bluuebunny/crossref_metadata_2025 huggingface dataset:
Life beyond 5 Years after TAVI: Patients’ Perceived Health Status and Long-Term Outcome after Transcatheter Aortic Valve Implantation
Authors: Murray Marie-Isabel K. , Hofmann Eileen , De Rosa Roberta , Mas-Peiro Silvia , Seppelt Philipp , Walther Thomas , Zeiher Andreas M. , Fichtlscherer Stephan , Vasa-Nicotera Mariuca
Published: October 2019

Background. Transcatheter aortic valve implantation (TAVI) is currently recommended for patients with severe aortic stenosis at intermediate or high surgical risk. The decision process during TAVI evaluation includes a thorough benefit-risk assessment, and knowledge about long-term benefits and outcomes may improve patients’ expectation management. Objective. To evaluate patients’ perceived health status and self-reported long-term outcome more than 5 years after TAVI. Methods and Results. Demographic and procedure data were obtained from all patients treated with TAVI at our institution from 2006 to 2012. A cross-sectional survey was conducted on the patients alive, measuring health status, including the EQ-5D-5L questionnaire, and clinical outcomes. 103 patients (22.8%) were alive at a median follow-up period of 7 years (5.4–9.8). 99 (96%) of the 103 patients were included in the final analysis. The mean age at follow-up was 86.5 years ± 8.0 years, and 56.6% were female. Almost all patients (93.9%) described an improvement of their quality of life after receiving TAVI. At late follow-up, the mean utility index and EQ-VAS score were 0.80 ± 0.20 and 58.49 ± 11.49, respectively. Mobility was found to be the most frequently reported limitation (85.4%), while anxiety/depression was the least frequently reported limitation (19.8%). With respect to functional class, 64.7% were in New York Heart Association (NYHA) class III or IV, compared to 67.0% prior to TAVI (p=0.51). Self-reported long-term outcomes revealed mainly low long-term complication rates. 74 total hospitalizations were reported after TAVI, and among those 43% for cardiovascular reasons. Within cardiovascular rehospitalizations, new pacemaker implantations were the most frequently reported (18.9%), followed by cardiac decompensation and coronary heart disease (15.6%). Conclusion. The majority of the patients described an improvement of health status after TAVI. More than five years after TAVI, the patients’ perceived health status was satisfactory, and the incidence of clinical events and hospitalizations was very low.
Experimental Study on Bearing Capacity of Reinforced Steel Tubular Scaffold under Uniform Loads
Authors: Jia Li , Liu Hongbo , Chen Zhihua , Liu Yang , Wu Yapeng
Published: September 2019

Five groups of tests were designed to analyze the influence of node types (fastener connection and mortise‐and‐tenon joint) and reinforcement modes of top horizontal cross rods (weak truss and stiffening truss) on the bearing capacity of the steel tubular scaffold under vertical uniform loads. Loading phenomenon, bearing capacity, failure mode, displacement at key positions, and strain development characteristics during tests were analyzed. The following conclusions were drawn: (1) The fastener scaffold reinforced by a top truss showed the highest bearing capacity and high material utilization. (2) The fastener scaffold reinforced by a top weak truss increased the bearing capacity and caused coordinated deformation of the top horizontal force rods. (3) The node displacement of the mortise‐and‐tenon scaffold was smaller than that of the fastener joint, whereas its bearing capacity was higher. (4) Vertical diagonal bracing can slightly increase the bearing capacity of the mortise‐and‐tenon scaffold but can also constrain the deformation of the vertical rods and change the failure mode.
On Some Sufficiency-Type Global Stability Results for Time-Varying Dynamic Systems with State-Dependent Parameterizations
Authors: De la Sen M.
Published: October 2019

This paper formulates sufficiency-type global stability and asymptotic stability results for, in general, nonlinear time-varying dynamic systems with state-trajectory solution-dependent parameterizations. The stability proofs are based on obtaining sufficiency-type conditions which guarantee that either the norms of the solution trajectory or alternative interval-type integrals of the matrix of dynamics of the higher-order than linear terms do not grow faster than their available supremum on the preceding time intervals. Some extensions are also given based on the use of a truncated Taylor series expansion of chosen truncation order with multiargument integral remainder for the dynamics of the differential system.
Spica Prunellae Extract Enhances Fluorouracil Sensitivity of 5-Fluorouracil-Resistant Human Colon Carcinoma HCT-8/5-FU Cells via TOP2α and miR-494
Authors: Fang Yi , Yang Chi , Zhang Ling , Wei Lihui , Lin Jiumao , Zhao Jinyan , Peng Jun
Published: September 2019

The use of 5-fluorouracil (5-FU) has been proven benefits, but it also has adverse events in colorectal cancer (CRC) chemotherapy. In this study, we explored the mechanism of 5-FU resistance by bioinformatics analysis of the NCBI public dataset series GSE81005. Fifteen hub genes were screened out of 582 different expressed genes. Modules of the hub genes in protein-protein interaction networks gathered to TOP2α showed a decrease in HCT-8 cells but an increase in 5-FU-resistant HCT-8/5-FU cells with 5-FU exposure. Downregulation of TOP2α with siRNA or miR-494 transfection resulted in an increase of cytotoxicity and decrease of cell colonies to 5-FU for HCT-8/5-FU cells. Moreover, we found that an ethanol extract of Spica Prunellae (EESP), which is a traditional Chinese medicine with clinically beneficial effects in various cancers, was able to enhance the sensitivity of 5-FU in HCT-8/5-FU cells and partly reverse the 5-FU resistance effect. It significantly helped suppress cell growth and induced cell apoptosis in HCT-8/5-FU cells with the expression of TOP2α being significantly suppressed, which increased by 5-FU. Consistently, miR-494, which reportedly regulates TOP2α, exhibited reverse trends in EESP/5-FU combination treatment. These results suggested that Spica Prunellae may be beneficial in the treatment of 5-FU-resistant CRC patients.
About the Influence of Doping Approach on the Alkali Metal Catalyzed Slow Pyrolysis of Xylan
Authors: Gargiulo Valentina , Giudicianni Paola , Alfè Michela , Ragucci Raffaele
Published: September 2019

In this study, we highlighted how the catalytic effect of alkali metals on xylan pyrolysis is strongly affected by the adopted doping approach. Thermogravimetric and pyrolysis tests, up to 973 K and at a heating rate of 7 K/min, were conducted on a set of potassium- or sodium-doped xylan samples containing controlled amounts of KCl or NaCl introduced, starting from a demineralized xylan sample, through a conventional wet impregnation approach. Pyrolysis product yields from xylan-doped samples were compared with those related to the demineralized xylan sample. The performances of the doping procedure were assessed through a comparison with the data collected on raw xylan and a xylan sample doped with potassium ions by a cationic exchange approach. The results showed that the introduction of potassium ions by wet impregnation using a chloride salt negligibly affected the pyrolytic behaviour of the demineralized sample and indicated that the doping approach based on wet impregnation using chloride salts is not appropriate for the study of the effect of alkali metals on the pyrolysis of polysaccharides bearing acidic functional groups as xylan.
Management of Wet Age-Related Macular Degeneration in Spain: Challenges for Treat and Extend Implementation in Routine Clinical Practice
Authors: García-Layana A. , García-Arumí J. , Figueroa M. S. , Arias Barquet L. , Ruíz-Moreno J. M. , Monclús-Arbona L. , The Spanish AMD Multicenter Group
Published: September 2019

Purpose. To ascertain wet AMD (wAMD) management patterns in Spain. Methods. A two-round Delphi study conducted through a questionnaire-based survey designed from literature review and validated by an independent Steering Committee. Results. Forty-nine retina specialists experienced in wAMD participated by answering the two-round study questionnaire. Retina specialists are the main responsible for wAMD diagnosis and monitoring, including visits and associated procedures, with a median time per visit of 15 minutes. Standard treatment strategies are based on anti-VEGF administration, including standard loading dose administration followed by maintenance with aflibercept or ranibizumab (81% of patients). Although treat and extend (T&E) dosing strategy is considered as optimal for wAMD management (78% of the panelists), the main routine healthcare limitations (i.e., visits overload, reduced staff, short visit time, coordination issues, lack of facilities) conduct to self-defined “flexible” strategies, based on T&E and pro-re-nata (PRN) protocols. Conclusion. Proactive treatment patterns (T&E) are the preferred ones by the retina specialists in Spain. However, their proper implementation is difficult due to healthcare resource limitations, as well as organisation and logistic issues. The use of anti-VEGF agents with longer duration of action could facilitate the use of strict T&E approaches according to routine clinical practices.
Lemurs in Cacao: Presence and Abundance within the Shade Plantations of Northern Madagascar
Authors: Webber Amanda D. , Solofondranohatra James S. , Razafindramoana Simon , Fernández David , Parker Charlotte A. , Steer Mark , Abrahams Mark , Allainguillaume Joel
Published: October 2019

The recognition that much biodiversity exists outside protected areas is driving research to understand how animals survive in anthropogenic landscapes. In Madagascar, cacao (Theobroma cacao) is grown under a mix of native and exotic shade trees, and this study sought to understand whether lemurs were present in these agroecosystems. Between November 2016 and March 2017, discussions with farmers, nocturnal reconnaissance surveys and camera traps were used to confirm the presence of lemurs in the Cokafa and Mangabe plantations near Ambanja, north-west Madagascar. Four species of lemur were encountered in nocturnal surveys: Mirza zaza, Phaner parienti, Microcebussp. and Cheirogaleussp. with encounter rates of 1.2, 0.4, 0.4 and 0.3 individuals/km, respectively. The presence of Lepilemur dorsalis was confirmed by camera trap. This is the first time lemurs have been studied in cacao plantations, and understanding how these threatened animals use anthropogenic landscapes is vital for their conservation.
Atypical Presentation of a Medullary Thyroid Carcinoma Producing Acth and Serotonin
Authors: Ferreira Mariana , Leal Christianne Toledo de Souza , Ferreira Lize Vargas , Ezequiel Danielle Guedes Andrade , Costa Mônica Barros
Published: September 2019

Medullary carcinoma accounts for about 5% of all thyroid malignancies. The tumor may produce other hormones in addition to calcitonin that typically occurs in the presence of distant metastases. The aim of this report is to present a case of invasive medullary thyroid carcinoma producing ACTH and serotonin. A male patient sought medical attention due to facial plethora and distal paresthesia. On thyroid ultrasound, he presented a hypoechoic nodule measuring 6.7 × 3.2 × 3.5 cm, with punctate calcifications and central vascular pattern. The chest computed tomography showed an extensive solid lesion with epicenter in the superior mediastinum and absence of a cleavage plane with the left thyroid lobe. The lesion extended from the glottic area to the lower portion of the trachea and invaded esophagus, posterior tracheal wall, and left jugular. The patient presented hyperglycemia, hypokalemia, increased free urinary cortisol, calcitonin, ACTH and 5-hydroxyindoleacetic acid levels. The nodule cytological examination obtained by fine-needle aspiration was inconclusive, and the open biopsy confirmed the diagnosis of medullary thyroid carcinoma. Due to the advanced disease stage and increased risk of large caliber vessels injury in case of surgery, local chemotherapy and radiotherapy were recommended. With this report, we want to draw attention to an unusual association between advanced medullary thyroid carcinoma with an aggressive course and ectopic production of ACTH and serotonin.
Kann Ungerechtigkeit bei der Arbeit krank machen? Grundannahmen, subjektive Wahrnehmung und Person-Job-Fit
Authors: Meier-Credner Anne , Muschalla Beate
Published: October 2019

Ungerechtigkeitserleben am Arbeitsplatz kann einhergehen mit verschiedenen physischen und psychischen Befindensstörungen, wie z.B. Schlafproblemen, reduziertem allgemeinen Wohlbefinden, erhöhten Arbeitsunfähigkeitszeiten und schlechter Stimmung. Bisherige Untersuchungsansätze zu Ungerechtigkeit am Arbeitsplatz sind vor allem deskriptiv vorgegangen. Das heißt, sie berichten Zusammenhänge, können jedoch keine Kausalaussagen darüber machen, ob Ungerechtigkeit zu psychischen Beschwerden oder gar Erkrankungen führt oder ob (gegebenenfalls bestimmte) psychische Erkrankungen zu stärker ausgeprägtem Ungerechtigkeitserleben beitragen. Bislang wurden vor allem allgemeine Effekte populationsbezogen untersucht, z.B. wie stark psychisches Missbefinden in einer bestimmten Stichprobe (z.B. ÄrztInnen in Finnland) zusammenhängt mit der Wahrnehmung ungerechter Ressourcenverteilung am Ar­beitsplatz. Es gibt jedoch aus klinischer Perspektive und mit Berücksichtigung der transaktionalen Stresstheorie (Lazarus) Grund zu der Annahme, dass individuelle Voraussetzungen eine wichtige Rolle dabei spielen. Grundannahmen, wie beispielsweise der Glaube an eine gerechte Welt oder die Idee, dass nur Leistung im Leben zählt, oder aber die Überzeugung, dass gutes Zusammenleben mit Mitmenschen nur bei absoluter Loyalität möglich ist, spielen eine wesentliche Rolle dabei, wie verschiedene Menschen ein und dieselbe Arbeitssituation erleben, und gegebenenfalls auch mit Ereignissen oder Ungerechtigkeit umgehen. Dieser Artikel ­bietet eine Übersicht über bisherige Forschungsergebnisse. Therapeutisch-praktische Implikationen werden diskutiert und Fragen für zukünftige Forschung aufgeworfen.
Pursuing an Elusive Prostate Carcinoma: A Case Report Involving Multiparametric MR and CT-Guided Biopsy
Authors: Olson Dana O. , Baisden Joseph M. , Groten David L. , Talug Can
Published: September 2019

Prostate cancer is usually diagnosed when elevated PSA levels lead to a TRUS biopsy. We present a case in which there were several negative biopsies and a rising PSA. This led to a multiparametric MR (mpMRI) which demonstrated a large mass which originated in the anterior transition zone and had extended through the anterior fibromuscular stroma and prostate capsule with a significant extra-prostatic component. The mass was successfully approached anteriorly with a CT-guided biopsy. The patient was subsequently successfully treated with radiotherapy utilizing MR in the planning process. This case report summarizes the utility of mpMRI in this clinical setting. For patients with high suspicion of prostate malignancy despite prior negative biopsies, it can identify tumor in locations not amenable to TRUS biopsy. It also is critical for accurate radiation treatment planning, allowing for increased confidence in tumor targeting as well as sparing sensitive normal tissue.
MicroRNA-296-5p Promotes Cell Invasion and Drug Resistance by Targeting Bcl2-Related Ovarian Killer, Leading to a Poor Prognosis in Pancreatic Cancer
Authors: Okazaki Jun , Tanahashi Toshihito , Sato Yasushi , Miyoshi Jinsei , Nakagawa Tadahiko , Kimura Tetsuo , Miyamoto Hiroshi , Fujino Yasuteru , Nakamura Fumika , Takehara Masanori , Ma Beibei , Bando Masahiro , Kitamura Shinji , Okamoto Koichi , Muguruma Naoki , Sogabe Masahiro , Takayama Tetsuji
Published: September 2019

Background/Aims: Pancreatic ductal adenocarcinoma (PDAC) is characterized by aggressive invasion, early metastasis, and resistance to chemotherapy, leading to a poor prognosis. To clarify the molecular mechanism of these malignant characteristics, we performed a genome-wide microRNA (miRNA) array analysis utilizing micro-cancer tissues from patients with unresectable PDAC (stage IV), obtained by endoscopic ultrasound-fine needle aspiration (EUS-FNA). Methods: The expression profiles of 2,042 miRNAs were determined using micro-cancer tissues from 13 patients with unresectable PDAC obtained by EUS-FNA. The relationship between individual miRNA levels and overall survival (OS) was analyzed. Possible target genes for miRNAs were bioinformatically analyzed using the online database miRDB. Pancreatic cancer cell lines PANC-1, MIA PaCa-2, and PK-8 were transfected with miRNA mimic or small interfering RNA, and cell invasion, epithelial-mesenchymal transition (EMT), and apoptosis markers were examined. miRNA and mRNA expressions were examined by quantitative polymerase chain reaction. Results: Of 2,042 miRNAs, the 10 that exhibited the lowest correlation coefficient (p ≤ 0.005) between miRNA expression level and OS among the patients were identified. The miRDB and expression analysis in cancer cell lines for the 10 miRNAs identified miR-296-5p and miR-1207-5p as biomarkers predictive of shorter survival (p < 0.0005). Bioinformative target gene analysis and transfection experiments with miRNA mimics showed that Bcl2-related ovarian killer (BOK), a pro-apoptotic gene, is a target for miR296-5p in pancreatic cancer cells; transfection of miR-296-5p mimic into PANC-1, MIA PaCa-2, and PK-8 cells resulted in significant suppression of BOK mRNA and protein expression. These transfectants showed significantly higher invasion capability compared with control cells, and knock down of BOK in pancreatic cancer cells similarly enhanced invasion capability. Transfectants of miR-296-5p mimic also exhibited aberrant expression of EMT markers, including vimentin and N-cadherin. Moreover, these transfectants showed a significantly lower apoptosis rate in response to 5-fluorouracil and gemcitabine with a decrease of BOK expression, suggesting a role of miR-296-5p in drug resistance. Conclusion: These results suggest that miR-296-5p is a useful biomarker for a poor prognosis in patients with PDAC, and that the miR-296-5p/BOK signaling axis plays an important role in cell invasion, drug resistance, and EMT in PDACs.
Unexpected Early Oncologic Mortality after Open Radical Cystectomy for Bladder Cancer: Who Is to Be Blamed?
Authors: Hautmann Richard E. , Bolenz Christian , Volkmer Björn
Published: September 2019

Purpose: To investigate prevalence and variables associated with early oncologic mortality (EOM; within ≥30 to ≤90 days) of open radical cystectomy (RC) for bladder cancer. The unexpected rapidity of tumour recurrence and the huge metastatic burden of these patients drew us to analyse this cohort. Methods: We reviewed our RC database. All 1,487 patients were treated with curative intent between January 1986 and December 2008. Imaging for staging was done by CT (chest) and CT or MRI (abdomen). Clinical and histopathological variables were recorded until death to determine whether disease- or treatment-related factors were associated with mortality. Results: There were 93 deaths within 90 days of surgery. Twenty-four patients died from early progression to high volume disseminated metastatic disease. Group 1: unresectable tumours, which were never free of disease. Group 2: resectable tumours, considered tumour-free after RC. Group 1 is characterized by local tumour spread and a low distant failure rate. Group 2 has a low local and a high distant failure rate. Conclusions: Disease related (advanced tumour stage, positive soft tissue surgical margins (+STSM), non urothelial histology, unresectable tumours, atypical occult metastasis), rather than technical factors, had the leading role in EOM. Understaging was universal.
Experiences of Adults Using Continuous Subcutaneous Insulin Infusion: A Qualitative Study
Authors: Mesbah Naglaa Ibrahim , Taha Nehad Abd-El-Raheem , Rahme Zahra Nema , Sukkar Faten Fawzi , Omar Dina Mohamed
Published: September 2019

Objectives: We aimed to determine the quality of life (QoL) of Kuwaiti adults with type 1 diabetes mellitus (T1DM) who used continuous subcutaneous insulin infusions (CSIIs) and to understand their perception of this treatment. Background: CSII is an effective and safe alternative to multiple daily injections for T1DM, with the potential to improve both glycemic control and QoL. Although CSII has been widely used in Kuwait, its effectiveness and benefits have not been properly evaluated. Healthcare providers and patients need more information on CSII before its initiation. Methods: In this qualitative case study, semi-structured individual interviews were performed using a topic guide. Interviews were stopped at data saturation point. Subsequently, a thematic analysis of transcripts was performed. Results: Eighteen adults with T1DM (8 males and 10 females; age 31.4 ± 6.4 years; diabetes duration 17.7 ± 9.5 years; CSII duration 3.6 ± 2.4 years) were recruited from the CSII clinic. Six main themes were studied: health benefits, lifestyle flexibility, improvement of mood and emotion, practical problems, physical and personal effects, and self-confidence to manage diabetes. CSII positively affected the QoL of participants’, most notably by enhancing lifestyle flexibility; however, important negative qualities were also reported. Conclusion: The identified themes highlight the complexity of the experiences of participants, and can be used to provide a framework to help healthcare providers understand how people with T1DM become aware of their treatment regimens. It is important to identify the positive aspects of CSII and not focus only on its negative effects.
Cytoskeleton Protein Filamin A Is Required for Efficient Somatostatin Receptor Type 2 Internalization and Recycling through Rab5 and Rab4 Sorting Endosomes in Tumor Somatotroph Cells
Authors: Treppiedi Donatella , Mangili Federica , Giardino Elena , Catalano Rosa , Locatelli Marco , Lania Andrea Gerardo , Spada Anna , Arosio Maura , Calebiro Davide , Mantovani Giovanna , Peverelli Erika
Published: October 2019

The high expression of somatostatin receptor 2 (SST2) in growth hormone (GH)-secreting tumors represents the rationale for the clinical use of somatostatin analogs (SSAs) in acromegaly. Recently, the cytoskeletal protein Filamin A (FLNA) has emerged as key modulator of the responsiveness of GH-secreting pituitary tumors to SSAs by regulating SST2 signaling and expression. The aim of this study was to explore FLNA involvement in SST2 intracellular trafficking in tumor somatotroph cells. By biotinylation assay, we found that FLNA silencing abolished octreotide-mediated SST2 internalization in rat GH3 cell line (28.0 ± 2.7 vs. 4 ± 4.3% SST2 internalization, control versus FLNA small interfering RNAs (siRNA) cells, respectively, p < 0.001) and human GH-secreting primary cultured cells (70.3 ± 21.1 vs. 24 ± 19.2% SST2 internalization, control versus FLNA siRNA cells, respectively, p < 0.05). In addition, confocal imaging revealed impaired SST2 recycling to the plasma membrane in FLNA silenced GH3 cells. Coimmunoprecipitation and immunofluorescence experiments showed that FLNA, as well as β-arrestin2, is timely dependent recruited to octreotide-stimulated SST2 receptors both in rat and human tumor somatotroph cells. Although FLNA expression knock down did not prevent the formation of β-arrestin2-SST2 complex in GH3 cells, it significantly impaired efficient SST2 loading into cytosolic vesicles positive for the early endocytic and recycling markers Rab5 and 4, respectively (33.7 ± 8.9% down to 25.9 ± 6.9%, p < 0.05, and 28.4 ± 7.4% down to 17.6 ± 5.7%, p < 0.01, for SST2-Rab5 and SST2-Rab4 colocalization, respectively, in control versus FLNA siRNA cells). Altogether these data support an important role for FLNA in the mediation of octreotide-induced SST2 trafficking in GH-secreting pituitary tumor cells through Rab5 and 4 sorting endosomes.
What does immunology have to do with brain development and neuropsychiatric disorders?
Authors: Leckman James F. , Alvarenga Pedro G. de , Ravagnani Beatriz , Johnson Isaac N. S.
Published: October 2019

Introduction: Neural development is an enormously complex and dynamic process. From very early in brain development ‘immune cells’ play a key role in a number of processes including the formation and refinement of neural circuits, as well as sexual differentiation. There is a growing body of evidence that the immune system also plays an important role in the pathobiology of several neurodevelopmental and neuropsychiatric disorders. Objective: The goal of this article is to review the currently available data concerning the role of the ‘immune system’ in normal brain development, as well as its role in the pathobiology of neurodevelopmental and neuropsychiatric disorders. Methodology: We conducted a traditional literature search using PubMed and recent special issues of journals to locate relevant review articles. Results: The cellular and molecular processes that make up our ‘immune system’ are crucial to normal brain development and the formation and maintenance of neural circuits. It is also increasingly evident that the immune system and neuroinflammation play important roles in the pathobiology of at least a subset of individuals with Autism Spectrum Disorder (ASD), schizophrenia, obsessive-compulsive disorder, Tourette syndrome and mood disorders, such as depression, as well as autoimmune and neurodegenerative disorders. Emerging evidence also points to the importance of the ‘gut-brain axis’ and an individual’s microbiome, which can impact an individual’s somatic and mental well-being. Conclusions: There are multidirectional interconnections across multiple biological systems in our brains and bodies that are mediated in part by the immune system. At present, however, the ‘promise’ of this field remains greater than the ‘deliverables.’ Time will tell whether novel interventions will be developed that will make a positive difference in the care of our patients. It is also possible that valid biomarkers will emerge that will guide a more personalized approach to treatment.
Flora da Serra do Cipó, Minas Gerais
Authors: Arbo Maria Mercedes
Published: September 2019

Este trabalho apresenta os taxa de Turneraceae da Serra do Cipó. A família é representada por três gêneros e 14 espécies: Oxossia capitata, Piriqueta aurea, P. sidifolia, P. tamberlikii, P. viscosa, Turnera cipoensis, T. coriacea, T. cuneiformis, T. dichotoma, T. oblongifolia, T. pumilea, T. revoluta e T. subnuda. São apresentadas chaves de identificação para gêneros e espécies, descrições e ilustrações, bem como comentários sobre distribuição geográfica, habitats e fenologia.
Mortality Assessment of Paclitaxel-Coated Balloons
Authors: Gray William A. , Jaff Michael R. , Parikh Sahil A. , Ansel Gary M. , Brodmann Marianne , Krishnan Prakash , Razavi Mahmood K. , Vermassen Frank , Zeller Thomas , White Roseann , Ouriel Kenneth , Adelman Mark A. , Lyden Sean P.
Published: September 2019

Background:

A recent summary-level meta-analysis comprising randomized, controlled trials (RCTs) of femoropopliteal paclitaxel-coated balloon and stent intervention identified excess late mortality in the paclitaxel-treated patients.

Methods:

We evaluated the safety of the Stellarex drug-coated balloon (DCB) for femoropopliteal artery disease with an independently performed meta-analysis of patient-level data from all patients in the Stellarex femoropopliteal clinical program. To compare mortality after DCB or uncoated percutaneous transluminal angioplasty (PTA), we aggregated data from 2 RCTs comprising 419 patients treated with DCB and 170 patients treated with PTA. In an additional analysis, data were aggregated from 6 poolable Stellarex DCB studies (2 RCTs, 3 single-arm studies, and 1 registry). All serious adverse events including deaths were adjudicated by a blinded, third-party, independent Clinical Events Committee. Kaplan–Meier estimates in the RCTs were compared with restricted mean survival time. Predictors of death were assessed with hazard ratios (HRs) and Cox proportional hazards modeling.

Results:

Baseline characteristics were similar in the patients treated with DCB and PTA in the pooled RCT analysis, with the exception that the DCB cohort was younger (67.4±9.7 versus 69.4±9.4 years,
P
=0.02), smoked more frequently (86.6% versus 78.8%,
P
=0.02), and were less often treated for recurrent lesions (8.8% versus 14.7%,
P
=0.04). In the RCTs, patients treated with DCB had all-cause mortality rates that were not different from those of patients treated with PTA (Kaplan–Meier estimates 1.8±0.7% versus 1.3±0.9%, 6.5±1.2% versus 5.9±1.9%, and 9.3±1.5% versus 9.9±2.4% at 1, 2, and 3 years, respectively,
P
=0.86). All-cause mortality rates were similar in a 1906-patient pooled nonrandomized DCB data set (Kaplan–Meier estimates of 2.1%, 4.9%, and 7.0% at 1, 2, and 3 years, respectively). Clinical Events Committee–adjudicated causes of death were balanced between the DCB and PTA cohorts. Multivariable Cox modeling identified age (HR, 1.06; 95% CI, 1.04–1.08;
P
<0.001), diabetes mellitus (HR, 1.42; 95% CI, 1.01–2.00;
P
=0.04), congestive heart failure (HR, 1.88; 95% CI, 1.12–3.16;
P
=0.02), and renal insufficiency (HR, 2.00; 95% CI, 1.33–3.01;
P
<0.001) as predictors of mortality. Paclitaxel exposure was unrelated to mortality (HR, 1.04; 95% CI, 0.98–1.10;
P
=0.23).

Conclusions:

The mortality rates for patients treated with the DCB and uncoated PTA were indistinguishable over 3-year follow-up. Additional patient-level, adequately powered meta-analyses with larger RCT data sets will be needed to confirm the generalizability of these findings.

Clinical Trial Registration:

URL:
http://www.clinicaltrials.gov
. Unique identifiers: NCT02110524, NCT01858363, NCT01858428, NCT03421561, NCT01912937, NCT01927068, and NCT02769273.
Stroke Risk as a Function of Atrial Fibrillation Duration and CHA
2
DS
2
-VASc Score
Authors: Kaplan Rachel M. , Koehler Jodi , Ziegler Paul D. , Sarkar Shantanu , Zweibel Steven , Passman Rod S.
Published: September 2019

Background:

Studies of patients with cardiovascular implantable electronic devices show a relationship between atrial fibrillation (AF) duration and stroke risk, although the interaction with CHA
2
DS
2
-VASc score is poorly defined. The objective of this study is to evaluate rates of stroke and systemic embolism (SSE) in patients with cardiovascular implantable electronic devices as a function of both CHA
2
DS
2
-VASc score and AF duration.

Methods:

Data from the Optum electronic health record deidentified database (2007–2017) were linked to the Medtronic CareLink database of cardiovascular implantable electronic devices capable of continuous AF monitoring. An index date was assigned as the later of either 6 months after device implantation or 1 year after electronic health record data availability. CHA
2
DS
2
-VASc score was assessed using electronic health record data before the index date. Maximum daily AF burden (no AF, 6 minutes–23.5 hours, and >23.5 hours) was assessed over the 6 months before the index date. SSE rates were computed after the index date.

Results:

Among 21 768 nonanticoagulated patients with cardiovascular implantable electronic devices (age, 68.6±12.7 years; 63% male), both increasing AF duration (
P
<0.001) and increasing CHA
2
DS
2
-VASc score (
P
<0.001) were significantly associated with annualized risk of SSE. SSE rates were low in patients with a CHA
2
DS
2
-VASc score of 0 to 1 regardless of device-detected AF duration. However, stroke risk crossed an actionable threshold defined as >1%/y in patients with a CHA
2
DS
2
-VASc score of 2 with >23.5 hours of AF, those with a CHA
2
DS
2
-VASc score of 3 to 4 with >6 minutes of AF, and patients with a CHA
2
DS
2
-VASc score ≥5 even with no AF.

Conclusions:

There is an interaction between AF duration and CHA
2
DS
2
-VASc score that can further risk-stratify patients with AF for SSE and may be useful in guiding anticoagulation therapy.
Association of Adverse Pregnancy Outcomes With Hypertension 2 to 7 Years Postpartum
Authors: Haas David M. , Parker Corette B. , Marsh Derek J. , Grobman William A. , Ehrenthal Deborah B. , Greenland Philip , Bairey Merz C. Noel , Pemberton Victoria L. , Silver Robert M. , Barnes Shannon , McNeil Rebecca B. , Cleary Kirsten , Reddy Uma M. , Chung Judith H. , Parry Samuel , Theilen Lauren H. , Blumenthal Elizabeth A. , Levine Lisa D. , Mercer Brian M. , Simhan Hyagriv , Polito LuAnn , Wapner Ronald J. , Catov Janet , Chen Ida , Saade George R. ,   for the NHLBI nuMoM2b Heart Health Study
Published: September 2019

Background

Identifying pregnancy‐associated risk factors before the development of major cardiovascular disease events could provide opportunities for prevention. The objective of this study was to determine the association between outcomes in first pregnancies and subsequent cardiovascular health.

Methods and Results

The Nulliparous Pregnancy Outcomes Study Monitoring Mothers‐to‐be Heart Health Study is a prospective observational cohort that followed 4484 women 2 to 7 years (mean 3.2 years) after their first pregnancy. Adverse pregnancy outcomes (defined as hypertensive disorders of pregnancy, small‐for‐gestational‐age birth, preterm birth, and stillbirth) were identified prospectively in 1017 of the women (22.7%) during this pregnancy. The primary outcome was incident hypertension (
HTN
). Women without adverse pregnancy outcomes served as controls. Risk ratios (
RR
) and 95%
CI
s were adjusted for age, smoking, body mass index, insurance type, and race/ethnicity at enrollment during pregnancy. The overall incidence of
HTN
was 5.4% (95%
CI
4.7% to 6.1%). Women with adverse pregnancy outcomes had higher adjusted risk of
HTN
at follow‐up compared with controls (
RR
2.4, 95%
CI
1.8‐3.1). The association held for individual adverse pregnancy outcomes: any hypertensive disorders of pregnancy (
RR
2.7, 95%
CI
2.0‐3.6), preeclampsia (
RR
2.8, 95%
CI
2.0‐4.0), and preterm birth (
RR
2.7, 95%
CI
1.9‐3.8). Women who had an indicated preterm birth and hypertensive disorders of pregnancy had the highest risk of
HTN
(
RR
4.3, 95%
CI
2.7‐6.7).

Conclusions

Several pregnancy complications in the first pregnancy are associated with development of
HTN
2 to 7 years later. Preventive care for women should include a detailed pregnancy history to aid in counseling about
HTN
risk.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
Unique identifier:
NCT
02231398.
Marine Omega‐3 Supplementation and Cardiovascular Disease: An Updated Meta‐Analysis of 13 Randomized Controlled Trials Involving 127 477 Participants
Authors: Hu Yang , Hu Frank B. , Manson JoAnn E.
Published: September 2019

Background

Whether marine omega‐3 supplementation is associated with reduction in risk of cardiovascular disease (CVD) remains controversial.

Methods and Results

This meta‐analysis included study‐level data from 13 trials. The outcomes of interest included myocardial infarction, coronary heart disease (CHD) death, total CHD, total stroke, CVD death, total CVD, and major vascular events. The unadjusted rate ratios were calculated using a fixed‐effect meta‐analysis. A meta‐regression was conducted to estimate the dose–response relationship between marine omega‐3 dosage and risk of each prespecified outcome. During a mean treatment duration of 5.0 years, 3838 myocardial infarctions, 3008 CHD deaths, 8435 total CHD events, 2683 strokes, 5017 CVD deaths, 15 759 total CVD events, and 16 478 major vascular events were documented. In the analysis excluding REDUCE‐IT (Reduction of Cardiovascular Events with Icosapent Ethyl‐Intervention Trial), marine omega‐3 supplementation was associated with significantly lower risk of myocardial infarction (rate ratio [RR] [95% CI]: 0.92 [0.86, 0.99];
P
=0.020), CHD death (RR [95% CI]: 0.92 [0.86, 0.98];
P
=0.014), total CHD (RR [95% CI]: 0.95 [0.91, 0.99];
P
=0.008), CVD death (RR [95% CI]: 0.93 [0.88, 0.99];
P
=0.013), and total CVD (RR [95% CI]: 0.97 [0.94, 0.99];
P
=0.015). Inverse associations for all outcomes were strengthened after including REDUCE‐IT while introducing statistically significant heterogeneity. Statistically significant linear dose–response relationships were found for total CVD and major vascular events in the analyses with and without including REDUCE‐IT.

Conclusions

Marine omega‐3 supplementation lowers risk for myocardial infarction, CHD death, total CHD, CVD death, and total CVD, even after exclusion of REDUCE‐IT. Risk reductions appeared to be linearly related to marine omega‐3 dose.
Phaeosphaeria chinensis sp. nov. (Phaeosphaeriaceae) with an asexual/sexual morph connection from GuangDong Province, China

Authors: ZHANG KE-KE , HONGSANAN SINANG , TENNAKOON DANUSHKA S. , TIAN SHENG-LI , XIE NING
Published: September 2019

Phaeosphaeria chinensis sp. nov. was found on dead leaves, collected from Guangdong Province, China. Morphology of the new species was compared with other Phaeosphaeria species and related genera of Phaeosphaeriaceae. Phylogenetic analyses of combined ITS, LSU, SSU and TEF-1 sequence data based on maximum parsimony (MP), maximum likelihood (ML) and Bayesian inference (BI) revealed that P. chinensis as a distinct species within the Phaeosphaeria with high bootstrap support. The comparison of the new species with other Phaeosphaeria species and a comprehensive description and micrographs are provided. The linkage of sexual and asexual morphs of the new species is also showed.
Novel Neidium Pfitzer species from western Canada based upon morphology and plastid DNA sequences

Authors: HAMILTON PAUL B. , SAVOIE AMANDA M. , SAYRE CYNTHIA M. , SKIBBE OLIVER , ZIMMERMANN JONAS , BULL ROGER D.
Published: September 2019

Five taxa in the genus Neidium, N. iridis, N. beatyi sp. nov., N. vandusenense sp. nov., N. collare sp. nov. and N. lavoieanum sp. nov. are documented from a pond and stream system in the VanDusen Botanical Garden, Vancouver, Canada. Neidium beatyi is a large linear species with multiple longitudinal canals and sagittate apices. The areolae are occluded by finger-like silica extensions on the external surface. This taxon is distinguished from Neidium iridis by the number of longitudinal canals (>5), shape of the valve apices, and smaller size. Neidium vandusenense is broadly linear with distinct rostrate apices. Two-three longitudinal canals are present along each margin. Plastid rbcL sequence data associates this taxon with N. amphigomphus. Neidium collare is an elliptic lanceolate taxon with one longitudinal canal. This taxon is genetically related to N. bisculatum sensu lato, but with a different shape form. Neidium lavoieanum has a valve shape form similar to Neidium potapovae, but is larger and genetically similar to N. productum sensu lato. The five Neidium taxa were observed in a small stream next to Lake Victoria (pond) in the VanDusen Botanical Garden Vancouver, Canada. The water was mildly alkaline with a pH of 7.86, a conductance of 163 µS/cm, higher nutrient loads and low metal content.
Dispora speciosa, a new addition to the genus Parallela and the first coccoid member of the family Microsporaceae

Authors: ŠTENCLOVÁ LENKA , FUČÍKOVÁ KAROLINA
Published: September 2019

The clade that currently represents the green algal family Microsporaceae is one of the few filament-forming groups of Chlorophyceae. Molecular phylogenies show this clade containing the genus Microspora and the more recently circumscribed Parallela, whose filaments are loosely arranged and often multiseriate. We initially investigated the enigmatic bog-loving Dispora speciosa as a commonly accepted member of the mucilage-forming Radiococcaceae or a putative member of crucigenoid chlorophytes (a non-monophyletic group formerly placed in Scenedesmaceae) based on its two-dimensional colony formation. However, our plastid and nuclear ribosomal phylogenies confidently placed Dispora within the genus Parallela instead, and therefore distantly related to both Radiococcaceae and crucigenoids. Upon further examination of the cell morphology and ultrastructure, we found several corresponding features between Dispora and Parallela, despite Dispora’s apparent coccoid-colonial gross morphology. Both genera have cells with a parietal plastid positioned around a large central nucleus. The loose, multiseriate filament formation in Parallela can be interpreted as similar to Dispora’s flat colony formation in its natural state. Because we only present data from one non-type species and strain of Dispora, we cannot merge the entire genus with Parallela. We do however argue that D. speciosa, of which this strain is the sole available, morphologically and ecologically faithful representative, should be transferred into Parallela, and the specimen prepared from strain ACOI 1508 be designated as type. Our study also impacts the current view on evolution of multicellular (colonial and filamentous) forms in Chlorophyceae.
The Shape and Density Evolution of Snow Aggregates
Authors: Dunnavan Edwin L. , Jiang Zhiyuan , Harrington Jerry Y. , Verlinde Johannes , Fitch Kyle , Garrett Timothy J.
Published: September 2019

Snow aggregates evolve into a variety of observed shapes and densities. Despite this diversity, models and observational studies employ fractal or Euclidean geometric measures that are assumed universal for all aggregates. This work therefore seeks to improve understanding and representation of snow aggregate geometry and its evolution by characterizing distributions of both observed and Monte Carlo–generated aggregates. Two separate datasets of best-fit ellipsoid estimates derived from Multi-Angle Snowflake Camera (MASC) observations suggest the use of a bivariate beta distribution model for capturing aggregate shapes. Product moments of this model capture shape effects to within 4% of observations. This mathematical model is used along with Monte Carlo simulated aggregates to study how combinations of monomer properties affect aggregate shape evolution. Plate aggregates of any aspect ratio produce a consistent ellipsoid shape evolution whereas thin column aggregates evolve to become more spherical. Thin column aggregates yield fractal dimensions much less than the often-assumed value of 2.0. Ellipsoid densities and fractal analogs of density (lacunarity) are much more variable depending on combinations of monomer size and shape. Simple mathematical scaling relationships can explain the persistent triaxial ellipsoid shapes that appear in both observed and modeled aggregates. Overall, both simulations and observations prove aggregates are rarely oblate. Therefore, the use of the proposed bivariate ellipsoid distribution in models will allow for similar-sized aggregates to exhibit a realistic dispersion of masses and fall speeds.
Mechanisms of Future Changes in Equatorial Upwelling: CMIP5 Intermodel Analysis
Authors: Terada Mio , Minobe Shoshiro , Deutsch Curtis
Published: September 2019

The future change in equatorial upwelling between 1971–2000 and 2071–2100 is investigated using data from 24 coupled climate models. The multimodel ensemble (MME) mean exhibits substantial equatorial upwelling decrease in the eastern Pacific and weaker decrease in the western Atlantic Ocean. The MME mean of upwelling change and intermodel variation of that are decomposed into distinct isopycnal and diapycnal components. In the Pacific, the diapycnal upwelling decreases near the surface, associated with a weakened Ekman pumping. The isopycnal upwelling decreases at depths of 75–200 m around the core of the Equatorial Undercurrent (EUC) due to flattening of the density layer in which it flows. Both the weakened Ekman pumping and the EUC flattening are induced by the locally weakened trade wind over the eastern Pacific basin. In the equatorial Atlantic, both the change in MME mean and the intermodel variation of upwellings are significantly related to the weakened trade wind and enhanced stratification, although these drivers are not independent. The results for the Pacific Ocean imply that future reduction in upwelling may have impacts at different depths by different mechanisms. In particular, the rapid warming of sea surface temperature in the eastern Pacific basin may be mainly caused by the near-surface diapycnal upwelling reduction rather than isopycnal upwelling reduction associated EUC flattening, which is important at deeper levels.
Interaction of the Westerlies with the Tibetan Plateau in Determining the Mei-Yu Termination
Authors: Kong Wenwen , Chiang John C. H.
Published: September 2019

This study explores how the termination of the mei-yu is dynamically linked to the westerlies impinging on the Tibetan Plateau. It is found that the mei-yu stage terminates when the maximum upper-tropospheric westerlies shift beyond the northern edge of the plateau, around 40°N. This termination is accompanied by the disappearance of tropospheric northerlies over northeastern China. The link between the transit of the jet axis across the northern edge of the plateau, the disappearance of northerlies, and termination of the mei-yu holds on a range of time scales from interannual through seasonal and pentad. Diagnostic analysis indicates that the weakening of the meridional moisture contrast and meridional wind convergence, mainly resulting from the disappearance of northerlies, causes the demise of the mei-yu front. The authors propose that the westerlies migrating north of the plateau and consequent weakening of the extratropical northerlies triggers the mei-yu termination. Model simulations are employed to test the causality between the jet and the orographic downstream northerlies by repositioning the northern edge of the plateau. As the plateau edge extends northward, orographic forcing on the westerlies strengthens, leading to persistent strong downstream northerlies and a prolonged mei-yu. Idealized simulations with a dry dynamical core further demonstrate the dynamical link between the weakening of orographically forced downstream northerlies with the positioning of the jet from south to north of the plateau. Changes in the magnitude of orographically forced stationary waves are proposed to explain why the downstream northerlies disappear when the jet axis migrates beyond the northern edge of the plateau.
Stop the Presses? Moving From Strategic Silence to Strategic Amplification in a Networked Media Ecosystem
Authors: Donovan Joan , boyd danah
Published: September 2019

In a media ecosystem besieged with misinformation and polarizing rhetoric, what the news media chooses not to cover can be as significant as what they do cover. In this article, we examine the historical production of silence in journalism to better understand the role amplification plays in the editorial and content moderation practices of current news media and social media platforms. Through the lens of strategic silence (i.e., the use of editorial discretion for the public good), we examine two U.S.-based case studies where media coverage produces public harms if not handled strategically: White violence and suicide. We analyze the history of journalistic choices to illustrate how professional and ethical codes for best practices played a key role in producing a more responsible field of journalism. As news media turned to online distribution, much has changed for better and worse. Platform companies now curate news media alongside user generated content; these corporations are largely responsible for content moderation on an enormous scale. The transformation of gatekeepers has led an evolution in disinformation and misinformation, where the creation and distribution of false and hateful content, as well as the mistrust of social institutions, have become significant public issues. Yet it is not just the lack of editorial standards and ethical codes within and across platforms that pose a challenge for stabilizing media ecosystems; the manipulation of search engines and recommendation algorithms also compromises the ability for lay publics to ascertain the veracity of claims to truth. Drawing on the history of strategic silence, we argue for a new editorial approach—“strategic amplification”—which requires both news media organizations and platform companies to develop and employ best practices for ensuring responsibility and accountability when producing news content and the algorithmic systems that help spread it.