bluuebunny/crossref_metadata_2025 huggingface dataset:
Afforestation for climate change mitigation: Potentials, risks and trade‐offs
Authors: Doelman Jonathan C. , Stehfest Elke , van Vuuren Detlef P. , Tabeau Andrzej , Hof Andries F. , Braakhekke Maarten C. , Gernaat David E. H. J. , van den Berg Maarten , van Zeist Willem‐Jan , Daioglou Vassilis , van Meijl Hans , Lucas Paul L.
Published: October 2019

Afforestation is considered a cost‐effective and readily available climate change mitigation option. In recent studies afforestation is presented as a major solution to limit climate change. However, estimates of afforestation potential vary widely. Moreover, the risks in global mitigation policy and the negative trade‐offs with food security are often not considered. Here we present a new approach to assess the economic potential of afforestation with the IMAGE 3.0 integrated assessment model framework. In addition, we discuss the role of afforestation in mitigation pathways and the effects of afforestation on the food system under increasingly ambitious climate targets. We show that afforestation has a mitigation potential of 4.9 GtCO2/year at 200 US$/tCO2in 2050 leading to large‐scale application in an SSP2 scenario aiming for 2°C (410 GtCO2cumulative up to 2100). Afforestation reduces the overall costs of mitigation policy. However, it may lead to lower mitigation ambition and lock‐in situations in other sectors. Moreover, it bears risks to implementation and permanence as the negative emissions are increasingly located in regions with high investment risks and weak governance, for example in Sub‐Saharan Africa. Afforestation also requires large amounts of land (up to 1,100 Mha) leading to large reductions in agricultural land. The increased competition for land could lead to higher food prices and an increased population at risk of hunger. Our results confirm that afforestation has substantial potential for mitigation. At the same time, we highlight that major risks and trade‐offs are involved. Pathways aiming to limit climate change to 2°C or even 1.5°C need to minimize these risks and trade‐offs in order to achieve mitigation sustainably.
Snipe taxonomy based on vocal and non‐vocal sound displays: the South American Snipe is two species
Authors: Miller Edward H. , Areta Juan Ignacio , Jaramillo Alvaro , Imberti Santiago , Matus Ricardo
Published: October 2019

We analysed breeding sounds of the two subspecies of South American SnipeGallinago paraguaiae paraguaiaeandGallinago paraguaiae magellanicato determine whether they might be different species: loud vocalizations given on the ground, and the tail‐generatedWinnowgiven in aerial display. Sounds of the two taxa differ qualitatively and quantitatively. Both taxa utter two types of ground call. InG. p. paraguaiae, the calls are bouts of identical sound elements repeated rhythmically and slowly (about five elements per second (Hz)) or rapidly (about 11 Hz). One call ofG. p. magellanicais qualitatively similar to those ofG. p. paraguaiaebut sound elements are repeated more slowly (about 3 Hz). However, its other call type differs strikingly: it is a bout of rhythmically repeated sound couplets, each containing two kinds of sound element. TheWinnowofG. p. paraguaiaeis a series of sound elements that gradually increase in duration and energy; by contrast, that ofG. p. magellanicahas two or more kinds of sound element that roughly alternate and are repeated as sets, imparting a stuttering quality. Sounds of the related Puna Snipe (Gallinago andina) resemble but differ quantitatively from those ofG. p. paraguaiae. Differences in breeding sounds ofG. p. paraguaiaeandG. p. magellanicaare strong and hold throughout their geographical range. Therefore we suggest that the two taxa be considered different species:G. paraguaiaeeast of the Andes in much of South America except Patagonia, andG. magellanicain central and southern Chile, Argentina east of the Andes across Patagonia, and Falklands/Malvinas.
Use of the metal artefact reduction tool in the identification of fractured endodontic instruments in cone‐beam computed tomography
Authors: Costa E. D. , Brasil D. M. , Queiroz P. M. , Verner F. S. , Junqueira R. B. , Freitas D. Q.
Published: October 2019

Aim

To evaluate the influence of the metal artefact reduction (MAR) tool in the diagnosis of fractured instruments in root canals of extracted mandibular molars, with or without root canal fillings.

Methodology

The root canals of 31 mandibular molars were divided into four groups: (i) the control group, without root fillings; (ii) the fracture group, without fillings and with fractured files; (iii) the fill group, with root filling; and (iv) the fill/fracture group, root filled and with fractured files. The following instruments were used as fractured endodontic instruments: stainless steel hand files, NiTi reciprocating files and NiTi rotary files. Each tooth was inserted in a dry mandible to obtain cone‐beam computed tomography (CBCT) images using a CBCT OP300 3D Maxio (Instrumentarium Dental, Tuusula, Finland) and Picasso Trio (Vatech, Hwaseong, Republic of Korea), with and without application of the MAR tool. All images were evaluated by three radiologists for the presence or absence of fractured files on a 5‐point scale. The diagnostic accuracy (area under ROC curve) was calculated. Image noise was measured in regions of trabecular and cortical bone and soft tissue. The comparison between the ROC curve values with the MAR tool enabled or disabled was performed using a t‐test. A t‐test was also employed for comparing image noise when the MAR tool was enabled and disabled. The significance level was set at 5%.

Results

The use of the MAR tool did not influence the diagnostic accuracy for identifying fractured endodontic instruments in root canals with and without fillings in both CBCT systems (P > 0.05), nor did it influence the image noise (P > 0.05).

Conclusions

The MAR tool on these two devices did not increase the detection of fractured endodontic instruments and did not reduce image noise using extracted mandibular molars. Therefore, the MAR tool is not recommended for evaluation of fractured endodontic instruments in teeth with and without root fillings in mandibular molars.
Mechanisms of oil uptake during deep frying and applications of predrying and hydrocolloids in reducing fat content of chips
Authors: Lumanlan Jane Cantre , Fernando Warnakulasuriya Mary Ann Dipika Binosha , Jayasena Vijay
Published: October 2019

Deep frying resulting in high‐fat content is extensively used in the food industries and domestic households, and becoming an integral diet globally. The physical and chemical changes and oil uptake contributes to the unique taste and texture of fried food. Consumption of food high in fat is a health concern due to the increasing rate of obesity and cardiovascular diseases. Consumer awareness has led food industries to aim at fat reduction while maintaining the organoleptic properties of fried foods. This article reviews recent findings in reducing fat content emphasising on pretreatments. Modification of product surface was proven to lower fat content, reducing moisture content by 10% after predrying results in 54% fat reduction, while hydrocolloids coating in potato chips reduces fat content by 57% after deep frying. Although current technology, vacuum frying and air frying have a promising result in using less oil, but the initial cost is high.
The role of innate immune responses and neuroinflammation in amyloid accumulation and progression of Alzheimer's disease
Authors: Webers Alessandra , Heneka Michael T , Gleeson Paul A
Published: October 2019

Alzheimer's disease (AD) is characterized by amyloid beta (Aβ) accumulation, tau pathology and neuroinflammation. Recently, there has been considerable interest in the role of neuroinflammation in directly contributing to the progression of AD. Studies in mice and humans have identified a role for microglial cells, the resident innate immune cells of the central nervous system, in AD. Activated microglia are a key hallmark of the disease and the secretion of proinflammatory cytokines by microglia may result in a positive feedback loop between neurons and microglia, resulting in ongoing low‐grade inflammation. Traditionally, the pathways of Aβ production and neuroinflammation have been considered independently; however, recent studies suggest that these processes may converge to promote the pathology associated with AD. Here we review the importance of inflammation and microglia in AD development and effects of inflammatory responses on cellular pathways of neurons, including Aβ generation.
Multiobjective pseudo‐variable neighborhood descent for a bicriteria parallel machine scheduling problem with setup time
Authors: Queiroz Thiago Alves de , Mundim Leandro Resende
Published: October 2019

A multiobjective variable neighborhood descent (VND) based heuristic is developed to solve a bicriteria parallel machine scheduling problem. The problem considers two objectives, one related to the makespan and the other to the flow time, where the setup time depends on the sequence, and the machines are identical. The heuristic has a set of neighborhood structures based on swap, remove, and insertion moves. We propose changing the local search inside the VND to a sequential search through the neighborhoods to obtain nondominated points for the Pareto‐front quickly. In the numerical tests, we consider a single‐objective version of the heuristic, comparing the results on 510 benchmark instances to show that it is quite effective. Moreover, new instances are generated in accordance with the literature for the bicriteria problem, showing the ability of the proposed heuristic to return an efficient set of nondominate solutions compared with the well‐known nondominated sorting genetic algorithm II.
Characterization and modulation of microglial phenotypes in an animal model of severe sepsis
Authors: Michels Monique , Abatti Mariane Rocha , Ávila Pricila , Vieira Andriele , Borges Heloisa , Carvalho Junior Celso , Wendhausen Diogo , Gasparotto Juciano , Tiefensee Ribeiro Camila , Moreira José Claudio Fonseca , Gelain Daniel Pens , Dal‐Pizzol Felipe
Published: October 2019

We aim to characterize the kinetics of early and late microglial phenotypes after systemic inflammation in an animal model of severe sepsis and the effects of minocycline on these phenotypes. Rats were subjected to CLP, and some animals were treated with minocycline (10 ug/kg) by i.c.v. administration. Animals were killed 24 hours, 5, 10 and 30 days after sepsis induction, and serum and hippocampus were collected for subsequent analyses. Real‐time PCR was performed for M1 and M2 markers. TNF‐α, IL‐1β, IL‐6, IL‐10, CCL‐22 and nitrite/nitrate levels were measured. Immunofluorescence for IBA‐1, CD11b and arginase was also performed. We demonstrated that early after sepsis, there was a preponderant up‐regulation of M1 markers, and this was not switched to M2 phenotype markers later on. We found that up‐regulation of both M1 and M2 markers co‐existed up to 30 days after sepsis induction. In addition, minocycline induced a down‐regulation, predominantly, of M1 markers. Our results suggest early activation of M1 microglia that is followed by an overlap of both M1 and M2 phenotypes and that the beneficial effects of minocycline on sepsis‐associated brain dysfunction may be related to its effects predominantly on the M1 phenotype.
Circular RNA USP1 regulates the permeability of blood‐tumour barrier via miR‐194‐5p/FLI1 axis
Authors: Gao Yang , Wu Peiqi , Ma Yawen , Xue Yixue , Liu Yunhui , Zheng Jian , Liu Xiaobai , He Qianru , Ma Jun , Liu Libo , Wang Ping
Published: October 2019

Recent studies indicate circular RNAs are related to dysregulation of vascular endothelial cell function, yet the underlying mechanisms have remained elusive. Here, we characterized the functional role of circular RNA USP1 (circ‐USP1) in the regulation of the blood‐tumour barrier (BTB) permeability and the potential mechanisms. In the current study, the circ‐USP1 expressing level was up‐regulated in glioma cerebral microvascular endothelial cells (GECs) of the BTB model in vitro. Knockdown of circ‐USP1 disrupted the barrier integrity, increased its permeability as well as reduced tight junction‐related protein claudin‐5, occludin and ZO‐1 expressions in GECs. Bioinformatic prediction and luciferase assay indicated that circ‐USP1 bound to miR‐194‐5p and suppressed its activity. MiR‐194‐5p contributed to circ‐USP1 knockdown‐induced increase of BTB permeability via targeting and down‐regulating transcription factor FLI1. Furthermore, FLI1 regulated the expressions of claudin‐5, occludin and ZO‐1 in GECs through binding to their promoter regions. Single or combined treatment of circ‐USP1 and miR‐194‐5p effectively promoted anti‐tumour drug doxorubicin across BTB to induce apoptosis of glioma cells. Overall, this present study identified the crucial regulation of circ‐USP1 on BTB permeability via miR‐194‐5p/FLI1 axis‐mediated regulation of tight junction proteins, which might facilitate the development of therapeutics against human gliomas.
Cost‐effectiveness of psychological interventions for children and young people with post‐traumatic stress disorder
Authors: Mavranezouli Ifigeneia , Megnin‐Viggars Odette , Trickey David , Meiser‐Stedman Richard , Daly Caitlin , Dias Sofia , Stockton Sarah , Pilling Stephen
Published: October 2019

Background

PTSD in youth may lead to long‐lasting psychological implications, educational difficulties and increased healthcare costs. Psychological interventions have been shown to be effective in its management. The objective of this study was to assess the cost‐effectiveness of a range of psychological interventions for children and young people with PTSD.

Methods

A decision‐analytic model was constructed to compare costs and quality‐adjusted life years (QALYs) of 10 psychological interventions and no treatment for children and young people with PTSD, from the perspective of the National Health Service and personal social services in England. Effectiveness data were derived from a systematic review and network meta‐analysis. Other model input parameters were based on published sources, supplemented by expert opinion.

Results

Cognitive therapy for PTSD, a form of individual trauma‐focused cognitive behavioural therapy (TF‐CBT), appeared to be the most cost‐effective intervention for children and young people with PTSD (with a probability of .78 amongst the 11 evaluated options at a cost‐effectiveness threshold of £20,000/QALY), followed by narrative exposure (another form of individual TF‐CBT), play therapy, and other forms of individual TF‐CBT. After excluding cognitive therapy from the analysis, narrative exposure appeared to be the most cost‐effective option with a .40 probability of being cost‐effective amongst the remaining 10 options. EMDR, parent training and group TF‐CBT occupied middle cost‐effectiveness rankings. Family therapy and supportive counselling were less cost‐effective than other active interventions. There was limited evidence for some interventions, in particular cognitive therapy for PTSD and parent training.

Conclusions

Individual forms of TF‐CBT and, to a lesser degree, play therapy appear to be cost‐effective in the treatment of children and young people with PTSD. Family therapy and supportive counselling are unlikely to be cost‐effective relative to other interventions. There is a need for well‐conducted studies that examine the long‐term clinical and cost‐effectiveness of a range of psychological treatments for children and young people with PTSD.
Reply to: Underestimation of the prevalence of medication errors in nursing homes
Authors: Ferrah Noha , Ibrahim Joseph E.
Published: October 2019

This letter comments on the letter by Ramesh Poudel and Shakti Shrestha
Underestimation of the Prevalence of Medication Errors in Nursing Homes
Authors: Poudel Ramesh Sharma , Shrestha Shakti
Published: October 2019

See the response from Joseph Ibrahim
Reply to Changes in Institutionalized Older People's Dentition Status in Helsinki 2003 to 2017
Authors: Griffin Susan O. , Griffin Paul M. , Li Chien‐Hsun
Published: October 2019

This letter comments on the letter by Saarela et al.
Changes in Institutionalized Older People's Dentition Status in Helsinki, 2003‐2017
Authors: Saarela Riitta K.T. , Hiltunen Kaija , Mäntylä Päivi , Pitkälä Kaisu H.
Published: October 2019

See the Reply by Griffin.
What do highly narcissistic people think and feel about (their) intelligence?
Authors: Zajenkowski Marcin , Czarna Anna Z. , Szymaniak Kinga , Dufner Michael
Published: October 2019

Objective

The current research comprehensively examined how grandiose and vulnerable narcissism are linked to intelligence and intelligence‐related beliefs and emotions.

Method

In four studies (total N = 1,141), we tested the associations between both forms of narcissism, subjectively and objectively assessed intelligence, basic personality traits, test‐related stress, beliefs about intelligence, and well‐being.

Results

Both forms of narcissism (grandiose and vulnerable) were unrelated to objective intelligence. Grandiose narcissism was associated with high self‐perceived intelligence (Studies 1–3) and explained more variance in self‐perceived intelligence than objective intelligence and the Big Five personality traits. It was correlated with reduced distress in the context of IQ testing and low engagement in cognitive performance (Study 2). Individuals with high grandiose narcissism based their well‐being (Study 3) partly on intelligence and considered intelligence important for success in different life domains, especially for social relations (Study 4). Vulnerable narcissism was unrelated to self‐perceived intelligence (Studies 1–3) and went along with increased distress in the context of IQ testing (Study 2).

Conclusions

The results indicate that the topic of intelligence is of key importance for people with high grandiose narcissism psychological functioning and it also has some relevance for individuals with high vulnerable narcissism.
Use of clinician‐performed ultrasound in the assessment of safe umbilical venous catheter tip placement
Authors: Seigel Amber , Evans Nick , Lutz Tracey
Published: October 2019

Aim

Safe tip placement of umbilical venous catheters (UVCs) in sick neonates is critical in minimising risk. We aimed to demonstrate the utility of clinician‐performed ultrasound (CPU) in identifying UVCs that are placed within small intrahepatic portal vessels or within the heart despite the appearance of being well placed on X‐ray.

Methods

This was a retrospective observational study of preterm and term neonates who had a UVC placed and the position assessed by X‐ray and/or CPU according to the Royal Prince Alfred Hospital level 3 neonatal intensive care unit (NICU) guideline. Cases were identified by exporting the records of all admissions between 1 April 2015 and 30 June 2016 from the NICU's data collection database. Paper‐based medical records, NICU's data collection database records and the ultrasound reporting system were reviewed to determine X‐ray and CPU findings.

Results

A total of 157 neonates had 169 UVCs placed. CPU was performed in 77% (111). In 15 cases (14%), UVC placement on X‐ray appeared appropriate based on estimated vertebral level; however, CPU demonstrated the line to be in an unsafe position (small intrahepatic portal vessel (3); right atrium (9); left atrium (3)).

Conclusions

Assessment of safe UVC placement by estimations according to vertebral level on X‐ray alone is inadequate. CPU offers confident localisation of the UVC tip and enables corrective manipulation of intracardiac or intrahepatic UVCs in real time. We recommend CPU as an adjunct to X‐ray to ensure safe UVC placement.
Acid induced gelation behavior of skim milk concentrated by membrane filtration
Authors: Li Ying , Corredig Milena
Published: October 2019

This work reports a detailed study of the effect of ultrafiltration (UF) and diafiltration (DF) on the acid‐induced gelation behavior of fresh milk retentates (2× and 4×). Concentrates were heated at 80°C for 15 min, and compared to unheated samples. The use of extensive DF caused a significantly greater amount of protein (both caseins and whey proteins) in the supernatant fraction, compared to UF retentates at the same concentration, both in unheated and heated samples. DF retentates showed higher pH of gelation, compared to the corresponding UF retentates. The development of tan δ is reported for the first time as a function of colloidal calcium release, and the protein gelation behavior discussed in light differences in composition of the soluble fraction. The results demonstrate how processing history can affect compositional changes and the gelation behavior of fresh milk retentates. Membrane filtration is a widespread unit operation in the dairy industry, employed either to prepare fresh concentrates for further processing, or ingredients with specific functional properties. This work describes in detail the effect of processing history during membrane filtration on the rheological properties of acid induced gels and will help in optimizing formulations and prepare the right ingredients for the right application. It will also be possible to determine new ways to define processing quality of the milk protein concentrates, as it relates to their ability to form texture in fermented dairy products.
Long‐term morbidity and mortality in a Canadian post‐transfusion hepatitis C cohort: Over 15 years of follow‐up
Authors: Sahakyan Yeva , Wong William WL , Yi Qilong , Thein Hla‐Hla , Tomlinson George A , Krahn Murray D
Published: October 2019

The Federal Government of Canada established a $1.1 billion compensation programme in 1999 to support individuals who acquired hepatitis C virus (HCV) through blood products between January 1986 and July 1990. We aimed to describe the morbidity and mortality of this unique post‐transfusion cohort (n = 4550) followed for over 15 years from 2000 to 2016. The age‐standardized mortality rates were compared with that of the Canadian general population and HCV cohorts from other countries. We evaluated all‐cause mortality using Kaplan‐Meier survival curves and HCV‐related and unrelated mortality using competing risk models. The age‐standardized all‐cause and HCV‐related mortality rates per 10 000 person‐years were 127 (95% CI: 117‐138) and 76 (95% CI: 69‐85) for males, and 77 (95% CI: 69‐87) and 43 (95% CI: 37‐51) for females, respectively. The risk of death of the post‐transfusion cohort was almost twice as high as the Canadian general population (rate ratio = 1.8; 95% CI: 1.7‐1.9). All‐cause, HCV‐related and HCV‐unrelated mortality were 20%, 12% and 8%, respectively at 15 years of follow‐up. By comparison, HCV‐related mortality rates per 10 000 person‐years for population‐based HCV cohorts varied from 18 and 11 in Australia to 65 and 43 in Scotland for males and females, respectively. We reported long‐term follow‐up data for the largest post‐transfusion cohort in the literature. The all‐cause mortality rates were markedly higher than that of the Canadian general population. We also showed that HCV‐related mortality were greater compared to other HCV cohorts. This suggests that continued efforts to identify and treat post‐transfusion HCV are warranted.
Direct‐acting antiviral interactions with opioids, alcohol or illicit drugs of abuse in HCV‐infected patients
Authors: Ing Lorenzini Kuntheavy , Girardin François
Published: October 2019

The hepatitis C virus (HCV) prevalence is extremely high in patients who consume and inject illicit drugs. Concerns about poor adherence and fear of interaction with drugs of abuse could constitute further disincentive for treatment initiation in these patients. We discussed the pharmacokinetics (PKs) and pharmacodynamics (PD) of currently prescribed direct antiviral agents (NSA5 inhibitors: daclatasvir, elbasvir, ledipasvir, pibrentasvir, velpatasvir; NS5B inhibitor: sofosbuvir; NS3/4A protease inhibitors: glecaprevir, grazoprevir, voxilaprevir) and most common substances of abuse (opioids: buprenorphine, fentanyl, heroin, methadone, morphine, oxycodone; stimulants: amphetamines, cathinones, cocaine; cannabinoids; ethanol). Overall, most direct‐acting antivirals (DAAs) are substrates and inhibitors of the transmembrane transporter P‐glycoprotein (P‐gp), and several of them are metabolized by cytochrome P450 enzymes. Clinically relevant interactions are associated with P‐gp and CYP3A modulators. Most substances of abuse are eliminated by Phase I and Phase II metabolizing enzymes, but none of them are either major inhibitors or inducers. PK studies did not show any relevant interactions between DAA and methadone or buprenorphine. Based on pharmacological considerations, neither efficacy loss nor adverse drug event associated with detrimental interaction are expected with opioids, stimulants, cannabinoids and ethanol. In summary, our literature review shows that the interaction potential of DAA with most opioids and illicit drugs is limited and should not be a hurdle to the initiate DAA.
Evolution and paleobiogeography of mangroves
Authors: Srivastava Jyoti , Prasad Vandana
Published: October 2019

We reviewed the geological record of mangroves based on fossil pollen, fruits, and wood evidence ofNypa,Avicennia,Sonneratia, Rhizophoraceae, and mangrove associates to trace the origin, distribution, extinction, and range contraction of paleo‐mangroves during the Late Cretaceous–Miocene time. Our study region covers paleocoastal areas of Indo‐West Pacific (IWP) and Atlantic East Pacific (AEP) region. First, we compiled the mangrove fossil records from the Late Cretaceous till Miocene and identified the migration pattern forNypa, Avicennia,Sonneratia, Rhizophoraceae members, and mangrove associates such asAcrostichum, Wetherellia, Pelliciera, Aegiceras, Heritiera, Excoecaria,andBarringtonia. Second, we interpreted the paleoclimate shifts which caused the dispersal/extinction of this specialized ecosystem. Lastly, we proposed the future consequences of mangrove diversity for restoration and conservation strategies. First mangroves appeared during the Late Cretaceous, 100–65 Ma, since then their evolution is closely related to sea‐level changes in geological times. The oldest geological record ofNypapalm which prefers broad ecological tolerance is a good example for pantropical distribution of mangroves. High sea‐level and humid climate offered sufficient coastal regions and climate for the development of 12 genera of mangroves in nine families and subsequent proliferation into newer areas during early to middle Eocene (~50–40 Ma). The Eocene/Oligocene boundary crisis heralds the beginning of a biogeographical split between the present‐day eastern and western provinces of mangroves with records ofSonneratia,Rhizophora, Pelliciera, Barringtonia,andAcrostichum. However, during Oligocene and Middle Miocene mangroves occupied the present geographical position with addition ofNypa,Avicennia,andExcoecariaspecies. Re‐evaluation of Cenozoic records suggests that the climatic conditions of Late Paleocene, end of Eocene, and middle Pliocene were the driving force that led to the evolution and expansion of mangrove flora. During the Neogene, latitudinal contraction, extinction, and migration of mangroves led to the present bipartite distribution. The Himalayan uplift and establishment of Asian summer monsoon toward Late Neogene further affected the coastal dynamics which tailored the mangrove distribution of the Indian subcontinent. Loss of ecological habitats and local extinction forming disjunct distribution of mangroves during the Quaternary have also affected its overall biogeography.
Epidemiology of emergency department acute kidney injury
Authors: Foxwell David A. , Pradhan Sara , Zouwail Soha , Rainer Timothy H. , Phillips Aled O.
Published: October 2019

Aim

The epidemiology of acute kidney injury (AKI) diagnosed in the emergency department (ED) is poorly described. This study describes the incidence, demographics and outcomes of patients diagnosed with AKI in the ED (ED‐AKI).

Methods

A prospective cohort study was completed in a University Teaching Hospital, (UK) between April and August 2016. In total, 20  421 adult patients attended the ED and had a serum creatinine measurement. The incident ED‐AKI patient episodes were compared with a randomly selected cohort of non‐AKI ED patients.

Results

A total of 572 patients had confirmed eAlert ED‐AKI (548 incident cases), incidence 2.8% (of all ED attendances). ED‐AKI was associated with a 24.4% in‐patient mortality (non‐AKI 3.2%, P < .001) of which 22.3% of deaths occurred within 24 hours and 58% within 7 days. Progression of the admission AKI stage to a higher AKI stage was associated with a 38.8% mortality compared with a 21.4% mortality in those who did not progress (P < .001). In multivariate analysis, ED‐AKI was an independent risk for mortality (hazard ratio, 6.293; 95% confidence interval, 1.887‐20.790, P = .003). For those discharged from hospital, 20.4% of ED‐AKI patients re‐attend for acute assessment within 30‐days post‐discharge (non‐AKI 7.6%, P < .001). At 90‐days post‐discharge, 10.0% of ED‐AKI patients died (non‐AKI 1.4%, P < .001). Twelve months post‐discharge 17.8% of ED‐AKI patients developed CKD progression or de‐novo CKD (non‐AKI 6.0%).

Conclusion

The ED‐AKI is an independent predictor of death. Mortality is predominantly in the early stages of hospital admission, but for those who survive to discharge have significant long‐term morbidity and mortality.
Adult stem cells and regenerative medicine—a symposium report
Authors: Cable Jennifer , Fuchs Elaine , Weissman Irving , Jasper Heinrich , Glass David , Rando Thomas A. , Blau Helen , Debnath Shawon , Oliva Anthony , Park Sangbum , Passegué Emmanuelle , Kim Carla , Krasnow Mark A.
Published: October 2019

Adult stem cells are rare, undifferentiated cells found in all tissues of the body. Although normally kept in a quiescent, nondividing state, these cells can proliferate and differentiate to replace naturally dying cells within their tissue and to repair its wounds in response to injury. Due to their proliferative nature and ability to regenerate tissue, adult stem cells have the potential to treat a variety of degenerative diseases as well as aging. In addition, since stem cells are often thought to be the source of malignant tumors, understanding the mechanisms that keep their proliferative abilities in check can pave the way for new cancer therapies. While adult stem cells have had limited practical and clinical applications to date, several clinical trials of stem cell–based therapies are underway. This report details recent research presented at the New York Academy of Sciences on March 14, 2019 on understanding the factors that regulate stem cell activity and differentiation, with the hope of translating these findings into the clinic.
Osteoradionecrosis beyond the jaws: a mini case series and review of the literature
Authors: Wali R. , King R. , Patel V.
Published: October 2019

Osteoradionecrosis (ORN) of the mandible is a well‐known complication of head and neck radiotherapy (RT). In contrast, osteonecrosis of surrounding non‐target structures in the craniofacial region is less commonly reported. Various bones within the head and neck are susceptible to ORN and this may present years after initial radiation exposure especially with improving survival rates. We report three cases of ORN involving the hyoid bone and temporal bone, and review the literature regarding numerous bones within the head and neck skeleton that have been affected by ORN.
Clinical utility of microarray B‐cell epitope mapping in food allergies: A systematic review
Authors: Sánchez‐Ruano Laura , de la Hoz Belén , Martínez‐Botas Javier
Published: October 2019

Background

Peptide microarray technology has been proposed as a useful tool for diagnosing food allergy. However, there is considerable heterogeneity in the clinical methods and analytical procedures used to assess its diagnostic and prognostic performance. We performed a systematic review of studies that have used B‐cell epitopes by peptide microarray in food allergies to identify the clinical utility of this immunologic technique.

Methods

Studies were screened in PubMed, Web of Science, and Embase according to an established keyword algorithm. Data extraction was performed, and information was collected in an Excel database. Descriptive analysis was carried out using Stata software.

Results

Thirty relevant studies were identified. Most articles were cross‐sectional (n = 24), included epitope mapping (n = 9), and assessed diagnostic utility (n = 11). All studies recruited allergic patients, and some included additional patients (sensitized, persistent, and tolerant). The primary microarray variables studied were IgE intensity (n = 29), IgG4 intensity (n = 15), and number of peptides (n = 17). Statistical approaches differed significantly between studies, with the Wilcoxon test being the most frequently used (n = 10).

Conclusions

Sensitization to particular epitopes of milk, peanut, and shrimp allergens can be used to determine clinical reactivity, persistence, severity, or response to oral immunotherapy; however, important methodological questions need to be addressed before drawing definitive conclusions. More research is needed to address the accuracy and clinical benefits of microarray‐based technology. Standards are required to improve consistency and reproducibility, and to allow for better understanding of research findings.
Prediction of postnatal clinical course in primary congenital dilated cardiomyopathy
Authors: Yamamoto Hidenori , Fukasawa Yoshie , Ohashi Naoki , Yokoyama Takehiko , Suzuki Kazutaka , Ota Takaya , Yasuda Kazushi , Omoya Kentaro , Takahashi Yoshiyuki , Kato Taichi
Published: October 2019

Background

The aim of this study was to investigate the prediction of postnatal prognosis using fetal and perinatal data in patients with primary congenital dilated cardiomyopathy (PCDCM), and to estimate the incidence of this disease.

Methods

We examined correlations between fetal or perinatal data and postnatal clinical course in a multicenter retrospective study of eight patients with PCDCM. Incidence was calculated in a population‐based study.

Results

All patients developed heart failure at a median of 8 days (range, 0–43 days), and six patients died or required extracorporeal artificial heart therapy at a median of 67 days (range, 0–92 days). The cardiothoracic area ratio from fetal echocardiography, the Apgar score, and the standard deviation of birth weight correlated significantly with the date at onset of heart failure. However, no data correlated with survival. Cumulative incidence of PCDCM was calculated as 1.21 per 100 000 total births (95% confidence interval, 0.37 to 2.06).

Conclusions

Primary congenital dilated cardiomyopathy has a poor prognosis, but cardiothoracic area ratio from fetal echocardiography, body weight at birth, and Apgar score correlate with the timing of the onset of heart failure, and these indicators might therefore be useful for peri‐ and postnatal management.
Usefulness of the pediatric appendicitis score for assessing the severity of acute appendicitis in children
Authors: Fujii Takayuki , Tanaka Aya , Katami Hiroto , Shimono Ryuichi
Published: October 2019

Background

We investigated relationships between the Pediatric Appendicitis Score (PAS) and pathological progression and disease severity in pediatric acute appendicitis.

Methods

We retrospectively evaluated 72 children who underwent surgery for acute appendicitis. We divided them into groups: simple appendicitis (n = 28) or complicated appendicitis (n = 44). We compared the influence of age, body temperature, blood test findings, hospitalization period, number of complications, and PAS between the groups. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the PAS for diagnosing complicated appendicitis. A receiver operating characteristic curve was constructed to evaluate the cut‐off value for diagnosing complicated appendicitis. To assess the severity of acute appendicitis, we divided the patients into groups according to that cut‐off value.

Results

There were statistically significant differences in the PAS between simple appendicitis and complicated appendicitis (5.8 versus 7.9). The receiver operating characteristic curve indicated a PAS cut‐off value of 8. A PAS ≥ 8 had a sensitivity of 73%, a specificity of 89%, a positive predictive value of 91%, and a negative predictive value of 68%. A PAS ≥ 8 was associated with significantly longer hospitalization and more complications than a PAS < 8.

Conclusions

The PAS may be associated with pathological progression and disease severity in appendicitis.
Neonatal behavior and social behavior and sensory issues in 18‐month toddlers
Authors: Tokunaga Akiko , Akiyama Tomitaro , Miyamura Tsunetake , Honda Sumihisa , Nakane Hideyuki , Iwanaga Ryoichiro , Tanaka Goro
Published: October 2019

Background

There has long existed a need for early detection and early intervention for children with autism spectrum disorder. Accordingly, the aim of this study was to demonstrate, in a prospective manner, the relationship between behavioral features during the neonatal period and social behavior and sensory issues at 18 months.

Methods

Participants were 105 full‐term infants considered “healthy” by an obstetrician. The behavioral features of the infants were evaluated using the Neonatal Behavioral Assessment Scale (NBAS) between 2 and 7 days after birth. Follow‐up assessments were conducted 18 months later using a Japanese version of the Modified Checklist for Autism in Toddlers (M‐CHAT‐JV) and the Infant / Toddler Sensory Profile (ITSP).

Results

Sixteen (15.2%) of the 105 infants were M‐CHAT‐JV‐positive. There were significant differences between the M‐CHAT‐JV‐positive and M‐CHAT‐JV‐negative groups in two of the NBAS clusters: orientation and motor. We observed a significant negative correlation between the NBAS orientation cluster and the ITSP “low registration” and “auditory processing” sections, as well as between the NBAS motor cluster and the ITSP “sensation avoiding” and “tactile processing” sections. Logistic regression analysis showed that the NBAS orientation cluster and ITSP low registration were significantly associated with the M‐CHAT‐JV at 18 months.

Conclusions

The results suggest a relationship between the NBAS orientation cluster in full‐term neonates and their social behavior and sensory features at 18 months.
Perceived social support mediates the association between attachment and cardiovascular reactivity in young adults
Authors: McMahon Grace , Creaven Ann‐Marie , Gallagher Stephen
Published: October 2019

To understand the influence of social relationships on cardiovascular responses to stress, the present study investigated perceived affectionate support as a mediating variable explaining the association between specific attachment bonds (i.e., mother, father, partner, best friend) and cardiovascular reactivity (CVR). Utilizing a standardized stress testing protocol, 138 young adults completed measures of attachment and social support, with continuous cardiovascular measurements obtained using the Finometer Pro hemodynamic monitor. Results showed that the association between anxious and avoidant attachment and reactivity were mediated by perceived affectionate support; insecure attachment was linked to lower levels of perceived social support, which in turn was associated with lower CVR. For anxious attachment, this was noted only for mothers (SBP: B = −0.94, 95% CI [−1.94, −0.20]; DBP: B = −0.57, [−1.27, −0.10]), fathers (SBP: B = −0.72, [−1.42, −0.17]; DBP: B = −0.48, [−1.01, −0.13]), and best friends (SBP: B = −0.64, [−1.23, −0.18]; DBP: B = −0.40, [−0.81, −0.12]). For avoidant attachment, it was evident only for fathers (SBP: B = −0.70, [−1.33, −0.17]; DBP: B = −0.48, [−0.92, −0.15]) and partners (SBP: B = −0.78, [−1.64, −0.09]; DBP: B = −0.53, [−1.10, −0.11]). These findings suggest that insecure attachment is associated with lower levels of reactivity, which have been linked to negative health outcomes such as poor self‐reported health, depression, and obesity. Overall, this research expands on the support and relationship science literature by incorporating under‐researched aspects of social relationships (i.e., specific attachment styles) and focusing on the mechanisms by which they are associated with physiological stress responses.
Impact of the addition of azithromycin to antimalarials used for seasonal malaria chemoprevention on antimicrobial resistance of Streptococcus pneumoniae
Authors: Hema‐Ouangraoua Soumeya , Aziz Maiga Abdoul , Cairns Matthew , Zongo Issaka , Frédéric Nikiema , Serge Yerbanga Rakiswendé , Tamboura Boubou , Badji Henry , Gore‐Langton Georgia , Kuepfer Irene , Tinto Halidou , Sagara Issaka , Dicko Alassane , Sow Samba O. , Chandrahoman Daniel , Greenwood Brian , Bosco Ouedraogo Jean
Published: October 2019

Objective

A trial was conducted in Burkina Faso and Mali to investigate whether addition of azithromycin to the antimalarials used for seasonal malaria chemoprevention reduces mortality and hospital admissions of children. We tested the sensitivity of nasal isolates of Streptococcus pneumoniae obtained during this trial to azithromycin and other antibiotics.

Methods

Azithromycin or placebo was administered monthly, in combination with the antimalarials used for seasonal malaria chemoprevention, for four months, over the annual malaria transmission seasons of 2014, 2015, and 2016. Nasopharyngeal swabs were collected from 2773 Burkinabe and 2709 Malian children on seven occasions: in July and December each year prior to and after drug administration, and at a final survey in early 2018. Pneumococci were isolated from nasopharyngeal swabs and tested for sensitivity to azithromycin and other antibiotics.

Results

A total of 5482 samples were collected. In Burkina Faso, the percentage of pneumococcal isolates resistant to azithromycin among children who had received it increased from 4.9% (95% CI: 2.4%, 9.9%) before the intervention to 25.6% (95% CI: 17.6%, 35.7%) afterward. In Mali, the increase was from 7.6% (95% CI: 3.8%, 14.4%) to 68.5% (95% CI: 55.1%, 79.4%). The percentage of resistant isolates remained elevated (17.7% (95% CI: 11.1%, 27.1%) in Burkina Faso and 19.1% (95% CI: 13.5%, 26.3%) in Mali) among children who had received azithromycin 1 year after stopping the intervention. An increase in resistance to azithromycin was also observed in children who had received a placebo but it was less marked.

Conclusion

Addition of azithromycin to the antimalarial combination used for seasonal malaria chemoprevention was associated with an increase in resistance of pneumococci to azithromycin and erythromycin, which persisted 1 year after the last administration of azithromycin.
Glycoside‐specific glycosyltransferases catalyze regio‐selective sequential glucosylations for a sesame lignan, sesaminol triglucoside
Authors: Ono Eiichiro , Waki Toshiyuki , Oikawa Daiki , Murata Jun , Shiraishi Akira , Toyonaga Hiromi , Kato Masako , Ogata Naoki , Takahashi Seiji , Yamaguchi Masa‐atsu , Horikawa Manabu , Nakayama Toru
Published: October 2019

Sesame (Sesamum indicum) seeds contain a large number of lignans, phenylpropanoid‐related plant specialized metabolites. (+)‐Sesamin and (+)‐sesamolin are major hydrophobic lignans, whereas (+)‐sesaminol primarily accumulates as a water‐soluble sesaminol triglucoside (STG) with a sugar chain branched via β1→2 and β1→6‐O‐glucosidic linkages [i.e. (+)‐sesaminol 2‐O‐β‐d‐glucosyl‐(1→2)‐O‐β‐d‐glucoside‐(1→6)‐O‐β‐d‐glucoside]. We previously reported that the 2‐O‐glucosylation of (+)‐sesaminol aglycon and β1→6‐O‐glucosylation of (+)‐sesaminol 2‐O‐β‐d‐glucoside (SMG) are mediated by UDP‐sugar‐dependent glucosyltransferases (UGT), UGT71A9 and UGT94D1, respectively. Here we identified a distinct UGT, UGT94AG1, that specifically catalyzes the β1→2‐O‐glucosylation of SMG and (+)‐sesaminol 2‐O‐β‐d‐glucosyl‐(1→6)‐O‐β‐d‐glucoside [termed SDG(β1→6)]. UGT94AG1 was phylogenetically related to glycoside‐specific glycosyltransferases (GGTs) and co‐ordinately expressed with UGT71A9 and UGT94D1 in the seeds. The role of UGT94AG1 in STG biosynthesis was further confirmed by identification of a STG‐deficient sesame mutant that predominantly accumulates SDG(β1→6) due to a destructive insertion in the coding sequence of UGT94AG1. We also identified UGT94AA2 as an alternative UGT potentially involved in sugar–sugar β1→6‐O‐glucosylation, in addition to UGT94D1, during STG biosynthesis. Yeast two‐hybrid assays showed that UGT71A9, UGT94AG1, and UGT94AA2 were found to interact with a membrane‐associated P450 enzyme, CYP81Q1 (piperitol/sesamin synthase), suggesting that these UGTs are components of a membrane‐bound metabolon for STG biosynthesis. A comparison of kinetic parameters of these UGTs further suggested that the main β‐O‐glucosylation sequence of STG biosynthesis is β1→2‐O‐glucosylation of SMG by UGT94AG1 followed by UGT94AA2‐mediated β1→6‐O‐glucosylation. These findings together establish the complete biosynthetic pathway of STG and shed light on the evolvability of regio‐selectivity of sequential glucosylations catalyzed by GGTs.
Prognostic indicators in cats with septic peritonitis (2002–2015): 83 cases
Authors: Scotti Katherine Maria , Koenigshof Amy , Sri‐Jayantha Loren S.H. , Kato Michael , Bishop Micah , Barr James W. , Pashmakova Medora B.
Published: October 2019

Objective

To identify physical exam findings, clinicopathological parameters, time to surgery, empirical antimicrobial use, and culture results that could be associated with outcome in cats with septic peritonitis (SP).

Design

Retrospective cohort study of cats from 2002 to 2015.

Setting

Four university teaching hospitals.

Animals

Eighty‐three cats diagnosed with SP by cytology or culture.

Interventions

None

Measurements and Main Results

Fifty‐eight cats survived to discharge (69.9%); 1 cat was euthanized in surgery; 20 were euthanized postoperatively; 4 cats suffered cardiac arrest after surgery. The most common etiology of SP was secondary SP due to gastrointestinal perforation (49.4%), followed by primary SP (22.3%). Mean blood glucose concentration was significantly different between survivors and nonsurvivors (P = 0.006). Cats that received appropriate empirical antibiotic therapy were 4.4 times more likely to survive than cats that did not receive appropriate antibiotics (P = 0.018).

Conclusions

As previously documented, SP secondary to gastrointestinal leakage was the most common etiology. In this population, cats with a higher blood glucose concentration on presentation had a worse prognosis. Cats that received appropriate empirical antimicrobial therapy were more likely to survive.