bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Atrial Fibrillation Subtypes in Italy and Projections to 2060 for Italy and Europe
Authors: Di Carlo Antonio , Zaninelli Augusto , Mori Fabio , Consoli Domenico , Bellino Leonardo , Baldereschi Marzia , Sgherzi Bruno , Gradia Chiara , DʼAlfonso Maria Grazia , Cattarinussi Alessandro , Pracucci Giovanni , Piccardi Benedetta , Polizzi Bianca Maria , Inzitari Domenico ,   for the National Research Program: Progetto FAI. La Fibrillazione Atriale in Italia
Published: August 2020

BACKGROUND/OBJECTIVES

Atrial fibrillation (AF) subtypes may carry different cardiovascular risk profiles, but information on their frequency from population‐based studies is lacking. We estimated prevalence of AF subtypes in a representative sample of the Italian older population, projecting figures for Italy and the European Union.

DESIGN

Cross‐sectional study.

SETTING

Three primary care practices in northern, central, and southern Italy.

PARTICIPANTS

All individuals aged 65 years or older, for a total sample of 6,016 subjects. Excluding 235 noneligible, participation was 78.3%, which left 4,528 participants.

MEASUREMENTS

A double systematic and opportunistic screening procedure identified possible AF cases, followed by clinical and electrocardiogram confirmation. Patients were categorized with paroxysmal, persistent, or permanent AF. Prevalence was calculated by sex and 5‐year age groups. Prevalence figures were applied to population projections for all 28 European Union states to estimate AF subtypes expected in future decades.

RESULTS

In the 4,528 participants (mean age = 74.5 ± 6.8 years; 47.2% men), 331 AF cases were identified: 140 (42.3%) paroxysmal, 77 (23.3%) persistent, and 114 (34.4%) permanent. Prevalence was 3.1% (95% confidence interval (CI) = 2.6%–3.6%) for paroxysmal, 1.7% (95% CI = 1.4%–2.1%) for persistent, and 2.5% (95% CI = 2.1%–3.0%) for permanent AF. Italian older persons having AF in 2016 were estimated at approximately 449,000 for paroxysmal, approximately 240,000 for persistent, and approximately 391,000 for permanent AF, projected to increase in 2060 to approximately 785,000, approximately 358,000, and approximately 748,000, respectively. European Union older persons having AF in 2016 were estimated at approximately 3,185,000 for paroxysmal, approximately 1,722,000 for persistent, and approximately 2,710,000 for permanent AF, projected to increase in 2060 to approximately 5,989,000, approximately 2,833,000, and approximately 5,579,000, respectively.

CONCLUSION

We provided first projections of AF subtypes for Italy and Europe. The worse cardiovascular risk profile of persistent and permanent forms indicates an increased burden in future decades.
Benzodiazepine Use and Deprescribing in Belgian Nursing Homes: Results from theCOME‐ONStudy
Authors: Evrard Perrine , Henrard Séverine , Foulon Veerle , Spinewine Anne
Published: August 2020

BACKGROUND/OBJECTIVES

To describe the use and deprescribing of benzodiazepine receptor agonists (BZRAs) among nursing home residents (NHRs), to evaluate appropriateness of use and to identify factors associated with BZRA use and deprescribing.

DESIGN

Posthoc analysis of the Collaborative Approach to Optimize Medication Use for Older People in Nursing Homes (COME‐ON) study, a cluster controlled trial that evaluated the impact of a complex intervention on potentially inappropriate prescriptions (PIPs) in nursing homes (NHs).

SETTING

A total of 54NHsin Belgium.

PARTICIPANTS

A total of 797 NHRs included in the study who had complete medical, clinical, and medication information at baseline and at the end of the study (month 15).

MEASUREMENTS

Data were recorded by participating healthcare professionals. Reasons why BZRA use was considered as PIPs were assessed using the 2019 American Geriatrics Society Beers Criteria® and the Screening Tool of Older Persons’ Prescriptions (STOPP) criteria, version 2. Deprescribing included complete cessation or decreased daily dose. We identified factors at the NHR, prescriber, and NH levels associated with BZRA use and BZRA deprescribing using multivariable binary and multinomial logistic regression, respectively.

RESULTS

At baseline, 418 (52.4%) NHRs were taking a BZRA. The use of BZRA for longer than 4 weeks, with two or more other central nervous system active drugs, and in patients with delirium, cognitive impairment, falls, or fractures was found in more than 67% of BZRA users. Eight NHR‐related variables and two prescriber‐related variables were associated with regular BZRA use. Deprescribing occurred in 28.1% of BZRA users (32.9% in the intervention group and 22.1% in the control group). In addition to four other factors, dementia (odds ratio [OR] = 2.35; 95% confidence interval [CI] = [1.45–3.83]) and intervention group (OR = 1.74; 95% CI = 1.07–2.87) were associated with deprescribing.

CONCLUSION

Use of BZRAs was highly prevalent, and reasons to consider it as PIP were frequent. Deprescribing occurred in one‐fourth of NHRs, which is encouraging. Future interventions should focus on specific aspects of PIPs (ie, indication, duration, drug‐drug and drug‐disease interactions) as well as on nondementia patients.
Frailty, Cognitive Impairment, and Anticoagulation Among Older Adults with Nonvalvular Atrial Fibrillation
Authors: Mailhot Tanya , McManus David D. , Waring Molly E. , Lessard Darleen , Goldberg Robert , Bamgbade Benita A. , Saczynski Jane S.
Published: August 2020

BACKGROUND/OBJECTIVES

Oral anticoagulation (OAC) is challenging in older patients with nonvalvular atrial fibrillation (NVAF) who are often frail and have cognitive impairment. We examined the characteristics of older NVAF patients associated with higher odds of physical and cognitive impairments. We also examined if these high‐risk patients have different OAC prescribing patterns and their satisfaction with treatment because it may impact optimal management of their NVAF.

METHODS

The patients in the Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE‐AF study cohort 2016–2018) had NVAF, were aged 65 and older, and eligible for the receipt of OAC. Measures included frailty (Fried Frailty scale), cognitive impairment (Montreal Cognitive Assessment Battery), OAC prescribing and type (direct oral anticoagulant [DOAC] or vitamin K antagonist [VKA]), depressive symptoms (Patient Health Questionnaire‐9), bleeding, stroke risk, and treatment benefit (Anti‐Clot Treatment Scale).

RESULTS

Patients (n = 1,244) were 49% female, aged 76 (standard deviation = 7) years. A total of 14% were frail, and 42% had cognitive impairment. Frailty and cognitive impairment co‐occurred in 9%. Odds of having both impairments versus none were higher with depression (odds ratio [OR] = 4.62; 95% confidence interval [CI] = 2.59–8.26), older age (OR = 1.56; 95% CI = 1.29–1.88), lower education (OR = 3.81; 95%CI = 2.13–6.81), race/ethnicity other than non‐Hispanic White (OR = 7.94; 95% CI = 4.34–14.55), bleeding risk (OR = 1.43; 95% CI = 1.12–1.81), and stroke risk (OR = 1.35; 95% CI = 1.13–1.62). OAC prescribing was not associated with CI and frailty status. Among patients taking OACs (85%), those with both impairments were more likely to take DOAC than VKA (OR = 1.69; 95% CI = 1.01–2.80). Having both impairments (OR = 1.87; 95% CI = 1.08–3.27) or cognitive impairment (OR = 1.56; 95% CI = 1.09–2.24) was associated with higher odds of reporting lower treatment benefit.

CONCLUSION

In a large cohort of older NVAF patients, half were frail or cognitively impaired, and 9% had both impairments. We highlight the characteristics of patients who may benefit from cognitive and physical function screenings to maximize treatment and enhance prognosis. Finally, the co‐occurrence of impairment was associated with low perceived benefit of treatment that may impede optimal management.
Characterization and classification of different female hairline patterns in the Thai population
Authors: Natpracha Wasrin , Sukanjanapong Siriorn , Chanprapaph Kumutnart , Suchonwanit Poonkiat
Published: August 2020

Background

The hairline is an essential component of the human face. Disfigurement of the hairline may cause physical and psychological problems. Standard guidelines do not exist for female hairline designs, average values of infratemporal portion, hairline classifications, and preferences.

Aims

We aimed to study hairline characteristics in Thai females and further compare the values with previous studies in different populations. Furthermore, we aimed to introduce a comprehensive hairline classification system that allowed an easy and detailed phenotypic characterization of female hairline.

Patients/Methods

Healthy Thai females aged over 18 years were included in the study. Collection of demographic data, infratemporal measurements, and standard photography was performed. All collected data were analyzed to determine the standard values of each hairline dimension for comparison to previous studies.

Results

Two hundred and twenty‐nine females, with a mean age of 32.4 ± 8.6 years, participated in this study. The mean mid‐frontal line was 6.45 ± 0.89 cm, which was not correlated with age. Lateral mounds, widow's peaks, and cowlicks were observed in 42.35%, 24.45%, and 1.74% participants, respectively. Our study revealed five patterns of the frontal hairline and four patterns of the temporal hairline. The mid‐frontal line in Asian females trended longer than that in Caucasians, without statistical significance.

Conclusions

Measurements of the infratemporal portions in Thai females revealed no change with age, and the mid‐frontal line showed no statistically significant differences between Korean and Turkish participants. The hairline classification system introduced in our study was comprehensive and would be easily applicable in clinical practice. Female hairline dimensions and patterns reported in our study could provide reference values for hairline design in hairline restoration surgery as well as assist in accurate diagnosis of hair disorders.
Involuntary treatment in dementia care at home: Results from the Netherlands and Belgium
Authors: Mengelers Angela M. H. J. , Moermans Vincent R. A. , Bleijlevens Michel H. C. , Verbeek Hilde , Capezuti Elizabeth , Tan Frans , Milisen Koen , Hamers Jan P. H.
Published: August 2020

Aims and objectives

To gain insight into the request, use and associated factors of involuntary treatment in people with dementia (PwD) receiving professional home care in the Netherlands and Belgium.

Background

Most of the PwD remain living at home as long as possible. Due to complex care needs, this can result in an increased risk for care provided against the wishes of the client and/or to which the client resists, referred to as involuntary treatment.

Design

Secondary data analyses of two cross‐sectional surveys.

Methods

Dementia case managers and district nurses filled in a questionnaire for each PwD in their caseload. This study included data of 627 PwD receiving professional home care in the Netherlands and 217 in Belgium. The same methodology (questionnaire and variables) was used in both samples. Descriptive statistics and multi‐level logistic regression analyses were used to analyse the data. The study adhered to the STROBE checklist.

Results

More than half of the PwD (50.7%) living at home received involuntary treatment (Belgium 68.2% and the Netherlands 44.7%). Nonconsensual care (82.7%) was the most common, followed by psychotropic medication (40.7%) and physical restraints (18.5%). Involuntary treatment use was associated with living alone, greater ADL dependency, lower cognitive ability, higher family caregiver burden and receiving home care in Belgium versus the Netherlands. Involuntary treatment was most often requested by family caregivers.

Conclusions

Involuntary treatment is often used in PwD, which is in line with previous findings indicating dementia as a risk factor for involuntary treatment use. More research is needed to gain insight into variations in prevalence across other countries, which factors influence these differences and what countries can learn from each other regarding prevention of involuntary treatment.

Relevance to clinical practice

To provide person‐centred care, it is important to study ways to prevent involuntary treatment in PwD and to stimulate dialogue between professional and family caregivers for alternative interventions.
Effects of Denture Cleansers on the Flexural Strength of PMMA Denture Base Resin Modified with ZrO2 Nanoparticles
Authors: Gad Mohammed M. , Abualsaud Reem , Fouda Shaimaa M. , Rahoma Ahmed , Al‐Thobity Ahmad M. , Khan Soban Q. , Akhtar Sultan , Al‐Harbi Fahad A.
Published: August 2020

Purpose

The additions of zirconium oxide nanoparticles (nano‐ZrO2) to denture base materials have produced nanocomposites with satisfactory properties, although there is a lack of research investigating the effects of denture cleansers on these materials. This study aimed to evaluate the effect of denture cleansers on the flexural strength of denture base materials modified with nano‐ZrO2.

Materials and Methods

A total of 270 specimens were fabricated from pure and nano‐ZrO2 reinforced acrylic resins at 2.5% and 5%, resulting in 3 main groups. The groups were further divided into subgroups (n = 10) according to immersion solution (distilled water, Corega, sodium hypochlorite, and Renew) and immersion duration. Flexural strength was measured at baseline (T0) in distilled water and after 180 and 365 days of immersion (T1 and T2) in denture cleansers. Data were collected and analyzed using repeated measure ANOVA and Bonferroni post hoc tests (α = 0.05).

Results

The flexural strength of the nano‐ZrO2 modified denture base material decreased significantly after immersion in different denture cleansers at different immersion durations in comparison to baseline (T0) (p < 0.001). Sodium hypochlorite showed the highest reduction in flexural strength followed by Corega, while Renew cleansing solution resulted in the least change.

Conclusion

Denture cleansers can significantly affect the flexural strength of nano‐ZrO2 modified denture base materials and thus should be used cautiously.
Risk factors associated with progressive increases in serum creatinine concentrations in cats with cancer receiving doxorubicin
Authors: Kopecny Lucy , Palm Carrie A. , Skorupski Katherine A. , Delgado Mikel , Rebhun Robert B.
Published: August 2020

Background

Azotemia occurs in cats administered doxorubicin, but risk factors have not been explored.

Objective

To determine incidence of progressive increases in serum creatinine concentration in cats with cancer receiving doxorubicin in single or multiagent chemotherapy protocols and associated risk factors.

Animals

Seventy cats with cancer receiving doxorubicin.

Methods

A retrospective study (2007‐2017) of cats with indices of kidney function recorded before and after doxorubicin administration was reviewed. Cats diagnosed with kidney injury because of known etiologies other than possible doxorubicin toxicosis were excluded. Variables were compared to identify risk factors.

Results

Mean age (±SD) was 10.9 years (±3.2). Cancer types included lymphoma (n = 36), sarcoma (n = 19) and carcinoma (n = 14). Chronic kidney disease was present in 29/70 (41%) cats before receiving doxorubicin. Of 70 cats, 24 (34%) developed an increase in serum creatinine concentration ≥0.3 mg/dL and 10 (14%) had an increase ≥50% from baseline. Mean time to increases in serum creatinine concentration ≥0.3 mg/dL from first administration of doxorubicin was 119.3 days (±89.7), with mean 2.8 (±1.2) doses administered. Neutropenia or anemia during chemotherapy and number of radiation therapy treatments under general anesthesia were risk factors for increases in serum creatinine concentration (P < .05). Cats receiving single agent doxorubicin had a higher likelihood of an increase in serum creatinine concentration ≥0.3 mg/dL from baseline than cats receiving CHOP‐based chemotherapy protocols (OR 20.0, 95% CI 2.9‐100).

Conclusions and Clinical Importance

Progressive increases in serum creatinine concentration from baseline were common in cats receiving doxorubicin and associated risk factors were identified.
Disentangling the effects of multiple fires on spatially interspersed sagebrush (Artemisia spp.) communities
Authors: Shinneman Douglas J. , McIlroy Susan K. , de Graaff Marie‐Anne
Published: August 2020

Questions

Relative to a landscape with a mosaic of two sagebrush community types and increasing fire frequency, we asked: (a) do vegetation characteristics vary significantly with number of times burned for each sagebrush community; (b) how do vegetation responses to different fire frequencies compare between the two sagebrush communities?

Location

Columbia Plateau Ecoregion, Washington, USA.

Methods

We sampled vegetation across a landscape that burned three times over a 10‐year period in two sagebrush community types that are interspersed on unique land forms: big sagebrush (Artemisia tridentata) communities that occur on small “mounds” and scabland sagebrush (A. rigida) communities that occur on surrounding “flats.” Spatially overlapping fires permitted a balanced sampling design to assess unburned and once‐, twice‐, and thrice‐burned locations for each land form/community type. We utilized a suite of statistical analyses to determine differences among plant functional groups and biomass among unburned/burned strata by land form and compared results between land forms.

Results

Big sagebrush and scabland sagebrush communities responded uniquely to multiple fires, due to different fuel loadings, fire severities, succession and invasion dynamics. Big sagebrush experienced nearly complete shrub loss and conversion from exotic‐invaded shrubland to exotic annual grassland after only one fire. In contrast, scabland sagebrush retained a minor shrub component and higher relative cover of native herbaceous species, even after three fires. Both communities retained cover of native perennial grasses, including shallow‐ and deep‐rooted species, likely reflecting decreasing fire intensity with number of times burned.

Conclusions

Despite different community‐level responses, increasing fire frequency is transforming the entire landscape to a non‐native/native grassland mix. Quantifying unique ecosystem responses to altered wildfire regimes is critical to understanding the relative resilience of communities to disturbance and their resistance to exotic species invasion (and community type conversion). Management actions may help to maintain spatial heterogeneity of ecosystems and fire‐tolerant native species.
Using forestry inventories and satellite imagery to assess floristic variation in bamboo‐dominated forests in Peruvian Amazonia
Authors: Chaves Pablo Pérez , Reategui Echeverri Natalia , Ruokolainen Kalle , Kalliola Risto , Van doninck Jasper , Gómez Rivero Elvira , Zuquim Gabriela , Tuomisto Hanna
Published: August 2020

Questions

Does the floristic composition of trees differ between bamboo forests and adjacent non‐bamboo forests? Can the degree of compositional differences be predicted from differences in canopy reflectance as measured by Landsat satellites? Are the results sensitive to different taxonomical data cleaning strategies, or to which tree‐size class is considered? Are some tree taxa associated with either bamboo or non‐bamboo forests?

Location

Peruvian Amazonia.

Methods

We used national forestry inventory data to characterise floristic composition of trees at 25 sites. Bamboo and non‐bamboo forests were identified with a pixel‐based time series analysis using the entire Landsat TM/ETM+ archive. To visualise floristic similarity among the plots, we used non‐metric multidimensional scaling. Floristic differences between bamboo and non‐bamboo forests were tested using an analysis of similarity (ANOSIM). Mantel tests were used to assess correlation between floristic turnover and differences in canopy reflectance. We tested the impact of applying three different taxonomic data cleaning strategies and of analysing different tree‐size classes. Finally, we ran an indicator species analysis to identify taxa that were associated with either bamboo or non‐bamboo forests.

Results

In floristic ordinations, bamboo‐dominated forests appeared floristically distinct from non‐bamboo forests regardless of the taxonomic cleaning strategy and tree‐size class. This floristic separation was also confirmed through analysis of floristic similarity (ANOSIM). Turnover in floristic composition was strongly correlated with differences in the reflectance values of Landsat bands, especially when using genus‐level rather than species‐level data. Different palm taxa were associated with bamboo (Socratea) and non‐bamboo forests (Iriartea).

Conclusions

Floristic differences of trees between bamboo‐dominated and non‐bamboo forests are consistent enough to be observable with different tree‐size classes and taxonomic cleaning strategies. Although coarsening the taxonomic resolution to the genus level may hide ecological detail from the results, the fact that it allows keeping incompletely identified stems in the analyses seems to compensate for this.
Modelling the spatial distribution of selected North American woodland mammals under future climate scenarios
Authors: Deb Jiban Chandra , Forbes Graham , MacLean David A.
Published: August 2020

North America has a diverse array of mammalian species. Model projections indicate significant variations in future climate conditions of North America, and the habitats of woodland mammals of this continent may be particularly sensitive to changes in climate.

We report on the potential spatial distributions of 13 wide‐ranging, relatively common species of North American woodland mammals under future climate scenarios.

We examined the potential influence of the mean and seasonal climate variables on the distribution of species. Presence‐only occurrence records of species, four predictor variables, two future climate scenarios (Representative Concentration Pathways 4.5 and 8.5), and two time steps (current and 2070) were used to build species’ distribution models using a maximum entropy algorithm (MaxEnt).

Our results suggested that overall, 11 of the 13 species are likely to gain climatically suitable space (regions where climate conditions will be similar to those of area currently occupied) at the continental scale, but American marten Martes americana and ‘woodland’ caribou Rangifer tarandus are likely to lose suitable climate range by 2070. Furthermore, climate space is likely to be expanding northwards under future climate scenarios for most of the mammals, and many jurisdictions in the border region between Canada and the USA are likely to lose iconic species, such as moose Alces alces. We identified regions as potential in situ and ex situ climate change refugia, which are increasingly considered to be important for biodiversity conservation.

The model results suggest significant implications for conservation planning for the 13 mammalian species under global climate change, especially at fine spatial scales. Numerous species that are presently common at their southern range edge will be functionally or completely extirpated in 50 years. The potential in situ and ex situ climate change refugia could provide an effective support for adaptive strategies aimed at species conservation planning.
Glucan rich nutrition does not increase gut translocation of beta‐glucan
Authors: Hoenigl Martin , Lin John , Finkelman Malcolm , Zhang Yonglong , Karris Maile Y. , Letendre Scott L. , Ellis Ronald J. , Burke Leah , Richard Byron , Gaufin Thaidra , Isnard Stéphane , Routy Jean‐Pierre , Gianella Sara
Published: August 2020

Background

(1‐3)‐b‐D‐glucan (BDG) is a fungal cell wall component and, in the absence of invasive fungal infection, a novel biomarker for microbial translocation of endogenous fungal products from the gastrointestinal tract into systemic circulation. However, its value as a marker of fungal translocation is limited by a concern that plant BDG‐rich food influences blood BDG levels.

Methods

We conducted a pilot clinical trial to evaluate the impact of a standardised oral BDG challenge on blood BDG levels in participants with and without elevated microbial translocation. We enrolled 14 participants including 8 with HIV infection, 2 with advanced liver cirrhosis, and 4 healthy controls. After obtaining a baseline blood sample, participants received a standardised milkshake containing high levels of BDG followed by serial blood samples up to 8 hours after intake.

Results

The standardised oral BDG challenge approach did not change the blood BDG levels over time in all participants. We found consistently elevated blood BDG levels in one participant with advanced liver cirrhosis and a single person with HIV with a low CD4 count of 201 cells/mm3.

Conclusion

Our findings indicate that BDG blood levels were not influenced by plant origin BDG‐rich nutrition in PWH, people with advanced liver cirrhosis, or healthy controls.

Future studies are needed to analyse gut mycobiota populations in individuals with elevated blood BDG levels.
Genotyping of Russian isolates of fungal pathogen Trichophyton rubrum, based on simple sequence repeat and single nucleotide polymorphism
Authors: Pchelin Ivan M. , Mochalov Yuri V. , Azarov Daniil V. , Romanyuk Sofya A. , Chilina Galina A. , Vybornova Irina V. , Bogdanova Tatiyana V. , Zlatogursky Vasily V. , Apalko Svetlana V. , Vasilyeva Natalia V. , Taraskina Anastasia E.
Published: August 2020

Background

The Trichophyton rubrum species group consists of prevalent causative agents of human skin, nail and hair infections, including T rubrum sensu stricto and T violaceum, as well as other less well‐established or debatable taxa like T soudanense, T kuryangei and T megninii. Our previous study provided limited evidence in favour of the existence of two genetic lineages in the Russian T rubrum sensu stricto population.

Objectives

We aimed to study the genetic structure of the Russian population of T rubrum and to identify factors shaping this structure.

Methods

We analysed the polymorphism of 12 simple sequence repeat (SSR or microsatellite) markers and single nucleotide polymorphism in the TERG_02941 protein‐coding gene in 70 T rubrum isolates and performed a phylogenomic reconstruction.

Results

All three types of data provided conclusive evidence that the population consists of two genetic lineages. Clustering, performed by means of microsatellite length polymorphism analysis, was strongly dependent on the number of nucleotide repeats in the 5’‐area of the fructose‐1,6‐bisphosphate aldolase gene. Analysis of molecular variance (AMOVA) on the basis of SSR typing data indicated that 22%‐48% of the variability was among groups within T rubrum. There was no clear connection of population structure with types of infection, places of geographic origin, aldolase gene expression or urease activity.

Conclusion

Our results suggest that the Russian population of T rubrum consists of two cosmopolitan genetic lineages.
Variations in ribosomal DNA copy numbers in a genome of Trichophyton interdigitale
Authors: Iwanaga Tomoyuki , Anzawa Kazushi , Mochizuki Takashi
Published: August 2020

Background

Ribosomal DNA (rDNA) reportedly has multiple copies in the fungal genome. The internal transcribed spacer (ITS) region in rDNA is useful for investigating relationships between close taxonomic relatives. Thus, ITS has been widely used as a target gene in medical mycology for the detection of pathogenic fungi and identification of fungal species. However, the rDNA copy number in a genome of Trichophyton interdigitale, the pathogen causing dermatophytosis, currently remains unknown.

Objective

Clarification of the rDNA copy number in a genome of T. interdigitale.

Methods

rDNA copy numbers in 64 clinical isolates of T. interdigitale were examined using quantitative real‐time PCR (qPCR) with the absolute quantitative method targeting TruMDR2, a single‐copy control gene and the ITS region in rDNA.

Results

The copy numbers of the rDNA subunit varied among the 64 strains tested, from 24 to 116 copies per genome. The average rDNA copy number ± standard deviation was 59 ± 16. No correlations were observed between the rDNA copy number and colony colour, colony morphology or molecular type of the non‐transcribed spacer region in rDNA. Experiments on rDNA copy numbers obtained from independent colonies of each strain in single‐spore cultures revealed that the copy number was homogeneous within each strain.

Conclusion

This is the first study to estimate copy numbers of the rDNA subunit in a genome of T. interdigitale. The rDNA copy number of T. interdigitale varied among the strains tested and was homogeneous within each strain.
Heterochromatic silencing is reinforced by ARID1‐mediated small RNA movement in Arabidopsis pollen
Authors: Wu Wenye , Li Lei , Zhao Yi , Zhao Youshang , Jiang Ting , McCormick Sheila , Zheng Binglian
Published: August 2020

In the plant male germline, transposable elements (TEs) are reactivated in the companion vegetative nucleus, resulting in siRNA production and the intercellular movement of these siRNAs to reinforce TE silencing in sperm. However, the mechanism by which siRNA movement is regulated remains unexplored.

Here we show that ARID1, a transcription factor which is constitutively expressed in the vegetative nucleus but dynamically accumulates in the generative cell (the progenitor of sperm) to promote the second pollen mitosis, mediates siRNA movement to reinforce heterochromatic silencing in the male germline.

We looked for regulators involved in the accumulation of ARID1 in the generative cell, and found that AGO9, a germline‐specific AGO in Arabidopsis, is required for the accumulation of ARID1 in the generative cell. Mutations in either ARID1 or AGO9 lead to the interruption of not only the second pollen mitosis but also the movement of siRNA from the vegetative nucleus to the male germline, resulting in the release of heterochromatic silencing in the male germline. Moreover, conditional knockdown of ARID1 in the generative cell causes reduced heterochromatic silencing in both bicellular and mature pollen.

This study provides insights into how a spatiotemporal transcription factor coordinates heterochromatic silencing and male germline maturation.
Inflammatory conditions of the esophagus: an update
Authors: Lisovsky Mikhail
Published: August 2020

A variety of inflammatory disorders involve the esophagus. This commentary discusses the pathology of some forms of esophagitis, with an emphasis on recent developments. The initial section focuses on some common forms of nonreflux esophagitis, including lymphocytic esophagitis and eosinophilic esophagitis. Recent studies suggest that lymphocytic esophagitis may be associated with esophageal motility disorders and gastroesophageal reflux disease. Immunophenotypic features of intraepithelial lymphocytes may be helpful in distinguishing these conditions. Updates on the criteria and the limitations of histologic approach to the diagnosis of eosinophilic esophagitis are presented and new diagnostic adjuncts are discussed. In the remaining section, novel entities, such as IgG4‐related esophagitis, are discussed. IgG4‐related esophagitis has been recognized as a cause of esophageal lymphoplasmacytic inflammation. Increased understanding of esophageal inflammation remains an important goal that likely will lead to new approaches in the therapy of inflammatory esophageal diseases.
Recent advances in minimally invasive esophagectomy for squamous esophageal cancer
Authors: Yip Hon Chi , Shirakawa Yasuhiro , Cheng Ching‐Yuan , Huang Chang‐Lun , Chiu Philip Wai Yan
Published: August 2020

Over the past decade there has been tremendous development in the clinical application of minimally invasive esophagectomy (MIE) for the treatment of squamous esophageal carcinoma. The major challenges in the performance of MIE include limitations in visualization and manipulation within the confined, rigid thoracic cavity; the need for adequate patient positioning and anesthetic techniques to accommodate the surgical exposure; and changes in the surgical steps for achieving radical nodal dissection, especially for the superior mediastinum. The surgical procedure for MIE is more and more standardized, and there is an increasing practice of MIE worldwide. Randomized trials and meta‐analyses have confirmed the advantages of MIE over open esophagectomy, including a significantly lower rate of complications and shorter hospital stays. The recent application of robotics technologies for MIE has further enhanced the quality and safety of the surgical dissection, while intraoperative nerve monitoring has contributed to a lower rate of recurrent laryngeal nerve palsy. With the application of new technologies, we expect further improvement in surgical outcomes for MIE in the treatment of squamous esophageal cancer.
Global prevalence of obesity, overweight and underweight in children, adolescents and adults with autism spectrum disorder, attention‐deficit hyperactivity disorder: A systematic review and meta‐analysis
Authors: Li Yong‐Jiang , Xie Xue‐Ni , Lei Xue , Li Ya‐Min , Lei Xianyang
Published: August 2020

Individuals with autism spectrum disorder (ASD) or attention‐deficit hyperactivity disorder (ADHD) may have unhealthy bodyweight. This meta‐analysis was performed to understand the weight status in individuals with ASD or ADHD. PubMed, Embase, Cochrane and ISI Web of Science databases were searched from inception until June 2020 to identify relevant studies. Prevalence estimates and their 95% confidence intervals (CIs) of obesity, overweight and underweight were separately pooled using random‐effects models. A total of 95 studies were included in the meta‐analysis. The pooled estimates of the prevalence of obesity, overweight and underweight were 21.8%, 19.8% and 6.4% in individuals with ASD and 14.7%, 20.9% and 4.0% in individuals with ADHD. In subgroup analyses, an increasing trend in the prevalence of unhealthy weight was observed from children aged 2 to 5 years to adults with ASD (obesity: from 16.7% to 31.3%, overweight: from 16.2% to 27.2%, underweight from 5.3% to 8.6%) and from children aged 6 to 12 years to adults with ADHD (obesity: from 13.5% to 19.3%, overweight: from 18.8% to 31.2%). The worrisome epidemic of obesity and overweight in individuals with ASD, ADHD highlighted the need for weight management.
Effects of intraoperative dexmedetomidine on the incidence of acute kidney injury in pediatric cardiac surgery patients: A randomized controlled trial
Authors: Kim Eun‐Hee , Lee Ji‐Hyun , Kim Hee‐Soo , Jang Young‐Eun , Ji Sang‐Hwan , Kim Woong‐Han , Kwak Jae Gun , Kim Jin‐Tae
Published: August 2020

Background

Perioperative dexmedetomidine use has been reported to reduce the incidence of postoperative acute kidney injury after adult cardiac surgery. However, large‐scale randomized controlled trials evaluating the effect of dexmedetomidine use on acute kidney injury in pediatric patients are lacking.

Aims

We investigated whether intraoperative dexmedetomidine could reduce the incidence of acute kidney injury in pediatric cardiac surgery patients.

Methods

In total, 141 pediatric patients were randomly assigned to dexmedetomidine or control groups. After anesthetic induction, patients in the dexmedetomidine group were administered 1 µg/kg of dexmedetomidine over 10 minutes and an additional 0.5 µg/kg/h of dexmedetomidine during surgery. Additionally, 1 µg/kg of dexmedetomidine was infused immediately after cardiopulmonary bypass was initiated. The incidence of acute kidney injury was defined following Kidney Disease Improving Global Outcomes guidelines.

Results

The final analysis included 139 patients. The incidence of acute kidney injury did not differ between dexmedetomidine and control groups (16.9% vs 23.5%; odds ratio 0.661; 95% CI 0.285 to 1.525; P = .33). Similarly, neither the incidence of abnormal postoperative estimated glomerular filtration rate values (P = .96) nor the incidence of arrhythmia, mechanical ventilation duration, length of stay in the intensive care unit, and hospitalization differed between the two groups.

Conclusions

Intraoperative dexmedetomidine did not reduce acute kidney injury incidence in pediatric cardiac surgery patients.
Pathogenicity variation and DNA polymorphism ofBipolaris sorokinianainfecting winter wheat in the Huanghuai floodplain of China
Authors: Kang Ruijiao , Hu Yanfeng , Wang Limin , Xie Shunpei , Li Yonghui , Yuan Hongxia , Wang Min , Chen Linlin , Ding Shengli , Li Honglian
Published: August 2020

Wheat root rot, caused byBipolaris sorokiniana, has led to severe losses of wheat products worldwide. To evaluate the pathogenicity and genetic variation ofB.sorokiniana, diseased wheat samples were collected from 97 locations in the Huanghuai floodplain of China in 2014 and 2015 for analysis. A total of 673 isolates were obtained, 262 of which were identified asB.sorokiniana. Pathogenicity analysis of the isolates revealed variation in pathogenicity, which was not directly correlated with geographic region. Large variations in pathogenicity were also found within geographic groups. To determine the genetic structure of the populations, PCR was performed with universal rice primers (URP). Cluster analysis based on amplification patterns showed that the classified groups were correlated with geographical regions. Thus, analysis of the genetic diversity of the population indicated a negative correlation with geographic origin, that is, the greater the distance between sites, the lower the genetic variation similarity coefficient. Identification of wheat germplasm resistance showed that resistant cultivars accounted for a low percentage, while susceptible and highly susceptible cultivars were in the majority. Overall, these results are meaningful for developing strategies to prevent and control wheat root rot.
Restoration potential of Asian oysters on heavily developed coastlines
Authors: Lau Sally C. Y. , Thomas Marine , Hancock Boze , Russell Bayden D.
Published: August 2020

Reef‐building oysters historically provided the main structural and ecological component of temperate and subtropical coastal waters globally. While the loss of oyster reefs is documented in most regions globally, assessments of the status of Asian oyster reefs are limited. The feasibility of restoration within the regional biological and societal contexts needs to be assessed before implementation. Here, we quantified the current distribution of natural oyster reefs (Crassostrea spp.) in the shallow coastal waters of Hong Kong, assessed the biological feasibility of reestablishing reefs using natural recruitment, and examined their current and potential water filtration capacity as a key ecosystem service provided by restoration. We found natural low‐relief oyster beds in the low intertidal coastal areas at a subset of the locations surveyed. These areas are, however, degraded and have sparse densities of oysters generally <2 years old. Recruitment was high in some areas (>500,000 indiv./m2) and while survival to maturity varied across sites there was adequate larval supply and survival for restoration. Filtration rates for a 1‐year‐old recruit (90 mm length, approximately 30 L/hour per individual) at summer temperatures (30°C) meant that even the small remnant populations are able to provide some filtration services (up to 31.7 ML/hour). High natural recruitment means that oyster reef restoration can be achieved with the addition of hard substrate for recruitment, increased protection of restoration sites, and would not only increase the ecological value of reefs regionally but also serve as a model for future restoration in Asia.
Patients' experiences of everyday living before and after transcatheter aortic valve implantation
Authors: Lysell Eva , Wolf Axel
Published: August 2020

Background

Aortic stenosis (AS) is the most common valvular disease in western countries. Unless treated, it is associated with a poor prognosis. Surgical aortic valve replacement, the gold‐standard approach, aims to increase survival and improve quality of life. In recent years, though, transcatheter aortic valve implantation (TAVI) has become the treatment of choice in elderly, high‐risk patients who are denied open surgery. To date, however, little is known about their personal psychological experience after undergoing TAVI.

Aim

This study aimed to explore patients’ experiences during everyday life before and after TAVI.

Method

Altogether, 14 elderly Swedish patients (9 women, 5 men), treated with TAVI, were interviewed between 2 and 6 months after the implantation. The interviews were analysed using qualitative content analysis.

Results

Analysis of the participants’ experiences was divided into two domains: before and after, that is, life with AS vs. life after TAVI. From these domains, four categories were derived: (1) adapting to the deteriorating self; (2) feeling disconnected; (3) reconstruction of self; and (4) processing disappointment.

Conclusions

Transcatheter aortic valve implantation involves not only adding years to life but also adding life to years. The urge to live an autonomous life in a social context with others is an important argument for undergoing a TAVI procedure. Despite severe illness and demanding rehabilitation, elderly TAVI patients have the ability to regain independence and rebuild their lives when they base their decision to undergo TAVI on personal goals. These findings might be helpful when implementing person‐centred care.
Informal carers’ support needs when caring for a person with dementia – A scoping literature review
Authors: Holt Clemmensen Trine , Hein Lauridsen Henrik , Andersen‐Ranberg Karen , Kaae Kristensen Hanne
Published: August 2020

Background

Informal carers of people with dementia report having unmet needs for support and few supportive interventions have been shown to be effective. There is a need to develop needs assessment instruments and supportive interventions with a holistic and person‐centred approach to meet the various and complex needs of carers. The aim of this study was to provide an overview of carers’ support needs when caring for people with dementia with the objectives to map and synthesise knowledge on key concepts of carers’ support needs.

Methods

A scoping review methodology was used. A literature search was conducted in PsycINFO, CINAHL, PubMed and EMBASE between January 2007 and October 2019. Three authors independently selected articles meeting the inclusion criteria, and data were extracted using a matrix developed for that purpose. Inductive content analysis was used to synthesise key concepts of carers’ support needs.

Results

The search identified 2748 articles after removing duplicates, and 122 articles were included in the mapping of carers’ support needs. Synthesising carers’ support needs indicated that the full extent of support needs emerges in the interaction between the carer and the person cared for and that it is possible to categorise support needs into four key concepts related to: 1) the carer as a person, 2) managing being a carer, 3) providing care, and 4) knowledge of dementia.

Conclusion

The findings of this study help to map a framework describing carers’ support needs that may guide the development of future needs assessment instruments and supportive interventions.
Variability in hemoglobin mass response to altitude training camps
Authors: Nummela Ari , Eronen Timo , Koponen Anne , Tikkanen Heikki , Peltonen Juha E.
Published: August 2020

The present study investigated whether athletes can be classified as responders or non‐responders based on their individual change in total hemoglobin mass (tHb‐mass) following altitude training while also identifying the potential factors that may affect responsiveness to altitude exposure. Measurements were completed with 59 elite endurance athletes who participated in national team altitude training camps. Fifteen athletes participated in the altitude training camp at least twice. Total Hb‐mass using a CO rebreathing method and other blood markers were measured before and after a total of 82 altitude training camps (1350‐2500 m) in 59 athletes. In 46 (56%) altitude training camps, tHb‐mass increased. The amount of positive responses increased to 65% when only camps above 2000 m were considered. From the fifteen athletes who participated in altitude training camps at least twice, 27% always had positive tHb‐mass responses, 13% only negative responses, and 60% both positive and negative responses. Logistic regression analysis showed that altitude was the most significant factor explaining positive tHb‐mass response. Furthermore, male athletes had greater tHb‐mass response than female athletes. In endurance athletes, tHb‐mass is likely to increase after altitude training given that hypoxic stimulus is appropriate. However, great inter‐ and intra‐individual variability in tHb‐mass response does not support classification of an athlete permanently as a responder or non‐responder. This variability warrants efforts to control numerous factors affecting an athlete's response to each altitude training camp.
Identification of transcription factors controlling floral morphology in wild Petunia species with contrasting pollination syndromes
Authors: Yarahmadov Tural , Robinson Sarah , Hanemian Mathieu , Pulver Valentin , Kuhlemeier Cris
Published: August 2020

Adaptation to different pollinators is an important driver of speciation in the angiosperms. Genetic approaches such as QTL mapping have been successfully used to identify the underlying speciation genes. However, these methods are often limited by widespread suppression of recombination due to divergence between species. While the mutations that caused the interspecific differences in floral color and scent have been elucidated in a variety of plant genera, the genes that are responsible for morphological differences remain mostly unknown. Differences in floral organ length determine the pollination efficiency of hawkmoths and hummingbirds, and therefore the genes that control these differences are potential speciation genes. Identifying such genes is challenging, especially in non‐model species and when studying complex traits for which little prior genetic and biochemical knowledge is available. Here we combine transcriptomics with detailed growth analysis to identify candidate transcription factors underlying interspecific variation in the styles of Petunia flowers. Starting from a set of 2284 genes, stepwise filtering for expression in styles, differential expression between species, correlation with growth‐related traits, allele‐specific expression in interspecific hybrids, and/or high‐impact polymorphisms resulted in a set of 43 candidate speciation genes. Validation by virus‐induced gene silencing identified two MYB transcription factors, EOBI and EOBII, that were previously shown to regulate floral scent emission, a trait associated with pollination by hawkmoths.