bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of albumin and cholesterol levels with incidence of hypoglycaemia in people admitted to general internal medicine units
Authors: Leibovitz E. , Wainstein J. , Boaz M.
Published: August 2018

Aim

To study the association between serum albumin and cholesterol levels at hospital admission and incident hypoglycaemia among people admitted to internal medicine units.

Methods

In this cross‐sectional analysis, we examined the electronic medical records of people hospitalized in internal medicine departments. Data extracted included all glucose measurements as well as serum albumin and cholesterol, which were measured upon admission. A hypoglycaemia event was recorded for a given person if at least one glucose measurement of ≤ 3.9 mmol/l was recorded during the hospital stay. Regression analysis was used to determine which clinical measures predict hypoglycaemia.

Results

During the acquisition period, 45 224 people (mean age 68.9 ± 17.8 years, 49.4% male, 21.1% diabetes mellitus) were discharged from internal medicine units. Hypoglycaemia was documented in 7.5% of these individuals (15.4% of people with diabetes vs. 5.5% of those without; P < 0.001). Logistic regression showed that both serum albumin [odds ratio (OR) 0.908, 95% confidence interval (CI) 0.896–0.919; P < 0.001) and cholesterol (OR 0.938, 95% CI 0.896–0.981; P = 0.005] were significantly associated with incident hypoglycaemia. Results remained significant even after controlling for age, sex, average glucose during hospitalization, length of hospital stay, acute infection upon admission, diabetes status, haemoglobin, white blood cell count and C‐reactive levels.

A combination of hypoalbuminaemia (< 35 g/l) and hypocholesterolaemia (< 3.37 mmol/l) upon admission greatly increased the risk of incident hypoglycaemia (OR 2.544, 95% CI 2.096–3.088; P < 0.001).

Conclusion

Hypoalbuminaemia and hypocholesterolaemia predict incident hypoglycaemia in the hospital setting among people with and without diabetes mellitus.
Cardiovascular protection in type 2 diabetes: Insights from recent outcome trials
Authors: Bailey Clifford J. , Marx Nikolaus
Published: August 2018

This review examines recent randomized controlled cardiovascular (CV) outcome trials of glucose‐lowering therapies in type 2 diabetes and their impact on the treatment of patients with type 2 diabetes. The trials were designed to comply with regulatory requirements to confirm that major adverse cardiac events (MACE) are not detrimentally affected by such therapies. Trials involving dipeptidyl peptidase‐4 (DPP‐4) inhibitors did not alter a composite MACE outcome comprising CV deaths, non‐fatal myocardial infarction and non‐fatal stroke; however, the possibility that some members of this class might incur a small increased risk or worsening of heart failure cannot be excluded. Some studies on glucagon‐like peptide‐1 receptor agonists (liraglutide: LEADER trial; semaglutide: SUSTAIN‐6 trial) found significant benefits for MACE, while treatment with sodium‐glucose co‐transporter‐2 inhibitors (empagliflozin: EMPA‐REG OUTCOME trial; canagliflozin: CANVAS trial) also significantly reduced MACE and reduced hospitalization for heart failure. Comparisons among trials are complicated by variance in the populations recruited, particularly CV status at randomization, and differences in trial design, data collection and analyses. A large proportion of patients recruited into these trials have previously experienced adverse CV events; thus, the therapies are mostly assessing secondary prevention of a further event. This contrasts with the overall type 2 diabetes population receiving glucose‐lowering therapies, of whom the majority will not have had MACE and will be regarded as primary prevention. Overall, the trials provide reassuring evidence that new glucose‐lowering medications do not adversely affect CV events and some of these agents may offer CV protection.
Risk of heart failure in a population with type 2 diabetes versus a population without diabetes with and without coronary heart disease
Authors: Chen Hua‐Fen , Ho Ching‐An , Li Chung‐Yi
Published: August 2018

Aims

To conduct a population‐based study comparing age‐ and sex‐specific risk estimates of heart failure (HF) between people with type 2 diabetes and people without diabetes, and to investigate the risks of HF in association with type 2 diabetes in people with various coronary heart diseases (CHDs).

Materials and methods

We used a nationally representative sample (one million people) selected from Taiwan's National Health Insurance (NHI) system. A total of 34 291 patients with type 2 diabetes were identified from ambulatory care claims in 2000, and the same number of age‐ and sex‐matched controls were randomly selected from the registry of NHI beneficiaries in the same year. All study subjects were linked to inpatient claims (2000‐2013) to identify the possible admissions for HF. Using a Cox proportional hazard regression model, we compared the relative hazards of HF in relation to type 2 diabetes according to various age and sex stratifications. We also compared the relative hazard of HF between type 2 diabetes and controls, with and without histories of various CHDs and coronary revascularization procedures.

Results

Compared with absence of diabetes (control group), type 2 diabetes was significantly associated with an increased hazard of HF (adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.40‐1.54]. In both sexes, those with type 2 diabetes aged <45 years had the highest increased hazard of HF, with an aHR of 2.54 (95% CI 1.62‐3.98) and 4.12 (95% CI 2.35‐7.23) for men and women, respectively. Compared with the control subjects without any CHD, people with type 2 diabetes without prior CHD had increased hazards of HF (aHR 1.54, 95% CI 1.41‐1.68, in men and aHR 1.56, 95% CI 1.43‐1.71, in women), which were similar to the aHRs for people without diabetes who had histories of heart diseases (aHR 1.60 and 1.55 for men and women, respectively).

Conclusions

Diabetes mellitus may increase the risk of HF in both men and women, as well as in all age groups, especially in young people. People with type 2 diabetes without CHD had a similarly increased risk of HF to that of control subjects with CHD. Certain coronary revascularization procedures and CHDs, including percutaneous transluminal coronary angiography, coronary artery bypass surgery and acute myocardial infarction, were found to greatly increase risk of HF in people with type 2 diabetes.
Cannabinoid‐1 receptor regulates mitochondrial dynamics and function in renal proximal tubular cells
Authors: Drori Adi , Permyakova Anna , Hadar Rivka , Udi Shiran , Nemirovski Alina , Tam Joseph
Published: August 2018

Aims

To evaluate the specific role of the endocannabinoid/cannabinoid type‐1 (CB1R) system in modulating mitochondrial dynamics in the metabolically active renal proximal tubular cells (RPTCs).

Materials and methods

We utilized mitochondrially‐targeted GFP in live cells (wild‐type and null for the CB1R) and electron microscopy in kidney sections of RPTC‐CB1R‐/‐ mice and their littermate controls. In both in vitro and in vivo conditions, we assessed the ability of CB1R agonism or fatty acid flux to modulate mitochondrial architecture and function.

Results

Direct stimulation of CB1R resulted in mitochondrial fragmentation in RPTCs. This process was mediated, at least in part, by modulating the phosphorylation levels of the canonical fission protein dynamin‐related protein 1 on both S637 and S616 residues. CB1R‐induced mitochondrial fission was associated with mitochondrial dysfunction, as documented by reduced oxygen consumption and ATP production, increased reactive oxygen species and cellular lactate levels, as well as a decline in mitochondrial biogenesis. Likewise, we documented that exposure of RPTCs to a fatty acid flux induced CB1R‐dependent mitochondrial fission, lipotoxicity and cellular dysfunction.

Conclusions

CB1R plays a key role in inducing mitochondrial fragmentation in RPTCs, leading to a decline in the organelle's function and contributing to the renal tubular injury associated with lipotoxicity and other metabolic diseases.
Pay it forward: refuse dump from leaf‐cutting ants promotes caterpillar digestive performance by increasing plant nitrogen content
Authors: Lescano Maria Natalia , Quintero Carolina , Farji‐Brener Alejandro Gustavo , Balseiro Esteban
Published: August 2018

1. The activity of soil‐disturbing animals that increase soil nutrients can affect the carbon : nitrogen (C : N) ratio of plants, which, in turn, may determine the transfer of energy and nutrients through higher trophic levels. However, the strength and sign of this indirect effect depend on whether enhanced nutrient substrates increase plant foliar nutrients and/or plant defensive traits.

2. We investigated how the nutrient‐rich refuse dumps of the leaf‐cutting ant Acromyrmex lobicornis, as a result of their direct effects on thistles, indirectly impact the growth rate and digestive performance of a generalist chewing herbivore. We also included the application of commercial fertilisers to test whether the enhanced soil nutrients comprises the mechanism behind the impact of refuse dumps on the upward cascade effects.

3. Thistles growing on nutrient‐rich substrates (i.e. ant refuse dumps and fertilised soil) had more and larger leaves, up to 80% lower C : N ratios, and higher physical defences compared to plants growing on steppe soil. Caterpillars showed an enhanced digestive performance and growth rate when feed on nutrient‐rich plants and were able to adjust the C : N ratio of their excretion to regulate the relative acquisition of nutrients.

4. The positive effect of nutrient‐rich substrates on caterpillar feeding efficiency suggest that the enhanced nutritional quality of the thistles could compensate for the negative effects of the increased physical defences. The results of the present study indicate how organisms that increase soil nutrient availability may diminish the stoichiometric constraints at the base of food chains, enhancing the development and growth rate of herbivores and, thus, indirectly mediating plant–herbivore interactions.
Envy and us
Authors: Salice Alessandro , Montes Sánchez Alba
Published: August 2018

Within emotion theory, envy is generally portrayed as an antisocial emotion because the relation between the envier and the rival is thought to be purely antagonistic. This paper resists this view by arguing that envy presupposes a sense of us. First, we claim that hostile envy is triggered by the envier's sense of impotence combined with her perception that an equality principle has been violated. Second, we introduce the notion of “hetero‐induced self‐conscious emotions” by focusing on the paradigmatic cases of being ashamed or proud of somebody else. We describe envy as a hetero‐induced self‐conscious emotion by arguing (a) that the impotence felt by the subject grounds the emotion's self‐reflexivity and (b) that the rival impacts the subject's self‐assessment because the rival is framed by the subject as an in‐group member. Finally, we elaborate on the asset at stake in envy. We contend that this is esteem recognition: The envier covets the esteem that her reference group accords to the rival. Because, in envy, the subject conceives of herself as member of a group to which the other is also understood to belong, we conclude that envy is a social emotion insofar as it presupposes a sense of us.
Peptide nucleic acid (PNA) probe‐based analysis to detect filaggrin mutations in atopic dermatitis patients
Authors: Hwang Joonsung , Lee Sangku , Kim Daehwan , Han Goeun , Soung Nak Kyun , Cha‐Molstad Hyunjoo , Lee Kyung Ho , Ryoo In Ja , Ahn Mi Ja , Kim Sung Tae , Lee Min Jae , Yoo Young Dong , Lee Hee Gu , Hong Jin Tae , Kim Hyunjung , Choi Eung Ho , Kim Soo‐Chan , Kwon Yong Tae , Ahn Jong Seog , Kim Bo Yeon
Published: August 2018

Atopic dermatitis (AD) is a chronic inflammatory skin disease whose prevalence is increasing worldwide. Filaggrin (FLG) is essential for the development of the skin barrier, and its genetic mutations are major predisposing factors for AD. In this study, we developed a convenient and practical method to detect FLG mutations in AD patients using peptide nucleic acid (PNA) probes labelled with fluorescent markers for rapid analysis. Fluorescence melting curve analysis (FMCA) precisely identified FLG mutations based on the distinct difference in the melting temperatures of the wild‐type and mutant allele. Moreover, PNA probe‐based FMCA easily and accurately verified patient samples with both heterozygote and homozygote FLG mutations, providing a high‐throughput method to reliable screen AD patients. Our method provides a convenient, rapid and accurate diagnostic tool to identify potential AD patients allowing for early preventive treatment, leading to lower incidence rates of AD, and reducing total healthcare expenses.
Overexpression of the Na+/Ca2+ exchanger influences ouabain‐mediated spontaneous Ca2+ activity but not positive inotropy
Authors: Bögeholz Nils , Pauls Paul , Bauer Bastian K. , Schulte Jan S. , Frommeyer Gerrit , Dechering Dirk G. , Boknik Peter , Kirchhefer Uwe , Müller Frank U. , Pott Christian , Eckardt Lars
Published: August 2018

Administration of digitalis in heart failure (HF) increases quality of life but does not carry a prognostic benefit. Digitalis is an indirect inhibitor of the Na+/Ca2+ exchanger (NCX), which is overexpressed in HF. We therefore used the cardiac glycoside ouabain in Ca2+ imaging experiments and patch‐clamp experiments in isolated ventricular myocytes from nonfailing transgenic NCX overexpressor mice (OE). In field‐stimulated myocytes, ouabain (1–100 μm) increased the amplitude of the Ca2+ transient in OE and wild‐type (WT) similarly. Ouabain‐mediated spontaneous Ca2+‐activity was significantly more pronounced in OE compared to WT myocytes at higher concentrations (100 μm). Also, at very high concentrations (1000 μm) of ouabain, the number of cells with hypercontraction leading to cell death was higher in OE. Ouabain (10 μm) shortened the action potential duration in both genotypes. Our findings suggest that the proarrhythmic but not the inotropic effects of cardiac glycosides are enhanced by increased NCX expression. This may offer an explanation for the observed lack of prognostic benefit but increased quality of life in HF, which is accompanied by NCX upregulation.
Effect of stress regime‐dependent creep behaviour on measurement of creep strain rate based on small specimen techniques
Authors: Tu Shan‐Tung , Zhang Kun , Bai Yu , Tan Jian‐Ping , Deng Guo‐Jian
Published: August 2018

Small specimen creep testing technique has become a hot topic of research as bulk materials are not available in many occasions. The stress distributions in the small specimens such as small punch and 3‐point bending specimens are essentially nonuniform. As it is known, the creep deformation/damage accumulation mechanisms exhibited at a high stress regime are not the same as the ones at a lower stress regime for many engineering alloys. The potential measurement errors because of stress regime‐dependent creep behaviour, however, has not been considered in the determination of the creep parameters based on small specimen testing in the previous studies. In this paper, 2 kinds of materials that show different Norton's parameters at the corresponding stress regimes are examined. A simple case of 2‐bar structure is firstly adopted to illustrate the measurement error of creep strain rate because of stress regime‐dependent creep behaviour. Furthermore, clamped beam bending testing and small punch testing are investigated to demonstrate the significance of measurement error using the same materials. It is shown that an error of more than 8 times may occur near the transition point of creep deformation mechanism depending on specimen types and materials. Attention should thus be paid to the selection of stress level in the small specimen testing to avoid significant measurement errors.
Soil biodiversity and soil erosion: It is time to get married
Authors: Orgiazzi Alberto , Panagos Panos
Published: August 2018

Aim

The relationship between erosion and biodiversity is reciprocal. Soil organisms can both reduce soil loss, by improving porosity, and increase it, by diminishing soil stability as a result of their mixing activities. Simultaneously, soil runoff has ecological impacts on belowground communities. Despite clear research into interactions, soil erosion models do not consider biodiversity in their estimates and soil ecology has poorly investigated the effects of erosion. In order to start filling in these research gaps, we present a novel biological factor and introduce it into a well‐known soil erosion model (the revised universal soil loss equation). Furthermore, we propose insights to advance soil erosion ecology.

Location

Pan‐European.

Time period

Simulation of present‐day conditions.

Major taxa studied

Earthworms.

Methods

We present three pathways to fill in current knowledge gaps in soil biodiversity and erosion studies: (a) introducing a biological factor into soil erosion models; (b) developing plot‐scale experiments to clarify and quantify the positive/negative effects of soil organisms on erosion; (c) promoting ecological studies to assess both short‐ and long‐term effects of soil erosion on soil biota.

Results

We develop a biological factor to be included in soil erosion modelling. Thanks to available data on earthworm diversity (richness and abundance), we generate an “earthworm factor”, incorporate it into a model of soil erosion and produce the first pan‐European maps of it.

Main conclusions

New estimates of soil loss can be generated by including biological factors in soil erosion models. At the same time, the effects of soil loss on belowground diversity require further investigation. Available data and technologies make both processes possible. We think that it is time to commit to fostering the fundamental, although complex, relationship between soil biodiversity and erosion.
Opposing roles of IgM and IgD in BCR‐induced B‐cell survival
Authors: Yasuda Shoya , Sun Jiping , Zhou Yang , Wang Yanqing , Lu Qing , Yamamura Masayuki , Wang Ji‐Yang
Published: August 2018

The B‐cell receptor (BCR) transmits a tonic survival signal in the absence of antigen stimulation and an antigen‐triggered survival signal. Mature B cells express two types of BCR, IgM and IgD, but it remains unclear how B‐cell survival is differentially regulated by these two receptors. We found that, whereas cross‐linking IgM on spleen B cells greatly enhanced their survival, cross‐linking IgD did not enhance, but rather decreased, their survival. Consistently, cross‐linking both IgM and IgD only moderately enhanced B‐cell survival, suggesting that IgM and IgD play opposing roles in B‐cell survival induced by BCR stimulation. Based on these and additional experimental results, we present a mathematical model integrating IgM‐ and IgD‐mediated survival signals. Our model shows that IgD can transmit a tonic survival signal in the absence of antigen stimulation but cross‐linking IgD not only does not generate a survival signal but also disrupts its tonic signal, resulting in inhibition of B‐cell survival. These results suggest that IgD attenuates BCR‐induced survival in mature B cells, presumably to restrain B‐cell response to weak and/or self‐antigens and prevent nonspecific B‐cell activation and autoimmunity.
Helicobacter pylori antimicrobial resistance in a pediatric population
Authors: Silva Gisela M. , Silva Helena Moreira , Nascimento Joao , Gonçalves Jean‐Pierre , Pereira Fernando , Lima Rosa
Published: August 2018

Background

The increasing prevalence of Helicobacter pylori (H. pylori) antimicrobial resistance, primarily for clarithromycin decreases the success of treatment. The aim of this study is to determine the local pattern of first‐line antimicrobials resistance and the eradication rate.

Material and Methods

Prospective cohort study of H. pylori infected patients (positive histological or cultural exams) treated at Centro Materno‐Infantil do Norte from January of 2013 to October of 2017. Susceptibility to 4 antibiotics: amoxicilin, metronidazole, clarithromycin, and levofloxacin were analyzed by E‐test (phenotypic resistance). The E‐test was chosen because it is simple and cost‐effective for routine susceptibility testing. Point mutations that confer clarithromycin resistance were surveyed (genotypic resistance). Eradication of H. pylori infection was defined by a negative urea breath test or fecal antigen 6‐8 weeks after the end of treatment.

Results

Of a total of 74 H. pylori infected patients, 16 were excluded because they had previous H. pylori treatment or severe systemic disease. Median age of infection cases was 15 years (3‐17 years). Eradication regimen used in all patients combined the use of 3 antibiotics (amoxicillin and metronidazole or clarithromycin) and proton pump inibhitor for 14 days and was tailored according antimicrobial susceptibility. 79.5% of the patients completed the treatment. The resistance rate for metronidazole and clarithromycin was 3.3% and 23.3%, respectively. There was no resistance for amoxicilin and levofloxacin. The rate of genotypic resistance to clarithromycin was 37.2%. The eradication rate was 97.8%.

Conclusions

The authors found a high resistance rate of H. pylori for clarithromycin in this northern portuguese pediatric center. This factor should determine a change in local current treatment, contraindicating the use of clarithromycin as a first‐line treatment for H. pylori infection in children. The high eradication rate maybe explained for the eradication treatment tailored according antimicrobial susceptibility.
Effectiveness of Reciproc Blue in removing canal filling material and regaining apical patency
Authors: De‐Deus G. , Belladonna F. G. , Zuolo A. S. , Simões‐Carvalho M. , Santos C. B. , Oliveira D. S. , Cavalcante D. M. , Silva E. J. N. L.
Published: August 2018

Aim

To compare the efficiency of M‐Wire Reciproc and Reciproc Blue instruments in the removal of root filling material and in their ability to regain apical patency through micro‐computed tomographic (micro‐CT) analysis.

Methodology

Ten anatomically matched pairs of teeth, with a single oval‐shaped straight canal, were selected and scanned in a micro‐CT device. The root canals were prepared with M‐Wire Reciproc R25 instruments and filled with gutta‐percha and AH Plus sealer. The root canals were then randomly allocated into two groups (n = 10), according to the instrument used: M‐Wire Reciproc and Reciproc Blue. The canals were retreated up to instrument sizes 25 and then 40 in both groups. The surface area and volume of residual filling material were assessed using micro‐CT imaging after the retreatment procedures. The time required to remove the root fillings was recorded. Data were analysed statistically using t‐test with a significance level of 5%.

Results

No significant difference (P > 0.05) was observed between the instruments in terms of the volume of residual root filling material. Apical enlargement from size 25 to 40 significantly improved the removal of filling materials (P < 0.05). It was possible to regain apical patency in all specimens from both M‐Wire Reciproc and Reciproc Blue groups. No difference was observed in the time required to perform the retreatment between the instruments.

Conclusions

Both M‐Wire Reciproc and Reciproc Blue instruments were effective in removing filling materials from oval‐shaped straight canals. Apical patency was reestablished in all specimens.
Developing a model of factors that influence meeting the needs of family with a relative inICU
Authors: Kynoch Kathryn , Chang Anne , Coyer Fiona , McArdle Annie
Published: August 2018

Aim

To develop a model of factors influencing meeting family needs when a relative was admitted to the intensive care unit (ICU).

Background

Studies identify individual factors impact on the needs of family members with a relative in ICU. No studies have reported on relationships between these factors and/or the extent of influence of multiple factors on family needs.

Design

Observational, correlational, and predictive study design.

Methods

Data were collected from August 2013 to June 2014 using validated scales and a demographic tool. The setting was a large tertiary referral hospital in Brisbane, Australia. Structural equation modelling was undertaken.

Results

One hundred and seventy ICU family members participated. Factors included in the developed model were consistent with the literature. Family member anxiety had direct and significant influence on ICU family needs (β = 0.21). Gender was also found to have direct influence (β = 0.19), suggesting female family members were more likely to report needs being met. Family member coping self‐efficacy (β = −0.40) and family member depression (β = −0.33) were mediating variables.

Discussion

Interventions to meet family needs within the ICU should take into account family member levels of anxiety, depression, and coping self‐efficacy with consideration of gender. Further model validation is required to confirm findings.
Bioactive components in human milk are differentially associated with rates of lean and fat mass deposition in infants of mothers with normal vs. elevated BMI
Authors: Young B. E. , Levek C. , Reynolds R. M. , Rudolph M. C. , MacLean P. , Hernandez T. L. , Friedman J. E. , Krebs N. F.
Published: August 2018

Objective

To model breastfed infant growth and body composition patterns over the first 4 months with multiple bioactive components of human milk (HM) and clinical factors (including maternal BMI status), which are related to growth.

Methods

Longitudinal observation of infant growth and body composition from 0 to 4 months among 41 predominantly breastfed infants (25 mothers of Normal‐weight and 16 mothers with overweight/obesity). Fasted morning HM samples were collected at 5 time‐points. Macronutrients, leptin, adiponectin, ghrelin, insulin, cytokines and n‐6:n‐3 esterified fatty acid ratio were measured. Infant weight‐for‐length Z‐score (WLZ) trajectory, fat‐free mass (FFM) gain, fat mass gain and %fat gain were modelled controlling for clinical covariates.

Results

HM insulin negatively associated with WLZ trajectory among infants of NW mothers (P = 0.028), but not associated with WLZ trajectory among infants of OW/Ob mothers. HM glucose (P < 0.001) was associated with slower rates of infant FFM gain. Infants of mothers with OW/Ob exhibited slower rates of FFM gain. HM protein, adiponectin and insulin concentrations, and n‐6:n‐3 ratio were all significant predictors in the model of infant fat mass gain (P < 0.03). Any amount of formula supplementation was associated with faster fat gain (P = 0.002). The model of %fat gain was similar to that of fat mass gain, excepting HM adiponectin was not a significant covariate, and a trend for maternal OW/Ob to correlate with faster %fat gain (P = 0.056).

Conclusions

Bioactive components in HM may contribute to regulation of partitioning of body composition, and these contributions may differ between mothers of normal‐weight vs. with OW/Ob.
Infliximab and adalimumab concentrations and anti‐drug antibodies in inflammatory bowel disease control using New Zealand assays
Authors: Barclay Murray L. , Karim Shwan , Helms Esther T. Johanna , Keating Paula E. , Hock Barry , Stamp Lisa K. , Schultz Michael
Published: August 2018

Background

Therapeutic drug monitoring of anti‐tumour necrosis factor (TNF) drugs and anti‐drug antibodies (ADA) is now recommended in the treatment of inflammatory bowel disease. However, assay types and drug concentration thresholds are still debated.

Aim

To correlate inflammatory bowel disease activity in a New Zealand cohort with trough concentrations of infliximab and adalimumab, and ADA using locally developed competitive‐binding enzyme‐linked immunosorbent assays (ELISA) to establish threshold concentrations.

Methods

Patients with ulcerative colitis (UC) and Crohn disease (CD) from Christchurch and Dunedin on anti‐TNF drugs >12 weeks were enrolled. Trough blood samples were assayed for drug and ADA concentrations. Other data included quality of life, blood count, C‐reactive protein, albumin, renal function and disease activity indices.

Results

Of 103 patients, 53 were on infliximab (36 CD, 15 UC and 2 unclassified) and 50 adalimumab (48 CD and 2 UC). Median (range) infliximab and adalimumab concentrations were 10.5 (0–41) and 9.61 mg/L (0–30). CD remission, Crohn Disease Activity Index <150, correlated with infliximab and adalimumab concentration in CD (infliximab, P = 0.03; adalimumab, P = 0.04), with too few UC patients for analysis. Receiver operator curve analysis suggested a threshold value of 5.1 mg/L for distinguishing active disease from remission for infliximab and 7.3 mg/L for adalimumab in CD. Of 13 patients with infliximab <2 mg/L, 10 were ADA positive by homogeneous mobility shift assay (HMSA), including five with neutralising antibodies using ELISA. Of six with adalimumab <2 mg/L, three were ADA positive using HMSA, including one with neutralising antibodies.

Conclusion

Using the New Zealand ELISA assay, threshold concentrations of 5 mg/L for infliximab and 7 mg/L for adalimumab are suggested to aid dosing decisions, consistent with results internationally. Both neutralising (ELISA) and non‐neutralising ADA (HMSA) are associated with low drug concentrations.
Nocardiosis: 7‐year experience at an Australian tertiary hospital
Authors: Paige Emma K. , Spelman Denis
Published: August 2018

Background

Nocardiosis has historically been reported in immunocompromised patients, but Australian epidemiological and antimicrobial susceptibility data are limited.

Aim

To describe the epidemiology, diagnosis and initial treatment of nocardiosis in an Australian tertiary hospital over 7 years.

Methods

In this retrospective study, all positive cultures for Nocardia species from any site isolated at the Alfred Hospital, Melbourne, between 1 January 2010 and 31 December 2016 were identified, and corresponding laboratory data and medical records reviewed.

Results

Sixty‐eight non‐duplicate isolates were identified from 67 patients. Common predisposing factors were chronic lung disease (38/67; 57%), organ, particularly lung, transplantation (13/67; 19%) and solid organ malignancy (6/67; 9%); 12% (8/67) of patients had no identifiable systemic risk factors. Seventy‐nine percent (53/67) of patients had pulmonary nocardiosis only. Nocardia nova was the most commonly isolated species (20/68; 29%). In 48% (32/67) of patients, Nocardia species were isolated only on specific mycobacterial media. All tested species were susceptible to sulfamethoxazole‐trimethoprim and amikacin, with the majority (58/63; 92%) susceptible to imipenem. All‐cause mortality rates at 6 and 12 months where data were available were 15% (10/66 patients) and 22% (14/64 patients) respectively.

Conclusion

In the largest Australian series in 25 years, nocardiosis predominantly affected patients with chronic lung disease or impaired cell‐mediated immunity. A significant proportion of organisms from pulmonary sites were isolated on mycobacterial culture media only, suggesting that its use may improve yield. Isolates remain highly susceptible to sulfamethoxazole‐trimethoprim, amikacin and imipenem, while other agents should be used only after confirmation of in vitro susceptibility.
Confidence Intervals for the Area Under the Receiver Operating Characteristic Curve in the Presence of Ignorable Missing Data
Authors: Cho Hunyong , Matthews Gregory J. , Harel Ofer
Published: August 2018

Receiver operating characteristic curves are widely used as a measure of accuracy of diagnostic tests and can be summarised using the area under the receiver operating characteristic curve (AUC). Often, it is useful to construct a confidence interval for the AUC; however, because there are a number of different proposed methods to measure variance of the AUC, there are thus many different resulting methods for constructing these intervals. In this article, we compare different methods of constructing Wald‐type confidence interval in the presence of missing data where the missingness mechanism is ignorable. We find that constructing confidence intervals using multiple imputation based on logistic regression gives the most robust coverage probability and the choice of confidence interval method is less important. However, when missingness rate is less severe (e.g. less than 70%), we recommend using Newcombe's Wald method for constructing confidence intervals along with multiple imputation using predictive mean matching.
Association of breastfeeding and malocclusion in 5‐year‐old children: Multilevel approach
Authors: Corrêa‐Faria Patrícia , de Abreu Mauro Henrique Nogueira Guimarães , Jordão Lidia Moraes Ribeiro , Freire Maria do Carmo Matias , Costa Luciane Rezende
Published: August 2018

Background

Breastfeeding plays an important role in child health, including the development of normal dental occlusion, but large epidemiological findings on the association breastfeeding‐malocclusion are lacking.

Aim

To investigate the association between the proportion of breastfed children in the city level and the prevalence of malocclusion in the primary dentition at age 5.

Design

This cross‐sectional analysis used data from national population surveys on oral health and on breastfeeding practices. Data refer to 5278 5‐year‐old children and 44 Brazilian towns. Information on malocclusion and individual sociodemographic characteristics were obtained from the 2010 Brazilian Oral Health Survey. Breastfeeding rates during the first year of life were extracted from the Breastfeeding Prevalence Survey in Brazilian Towns. Population sociodemographic data were analysed as confounder. Multilevel Poisson analyses were performed.

Results

Malocclusion prevalence was 63.3%. Towns exhibiting higher prevalence of breastfeeding among 9‐ to 12‐month‐olds presented lower prevalence of malocclusion among children at age 5 (PR 0.98; 95% CI 0.98‐0.99).

Conclusions

Lower prevalence of malocclusion among 5‐year‐old children was associated with a higher proportion of children breastfed at ages 9 to 12 months at a city level, regardless of sociodemographic factors. These findings highlight the importance of encouraging breastfeeding during a child's first year.
Use of Cellutome for the healing of venous or mixed ulcers
Authors: Vinceneux Talvande Blandine , Carvalho Lallement Priscille , Safa Gilles , Journet Tollhupp Julie , Lembelembe Jean‐Paul , Blaise Sophie , Maillard Hervé
Published: August 2018

Venous or mixed ulcers are common and invalidating. Cutaneous transplants may be necessary if conventional treatment is ineffective. We evaluated the performance of Cellutome in promoting the healing of venous or mixed ulcers 2 months after grafting. This was a retrospective, multi‐centric, descriptive study of patients who had a venous or mixed ulcer for at least several months and who received an autologous skin graft using the Cellutome system at least 2 months before. The principle evaluation criterion was the state of the wound after 2 months (completely healed vs not healed). The secondary evaluation criterion was the percentage of wound healing after 2 months. A total of 47 patients were included in the study. The ulcers had evolved over an average of 18 months. The average surface area was 13.37 cm2. After 2 months, the grafts of 26 of 47 patients (55.3%) were completely healed. The grafts of 21 patients (44.6%) were not completely healed but showed an average rate of healing of 51%. Use of the Cellutome system for epidermal transplants promoted complete or improved healing after 2 months for 55.3% of patients with chronic venous or mixed ulcers. The limited data on the rate of healing of conventional transplants in the literature report rates of approximately 50%. The Cellutome system may therefore be of interest as the healing rate is similar to that of conventional techniques, but using a much simpler, painless procedure on an outpatient basis.
Computer‐based testing and the 12‐item Screener and Opioid Assessment for Patients with Pain‐Revised: A combined approach to improving efficiency
Authors: Finkelman Matthew D. , Jamison Robert N. , Magnuson Britta , Kulich Ronald J. , Butler Stephen F. , Smits Niels , Weiner Scott G.
Published: August 2018

Objectives were to combine computer‐based stopping rules with the 12‐item form of the Screener and Opioid Assessment for Patients with Pain‐Revised (SOAPP‐R), and to compare this combined procedure with the full‐length (24‐item) SOAPP‐R, the computer‐based stopping rules alone, and the 12‐item short form alone. Three datasets were analyzed, including data from 428 subjects from the initial or cross‐validation studies of the SOAPP‐R; 84 patients from a pain center; and 110 primary care patients. Subjects completed the full‐length SOAPP‐R and were assessed for aberrant medication‐related behaviors. A real‐data simulation was conducted to determine the screening characteristics and mean test length of each version of the SOAPP‐R. One procedure combining stochastic curtailment with the 12‐item short form reduced the mean length by 37% to 42% compared to the short form alone; by 42% to 45% compared to stochastic curtailment alone; and by 68% to 71% compared to the full‐length form. The combined procedure had lower mean test lengths, and equal screening characteristics, compared to a procedure coupling curtailment with the 12‐item short form. A procedure combining computer‐based stopping rules with the 12‐item short form of the SOAPP‐R has potential to enhance the efficiency of the screener.
Environmental prevalence and the distribution of species richness across climatic niche space
Authors: Meyer Andreas L. S. , Pie Marcio R.
Published: August 2018

Aim

The reciprocal relationship between geographical and ecological niche space known as Hutchinson's duality provides a powerful framework to analyse the relationship between biogeographical distributions and environmental variables. However, little attention has been given to how the structure of niche space is associated with the distribution of species across niche space itself. We examined whether environmental prevalence (i.e. the relative availability of different combinations of climatic conditions) can predict the climate‐richness relationship and consequently influence broad‐scale patterns of species richness.

Location

Worldwide

Methods

We tested our hypothesis using distribution data on >10,000 species of amphibians and mammals. We measured the environmental prevalence of five climatic variables associated with broad‐scale patterns of species richness. To this end, we divided each variable into equally spaced intervals representing particular climatic regimes, and calculated the geographical area where each regime is present. We then used species‐area regression models and hierarchical partitioning to test the relationship between environmental prevalence and the number of species in each climatic regime, and measure the relative importance of environmental prevalence and climate in explaining species richness across climatic niche space.

Results

Our results indicate a strong relationship between environmental prevalence and the number of species found in each climatic regime, especially in temperature‐related variables. Moreover, environmental prevalence was generally a stronger predictor of species richness than climate. Results were similar for amphibians and mammals, being observed at both global‐ and realm‐scales.

Main conclusions

Our findings suggest that the relationship between climate and species richness can arise from the variation in environmental prevalence. This conclusion challenges the traditional idea that climate itself is a primary driver of the climate‐richness relationship. We argue that environmental prevalence should be considered in future tests of the relationship between environmental variables and species richness.
rSjP40 suppresses hepatic stellate cell activation by promoting microRNA‐155 expression and inhibiting STAT5 and FOXO3a expression
Authors: Zhu Dandan , Yang Chunzhao , Shen Pei , Chen Liuting , Chen Jinling , Sun Xiaolei , Duan Lian , Zhang Li , Zhu Jinhua , Duan Yinong
Published: August 2018

Activation of hepatic stellate cells (HSCs) is the central event of the evolution of hepatic fibrosis. Schistosomiasis is one of the pathogenic factors which could induce hepatic fibrosis. Previous studies have shown that recombinant Schistosoma japonicum egg antigen P40 (rSjP40) can inhibit the activation and proliferation of HSCs. MicroRNA‐155 is one of the multifunctional noncoding RNA, which is involved in a series of important biological processes including cell development, proliferation, differentiation and apoptosis. Here, we try to observe the role of microRNA‐155 in rSjP40‐inhibited HSC activation and explore its potential mechanisms. We found that microRNA‐155 was raised in rSjP40‐treated HSCs, and further studies have shown that rSjP40 enhanced microRNA‐155 expression by inhibiting STAT5 transcription. Up‐regulated microRNA‐155 can down‐regulate the expression of FOXO3a and then participate in rSjP40‐inhibited expression of α‐smooth muscle actin (α‐SMA) and collagen I. Furthermore, we observed microRNA‐155 inhibitor could partially restore the down‐regulation of FOXO3a, α‐SMA and collagen I expression in LX‐2 cells induced by rSjP40. Therefore, our research provides further insight into the mechanism by which rSjP40 could inhibit HSC activation via miR‐155.
Histopathology and external examination of heavily parasitized Lost River Sucker Deltistes luxatus (Cope 1879) and Shortnose Sucker Chasmistes brevirostris (Cope 1879) from Upper Klamath Lake, Oregon
Authors: Janik Andrew J , Markle Douglas F , Heidel Jerry R , Kent Michael L
Published: August 2018

Shortnose Sucker (Chasimistes brevirostris) and Lost River Sucker (Deltistes luxatus) are endemic to the Upper Klamath Basin of Southern Oregon and Northern California, and their populations are in decline. We used histopathology and external examination of 140 and external examination only of 310 underyearling suckers collected in 2013, 2015 and 2016 to document pathological changes, particularly those relating to parasites. The most severe infection was caused by a Contracaecum sp., infecting the atrium of 8%–33% of Shortnose Suckers. The most prevalent infections were caused by Bolbophorus sp. metacercariae in the muscle of Shortnose Suckers (21%–63%) and Lernaea cyprinacea in the skin and muscle of Lost River Suckers (30%–81%). Histology detected Bolbophorus in only 5% of cases where it was not seen externally. Three myxozoans were observed; a Parvicapsula sp. in the renal tubules (10%), a Myxobolus sp. in the intestinal mucosa (2%) and an unusual multicellular, presporogonic myxozoan in the intestinal lumen of one sucker. Severe gill epithelial hyperplasia was observed in several fish collected in 2016. Trichodinids and Ichthyobodo sp. were observed on some of the gills, but absent in many of the fish with severe lesions. A histiocytic sarcoma was observed in sucker.
Image recognition of automatic evisceration of Cherry Valley ducks and biological activities of protein extracts isolated from the duck meat
Authors: Chen Yan , Kong Lina , Wang Shucai
Published: August 2018

Based on active contour segmentation algorithm and image acquisition system, Cherry Valley duck meats were collected after evisceration, protein extracts were preliminarily isolated, and their various biological properties were evaluated in present study. The amino acid analysis revealed that these protein extracts contained abundant essential amino acids including Thr, Val, Ile, Leu, Met, Phe, Lys, and His, suggesting that this duck meat have high nutritional value. Antioxidant results indicated that the protein extracts had great free radical scavenging effects and excellent in vivo antioxidant capacities. The immunomodulatory results demonstrated that the duck protein extracts exhibited obvious co‐mitogenic effects on the splenocytes activated by the mitogen and effective natural killer (NK) cells' activity. Moreover, the proposed image processing method based on the visceral contour recognition can be applied in poultry processing, which can improve the production efficiency of Cherry Valley duck processing in the poultry industry.

Practical applications

In the world, duck meat is very popular by people for a long time because of its delicacy and high nutritional value. In the present study, antioxidant and immunomodulatory activities of protein extracts from the Cherry Valley duck show that this duck has significant nutritional value to human body. For a long time, there are many difficult problems on the automatic slaughter and evisceration of duck, chicken and goose in poultry processing industry. Moreover, avian influenza virus has been threatening poultry breeding and slaughter processing, which can easily harm to the health of workers and cause a wide range of virus spread. Image recognition system and contour segmentation algorithm may provide useful information for the development of automatic slaughter of Cherry Valley ducks, which is also helpful to conduct further research in food processing and utilization of various kinds of poultry.
Preoperative Anemia, Functional Outcomes, and Quality of Life After Hip Fracture Surgery
Authors: Sim Yilin Eileen , Sim Shao‐en David , Seng Chusheng , Howe Tet Sen , Koh Suang Bee , Abdullah Hairil Rizal
Published: August 2018

Objectives

To determine whether preoperative anemia, perioperative blood transfusion, and predischarge anemia affect function and health‐related quality of life (HRQoL) after hip fracture surgery.

Design

Retrospective single‐center cohort study

Participants

Individuals undergoing traumatic hip fracture surgery from 2012 to 2016 (N=973).

Measurements

Demographic data, Charlson Comorbidity Index, preoperative hemoglobin level, perioperative blood transfusion, predischarge hemoglobin level, type of surgery (replacement or fixation). Anemia was divided into quintiles at 10.0, 11.0, 12.0, and 13.0 g/dL. Baseline, 6‐week, and 6‐month Harris Hip Scale (HHS), Parker Mobility Scale (PMS), and Medical Outcomes Study 36‐item Short‐Form Health Survey (SF‐36) scores were obtained. PMS; HHS and SF‐36 role physical (RP), physical function (PF), and social functioning (SF) domains had more than 20% change from baseline to 6 weeks and from 6 weeks to 6 months. Univariate and multivariate analyses were conducted to examine the association between preoperative anemia, transfusion and predischarge anemia on 6‐month scores.

Results

On univariate analysis, preoperative hemoglobin less than 10.0 g/dL was associated with lower baseline prefall PMS, PF, RP, and SF scores. Predischarge anemia did not affect 6‐month scores. On multivariate analysis, preoperative anemia (hemoglobin <10.0 g/dL) was associated with lower 6‐month HHS, PMS, PF, and RP scores, whereas transfusion was not significant.

Conclusion

Preoperative anemia (hemoglobin <10.0 g/dL) is associated with poorer physical function and HRQoL after hip fracture surgery. Perioperative blood transfusion and predischarge anemia had no effect.