bluuebunny/crossref_metadata_2025 huggingface dataset:
Attitudes, Perceptions, and Preferences of Individuals from Temuco (Chile) About Denture Marking
Authors: Rojas‐Torres Javier , Navarro‐Cáceres Pablo , Fonseca Gabriel M.
Published: December 2018

Denture marking (DM) helps identify edentulous people with different methods. Analyzing perceptions and attitudes of denture wearers would enable understanding of the practical aspects, an analysis still absent in South America. Fifty‐three individual candidates for removable dentures were instructed on disaster victim identification (DVI) and the usefulness of DM for this purpose. They were physically shown eight DM systems and a questionnaire to which they responded by highlighting preferences in those systems. Although 98.11% did not know that dentures could be marked, only 9.43% denied interest in some type of DM. The 90.57% would mark their dentures with some system, preferring the inclusion of QR codes or a micro SIM card. The proven weaknesses of DVI and propensity for disaster mean this community in Chile is an opportunity to implement DM systems. Obstacles may come not from patients but from their dentists, educational institutions, or a lack of public policies.
Methamphetamine presentations to an emergency department: Management and complications
Authors: Isoardi Katherine Z , Ayles Sarah F , Harris Keith , Finch Clare J , Page Colin B
Published: December 2018

Objective

There is little recent published data characterising methamphetamine intoxication. The present study aims to describe the clinical effects, management, complications and disposition of patients with methamphetamine exposure.

Methods

This is a retrospective review of patients presenting with methamphetamine intoxication to an ED in 2016. All presentations were extracted from a relational database and each medical record reviewed. Demographics, clinical features, complications and disposition were extracted.

Results

There were 378 presentations of 329 patients (234 men [71%]), median age 31 years (range 16–68 years). The most common clinical effect was acute behavioural disturbance, occurring in 295 (78%) presentations. This was successfully managed with oral sedation alone in 180 (61%) patients, with the remainder receiving parenteral sedation. Other effects included tachycardia in 212 (56%), hypertension in 160 (42%) and hyperthermia in 17 (5%) presentations. No anti‐hypertensives were given. One patient was actively cooled. Complications included 21 (30%) presentations with rhabdomyolysis and 41 (13%) presentations with acute kidney injury. There were two seizures, three intracranial bleeds and one myocardial infarction. The majority (317 [84%]) of patients were managed solely within the ED. The median length of stay was 14 h. There were 41 (11%) mental health admissions. Two deaths occurred: one following an out‐of‐hospital cardiac arrest and the other a subarachnoid haemorrhage.

Conclusion

The main toxicity seen with methamphetamines is acute behavioural disturbance, which is managed well with sedation. Complications, apart from rhabdomyolysis and acute kidney injury, are rare. Most patients are managed within the ED and discharged home.
Characterization of Heat‐Induced Water Adsorption of Sea Cucumber Body Wall
Authors: Dong Xiuping , Liu Wentao , Song Xue , Lin Xiaoyu , Yu Da , Yu Chenxu , Zhu Beiwei
Published: December 2018

Different heating conditions could change water absorption capacity of sea cucumbers body wall (SCBW), and subsequently affect the sensory quality of the rehydrated sea cucumbers. In this study, fresh SCBWs were boiled for 30, 60, 90, 120, 150, 180 min, respectively. The boiled SCBWs were then soaked in deionized water for 48 hr. The changes in water absorption ratio (Wabs), water holding capacity, water distribution, texture and ultrastructure of the SCBW were investigated. With increasing cooking time (from 30 to 180 min) the water absorption capacity is significantly enhanced (from 1.84 times to 3.37 times). The absorbed water was found to exist inside the SCBW in two forms, physisorbed water, which entered the SCBW via diffusion and could be easily removed, and associated water, which formed association with the SCBW structure, evidenced by the difference in mobility determined by low field nuclear magnetic resonance (LF‐NMR) spectroscopy. Study of the microstructure of the SCBW showed that the collagen fibers in the SCBW gradually depolymerized and degraded, resulting in the formation of inter‐fiber pores and gaps which became internal space that could accommodate more and more water as the cooking time increased. This water was mainly physisorbed with high mobility. The texture characteristics of the SCBW negatively correlated with the accumulation of physiosorbed water. These findings suggest that proper control of heating time could be critical in determining the sensory/eating quality of sea cucumbers.

Practical Application

Different heating conditions allows sea cucumbers to have different water absorption capacity during the subsequent soaking process, which could greatly affect sea cucumber sensory quality. Understanding the effects of heating on the water absorption characteristics and texture characteristics of sea cucumber body wall will provide knowledge basis and guidelines to optimize the processing parameters for the emerging ready‐to‐eat sea cucumber industry
Evaluation of SWAT Impoundment Modeling Methods in Water and Sediment Simulations
Authors: Jalowska Anna M. , Yuan Yongping
Published: December 2018

Worldwide studies show 80%–90% of all sediments eroded from watersheds is trapped within river networks such as reservoirs, ponds, and wetlands. To represent the impact of impoundments on sediment routing in watershed modeling, Soil and Water Assessment Tool (SWAT) developers recommend to model reservoirs, ponds, and wetlands using impoundment tools (ITs). This study evaluates performance of SWAT ITs in the modeling of a small, agricultural watershed dominated by lakes and wetlands. The study demonstrates how to incorporate impoundments into the SWAT model, and discusses and evaluates involved parameters. The study then recommends an appropriate calibration sequence, i.e., landscape parameters calibration, followed by pond/wetlands calibration, then channel parameter calibrations, and lastly, reservoir parameter calibration. Results of this study demonstrate not following SWAT recommendation regarding modeling water land use as an impoundment depreciates SWAT performance, and may lead to misplaced calibration efforts and model over‐calibration. Further, the chosen method to model impoundments’ outflow significantly impacts sediment loads in the watershed, while streamflow simulation is not very sensitive. This study also allowed calculation of mass accumulation rates in modeled impoundments where the annual mass accumulation rate in wetlands (2.3 T/ha/yr) was 39% higher than mass accumulation rate in reservoirs (1.4 T/ha/yr).
Increased formation of neutrophil extracellular traps is associated with gut leakage in patients with type 1 but not type 2 diabetes
Authors: You Qi , He Dong Mei , Shu Guo Fang , Cao Bo , Xia Yong Quan , Xing Yun , Ni Min , Chen Ji Fang , Shi Shu Li , Gu Harvest F. , Liu Yu , Wu Jie
Published: December 2018

Background

The aim of this study was to investigate the association of the formation of neutrophil extracellular traps (NETs) with gut leakage in type 1 (T1D) and type 2 diabetes (T2D).

Methods

In all, 105 subjects (56 T1D, 49 T2D) were included in the study. Eight biomarkers of NET formation and gut leakage (ie, protein arginine deiminase type 4 [PAD4], neutrophil elastase [NE], proteinase 3 [PR3], complement 5a [C5a], α1‐antitrypsin [AAT], DNase I, zonulin, and lipopolysaccharide [LPS]) were measured in serum samples by ELISA. Neutrophils were isolated and stimulated by phorbol myristate acetate to form NETs in vitro. Neutrophil intracellular contents were then collected and used as antigens to detect anti‐neutrophil cytoplasmic antibodies (ANCA) in the serum.

Results

There was an increase in NET‐associated proteins (PAD4, NE, PR3, C5a, AAT and DNase I) in new‐onset T1D patients but not in those with T2D. Of PAD4, NE, and PR3, PAD4 was found to be the most sensitive biomarker for the diagnosis of T1D. Furthermore, circulating levels of zonulin and LPS were not only increased, but were also strongly correlated with NET formation and ANCA generation in T1D patients.

Conclusions

This study provides evidence that increased formation of NETs, particularly PAD4, is closely associated with gut leakage in T1D but not T2D, and suggests that microorganisms and the release of neutrophil cytoplasmic antigen during the formation of NETs may be involved in the pathogenesis of T1D.
Effect of diabetes mellitus on the recovery of changes in renal functions and glomerular permeability following reversible 24‐hour unilateral ureteral obstruction
Authors: Bakoush Omran , Lubbad Loay , Öberg Carl M. , Hammad Fayez T.
Published: December 2018

Background

Following reversal of short periods of ureteral obstruction (UO), glomerular and tubular renal dysfunction recovers with time. Diabetes mellitus (DM) affects glomerular function; thus, the ability of diabetic kidneys to recover from UO may be impaired. This study investigated the effects of long‐term DM on the recovery of glomerular and tubular function, as well as permeability of the glomerular filtration barrier (GFB), after unilateral UO (UUO) reversal.

Methods

Diabetes mellitus was induced in Wistar rats by intraperitoneal streptozotocin. All diabetic and age‐matched control rats underwent reversible 24‐hour left UUO. The renal function of both kidneys was measured using clearance techniques 3 hours and 7 and 30 days after UUO reversal. Glomerular permeability was assessed by measuring the glomerular sieving coefficients for fluorescein isothiocyanate‐conjugated Ficoll (molecular radius: 20‐90 Å).

Results

Unilateral UO induced transient changes in the size selectivity of GFB small pores. However, the size selectivity function of large pores had not returned to baseline even 30 days after UUO reversal. Diabetes mellitus caused exaggerated early alterations in glomerular hemodynamic and tubular function, as well as size selectivity dysfunction of both small and large pores. At 30 days after UUO reversal, despite glomerular hemodynamic and tubular function and the size selectivity of small pores returning to normal in both diabetic and non‐diabetic rats, the residual size selectivity dysfunction of large pores was more severe in diabetic rats.

Conclusion

Unilateral UO caused long‐term dysfunction in the size selectivity of large pores of the GFB. In addition, DM significantly exaggerated this dysfunction, indicating a more ominous outcome in diabetic kidneys following UUO.
Serum levels of Krebs von den Lungen‐6 as a promising marker for predicting occurrence and deterioration of systemic sclerosis‐associated interstitial lung disease from a Chinese cohort
Authors: Cao Xiao‐yu , Hu Sha‐sha , Xu Dong , Li Meng‐tao , Wang Qian , Hou Yong , Zeng Xiao‐feng
Published: December 2018

Aim

A prospective and longitudinal study to investigate the correlations between Krebs von den Lungen‐6 (KL‐6) serum levels and systemic sclerosis associated with interstitial lung disease (SSc‐ILD).

Method

Blood samples of baseline and the time point at 2 years follow‐up intervals were collected for the measurement of serum KL‐6 levels. The baseline clinical, laboratory characteristics, and incidence density of newly diagnosed ILD during the follow up were compared between SSc patients with elevated serum KL‐6 levels (KL‐6 > 500 U/mL) and those with normal KL‐6 levels (KL‐6 ≤ 500 U/mL) at baseline. Further, we explored the association between serum KL‐6 and deterioration of ILD measured by lung function parameters during follow‐up of 2 years.

Results

Patients with elevated baseline serum KL‐6 had a significant tendency to have disappearance of the finger pad. The incidence density of new‐onset ILD in SSc patients with elevated baseline serum KL‐6 and those with normal baseline serum KL‐6 was 1.33% and 0.51%, respectively. Among the mild lung injury group, the incidence density of ILD deterioration in SSc patients with elevated baseline serum KL‐6 and those with normal serum KL‐6 was 1.2% and 0.74%, respectively.

Conclusion

Serum KL‐6 level correlates with the clinical manifestations of microvascular injury. Baseline elevated serum KL‐6 may predict deterioration of lung function of SSc‐ILD patients with mild lung injury.
Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study
Authors: Clemency Brian M. , Eggleston William , Shaw Evan W. , Cheung Michael , Pokoj Nicholas S. , Manka Michael A. , Giordano Donald J. , Serafin Laura , Yu Han , Lindstrom Heather A. , Hostler David
Published: December 2018

Objective

St. Paul's Early Discharge Rule was derived to determine which patients could be safely discharged from the emergency department after a 1‐hour observation period following naloxone administration for opiate overdose. The rule suggested that patients could be safely discharged if they could mobilize as usual and had a normal oxygen saturation, respiratory rate, temperature, heart rate, and Glasgow Coma Scale score. Validation of the St. Paul's Early Discharge Rule is necessary to ensure that these criteria are appropriate to apply to patients presenting after an unintentional presumed opioid overdose in the context of emerging synthetic opioids and expanded naloxone access.

Methods

In this prospective, observational validation study, emergency medicine providers assessed patients 1 hour after administration of prehospital naloxone. Unlike in the derivation study the threshold for normal oxygen saturation was set at 95% and patients were not immediately discharged after a normal 1‐hour evaluation. Patients were judged to have a normal 1‐hour evaluation if all six criteria of the rule were met. Patients were judged to have an adverse event (AE) if they had one or more of the preestablished AEs.

Results

A total of 538 patients received at least one administration of prehospital naloxone, were transported to the study hospital, and had a 1‐hour evaluation performed by a provider. AEs occurred in 82 (15.4%) patients. The rule exhibited a sensitivity of 84.1% (95% confidence interval [CI] = 76.2%–92.1%), a specificity of 62.1% (95% CI = 57.6%–66.5%), and a negative predictive value of 95.6% (95% CI = 93.3%–97.9%). Only one patient with a normal 1‐hour evaluation subsequently received additional naloxone following a presumed heroin overdose.

Conclusion

This rule may be used to risk stratify patients for early discharge following naloxone administration for suspected opioid overdose.
Real earnings management around CEO turnovers
Authors: Geertsema Paul G. , Lont David H. , Lu Helen
Published: December 2018

Following CEO turnovers, US firms adjust real business activities to manage earnings downwards (REM bath). This effect is most pronounced in firms with low levels of institutional ownership. REM baths early in CEOs’ tenure can be confounded with legitimate adjustments to business activities. However, we show that they are not accompanied by increases in R&D or capital expenses, nor are they explained by restructuring expenses. CEOs with short tenure record more negative REM measures in their first year of tenure, when compared with CEOs with long tenure.
Comparing two commercial domestic dog (Canis familiaris) STR genotyping kits for forensic identity calculations in a mixed‐breed dog population sample
Authors: Kanthaswamy S. , Oldt R. F. , Montes M. , Falak A.
Published: December 2018

Almost half of all US households own a dog (Canis familiaris). Though these household pets can attack humans and other animals, they are also frequently victims of cruelty, neglect and theft. In human‐oriented investigations, the tendency of domestic dogs to leave behind physical traces (such as hair) can serve as valuable links between crime scenes and suspects/victims. This demonstrated utility of canine biological evidence has created demand for genotyping marker sets for canine forensic genetic testing. Through research and casework, short tandem repeat (STR) panels have been shown to be very efficient for identity and parentage testing in dogs. However, there is an absence of comparative studies between different canine forensic identification kits. The Thermo Fisher Scientific Canine Genotypes ™ Panel 1.1 and 2.1 Kits were originally designed and developed for routine and forensic use respectively, although both kits can be used for either purpose. In this study, we evaluated both STR panels to determine how critical forensic genetic metrics are affected by panel‐to‐panel variation in marker composition and design. Our results show that although STR panel composition can influence estimates such as inbreeding, combined power of discrimination and combined probability of exclusion, greater average allele number values exhibited across all markers in Panel 2.1 facilitated significantly more precise estimates of random match probability (RMP) and combined probability of identity. Furthermore, we demonstrate that a theta (θ) correction of 0.09 can be used to conservatively adjust RMPs generated from a small reference database of fewer than 50 samples, confirming that Panel 2.1 is a more robust forensic genotyping system than is Panel 1.1. for domestic dogs. We also demonstrate that opportunistic local sampling of fewer than 50 mixed‐breed dogs can produce sufficient discriminatory and exclusionary power with either genotyping kit.
Protecting the Passport: Defending US Borders Built in the United Arab Emirates
Authors: Sanchez Shaundel
Published: December 2018

Muslim American women who live or have lived in the United Arab Emirates (re)produce figurative US border walls by self‐ and group‐policing choices in marriage partners. The research presented in this article concentrates on a group of Muslim women who came together through the Tablighi Jama'at (Preaching Party), their relationship with Sharjah royal family members, and their shared history of living in a neighborhood built for them in the UAE. Since 9/11, a shift has occurred in how these Muslims choose marriage partners. Before, a potential partner's religiosity was paramount; since 9/11, however, the power of a potential husband's passport (i.e., how easily he can travel visa‐free) has taken precedence. This change, I argue, can be traced to restrictions imposed by the US “War on Terror.” After 9/11, Muslims became disproportionately surveilled and stereotyped. The women I study have internalized post‐9/11 security regime practices and prevent certain non‐US persons from getting citizenship through marriage. By discriminating against men without “powerful” passports, these women seamlessly perform their national, religious, and gendered identities. [marriage, (im)mobility, citizenship, Muslim Americans, United Arab Emirates]
Russia‐Australia Relations in the Context of the Ukrainian Crisis
Authors: Krivushin Ivan
Published: December 2018

This article examines the 2014–2015 crisis in Australia‐Russia relations that occurred after Russia’s annexation of Crimea in March 2014, from the point of view of both Moscow and of Canberra. It finds that the Kremlin did not take into account a number of factors that negatively affected Canberra’s stance towards the Kremlin even before 2014, and which greatly contributed to the crisis. These include the very limited involvement of Australia in commercial exchanges with Russia, Canberra’s growing suspicions about Moscow’s foreign policy intentions and view of Russia as a revisionist power (especially after the 2008 Russia‐Georgia war), a strong sense of solidarity with the West among Australia’s political elites, and Russia’s increasingly worsening public image in Australia, Prospects and contemporary challenges in the relations are also discussed.
Post‐marketing dosing changes in the label of biologicals
Authors: Minnema Lotte A. , Giezen Thijs J. , Gardarsdottir Helga , Egberts Toine C. G. , Leufkens Hubert G. M. , Mantel‐Teeuwisse Aukje K.
Published: December 2018

Aim

The aim of this study was to evaluate post‐marketing label changes in dosing information of biologicals.

Methods

Biologicals authorized between 2007 and 2014 by the European Medicines Agency (EMA) were included and followed up from marketing authorization until 31 December 2016 or date of withdrawal of the marketing authorization. The primary outcome of the study was defined as label change in dosing information for the initially approved indication. Incidence of changes, type of change and mean time to change were assessed. As a secondary outcome, label changes in dosing information for extended indications were assessed.

Results

A total of 71 biologicals were included. Dosing information in the label changed for the initial indication during follow‐up for eight products (11%). In one of the eight products the change concerned an increase in dose. Also, a change in dosing frequency was identified in three products, for one product a recommendation was added that therapy could be initiated with or without a loading dose, and for one product the minimum dose was removed and a maximum dose was added. For the remaining product the dose was decreased due to safety issues. For 30 products (42%) the indication was extended at least once. No changes in dosing information were observed for the extended indications (n = 59) during follow‐up.

Conclusions

This study showed that in 11% of the biologicals, the dosing for the initial indication in the label was changed. In contrast to small molecules, the dose was rarely reduced for safety reasons.
Women‐centered care: Implementation of CenteringPregnancy® in The Netherlands
Authors: Rijnders Marlies , Jans Suze , Aalhuizen Inger , Detmar Symone , Crone Matty
Published: December 2018

Introduction

In response to a relatively high perinatal mortality rate in The Netherlands, the Dutch Health Ministry recommended changes to maternity care, opening a pathway toward more integrated woman‐centered services. Because of its potential to positively influence risk factors for adverse pregnancy outcomes, CenteringPregnancy (CP) group prenatal care was implemented.

Methods

We performed a retrospective cohort study (n = 2318) and survey on women's experiences (n = 222) in eight primary care midwifery practices to investigate outcome differences between CP and traditional individual prenatal care. Data from the period 2011‐2013 were analyzed.

Results

Primiparous and multiparous CP women attended more prenatal care visits compared with women who received individual care (adjusted odds ratio [aOR] 1.23 [95% confidence interval [CI] 1.18‐1.29] and 1.29 [1.21‐1.36]). Fewer primiparous CP women used pain relief during labor (0.56 [0.43‐0.73]), and they initiated breastfeeding more often (1.74 [1.15‐2.62]). Women participating in CP were more likely to feel that their wishes with respect to medication use (69.1% vs 54.4%, P = 0.039), physical activities (72.8% vs 52.5%, P = 0.008), and relaxation exercises (67.9% vs 35.6%, P ≤ 0.001) were listened to by care providers. They also felt more supported to actively participate in their care (89.6% vs 68.5%, P = 0.001) and felt more able to voice opinions about care (92.7% vs 73.9%, P = 0.002).

Conclusions

The CP model is a good approach aligning with Dutch policy calling for women‐centered care and responding to the needs of pregnant women. This study supports CP scale‐up in The Netherlands and adds to the pool of international knowledge about CP implementation.
Transfusion strategies for major haemorrhage in trauma
Authors: Curry Nicola S. , Davenport Ross
Published: December 2018

Trauma is a leading cause of death worldwide in persons under 44 years of age, and uncontrolled haemorrhage is the most common preventable cause of death in this patient group. The transfusion management of trauma haemorrhage is unrecognisable from 20 years ago. Changes in clinical practice have been driven primarily by an increased understanding of the pathophysiology of trauma‐induced coagulopathy (TIC), which is associated with poor clinical outcomes, including a 3‐ to 4‐fold increased risk of death. Targeting this coagulopathy alongside changes to surgical and anaesthetic practices (an overarching strategy known as damage control surgery/damage control resuscitation) has led to a significant reduction in mortality rates over the last two decades. This narrative review will discuss the transfusion practices that are currently used for trauma haemorrhage and the evidence that supports these practices.
Ten‐year single‐centre experience in fertility preservation of 459 patients suffering from acute leukaemia
Authors: Noetzli Jasmine , Voruz Sophie , Wunder Dorothea , Primi Marie‐Pierre , Spertini Olivier , Blum Sabine
Published: December 2018

Acute leukaemia is a life‐threatening disease that needs treatment without delay. Fertility preservation is recommended, but often not possible because of the necessity to start treatment as soon as possible. The present study is a retrospective single‐centre analysis of 459 patients diagnosed with acute leukaemia between 2002 and 2012. Sperm or oocyte preservation was successfully performed in only 29 (6%) patients. Of the 150 children, no paediatric patient sample was taken. The collected samples enabled the conception of 2 children by in vitro fertilisation; in addition, 3 spontaneous, non‐assisted births in partners of male patients were observed. Fertility preservation is important but difficult to accomplish in patients with acute leukaemia; more efforts are clearly needed to preserve fertility in long‐term survivors of acute leukaemia.
Haemophilia and ageing
Authors: Shapiro Susan , Makris Mike
Published: December 2018

Advances in the development of effective and safe treatments for haemophilia over the last 50 years have resulted in a significant increase in the life expectancy of persons with haemophilia (PWH). The management of this new cohort of middle‐aged and elderly PWH is challenging because of the opposing risks of haemophilia and age‐related cardiovascular disease and malignancy. Furthermore, this cohort of ageing PWH has the additional comorbidities of human immunodeficiency virus/hepatitis C and chronic haemophilic arthropathy. This article reviews the prevalence, underlying mechanisms and treatment strategies for managing these comorbidities. International collaboration is essential for registry data and further prospective trials to inform optimal evidence‐based management for this rare disorder in the future.
Towards a More Enabling Representation: Framing an Emergent Conceptual Approach to Measure Social Conditions Following Mega‐Event Transformation in Manaus, Brazil
Authors: WISE NICHOLAS
Published: December 2018

This paper presents a conceptual and methodological approach for researching social conditions to understand how urban change and development affects a community and its residents. Manaus, in Brazil's Amazonia region, received much criticism after US$300 million that was spent on a 40,000+ seat (upgraded) stadium in a city with no regular sporting tournaments. This paper positions the need to look beyond tangible features and assess social impacts based on community perceptions using ethnography to locate local meanings of social transformation. Attention is needed in communities adjacent to new stadium developments in Manaus to understand inclusion, exclusion and social leveraging.
Molecular mechanisms underlying the models of neurodevelopmental disorders in maternal immune activation relevant to the placenta
Authors: Tsukada Tsuyoshi , Shimada Hiroki , Sakata‐Haga Hiromi , Iizuka Hideaki , Hatta Toshihisa
Published: December 2018

The rapid rise in the prevalence of autism spectrum disorders (ASD) and other psychiatric disorders displaying similar traits has increased the need to elucidate their molecular mechanisms. Epidemiological studies have shown that maternal infection during mid‐pregnancy is associated with increased risk of neurodevelopmental disorders such as ASD in offspring. Using maternal infection models, researchers have gathered evidence relevant to such disorders. A comprehensive summary of the changes in the brain structure, function, and behavior in offspring induced by maternal immune activation (MIA) has been reported. However, the molecular mechanisms underlying the association between MIA and improper brain development, which ultimately lead to neurodevelopmental disorders, have not been fully reviewed. This paper summarizes the currently known molecular mechanisms associated with the MIA model, with a special focus on the role of the placenta in fetal brain development.
Biologics and immunoglobulins in the treatment of pyoderma gangrenosum – analysis of 52 patients
Authors: Herberger Katharina , Dissemond Joachim , Brüggestrat Sarah , Sorbe Christina , Augustin Matthias
Published: December 2018

Background and objectives

Corticosteroids and cyclosporine A are frequently ineffective as first‐line therapies in the treatment of pyoderma gangrenosum (PG) and associated with a number of adverse effects. The objective of the present study was to analyze the effectiveness and safety of biologics and intravenous immunoglobulins (IVIGs).

Patients and methods

Retrospective, dual‐center cohort study analyzing the treatment outcome in patients with PG who received biologics and IVIGs.

Results

Fifty‐two patients (mean age: 58.4 years) with 75 wound episodes (mean wound size: 53.2 cm²) were included in the study. Overall, 92.3 % of patients initially received corticosteroids (CSs; 48/52); 51.9 % cyclosporine A (CSA; 27/52). In 275 therapeutic attempts, complete remission or improvement were achieved in 63.6 % (21/33) of patients on infliximab; 57.1 % (16/28) on adalimumab; 71.4 % (5/7) on etanercept; 66.6 % (6/9) on ustekinumab and 66.7 % (10/15) of patients who were given IVIGs. That figure was 48.8 % (38/78) for those treated with CSs and 20.0 % (7/35) for individuals on CSA. On average, adverse events occurred in 18.5 % (15/81) of cases treated with biologics in 20 % (3/15) of patients receiving IVIGs, in 40 % (14/35) of individuals on CSA and in 10.4 % of those treated with CSs (5/48).

Conclusions

The present retrospective analysis suggests that both biologics – especially TNFα antagonists – and IVIGs are well‐tolerated and safe options in the treatment of PG. Data from prospective comparative studies would be highly desirable.
Systematic definition of threatened fauna communities is critical to their conservation
Authors: Fraser Hannah , Simmonds Jeremy S. , Kutt Alex S. , Maron Martine
Published: December 2018

Aim

Most terrestrial ecological communities are defined primarily on their constituent flora. We aimed to develop a repeatable approach to defining a community, both intact and degraded, based on its fauna. We demonstrate how the approach can be used to guide conservation—for example, determining whether a multispecies community of animals is threatened.

Location

Temperate and subtropical woodlands of Australia.

Methods

We used expert opinion to develop a definition of the Australian Temperate and Subtropical Woodland Bird Community and metrics of its condition. Using continental‐scale vegetation change mapping, and national bird atlas data, we assessed this community against criteria for listing as a threatened ecological community under national biodiversity conservation law.

Results

We defined and described a recognizable and consistent Australian Temperate and Subtropical Woodland Bird Community. Although taxonomically and functionally very similar, we identified six community variants that show species‐ or genus‐level substitutions. The community was evaluated to be Endangered or Critically Endangered across its extent based on criteria from Australia's Environment Protection and Biodiversity Conservation Act 1999. We used a novel metric of condition using historical changes in woodland extent and bird species, to demonstrate the community has declined substantially in geographical extent and integrity and is subject to severe and ongoing threats.

Conclusions

The consequences of global change affect entire communities, not just single species; however, defining ecological communities based predominantly on plant species composition can fail to illuminate the complex associations of animals that are both sustained by, and sustain, the vegetation. In this study, we present a process for defining and evaluating the status of a fauna community against threat criteria. The explicit recognition and protection of fauna communities can be an important complement to the protection of plant‐based ecological communities.
Double‐chambered left ventricle diagnosis by 2D and 3D echocardiography: From fetus to birth
Authors: Xue Chao , Zhao Ying , Zhang Ye , Gu Xiaoyan , Han Jiancheng , Henein Michael , He Yihua
Published: December 2018

Double‐chambered left ventricle (DCLV) is a rare cardiac anomaly and is characterized by the division of the left ventricle by abnormal muscle and/or fiber bundles into two chambers. We hereby report a fetus which was diagnosed with DCLV in utero by 2D and 3D Fetal echocardiography and the findings were confirmed after birth.
Automated, machine learning‐based, 3D echocardiographic quantification of left ventricular mass
Authors: Volpato Valentina , Mor‐Avi Victor , Narang Akhil , Prater David , Gonçalves Alexandra , Tamborini Gloria , Fusini Laura , Pepi Mauro , Patel Amit R. , Lang Roberto M.
Published: December 2018

Background

Although 3D echocardiography (3DE) circumvents many limitations of 2D echocardiography by allowing direct measurements of left ventricular (LV) mass, it is seldom used in clinical practice due to time‐consuming analysis. A recently developed 3DE machine learning (ML) approach allows automated determination of LV mass. We aimed to evaluate the accuracy of this new approach by comparing it to cardiac magnetic resonance (CMR) reference and to conventional 3DE volumetric analysis.

Methods

We prospectively studied 23 patients who underwent 3DE (Philips EPIQ) and CMR imaging on the same day. Single‐beat wide‐angle 3D datasets of the left ventricle were acquired. LV mass was quantified using the new automated software (Philips HeartModel) with manual corrections when necessary and using conventional volumetric analysis (TomTec). CMR analysis was performed by manual slice‐by‐slice tracing of LV endo‐ and epicardial boundaries. Reproducibility of the ML approach was assessed using repeated measurements and quantified by intra‐class correlation (ICC) and coefficients of variation (CoV).

Results

Automated LV mass measurements were feasible in 20 patients (87%). The results were similar to CMR‐derived values (Bland‐Altman bias 5 g, limits of agreement ±37 g) and also to the conventional 3DE analysis (bias 7 g, ±27 g). Processing time was considerably shorter: 1.02 ± 0.24 minutes (CMR: 2.20 ± 0.13 minutes; TomTec: 2.36 ± 0.09 minutes), although manual corrections were performed in most patients. Repeated measurements showed high reproducibility: ICC = 0.99; CoV = 4 ± 5%.

Conclusions

3D Echocardiography analysis of LV mass using novel ML‐based algorithm is feasible, fast, and accurate and may thus facilitate the incorporation of 3DE measurements of LV mass into clinical practice.
Peripheral saline contrast with Valsalva and a modified Müller's maneuver may improve detection of atrial level right‐to‐left shunts: A preliminary observation
Authors: Becnel Melanie , Kerut Edmund Kenneth , Nanda Navin C.
Published: December 2018

As part of an evaluation for source of embolism, transthoracic echocardiography with peripheral saline contrast injection during normal respirations and also Valsalva release is routinely performed to evaluate for an atrial level shunt. We present a preliminary observation of addition of a modified Müller's maneuver early during the Valsalva release. The Müller's maneuver has been described to occur with sleep apnea and will increase right‐to‐left shunting through a PFO. Of 34 patients, 24 were negative for a right‐to‐left shunt with normal respiration or Valsalva release. Of these 24 patients, 8 were then positive for a shunt by addition of a modified Müller's maneuver. One additional patient could not perform the modified Müller's maneuver. This preliminary observation suggests that in patients referred to an echocardiography laboratory for evaluation of source of embolism, adding the modified Müller's maneuver to those negative for shunting during normal respirations and Valsalva release may yield an increase in right‐to‐left atrial level shunt detection.
Mitral annular peak systolic and diastolic velocities are characteristic of healthy hearts: A Doppler tissue imaging study
Authors: Simpson Timothy F. , Tyler Jeffrey M. , Thomas Randell C. , Fang Qizhi , Bibby Dwight , Schiller Nelson B.
Published: December 2018

Introduction

Although systolic and diastolic dysfunction must coexist, they are most often considered in isolation. Therefore, a simple and reproducible quantitative measurement that integrates systolic and diastolic function is desirable. We hypothesize that the absolute sum of lateral mitral annular systolic and early diastolic peak velocities is predictive of overall cardiac function.

Methods

In this study, lateral mitral annular systolic (S′) and early diastolic (E′) peak velocities were measured in healthy subjects and compared against subjects with progressive degrees of systolic and diastolic dysfunction.

Results

A total of 149 subjects (56% male, mean age 48 years) were enrolled and stratified according to global left ventricular function: 76 normal, 40 mild‐moderate dysfunction, and 33 moderate‐severe dysfunction. Adjusting for baseline differences including age, univariate analysis showed mean S′ + E′ values were significantly different between subjects with normal, mild‐moderate, and moderate‐severe global left ventricular function (27, 17, 13 cm/s; P < 0.001 for all comparisons). The absolute sum of S′ + E′ ≥ 20 cm/s identified normal global left ventricular function with a sensitivity of 95%, specificity of 85%, and ROC area under the curve of 0.924.

Conclusions

In a cohort of subjects with varying levels of combined systolic and diastolic function, the easily obtainable composite score of S′ + E′ ≥ 20 cm/s is strongly predictive of normal global left ventricular function with a high degree of sensitivity and specificity. Additional studies should be considered to expand this concept to additional populations.
Questioning assumptions of trophic behavior in a broadly ranging marine predator guild
Authors: Shipley Oliver N. , Olin Jill A. , Power Michael , Cerrato Robert M. , Frisk Michael G.
Published: December 2018

We evaluated whether existing assumptions regarding the trophic ecology of a poorly‐studied predator guild, northwest (NW) Atlantic skates (family: Rajidae), were supported across broad geographic scales. Four hypotheses were tested using carbon (δ13C) and nitrogen (δ15N) stable isotope values as a proxy for foraging behavior: 1) species exhibit ontogenetic shifts in habitat and thus display a shift in 13C with differential use of the continental shelf; 2) species exhibit ontogenetic prey shifts (i.e. from smaller to larger prey items) and become enriched in 15N; 3) individuals acquire energy from spatially confined local resource pools and exhibit limited displacement; and 4) species exhibit similarly sized and highly overlapping trophic niches. We found some evidence for ontogenetic shifts in habitat‐use (δ13C) for thorny and little skate and diet (δ15N) of thorny and winter skate and hypothesize that individuals exhibit gradual trophic niche transition, especially in δ15N space, rather than a clear and distinct shift in diet throughout ontogeny. Spatial isoscapes generated for little, thorny, and winter skate highlighted distinct spatial patterns in isotopic composition across the coastal shelf. For little and thorny skate, patterns mimicked expected spatial variability in the isotopic composition of phytoplankton/POM, suggesting limited displacement and utilization of spatially confined resource pools. Winter skate, however, exhibited a much narrower range of δ13C and δ15N values, suggesting individuals may use resources from a more confined latitudinal range. Although high total trophic niche overlap was observed between some species (e.g. little and thorny skate), sympatric species (e.g. little and winter skate) exhibited a degree of trophic niche separation. These findings offer new insight into the trophic dynamics of a poorly‐studied, vulnerable group of predators, and highlight a need to re‐examine assumptions pertaining to aspects of their ecology.
Distribution pattern and competition of insects breeding on Camellia japonica flower
Authors: Mitsui Hideyuki , Kimura Masahito T.
Published: December 2018

The distribution pattern and competition of insects exploiting Camellia japonica flowers were studied in Tokyo, central Japan, to understand how their distributions are determined. Dasiops sp. of Lonchaeidae (Diptera) exploited flower buds and showed random distribution, whereas Drosophila unipectinata, D. oshimai and D. lutescens of Drosophilidae (Diptera) and Epuraea commutata of Nitidulidae (Coleoptera) exploited fully opened, late and fallen flowers and showed aggregated distribution. From the distribution pattern, it is assumed that Dasiops sp. has clutches of single egg whereas drosophilid and nitidulid species have clutches of more than one egg. In resource supplementary experiments, body size of drosophilid flies increased if resources were supplemented, although their survival is assumed to be unaffected. However, their body size did not decrease with increase of larval density in resource patches. It is therefore unclear whether resource competition occurs among drosophilid flies in Camellia flowers in nature. From the present and previous studies, it is assumed that aggregation (or production of clutches of more than one egg) is related to the use of fermenting or decayed resources; aggregation might increase larval survival and/or performance under the presence of molds or microorganisms.
Credit scoring for a microcredit data set using the synthetic minority oversampling technique and ensemble classifiers
Authors: Gicić Adaleta , Subasi Abdulhamit
Published: December 2018

Although microfinance organizations play an important role in developing economies, decision support models for microfinance credit scoring have not been sufficiently covered in the literature, particularly for microcredit enterprises. The aim of this paper is to create a three‐class model that can improve credit risk assessment in the microfinance context. The real‐world microcredit data set used in this study includes data from retail, micro, and small enterprises. To the best of the authors' knowledge, existing research on microfinance credit scoring has been limited to regression and genetic algorithms, thereby excluding novel machine learning algorithms. The aim of this research is to close this gap. The proposed models predict default events by analysing different ensemble classification methods that empower the effects of the synthetic minority oversampling technique (SMOTE) used in the preprocessing of the imbalanced microcredit data set. Initial results have shown improvement in the prediction results for certain classes when the oversampling technique with homogeneous and heterogeneous ensemble classifier methods was applied. A prediction improvement for all classes was achieved via application of SMOTE and the Consolidated Trees Construction algorithm together with Rotation Forest. To obtain a complete view of all aspects, an additional set of metrics is used in the evaluation of performance.
Children of Mumbai's Brothels: Investigating Developmental Prospects, Primary Relationships, and Service Provision
Authors: Dalla Rochelle L. , Erwin Sarah , Kreimer Lee M.
Published: December 2018

Objective

To understand the context of the lives of children reared in India's red‐light brothel districts.

Background

Substantial empirical insight has emerged on the commercial sexual exploitation of children (CSEC). Yet the extant literature on brothel‐based children (BBC), a uniquely vulnerable subset of at‐risk children, is paradoxically deficient. Understanding the developmental needs of BBC is critical to mitigating risk.

Method

In‐depth, semistructured interviews were conducted with 9 service providers and 30 women residing in 2 red‐light brothel districts of Mumbai. Phenomenological inquiry informed the research methodology and data analysis.

Results

Mothers' goals for children included survival, academic success, and future employment. Formal services were critical in meeting the basic needs of BBC, ensuring access to developmentally appropriate education, and maintaining safety overnight.

Conclusion

BBC are at considerable risk for an array of developmental challenges. Multisector service providers must work together and with the mothers of BBC to mitigate intergenerational sexual exploitation in the formal sex economy.

Implications

Results provide key areas for further research including longitudinal assessment of BBCs' educational and occupational outcomes, as well as incidence of complex trauma among BBC and treatment options. Service gaps include outreach to older male BBC as well as shame reduction intervention.
Multi‐faceted impacts of native and invasive alien decapod species on freshwater biodiversity and ecosystem functioning
Authors: Doherty‐Bone Thomas M. , Dunn Alison M. , Jackson Faye L. , Brown Lee E.
Published: December 2018

Changes to species composition, such as biological invasions and extinctions, have the potential to alter ecosystems. Invaders often replace taxonomically similar species, resulting in potentially redundant impacts. For example, freshwater decapod crustaceans are pervasive invasive alien species but they often extirpate native decapods. This study addresses whether or not these compositional shifts lead to impacts on the structure of the macroinvertebrate community, key ecosystem functions such as decomposition rates and primary productivity, and freshwater properties such as turbidity.

In a controlled outdoor mesocosm experiment that ran for 33 days, impacts on biodiversity, ecosystem functioning and properties were compared between a native, endangered crayfish (Austropotamobius pallipes) and two invasive alien decapods: the crayfish Pacifastacus leniusculus and crab Eriocheir sinensis. Equal densities of these decapod species were compared between mesocosms, with a replicated array of decapod free controls. Measurements included macroinvertebrate densities, decomposition of leaf litter, production of biofilms, plankton, macrophytes, gross primary productivity, turbidity, and dissolved nutrients.

While taxonomic richness of non‐decapod macroinvertebrates was marginally higher in the invasive alien treatments, differences in Shannon diversity were negligible, and β‐diversity was higher for the invasive alien crab. Gastropod density was reduced in the benthos of invasive alien treatments. This was associated with increased primary productivity of periphyton, particularly in the presence of P. leniusculus. Increased turbidity was, however, inversely correlated with periphyton primary productivity in the E. sinensis treatment. Nitrate concentration was significantly lower in invasive compared to native crayfish mesocosms, but similar to decapod free controls. This reflects the potential for the invasive crayfish to act as a nitrogen sink, mediated through both enhanced periphyton and reduced nitrogen recycling. Other processes, such as decomposition rates, sediment respiration, community respiration, and gross primary productivity, did not differ between treatments.

This study demonstrates impacts of both native and invasive alien decapod species on certain aspects of benthic biodiversity and ecosystem processes, but with many of these parameters unaffected. This assumes equal densities of each species in its environment. The enhanced gastropod predation and associated trophic cascade by invasive decapods are likely explained through higher consumption rates, metabolism and activity. These per‐capita impacts are likely to be exacerbated further in‐situ due to typically higher densities of invasive compared to native crayfish.