bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased residual cardiovascular risk in patients with diabetes and high versus normal triglycerides despite statin‐controlled LDL cholesterol
Authors: Nichols Gregory A. , Philip Sephy , Reynolds Kristi , Granowitz Craig B. , Fazio Sergio
Published: September 2018

Aim

To determine whether high triglycerides (TG) in the presence of statin‐controlled LDL‐C influence the risk of cardiovascular disease (CVD) among patients with diabetes in real‐world clinical practice.

Materials and methods

We identified adults with diabetes from the Southern California and Pacific Northwest regions of Kaiser Permanente. We included patients undergoing statin therapy with LDL‐C from 40‐100 mg/dL who were not undergoing other lipid‐lowering therapies and had a prior diagnosis of atherosclerotic CVD or at least one other CVD risk factor. We grouped patients into high TG (200‐499 mg/dL; n = 5542) or normal TG (<150 mg/dL, n = 22 411) from January 2010 through December 2016 to compare incidence rates and rate ratios of first non‐fatal myocardial infarction (MI), non‐fatal stroke, unstable angina and coronary revascularization. We adjusted multivariable analyses for age, sex, race/ethnicity, smoking status, blood pressure, HbA1c, serum creatinine, presence of ischaemic heart disease and study site.

Results

Adjusted rate ratios for the four outcomes were all statistically significantly different. The incidence rate for non‐fatal MI was 30% higher in the high TG group (rate ratio, 1.30; 95% CI, 1.08‐1.58; P = 0.006). The rate was 23% higher for non‐fatal stroke (1.23, 1.01‐1.49, P = 0.037), 21% higher for coronary revascularization (rate ratio, 1.21; 95% CI, 1.02‐1.43; P = 0.027) and was, non‐significantly, 33% higher for unstable angina (rate ratio, 1.33; 95% CI, 0.87‐2.03; P = 0.185).

Conclusions

Despite statin‐controlled LDL‐C levels, CV events were greater among patients with diabetes and high TG levels. Because we controlled for cardiometabolic risk factors, it is likely that the difference in TG levels contributed to the excess risk observed in patients with high TGs.
Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: A review
Authors: Bain Stephen C. , Klufas Michael A. , Ho Allen , Matthews David R.
Published: September 2018

Worsening of diabetic retinopathy (DR) is associated with the initiation of effective treatment of glycaemia in some patients with diabetes. It has been associated with risk factors such as poor blood‐glucose control and hypertension, and it manifests prior to the long‐term benefits of optimizing glycaemic control. The majority of evidence supports an association of large and rapid reductions in blood‐glucose levels with early worsening of DR. Despite a general awareness of early worsening within the diabetes community, mechanisms to explain the phenomenon remain speculative. We provide an overview of early worsening of DR and its pathophysiology based on current data. We describe the phenomenon in various settings, including in patients receiving insulin‐ or non‐insulin‐based treatments, in those undergoing bariatric surgery, and in pregnant women. We discuss various mechanisms and theories that have been suggested to explain this paradoxical phenomenon, and we summarize the implications of these in clinical practice.
Effect of different K:Na ratios in soil on dispersive charge, cation exchange and zeta potential
Authors: Farahani E. , Emami H. , Fotovat A. , Khorassani R.
Published: September 2018

The role of potassium (K) in clay dispersion in agricultural soils containing large concentrations of K could be similar to Na. This research was carried out to assess the effect of potassium to sodium ratios (K:Na) on net dispersive charge, Gapon selectivity coefficient (KG), zeta potential (ζ) and percentage of dispersible clay. Different K:Na ratios at two electrical conductivity levels (EC = 3 and 6 dS m−1) were added to an agricultural loamy soil. The results demonstrated that the net dispersive charge and percentage of dispersible clay showed positive relations with K concentration and K:Na ratio; also, the percentage of dispersible clay and net dispersive charge had a positive correlation, at both EC levels. Therefore, net dispersive charge as well as percentage of dispersible clay can show the degrading effect of K on soil structure. The KG values for K (KG(K)) were larger than those of Na (KG(Na)) because of large cation selectivity for K in soil. Neither KG(K) nor KG(Na) had a significant effect on the percentage of dispersible clay, but they did influence net dispersive charge, indicating that the status of cation exchange might affect dispersive charge of the soil. At both EC levels, absolute amounts of ζ, as an index of diffuse double layer (DDL) thickness, increased with increasing concentrations of monovalent cations (especially K). In addition, a strong positive correlation was observed between the dispersive charge and ζ. Our results demonstrated that K could affect soil structure because of a change in cation selectivity, with K increasing repulsive forces among clay particles and creating dispersion.

Highlights

K created repulsive forces between clay particles that led to clay dispersion.

Net dispersive charge and dispersible clay increased with increasing K concentration and K:Na ratio.

Cation exchange status (KG values) affected soil net dispersive charge significantly.

A positive correlation between dispersive charge and zeta potential was observed.
Multi‐year net ecosystem carbon balance of a restored peatland reveals a return to carbon sink
Authors: Nugent Kelly A. , Strachan Ian B. , Strack Maria , Roulet Nigel T. , Rochefort Line
Published: September 2018

Peatlands after drainage and extraction are large sources of carbon (C) to the atmosphere. Restoration, through re‐wetting and revegetation, aims to return the C sink function by re‐establishing conditions similar to that of an undrained peatland. However, the time needed to re‐establish C sequestration is not well constrained due to the lack of multi‐year measurements. We measured over 3 years the net ecosystem exchange of CO2 (NEE), methane (), and dissolved organic carbon (DOC) at a restored post‐extraction peatland (RES) in southeast Canada (restored 14 years prior to the start of the study) and compared our observations to the C balance of an intact reference peatland (REF) that has a long‐term continuous flux record and is in the same climate zone. Small but significant differences in winter respiration driven by temperature were mainly responsible for differences in cumulative NEE between years. Low growing season inter‐annual variability was linked to constancy of the initial spring water table position, controlled by the blocked drainage ditches and the presence of water storage structures (bunds and pools). Half‐hour at RES was small except when Typha latifolia‐invaded drainage ditches were in the tower footprint; this effect at the ecosystem level was small as ditches represent a minor fraction of RES. The restored peatland was an annual sink for CO2 (−90 ± 18 g C m−2 year−1), a source of CH4 (4.4 ± 0.2 g C m−2 year−1), and a source of DOC (6.9 ± 2.2 g C m−2 year−1), resulting in mean net ecosystem uptake of 78 ± 17 g C m−2 year−1. Annual NEE at RES was most similar to wetter, more productive years at REF. Integrating structures to increase water retention, alongside re‐establishing key species, have been effective at re‐establishing the net C sink rate to that of an intact peatland.
Development of the Dementia Assessment Sheet for Community‐based Integrated Care System 8‐items, a short version of the Dementia Assessment Sheet for Community‐based Integrated Care System 21‐items, for the assessment of cognitive and daily functions
Authors: Toyoshima Kenji , Araki Atsushi , Tamura Yoshiaki , Iritani Osamu , Ogawa Sumito , Kozaki Koichi , Ebihara Satoru , Hanyu Haruo , Arai Hiroyuki , Kuzuya Masafumi , Iijima Katsuya , Sakurai Takashi , Suzuki Takao , Toba Kenji , Arai Hidenori , Akishita Masahiro , Rakugi Hiromi , Yokote Koutaro , Ito Hideki , Awata Shuichi
Published: September 2018

Aim

The present study aimed to: (i) examine the reliability and validity of the Dementia Assessment Sheet for Community‐based Integrated Care System 21‐items for classifying patients to the appropriate categories for glycemic targets in older patients; and (ii) develop a short version of the tool and examine its reliability and validity.

Methods

A total of 410 older individuals were recruited for this multicenter cross‐sectional study. We classified them into three categories used for determining the glycemic target in older patients in Japan based on cognitive functions and activities of daily living. Exploratory factor analyses were used to select the eight items of the shorter version. The reliability and validity of the assessment tools were assessed using Cronbach's alpha coefficients and receiver operating characteristic analyses, respectively.

Results

The Dementia Assessment Sheet for Community‐based Integrated Care System 21‐items had three latent factors: cognitive function, instrumental activities of daily living and basic activities of daily living. The Dementia Assessment Sheet for Community‐based Integrated Care System 8‐items was developed based on each factor load quantity and was confirmed to have a strong correlation with the original version (r = 0.965, P < 0.001). Both tools significantly discriminated older adults belonging to category I from those belonging to category II or III, and category III from category I or II.

Conclusions

Both tools had sufficient internal consistency and validity to classify older patients into the categories for determining the glycemic target in this population based on cognitive and daily functions. Geriatr Gerontol Int 2018; 18: 1458–1462.
Combined effects of four major geriatric syndromes on adverse outcomes based on Korean National Health Insurance claims data
Authors: Kim Sunyoung , Park Jong‐heon , Won Chang Won
Published: September 2018

Aim

Geriatric syndromes are common among older individuals, and can affect their health and quality of life. The present study aimed to determine if combinations of geriatric syndromes affected adverse outcomes among older Koreans.

Methods

Korean national health insurance data were collected for a cohort of 5 058 720 individuals who were aged ≥65 years in 2008. The same data source was used to follow these individuals until 2015. Diagnostic codes were used to assess four major geriatric syndromes (delirium, fall‐related fractures, incontinence and pressure ulcers) and adverse outcomes (mortality and nursing home institutionalization).

Results

The prevalence of geriatric syndromes was 0.3% for delirium, 3.49% for fall‐related fractures, 1.08% for incontinence and 0.82% for pressure ulcers. All four geriatric syndromes were associated with increased risks of institutionalization (adjusted hazard ratio [aHR] 2.18, 95% CI 2.08–2.17 for delirium; aHR 1.59, 95% CI 1.58–1.60 for fall‐related fractures; aHR 1.43, 95% CI 1.41–1.44 for incontinence; and aHR 2.51, 95% CI 2.47–2.55 for pressure ulcers) and increased risks of mortality (aHR 2.13, 95% CI 2.08–2.17 for delirium; aHR 1.41, 95% CI 1.40–1.42 for fall‐related fractures; aHR 1.09, 95% CI 1.07–1.10 for incontinence; and aHR 3.23, 95% CI 3.20–3.27 for pressure ulcers). The aHR for institutionalization were 1.64 (95% CI 1.63–1.65) for one geriatric syndrome, 2.40 (95% CI 2.35–2.44) for two coexisting geriatric syndromes and 2.56 (95% CI 2.35–2.74) for three coexisting geriatric syndromes. The aHR for mortality were 1.52 (95% CI 1.51–1.53) for one geriatric syndrome, 2.36 (95% CI 2.32–2.40) for two coexisting geriatric syndromes and 2.90 (95% CI 2.72–3.09) for three coexisting geriatric syndromes.

Conclusions

Delirium, fall‐related fractures, incontinence and pressure ulcers were associated with increased risks of institutionalization and mortality. The magnitude of these risks increased with increasing numbers of coexisting geriatric syndromes. Geriatr Gerontol Int 2018; 18: 1463–1468.
Thirty‐day hospital readmission rate amongst older adults correlates with an increased number of medications, but not with Beers medications
Authors: Basnet Suresh , Zhang Meng , Lesser Martin , Wolf‐Klein Gisele , Qiu Guang , Williams Myia , Pekmezaris Renee , DiMarzio Paola
Published: September 2018

Aim

We sought to explore the relationship between the number of medications at hospital discharge and 30‐day rehospitalization in older adults aged >65 years.

Methods

This was a multicenter cohort study to determine whether an increased number of medications was associated with 30‐day rehospitalization in patients aged >65 years. We explored the relationship between rehospitalization and other risk factors. Data were collected from a large health system in the New York metropolitan area from September 2011 to January 2013. The primary outcome was 30‐day hospital readmission from the index hospitalization.

Results

Patients had a mean ± SD age of 78 ± 9 years; 55% were women. The average length of stay after discharge from the hospital was 6 days. An increased number of medications was significantly associated with unplanned 30‐day hospital readmission (P < 0.05). For each medication, the risk of rehospitalization increased by 4% (OR 1.04, 95% CI 1.03, 1.05). Patients discharged to rehabilitation centers were 32% more likely to be readmitted than patients discharged home (OR 1.39, 95% CI 1.27–1.51). Other risk factors significantly associated with 30‐day rehospitalization were: cancer, intensive care unit, chronic heart failure, renal diseases and peripheral vascular diseases. Hypertension was negatively associated with 30‐day unplanned rehospitalization (OR 0.88, 95% CI 0.82–0.95). No significant association between the number of Beers medications and 30‐day rehospitalization was observed, after controlling for the number of medications and other covariates.

Conclusions

The number of discharge medications was significantly associated with 30‐day hospital readmission among older adult patients. Important risk factors for 30‐day rehospitalization were discharge location, cancer, intensive care unit, chronic heart failure, renal diseases and peripheral vascular diseases. Geriatr Gerontol Int 2018; 18: 1513–1518.
Evaluation of durability and cleanability performances of protective treatments for lapped ceramic tiles ‐ Part 2
Authors: Rambaldi Elisa , Lucchese Beatrice , Engels Marcel , Bignozzi Maria Chiara
Published: September 2018

The aim of this work is to evaluate the cleanability performances of lapped porcelain stoneware surfaces with and without protective treatments. The knowledge of the material cleanability is an important selection parameter in buying tiles. However, an objective basis for testing and assessing this property still is lacking. In this study, standardized and laboratory tests to evaluate the cleanability performance of lapped porcelain stoneware products have been carried out and compared. Cleanability tests were performed by applying two different soiling suspensions, optimized for tile surfaces and reproducing chemical and mechanical actions simulating the working conditions and traditional cleaning operations. Surface characteristics (microstructure, topography, roughness) were analyzed before and after cleanability tests. The results showed a good correlation between different behavior in terms of cleanability and the microscopic and topographic characteristics of lapped tile. Respect to international standardized tests specific for ceramic tiles, such as stains resistance test, the laboratory procedures to evaluate the surface cleanability are able to better show cleanability improvements of lapped tiles with protective treatments.
The effect of netbook ownership on children's academic achievement in mathematics, reading, and writing
Authors: Starkey Louise , Zhong Jingyi
Published: September 2018

How computers in schools impact on children's learning has been studied through research that explores student achievement at one point in time or by comparing different classroom contexts with differing results. The introduction of an optional netbook purchasing scheme for children in a low socio‐economic community provided an opportunity to compare the academic improvement for those who joined the scheme with those who did not with both groups learning within the same context with the same teachers. Using nationally calibrated assessment tools that test reading, writing, and mathematical skill progression, the student achievement data from six schools across a 2‐year period were analysed using chi‐square testing, regression analysis, propensity score matching, and cumulative logit modelling. The results identified few significant differences between the students in most aspects of achievement and no significant difference in academic improvement between the two groups.
An investigation of the validity of course‐based online assessment methods: The role of computer‐related attitudes and assessment mode preferences
Authors: Hewson Claire , Charlton John P.
Published: September 2018

The use of e‐assessment methods raises important concerns regarding the reliability and validity of these methods. Potential threats to validity include mode effects and the possible influence of computer‐related attitudes. Although numerous studies have now investigated the validity of online assessments in noncourse‐based contexts, few studies have addressed this issue in an educational context. The present study helps fill this research gap by investigating whether university students' computer‐related attitudes and assessment mode preferences were related to performance on a course‐based online assessment task. Overall, students' attitudes and preferences bore no greater relationships to performance on the online than offline module assessment tasks. This provides support for the validity of course‐based online assessment methods and should help alleviate educators' concerns and encourage more widespread adoption of these methods, helping address the issue of their slow uptake to date. Suggestions for follow‐up studies to corroborate and extend the current findings are offered.
Comparison of bathymetric data sources used in hydraulic modelling of floods
Authors: Bures Ludek , Roub Radek , Sychova Petra , Gdulova Katerina , Doubalova Jana
Published: September 2018

Topographic data plays an essential role in hydraulic modelling of floods. A high‐precision digital elevation model (DEM) including river bathymetry (bed topography) is required. DEMs can be derived from such various data sources as ground surveying or remote sensing techniques. This study is focused on (a) the DEM error that results from the inability to scan the morphology of the channel using remote sensing methods, and (b) assessment of its impact on the results of a one‐dimensional (1D) hydraulic model. DEMs produced by remote sensing techniques were tested in combination with ground surveying and by software‐updated remote sensing data. Differences in riverbed representation and thalweg position were evaluated. The 1D hydraulic model HEC−RAS was chosen to determine the impact of various DEM sources on the hydraulic quantities (water surface elevation, inundation area). The study was carried out on a reach of the River Vltava (Czech Republic). The best results were achieved by DEMs that combined remote sensing data with ground mapping. Good results also were obtained using software‐updated remote sensing data. Neglecting of cross‐sectional area in remote sensing data has an important impact on the results of hydrodynamic models.
Prospective cohort trial to confirm the efficacy of no‐touch radio frequency ablation
Authors: Hirooka Masashi , Hiraoka Atsushi , Ochi Hironori , Koizumi Yohei , Michitaka Kojiro , Joko Kouji , Abe Masanori , Hiasa Yoichi
Published: September 2018

Background and Aim

The aim of the present prospective study was to evaluate tumor recurrence (intrasubsegmental recurrence‐free survival and local tumor recurrence‐free survival) and hepatic functional reserve following no‐touch ablation.

Methods

The prospective cohort study protocols were approved by the institutional ethics committee. All patients provided written, informed consent. Between January 2014 and September 2016, 231 patients with 277 hepatocellular carcinoma nodules were prospectively enrolled. An internally cooled bipolar electrode was used for no‐touch ablation, while a monopolar electrode was used for direct puncture ablation. The intrasubsegmental recurrence‐free survival rate was the primary end‐point. The secondary outcomes were the local recurrence‐free survival rate, the disease‐free survival rate, and the changes in the Child–Pugh score.

Results

No‐touch ablation resulted in significantly higher cumulative intrasubsegmental tumor recurrence‐free survival rates than direct puncture ablation (98.0% vs 87.1% at 1 year, 96.9% vs 76.8% at 2 years, and 91.0% vs 68.3% at 3 years, P < 0.001). The no‐touch group also showed significantly better local recurrence‐free survival and disease‐free survival. Even when only primary cases were analyzed, the same results were obtained. To adjust for differences in the background characteristics, inverse probability of treatment weighting adjustment was performed. Only intrasubsegmental tumor recurrence‐free survival was significantly better in the no‐touch group (hazard ratio [HR], 0.08; 95% confidence interval [CI], 0.02–0.20, P < 0.001); there was no difference in local tumor recurrence‐free survival (HR, 0.36; 95% CI, 0.10–1.02, P = 0.071).

Conclusions

No‐touch ablation appears to be an ideal method for the prevention of intrahepatic dissemination.
Towards a better recording of microtubule cytoskeletal spatial organization and dynamics in plant cells
Authors: Liu Weiwei , Wang Chaofeng , Wang Guangda , Ma Yinping , Tian Juan , Yu Yanjun , Dong Li , Kong Zhaosheng
Published: September 2018

Numerous fluorescent marker lines are currently available to visualize microtubule (MT) architecture and dynamics in living plant cells, such as markers expressing p35S::GFP‐MBD or p35S::GFP‐TUB6. However, these MT marker lines display obvious defects that affect plant growth or produce unstable fluorescent signals. Here, a series of new marker lines were developed, including the pTUB6::VisGreen‐TUB6‐expressing line in which TUB6 is under the control of its endogenous regulatory elements and eGFP is replaced with VisGreen, a brighter fluorescent protein. Moreover, two different markers were combined into one expression vector and developed two dual‐marker lines. These marker lines produce bright, stable fluorescent signals in various tissues, and greatly shorten the screening process for generating dual‐marker lines. These new marker lines provide a novel resource for MT research.
Histological findings correlated with clinical outcomes in telangiectasia treated with ohmic thermolysis and 940 nm laser
Authors: Bush Ronald , Bush Peggy
Published: September 2018

Background

Heat modalities are commonly used as either primary or adjunctive treatment for telangiectasia. Minimal information is available as to the nature of injury to the vessel and surrounding tissue.

Method

A total of 135 patients were treated over a 2‐year period using ohmic thermolysis (45), 940 nm laser (50), and 940 nm laser with sclerotherapy (40). After treatment, 1 mm biopsies were done in selected patients in each group. Clinical correlation was studied in each group by observing vessel response at 4‐6 weeks postprocedure.

Results

Ohmic thermolysis produces electrodessication of the squamous epithelium, reticular dermis, and fusion of the target vessel. 940 nm laser results include squamous epithelial damage, subcutaneous water blister, collagen denaturation, and vessel endothelial cell loss with thrombus at point of maximal impact. The addition of sclerotherapy at time of laser potentiates vessel damage. There was no long‐term skin sequelae after treatment when each device is used at recommended settings and on appropriate vessel size.

Conclusion

Each device causes damage to the squamous epithelium and papillary reticular dermis that is transient. Ohmic thermolysis provides vessel clearance of >90% in telangiectasias <0.5 mm. 940 nm laser effectiveness is <70% for vessel clearance, but improves to >90% when sclerotherapy is performed at time of treatment.
Safety and efficacy of a novel high‐intensity focused electromagnetic technology device for noninvasive abdominal body shaping
Authors: Jacob Carolyn I. , Paskova Katya
Published: September 2018

Background

Thermal fat reduction technologies are leading the market for nonsurgical abdominal contouring. However, they are ideal principally for patients with fat bulges.

Objectives

Our study investigates the effects of a novel nonthermal technology affecting the abdominal musculature and subcutaneous adipose tissue.

Materials and Methods

A total of 22 patients (avg. BMI 23.8 kg m−2) underwent 4 treatments on abdomen with high‐intensity focused electromagnetic (HIFEM) field device. Treatments took 30 minutes and were spaced apart by 2‐3 days. Photographs, weight, and waist measurements were taken at the baseline, after the last treatment, and at month 3 follow‐up. Patient satisfaction was noted. Photographs were evaluated by blinded evaluators.

Results

The study protocol was completed by 19 patients. At month 3, the average waist size reduction was 4.37 ± 2.63 cm (P < 0.01). The evaluators identified the before image from the 3‐month image 89.47% of the time. About 91% of patients reported their abdominal appearance improved, and 92% stated they are satisfied with treatment results at month 3. No adverse events occurred.

Conclusion

Observed waist size reduction and aesthetic improvement appear to be a combination of fat reduction and increased muscle definition of abdominal wall. In lower BMI patients, the increased abdominal muscle definition was largely responsible for the improvement. This novel energy device provides an additional tool for body contouring with primary application for lower and medium BMI patients.
Sensation Seeking and Hedge Funds
Authors: BROWN STEPHEN , LU YAN , RAY SUGATA , TEO MELVYN
Published: September 2018

We show that, motivated by sensation seeking, hedge fund managers who own powerful sports cars take on more investment risk but do not deliver higher returns, resulting in lower Sharpe ratios, information ratios, and alphas. Moreover, sensation‐seeking managers trade more frequently, actively, and unconventionally, and prefer lottery‐like stocks. We show further that some investors are themselves susceptible to sensation seeking and that sensation‐seeking investors fuel the demand for sensation‐seeking managers. While investors perceive sensation seekers to be less competent, they do not fully appreciate the superior investment skills of sensation‐avoiding fund managers.
First Language Attrition as a Function of Age at Onset of Bilingualism: First Language Attainment of Turkish–English Bilinguals in the United Kingdom
Authors: Karayayla Tuğba , Schmid Monika S.
Published: September 2018

This investigation aimed to provide insights into the controversial debate on the role that age at onset of bilingualism plays in human language capacity with a focus on what it entails for first language (L1) attrition. L1 performance of Turkish immigrants (n = 57) in the United Kingdom with age at onset ranging between 7 and 34 years was compared to that of Turkish monolingual controls (n = 29) across two linguistic properties: structural complexity and accent. Findings generally showed that although the immigrants achieved nativelike proficiency with respect to the overall structural complexity of their L1, this was not the case for accent as those with an earlier age of onset were less likely to sound like native Turkish speakers. We discuss these findings in relation to two competing theoretical models of age effects and suggest that attrition data need to be better accommodated within these models.

Open Practices

This article has been awarded an Open Materials badge. All materials are publicly accessible via the IRIS Repository at https://www.iris-database.org. Learn more about the Open Practices badges from the Center for Open Science: https://osf.io/tvyxz/wiki.
More Is More in Language Learning: Reconsidering the Less‐Is‐More Hypothesis
Authors: Brooks Patricia J. , Kempe Vera
Published: September 2018

The Less‐Is‐More hypothesis was proposed to explain age‐of‐acquisition effects in first language (L1) and second language (L2) learning. We scrutinize different renditions of the hypothesis by examining how learning outcomes are affected by (a) limited cognitive capacity, (b) reduced interference resulting from less prior knowledge, and (c) simplified language input. While there is little to no evidence of benefits of limited cognitive capacity, there is ample support for a More‐Is‐More account linking enhanced capacity with better L1 and L2 learning outcomes and reduced capacity with childhood language disorders. Instead, reduced prior knowledge (relative to adults) may afford children greater flexibility in inductive inference; this contradicts the idea that children benefit from a more constrained hypothesis space. Finally, studies of child‐directed speech confirm benefits from less complex input at early stages but also emphasize how greater lexical and syntactic complexity of the input confers benefits in L1 attainment.
Severity in polycystic liver disease is associated with aetiology and female gender: Results of the International PLD Registry
Authors: van Aerts René M. M. , Kievit Wietske , de Jong Michiel E. , Ahn Curie , Bañales Jesús M. , Reiterová Jana , Nevens Frederik , Drenth Joost P. H.
Published: September 2018

Background & Aims

Polycystic liver disease (PLD) occurs in two genetic disorders, autosomal‐dominant polycystic kidney disease (ADPKD) and autosomal‐dominant polycystic liver disease (ADPLD). The aim of this study is to compare disease severity between ADPKD and ADPLD by determining the association between diagnosis and height‐adjusted total liver volume (hTLV).

Methods

We performed a cross‐sectional analysis with hTLV as endpoint. Patients were identified from the International PLD Registry (>10 liver cysts) and included in our analysis when PLD diagnosis was made prior to September 2017, hTLV was available before volume‐reducing therapy (measured on computed tomography or magnetic resonance imaging) and when patients were tertiary referred. Data from the registry were retrieved for age, diagnosis (ADPKD or ADPLD), gender, height and hTLV.

Results

A total of 360 patients (ADPKD n = 241; ADPLD n = 119) met our inclusion criteria. Female ADPKD patients had larger hTLV compared with ADPLD (P = 0.008). In a multivariate regression analysis, ADPKD and lower age at index CT were independently associated with larger hTLV in females, whereas in males a higher age was associated with larger hTLV. Young females (≤51 years) had larger liver volumes compared with older females (>51 years) in ADPKD.

Conclusion

Aetiology is presented as a new risk factor associated with PLD severity. Young females with ADPKD represent a subgroup of PLD patients with the most severe phenotype expressed in hTLV.
A modified DNA barcode approach to define trophic interactions between native and exotic pentatomids and their parasitoids
Authors: Gariepy Tara D. , Bruin Allison , Konopka Joanna , Scott‐Dupree Cynthia , Fraser Hannah , Bon Marie‐Claude , Talamas Elijah
Published: September 2018

The establishment of invasive Halyomorpha halys (Stål) outside of its native range may impact native species assemblages, including other pentatomids and their scelionid parasitoids. This has generated interest in defining species diversity and host‐parasitoid associations in this system to better understand the impact of invasive alien species on trophic interactions in invaded regions. Information on scelionid–pentatomid associations in natural habitats is lacking, and species‐level identification of these associations can be tenuous using rearing and dissection techniques. Naturally occurring pentatomid eggs were collected in areas where H. halys has established in Canada and were analysed using a modified DNA barcoding approach to define species‐level trophic interactions. Identification was possible for >90% of egg masses. Eleven pentatomid and five scelionid species were identified, and trophic links were established. Approximately 70% of egg masses were parasitized; parasitism and parasitoid species composition were described for each species. Telenomus podisi Ashmead was the dominant parasitoid and was detected in all host species. Trissolcus euschisti Ashmead was detected in several host species, but was significantly more prevalent in Chinavia hilaris (Say) and Brochymena quadripustulata (Fabricius). Trissolcus brochymenae Ashmead and Tr. thyantae Ashmead were recorded sporadically. Parasitism of H. halys was 55%, and this species was significantly less likely to be parasitized than native pentatomids. The scelionid species composition of H. halys consisted of Te. podisi, Tr. euschisti and Tr. thyantae. Although these species cannot develop in fresh H. halys eggs, we demonstrate that parasitoids attempt to exploit this host under field conditions.
RADseq data reveal ancient, but not pervasive, introgression between Californian tree and scrub oak species (Quercussect.Quercus: Fagaceae)
Authors: Kim Bernard Y. , Wei Xinzeng , Fitz‐Gibbon Sorel , Lohmueller Kirk E. , Ortego Joaquín , Gugger Paul F. , Sork Victoria L.
Published: September 2018

A long‐term debate in evolutionary biology is the extent to which reproductive isolation is a necessary element of speciation. Hybridizing plants in general are cited as evidence against this notion, and oaks specifically have been used as the classic example of species maintenance without reproductive isolation. Here, we use thousands of SNPs generated by RAD sequencing to describe the phylogeny of a set of sympatric white oak species in California and then test whether these species exhibit pervasive interspecific gene exchange. Using RAD sequencing, we first constructed a phylogeny of ten oak species found in California. Our phylogeny revealed that seven scrub oak taxa occur within one clade that diverged from a common ancestor withQ. lobata, that they comprise two subclades, and they are not monophyletic but include the widespread tree oakQ. douglasii. Next, we searched for genomic patterns of allele sharing consistent with gene flow between long‐divergent tree oaks with scrub oaks. Specifically, we utilized theD‐statistic as well as model‐based inference to compare the signature of shared alleles between two focal tree species (Q. lobataandQ. engelmannii) with multiple scrub species within the two subclades. We found that introgression is not equally pervasive between sympatric tree and scrub oak species. Instead, gene flow commonly occurs from scrub oaks to recently sympatricQ. engelmannii, but less so from scrub oaks to long‐sympatricQ. lobata. This case study illustrates the influence of ancient introgression and impact of reproductive isolating mechanisms in preventing indiscriminate interspecific gene exchange.
A comparison of mosquito densities, weather and infection rates of Aedes aegypti during the first epidemics of Chikungunya (2014) and Zika (2016) in areas with and without vector control in Puerto Rico
Authors: Barrera R. , Amador M. , Acevedo V. , Beltran M. , Muñoz J. L.
Published: September 2018

In Puerto Rico, the first records of the transmission of Chikungunya (CHIKV) and Zika (ZIKV) viruses were confirmed in May 2014 and December 2015, respectively. Transmission of CHIKV peaked in September 2014, whereas that of ZIKV peaked in August 2016. The emergence of these mosquito‐transmitted arboviruses in the context of a lack of human population immunity allowed observations of whether the outbreaks were associated with Aedes aegypti (Diptera: Culicidae) densities and weather. Mosquito density was monitored weekly in four communities using sentinel autocidal gravid ovitraps (AGO traps) during 2016 in order to provide data to be compared with the findings of a previous study carried out during the 2014 CHIKV epidemic. Findings in two communities protected against Ae. aegypti using mass AGO trapping (three traps per house in most houses) were compared with those in two nearby communities without vector control. Mosquito pools were collected to detect viral RNA of ZIKV, CHIKV and dengue virus. In areas without vector control, mosquito densities and rates of ZIKV detection in 2016 were significantly higher, similarly to those observed for CHIKV in 2014. The density of Ae. aegypti in treated sites was less than two females/trap/week, which is similar to the putative adult female threshold for CHIKV transmission. No significant differences in mosquito density or infection rates with ZIKV and CHIKV at the same sites between years were observed. Although 2016 was significantly wetter, mosquito densities were similar.
Altered intestinal antibacterial gene expression response profile in irritable bowel syndrome is linked to bacterial composition and immune activation
Authors: Bennet Sean M. P. , Sundin Johanna , Magnusson Maria K. , Strid Hans , Tap Julien , Derrien Muriel , Le Nevé Boris , Doré Joël , Törnblom Hans , Simrén Magnus , Öhman Lena
Published: September 2018

Background

Immune activity and gut microbiota may impact the pathophysiology of irritable bowel syndrome (IBS). We aimed to determine whether antibacterial gene expression of immune activity‐defined IBS patients differed compared to healthy subjects (HS) and ulcerative colitis (UC) patients and whether antibacterial profiles reflected gut microbiota composition and IBS symptoms.

Methods

Expression of 84 antibacterial genes in biopsies from HS, IBS patients (clustered according to immune activity (systemic and intestinal cytokines): immunonormal or immunoactive), and UC patients was assessed by Human Antibacterial Response RT2 Profiler PCR Array. In IBS patients, 16S rRNA gene sequencing of fecal and mucosal bacteria was performed and symptom pattern and severity were assessed.

Key Results

Intestinal antibacterial gene expression profiles differed between IBS patients (n = 31) and HS (n = 16), but did not differ between IBS subgroups based on bowel habit predominance or symptom severity. Based on previously identified IBS clusters, IBS patients with normal (n = 15) and enhanced immune activity (n = 16) had clearly separate antibacterial gene expression profiles from active UC patients (n = 12) and differed compared to each other and to HS. The differences in antibacterial gene expression profiles between immunonormal and immunoactive IBS patients were also reflected in distinct fecal and mucosal microbiota composition profiles, but not in symptom pattern or severity.

Conclusions & Inferences

This study demonstrates an altered antibacterial gene expression profile in IBS patients compared to HS and UC patients. While not linked to symptoms, immune activity‐defined IBS clusters showed different intestinal antibacterial gene expression and distinct fecal and mucosal bacterial profiles.
Is metformin still the most efficacious first‐line oral hypoglycaemic drug in treating type 2 diabetes? A network meta‐analysis of randomized controlled trials
Authors: Jia Y. , Lao Y. , Zhu H. , Li N. , Leung S.‐W.
Published: September 2018

Objectives

The objective of the study is to compare the efficacy of hypoglycaemic drugs for type 2 diabetes mellitus (T2DM) by network meta‐analysis of randomized controlled trials (RCTs).

Methods

We compared 11 major oral hypoglycaemic drugs under five categories evaluated by RCTs as drug monotherapy for the patients with T2DM, measuring glycosylated haemoglobin (%) or fasting plasma glucose (mmol L−1) as outcomes. RCT quality was assessed with the Cochrane risk of bias tool. Network meta‐analysis estimated the mean differences and 95% credible intervals. Subgroup and sensitivity analyses were performed to determine the results robustness. The Grading of Recommendation, Assessment, Development, and Evaluation evidence strength was assessed.

Results

Seventy‐five RCTs including 33,830 patients were identified. Their study quality was high. Regarding glycosylated haemoglobin, top three anti‐diabetics were repaglinide (mean differences −1.39 [95% credible intervals −1.75 to −1.03]), gliclazide (−1.37 [−2.04 to −0.71]) and metformin (−1.13 [−1.37 to −0.90]), against placebo. Regarding fasting plasma glucose, top three anti‐diabetics were repaglinide (−2.01 [−2.75 to −0.97]), metformin (−1.72 [−2.16 to −1.27]) and glipizide (−1.57 [−2.44 to −0.64]), against placebo. There was no difference between metformin and repaglinide. Subgroup and sensitivity analyses found the results to be robust. The evidence strength was moderate to high.

Conclusion

This meta‐analysis showed that repaglinide and metformin would be the most efficacious oral drugs for first‐line monotherapy of T2DM.
High‐density characterization of a localized reentry circuit occurred after AF ablation
Authors: Frontera Antonio , Takigawa Masateru , Haïssaguerre Michel , Derval Nicolas , Jaïs Pierre
Published: September 2018

We present the case of a localized reentry circuit that developed 24 h after radiofrequency ablation of atrial fibrillation (AF). The circuit was of interest because it overlapped with sites of previous defragmentation during AF. The circuit presented a small funnel that measured only 1.4 mm at its narrowest segment. Fractionated signals, which codify for slow conduction zones, corresponded to the isthmus site. Ablation at this site interrupted the atrial tachycardia.
Effects of the short‐term exposure to ambient air pollution on atrial fibrillation
Authors: Liu Xiaole , Kong Dehui , Liu Yanbo , Fu Jia , Gao Peng , Chen Taibo , Fang Quan , Cheng Kang'an , Fan Zhongjie
Published: September 2018

Background

Atrial fibrillation (AF) is an important arrhythmia associated with cardiovascular morbidity and mortality. This study is focused on exploring the potential relationship between short‐term air pollution exposure and occurrence of AF.

Methods

A case‐crossover design was used to investigate the effect of pollutants on AF occurrence among 100 patients from 2013 to 2014. The air pollutants included ambient particulate matter less than 2.5 μm in aerodynamic diameter (PM2.5), particulate matter less than 10 μm in aerodynamic diameter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3). Participants with cardiac implantable electronic devices implanted were followed‐up to December 31, 2014.

Results

A 10 μg/m3 increase of PM2.5 and PM10 was associated with 3.8% (95% confidence interval [CI]: 1.4–6.2) and 2.7% (95% CI: 0.6–4.8) increase in the risk of AF occurrence, respectively. No statistically significant association was noted with SO2, NO2, CO, and O3.

Conclusions

Short‐term exposure to particular matter, both PM2.5 and PM10, is associated with an increased risk of AF. This further demonstrates the urgency for air quality monitoring and control in geographical area with intense pollution.
Left atrial voltage mapping using a new impedance‐based algorithm in patients with paroxysmal atrial fibrillation
Authors: Asvestas Dimitrios , Vlachos Konstantinos , Bazoukis George , Martin Claire A. , Letsas Konstantinos P. , Sakellaropoulou Antigoni , Kossyvakis Charalampos , Saplaouras Athanasios , Prappa Efstathia , Goga Christina , Vassilikos Vassilios , Valkanas Kosmas , Deftereos Spiridon , Sideris Antonios , Efremidis Michael
Published: September 2018

Aims

Atrial fibrosis is associated with the pathogenesis and progression of atrial fibrillation (AF). We sought to evaluate the extent of left atrial (LA) scarring in patients with paroxysmal AF (PAF) undergoing catheter ablation using a new impedance‐based algorithm.

Methods

We prospectively enrolled 73 consecutive patients (43 males, 58 years) with PAF who underwent pulmonary vein antral isolation. We first performed high‐density bipolar voltage mapping during sinus rhythm using Tissue Proximity Indicator (TPI), one of the features of the ConfiDense mapping module integrated in the electroanatomic mapping system. A dense LA shell was created initially without TPI (mean points 2,411) and subsequently activating TPI (mean points 1,167). Each point was classified according to the peak‐to‐peak bipolar voltage electrogram based on two criteria (criterion A: healthy >0.8 mV, border zone: 0.4–0.8 mV, scarred: <0.4 mV; criterion B: healthy: >0.5 mV, border zone: 0.25–0.5 mV, scarred: <0.25 mV).

Results

LA voltage analysis represented significantly smaller scarred areas when mapping was performed with TPI‐ON compared with TPI‐OFF in both voltage criteria (average LA voltage area: 3.02 ± 5.28 cm2 vs 9.15 ± 13.11 cm2 vs in criterion A and 1.19 ± 2.54 cm2 vs 5.61 ± 9.56 cm2 in criterion B). A statistically significant voltage difference was observed in all segments of the left atrium between the two mapping protocols, particularly on the inferior wall.

Conclusion

A more specific delineation of LA fibrosis may be produced using the TPI feature of the ConfiDense mapping module, through elimination of false‐positive annotated mapping points due to low contact.
Public health nurses’ experiences of using interpreters when meeting with Arabic‐speaking first‐time mothers
Authors: Rifai Elissa , Janlöv Ann‐Christin , Garmy Pernilla
Published: September 2018

Objectives

The aim of this study was to investigate public health nurses’ experiences of using interpreters when meeting with Arabic‐speaking first‐time mothers.

Design and Sample

An inductive qualitative design was used. Individual interviews were conducted with Swedish public health nurses (n = 11) with experience of working in child health care with interpreters when meeting with Arabic‐speaking first‐time mothers.

Measures

Data were analyzed using qualitative content analysis.

Results

The analysis of the interviews resulted in one overarching theme: Having to accept and learn to incorporate interpreters when meeting with Arabic‐speaking first‐time mothers. Three subthemes were identified: (a) enabling an understanding of the situation of the mothers; (b) contributing to a trustful relationship; and (c) creating disturbing elements in the dialogue.

Conclusions

Using interpreters optimized the conversation between the public health nurse and the Arab‐speaking first‐time mother; however, the complexity of using interpreters was also apparent.
(In)credible Subjects: NGOs, Attorneys, and Permissible LGBT Asylum Seeker Identities
Authors: McGuirk Siobhán
Published: September 2018

In this paper, I demonstrate how statist logics concerning acceptable lesbian, gay, bisexual, and/or transgender (LGBT) immigrants permeate civic spheres, creating new forms of exclusion for asylum seekers in the United States. Existing research on US asylum policy and procedures as they pertain to LGBT claimants suggests that a “gay enough” litmus test typifies U.S. Citizenship and Immigration Services (USCIS) adjudications, such that officers expect claimants to engage in conspicuous consumption of stereotypical commodities and culture and to appear visibly “LGBT,” either through gender non‐conformity or by being “out.” My analysis focuses on the social as well as legal lives of LGBT asylum seekers in the United States. Drawing on ethnographic and interview data collected at specialist NGOs, I argue that limited ideas about LGBT subjectivity often structure NGO workers’ attitudes and practices in ways that echo USCIS criteria for granting asylum. I demonstrate how NGO client selection and intake processes assume homonormative ideals and subtly yet effectively replicate existing adjudication norms. Within ostensibly non‐governmental spaces, LGBT asylum seekers experience suspicion, surveillance, and pressure to conform to NGO workers’ expectations of “credible” claimants. Contrary to NGOs’ stated intentions, these processes extend, rather than challenge, existing barriers to asylum.