential involvement of the salt sensitivity biomarker, marinobufagenin—The African‐PREDICT study
Authors: Strauss‐Kruger Michél , Smith Wayne , Wei Wen , Bagrov Alexei Y. , Fedorova Olga V. , Schutte Aletta E.
Published: December 2019

Suppressed nighttime blood pressure dipping is associated with salt sensitivity and may increase the hemodynamic load on the microvasculature. The mechanism remains unknown whereby salt sensitivity may increase the cardiovascular risk of non‐dippers. Marinobufagenin, a novel steroidal biomarker, is associated with salt sensitivity and other cardiovascular risk factors independent of blood pressure. The authors investigated whether microvascular function in non‐dippers is associated with marinobufagenin. The authors included 220 dippers and 154 non‐dippers (aged 20‐30 years) from the African‐PREDICT study, with complete 24‐hour urinary marinobufagenin and sodium data. The authors determined dipping status using 24‐hour blood pressure monitoring and defined nighttime non‐dipping <10%. The authors measured microvascular reactivity as retinal artery dilation in response to light flicker provocation. Young healthy non‐dippers and dippers presented with similar peak retinal artery dilation, urinary sodium, and MBG excretion (P > .05). However, only in non‐dippers did peak retinal artery dilation relate negatively to marinobufagenin excretion after single (r = −0.20; P = .012), partial (r = −0.23; P = .004), and multivariate‐adjusted regression analyses (Adj. R2 = 0.34; β = −0.26; P < .001). The authors also noted a relationship between peak artery dilation and estimated salt intake (Adj. R2 = 0.30; β = −0.14; P = .051), but it was lost upon inclusion of marinobufagenin (Adj. R2 = 0.33; β = −0.015; P = .86). No relationship between microvascular reactivity and marinobufagenin was evident in dippers (P = .77). Marinobufagenin, representing salt sensitivity, may be involved in early microvascular functional changes in young non‐dippers and thus contributes to the development of hypertension and cardiovascular disease later in life.
Association between blood pressure and intracranial artery stenosis in a Chinese population
Authors: Song Xiaowei , Zhao Qiannan , Hua Yang , Wang Chunxiu , Liu Beibei , Guan Shaochen , Li Jun , Zhang Zhongying , Fang Xianghua , Wu Jian
Published: December 2019

The association between blood pressure and intracranial artery stenosis (ICAS) in different age groups has not been elucidated. Using data from the “China Hypertension Survey,” we conducted a cross‐sectional analysis of the association between blood pressure parameters and ICAS. In this study, participants older than 35 years were selected by stratified, multistage random sampling. Blood pressure was measured repeatedly at rest, and ICAS was assessed by transcranial doppler ultrasound. Binary logistic regression analysis was used to demonstrate the association between different blood pressure indicators and ICAS. Of the 3640 participants included (mean age 63 ± 13 years old, 57.8% female), systolic blood pressure (SBP) and pulse pressure (PP) were associated with ICAS in the general population; the multivariable adjusted odds ratio (OR) and corresponding 95% confidence interval (95% CI) of ICAS and multivessel stenosis were 1.32 (1.21, 1.45) and 1.29 (1.14, 1.46) per standard deviation (SD) increase in SBP and 1.44 (1.30, 1.59) and 1.52 (1.33, 1.74) for PP, respectively. Further analysis of this association in different age groups revealed inconsistent results between SBP and ICAS. Prehypertension (120 ≤ SBP < 140) could predict ICAS in the older group but not in the younger group, and the positive association between SBP and multivessel stenosis disappeared in the younger age group (P > .05 in all SBP subgroups). In conclusion, SBP and PP could not only identify ICAS in the middle‐aged and elderly population but could also provide some information about ICAS burden; however, these associations need to be interpreted differentially based on age subgroup.
Reimbursement of ambulatory blood pressure monitoring in the US commercial insurance marketplace
Authors: Dietrich Eric , Desai Raj , Garg Mahek , Park Haesuk , Smith Steven M.
Published: December 2019

Ambulatory blood pressure monitoring (ABPM) is increasingly recommended for confirming hypertension diagnosis and ongoing hypertension monitoring. However, reimbursement in the United States is variable and low compared with other advanced health care systems. We examined the reimbursement of ABPM and factors associated with successful reimbursement. A retrospective analysis of IBM MarketScan® commercial claims database was conducted for patients ≥18 years with ≥1 ABPM claim from January 2012 to December 2016. The date of first the ABPM claim was used as the index date. Per‐beneficiary ABPM episode reimbursements were calculated by aggregating all ABPM‐related reimbursements within a 30‐day post‐index window, considered as an ABPM episode. Multivariable logistic regression was used to identify predictors of successful reimbursement. Of 20 875 beneficiaries with ABPM claims, 16 920 (81.0%) were reimbursed. The median reimbursement per beneficiary for an ABPM episode was $89 (Inter Quartile Range [IQR], $62, $132), driven primarily by reimbursement for the full procedure (median, $86; IQR, $66, $110). Comparing benefit plan types, consumer‐directed health plans provided the highest median reimbursement ($96; IQR, $61, $175). Successful reimbursement was associated with female patient sex (adjusted OR [aOR], 1.20; 95% CI, 1.11‐1.28), having a health maintenance organization (aOR 2.11; 95% CI, 1.82‐2.43) or point of service (aOR 2.08; 95% CI, 1.74‐2.49) as benefit plan types, claim filing by a specialist (aOR 1.26; 95% CI, 1.14‐1.40) and services provided at an outpatient hospital (aOR 1.17; 95% CI, 1.01‐1.35). Among commercially insured Americans, our data suggest significant variability in successful reimbursement. Accordingly, more uniform criteria for ABPM reimbursement may facilitate greater use of guideline‐recommended monitoring.
Inverted meiosis and the evolution of sex by loss of complementation
Authors: Archetti Marco
Published: December 2019

Inverted meiosis, in which sister chromatids segregate before homologous chromosomes, is a common aberration of conventional meiosis (in which sister chromatids segregate after homologous chromosomes) and is routinely observed in certain species. This raises an evolutionary mystery: what is the adaptive advantage of the more common, conventional order of segregation in meiosis? I use a population genetic model to show that asexual mutants arising from inverted meiosis are relatively immune from the deleterious effects of loss of complementation (heterozygosity), unlike the asexual mutants arising from conventional meiosis, in which loss of complementation can outweigh the two‐fold cost of meiosis. Hence, asexual reproduction can replace sexual reproduction with inverted meiosis, but not with conventional meiosis. The results are in line with analogous considerations on other alternative types of reproduction and support the idea that amphimixis is stable in spite of the two‐fold cost of meiosis because loss of complementation in mutant asexuals outweigh the two‐fold cost.
Epigenetic regulation in plant abiotic stress responses
Authors: Chang Ya‐Nan , Zhu Chen , Jiang Jing , Zhang Huiming , Zhu Jian‐Kang , Duan Cheng‐Guo
Published: December 2019

In eukaryotic cells, gene expression is greatly influenced by the dynamic chromatin environment. Epigenetic mechanisms, including covalent modifications to DNA and histone tails and the accessibility of chromatin, create various chromatin states for stress‐responsive gene expression that is important for adaptation to harsh environmental conditions. Recent studies have revealed that many epigenetic factors participate in abiotic stress responses, and various chromatin modifications are changed when plants are exposed to stressful environments. In this review, we summarize recent progress on the cross‐talk between abiotic stress response pathways and epigenetic regulatory pathways in plants. Our review focuses on epigenetic regulation of plant responses to extreme temperatures, drought, salinity, the stress hormone abscisic acid, nutrient limitations and ultraviolet stress, and on epigenetic mechanisms of stress memory.
Variability of piglet birth weights: A systematic review and meta‐analysis
Authors: Moreira Rennan Herculano Rufino , Pérez Palencia Jorge Yair , Moita Vitor Hugo Cardoso , Caputo Luciano Sales Santiago , Saraiva Alysson , Andretta Inês , Ferreira Rony Antônio , de Abreu Márvio Lobão Teixeira
Published: December 2019

The objective of the study was to evaluate the effects of litter size and supplementation of functional amino acids on the piglet birth weight variability through of a systematic review and meta‐analysis. PubMed, ISI Web of Science, Science Direct, Scopus and SciELO are the main used databases and were searched in January 2019 by using the following keywords and their combinations: within‐litter birth, weight variability, piglets, litter size, sow, amino acids, gestation, uniformity, CV and/or SD. Of the 64 pre‐selected articles, only articles presenting the coefficients of variation and/or standard deviations according to the litter size and different levels of amino acid supplementation in the sow diets during gestation were selected. The average birth weights of total and live piglets were 43% lower in litters from sows with high prolificacy than those from sows with low prolificacy. The weight variability was affected by high prolificacy sows, with increases of 4.04% and 4.54% in the coefficients of variation of total and born alive piglets respectively (p = .074; p = .009). The standard deviation increased by 180 g in born alive piglets to high prolificacy sows. The coefficients of variation of total and live piglets born from high prolificacy sows showed an increase of 4.04% and 4.54% respectively (p = .07; p < .05). There was a tendency for reduced weight variability with amino acids supplementation when considering the standard deviation of total born (p = .072). However, reproductive performance was not significantly influenced (p > .05). In conclusion, the average litter weight and the number of piglets born influence weight variability. Amino acids supplementation may reduce the birth weight variability between piglets. However, this effect depends on the amino acid used, the levels of supplementation and on other factors not completely addressed in this study. Thus, more research is necessary to fully elucidate this topic.
Validation of self‐reported measures of periodontitis in a Spanish Population
Authors: Montero Eduardo , La Rosa Martina , Montanya Eduard , Calle‐Pascual Alfonso L. , Genco Robert J. , Sanz Mariano , Herrera David
Published: December 2019

Background and Objective

Use of self‐reported questionnaires in Dentistry may be useful to estimate the prevalence of periodontitis in epidemiological studies. This study aims to assess the accuracy of self‐reporting for predicting the prevalence of periodontitis in a Spanish population participating in a diabetes incidence study.

Materials and Methods

Data were collected from 231 patients participating in the Di@bet.es study. Eight questions about periodontal health were included in a health patient‐reported questionnaire. The outcomes from self‐reporting were validated against a full‐mouth periodontal examination. Multivariable logistic regression predictive modeling was used to determine the sensitivity, specificity, and area under the receiver operator characteristic curve (AUROCC).

Results

Self‐reported gum health, loose teeth, tooth appearance, and use of dental floss were associated with different definitions of severe periodontitis. Correlations between responses to the questions were weak. The question “Do you think you might have gum disease?” combined with demographic and well‐established risk factors resulted in an AUC value of 0.75, sensitivity of 75.2%, and specificity of 60.6% for severe periodontitis. The answer to 4 questions combined with age, educational level, smoking status, and tooth loss was 76.4% sensitive and 63.5% specific, with an AUC of 0.75 in predicting prevalence of ≥25% of teeth with probing pocket depth (PPD) ≥6 mm.

Conclusion

Predictive models, combining self‐reporting on oral health status with demographic and risk factors, were useful for estimating the prevalence of severe periodontitis in the Spanish population.
Tolerogenic properties of liver macrophages in non‐alcoholic steatohepatitis
Authors: Orci Lorenzo A. , Kreutzfeldt Mario , Goossens Nicolas , Rubbia‐Brandt Laura , Slits Florence , Hammad Karim , Delaune Vaihere , Oldani Graziano , Negro Francesco , Clément Sophie , Gonelle‐Gispert Carmen , Buhler Léo H. , Toso Christian , Lacotte Stéphanie
Published: December 2019

Background & Aims

Our understanding of non‐alcoholic fatty liver disease (NAFLD) pathogenesis is improving, but there is still limited data on the function of resident liver macrophages in this context, especially when considering their contribution in dampening liver inflammation.

Methods

Liver macrophages were studied in mouse models of prolonged diet‐induced liver steatohepatitis and carbon tetrachloride‐induced liver injury. We assessed liver macrophages phenotype and costimulatory/inhibitory properties upon exposure to lipopolysaccharide or interleukin 4. We did phagocytosis and antigen presentation assays to investigate liver macrophages function as scavengers and immune response initiators. Using immunofluorescence staining, we further determined, in human liver tissue of patients with simple steatosis, non‐alcoholic steatohepatitis and chronic hepatitis B infection, the expression of the co‐inhibitory protein CD274 (Programmed‐death ligand 1) and major histocompatibility complex (MHC) class II.

Results

Both in humans and mice, within chronically inflamed fatty livers, liver macrophages acquired immunomodulatory properties by reducing the expression of MHC class II, and by enhancing co‐inhibitory signalling. Liver macrophages circumscribed endotoxin‐mediated inflammatory response by upregulating anti‐inflammatory genes arginase 1 and interleukin‐10. While hepatic macrophages isolated from mice with normal livers were capable of achieving endotoxin tolerance, our results indicated an impairment of this protective mechanism in the presence NASH‐like parenchymal abnormalities.

Conclusions

Liver macrophages can achieve endotoxin tolerance, but in the chronically inflamed fatty liver, while they acquire an immunomodulatory phenotype, liver macrophages fail to dampen immune‐mediated damage. Therefore, loss of tolerogenicity induced by ongoing liver insult may be a mechanism contributing to the worsening of NAFLD.
Remediating professionalism lapses in medical students and doctors: A systematic review
Authors: Brennan Nicola , Price Tristan , Archer Julian , Brett Joe
Published: December 2019

Context

A remediation intervention aims to facilitate the improvement of an individual whose competence in a particular skill has dropped below the level expected. Little is known regarding the effectiveness of remediation, especially in the area of professionalism. This review sought to identify and assess the effectiveness of interventions to remediate professionalism lapses in medical students and doctors.

Methods

Databases Embase, MEDLINE, Education Resources Information Center and the British Education Index were searched in September 2017 and October 2018. Studies reporting interventions to remediate professionalism lapses in medical students and doctors were included. A standardised data extraction form incorporating a previously described behaviour change technique taxonomy was utilised. A narrative synthesis approach was adopted. Quality was assessed using the Critical Appraisal Skills Programme checklist.

Results

A total of 19 studies on remediation interventions reported in 23 articles were identified. Of these, 13 were case studies, five were cohort studies and one was a qualitative study; 37% targeted doctors, 26% medical students, 16% residents and 21% involved mixed populations. Most interventions were multifaceted and addressed professionalism issues concomitantly with clinical skills, but some focused on specific areas (eg sexual boundaries and disruptive behaviours). Most used three or more behaviour change techniques. The included studies were predominantly of low quality as 13 of the 19 were case studies. It was difficult to assess the effectiveness of the interventions as the majority of studies did not carry out any evaluation.

Conclusions

The review identifies a paucity of evidence to guide best practice in the remediation of professionalism lapses in medical students and doctors. The literature tentatively suggests that remediating lapses in professionalism, as part of a wider programme of remediation, can facilitate participants to graduate from a programme of study, and pass medical licensing and mock oral board examinations. However, it is not clear from this literature whether these interventions are successful in remediating lapses in professionalism specifically. Further research is required to improve the design and evaluation of interventions to remediate professionalism lapses.
Species‐specific root proliferation of tree seedlings in tropical litter: do nutrients matter?
Authors: Sarker Tushar C. , Maisto Giulia , De Marco Anna , Memoli Valeria , Panico Speranza C. , Motti Riccardo , Idbella Mohamed , Incerti Guido , Mazzoleni Stefano , Bonanomi Giuliano
Published: December 2019

Litter decomposition mobilizes nutrients that sustain ecosystem productivity, but decomposition by‐products may also hamper root proliferation by phytotoxicity. The aim of this study was to assess the litter substrate preferences of tropical tree seedlings in relation to litter chemical traits.

We characterized 44 litter types (11 species at four decomposition ages; 0, 30, 90 and 180 days) for nutrients (N, P, K, Mg, Mn, Na, Fe and Zn) and proximate chemical parameters (cellulose, extractive, lignin and C) and tested the effect of such litter materials on seedling root growth of Albizia procera, Dalbergia sissoo and Terminalia arjuna. Albizia procera root growth was inhibited by all litter types and ages, including conspecific materials, while different heterospecific litters had inhibitory or stimulatory effect on D. sissoo and T. arjuna root growth, compared to the control. Interestingly, inhibitory and stimulatory effects of heterospecific litters significantly changed with litter age, although with no clear‐cut pattern among target species and litter species and age, while conspecific litters consistently inhibited root growth when aged, but not when fresh. Litter nutrient, extractive, C, cellulose and lignin showed no consistent association with root growth of tested plants. Albizia procera root growth was positively associated with Na content and N:P ratio. Dalbergia sissoo root growth was positively associated to C:N and lignin:N ratios, and negatively to K, Na and Zn content. Finally, T. arjuna root was positively associated to cellulose and N:P ratio, but negatively to extractive. We conclude that studied nutrient, cellulose and lignin do not consistently explain the species‐specific response of root of tree seedlings to decomposing litter.
Foliar herbivory by caterpillars and aphids differentially affects phytohormonal signalling in roots and plant defence to a root herbivore
Authors: Karssemeijer Peter N. , Reichelt Michael , Gershenzon Jonathan , van Loon Joop , Dicke Marcel
Published: December 2019

Plant‐mediated interactions are an important force in insect ecology. Through such interactions, herbivores feeding on leaves can affect root feeders. However, the mechanisms regulating the effects of above‐ground herbivory on below‐ground herbivores are poorly understood. Here, we investigated the performance of cabbage root fly larvae (Delia radicum) on cabbage plants (Brassica oleracea) previously exposed to above ground herbivores belonging to two feeding guilds: leaf chewing diamondback moth caterpillars (Plutella xylostella) or phloem‐feeding cabbage aphids (Brevicoryne brassicae). Our study focusses on root‐herbivore performance and defence signalling in primary roots by quantifying phytohormones and gene expression. We show that leaf herbivory by caterpillars, but not by aphids, strongly attenuates root herbivore performance. Above‐ground herbivory causes changes in primary roots in terms of gene transcripts and metabolites involved in plant defence. Feeding by below‐ground herbivores strongly induces the jasmonate pathway in primary roots. Caterpillars feeding on leaves cause a slight induction of the primary root jasmonate pathway and interact with plant defence signalling in response to root herbivores. In conclusion, feeding by a leaf chewer and a phloem feeder differentially affects root‐herbivore performance, root‐herbivore‐induced phytohormonal signalling, and secondary metabolites.