bluuebunny/crossref_metadata_2025 huggingface dataset:
Double‐blind placebo‐controlled challenge showed that peanut oral immunotherapy was effective for severe allergy without negative effects on airway inflammation
Authors: Kukkonen Anna Kaarina , Uotila Riikka , Malmberg Leo Pekka , Pelkonen Anna Susanna , Mäkelä Mika Juhani
Published: November 2016

Aim

This study examined the efficacy and the safety of peanut oral immunotherapy (OIT).

Methods

We recruited 60 patients aged six years to 18 years who had a moderate‐to‐severe reaction to a double‐blind placebo‐controlled peanut challenge: 39 received OIT during an eight‐month build‐up phase and maintenance phase and 21 controls avoided peanuts. We measured specific immunoglobulin E and G4 (IgE and IgG4) to peanuts and to Ara h 1, 2, 3, 8 and 9 and monitored adverse events, bronchial hyper‐responsiveness (BHR) to methacholine and fractional concentrations of exhaled nitric oxide (FeNO). The median follow‐up period was 30 months.

Results

Most (85%) of the OIT patients passed the build‐up phase and 67% tolerated 5 g of peanuts during the post‐treatment challenge. No controls were desensitised, with a risk ratio of 29 and 95% confidence interval of 1.9–455. During OIT, IgE to peanut, Ara h 1, 2 and 3 decreased and IgG4 increased. Consuming peanuts had no harmful effects on BHR or FeNO. The annual incidence rate of emergency visits during the follow‐up period was 11% or 3.0 per 10 000 patient‐days.

Conclusion

Peanut OIT was efficacious in severe allergies without negative effects on airway inflammation, but unpredictable long‐term reactions might occur.
NS5ABP37 inhibits liver cancer by impeding lipogenesis and cholesterogenesis
Authors: Feng Shenghu , Han Ming , Zhou Li , Wang Qi , Li Zhongshu , Li Yaru , Lu Hongping , Liu Ting , Ma Yanhua , Liu Shunai , Cheng Jun
Published: November 2016

The molecular mechanism underlying non‐alcoholic fatty liver disease progression to hepatocellular carcinoma (HCC) remains unknown. In this study, immunohistochemistry staining results showed that NS5ABP37 protein, which is in a state of lower expression in tumor tissues, decreased with increasing degree of HCC malignancy. Two cell models, HepG2 and L02, were used to analyze the mechanism between NS5ABP37 and HCC. In agreement, NS5ABP37 protein overexpression significantly suppressed cell proliferation, caused G1/S cell cycle arrest, and induced apoptosis by increasing caspase‐3/7 activity and cleaved caspase‐3 levels. In addition, NS5ABP37 overexpression resulted in decreased intracellular triglyceride and total cholesterol contents, with level reduction in sterol regulatory element‐binding proteins (SREBPs) and downstream effectors. Furthermore, NS5ABP37 overexpression decreased SREBP1c and SREBP2 levels by reducing their respective promoters. Finally, reactive oxygen species levels and endoplasmic reticulum stress were both induced by NS5ABP37 overexpression. These findings together indicate that NS5ABP37 inhibits cancer cell proliferation and promotes apoptosis, by altering SREBP‐dependent lipogenesis and cholesterogenesis in HepG2 and L02 cells and inducing oxidative stress and endoplasmic reticulum stress.
1H‐1,2,3‐triazole‐tethered uracil‐ferrocene and uracil‐ferrocenylchalcone conjugates: Synthesis and antitubercular evaluation
Authors: Singh Amandeep , Biot Christophe , Viljoen Albertus , Dupont Christian , Kremer Laurent , Kumar Kewal , Kumar Vipan
Published: November 2016

Copper‐catalyzed azide‐alkyne [3 + 2] cycloaddition has been utilized for preparing a series of 1H‐1,2,3‐triazoles with the purpose of probing structure–activity relationships among a uracil‐ferrocene‐triazole conjugate family. The antitubercular evaluation studies revealed an improvement in activity with the introduction of a ferrocene nucleus among N‐alkylazido‐uracil precursors, with a preference for a bromo‐substituent along with moderate chain lengths of n = 2–6. The reported protocol is a successful approach for integrating uracil‐ferrocene‐chalcone functionalities tethered via 1H‐1,2,3‐triazole rings with apparent physicochemical stability.
Characteristics and outcome of surgically treated pituitary tumours in South Africa: a single‐centre experience
Authors: Elmezughi Khaled K. , Pirie Fraser J. , Motala Ayesha A.
Published: November 2016

Aims

To describe the clinical, biochemical, radiological and histological features and to determine the outcome of all patients with pituitary tumours treated surgically at Inkosi Albert Luthuli Central Hospital (ILACH) in Durban over a 5‐year period.

Research design

Retrospective chart review from 2008 to 2012. Clinical, biochemical and radiological data were collected before and 1 year after surgery. Histopathology findings and perioperative complications were recorded.

Results

Seventy patients were included (age 44·8 ± 14·9 years, 55·7% female). Headache (84·1%) and visual disturbances (78·3%) were the predominant presenting symptoms (84·1% and 78·3%). Most tumours were macroadenomas (97·1%). Trans‐sphenoidal surgery was employed in the majority (90%). A single procedure was required in 55·7% patients, two procedures in 30% and up to six in others. Complete resection was achieved in only nine patients (12·8%), residual tumour postsurgery was found in 48 (68·6%), and no change in tumour size was found in 13 (18·6%) patients. Additional medical therapy was used in 22 (31·4%) and radiotherapy in 13 (18·6%). On biopsy, the most common pathology was nonfunctional adenoma in 33 (47·1%); 29 (41·4%) were secretory tumours, and 8 (11·4%) were craniopharyngiomas. Overall mortality was 4·3%. The commonest surgical complication was cerebrospinal fluid (CSF) leak (10%; n = 7). New postsurgical pituitary hypofunction occurred in 50 (71·4%) patients. The outcome at 1 year was similar to that on discharge.

Conclusions

Patients presenting to IALCH had large tumours, and complete resection was achieved in a minority. There was a low overall mortality but high rate of postsurgical pituitary hypofunction.
What makes foster carers think about quitting? Recommendations for improved retention of foster carers
Authors: Randle Melanie , Ernst Dominik , Leisch Friedrich , Dolnicar Sara
Published: November 2016

Ideation, or the formulation of ideas pertaining to a particular topic, is the precursor to individuals making significant life decisions. Many individuals think about foster caring long before they actually become carers, and it stands to reason that in many cases, carer discontinuation also follows a period of ideation. This being the case, it is possible that by monitoring ideation, interventions could be introduced to prevent placement disruptions occurring, particularly if the sources of dissatisfaction are known. Using a sample of 205 foster carers, a posteriori segmentation analysis identifies groups of carers dissatisfied with the same aspects of their role. One group is particularly dissatisfied with factors that are within the control of foster care agencies and also reports high levels of discontinuation ideation. Recommendations include that the individual support needs of carers be identified such that customized support can be offered, including boosting initial and ongoing training to manage expectations and ensure carers feel prepared for the role. Results also highlight the important role of caseworkers in making carers feel appreciated and taken seriously.
Role of honey after tonsillectomy: a systematic review and meta‐analysis of randomised controlled trials
Authors: Lal A. , Chohan K. , Chohan A. , Chakravarti A.
Published: November 2016

Background

Honey reduced post‐tonsillectomy pain, but its effects on awakening at night, inflammation and healing of the tonsillar fossa were controversial.

Objectives

This systematic review and meta‐analysis of randomised controlled trials (RCTs) evaluated the effect of oral honey on pain, consumption of painkillers, awakening at night, healing of tonsillar fossa and adverse effects in children after tonsillectomy.

Methods

A search of MEDLINE, EMBASE, Scopus, CINAHL and Cochrane Collaboration Library databases was performed without any restriction of publication year. The end date of search was 30 June 2016. The search was supplemented by search from Google, hand search of cross‐references of selected articles and reviews, and contacting the authors of different studies. The inclusion criteria were RCTs comparing the effect of honey with control on different outcomes, in children after tonsillectomy.

Results

Our search generated 64 studies, and eight RCTs met our inclusion criteria. The methodological quality of RCTs was poor. Compared to control, honey significantly decreased postoperative pain from day 1 to day 7 (P = 0.05 to <0.0001); consumption of painkillers from days 1 to 5 (P = 0.03 to 0.003) and on day 10 (P = 0.002); and number of awakening at night due to pain on days 2 and 4 after tonsillectomy (P = 0.0001, 0.004). The healing of tonsillar fossa was significantly greater with honey compared to control on days 3–4 (P = 0.02) and days ≥9 (P = 0.01) after tonsillectomy. The adverse effects were not significantly different between honey and control groups. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) of the evidence for different outcomes varied from ‘low’ to ‘very low’.

Conclusions

Honey improved pain, requirement of painkillers and awakening at night due to pain in children after tonsillectomy. There was little improvement in healing of tonsillar fossa. The GRADE of the evidence varied from ‘low’ to ‘very low’. A good‐quality, placebo‐controlled RCT of different doses and durations of administration of honey is required to evaluate its clear efficacy and safety in children after tonsillectomy.
Long‐term mortality after acute myocardial infarction among individuals with and without diabetes: A systematic review and meta‐analysis of studies in the post‐reperfusion era
Authors: Gholap Nitin N. , Achana Felix A. , Davies Melanie J. , Ray Kausik K. , Gray Laura , Khunti Kamlesh
Published: November 2016

Aims

To conduct a systematic review and meta‐analysis with the aim of providing robust estimates of the association between diabetes and long‐term (≥1 year) mortality after acute myocardial infarction (AMI).

Material and methods

Medline, Embase and Web of Science databases were searched (January 1985 to July 2016) for terms related to long‐term mortality, diabetes and AMI. Two authors independently abstracted the data. Hazard ratios (HRs) comparing mortality in people with and without diabetes were pooled across studies using Bayesian random‐effects meta‐analysis.

Results

A total of 10 randomized controlled trials and 56 cohort studies, including 714 780 patients, reported an estimated total of 202 411 deaths over the median (range) follow‐up of 2.0 (1‐20) years. The risk of death over time was significantly higher among those with diabetes compared with those without (unadjusted HR 1.82, 95% credible interval [CrI] 1.73‐1.91). Mortality remained higher in the analysis restricted to 23/64 cohorts reporting data adjusted for confounders (adjusted HR 1.48, 95% CrI 1.43‐1.53). The excess long‐term mortality in diabetes was evident irrespective of the phenotype and modern treatment of AMI, and persisted in early survivors (unadjusted HR 1.82, 95% CrI 1.70‐1.95).

Conclusions

Despite medical advances, individuals with diabetes have a 50% greater long‐term mortality compared with those without. Further research to understand the determinants of this excess risk are important for public health, given the predicted rise in global diabetes prevalence.
High‐density lipoprotein‐associated sphingosine‐1‐phosphate activity in heterozygous familial hypercholesterolaemia
Authors: Frias Miguel A. , Thomas Aurélien , Brulhart‐Meynet Marie‐Claude , Kövamees Oskar , Pernow John , Eriksson Mats , Angelin Bo , James Richard W. , Brinck Jonas W.
Published: November 2016

Background

Patients with heterozygous familial hypercholesterolaemia (FH) suffer from high plasma cholesterol and an environment of increased oxidative stress. We examined its potential effects on high‐density lipoprotein (HDL)‐associated sphingosine‐1‐phosphate (S1P) content (HDL‐S1P) and HDL‐mediated protection against oxidative stress, both with and without statin treatment.

Materials and methods

In a case–control study, HDL was isolated from 12 FH patients with and without statin treatment and from 12 healthy controls. The HDL‐S1P content and the capacity of HDL to protect cardiomyocytes against oxidative stress in vitro were measured.

Results

HDL‐associated S1P was significantly correlated with cell protection, but not with HDL‐cholesterol or apolipoprotein AI. The latter did not correlate with HDL‐mediated cell protection. Neither the HDL‐S1P content nor HDL protective capacity differed between nontreated FH patients and controls. The relative amounts of apolipoprotein AI and apolipoprotein M were similar between controls and FH patients. Statin treatment had no effect on any of these measures.

Conclusions

The FH environment is not detrimental to HDL‐S1P content or HDL‐S1P‐mediated cell protection. Statin treatment does not modulate HDL function in this regard.
Memory under stress: from single systems to network changes
Authors: Schwabe Lars
Published: November 2016

Stressful events have profound effects on learning and memory. These effects are mainly mediated by catecholamines and glucocorticoid hormones released from the adrenals during stressful encounters. It has been known for long that both catecholamines and glucocorticoids influence the functioning of the hippocampus, a critical hub for episodic memory. However, areas implicated in other forms of memory, such as the insula or the dorsal striatum, can be affected by stress as well. Beyond changes in single memory systems, acute stress triggers the reconfiguration of large scale neural networks which sets the stage for a shift from thoughtful, ‘cognitive’ control of learning and memory toward more reflexive, ‘habitual’ processes. Stress‐related alterations in amygdala connectivity with the hippocampus, dorsal striatum, and prefrontal cortex seem to play a key role in this shift. The bias toward systems proficient in threat processing and the implementation of well‐established routines may facilitate coping with an acute stressor. Overreliance on these reflexive systems or the inability to shift flexibly between them, however, may represent a risk factor for psychopathology in the long‐run.
Cerebral small vessel disease, medial temporal lobe atrophy and cognitive status in patients with ischaemic stroke and transient ischaemic attack
Authors: Arba F. , Quinn T. , Hankey G. J. , Ali M. , Lees K. R. , Inzitari D. ,   the VISTA Collaboration
Published: November 2016

Background and purpose

Small vessel disease (SVD) and Alzheimer's disease (AD) are two common causes of cognitive impairment and dementia, traditionally considered as distinct processes. The relationship between radiological features suggestive of AD and SVD was explored, and the association of each of these features with cognitive status at 1 year was investigated in patients with stroke or transient ischaemic attack.

Methods

Anonymized data were accessed from the Virtual International Stroke Trials Archive (VISTA). Medial temporal lobe atrophy (MTA; a marker of AD) and markers of SVD were rated using validated ordinal visual scales. Cognitive status was evaluated with the Mini Mental State Examination (MMSE) 1 year after the index stroke. Logistic regression models were used to investigate independent associations between (i) baseline SVD features and MTA and (ii) all baseline neuroimaging features and cognitive status 1 year post‐stroke.

Results

In all, 234 patients were included, mean (±SD) age 65.7 ± 13.1 years, 145 (62%) male. Moderate to severe MTA was present in 104 (44%) patients. SVD features were independently associated with MTA (P < 0.001). After adjusting for age, sex, disability after stroke, hypertension and diabetes mellitus, MTA was the only radiological feature independently associated with cognitive impairment, defined using thresholds of MMSE ≤ 26 (odds ratio 1.94; 95% confidence interval 1.28–2.94) and MMSE ≤ 23 (odds ratio 2.31; 95% confidence interval 1.48–3.62).

Conclusion

In patients with ischaemic cerebrovascular disease, SVD features are associated with MTA, which is a common finding in stroke survivors. SVD and AD type neurodegeneration coexist, but the AD marker MTA, rather than SVD markers, is associated with post‐stroke cognitive impairment.
Haemolytic anaemia and bilateral uveitis associated with leptospirosis in a 6‐year‐old Quarter Horse gelding
Authors: Delph K. M. , Sharpe E. , Beard L. A. , Rankin A. J.
Published: November 2016

A 6‐year‐old Quarter Horse gelding was presented for bilateral uveitis resulting in vision loss as well as icterus. Anaemia with autoagglutination was consistent with a presumptive immune‐mediated haemolytic anaemia. UrinaryPCRwas positive forLeptospiraspp. and microscopic agglutination test (MAT) titres were elevated to multiple serovars supportive of a diagnosis of leptospirosis. Treatments included broad spectrum antibiotics and aggressive anti‐inflammatory medications. While the horse was hospitalised, the development of bilateral corneal ulcers precluded the use of topical ophthalmic anti‐inflammatories for a number of days. The corneal ulceration resolved, vision returned in both eyes and the immune‐mediated haemolytic anaemia resolved. After 9 days of hospitalisation, oral minocycline was administered for 2 weeks at home as well as low dose oral flunixin meglumine and topical ophthalmic diclofenac and atropine. This case represents the first published case of haemolytic anaemia associated with leptospirosis in a horse.
Niche dynamics of Palaeolithic modern humans during the settlement of the Palaearctic
Authors: Giampoudakis Konstantinos , Marske Katharine A. , Borregaard Michael K. , Ugan Andrew , Singarayer Joy S. , Valdes Paul J. , Rahbek Carsten , Nogués‐Bravo David
Published: November 2016

Aim

During the Late Pleistocene (c. 126–10 ka), modern humans (Homo sapiens) expanded their geographical range across Eurasia and eventually colonized the Americas. Although the routes by which they migrated have been intensively analysed, the dynamics of their realized climatic niche are still largely unknown. We assess temporal changes in the climatic niche of modern humans, the geographical distribution of their climatic niche and whether niche dynamics correlate with the magnitude of climate change and cultural advances, between 46 and 11 ka.

Location

Palaearctic.

Methods

Using the radiocarbon dated archaeological record and spatial palaeoclimatic simulations, we quantify different parameters of the realized climatic niche of modern humans (niche overlap, niche breadth and climatic marginality) between consecutive 1000–2000 year intervals. Moreover, using climate envelope models, we map the potential distributions of modern humans for each time interval and identify the regions that remained more climatically suitable and stable for modern humans through time.

Results

Between 46 and 22 ka the climatic niche of modern humans expanded, including periods of intense growth in niche breadth at 40 and 30 ka. Changes in seasonal water availability and technological innovations partly correlate with dynamics in niche parameters. We document a persistent climatically suitable mid‐latitude belt in south Siberia linking western Europe to the Far East that may have facilitated human migration, and a potential climatic refugium in Beringia.

Main conclusions

The climatic niche of modern humans changed across the Late Pleistocene, as the result of both climatic and cultural changes. These populations of hunter‐gatherers occupied novel climatic conditions but also remained in previously occupied areas under changing climates during the settlement of the Palaearctic. Our approach can provide clues as to where early modern humans may have overlapped in geographical and environmental space with Neanderthals or Denisovans, as evidenced by their contribution to the genetic heritage of some current populations.
Influence of Competing Risks on Estimating the Expected Benefit of Warfarin in Individuals with Atrial Fibrillation Not Currently Taking Anticoagulants: The Anticoagulation and Risk Factors in Atrial Fibrillation Study
Authors: Ashburner Jeffrey M. , Go Alan S. , Chang Yuchiao , Fang Margaret C. , Fredman Lisa , Applebaum Katie M. , Singer Daniel E.
Published: November 2016

Objectives

To provide greater understanding of the “real world” effect of anticoagulation on stroke risk over several years.

Design

Cohort study.

Setting

Anticoagulation and Risk Factors in Atrial Fibrillation Study community‐based cohort.

Participants

Adults with nonvalvular atrial fibrillation (AF) between 1996 and 2003 (13,559).

Measurements

All events were clinician adjudicated. Extended Cox regression with longitudinal warfarin exposure was used to estimate cause‐specific hazard ratios (HRs) for thromboembolism and the competing risk event (all cause death). The Fine and Gray subdistribution regression approach was used to estimate this association while accounting for competing death events. As a secondary analysis, follow‐up was limited to 1, 3, and 5 years.

Results

The rate of death was much higher in the group not taking warfarin (8.1 deaths/100 person‐years (PY)) than in the group taking warfarin (5.5 deaths/100 PY). The cause‐specific HR indicated a large reduction in thromboembolism with warfarin use (adjusted HR = 0.57, 95% confidence interval (CI) = 0.50–0.65), although this association was substantially attenuated after accounting for competing death events (adjusted HR = 0.87, 95% CI = 0.77–0.99). In analyses limited to 1 year of follow‐up, with fewer competing death events, the results for models that did and did not account for competing risks were similar.

Conclusion

Analyses accounting for competing death events may provide a more‐realistic estimate of the longer‐term stroke prevention benefits of anticoagulants than traditional noncompeting risk analyses for individuals with AF, particularly those who are not currently treated with anticoagulants.
Sulfatide species with various fatty acid chains in oligodendrocytes at different developmental stages determined by imaging mass spectrometry
Authors: Hirahara Yukie , Wakabayashi Taketoshi , Mori Tetsuji , Koike Taro , Yao Ikuko , Tsuda Masayuki , Honke Koichi , Gotoh Hitoshi , Ono Katsuhiko , Yamada Hisao
Published: November 2016

HSO3‐3‐galactosylceramide (Sulfatide) species comprise the major glycosphingolipid components of oligodendrocytes and myelin and play functional roles in the regulation of oligodendrocyte maturation and myelin formation. Although various sulfatide species contain different fatty acids, it is unclear how these sulfatide species affect oligodendrogenesis and myelination. The O4 monoclonal antibody reaction with sulfatide has been widely used as a useful marker for oligodendrocytes and myelin. However, sulfatide synthesis during the pro‐oligodendroblast stage, where differentiation into the oligodendrocyte lineage has already occurred, has not been examined. Notably, this stage comprises O4‐positive cells. In this study, we identified a sulfatide species from the pro‐oligodendroblast‐to‐myelination stage by imaging mass spectrometry. The results demonstrated that short‐chain sulfatides with 16 carbon non‐hydroxylated fatty acids (C16) and 18 carbon non‐hydroxylated fatty acids (C18) or 18 carbon hydroxylated fatty acids (C18‐OH) existed in restricted regions of the early embryonic spinal cord, where pro‐oligodendroblasts initially appear, and co‐localized with Olig2‐positive pro‐oligodendroblasts. C18 and C18‐OH sulfatides also existed in isolated pro‐oligodendroblasts. C22‐OH sulfatide became predominant later in oligodendrocyte development and the longer C24 sulfatide was predominant in the adult brain. Additionally, the presence of each sulfatide species in a different area of the adult brain was demonstrated by imaging mass spectrometry at an increased lateral resolution. These findings indicated that O4 recognized sulfatides with short‐chain fatty acids in pro‐oligodendroblasts. Moreover, the fatty acid chain of the sulfatide became longer as the oligodendrocyte matured. Therefore, individual sulfatide species may have unique roles in oligodendrocyte maturation and myelination.

image

Read the Editorial Highlight for this article on page 356.
Can follow‐up phone calls improve patients self‐monitoring of blood glucose?
Authors: Brown‐Deacon Cheryl , Brown Terri , Creech Constance , McFarland Marilyn , Nair Anupama , Whitlow Kevin
Published: November 2016

Aims and objectives

To evaluate the effectiveness of follow‐up phone calls in improving frequency of glucose monitoring over a three month period in two groups of patients with type 2 diabetes with the goal to lower haemoglobin A1C.

Background

Telephone intervention has been successfully used in improving adherence to diabetes self‐management and other chronic disease conditions.

Design

A quality improvement study.

Methods

Forty one Type 2 diabetic patients with HA1C ≥7·5% were included in the study. The patients were assigned to two groups. The first group of patients received standard diabetic care (Group 1) and the second group of patients (Group 2) received standard diabetic care plus follow‐up phone calls within two weeks after a monthly clinic visit over a three month period. A haemoglobin A1C if indicated was done at the initial study visit.

Results

There were no statistically significant differences in the baseline haemoglobin A1C between the two groups or the three month haemoglobin A1C of the two groups. There were no statistically significant differences in mean haemoglobin A1C change between Group 1 and Group 2. The analysis revealed that there were no statistically significant differences between groups in the number of patients who kept logs of their blood glucose readings throughout the study.

Conclusion

The intervention using telephone follow‐up calls did not show a statistically significant improvement in overall HA1C, but there was a clinically significant change in HA1C in the group of patients that received follow‐up phone calls.

Relevance to clinical practice

The clinical significance of the change in A1C in the follow‐up phone call group (Group 2) supports that frequent contact by telephone may likely improve adherence to diabetes self‐management.
Impact of Diabetes Mellitus on Intravascular Ultrasound‐Guided Provisional Stenting in Coronary Bifurcation Lesions J‐REVERSE Sub‐Study
Authors: Yamawaki Masahiro , Terashita Daisuke , Takahashi Hachidai , Shinke Toshiro , Fujii Kenichi , Shimada Yoshihisa , Takeda Yoshihiro , Yamada Shinichiro , Kinoshita Yoshihisa , Murasato Yoshinobu ,   on behalf of J‐REVERSE Investigators
Published: November 2016

Objective

To investigate the impact of diabetes mellitus (DM) on provisional coronary bifurcation stenting under the complete guidance of intravascular‐ultrasound (IVUS).

Background

The efficacy of such intervention has not yet been fully elucidated in the DM patients.

Methods

A total of 100 DM and 139 non‐DM patients in a prospective multi‐center registry of IVUS‐guided bifurcation stenting were compared in angiographic results at 9 months. Vessel and luminal changes during the intervention were analyzed using the IVUS. Vascular healing at the follow‐up was also investigated in 23 lesions in each group using optical coherence tomography (OCT).

Results

No difference was detected regarding baseline reference vessel diameter and minimum lumen diameter in proximal main vessel (MV), distal MV, and side branch (SB). The rate of everolimus‐eluting stent use (78.4% vs. 78.3%), final kissing inflation (60.1% vs. 49.0%), and conversion to 2‐stent strategy (2.9% vs. 2.8%) were also similar. In the DM group, late loss was greater in proximal MV (DM 0.23 ± 0.29 vs. non‐DM 0.16 ± 0.24 mm, P < 0.05) and SB (0.04 ± 0.49 vs. −0.08 ± 0.35 mm, P < 0.05). Smaller vessel area restricted stent expansion in the proximal MV (6.18 ± 1.67 vs. 6.72 ± 2.07 mm2, P < 0.05). More inhomogeneous neointimal coverage (unevenness score, 1.90 ± 0.33 vs. 1.72 ± 0.29, P < 0.05) and more frequent thrombus attachment (26% vs. 4%, P < 0.05) were documented in the proximal MV at 9‐month follow‐up OCT.

Conclusions

Despite IVUS optimization for coronary bifurcation, DM is potentially associated with smaller luminal gain, higher late‐loss, and inhomogeneous vascular healing with frequent thrombus attachment in the proximal MV.
Teen Childbearing and Depression: Do Pregnancy Attitudes Matter?
Authors: Whitworth Tanya Rouleau
Published: November 2016

The relationship between teen childbearing and depression has been extensively studied; however, little is known about how young women's own attitudes toward becoming pregnant shape this association. This study used data from the National Longitudinal Study of Adolescent Health to investigate whether the relationship between teen childbearing and adult depression is moderated by adolescent attitudes toward becoming pregnant. The results showed that although, on average, women who had first births between ages 16 and 19 experienced no more depressive symptoms in adulthood than women who had first births at age 20 or older, the relationship between teen childbearing and adult depression varied significantly based on adolescent pregnancy attitudes. When they had negative adolescent attitudes toward getting pregnant, teen mothers had similar levels of depression as adult mothers, but when they had positive adolescent pregnancy attitudes, teen mothers actually had fewer depressive symptoms than women with adult first births.
Transorbital Sonography and Visual Outcome for the Diagnosis and Monitoring of Optic Neuritis
Authors: Lochner Piergiorgio , Leone Maurizio A. , Fassbender Klaus , Cantello Roberto , Coppo Lorenzo , Nardone Raffaele , Zorzi Gianni , Lesmeister Martin , Comi Cristoforo , Brigo Francesco
Published: November 2016

BACKGROUND AND PURPOSE

Transorbital sonography (TOS) is a promising tool to support the clinical diagnosis of optic neuritis (ON) by showing thickening of optic nerve. In this study, we aimed to define its specific role in follow‐up of ON patients.

METHODS

We measured ultrasonography parameters and visual acuity (VA) at presentation and after 1 year in 45 patients with newly diagnosed ON. Two vascular sonographers used B‐mode TOS to evaluate mean optic nerve diameter (OND) and optic nerve sheath diameter (ONSD).

RESULTS

Median ONSD values were significantly thicker in patients with ON in the affected eye (6.4 mm, interquartile range [IQR]: 6.0‐6.9) at presentation compared with the nonaffected side (5.7 mm; IQR: 5.2‐6.1) (P < .001). The median OND was not significantly thicker at presentation in the affected eye (3.0 mm; IQR: 2.9‐3.4) compared with the fellow eye (2.9 mm; IQR: 2.8‐3.2) (P = .09). Logarithmic VA was significantly compromised at presentation in the affected eye (.16; IQR: .00–.55) compared with fellow eye (.00; IQR: .00–.00) (P < .001). After 1 year, no significant difference (P ≥ .05) was found between ONSD or OND of the affected side compared with the nonaffected side. VA improved in most of the patients but remained significantly impaired in affected eye after 1 year.

CONCLUSIONS

TOS is a useful tool to support diagnosis of ON. This technique seems to have less value to evaluate atrophy of the optic nerve after 12 months.
Prognostic factors of single‐visit endodontic and restorative treatment under general anaesthesia for special needs patients
Authors: Chang J. , Kim H.‐Y.
Published: November 2016

The aim of this study was to evaluate the longevity of teeth with single‐visit endodontic and restorative treatment under general anaesthesia (GA) for special needs patients and to investigate factors associated with survival and success. Data were collected from 381 teeth in 203 patients [mean (s.d.) age = 27·0 (14·1)]. All endodontic and restorative procedures were performed during a single GA session except for cementation of crowns in the cases requiring crown restoration (38%). A total of 267 teeth (70·6%) were followed‐up for 6–81 months [mean (s.d.): 32·7 (20·0)]. Patients and teeth with and without follow‐up were compared. Kaplan–Meier analysis with generalised Wilcoxon test was used to compare the mean survival and success period. Cox proportion hazard regression model was applied for multivariate analysis. At the end of the observation period, 10 teeth had a crown fracture (5‐year survival rate = 89·8%), and an additional 10 teeth had primary or secondary caries (5‐year success rate = 86·4%). Risk factors associated with survival were age (>40), non‐parental caregiver, cooperation level and periodontal disease. A soft diet was an additional risk factor against the success of teeth. Single‐visit endodontic and restorative treatment under GA showed favourable outcomes, suggesting a promising treatment option for special needs patients. Patient‐ and dental‐specific circumstances need to be carefully considered to enhance the longevity of reconstructed teeth.
Effects of heat treatment on protein feeds evaluatedin vitroby the method of estimating utilisable crude protein at the duodenum
Authors: Vaga M. , Hetta M. , Huhtanen P.
Published: November 2016

The effect of heat treatment on the protein value of field beans, lupins and peas was studied using anin vitromethod. Protein feeds were subjected to heat treatment for 30, 60 and 90 min in forced air oven at 120, 140 and 160 °C and in autoclave at 105, 120 and 135 °C. The heat‐treated protein feeds were incubated in buffered rumen fluid together with grass silage and barley in complete isonitrogenous diets. The gas production (GP) was recorded continuously, and ammonia‐N (NH3‐N) concentrations were determined during thein vitroincubation at 8, 24 and 48 h and used to determine the utilisable crude protein (uCP) at the duodenum at 16 h of incubation (uCP16). Heat treatments decreased the concentration of soluble crude protein and increased neutral detergent insolubleCP(NDICP) in all protein feeds compared to untreated. Inclusion of protein feeds to basal diet showed no increase in theuCP16in untreated field bean diet and only a small numerical increase in theuCP16concentrations from 160 g/kg dry matter (DM) to 166 and 172 g/kgDMin untreated lupine and pea diets, respectively, indicating high degradability of untreated feeds. Increasing the time and temperature of the heat treatment linearly increased theuCP16concentrations in field bean and pea diets, but not in lupin diets. Autoclave treatment was more effective in decreasinguCP16than oven treatment despite the lower temperatures used. However, the combination of highest temperatures and treatment time in autoclave increased acid detergent insolubleCP(ADICP) concentrations in protein feeds, indicating protein damage and decreased intestinal digestibility. Determiningin vitrouCPandADICPshows to be a promising method for evaluating protein value in heat‐treated animal feeds.
Usefulness of albumin‐bilirubin grade for evaluation of long‐term prognosis for hepatitis B‐related cirrhosis
Authors: Chen R.‐C. , Cai Y.‐J. , Wu J.‐M. , Wang X.‐D. , Song M. , Wang Y.‐Q. , Zheng M.‐H. , Chen Y.‐P. , Lin Z. , Shi K. Q.
Published: November 2016

Long‐term prognosis varies widely among patients with hepatitis B virus (HBV)‐related liver cirrhosis. Our study aimed to investigate the applicability of albumin‐bilirubin (ALBI), Child‐Pugh and model for end‐stage liver disease (MELD) scores to the long‐term prognosis prediction of HBV‐related cirrhosis. Patients diagnosed with HBV‐associated cirrhosis from the First Affiliated Hospital of Wenzhou Medical University between January 2010 and December 2015 were enrolled in this study. The patients were followed up every 3 months. The prognostic performance of ALBI in long‐term outcome prediction for HBV‐related cirrhosis was compared with Child‐Pugh and MELD scores using time‐dependent receiver operating characteristic curve (tdROC) and decision curve analysis. A total of 806 patients were included in our study with 275 (34.1%) deceased during the follow‐up. Multivariate Cox regression analysis showed that ALBI grade was an independent predictor associated with mortality. The tdROC analysis showed that ALBI score (0.787, 0.830 and 0.833) was superior to MELD (0.693, P=.003; 0.717, P<.001; 0.744, P<.001) and Child‐Pugh score (0.641, P<.001; 0.649, P<.001; 0.657, P<.001) for predicting 1‐year, 2‐year and 3‐year mortality. Additionally, decision curves also got the similar results. In addition, patients with lower ALBI score had a longer life expectancy, even among patients within the same Child‐Pugh class. Thus, ALBI score was effective in predicting the long‐term prognosis for patients with HBV‐related cirrhosis and more accurate than Child‐Pugh and MELD scores.
Large‐scale, multidirectional larval connectivity among coral reef fish populations in the Great Barrier Reef Marine Park
Authors: Williamson David H. , Harrison Hugo B. , Almany Glenn R. , Berumen Michael L. , Bode Michael , Bonin Mary C. , Choukroun Severine , Doherty Peter J. , Frisch Ashley J. , Saenz‐Agudelo Pablo , Jones Geoffrey P.
Published: November 2016

Larval dispersal is the key process by which populations of most marine fishes and invertebrates are connected and replenished. Advances in larval tagging and genetics have enhanced our capacity to track larval dispersal, assess scales of population connectivity, and quantify larval exchange among no‐take marine reserves and fished areas. Recent studies have found that reserves can be a significant source of recruits for populations up to 40 km away, but the scale and direction of larval connectivity across larger seascapes remain unknown. Here, we apply genetic parentage analysis to investigate larval dispersal patterns for two exploited coral reef groupers (Plectropomus maculatus and Plectropomus leopardus) within and among three clusters of reefs separated by 60–220 km within the Great Barrier Reef Marine Park, Australia. A total of 69 juvenile P. maculatus and 17 juvenile P. leopardus (representing 6% and 9% of the total juveniles sampled, respectively) were genetically assigned to parent individuals on reefs within the study area. We identified both short‐distance larval dispersal within regions (200 m to 50 km) and long‐distance, multidirectional dispersal of up to ~250 km among regions. Dispersal strength declined significantly with distance, with best‐fit dispersal kernels estimating median dispersal distances of ~110 km for P. maculatus and ~190 km for P. leopardus. Larval exchange among reefs demonstrates that established reserves form a highly connected network and contribute larvae for the replenishment of fished reefs at multiple spatial scales. Our findings highlight the potential for long‐distance dispersal in an important group of reef fishes, and provide further evidence that effectively protected reserves can yield recruitment and sustainability benefits for exploited fish populations.
Genetic structure of native ant supercolonies varies in space and time
Authors: Schultner Eva , Saramäki Jari , Helanterä Heikki
Published: November 2016

Ant supercolonies are the largest cooperative units known in nature. They consist of networks of interconnected nests with hundreds of reproductive queens, where individuals move freely between nests, cooperate across nest boundaries and show little aggression towards non‐nestmates. The combination of high queen numbers and free mixing of workers, queens and brood between nests results in extremely low nestmate relatedness. In such low‐relatedness societies, cooperative worker behaviour appears maladaptive because it may aid random individuals instead of relatives. Here, we provide a comprehensive picture of genetic substructure in supercolonies of the native wood antFormica aquiloniausing traditional population genetic as well as network analysis methods. Specifically, we test for spatial and temporal variation in genetic structure of different classes of individuals within supercolonies and analyse the role of worker movement in determining supercolony genetic networks. We find that relatedness within supercolonies is low but positive when viewed on a population level, which may be due to limited dispersal of individuals and/or ecological factors such as nest site limitation and competition against conspecifics. Genetic structure of supercolonies varied with both sample class and sampling time point, which indicates that mobility of individuals varies according to both caste and season and suggests that generalizing has to be carried out with caution in studies of supercolonial species. Overall, our analysis provides novel evidence that native wood ant supercolonies exhibit fine‐scale genetic substructure, which may explain the maintenance of cooperation in these low‐relatedness societies.
Genome biogeography reveals the intraspecific spread of adaptive mutations for a complex trait
Authors: Olofsson Jill K. , Bianconi Matheus , Besnard Guillaume , Dunning Luke T. , Lundgren Marjorie R. , Holota Helene , Vorontsova Maria S. , Hidalgo Oriane , Leitch Ilia J. , Nosil Patrik , Osborne Colin P. , Christin Pascal‐Antoine
Published: November 2016

Physiological novelties are often studied at macro‐evolutionary scales such that their micro‐evolutionary origins remain poorly understood. Here, we test the hypothesis that key components of a complex trait can evolve in isolation and later be combined by gene flow. We use C4 photosynthesis as a study system, a derived physiology that increases plant productivity in warm, dry conditions. The grass Alloteropsis semialata includes C4 and non‐C4 genotypes, with some populations using laterally acquired C4‐adaptive loci, providing an outstanding system to track the spread of novel adaptive mutations. Using genome data from C4 and non‐C4 A. semialata individuals spanning the species’ range, we infer and date past migrations of different parts of the genome. Our results show that photosynthetic types initially diverged in isolated populations, where key C4 components were acquired. However, rare but recurrent subsequent gene flow allowed the spread of adaptive loci across genetic pools. Indeed, laterally acquired genes for key C4 functions were rapidly passed between populations with otherwise distinct genomic backgrounds. Thus, our intraspecific study of C4‐related genomic variation indicates that components of adaptive traits can evolve separately and later be combined through secondary gene flow, leading to the assembly and optimization of evolutionary innovations.
Expression in grasses of multiple transgenes for degradation of munitions compounds on live‐fire training ranges
Authors: Zhang Long , Routsong Ryan , Nguyen Quyen , Rylott Elizabeth L. , Bruce Neil C. , Strand Stuart E.
Published: November 2016

The deposition of toxic munitions compounds, such as hexahydro‐1, 3, 5‐trinitro‐1, 3, 5‐triazine (RDX), on soils around targets in live‐fire training ranges is an important source of groundwater contamination. Plants take up RDX but do not significantly degrade it. Reported here is the transformation of two perennial grass species, switchgrass (Panicum virgatum) and creeping bentgrass (Agrostis stolonifera), with the genes for degradation of RDX. These species possess a number of agronomic traits making them well equipped for the uptake and removal of RDX from root zone leachates. Transformation vectors were constructed with xplA and xplB, which confer the ability to degrade RDX, and nfsI, which encodes a nitroreductase for the detoxification of the co‐contaminating explosive 2, 4, 6‐trinitrotoluene (TNT). The vectors were transformed into the grass species using Agrobacterium tumefaciens infection. All transformed grass lines showing high transgene expression levels removed significantly more RDX from hydroponic solutions and retained significantly less RDX in their leaf tissues than wild‐type plants. Soil columns planted with the best‐performing switchgrass line were able to prevent leaching of RDX through a 0.5‐m root zone. These plants represent a promising plant biotechnology to sustainably remove RDX from training range soil, thus preventing contamination of groundwater.
Significant enhancement of fatty acid composition in seeds of the allohexaploid, Camelina sativa, using CRISPR/Cas9 gene editing
Authors: Jiang Wen Zhi , Henry Isabelle M. , Lynagh Peter G. , Comai Luca , Cahoon Edgar B. , Weeks Donald P.
Published: November 2016

The CRISPR/Cas9 nuclease system is a powerful and flexible tool for genome editing, and novel applications of this system are being developed rapidly. Here, we used CRISPR/Cas9 to target the FAD2 gene in Arabidopsis thaliana and in the closely related emerging oil seed plant, Camelina sativa, with the goal of improving seed oil composition. We successfully obtained Camelina seeds in which oleic acid content was increased from 16% to over 50% of the fatty acid composition. These increases were associated with significant decreases in the less desirable polyunsaturated fatty acids, linoleic acid (i.e. a decrease from ~16% to <4%) and linolenic acid (a decrease from ~35% to <10%). These changes result in oils that are superior on multiple levels: they are healthier, more oxidatively stable and better suited for production of certain commercial chemicals, including biofuels. As expected, A. thaliana T2 and T3 generation seeds exhibiting these types of altered fatty acid profiles were homozygous for disrupted FAD2 alleles. In the allohexaploid, Camelina, guide RNAs were designed that simultaneously targeted all three homoeologous FAD2 genes. This strategy that significantly enhanced oil composition in T3 and T4 generation Camelina seeds was associated with a combination of germ‐line mutations and somatic cell mutations in FAD2 genes in each of the three Camelina subgenomes.
Neonatal outcomes in a level II regional neonatal intensive care unit
Authors: Umran Raid MR , Al‐Jammali Asjad
Published: November 2016

Background

Improvement of neonatal mortality is a challenge in developing countries such as Iraq due to increased demand and overload of maternity services. The aim of this study was to document the number, disease patterns and outcome of admitted newborns and the improvement after implementation of clinical protocols, and to identify possible future target measures.

Method

A descriptive study was conducted at the neonatal intensive care unit (NICU) of a regional hospital from 2011 to 2013. Of 72 320 deliveries, 4694 newborns were admitted and met selection criteria. Clinical guidelines, clinical skills training of nurses and resident doctors, and improvement of medical records were implemented during the study period. All patient demographics, causes of admission/death and mortality were analyzed.

Results

From a total of 4694 admitted newborns; 42% were delivered vaginally, 60% were male, 43% were <2500 g, and 31% were premature. The neonatal deaths consisted of 1076 newborns, 84% of whom died before 7 days of age, and 39% of whom weighed ≤1500 g. Respiratory distress syndrome was the main cause of death (62.2%). Due to the increased total number of deliveries, and hence the corresponding increased number of vaginal deliveries (R = 0.97), the number of NICU admissions was significantly increased (R = 0.569, P = 0.009). Notably, the mortality rate was significantly decreased (R = −0.487, P = 0.004).

Conclusions

Maternity overload contributed to the high neonatal mortality, whereas implementation of clinical guidelines and of medical staff training improved neonatal outcomes. Future target interventions include optimized timing of cesarean section and the detection of potentially complicated deliveries.