bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiovascular diseases may play a negative role in the prognosis of amyotrophic lateral sclerosis
Authors: Mandrioli J. , Ferri L. , Fasano A. , Zucchi E. , Fini N. , Moglia C. , Lunetta C. , Marinou K. , Ticozzi N. , Drago Ferrante G. , Scialo C. , Sorarù G. , Trojsi F. , Conte A. , Falzone Y. M. , Tortelli R. , Russo M. , Sansone V. A. , Mora G. , Silani V. , Volanti P. , Caponnetto C. , Querin G. , Monsurrò M. R. , Sabatelli M. , Chiò A. , Riva N. , Logroscino G. , Messina S. , Calvo A.
Published: March 2018

Background and purpose

Only a few studies have considered the role of comorbidities in the prognosis of amyotrophic lateral sclerosis (ALS) and have provided conflicting results.

Methods

Our multicentre, retrospective study included patients diagnosed from 1 January 2009 to 31 December 2013 in 13 referral centres for ALS located in 10 Italian regions. Neurologists at these centres collected a detailed phenotypic profile and follow‐up data until death in an electronic database. Comorbidities at diagnosis were recorded by main categories and single medical diagnosis, with the aim of investigating their role in ALS prognosis.

Results

A total of 2354 incident cases were collected, with a median survival time from onset to death/tracheostomy of 43 months. According to univariate analysis, together with well‐known clinical prognostic factors (age at onset, diagnostic delay, site of onset, phenotype, Revised El Escorial Criteria and body mass index at diagnosis), the presence of dementia, hypertension, heart disease, chronic obstructive pulmonary disease, haematological and psychiatric diseases was associated with worse survival. In multivariate analysis, age at onset, diagnostic delay, phenotypes, body mass index at diagnosis, Revised El Escorial Criteria, dementia, hypertension, heart diseases (atrial fibrillation and heart failure) and haematological diseases (disorders of thrombosis and haemostasis) were independent prognostic factors of survival in ALS.

Conclusions

Our large, multicentre study demonstrated that, together with the known clinical factors that are known to be prognostic for ALS survival, hypertension and heart diseases (i.e. atrial fibrillation and heart failure) as well as haematological diseases are independently associated with a shorter survival. Our findings suggest some mechanisms that are possibly involved in disease progression, giving new interesting clues that may be of value for clinical practice and ALS comorbidity management.
Improved cardiac outcomes with combined atenolol and diazepam intervention in seizure
Authors: Read Morgayn I. , Millen Rebecca N. , McCann Dominic M. , Harrison Joanne C. , Kerr Douglas S. , Sammut Ivan A.
Published: March 2018

Objective

Altered autonomic activity has been implicated in the development of cardiac dysfunction during seizures. This study investigates whether intervening in seizure progression with diazepam will reduce seizure‐induced cardiomyopathy. Second, this study examines the hypothesis that combining atenolol with diazepam, as an intervention after seizure onset, will combat cardiac injury during status epilepticus.

Methods

Male Sprague‐Dawley rats were implanted with electroencephalographic/electrocardiographic electrodes to allow simultaneous recordings during seizures induced by intrahippocampal (2 nmol, 1 μL) kainic acid (KA). Subcutaneous saline, atenolol (5 mg·kg−1), diazepam (5 mg·kg−1), or atenolol and diazepam (n = 12/group) were administered at 60 minutes post‐KA and daily for 7 days, at which point echocardiography, susceptibility to aconitine‐induced arrhythmias, and histology were evaluated.

Results

Seizure activity was associated with immediately increased heart rate, QTc interval, and blood pressure (BP; 10%‐30% across indices). Seven days postseizure, saline‐treated animals were found to have reduced left ventricular function, increased fibrotic scarring, and an elevated risk of aconitine‐induced arrhythmias. Diazepam treatment significantly reduced cumulative seizure behaviors by 79% compared to saline‐treated animals but offered no cardiac protection. Diazepam significantly raised BP (35%) and increased the risk of bigeminal arrhythmias (36%) compared to saline‐treated animals. Atenolol administration, either alone or with diazepam, reduced heart rate, QTc interval, and BP back to control levels. Atenolol also preserved cardiac morphology and reduced arrhythmia risk.

Significance

Attenuation of seizure with diazepam offered no cardiac protection; however, coadministration of atenolol with diazepam prevented the development of seizure‐induced cardiac dysfunction. This study demonstrates that atenolol intervention should be strongly considered as an adjunct clinical treatment to reduce cardiomyopathy during seizures.
Analysis of psoriasis‐relevant gene expression and exon usage alterations after silencing of SR‐rich splicing regulators
Authors: Szlavicz Eszter , Olah Peter , Szabo Kornélia , Pagani Franco , Bata‐Csorgo Zsuzsanna , Kemeny Lajos , Szell Márta
Published: March 2018

In our recent cDNA microarray experiment, three SR‐rich splicing factors—SFRS18, PPIG and LUC7L3—were shown to exert altered responsiveness upon T‐lymphokine stimulation of psoriatic non‐involved and healthy epidermis samples. We have also demonstrated that double silencing LUC7L3 and SFRS18 efficiently decreased production of the psoriasis‐associated EDA+ fibronectin isoform. These findings prompted the further investigation of signalling pathways affected by LUC7L3 and SFRS18. To detect gene expression and splicing pattern alterations upon double silencing of LUC7L3 and SFRS18 in an HPV‐immortalised keratinocyte cell culture, paired‐end RNA sequencing was carried out. Marked changes in exon usage were revealed, in contrast to the modest alterations detected in gene expression, providing a closer delineation of the potential targets of the examined splicing factors. The most prominent gene expression change was detected for IFI6, an interferon‐inducible gene highly expressed in psoriasis. Interacting partners of IFI6 and certain psoriasis‐associated transcripts also exhibited significantly increased expression upon silencing. In addition to elevated abundance of the EDA+ fibronectin interactor ITGA5, we confirmed decreased EDA domain inclusion, which agrees well with our prior experimental data. Furthermore, differential exon usage was established for the transcription element CREB1, along with HERC6 and CUL1, which are implicated in ubiquitination. Although immortalised keratinocytes express low levels of TINCR, a long non‐coding RNA involved in terminal differentiation of keratinocytes, splicing alterations were successfully demonstrated for this RNA as well. We believe that the targeted investigation of mRNA maturation disturbances may help us gain deeper insight into the molecular pathogenesis of psoriasis.
Simplified equations for determining double‐K fracture parameters of concrete for 3‐point bending test
Authors: Choubey R.K. , Kumar S.
Published: March 2018

The paper presents simplified polynomial equations for determining the double‐K fracture parameters of concrete for 3‐point bending beams with variable strengths and material properties of concrete. The derived equations avoid complexities involved in computations of fracture parameters using existing analytical methods. The input data required for systematic computation in the study for deriving the nondimensional fracture parameters are obtained using a fictitious crack model. It is inferred that for a relative size of initial crack length, critical load and corresponding crack opening displacement maintain a linear relationship in their nondimensional forms. The value of critical mouth opening displacement can also be determined for known value of peak load using the derived nondimensional equation, thus avoiding the measurement of the crack mouth opening displacement in the experiment. Further, the derived polynomial equations predict the double‐K fracture parameters of concrete with negligible error as compared to those obtained based on experimental results.
Relationship between number of drugs and duration of hospital stay in older patients with neuromuscular diseases
Authors: Nishida Shohei , Hayashi Yuichi , Suzuki Akio , Kobayashi Ryo , Inuzuka Takashi , Itoh Yoshinori
Published: March 2018

Aim

Older patients are considered to be at high risk for developing adverse drug reactions (ADR), because they commonly receive multidrug therapy despite changes in pharmacokinetic function with age. In the present study, we assessed the relationship between the number of prescribed drugs and the incidence of ADR or the time to discharge in older patients with neuromuscular disease.

Methods

A retrospective study was carried out among 135 older patients (aged ≥65 years) who were admitted to the neurology ward from October 2007 through December 2011. Drugs that possess a high risk for initiation of grade ≥2 ADR were determined using logistic regression analysis.

Results

A total of 38 patients (28.1%) experienced grade ≥2 ADR. Multivariate logistic regression analysis showed that corticosteroids, antibiotics, enteric nutrients and insulin were significant risks for grade ≥2 ADR. Notably, the time to discharge extended as the grade of ADR increased, with mean values of 24.4 days for grade 0, 38.3 days for grade 1, 47.5 days for grade 2 and 73.1 days for grade 3–4 events. Furthermore, the number of high‐risk drugs for grade ≥2 ADR correlated well with the incidence of grade ≥2 events (R = 0.964, P = 0.008), as well as with the time to discharge (R = 0.473, P < 0.001).

Conclusions

Older patients receiving multidrug therapy using corticosteroids, antibiotics, enteric nutrients, or insulin were at high risk for grade ≥2 ADR and prolongation of hospital stay. Geriatr Gerontol Int 2018; 18: 1018–1024.
Financial impact and effect on the outcome of preoperative tests for at‐risk older hip fracture patients
Authors: Steinberg Ely L , Warschawski Yaniv , Elis Jacob , Rotman Dani , Rachevsky Gil , Factor Shai , Salai Moshe , Ben‐Tov Tomer
Published: March 2018

Aim

Older patients with proximal femoral fractures often undergo preoperative tests due to coexisting morbidities. Our aim was to evaluate these tests and their impact on patient outcome and medical expenses.

Methods

This retrospective study includes data on head computed tomography, carotid ultrasound, echocardiography and pulmonary functional tests calculated according to the type of surgery (osteosynthesis or hip arthroplasty) carried out on 2798 patients. Time‐to‐surgery, test repeated postoperatively, American Society of Anesthesiology Physical Status score, additional procedures, hospitalization time, 30‐day mortality and associated medical expenses were evaluated.

Results

A total of 921 preoperative tests were carried out in 780 (28%) patients, and 375 postoperative tests were carried out in 329 (12%) patients (P < 0.001). A total of 23 procedures were carried out after surgery, none related to the originally carried out tests. Significant group differences were found for American Society of Anesthesiology Physical Status score, days to surgery, hospitalization time (days) and mortality rates. The medical expenses of these tests were 1.3% of the average income per case, and 0.6% of the average study group income.

Conclusions

Non‐routine preoperative tests prolong time‐to‐surgery, increased hospitalization time and contribute to 30‐day mortality. No postoperative procedure was related to preoperative test findings. The financial cost for these tests does not burden the medical expenses per procedure. Geriatr Gerontol Int 2018; 18: 937–942.
1,4‐Dioxane Soil Remediation Using Enhanced Soil Vapor Extraction (XSVE): II. Modeling
Authors: Burris David R. , Johnson Paul C. , Hinchee Robert E. , Dahlen Paul R.
Published: March 2018

1,4‐Dioxane is a volatile organic compound that is fully miscible in water, allowing it to sequester in vadose zone pore water and serve as a long‐term source of groundwater contamination. Conventional soil vapor extraction (SVE) removes 1,4‐dioxane; however, substantial 1,4‐dioxane can remain even after other colocated chlorinated solvents have been remediated. A field demonstration of “enhanced SVE” (XSVE) with focused extraction and heated injection was conducted at former McClellan AFB, CA, achieving 94% reduction in soil concentrations. A screening‐level tool, HypeVent XSVE, was created to assist in system design and data reduction and to anticipate how operating factors affect XSVE performance (e.g., cleanup level, remediation time, etc.). It assumes well‐mixed conditions, and combines an energy balance, mass balances for water and contaminant, and a temperature‐dependent 1,4‐dioxane Henry's Law constant. User inputs include the target treatment zone size, initial 1,4‐dioxane and soil moisture concentrations, and ambient site and injection/extraction conditions (temperature, humidity). Projections based on inputs representative of demonstration site conditions adequately anticipated the observed macroscopic field results. Sensitivity analyses show that removal increases with increasing heated air injection temperature and relative humidity and decreasing initial soil moisture content.
Fifth Chinese National Consensus Report on the management ofHelicobacter pyloriinfection
Authors: Liu Wen Zhong , Xie Yong , Lu Hong , Cheng Hong , Zeng Zhi Rong , Zhou Li Ya , Chen Ye , Wang Jiang Bin , Du Yi Qi , Lu Nong Hua ,   Chinese Society of Gastroenterology, Chinese Study Group on Helicobacter pylori and Peptic Ulcer
Published: March 2018

Background

Since the ‘Fourth Chinese National Consensus Report on the management ofH. pyloriinfection’ was published in 2012, three important consensuses (Kyoto global consensus report onH. pylorigastritis, The Toronto Consensus for the Treatment ofH. pyloriInfection in Adults and Management ofH. pyloriinfection—the Maastricht V/Florence Consensus Report) have been published regarding the management ofH. pyloriinfection.

Materials and Methods

A Delphi method was adopted to develop the consensus of relevant ‘statements’. First, the established ‘statements’ were sent to experts via email. Second, after undergoing two rounds of consultation, the initial statements were discussed face to face and revised in the conference item by item on 16 December 2016. Finally, 21 core members of conferees participated in the final vote of statements. Voting for each statement was performed using an electronic system with levels of agreements shown on the screen in real time.

Results

Consensus contents contained a total of 48 “statements” and related 6 parts, including indications forH. pylorieradication, diagnosis, treatment,H. pyloriand gastric cancer,H. pyloriinfection in special populations,H. pyloriand gastrointestinal microbiota.

Conclusions

Recommendations are provided on the basis of the best available evidence.
Hepatic angiomyolipoma: mutation analysis and immunohistochemical pitfalls in diagnosis
Authors: Yan Zhen , Grenert James P , Joseph Nancy M , Ren Chuanli , Chen Xin , Shafizadeh Nafis , Kakar Sanjay
Published: March 2018

Aims

Hepatic angiomyolipoma (AML) often shows epithelioid morphology with inconspicuous fat. Epithelioid component can mimic hepatocellular adenoma (HCA) or carcinoma (HCC). The aims of this study were to examine the expression of commonly used markers for HCA or HCC in hepatic AML and highlight pitfalls in diagnosis.

Methods and results

Resected hepatic AMLs (n = 16) were reviewed; reticulin stain, immunohistochemistry for glutamine synthetase (GS), β‐catenin and liver fatty acid binding protein (LFABP) were performed along with Sanger sequencing of exon 3 of CTNNB1 and next‐generation sequencing (NGS). Predominant epithelioid component (≥50%) was seen in 80% of cases. Foamy macrophage was present in 33% of cases. High‐risk histological features were often present in tumours with benign outcome: marked atypia (19%), mitoses (20%) and necrosis (33%). GS staining (≥10% of tumour) was seen in epithelioid components in 13 (87%) cases, and was diffuse (>50% of tumour) in six (40%) cases. LFABP staining or nuclear β‐catenin staining was not seen in any case. Sanger sequencing and NGS did not reveal CTNNB1 mutation in any tested case. NGS demonstrated TSC2 mutations in all five cases tested.

Conclusions

The predominance of epithelioid component resembling HCA or HCC is common in hepatic AML. Absence of LFABP and presence of fat can be mistaken for HNF1α‐inactivated HCA. Diffuse GS staining can be mistaken for β‐catenin‐activated HCA or HCC. Diffuse GS expression is not related to CTNNB1 mutation. All tested cases showed TSC2 mutation, supporting this as the driving genetic event for hepatic AML.
Price rather than nutrition information the main influencer of consumer food purchasing behaviour in South Africa: A qualitative study
Authors: Koen Nelene , Wentzel‐Viljoen Edelweiss , Blaauw Reneé
Published: March 2018

In South Africa there has been a paucity of data on food and nutrition labelling since the publication of the new food‐labelling legislation. This study aimed to explore whether the nutrition information on food products influences consumer purchasing behaviour; reasons for reading or ignoring nutrition information on labels, and to investigate expectations regarding food / nutrition labelling. Nine focus‐group discussions were held with adult consumers (N=67) in Cape Town, South Africa. Food price was sometimes the only consideration when selecting food products, irrespective of quality and nutritional value. When buying products for the first time, consumers were more inclined to read the nutrition information compared to habitual purchases or buying known brands. The list of ingredients, nutrient content claims and specific health endorsement logos were considered important. Reasons for reading nutrition information were mainly to assess the nutritional value or health properties, to avoid certain ingredients/allergens and to determine quality. Consumers struggled to understand the information on labels, specifically the nutrition information table. A lack of time or interest, price concerns and trust in labelling information also emerged as reasons why consumers ignore the nutrition information. There is a need for simpler food labelling, more graphics, and less complex terminology, information overload and quantitative information. It is recommended that a standardised front‐of‐package labelling scheme and a single health endorsement logo for South Africa be considered. More should be done to educate consumers on utilising the information on food labels correctly, in order for them to make healthier food choices.
Metabonomics analysis of nonvolatile small molecules of beers during forced ageing
Authors: Yao Jiwei , Zong Xuyan , Cui Chun , Mu Lixia , Zhao Haifeng
Published: March 2018

Three kinds of beers with different degrees of ageing were used to examine their nonvolatile small molecules by a metabonomics approach based on ultra performance liquid chromatography coupled with quadrupole time‐of‐flight tandem mass spectrometry (UPLC‐Q‐ToF‐MS/MS). Results showed that a total of 2114 compounds were detected in forced‐aged beers with the positive mode of UPLC‐Q‐ToF‐MS/MS. There was a clear separation among three groups of beers with different degrees of ageing in principal component analysis (PCA) model. Sixteen potential metabolite markers related to beer oxidative stability were identified by orthogonal partial least‐squares discriminate analysis (OPLS‐DA). Results from the changes in the spectrum also indicated that some new compounds formed in beer during forced ageing. Thus, the proposed metabonomics approach is a powerful tool to give a fully understanding the ageing process of beer based on the identification of the markers related to oxidative stability.
Phenolic composition and sensory characteristics of Cabernet Sauvignon wines: effect of water stress and harvest date
Authors: Delgado Cuzmar Paula , Salgado Eduardo , Ribalta‐Pizarro Camila , Olaeta José A. , López Eugenio , Pastenes Claudio , Cáceres‐Mella Alejandro
Published: March 2018

The effect of three water status level and two harvest date 55 and 64 days after veraison (DAV) on phenolic and sensory composition of Cabernet Sauvignon wines were investigated. The later harvest date led to wine with a higher alcohol content. Total phenols varied from 1439.66 to 1643.08 mg L−1 with higher values at 64 DAV. No differences were observed between irrigation treatments. For total tannins and anthocyanins, no differences were found between harvest date. Separation of proanthocyanidins by Sep‐Pak Plus tC18 cartridges showed only differences in concentration but not in the proportion of proanthocyanidin fractions. The wines from the most restricted treatment had a better colour and the same aroma of red fruits, persistence, astringency, fullness and bitterness, as the wine from the treatment with highest irrigation. Under the assay conditions, it was possible to obtain wines with a similar chemical and sensory composition earlier and using less irrigation water.
Stability of complete blood count in different storage conditions using the ABX PENTRA 60 analyzer
Authors: Oliveira L. R. , Simionatto M. , Cruz B. R. , Bittencourt J. I. M. , Krum E. A. , Moss M. F. , Borato D. C. K.
Published: March 2018

Introduction

Sample stability is essential to obtain reliable results in the clinical laboratory. This study was conducted to investigate the reliability of hematological parameters using ABX Pentra 60 in samples stored for up to 72 hours at different temperatures.

Methods

A total of 651 blood samples were analyzed at different analysis times: 2, 24, 48, and 72 hours and forms and storage: room temperature (25°C) and at 4°C. The imprecision of the results was evaluated by the analytical coefficient of variation (CVa%) obtained by the typical error (TE) and Kruskal‐Wallis analysis, to compare the averages. The reliability of the results was evaluated by the CVa (%) within the maximum allowable analytical variation and by the difference of means of the results in relation to the baseline sample (2 hours).

Results

Red blood count, hemoglobin, and MCH parameters showed stability up to 72 hours at room temperature and at 4°C. The other complete blood count parameters showed imprecision results emitted by the ABX Pentra 60 from 24 hours of sample storage, independent of the storage temperature. In addition, there were significant oscillations in the mean values, particularly for the samples stored at room temperature, with the exception of platelet parameters that exhibited mean changes also at 4°C.

Conclusion

The results demonstrate the importance of the clinical analyst's knowledge about the behavior of the CBC parameters over time under different storage conditions, and mainly the imprecision of the hematological equipment used, for the suitable interpretation of the results.
Depression and suicide among medical practitioners in Australia
Authors: Bailey Eleanor , Robinson Jo , McGorry Patrick
Published: March 2018

This review will provide an overview of the prevalence of, and risk factors for, depression and suicide in medical practitioners. It will also discuss the barriers to accessing appropriate care and potential interventions for this population.
Regulation of autoimmune and anti‐tumour T‐cell responses by PTPN22
Authors: Brownlie Rebecca J. , Zamoyska Rose , Salmond Robert J.
Published: March 2018

A number of polymorphisms in immune‐regulatory genes have been identified as risk factors for the development of autoimmune disease. PTPN22 (that encodes a tyrosine phosphatase) has been associated with the development of several autoimmune diseases, including type 1 diabetes, rheumatoid arthritis and systemic lupus erythematosus. PTPN22 regulates the activity and effector functions of multiple important immune cell types, including lymphocytes, granulocytes and myeloid cells. In this review, we describe the role of PTPN22 in regulating T‐cell activation and effector responses. We discuss progress in our understanding of the impact of PTPN22 in autoimmune disease in humans and mouse models, as well as recent evidence suggesting that genetic manipulation of PTPN22 expression might enhance the efficacy of anti‐tumour T‐cell responses.
EBV transformation induces overexpression of hMSH2/3/6 on B lymphocytes and enhances γδT‐cell‐mediated cytotoxicity via TCR and NKG2D
Authors: Dai Yu‐mei , Liu Hai‐ying , Liu Yun‐feng , Zhang Yuan , He Wei
Published: March 2018

The engagement of Epstein–Barr virus (EBV)‐induced protein ligands in γδ T‐cell‐mediated anti‐EBV immunity, especially in EBV‐associated B‐cell malignancies, has not been fully elucidated. Previously we reported the overexpression of human MutS homologue 2 (hMSH2), a stress‐inducible protein ligand for human γδ T‐cells, on EBV‐transformed B lymphoblastic cell lines (B‐LCLs). In this study, we first generated EBV‐transformed B‐LCLs from peripheral blood mononuclear cells of healthy volunteers with B95‐8 cellular supernatant and cyclosporine A. Secondly, we demonstrated the significantly elevated cell surface protein expression and mRNA transcription of hMSH2 in EBV‐transformed B‐LCLs, 3D5 and EBV‐positive B lymphoma cell line Daudi and Raji. Thirdly, hMSH2‐mediated recognition of EBV‐transformed B malignant cells by human γδ T‐cells was confirmed by specific antibody blocking and siRNA interference. Both TCRγδ and NKG2D participated in hMSH2‐mediated recognition of EBV‐transformed B malignant cells. Furthermore, hMSH3 and hMSH6, the companion proteins of hMSH2, along with CD98, were found overexpressed on the surface of EBV‐transformed malignant B‐cells. We concluded that the induced overexpression of hMSH proteins might serve as early alerting biomarkers emerged in EBV‐related B‐cell malignances or as potential targets for establishing γδ T‐cell‐based therapeutic immunotherapies towards EBV infection.
Natural killer cell cytotoxicity and its regulation by inhibitory receptors
Authors: Kumar Santosh
Published: March 2018

Natural killer (NK) cells express an array of germ‐line encoded receptors that are capable of triggering cytotoxicity. NK cells tend to express many members of a given family of signalling molecules. The presence of many activating receptors and many members of a given family of signalling molecules can enable NK cells to detect different kinds of target cells, and to mount different kinds of responses. This contributes also to the robustness of NK cells responses; cytotoxic functions of NK cells often remain unaffected in the absence of selected signalling molecules. NK cells express many MHC‐I‐specific inhibitory receptors. Signals from MHC‐I‐specific inhibitory receptors tightly control NK cell cytotoxicity and, paradoxically, maintain NK cells in a state of proper responsiveness. This review provides a brief overview of the events that underlie NK cell activation, and how signals from inhibitory receptors intercept NK cell activation to prevent inappropriate triggering of cytotoxicity.
Geographical ecology of dry forest tree communities in the West Indies
Authors: Franklin Janet , Andrade Riley , Daniels Mark L. , Fairbairn Patrick , Fandino Maria C. , Gillespie Thomas W. , González Grizelle , Gonzalez Otto , Imbert Daniel , Kapos Valerie , Kelly Daniel L. , Marcano‐Vega Humfredo , Meléndez‐Ackerman Elvia J. , McLaren Kurt P. , McDonald Morag A. , Ripplinger Julie , Rojas‐Sandoval Julissa , Ross Michael S. , Ruiz Jorge , Steadman David W. , Tanner Edmund V. J. , Terrill Inge , Vennetier Michel
Published: March 2018

Aim

Seasonally dry tropical forest (SDTF) of the Caribbean Islands (primarily West Indies) is floristically distinct from Neotropical SDTF in Central and South America. We evaluate whether tree species composition was associated with climatic gradients or geographical distance. Turnover (dissimilarity) in species composition of different islands or among more distant sites would suggest communities structured by speciation and dispersal limitations. A nested pattern would be consistent with a steep resource gradient. Correlation of species composition with climatic variation would suggest communities structured by broad‐scale environmental filtering.

Location

The West Indies (The Bahamas, Cuba, Hispaniola, Jamaica, Puerto Rico, US Virgin Islands, Guadeloupe, Martinique, St. Lucia), Providencia (Colombia), south Florida (USA) and Florida Keys (USA).

Taxon

Seed plants—woody taxa (primarily trees).

Methods

We compiled 572 plots from 23 surveys conducted between 1969 and 2016. Hierarchical clustering of species in plots, and indicator species analysis for the resulting groups of sites, identified geographical patterns of turnover in species composition. Nonparametric analysis of variance, applied to principal components of bioclimatic variables, determined the degree of covariation in climate with location. Nestedness versus turnover in species composition was evaluated using beta diversity partitioning. Generalized dissimilarity modelling partitioned the effect of climate versus geographical distance on species composition.

Results

Despite a set of commonly occurring species, SDTF tree community composition was distinct among islands and was characterized by spatial turnover on climatic gradients that covaried with geographical gradients. Greater Antillean islands were characterized by endemic indicator species. Northern subtropical areas supported distinct, rather than nested, SDTF communities in spite of low levels of endemism.

Main conclusions

The SDTF species composition was correlated with climatic variation. SDTF on large Greater Antillean islands (Hispaniola, Jamaica and Cuba) was characterized by endemic species, consistent with their geological history and the biogeography of plant lineages. These results suggest that both environmental filtering and speciation shape Caribbean SDTF tree communities.
Exposure to childhood adversity and deficits in emotion recognition: results from a large, population‐based sample
Authors: Dunn Erin C. , Crawford Katherine M. , Soare Thomas W. , Button Katherine S. , Raffeld Miriam R. , Smith Andrew D.A.C. , Penton‐Voak Ian S. , Munafò Marcus R.
Published: March 2018

Background

Emotion recognition skills are essential for social communication. Deficits in these skills have been implicated in mental disorders. Prior studies of clinical and high‐risk samples have consistently shown that children exposed to adversity are more likely than their unexposed peers to have emotion recognition skills deficits. However, only one population‐based study has examined this association.

Methods

We analyzed data from children participating in the Avon Longitudinal Study of Parents and Children, a prospective birth cohort (n = 6,506). We examined the association between eight adversities, assessed repeatedly from birth to age 8 (caregiver physical or emotional abuse; sexual or physical abuse; maternal psychopathology; one adult in the household; family instability; financial stress; parent legal problems; neighborhood disadvantage) and the ability to recognize facial displays of emotion measured using the faces subtest of the Diagnostic Assessment of Non‐Verbal Accuracy (DANVA) at age 8.5 years. In addition to examining the role of exposure (vs. nonexposure) to each type of adversity, we also evaluated the role of the timing, duration, and recency of each adversity using a Least Angle Regression variable selection procedure.

Results

Over three‐quarters of the sample experienced at least one adversity. We found no evidence to support an association between emotion recognition deficits and previous exposure to adversity, either in terms of total lifetime exposure, timing, duration, or recency, or when stratifying by sex.

Conclusions

Results from the largest population‐based sample suggest that even extreme forms of adversity are unrelated to emotion recognition deficits as measured by the DANVA, suggesting the possible immutability of emotion recognition in the general population. These findings emphasize the importance of population‐based studies to generate generalizable results.
Diagnostic and clinical role of serum proteinase 3 antineutrophil cytoplasmic antibodies in inflammatory bowel disease
Authors: Takedatsu Hidetoshi , Mitsuyama Keiichi , Fukunaga Shuhei , Yoshioka Shinichiro , Yamauchi Ryosuke , Mori Atsushi , Yamasaki Hiroshi , Kuwaki Kotaro , Sakisaka Hideto , Sakisaka Shotaro , Torimura Takuji
Published: March 2018

Background and Aim

Proteinase 3 antineutrophil cytoplasmic antibodies (PR3‐ANCAs) are well‐known serological markers for granulomatosis with polyangiitis, but their role as serological markers for inflammatory bowel disease remains uncertain. The present study aimed to evaluate the diagnostic and clinical role of PR3‐ANCAs as markers for inflammatory bowel disease.

Methods

Using a new methodology with chemiluminescence enzyme immunoassay, serum PR3‐ANCA titers were assessed in 102 patients with ulcerative colitis (UC), 67 patients with Crohn's disease (CD), 44 controls with other intestinal diseases, and 66 healthy controls. Associations with clinical data were investigated. The diagnostic role of PR3‐ANCAs was evaluated by receiver operating characteristic analysis.

Results

Proteinase 3 antineutrophil cytoplasmic antibody titers were significantly higher in patients with UC than in those with CD patients, patients with intestinal diseases (intestinal controls), and healthy controls (all P < 0.001). Receiver operating characteristic analysis demonstrated an area under the curve of 0.85 (95% confidence interval: 0.83–0.87) and showed that the manufacturer's cutoff value (3.5 U/mL) had a sensitivity of 39.2% and specificity of 96.6% for UC. There was a significant difference between PR3‐ANCA‐positive and PR3‐ANCA‐negative patients with regard to disease duration (P < 0.05) and disease severity (P < 0.01).

Conclusions

Proteinase 3 antineutrophil cytoplasmic antibodies were significantly more prevalent in patients with UC than in those with CD and controls. Our results suggested the role of PR3‐ANCAs as serological markers for aiding in diagnosing UC and evaluating disease severity. Further prospective studies are needed across multiple populations of patients and ethnic groups.
Medical Costs of Fatal and Nonfatal Falls in Older Adults
Authors: Florence Curtis S. , Bergen Gwen , Atherly Adam , Burns Elizabeth , Stevens Judy , Drake Cynthia
Published: March 2018

Objectives

To estimate medical expenditures attributable to older adult falls using a methodology that can be updated annually to track these expenditures over time.

Design

Population data from the National Vital Statistics System (NVSS) and cost estimates from the Web‐based Injury Statistics Query and Reporting System (WISQARS) for fatal falls, quasi‐experimental regression analysis of data from the Medicare Current Beneficiaries Survey (MCBS) for nonfatal falls.

Setting

U.S. population aged 65 and older during 2015.

Participants

Fatal falls from the 2015 NVSS (N=28,486); respondents to the 2011 MCBS (N=3,460).

Measurements

Total spending attributable to older adult falls in the United States in 2015, in dollars.

Results

In 2015, the estimated medical costs attributable to fatal and nonfatal falls was approximately $50.0 billion. For nonfatal falls, Medicare paid approximately $28.9 billion, Medicaid $8.7 billion, and private and other payers $12.0 billion. Overall medical spending for fatal falls was estimated to be $754 million.

Conclusion

Older adult falls result in substantial medical costs. Measuring medical costs attributable to falls will provide vital information about the magnitude of the problem and the potential financial effect of effective prevention strategies.
Efficacy of stabilisation splint treatment on the oral health‐related quality of life–A randomised controlled one‐year follow‐up trial
Authors: Kokkola O. , Suominen A. L. , Qvintus V. , Myllykangas R. , Lahti S. , Tolvanen M. , Sipilä K.
Published: March 2018

The aim of this randomised controlled trial was to assess the efficacy of stabilisation splint treatment on the oral health‐related quality of life OHRQoL during a 1‐year follow‐up. Originally, the sample consisted of 80 patients (18 men, 62 women) with temporomandibular disorders (TMD) who had been referred to the Oral and Maxillofacial Department, Oulu University Hospital, Finland, for treatment. Patients were randomly designated into splint (n = 39) and control group (n = 41). Patients in the splint group were treated with a stabilisation splint. Additionally, patients in both groups received counselling and instructions on masticatory muscle exercises. The patients filled in the Oral Health Impact Profile‐14 (OHIP‐14) questionnaire before treatment and at 3 months, 6 months and 1 year. At total, 67 patients (35 in the splint group vs. 32 in the control group) completed the questionnaire at baseline. The outcome variables were OHIP prevalence, OHIP severity and OHIP extent. Linear mixed‐effect regression model was used to analyse factors associated with change in OHIP severity during the 1‐year follow‐up, taking into account treatment time, age, gender and group status. OHIP prevalence, severity and extent decreased in both groups during the follow‐up. According to linear mixed‐effect regression, decrease in OHIP severity did not associate significantly with group status. Compared to masticatory muscle exercises and counselling alone, stabilisation splint treatment was not more beneficial on self‐perceived OHRQoL among TMD patients over a 1‐year follow‐up
Dealing with stroke: Perspectives from stroke survivors and stroke caregivers from an underserved Hispanic community
Authors: Torregosa Marivic B. , Sada Rosemary , Perez Ilse
Published: March 2018

Globally, stroke is the leading cause of death and disease burden. While post‐stroke studies have been conducted, they excluded survivors and caregivers from underserved communities. It can be argued that the impact of stroke on survivors and caregivers from underserved communities may be greater. Using qualitative exploratory research design, the purpose of this study was to examine the lived experiences of post‐stroke recovery and readjustment among stroke survivors and stroke caregivers from an underserved community. Two separate focus groups were conducted, one each for stroke survivors and caregivers. Thematic analysis was used to analyze the data. Finding meaning in life is the general theme of stroke survivors' and stroke caregivers' journey of post‐stroke recovery and readjustment. For stroke survivors, the transition to stroke recovery required time, life goal reconfiguration, willpower, humor, and network support. Post‐stroke caregiving is a daily navigation and negotiation influenced by internal and external processes. Personal, economic, and socio‐cultural nuances play a role in how post‐stroke recovery is lived and experienced. Study findings highlight the importance of policies to support family‐centered and system‐level advocacy in post‐stroke care.
Experimentalist Governance with Interactive Central–Local Relations: Making New Pension Policies in China
Authors: Zhu Xufeng , Zhao Hui
Published: March 2018

Although regional policy experimentation has become a global trend, the distinct features of experimentalist governance in a given country, such as China, remains to be investigated. This article extends policy process theory by proposing the framework of experimentalist governance with interactive central–local relations or Chinese‐style experimentalist governance, which combines three features. First, policy goals and instruments are formed separately and interactively by the central and local governments. Second, the central government is burdened with its own concerns about policy performance for maintaining authority and legitimacy. Third, the evaluation of policy pilots relies primarily on the responses of local governments. We further conceptualize three new patterns of experimentalist governance in China, namely, “comparative trial,” “selective recognition,” and “adaptive reconciliation,” in addition to “hierarchical experimentation.” These patterns are illustrated with case studies on four pension policies in China, which are for public sector employees, urban employees, rural residents, and migrant workers.
Toward a better noninvasive assessment of preejection period: A novel automatic algorithm for B‐point detection and correction on thoracic impedance cardiogram
Authors: Forouzanfar Mohamad , Baker Fiona C. , de Zambotti Massimiliano , McCall Corey , Giovangrandi Laurent , Kovacs Gregory T. A.
Published: March 2018

Impedance cardiography is the most common clinically validated, noninvasive method for determining the timing of the opening of the aortic valve, an important event used for measuring preejection period, which reflects sympathetic beta‐adrenergic influences on the heart. Automatic detection of the exact time of the opening of the aortic valve (B point on the impedance cardiogram) has proven to be challenging as its appearance varies between and within individuals and may manifest as a reversal, inflection, or rapid slope change of the thoracic impedance derivative's (dZ/dt) rapid rise. Here, a novel automatic algorithm is proposed for the detection of the B point by finding the main rapid rise of the dZ/dt signal, which is due to blood ejection. Several conditions based on zero crossings, minima, and maxima of the dZ/dt signal and its derivatives are considered to reject any unwanted noise and artifacts and select the true B‐point location. The detected B‐point locations are then corrected by modeling the B‐point time data using forward and reverse autoregressive models. The proposed algorithm is validated against expert‐detected B points and is compared with different conventional methods; it significantly outperforms them by at least 54% in mean error, 30% in mean absolute error, and 27% in standard deviation of error. This algorithm can be adopted in ambulatory studies requiring beat‐to‐beat evaluation of cardiac hemodynamic parameters over extended time periods where expert scoring is not feasible.
Impact of invasive plant control on soil loss: a case study on Robinson Crusoe Island
Authors: Castillo Jessica , Smith‐Ramírez Cecilia
Published: March 2018

Mechanical and chemical controls are the most common methods used to detain the advance of plant invasions. In some areas, clear‐cutting of invasive plants produces soil loss, one of the worst impacts on ecosystems. It has been argued that cutting invasive plants in small areas with root retention could be an adequate control management strategy to deal with this problem. In this study, the soil loss in small gaps after cutting two invasive woody species with root retention is compared with the soil loss in the invasive surrounding scrubland. On Robinson Crusoe Island, 15 small canopy gaps of 36 m2 were created in an area covered with invasive species. The gaps had three slope ranks including 15–20°, 20–25°, and 25–35°. Annual soil loss was measured both in these gaps and the invasive scrubland over 1 year with graduate erosion pins. In spite of the small size of clear‐cutting areas, we found erosion to be severe, to extremely severe, after plant control with root retention inside the small gaps with slope ranks between 25 and 35°. On the other hand, in slopes less than 25° soil loss was similar in the small clear‐cut gaps and invasive scrublands. Thus, we recommend precaution if the intention is to avoid erosion through clear‐cutting control with root retention in fragile soils and slope areas, even in small areas.
Real‐world study of acute exacerbations of COPD reveals real gaps in care
Authors: Jenkins Christine
Published: March 2018

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Authors: Bates Jason H.T.
Published: March 2018

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Comparison of outcomes with vancomycin or metronidazole for mild‐to‐moderate Clostridium difficile associated diarrhea among solid organ transplant recipients: A retrospective cohort study
Authors: Nguyen Cynthia T. , Li Julius , Anders Stephanie , Garcia‐Diaz Julia , Staffeld‐Coit Catherine , Hand Jonathan
Published: March 2018

Background

Current guidelines recommend oral vancomycin or fidaxomicin for the treatment of mild‐to‐moderate Clostridium difficile associated diarrhea (CDAD), while metronidazole is recommended as an alternative when oral vancomycin and fidaxomicin are unavailable. However, data are lacking among the solid organ transplant (SOT) population.

Methods

This single center, retrospective cohort study evaluated adult SOT recipients with mild‐to‐moderate CDAD. Analysis 1 evaluated patients receiving initial therapy with metronidazole vs oral vancomycin for at least 72 hours. Analysis 2 evaluated patients receiving metronidazole vs oral vancomycin for at least 70% of the treatment duration. The primary outcome was treatment failure. Secondary outcomes included CDAD recurrence and all‐cause mortality.

Results

Analysis 1 included 71 patients (metronidazole n = 50, oral vancomycin n = 21) and analysis 2 included 75 patients (metronidazole n = 42, oral vancomycin n = 33). No significant differences in C. difficile risk factors were observed between groups in either analysis. However, in both analyses, more patients in the oral vancomycin arm received antibiotics during the CDAD episode (analysis 1, 52% vs 26%, P = .03; analysis 2, 55% vs 32%, P < .01). Neither analysis demonstrated differences in treatment failure (analysis 1, metronidazole 16%, oral vancomycin 10%, P = .71; analysis 2, metronidazole 2%, oral vancomycin 6%, P = .58). CDAD recurrence and all‐cause mortality were similar across groups in both analyses.

Conclusions

Results suggest that both metronidazole and oral vancomycin are reasonable options for the treatment of mild‐to‐moderate CDAD in patients with SOT. No difference in treatment failure was observed; however, oral vancomycin may be preferred for higher risk patients, such as those receiving concurrent antibiotics.
Reduction in mortality associated with secondary cytomegalovirus prophylaxis after solid organ transplantation
Authors: Serrano‐Alonso M. , Guillen‐Grima F. , Martin‐Moreno P. , Rabago G. , Manrique J. , Garcia‐del‐Barrio M. , Reina G. , Torre‐Cisneros J. , Fernandez‐Alonso M. , Herrero J.I.
Published: March 2018

Background

Cytomegalovirus (CMV) is the most important viral pathogen in solid organ transplant (SOT) recipients. The role of secondary CMV prophylaxis in this population remains unclear.

Methods

Retrospective cohort study in a single center. SOT recipients treated for CMV infection from 2007 to 2014 were studied to determine the efficacy and safety of secondary prophylaxis and its impact on graft loss and mortality. The outcome variable was CMV replication in the first 3 months after the end of therapy. Secondary variables were crude mortality and graft lost censored at 5 years after transplantation. Propensity score for the use of secondary prophylaxis was used to control selection bias.

Results

Of the 126 treated patients, 103 (83.1%) received CMV secondary prophylaxis. CMV relapse occurred in 44 (35.5%) patients. The use of secondary prophylaxis was not associated with fewer relapses (34.0% in patients with prophylaxis vs 42.9% in those without prophylaxis, P = .29). After a mean follow‐up of 32.1 months, graft loss was not different between both groups but patient mortality was significantly lower in patients who received secondary prophylaxis (5.8% vs 28.6%, P = .003).

Conclusion

Secondary prophylaxis did not prevent CMV infection relapse but it was associated with improved patient survival.