bluuebunny/crossref_metadata_2025 huggingface dataset:
Metabolic syndrome mediates proinflammatory responses of inflammatory cells in preeclampsia
Authors: Jabalie Gisoo , Ahmadi Majid , Koushaeian Ladan , Eghbal‐Fard Shadi , Mehdizadeh Amir , Kamrani Amin , Abdollahi‐Fard Sedigheh , Farzadi Laya , Hojjat‐ Farsangi Mohammad , Nouri Mohammad , Yousefi Mehdi
Published: January 2019

Problem

To investigate whether metabolic syndrome (MetS) is associated with exacerbation of inflammatory responses in preeclamptic (PE) patients, the dynamic changes of Th17 and Treg cells, monocytes, cytokines, and transcription pattern of inflammasome‐related genes were analyzed in 35 women with PE suffering from MetS in comparison to 38 PE women without MetS and healthy pregnant women.

Method of study

Expression of inflammasome‐related genes, cytokines, and also TLR4 was measured using real‐time PCR. Serum and medium supernatant cytokines levels of PBMCs and serum levels of HMGB1 and Caspase‐1 were also evaluated by ELISA. Monocytes, Th17, and Treg cells frequency were also determined by flow cytometry.

Result

PE women with MetS exhibited increased percentage of non‐classical and intermediate monocytes and Th17 cells (P = 0.025). Furthermore, decreased Treg cells frequency was also observed in PE women with MetS compared to PE women (P = 0.019). The mRNA expression of inflammasome‐related genes (Caspase‐1, NLRP3, HMGB1), TLR4, IL‐1β, IL‐6, IL‐17, IL‐18, and TNF‐α was significantly higher in PE patients with MetS than that of the healthy pregnant individuals (P < 0.0001) and PE patients (P < 0.0001). Serum levels of TGF‐β and TNF‐α in PE patients with MetS were increased compared to other two groups, while IL‐10 levels were significantly reduced. A significant sFlt (P = 0.016), Caspase‐1 (P = 0.012), HMGB1 (P = 0.016) upregulation, and VEGF (P = 0.023) downregulation were also observed in the serum of PE women having MetS compared to PE women.

Conclusion

MetS is closely related to the exacerbation of inflammatory reactions in PE. This study indicates that, in order to diminish the systemic features of PE, prior to conceive and start a pregnancy, MetS should be severely considered and managed.
Insights of efferocytosis in normal and pathological pregnancy
Authors: Sheng Yan‐Ran , Hu Wen‐Ting , Wei Chun‐Yan , Tang Ling‐Li , Liu Yu‐Kai , Liu Yu‐Yin , Qiu Jian‐ping , Li Da‐Jin , Zhu Xiao‐Yong
Published: January 2019

Efferocytosis, which is known as the phagocytic clearance of dying cells by professional as well as non‐professional phagocytes, including a great number of intracellular/extracellular factors and signals, is interrelated with the immune system, contributing to local and systemic homeostasis, especially in tissues with high constitutive rates of apoptosis. Accumulating studies have indicated that immune dysregulation is associated with the pathogenesis of the female reproductive system, which causes preeclampsia (PE), recurrent spontaneous abortion (RSA), ruptured ectopic pregnancy, and so on. And some studies have revealed the pleiotropic and essential role of efferocytosis in these obstetrical disorders. More specifically, the occurrence and development of these diseases were in connection with some efferocytosis‐related factors and signals, such as C1q, MBL, and IL‐33/ST2. In this review, we systematically review the diverse impacts of efferocytosis in immune system and discuss its relevance to normal and pathological pregnancy. These findings may instruct future basic researches as well as clinical applications of efferocytosis‐related factors and signals as latent predictors or therapeutic targets on the obstetrical disorders.
Advances in cellular and humoral immunotherapy – implications for the treatment of poor risk childhood, adolescent, and young adult B‐cell non‐Hodgkin lymphoma
Authors: Chu Yaya , Gardenswartz Aliza , Termuhlen Amanda M. , Cairo Mitchell S.
Published: January 2019

Patients with relapsed, refractory or advanced stage B non‐Hodgkin lymphoma (NHL) continue to have a dismal prognosis. This review summarises current and novel cellular and immunotherapy for these high‐risk populations, including haematopoietic stem cell transplant, bispecific antibodies, viral‐derived cytotoxic T cells, chimeric antigen receptor (CAR) T cells, and natural killer (NK) cell therapy, as discussed at the 6th International Symposium on Childhood, Adolescent and Young Adult Non‐Hodgkin Lymphoma on September 26th–29th 2018 in Rotterdam, the Netherlands, and explores the future of NK/CAR NK therapies.
An evaluation of a motor vehicle facility campaign with an established statewide donor registry: A test of sustainable, evidence‐based intervention strategies
Authors: Quick Brian L. , King Andy J. , Reynolds‐Tylus Tobias , Moore Miriam
Published: January 2019

Increasing organ donor registration enrollment inside motor vehicle facilities (MVF) is a common approach in the United States. From this research, a formula for what works has emerged within the literature including the presence of an interpersonal component, video messages, and point‐of‐decision materials. These intervention components have demonstrated effectiveness at increasing registrations in relatively new statewide registries; however, their effectiveness in MVFs with a mature registry remains understudied. The current study examined the effectiveness of an online MVF clerk intervention and the other examined the effectiveness of a multi‐message, phase MVF intervention aimed at increasing organ donation registrations. The results revealed that MVF clerks garnered increased knowledge and greater comfort in communicating about organ donation with patrons after the intervention. Moreover, the intervention revealed that clerk talk effectiveness was positively associated with organ donation registration among MVF customers. Against expectations, recall of video messages was negatively associated with new registrations. Exposure to the brochure, counter mat, and poster donation messages was not associated with organ donation registration. An emphasis on the strengths and shortcomings of using MVFs as intervention sites for organ donation registration promotion are discussed.
The Functional Communication Classification System: extended reliability and concurrent validity for children with cerebral palsy aged 5 to 18 years
Authors: Caynes Katy , Rose Tanya A , Theodoros Deborah , Burmester Debbie , Ware Robert S , Johnston Leanne M
Published: January 2019

Aim

To examine psychometric properties and clinical utility of the Functional Communication Classification System (FCCS) for classifying observable communication function in children with cerebral palsy (CP) aged 5 to 18 years.

Method

Eighty‐two children (38 males, 44 females) with CP in six age groups (5y [n=15], 8y [n=14], 10y [n=14], 12y [n=14], 15y [n=11], and 17y [n=14]) were assessed by a speech‐language pathologist (SLP) and parent for FCCS ratings. Data were compared with: (1) everyday communication function, assessed using the Clinical Evaluation of Language Fundamentals – Fourth Edition Pragmatics Profile (CELF‐4 PP) for familiar and unfamiliar partners; (2) motor speech, gross and fine motor function; and (3) associated impairments, including epilepsy, intelligence, hearing, and vision. Interrater agreement was calculated for FCCS ratings using kappa (κ) statistics. Relationships between FCCS ratings and other measures were examined using Spearman's correlation coefficient.

Results

Almost perfect interrater agreement was demonstrated between SLP and parent FCCS ratings (κw=0.96). Correlations were excellent between FCCS ratings with CELF‐4 PP ratings, motor speech, and intellect; moderate with gross and fine motor function; and fair with other associated impairments (hearing, visual, and epilepsy). There was no correlation between age and FCCS.

Interpretation

The FCCS is a reliable and valid communication classification system for children with CP aged 5 to 18 years, and highly suitable for surveillance, research, and clinical purposes.

What this paper adds

The Functional Communication Classification System (FCCS) is valid and reliable for communication classification in children with cerebral palsy.

Excellent agreement is present between speech language pathologists and parents.

The FCCS shows excellent correlation with pragmatics, motor speech, and intelligence.

The FCCS is moderately correlated with gross and fine motor function.

The FCCS has fair correlation with epilepsy, hearing, and vision.
Time trends in diabetes mellitus in Jordan between 1994 and 2017
Authors: Ajlouni K. , Batieha A. , Jaddou H. , Khader Y. , Abdo N. , El‐Khateeb M. , Hyassat D. , Al‐Louzi D.
Published: January 2019

Aim

The prevalence of diabetes has been increasing over the past few decades. The objective of this study is to assess the time trends in diabetes between 1994 and 2017 in Jordan.

Methods

Surveys were conducted in 1994, 2004, 2009 and 2017 by the same investigators using generally similar methods. Fasting blood glucose was measured in all surveys. Variables were obtained using structured questionnaires designed specifically for the surveys. Crude and age‐specific diabetes prevalence rates were derived for each sex, together with overall, crude and age‐standardized prevalence rates.

Results

The prevalence of diabetes in men aged ≥ 25 years increased from 14.2% in 1994 to 18.3% in 2004, 26.8% in 2009 and 32.4% in 2017. The corresponding prevalence rates in women were 12.3%, 16.9%, 18.8%, and 18.1%, respectively. The overall age‐standardized prevalence rate increased from 13.0% in 1994 to 17.1% in 2004, 22.2% in 2009 and 23.7% in 2017. Known diabetes in the 2017 survey accounted for 82.6% of people with diabetes. A HbA1c of < 59 mmol/mol (7.5%) was observed in 41.4% of participants with known diabetes.

Conclusion

The results showed a high prevalence of diabetes in Jordan among people aged ≥ 25 years. Prevalence increased from 1994 to 2009, but slowed thereafter. The increase was greater in men than in women. Previously diagnosed diabetes accounted for a high percentage of people with diabetes in all surveys and was highest in 2017 survey, suggesting that the national strategy against diabetes has brought some benefits. Efforts should be made to improve glycaemic control in people with diabetes.
Management of people with Type 2 diabetes shared between a specialized outpatient clinic and primary health care is noninferior to management in a specialized outpatient clinic: a randomized, noninferiority trial
Authors: Munch L. , Bennich B. B. , Overgaard D. , Konradsen H. , Middelfart H. , Kaarsberg N. , Knop F. K. , Vilsbøll T. , Røder M. E.
Published: January 2019

Aim

To evaluate whether management of people with Type 2 diabetes shared between a specialized outpatient clinic and primary health care has noninferior HbA1c outcomes compared with mono‐sectorial management in a specialized outpatient clinic.

Methods

A randomized controlled, noninferiority study. People with moderate hyperglycaemia, hypertension and/or incipient complications were eligible for the study. All participants had annual comprehensive check‐ups at the outpatient clinic. Quarterly check‐ups were conducted by general practitioners (GPs) for the shared care group and by endocrinologists at the outpatient clinic for the control group. The primary outcome was the mean difference in HbA1c from baseline to 12 months of follow‐up. The noninferiority margin for HbA1c was 4.4 mmol/mol.

Results

A total of 140 people were randomized [age 65.0 ± 0.9 years, HbA1c 52 ± 0.8 mmol/mol (6.9 ± 0.1%), systolic BP 135.6 ± 1.1 mmHg; all mean ± sem]. Peripheral neuropathy was present in 68% of participants and microalbuminuria in 19%; 15% had history of a previous major cardiovascular event. Among study completers (n = 133), HbA1c increased by 2.3 mmol/mol (0.2%) in the shared care group and by 1.0 mmol/mol (0.1%) in the control group, with a between‐group difference of 1.3 mmol/mol [90% confidence interval (CI) −1.3, 3.9] (0.1%, 90% CI −0.1, 0.4). Noninferiority was confirmed in both per protocol and intention to treat analyses.

Conclusion

We found that our shared care programme was noninferior to specialized outpatient management in maintaining glycaemic control in this group of people with Type 2 diabetes. Shared care should be considered for the future diabetes management of Type 2 diabetes.
Everything is clear: All perceptual experiences are transparent
Authors: Gow Laura
Published: January 2019

The idea that perceptual experience is transparent is generally used by naïve realists and externalist representationalists to promote an externalist account of the metaphysics of perceptual experience. It is claimed that the phenomenal character of our perceptual experience can be explained solely with reference to the externally located objects and properties which (for the representationalist) we represent, or which (for the naïve realist) partly constitute our experience. Internalist qualia theorists deny this and claim that the phenomenal character of our perceptual experience is internally constituted. However, my concern in this paper is not with the metaphysical debate but with transparency as a phenomenological feature of perceptual experience. Qualia theorists have presented a number of examples of perceptual experiences which, they claim, do not even seem to be transparent; these experiences involve objects or properties which seem to be internally realized. I argue, contrary to the qualia theorist's claim, that the phenomenal character of perceptual experience can in fact be characterized solely with reference to externally located objects and properties, and the sense in which some features of our perceptual experiences do not seem external is due to cognitive, not perceptual, phenomenology.
Does trade credit really help relieving financial constraints?
Authors: Cosci Stefania , Guida Roberto , Meliciani Valentina
Published: January 2019

The European Union introduced a directive aimed at reducing trade credit due to its supposedly negative effect on the European economy. This contrasts with the redistribution view arguing that trade credit could facilitate the financing of credit‐constrained firms by more liquid suppliers. But does trade credit mainly flow from relatively unconstrained suppliers to more financially constrained buyers? To answer this question, we look at the characteristics of net borrowers with respect to net lenders and then estimate the substitutability between trade and bank debt separately for the two groups of firms. Overall, the results show that, in Italy, efficient redistribution does not tend to prevail in the trade credit market.
Patterns of cross‐resistance and collateral sensitivity between clinical antibiotics and natural antimicrobials
Authors: Colclough Abigail , Corander Jukka , Sheppard Samuel K. , Bayliss Sion C. , Vos Michiel
Published: January 2019

Bacteria interact with a multitude of other organisms, many of which produce antimicrobials. Selection for resistance to these antimicrobials has the potential to result in resistance to clinical antibiotics when active compounds target the same bacterial pathways. The possibility of such cross‐resistance between natural antimicrobials and antibiotics has to our knowledge received very little attention. The antimicrobial activity of extracts from seaweeds, known to be prolific producers of antimicrobials, is here tested against Staphylococcus aureus isolates with varied clinical antibiotic resistance profiles. An overall effect consistent with cross‐resistance is demonstrated, with multidrug‐resistant S. aureus strains being on average more resistant to seaweed extracts. This pattern could potentially indicate that evolution of resistance to antimicrobials in the natural environment could lead to resistance against clinical antibiotics. However, patterns of antimicrobial activity of individual seaweed extracts vary considerably and include collateral sensitivity, where increased resistance to a particular antibiotic is associated with decreased resistance to a particular seaweed extract. Our correlation‐based methods allow the identification of antimicrobial extracts bearing most promise for downstream active compound identification and pharmacological testing.
Higher Moments and Exchange Rate Behavior
Authors: Khademalomoom Siroos , Narayan Paresh Kumar , Sharma Susan Sunila
Published: January 2019

This paper uses 15‐minute exchange rate returns data for the six most liquid currencies (i.e., the Australian dollar, British pound, Canadian dollar, Euro, Japanese yen, and Swiss franc) vis‐à‐vis the United States dollar to examine whether a GARCH model augmented with higher moments (HM‐GARCH) performs better than a traditional GARCH (TG) model. Two findings are unraveled. First, the inclusion of odd/even moments in modeling the return/variance improves the statistical performance of the HM‐GARCH model. Second, trading strategies that extract buy and sell trading signals based on exchange rate forecasts from HM‐GARCH models are more profitable than those that depend on TG models.
It is a Sweetheart of a Deal: Political Connections and Corporate‐Federal Contracting
Authors: Ferris Stephen P. , Houston Reza , Javakhadze David
Published: January 2019

We examine whether political connections measured by political contributions influence the choice of terms included in government contracts awarded to firms. We construct an index of four “sweetheart” contract terms and find that firms making larger political contributions more frequently have these favorable terms included in their contracts. We also find that political contributions have explanatory power for contract design after controlling for lobbying, negotiation power, and the employment of former government employees. These results are robust to alternative model specifications, different estimation techniques, various variable measurements, and adjustments for possible endogeneity.
River habitat homogenisation enhances trophic competition and promotes individual specialisation among young of the year fish
Authors: Latli Adrien , Michel Loïc N. , Lepoint Gilles , Kestemont Patrick
Published: January 2019

In large rivers, fish ontogenic development success is mainly influenced by resource availability and by the possibility of species to adapt their diet (i.e. trophic niche). Humans have drastically modified freshwater habitats, notably for navigation purposes. Such modifications may reduce food availability for young of the year (YOY) fish and, consequently, influence their ability to reach the adult age.

In the Meuse River, decrease of fish abundance is thought to be linked to a drastic reduction of phytoplankton biomass. In this context of decreasing phytoplankton biomass, we studied trophic niches of three cyprinid species (common bleak Alburnus alburnus, chub Squalius cephalus, and roach Rutilus rutilus) and one percid species (European perch Perca fluviatilis) at various stages of development, using stable isotope analysis in order to compare intra‐ and interspecific competition between sites differing in degree of channelisation.

Two reaches of the Meuse River differing by their degree of regulation were investigated. We hypothesised that habitat homogenisation would (1) decrease food resource availability and diversity and (2) increase trophic competition, particularly among earlier ontogenic stages, and promote individual specialisation.

Our study provides evidence that in the context of low planktonic biomass, most YOY relied on benthic food sources. Furthermore, the Meuse River flow and depth regulation significantly impacted the abundance and species richness of YOY. In the heavily channelised reach, between‐stages competition and low resource diversity lead to an increase in diet partitioning between cyprinid larvae, as well as consumption of non‐optimal energetic food sources such as aquatic vegetation by some individuals.

By contrast, in the less channelised reach, larvae displayed a generalist feeding habit focusing on high energy content prey such as different taxa of macroinvertebrates, suggesting that the diversity of habitat reduces the food competition within and between stages.

Intraspecific resource repartition is a key point for YOY fish having to cope with plankton‐depleted conditions. Younger cyprinid stages seem more affected by intra‐ and inter‐specific competition in the more channelised reach. YOY fish communities were also less diversified and abundant in the more altered site, which highlight the importance of limiting channelisation to better conserve fish communities.
Valuing urban green spaces in mitigating climate change: A city‐wide estimate of aboveground carbon stored in urban green spaces of China's Capital
Authors: Sun Yan , Xie Shuai , Zhao Shuqing
Published: January 2019

Urban green spaces provide manifold environmental benefits and promote human well‐being. Unfortunately, these services are largely undervalued, and the potential of urban areas themselves to mitigate future climate change has received little attention. In this study, we quantified and mapped city‐wide aboveground carbon storage of urban green spaces in China's capital, Beijing, using field survey data of diameter at breast height (DBH) and tree height from 326 field survey plots, combined with satellite‐derived vegetation index at a fine resolution of 6 m. We estimated the total amount of carbon stored in the urban green spaces to be 956.3 Gg (1 Gg = 109 g) in 2014. There existed great spatial heterogeneity in vegetation carbon density varying from 0 to 68.1 Mg C ha‐1, with an average density of 7.8 Mg C ha−1. As expected, carbon density tended to decrease with urban development intensity (UDI). Likely being affected by vegetation cover proportion and configuration of green space patches, large differences were presented between the 95th and 5th quantile carbon density for each UDI bin, showing great potential for carbon sequestration. However, the interquartile range of carbon density narrowed drastically when UDI reached 60%, signifying a threshold for greatly reduced carbon sequestration potentials for higher UDI. These findings suggested that urban green spaces have great potential to make contribution to mitigating against future climate change if we plan and design urban green spaces following the trajectory of high carbon density, but we should be aware that such potential will be very limited when the urban development reaches certain intensity threshold.
Establishment of a diabetic myocardial hypertrophy model in Mus musculus castaneus mouse
Authors: Zhang Jie , Qiu Hongmei , Huang Jiajun , Ding Shumei , Huang Bo , Wu Qin , Jiang Qingsong
Published: January 2019

The aim of this study was to establish a robust model of diabetic myocardial hypertrophy in Mus musculus castaneus mice. Mice were fed a high‐fat diet for four weeks and then given streptozotocin (STZ, 40 mg kg−1 d−1 for 5 days, intraperitoneally) and fasting blood glucose (FBG) levels were tested after seven days. Mice with FBG levels above 11.1 mmol/L were considered diabetic. Diabetic mice continued to have access to the high‐fat diet until cardiac hypertrophy developed. FBG and body weight (BW) were measured weekly. Myocardial hypertrophy was confirmed by left ventricle (LV) hypertrophy index (LVHI), LV/BW, LV histopathological observation and atrial natriuretic factor (ANF) mRNA expression. Serum insulin and plasma haemoglobin A1c (HbA1c) levels, total cholesterol (TCH) and triglyceride (TG) were measured, and then an insulin resistance index (HOMA.IR) was calculated. The level of FBG in the model group remained above 11.1 mmol/L, and the BW showed significant weight loss, compared with the control group (P < 0.01). The high levels of HbA1c, HOME.IR, TCH and TG, and the low level of insulin suggested that glucose metabolism was not balanced with insulin resistance; meanwhile, higher TCH and TG showed that dyslipidaemia had also developed. After the diabetic mice were kept on the high‐energy diet for another four  weeks, histopathological observation showed myocardial injuries, much more surface area and collagen fibres, higher LVHI and LV/BW, and elevated expression of ANF mRNA (P < 0.01), suggesting that myocardial hypertrophy had appeared in Mus musculus castaneus mice under the current experimental conditions. Thus a robust model of diabetic myocardial hypertrophy was established four  weeks after confirmation of diabetes, which was induced by feeding a high‐fat diet for four weeks combined with a repeated low‐dose STZ exposure, in Mus musculus castaneus mice.
Investigation of production parameters in fracture behavior of hot‐pressed Al2O3–SiC/graphite fibrous monolithic ceramics: Fibers orientation and cell boundary fraction
Authors: Akbari Elaheh , Ghassemi Kakroudi Mahdi , Shahedifar Vahideh
Published: January 2019

Fibrous monoliths (FMs) exhibit graceful failure in flexure and have higher toughness values. In this research, a mixture of Al2O3and SiC as the core and graphite as the shell material of fibers were produced by extrusion‐molding technique and after aligning along intended directions (0°, 90°, and 0°/90°) were sintered using the hot‐pressing method at the temperature of 1500°C under pressure of 35 MPa for 1 hour. The significance of fibers orientation angle and the cell to cell boundary volume ratio in defining the fracture behavior of theFMs was detected. Because of the extensive crack interactions with graphite cell boundary such as crack deflection and delamination, with increasing cell boundary content from 25 to 30 vol%, the fracture toughness was enhanced. The highest flexural strength (184.8 ± 0.61 MPa) obtained from samples with 0° fibers orientation compared to 0°/90°. Since in the transverse plies (layers with 90° aligning), the properties of matrix phase are dominant, hence the strength in specimens with 0°/90° fibers orientation decreased considerably due to weak graphite matrix phase. In addition, the fracture toughness value increased up to 8.35 ± 0.74MPa·m1/2for the unidirectional architecture of (0°) in comparison with cross‐ply (0°/90°) architecture.
Impact of processing on polysaccharides obtained from button mushroom (Agaricus bisporus)
Authors: Radzki Wojciech , Ziaja‐Sołtys Marta , Nowak Jakub , Topolska Jolanta , Bogucka‐Kocka Anna , Sławińska Aneta , Michalak‐Majewska Monika , Jabłońska‐Ryś Ewa , Kuczumow Andrzej
Published: January 2019

Agaricus bisporus fruiting bodies were subjected to processing: blanching, boiling in water and blanching followed by lactic acid fermentation. Water soluble polysaccharides were obtained from fruiting bodies, quantified and analysed in terms of chemical composition, antioxidant capacity and antiproliferative activity towards cancer cell lines (MCF‐7 and T‐47D). The content of water soluble polysaccharides ranged from 7.35 ± 0.12 to 6.90 ± 0.17 mg g−1 fresh weight of sample. Boiling in water and blanching followed by fermenting caused minor decrease in the content. Fourier Transform Infrared spectroscopy of the extracted polysaccharides showed that both α‐ and β‐linkages are present in the samples. Size exclusion chromatography confirmed the presence of 163.3 and 1.9 kDa molecules. The processing caused changes in chemical composition (protein and phenolics content decreased). The isolated polysaccharides exerted antioxidant and antiproliferative activities. Both the activities were slightly lowered as the result of the processing.
Three‐dimensional myocardial scar characterization from the endocardium: Usefulness of endocardial unipolar electroanatomic mapping
Authors: Bazan Victor , Frankel David S. , Santangeli Pasquale , Garcia Fermin C. , Tschabrunn Cory M. , Marchlinski Francis E.
Published: January 2019

Epicardial ablation may be required to eliminate ventricular tachycardia (VT) in patients with underlying structural heart disease. The decision to gain epicardial access is frequently based on the suspicion of an epicardial origin for the VT and/or presence of an arrhythmogenic substrate. Epicardial pathology and VT is frequently present in patients with nonischemic right and/or left cardiomyopathies even in the setting of modest or no endocardial bipolar voltage substrate. In this setting, unipolar voltage mapping from the endocardium serves to help identify midmyocardial and/or epicardial VT substrate. The additional value of endocardial unipolar mapping includes its usefulness to predict the clinical outcome after VT ablation, to determine the irreversibility of myocardial disease, and to guide endomyocardial biopsy procedures to specific areas of intramural scarring. In this review, we aim to provide a guide to the use of endocardial unipolar mapping and its appropriate interpretation in a variety of clinical situations.
Exit sites on the epicardium rarely subtend critical diastolic path of ischemic VT on the endocardium: Implications for noninvasive ablation
Authors: Bhaskaran Abhishek , Nayyar Sachin , Porta‐Sánchez Andreu , Haldar Shouvik , Bokhari Mahmoud , Massé Stéphane , Liang Timothy , Zehra Nawazish , Farid Talha , Downar Eugene , Nanthakumar Kumaraswamy
Published: January 2019

Background

Noninvasive electrocardiographic mapping of ventricular tachycardia (VT) and ablation using stereotactic radiotherapy was recently reported. This strategy does not directly evaluate the critical diastolic components and assumes that the epicardial exit site of VT subtends closely over the endocardial mid‐diastolic isthmus.

Objective

To determine if the epicardial exit site of VT spatially corresponds to the critical diastolic components of ischemic scar‐related VT.

Materials and methods

Intraoperative simultaneous endocardial and epicardial mapping were performed during VT using a 112‐bipole endocardial balloon and 112‐bipole epicardial sock array. In eight patients, nine VTs having entire diastolic circuit mapped were included in the study. The diastolic path and VT‐exit sites (epicardial and endocardial) were determined.

Results

The diastolic path was mapped in the endocardium for all nine VTs (median length, 50; interquartile range [IQR], 28 mm). The tachycardia cycle length ranged from 210‐500 ms. The VT‐exit site was early in the endocardium for six VTs and on the epicardium for three VTs. The mid‐diastolic isthmus and endocardial exit site of the six endocardial VTs were spatially distant from their epicardial exit site by a median distance of 32 and 27 mm, respectively. For the three VTs with an early epicardial exit, the isthmus and endocardial exit sites were distant from the epicardial exit site by a median distance of 34 and 38 mm, respectively.

Conclusion

The epicardial exit site and the mid‐diastolic isthmus sites were spatially distant and discrepant. Surface electrocardiography (ECG)‐derived strategy in identifying epicardial exit site to select noninvasive ablation targets is prone to identify epicardial exit sites and may not identify critical targets in ischemic scar VT.
The MNC‐Coalition Paradox: Issue Salience, Foreign Firms and the General Data Protection Regulation
Authors: Kalyanpur Nikhil , Newman Abraham L.
Published: January 2019

While the EU takes on an increasingly global regulatory role, we have only a limited understanding of how or when foreign firms influence EU regulation. Multinational Corporations (MNCs) have many of the power resources that determine lobbying success. We argue, however, that high salience blunts foreign corporate power. High salience generates legitimacy concerns for EU institutions, creating a political opportunity structure that favours pluralistic participation. Civil society can point to the instrumental power of foreign firms as a means to contaminate business interests, amplifying consumer voices in the process. We label this the MNC‐Coalition paradox. We investigate the European Union's General Data Protection Regulation to assess our argument, as the revelations made public by Edward Snowden created an exogenous shock in salience. Highlighting the presence of MNCs – such as Google and Facebook – in the lobbying process allowed civil society leaders to delegitimize business preferences and bolster consumer protection. In addition to the theoretical contribution, our evidence sheds light on the policy process behind legislation that will shape fundamental civil liberties and privacy rights not only for Europeans but globally.
Organizing Transmission Belts: The Effect of Organizational Design on Interest Group Access to EU Policy‐making
Authors: Albareda Adrià , Braun Caelesta
Published: January 2019

The European Commission's outreach to interest groups implies that they function as ‘transmission belts’ that aggregate and articulate interests as policy‐relevant information for policy‐makers. Operating as a transmission belt, however, requires an organizational design fit for this purpose. We offer one of the first systematic analyses of how organizational design affects interest group access to public officials. We draw from a novel dataset of 248 EU‐level interest groups including data on several dimensions of organizational design. One of our key findings is that qualified majority and consensus‐facilitating decision‐making procedures help interest groups gain access to administrative and political officials, whereas functional differentiation is important to get access to administrative officials, but not to political officials. Our findings thus demonstrate the relevance of organizational design in gaining access as well as the need to incorporate varying informational demands of public officials to properly explain interest group access to public decision‐making.
Warfarin use increases bleeding risk in hemodialysis patients with atrial fibrillation: A meta‐analysis of cohort studies
Authors: Hussain Salman , Siddiqui Ali Nasir , Baxi Harveen , Habib Anwar , Hussain Md Sarfaraj , Najmi Abul Kalam
Published: January 2019

Background and Aim

Atrial fibrillation is one of the most common comorbid conditions in hemodialysis patients, and warfarin is widely prescribed anticoagulant to prevent thromboembolic complications in such patients. In the last decade, several epidemiological studies pointed out the risk of bleeding with the use of warfarin. So, this meta‐analysis is aimed to assess the bleeding risk associated with the use of warfarin.

Methods

This meta‐analysis was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta‐analysis guidelines. PubMed, Embase, Scopus, and Cochrane central databases were searched from inception to June 10, 2018. The primary outcome was to quantify the bleeding risk associated with warfarin use. The secondary outcome was to assess the bleeding risk based on different subgroups. Review Manager (RevMan) version 5.3 was used for performing statistical analysis.

Results

A total of 15 studies, constituting a pooled sample of 53 581 patients (37.14% female), were included. Of these, 17 469 were warfarin users. We found that warfarin use had a significant association with the bleeding risk. The pooled relative risk (RR) of bleeding was estimated to be 1.35 (95% CI: 1.18–1.53, P = < 0.00001), and the pooled RR of major bleeding (five studies) was estimated to be 1.32 (95% CI: 1.07–1.63, P = 0.009). Subgroup analysis revealed a significant association of warfarin use with the intracranial hemorrhage/hemorrhagic stroke (nine studies) (pooled RR: 1.43 [95% CI: 1.20–1.71, P = < 0.0001]).

Conclusions

The results indicate that warfarin use increases the risk of bleeding in hemodialysis patients with atrial fibrillation.
Fluoxetine and its metabolite norfluoxetine induce microglial apoptosis
Authors: Dhami Kamaldeep S. , Churchward Matthew A. , Baker Glen B. , Todd Kathryn G.
Published: January 2019

Inflammatory insult to the central nervous system (CNS) can lead to development of depression, and subsequently depression is the most frequent psychiatric comorbidity following ischemic stroke, often limiting recovery and rehabilitation in patients. The initiators of inflammatory pathways in the CNS are microglia activated in response to acute ischemic stress, and anti‐depressants have been shown to have anti‐inflammatory effects in the CNS, promoting neuronal survival following ischemic insult. We have previously shown that the selective serotonin reuptake inhibitors (SSRIs) fluoxetine and citalopram promote neuronal survival after oxygen‐glucose deprivation, an in vitro model of ischemia, by attenuating the release of glutamate and D‐serine from activated microglia. Interestingly, we found that fluoxetine‐treated microglial cultures contained fewer numbers of cells compared to other groups and hypothesized that fluoxetine and citalopram attenuated the release of glutamate and D‐serine by promoting the apoptosis of microglia. The present study aimed to test and compare antidepressants from three distinct classes (tricyclics, monoamine oxidase inhibitors, and SSRIs) on microglial apoptosis. Primary microglia were treated with 1 μg/mL lipopolysaccharide and/or 10 μM antidepressants, and various apoptotic markers were assayed. Fluoxetine and its metabolite norfluoxetine decreased protein levels in cell lysates, decreased cell viability of microglia, and increased the expression of the apoptotic marker cleaved‐caspase 3 in microglia. Live/dead nuclear staining also showed that fluoxetine‐ or norfluoxetine‐treated cultures contained greater numbers of dying microglial cells compared to vehicle‐treated cultures. Cultures treated with citalopram, phenelzine, or imipramine showed no evidence of inducing microglial apoptosis. Our results demonstrate that fluoxetine and norfluoxetine induce the apoptotic death of microglia, which may serve as a mechanism to attenuate the release of glutamate and D‐serine from activated microglia.

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The association between high‐volume intraoperative fluid administration and outcomes among pediatric patients undergoing large bowel resection
Authors: Sanford Ethan L. , Zurakowski David , Litvinova Anna , Zalieckas Jill M. , Cravero Joseph P.
Published: January 2019

Background

Traditional intraoperative fluid administration practices have been challenged this century with data suggesting improved outcomes with restrictive or goal‐directed fluid administration during adult bowel surgery. Minimal data on outcomes associated with differing intraoperative fluid administration practice exists for pediatric patients.

Aims

We assessed factors and outcomes associated with high‐volume fluid administration in pediatric patients undergoing colectomy. We hypothesized that high‐volume fluid administration is associated with impaired recovery and, thus, increased length of stay.

Methods

A database of perioperative practice and postoperative outcomes at a tertiary pediatric hospital was queried for colectomy encounters between July 2012 and March 2017. Data extracted included patient characteristics, perioperative clinical data, and postoperative outcomes. Encounters were stratified into two groups: greater than 90th percentile fluids administered (high‐volume fluid administration group) vs less than 90th percentile fluids administered. Univariable tests, multivariable logistic regression, and propensity score matched group comparisons were used to asses outcomes associated with high‐volume fluid administration.

Results

A total of 209 colectomy encounters were identified from which 12 were excluded based on predetermined criteria. High‐volume fluid administration was associated with length of stay >6 days (AOR 8.14, CI 1.75‐37.8, P = 0.007), time to first meal >4 days (AOR of 5.91, CI 1.30‐27.17, P = 0.02), and supplemental oxygen requirement >24 hours (AOR 3.60, CI 1.25‐10.39, P = 0.02) after adjusting for ASA status, blood loss, transfusion, and open surgery. Similarly, propensity score matched patients with high‐volume fluid administration vs controls were more likely to have length of stay >6 days (93% vs 54%, P = 0.007), time to first meal >4 days (93% vs 57%, P = 0.009), and supplemental oxygen requirement >24 hours (36% vs 12%, P = 0.033).

Conclusion

High‐volume fluid administration during colectomy for pediatric patients is associated with worsened postoperative outcomes suggestive of impaired recovery.
Current perspectives on treatment of perioperative hemodynamic instability and hypotension
Authors: Joffe Denise C. , Latham Gregory J. , Ross Faith J.
Published: January 2019

Summary

Overall, there are numerous causes of hypotension in the perioperative period. The approach to definitive treatment must be tailored to the child's unique anatomy and physiology, as well as the current factors presumed to be eliciting the hypotensive state. It is imperative to consider both routine and lesion‐specific etiologies to the current hypotensive episode. Lastly, when employing pharmacologic therapy for hypotension, there are often multiple combinations of medications that can reasonably be used to achieve the desired hemodynamic effects.
Functional relationships between hydraulic traits and the timing of diurnal depression of photosynthesis
Authors: Bucci Sandra J. , Carbonell Silletta Luisina M. , Garré Analía , Cavallaro Agustín , Efron Samanta Thais , Arias Nadia S. , Goldstein Guillermo , Scholz Fabían G.
Published: January 2019

The hydraulic coordination along the water transport pathway helps trees provide adequate water supply to the canopy, ensuring that water deficits are minimized and that stomata remain open for CO2 uptake. We evaluated the stem and leaf hydraulic coordination and the linkages between hydraulic traits and the timing of diurnal depression of photosynthesis across seven evergreen tree species in the southern Andes. There was a positive correlation between stem hydraulic conductivity (ks) and leaf hydraulic conductance (KLeaf) across species. All species had similar maximum photosynthetic rates (Amax). The species with higher ks and KLeaf attained Amax in the morning, whereas the species with lower ks and KLeaf exhibited their Amax in the early afternoon concurrently with turgor loss. These latter species had very negative leaf water potentials, but far from the pressure at which the 88% of leaf hydraulic conductance is lost. Our results suggest that diurnal gas exchange dynamics may be determined by leaf hydraulic vulnerability such that a species more vulnerable to drought restrict water loss and carbon assimilation earlier than species less vulnerable. However, under stronger drought, species with earlier CO2 uptake depression may increase the risk of hydraulic failure, as their safety margins are relatively narrow.
Photo‐Modification of Melanin by a Mid‐infrared Free‐electron Laser
Authors: Kawasaki Takayasu , Sato Aomi , Tominaga Yuki , Suzuki You , Oyama Takahiro , Tadokoro Makoto , Tsukiyama Koichi , Nokihara Kiyoshi , Zen Heishun
Published: January 2019

Melanin is rigidly constructed by several nitrogen‐containing aromatic rings, and its excess accumulation in skin tissue is closely associated with melanosis. Although visible lasers (wavelength: 600–1000 nm) are conventionally used for the photo‐thermolysis of melanocyte, several pigmented nevi are difficult to be treated. Here, we propose an alternate method for targeting the molecular structure of melanin using an infrared free‐electron laser (FEL) tuned to 5.8 μm that corresponds to the stretching vibrational mode of carboxylate group. A drastic morphological change on the black‐colored surface of melanin powder was observed after the pulse irradiation with power energy of 500 mJ cm−2, and the minimum irradiation time for damage to the morphology was 1.4 s. Analyses by mass spectroscopy, infrared spectroscopy, and 13C‐nuclear magnetic resonance implied that a pyrrole group was removed by the FEL irradiation. In addition, the FEL irradiation dispersed almost all of the melanoma cells from a culture solution without any influence on other ingredients in the medium, and one‐cell analysis by infrared microscopy showed that the structure of melanoma could be substantially damaged by the irradiation. This study proposes the potency of intense mid‐infrared laser as novel alternative way to reduce melanin.
Bystander Me45 Melanoma Cells Increase Damaging Effect in UVC‐irradiated Cells
Authors: Krzywon Aleksandra , Widel Maria
Published: January 2019

The aim of our study was to investigate the possible mechanism(s) of the bystander effect induced by UVC light in malignant melanoma Me45 cells that were co‐incubated with irradiated cells of the same line. We have found that the UVC band effectively generated apoptosis, premature senescence, single and double DNA strand breaks and reduced clonogenic survival of bystander cells. However, in the feedback response, the bystander cells intensified damage in directly irradiated cells, especially seen at the level of apoptosis and survival of clonogenic cells. Pretreatment of bystander cells with inhibitor of inducible nitric oxide synthase blocks this signaling. It seems that the mediators of this phenomenon produced and secreted by neighboring cells are superoxide, nitric oxide and TGF‐β. The reverse deleterious effect caused by cells not exposed to UVC in directly exposed cells is opposed to the protective/rescue effect exerted by the bystander cells in the case of ionizing radiation known in the literature. Whether this opposite adverse effect is a feature of only Me45 melanoma cells or whether it is a general phenomenon occurring between cells of other types exposed to ultraviolet radiation requires further research.
Urban Growth and Environmental Concerns: The Venture of the Greater Mexico City Metropolitan Area
Authors: Graizbord Boris , González Granillo José Luis
Published: January 2019

During the second half of the twentieth century, Mexico City, the country’s capital, exhibited unprecedented demographic growth and physical expansion involving numerous local government jurisdictions transcending the historical city limits. The resulting spatial distribution of population and location of economic activities in a complex metropolitan structure generated direct and indirect pressures on the Mexico Valley environment and beyond. Comprising the metropolitan area, a set of weak municipalities impose an apparent insurmountable barrier to transcend roles and a traditional institutional structure. Most, if not all, metropolitan municipalities have shown limited capabilities to respond to what seems to be the cross‐cutting character of these trends that require coordinated multisectorial and multiscale management solutions. This article analyzes the impact of those processes and explores the scope (challenges and opportunities) of urban and environmental metropolitan policy responses.
Behavior Aware Service Staffing
Authors: Cho David D. , Bretthauer Kurt M. , Cattani Kyle D. , Mills Alex F.
Published: January 2019

Empirical studies of service systems have shown that workers exhibit different service rates depending on their assigned workload. In contrast, staffing models typically assume a constant service rate. To address this issue, we model two commonly observed behavioral effects, speedup and slowdown, in a general way that allows us to study their joint impact on service staffing. We fit our behavioral model to a hospital dataset and show that both effects are present across a variety of departments. Given these findings, we incorporate speedup and slowdown behavior into a multiperiod workforce staffing model and show that a workload (defined as the number of jobs assigned to each worker) that maximizes the service rate is typically not optimal. As expected, the effectiveness of the widely practiced single‐ratio workload staffing policy depends on the strength of the speedup and slowdown effects. Interestingly, we find that in the presence of slowdown, weak behavioral effects (where workers work at a relatively constant rate) are the cases where the single‐ratio policy performs the worst; the optimal workload instead varies the most as system demand changes. This result differs from practice in many services such as healthcare, where fixed patient‐to‐nurse ratio workloads are commonly used. We show that the strength of behavioral effects modulates the trade‐off between a steady workload and the number of schedule adjustments.