bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of endothelial dysfunction with cardiovascular risk factors and new‐onset diabetes mellitus in patients with hypertension
Authors: Triches Cristina Bergmann , Mayer Saurus , Quinto Beata Marie Redublo , Batista Marcelo Costa , Zanella Maria Teresa
Published: March 2018

Asymmetric dimethylarginine (ADMA), which is the main endogenous inhibitor of nitric oxide synthase, plays a critical role in the process of endothelial dysfunction. The authors evaluated the association between high plasma ADMA levels in patients with hypertension and the presence of cardiovascular risk factors and the development of type 2 diabetes mellitus (DM) and cardiovascular outcomes, including death. The authors evaluated 191 patients with hypertension who were stratified into two groups according to the median value of basal ADMA: those with high levels of plasma ADMA (>0.55 μmol/L) and low levels of plasma ADMA (≤0.55 μmol/L) who were prospectively evaluated over 5.8 years. High ADMA levels were seen in patients with higher weight, body mass index, waist circumference, triglycerides, uric acid, and high‐sensitivity C‐reactive protein, and lower levels of high‐density lipoprotein cholesterol and in patients with type 2 DM. There was an association between high plasma ADMA levels and the occurrence of cardiovascular death. In a subgroup of patients with hypertension free from metabolic syndrome and DM at baseline, there was an association between high ADMA levels and the development of type 2 DM. This study confirms the association of high plasma ADMA levels and the presence of cardiovascular risk factors in patients with hypertension and suggests a positive predictive value of high plasma ADMA levels for cardiovascular death in patients with hypertension and also for the development of type 2 DM in a subgroup of patients with hypertension free from metabolic abnormalities.
Developing and validating a new precise risk‐prediction model for new‐onset hypertension: The Jichi Genki hypertension prediction model (JG model)
Authors: Kanegae Hiroshi , Oikawa Takamitsu , Suzuki Kenji , Okawara Yukie , Kario Kazuomi
Published: March 2018

No integrated risk assessment tools that include lifestyle factors and uric acid have been developed. In accordance with the Industrial Safety and Health Law in Japan, a follow‐up examination of 63 495 normotensive individuals (mean age 42.8 years) who underwent a health checkup in 2010 was conducted every year for 5 years. The primary endpoint was new‐onset hypertension (systolic blood pressure [SBP]/diastolic blood pressure [DBP] ≥ 140/90 mm Hg and/or the initiation of antihypertensive medications with self‐reported hypertension). During the mean 3.4 years of follow‐up, 7402 participants (11.7%) developed hypertension. The prediction model included age, sex, body mass index (BMI), SBP, DBP, low‐density lipoprotein cholesterol, uric acid, proteinuria, current smoking, alcohol intake, eating rate, DBP by age, and BMI by age at baseline and was created by using Cox proportional hazards models to calculate 3‐year absolute risks. The derivation analysis confirmed that the model performed well both with respect to discrimination and calibration (n = 63 495; C‐statistic = 0.885, 95% confidence interval [CI], 0.865‐0.903; χ2 statistic = 13.6, degree of freedom [df] = 7). In the external validation analysis, moreover, the model performed well both in its discrimination and calibration characteristics (n = 14 168; C‐statistic = 0.846; 95%CI, 0.775‐0.905; χ2 statistic = 8.7, df = 7). Adding LDL cholesterol, uric acid, proteinuria, alcohol intake, eating rate, and BMI by age to the base model yielded a significantly higher C‐statistic, net reclassification improvement (NRI), and integrated discrimination improvement, especially NRInon‐event (NRI = 0.127, 95%CI = 0.100‐0.152; NRInon‐event = 0.108, 95%CI = 0.102‐0.117). In conclusion, a highly precise model with good performance was developed for predicting incident hypertension using the new parameters of eating rate, uric acid, proteinuria, and BMI by age.
Error‐related brain activity in pediatric anxiety disorders remains elevated following individual therapy: a randomized clinical trial
Authors: Ladouceur Cecile D. , Tan Patricia Z. , Sharma Vinod , Bylsma Lauren M. , Silk Jennifer S. , Siegle Greg J. , Forbes Erika E. , McMakin Dana L. , Dahl Ronald E. , Kendall Phillip C. , Mannarino Anthony , Ryan Neal D.
Published: March 2018

Background

Anxiety disorders are associated with an overactive action monitoring system as indexed by a larger error‐related negativity (ERN). This study tests whether ERN magnitude changes following treatment, predicts response to treatment, and varies by treatment type.

Methods

The sample included 130 youth (9–14 years): youth with an anxiety disorder (ANX; n = 100) and healthy control (HC; n = 30) youth with no lifetime DSM‐IV disorders. ANX youth were randomized to either a manualized cognitive‐behavior therapy (CBT) or a comparison child‐centered therapy (CCT). The ERN was assessed before and after 16 sessions of treatment and within a comparable interval for HC. Subjective ratings about making errors on the task were obtained following each testing session. The ClinicalTrials.gov identifier is NCT00774150.

Results

The ERN was larger in ANX than HC youth but ERN magnitude did not significantly change following treatment in the ANX youth, regardless of treatment type, and baseline ERN did not predict treatment response. Post‐task ratings revealed that ANX youth worried more about task performance feedback than HC. Like the ERN, mean ratings did not significantly change following treatment. However, these ratings were not correlated with ERN amplitude.

Conclusions

Findings of greater ERN in pediatric anxiety disorders are replicated in a larger sample. More importantly, findings from this randomized control trial show that a larger ERN and feeling worried about performance feedback remain unchanged following treatment and are unrelated to treatment response. Such findings suggest that action monitoring systems remain overactive in anxious youth treated with psychotherapy, suggesting the need for future investigation of whether novel complimentary cognitive and emotional training programs can modify these systems would be warranted.
When repetitive mental sets increase cognitive flexibility in adolescent obsessive–compulsive disorder
Authors: Wolff Nicole , Giller Franziska , Buse Judith , Roessner Veit , Beste Christian
Published: March 2018

Background

A major facet of obsessive–compulsive disorder (OCD) is cognitive inflexibility. However, sometimes, cognitive flexibility can be needed to reuse recently abandoned mental sets. Therefore, cognitive flexibility can in certain cases be useful to reinstate some form of rigid, repetitive behavior characterizingOCD. We test the counterintuitive hypothesis that under such circumstances, cognitive flexibility is better inOCDpatients than controls.

Methods

We examinedN = 20 adolescentOCDpatients andN = 22 controls in a backward inhibition (BI) paradigm. This was combined with event‐related potential (ERP) recordings and source localization. TheBIeffect describes the cost of overcoming the inhibition of a recently abandoned mental set that is relevant again. Therefore, a strongBIeffect is disadvantageous for cognitive flexibility.

Results

Compared to controls,OCDpatients revealed a smaller backward inhibition effect. TheEEGdata revealed larger P1 amplitudes in backward inhibition trials in theOCDgroup, which was due to activation differences in the inferior frontal gyrus (BA47). The severity of clinical symptoms predicted these neurophysiological modulations. The power of the observed effects was about 95%.

Conclusions

The study shows that cognitive flexibility can be better inOCDthan controls. This may be the case in situations where superior abilities in the reactivation of repeating mental sets and difficulties to process new ones coincide. This may be accomplished by intensified inhibitory control mechanisms. The results challenge the view onOCD, sinceOCDis not generally associated with cognitive inflexibility.
Effects of a novel selective peroxisome proliferator‐activated receptor‐α modulator, pemafibrate, on hepatic and peripheral glucose uptake in patients with hypertriglyceridemia and insulin resistance
Authors: Matsuba Ikuro , Matsuba Ren , Ishibashi Shun , Yamashita Shizuya , Arai Hidenori , Yokote Koutaro , Suganami Hideki , Araki Eiichi
Published: March 2018

Aims/Introduction

Pemafibrate is a novel selective peroxisome proliferator‐activated receptor‐α modulator with potent triglyceride‐lowering and high‐density lipoprotein cholesterol‐raising effects. We showed that pemafibrate decreased the homeostatic model assessment for insulin resistance in patients with dyslipidemia. To investigate how pemafibrate improves insulin sensitivity, we used a hyperinsulinemic‐euglycemic clamp technique to determine the splanchnic and peripheral glucose uptake in patients with hypertriglyceridemia and insulin resistance.

Materials and Methods

A total of 27 patients with hypertriglyceridemia and insulin resistance were randomly assigned to receive pemafibrate (0.4 mg/day, b.i.d.) or placebo treatment for 12 weeks. The hyperinsulinemic‐euglycemic clamp test combined with oral glucose loading was carried out at weeks 0 and 12 to evaluate the splanchnic and peripheral glucose uptake.

Results

Pemafibrate, but not the placebo, significantly increased the splanchnic glucose uptake rate from baseline (19.6 ± 5.9% with P = 0.005 and 2.1 ± 7.4% with P = 0.78, respectively), although no significant difference between the groups was observed (P = 0.084). Conversely, peripheral glucose uptake rate was not significantly altered. Pemafibrate, compared with the placebo, significantly decreased plasma triglycerides (−61.4 ± 16.4% vs −2.5 ± 41.4%, P = 0.001), free fatty acids (−24.8 ± 23.2% vs 2.0 ± 26.8%, P = 0.016) and gamma‐glutamyl transpeptidase (−30 ± 46 vs 10 ± 19 U/L, P = 0.009) levels, and significantly increased fibroblast growth factor 21 (457.7 ± 402.1 vs −41.7 ± 37.4 pg/mL, P = 0.007) levels.

Conclusions

Pemafibrate increased splanchnic glucose uptake from baseline in patients with hypertriglyceridemia.
Interspecific competition promotes habitat and morphological divergence in a secondary contact zone between two hybridizing songbirds
Authors: Sottas Camille , Reif Jiří , Kuczyński Lechosław , Reifová Radka
Published: March 2018

Interspecific competition is assumed to play an important role in the ecological differentiation of species and speciation. However, empirical evidence for competition's role in speciation remains surprisingly scarce. Here, we studied the role of interspecific competition in the ecological differentiation and speciation of two closely related songbird species, the Common Nightingale (Luscinia megarhynchos) and the Thrush Nightingale (Luscinia luscinia). Both species are insectivorous and ecologically very similar. They hybridize in a secondary contact zone, which is a mosaic of sites where both species co‐occur (syntopy) and sites where only one species is present (allotopy). We analysed fine‐scale habitat data for both species in both syntopic and allotopic sites and looked for associations between habitat use and bill morphology, which have been previously shown to be more divergent in sympatry than in allopatry. We found that the two nightingale species differ in habitat use in allotopic sites, where L. megarhynchos occurred in drier habitats and at slightly higher elevations, but not in syntopic sites. Birds from allotopic sites also showed higher interspecific divergence in relative bill size compared to birds from syntopic sites. Finally, we found an association between bill morphology and elevation. Our results are consistent with the view that interspecific competition in nightingales has resulted in partial habitat segregation in sympatry and that the habitat‐specific food supply has in turn very likely led to bill size divergence. Such ecological divergence may enhance prezygotic as well as extrinsic postzygotic isolation and thus accelerate the completion of the speciation process.
Effects of Metarhizium robertsii on the bloodsucking mosquito Aedes flavescens and non‐target predatory insects (Odonata)
Authors: Belevich O. , Yurchenko Y. , Krivopalov A. , Kryukov V. , Glupov V.
Published: March 2018

The effects of different concentrations and methods of treatment with Metarhizium robertsii Bisch., Rehner & Humber conidia on the non‐target aquatic dragonfly larvae Lestes sponsa Hansemann, Lestes dryas Kirby and Aeshna affinis Vander Linden and on the target bloodsucking mosquito larvae Aedes (O.) flavescens (Muller) were analysed. We found that dragonflies are significantly less susceptible than mosquitoes to the fungus. Larvae of L. sponsa larvae were more susceptible to wet conidia than dry conidia. However, the mortality of the air‐breathing larvae of A. affinis was significantly higher after treatment with dry conidia relative to aqueous suspension. The results help to minimize the negative effects of entomopathogenic fungi on non‐target predator insects under the control of mosquito larvae.
Translational neuroscience and psychiatry: A conceptual analysis
Authors: Marková Ivana S.
Published: March 2018

As rapidly developing research disciplines and enterprises, the translational sciences have made significant impact on research direction in medicine. Psychiatry has likewise been affected, and in this regard, the translational neurosciences have been the major drivers. This paper explores the conceptual underpinnings of this enterprise in relation to psychiatry. It shows that translation is used in a metaphorical sense in this context but that this can be misleading because of the resultant connotation that there is equivalence between neurobiological states and mental states. Furthermore, this equivalence is reinforced by the unidirectional flow or bottom up approach of the translational process.

Given that the epistemological basis to psychiatry is fundamentally different to that underlying medicine, questions are raised concerning the application of the translational neurosciences approach to mental symptoms and mental disorders. The hybrid structure of mental symptoms and mental disorders demands that attention is paid to the “semantic” as well as the neurobiological constituents. Neglect of the former would carry implications for the validity of research findings as well as have ethical consequences for treating patients. Translational neurosciences may have greater validity in those mental disorders and mental symptoms whose constitution and sense are carried by the neurobiological elements.
Objective quantification of psychomotor disturbances in patients with a major depressive episode
Authors: Terziivanova Petya , Haralanova Evelina , Milushev Emil , Dimitrov Rumen , Claussen Claus‐Frenz , Haralanov Svetlozar
Published: March 2018

Rationale, aims and objectives

Psychomotor disturbances have been regarded as cardinal symptoms of depression for centuries, and their objective assessment may have predictive value with respect to the severity of clinical depression, treatment outcome, and prognosis of the depressive disorder. In clinical practice, psychomotor disturbances are evaluated and measured subjectively—through clinical observation and/or by means of rating scales. Our aim is to introduce a novel objective approach for recording and measuring psychomotor activity and reactivity in patients with clinical depression.

Method

Psychomotor indicators of activity and reactivity were objectively recorded and measured using computerized ultrasonographic cranio‐corpo‐graphy.

Results and discussion

Objective and quantitative assessment of psychomotor symptoms may have pathophysiological significance as psychomotor disturbances go along with affective dysregulation. It is presumed that common neurotransmitter pathology in the brain structures causes simultaneously psychomotor and affective dysregulation that underlies the pathophysiology of the depressive disorder. Also, psychomotor retardation is thought to be a cardinal depressive symptom in endogenous depressions—unipolar and bipolar. On the other hand, psychomotor agitation may be considered as latent bipolarity, although the presence of manic symptoms within a depressive state and the role of psychomotor agitation in depressive patients are still disputable.

Conclusion

Integration between different methods is needed to improve the understanding of psychopathology and neurobiology of a disputable diagnosis such as clinical depression. We introduce in the field of psychiatry an objective and quantitative approach, which could permit psychomotor discrimination not only between depressive patients and healthy controls but also between subgroups of depressive patients.
Flawed statistics and science confirming existing paradigms
Authors: Rutten Lex A. L. B.
Published: March 2018

Background

Part of the scientific community states that implausible methods cannot have a true effect and that epidemiological proof can only lead to false positives.

Discussion

Homeopathy is regarded as an example of an implausible method with false positive evidence. However, epidemiological proof is necessary to falsify the placebo hypothesis. Implausibility is now supposed to rectify selection of a part of all trials, but the applied selection criteria are diverse and not common in conventional medicine. Applying Bayes' theorem only once to demonstrate that a low prior chance does not lead to reasonable probability is flawed application of this theorem.

Conclusion

Demanding scientific evidence and then rejecting the same with post‐hoc selection of trials and flawed statistics shows unwillingness to falsify the completeness of existing paradigms.
Proximate composition, lipid utilization and validation of a non‐lethal method to determine lipid content in migrating American shad Alosa sapidissima
Authors: Bayse S. M. , Regish A. M. , McCormick S. D.
Published: March 2018

Lipid content forms the most important energy reserve in anadromous fish and can limit survival, migration and reproductive success. A fat meter was evaluated and compared with a traditional extractive method of measuring available lipid for migrating American shad Alosa sapidissima in the Connecticut River, U.S.A. The fat meter gives rapid (<10 s) and non‐lethal lipid measurements, whereas traditional methods require lethal sampling that is both time consuming and expensive. The fat‐meter readings had a strong relationship to traditional lipid extractions for 60 fish, 30 whole body (R2 = 0·72) and 30 fillet only (R2 = 0·81). Additional validation showed that fat‐meter readings captured the gradual decrease of lipid in individual fish over time, were not affected by removal of gonads or scales and were stable for fish exposed to water or air for 24 h after death. These experiments indicate that the fat meter can be used as a reliable tool for future A. sapidissima energetic studies, allowing for larger sample sizes and non‐lethal sampling.
The influence of aquaculture unit proximity on the pattern of Lepeophtheirus salmonis infection of anadromous Salmo trutta populations on the isle of Skye, Scotland
Authors: Moore I. , Dodd J. A. , Newton M. , Bean C. W. , Lindsay I. , Jarosz P. , Adams C. E.
Published: March 2018

A total of 230 anadromous Salmo trutta (brown trout) were sampled in five sheltered coastal fjords (or sea lochs) on the Isle of Skye, Scotland, U.K., in 2016 at varying distances from active Atlantic salmon Salmo salar farms. Statistical models were developed to investigate potential correlations between salmon lice Lepeophtheirus salmonis burdens on S. trutta hosts and their proximity to S. salar farm cages. Significant correlations were found between lice burdens and fish fork length and proximity to the nearest S. salar farm. The probability of the presence of L. salmonis on fish hosts increased with fish host size and with distance from the nearest S. salar farm, but total lice burdens were highest in fish sampled near S. salar farms and decreased with distance. The proportion of different life‐cycle stages of L. salmonis were also dependent on S. salar farm proximity, with higher juvenile lice numbers recorded at sites near S. salar farm cages. These results highlight the complexity of the relationship between S. trutta and L. salmonis infections on wild fish and emphasize the requirement of further research to quantify these effects to better inform conservation and management strategies, particularly in areas of active S. salar farm facilities.
Mathematical modeling and thermodynamic properties of rice parboiling
Authors: Balbinoti Thaisa Carvalho Volpe , Jorge Luiz Mário de Matos , Jorge Regina Maria Matos
Published: March 2018

Due to the importance of hydration stage for parboiling, related studies are insufficiently addressed in the literature. The objective of this study was to model the moisture absorption kinetics of paddy rice, as well as estimate the thermodynamic properties involved in the hydration. The observed mass transfer in the process was directly influenced by the temperature of the system, showing changes in absorption capacity over time. The models addressed allowed satisfactorily describing the moisture gain under various thermal conditions. Particularly, the model based on Fick's second law best represented the experimental data. The effective diffusion coefficient was adjusted to an Arrhenius equation and a new model was generated, capable of describing hydration. The coefficient presented positive dependence with the temperature increase and allowed the determination of different forms of process energy. It was concluded that the hydration of the rice in the parboiling process is nonspontaneous and exothermic.

Practical applications

This study allowed characterizing the moisture transfer in the hydration stage of the parboiling process, exploring the time and temperature relationship. From these data, mathematical modeling was used as a quality tool, guaranteeing for the parboiling industries control and optimization of the process in a cheap and easy way. In addition, this study presented relevant information on the thermodynamic properties, which made it possible to understand the different forms of energies and phenomena involved. This information can help, in a practical way, in the elaboration of industrial projects aimed at the parboiling of rice.
Investigating the role of model structure and surface roughness in generating flood inundation extents using one‐ and two‐dimensional hydraulic models
Authors: Liu Z. , Merwade V. , Jafarzadegan K.
Published: March 2018

Hydraulic models play an important role in determining flood inundation areas. When considering a wide array of one‐ (1D) and two‐dimensional (2D) hydraulic models, selecting an appropriate model and its calibration are crucial in an accurate prediction of flood inundation. This study compares the performance of four commonly used 1D and 2D hydraulic models, including HEC‐RAS 1D, HEC‐RAS 2D, LISFLOOD‐FP diffusive, and LISFLOOD‐FP subgrid, with respect to their model structure and their sensitivity to surface roughness characterisation. Application of these models to four study reaches with different river geometry and roughness characterisation shows that for a given set of roughness condition, the geometry, including the sinuosity, reach length and floodplain width, does not affect the performance of a 1D or 2D model. Overall, the performance of a 1D model is comparable to the 2D models used in the study, with the 2D models showing slightly better results. The performance of 2D models is affected by low channel roughness, and it improves with increasing channel roughness that enables more water to enter into the floodplain. On the contrary, the performance of 1D model is positively affected with increasing floodplain roughness. When the models are evaluated for uniform versus distributed roughness characterisation in the floodplain, the uniform surface characterisation provides the best results compared to the distributed roughness characterisation.
Clinical and genetic risk factors for decreased bone mineral density in Japanese patients with inflammatory bowel disease
Authors: Naito Takeo , Yokoyama Naonobu , Kakuta Yoichi , Ueno Kazuko , Kawai Yosuke , Onodera Motoyuki , Moroi Rintaro , Kuroha Masatake , Kanazawa Yoshitake , Kimura Tomoya , Shiga Hisashi , Endo Katsuya , Nagasaki Masao , Masamune Atsushi , Kinouchi Yoshitaka , Shimosegawa Tooru
Published: March 2018

Background and Aim

Patients with inflammatory bowel disease (IBD) are at a high risk of low bone mineral density (BMD). Reportedly, clinical and genetic factors cause low BMD in Caucasians; however, studies in non‐Caucasian populations remain scarce.

Methods

Clinical risk factors for low BMD were investigated in 266 Japanese patients with IBD, and a genome‐wide association analysis (GWAS) was performed using linear regression with associated clinical factors as covariates. Genotyping was performed using a population‐optimized genotyping array (Japonica array®). After quality control, the genotype data of 4 384 682 single‐nucleotide polymorphisms (SNPs) from 254 patients with IBD were used for GWAS.

Results

Body mass index, age, and disease duration were independently associated with the BMD of the femoral neck (P = 1.41E − 13, 1.04E − 5, and 1.58E − 3, respectively), and body mass index and sex were associated with the BMD of the lumbar spine (P = 6.90E − 10 and 6.84E − 3, respectively). In GWAS, 118 and 42 candidate SNPs of the femoral neck and lumbar spine, respectively, were identified. Among 118, 111 candidate SNPs of the femoral neck were located within the SLC22A23 gene, which is a known IBD susceptibility gene (minimum P = 1.42E − 07). Among 42, 18 candidate SNPs of the lumbar spine were located within the MECOM gene, which is associated with osteopenia (minimum P = 5.86E − 07). Interestingly, none of the known loci showed a significant association with BMD.

Conclusions

Although clinical risk factors for low BMD in IBD were similar to those in the general population, genetic risk factors were rather different.
Can the same controlled attenuation parameter cut‐offs be used for M and XL probes for diagnosing hepatic steatosis?
Authors: Chan Wah‐Kheong , Nik Mustapha Nik Raihan , Mahadeva Sanjiv , Wong Vincent Wai‐Sun , Cheng Jenny Yeuk‐Ki , Wong Grace Lai‐Hung
Published: March 2018

Background and Aim

There are limited studies on controlled attenuation parameter (CAP) using Fibroscan XL probe for the diagnosis of hepatic steatosis grade. The aim of this study was to determine whether previously defined optimal cut‐offs for CAP using the M probe could be applied for the XL probe.

Methods

Adult patients with chronic liver disease who had a liver biopsy and examination with both the M and XL probes were included. Previously defined optimal cut‐offs for CAP using the M probe were used for the diagnosis of steatosis grades ≥S1, ≥S2, and S3 (248, 268, and 280 dB/m, respectively).

Results

Data for 180 patients were analyzed (mean age 53.7 ± 10.8 years; central obesity 84.5%; non‐alcoholic fatty liver disease 86.7%). The distribution of steatosis grades was S0, 9.4%; S1, 28.3%; S2, 43.9%, and S3, 18.3%. The sensitivity, specificity, positive predictive value, and negative predictive value of CAP using the M/XL probe for the diagnosis of steatosis grade ≥S1 was 93.9%/93.3%, 58.8%/58.8%, 95.6%/95.6%, and 50.0%/47.6%, respectively. These values were 94.6%/94.6%, 41.2%/44.1%, 72.6%/73.6%, and 82.4%/83.3%, respectively, for ≥S2, and 87.9%/87.9%, 27.2%/27.9%, 21.3%/21.5%, and 90.9%/91.1%, respectively, for S3.

Conclusion

The same cut‐off values for CAP may be used for the M and XL probes for the diagnosis of hepatic steatosis grade.
Oral budesonide in gastrointestinal and liver disease: A practical guide for the clinician
Authors: Miehlke Stephan , Acosta Manuel Barreiro‐de , Bouma Gerd , Carpio Daniel , Magro Fernando , Moreels Tom , Probert Chris
Published: March 2018

Oral budesonide is a second‐generation steroid that allows local, selective treatment of the gastrointestinal tract and the liver, minimizing systemic exposure. The results of randomized trials comparing budesonide versus placebo or active comparators have led to expert recommendations that budesonide be used to treat mild or moderate active ileocecal Crohn's disease, microscopic colitis (including both collagenous and lymphocytic colitis), ulcerative colitis, and non‐cirrhotic autoimmune hepatitis. The mechanism of budesonide action obviates the need for dose tapering due to safety reasons after induction therapy. Where low‐dose budesonide is used to maintain remission, usually in microscopic colitis, it does not appear to have adverse safety implications other than slight reductions in cortisol levels on rare occasions. As a gut‐selective and liver‐selective corticosteroid, budesonide offers an appealing alternative to conventional systemic glucocorticoids in diseases of these organs.
Apically extruded debris during the removal of canal filling material from root canals using three techniques
Authors: Topçuoğlu Hüseyin S. , Ulusan Özge , Topçuoğlu Gamze , Biricik Eda
Published: March 2018

Aim

In the present study, we evaluated the effect of the single‐cone technique (SCT), cold lateral compaction (CLC), and wave vertical compaction (WVC) technique performed using two different sealers on the amount of apically extruded debris (AED) produced during the removal of canal filling material.

Methods

Ninety extracted mandibular premolars were prepared with ProTaper instruments. The teeth were then randomly assigned to six groups (N = 15) for root canal filling: (a) group 1, CLC+AH Plus; (b) group 2, SCT+AH Plus; (c) group 3, WVC+AH Plus; (d) group 4, CLC+MTA Fillapex; (e) group 5, SCT+MTA Fillapex; and (f) group 6, WVC+MTA Fillapex. In all groups, the removal of canal filling material was performed with ProTaper retreatment instruments. The mean weight of the AED was assessed with an analytical balance.

Results

The amount of AED was lowest in groups 2 and 5 (P < .05), with no difference between these groups (P > .05). Groups 3 and 6 produced the greatest amount of extruded debris (P < .05); there was no difference between these groups (P > .05). Additionally, there was no difference between groups 1 and 4 (P > .05). There was no significant difference among the groups regarding sealer type (P > .05).

Conclusions

The canal filling technique used affected the amount of AED produced during the removal of canal filling material, but not sealer type.
Uncertainty Quantification in Life Cycle Assessments: Exploring Distribution Choice and Greater Data Granularity to Characterize Product Use
Authors: Ross Stephen A. , Cheah Lynette
Published: March 2018

The life cycle environmental profile of energy‐consuming products is dominated by the products’ use stage. Variation in real‐world product use can therefore yield large differences in the results of life cycle assessment (LCA). Adequate characterization of input parameters is paramount for uncertainty quantification and has been a challenge to wider adoption of the LCA method. After emphasis in recent years on methodological development, data development has become the primary focus again. Pervasive sensing presents the opportunity to collect rich data sets and improve profiling of use‐stage parameters. Illustrating a data‐driven approach, we examine energy use in domestic cooling systems, focusing on climate change as the impact category. Specific objectives were to examine: (1) how characterization of the use stage by different probability distributions and (2) how characterizing data aggregated at successively higher granularity affects LCA modeling results and the uncertainty in output. Appliance‐level electricity data were sourced from domestic residences for 3 years. Use‐stage variables were propagated in a stochastic model and analyses simulated by Monte Carlo procedure. Although distribution choice did not necessarily significantly impact the estimated output, there were differences in the estimated uncertainty. Characterization of use‐stage power consumption in the model at successively higher data granularity reduced the output uncertainty with diminishing returns. Results therefore justify the collection of high granularity data sets representing the life cycle use stage of high‐energy products. The availability of such data through proliferation of pervasive sensing presents increasing opportunities to better characterize data and increase confidence in results of LCA.
Quantity, Components, and Value of Waste Materials Landfilled in the United States
Authors: Powell Jon T. , Chertow Marian R.
Published: March 2018

The current system of production and consumption needs end‐of‐life disposal to function, but the linkage between upstream production‐consumption with the downstream landfill as terminus is, at best, a tenuous, one‐way relationship, suggesting a partial system failure. A starting point to fix this link is to confront, systematically, the messy “black box” that is mixed waste landfilling, interrogate its contents locally, and determine a baseline that can be used to scale up results. Here, we develop a detailed model characterizing landfilled municipal solid waste (MSW) in the United States across the dimensions of material quantity, quality, location, and time. The model triangulates measurements spanning 1,161 landfills (representing up to 95% of landfilled MSW) and 15,169 solid waste samples collected and analyzed at 222 sites across the United States. We confirm that landfilled quantities of paper (63 million megagrams [Mg]), food waste (35 million Mg), plastic (32 million Mg, textiles (10 million Mg), and electronic waste (3.5 million Mg) are far larger than computed by previous top‐down U.S. government estimates. We estimate the cost of MSW landfill disposal in 2015 (10.7 billion U.S. dollars [USD]) and gross lost commodity value of recyclable material (1.4 billion USD). Further, we estimate landfill methane emissions to be up to 14% greater (mass basis) than the 2015 U.S. inventory. By principally relying on measurements of waste quantity and type that are recorded annually, the model can inform more effective, targeted interventions to divert waste materials from landfill disposal, improve local, regional, and national emission estimates, enhance dissipative loss estimates in material flow analyses, and illuminate the dynamics linking material, energy, and economic dimensions to production, consumption, and disposal cycles.
HRTEMFringeAnalyzer a free python module for an automated analysis of fringe pattern in transmission electron micrographs
Authors: ALXNEIT IVO
Published: March 2018

A python module (HRTEMFringeAnalyzer) is reported to evaluate the local crystallinity of samples from high‐resolution transmission electron microscopy images in a mostly automated fashion. The user only selects the size of a square analyser window and a step size which translates the window in the micrograph. Together they define the resolution of the results obtained. Regions where fringe patterns are visible are identified and their lattice spacing d and direction ϕ as well as the corresponding mean errors σ determined. is proportional to the coherence length of the structure, whereas is a measure of how well the direction of the fringes is defined. Maps of these four indicators are computed. The performance of the program is demonstrated on two very different samples: ill‐crystalline carbon deposits on a coked Ni/LFNO (reduced LaFe0.8Ni0.2O) catalyst and well‐crystallized nanoparticles of zinc doped ceria. In the latter case, the automatic segmentation of large aggregates into individual crystalline domains is achieved by ϕ maps.
Deficits in prospective memory following damage to the medial subdivision of the mediodorsal thalamic nucleus
Authors: Cona Giorgia , Laera Gianvito , Edelstyn Nicola , Bisiacchi Patrizia S.
Published: March 2018

Identifying the neurocognitive mechanisms that lead individuals remembering to execute an intention at the right moment (prospective memory, PM) and how such mechanisms are influenced by the features of that intention is a fundamental theoretical challenge. In particular, the functional contribution of subcortical regions to PM is still unknown. This study was aimed at investigating the role of the medial subdivision of the mediodorsal thalamic nucleus (mMDT) in PM, with particular focus on the processes that are mediated by the projections from/to this structure. We analysed the performance of a patient (OG) with a right‐sided lesion involving the mMDT in a series of PM tasks that varied for focality (i.e., overlapping of processes for the PM and ongoing tasks) and emotional valence of the stimuli, comparing the patient's performance with that of a control group. We found that the mMDT damage led to deficits in PM that were modulated by focality and emotional valence. OG indeed showed: a greater cost in the ongoing performance when a non‐focal PM task was added; a slowing down in retrieving the intentions, in particular when these were associated with focal PM cues; an abnormal performance in the task with positive PM cues. Our findings provide evidence of a contribution of mMDT to PM and suggest a modulation of prefrontal‐dependent strategic monitoring and a possible interaction with the limbic structures in the integration of emotion and PM processes. They also give support to the still controversial idea that connections with the perirhinal cortex mediate familiarity‐based recognition.
Differences between acute‐onset chronic inflammatory demyelinating polyneuropathy and acute inflammatory demyelinating polyneuropathy in adult patients
Authors: Alessandro Lucas , Pastor Rueda José M. , Wilken Miguel , Querol Luis , Marrodán Mariano , Acosta Julián N. , Rivero Alberto , Barroso Fabio , Farez Mauricio F.
Published: March 2018

Acute inflammatory demyelinating polyneuropathy (AIDP) and acute‐onset chronic inflammatory demyelinating polyneuropathy (A‐CIDP) are conditions presenting overlapping clinical features during early stages (first 4 weeks), although the latter may progress after 8 weeks. The aim of this study was to identify predictive factors contributing to their differential diagnosis. Clinical records of adult patients with AIDP or A‐CIDP diagnosed at our institution between January 2006 and July 2017 were retrospectively reviewed. Demographic characteristics, clinical manifestations, cerebrospinal‐fluid (CSF) findings, treatment and clinical evolution were analyzed. Nerve conduction studies were performed in all patients with at least 12 months follow‐up. A total of 91 patients were included (AIDP, n = 77; A‐CIDP, n = 14). The median age was 55.5 years in patients with A‐CIDP vs 43 years in AIDP (P = .07). The history of diabetes mellitus was more frequent in A‐CIDP (29% vs 8%, P = .04). No significant differences between groups were observed with respect to: human immunodeficiency virus (HIV) status, presence of auto‐immune disorder or oncologic disease. Cranial, motor and autonomic nerve involvement rates were similar in both groups. Patients in the A‐CIDP group showed higher frequency of proprioceptive disturbances (83% vs 28%; P < .001), sensory ataxia (46% vs 16%; P = .01), and the use of combined immunotherapy with corticoids (29% vs 3%; P = .005). There were no significant differences in CSF findings, intensive care unit (ICU) admission, or mortality rates. During the first 8 weeks both entities are practically indistinguishable. Alterations in proprioception could suggest A‐CIDP. Searching for markers that allow early differentiation could favor the onset of corticotherapy without delay.
A randomised, multi‐centre phase III study of 3 different doses of intravenous immunoglobulin 10% in patients with chronic inflammatory demyelinating polyradiculoneuropathy (ProCID trial): Study design and protocol
Authors: Cornblath David R. , Hartung Hans‐Peter , Katzberg Hans D. , Merkies Ingemar S. J. , van Doorn Pieter A.
Published: March 2018

Patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) show varying degrees of response to intravenous immunoglobulin (IVIg) therapy. This randomised phase III study in patients with CIDP (ProCID trial) will compare the efficacy and safety of 3 different doses (0.5, 1.0, and 2.0 g/kg) of IVIg 10% (panzyga) administered every 3 weeks for 24 weeks. The primary efficacy endpoint is the rate of treatment response, defined as a decrease in adjusted inflammatory neuropathy cause and treatment disability score of ≥1 point, in the IVIg 1.0 g/kg arm at week 24. Patients with definite or probable CIDP according to European Federation of Neurological Sciences/Peripheral Nerve Society criteria with IVIg or corticosteroid dependency and active disease are eligible. All potentially eligible patients will undergo IVIg or corticosteroid dose reduction (washout phase) over ≤12 weeks or until deterioration of CIDP (active disease). Patients with deterioration during the washout phase will be randomised to receive study treatment during a dose‐evaluation phase starting with a loading dose of IVIg 2.0 g/kg followed by maintenance treatment with IVIg 0.5, 1.0, or 2.0 g/kg every 3 weeks. Rescue medication (2 doses of IVIg 2.0 g/kg given 3 weeks apart) will be administered to patients in the IVIg 0.5 and 1.0 g/kg groups who deteriorate after week 3 and before week 18 or who do not improve at week 6. Safety, tolerability and quality of life will be assessed. The ProCID study will provide new information on the best maintenance dose of IVIg for patients with CIDP.
Correlations between skin hydration parameters and corneocyte‐derived parameters to characterize skin conditions
Authors: Masaki Hitoshi , Yamashita Yuki , Kyotani Daiki , Honda Tatsuya , Takano Kenichi , Tamura Toshiyasu , Mizutani Taeko , Okano Yuri
Published: March 2018

Background

Skin hydration is generally assessed using the parameters of skin surface water content (SWC) and trans‐epidermal water loss (TEWL). To date, few studies have characterized skin conditions using correlations between skin hydration parameters and corneocyte parameters.

Aims

The parameters SWC and TEWL allow the classification of skin conditions into four distinct Groups. The purpose of this study was to assess the characteristics of skin conditions classified by SWC and TEWL for correlations with parameters from corneocytes.

Methods

A human volunteer test was conducted that measured SWC and TEWL. As corneocyte‐derived parameters, the size and thick abrasion ratios, the ratio of sulfhydryl groups and disulfide bonds (SH/SS) and CP levels were analyzed.

Results

Volunteers were classified by their median SWC and TEWL values into 4 Groups: Group I (high SWC/low TEWL), Group II (high SWC/high TEWL), Group III (low SWC/low TEWL), and Group IV (low SWC/high TEWL). Group IV showed a significantly smaller size of corneocytes. Groups III and IV had significantly higher thick abrasion ratios and CP levels. Group I had a significantly lower SH/SS value. The SWC/TEWL value showed a decline in order from Group I to Group IV.

Conclusion

Groups classified by their SWC and TEWL values showed characteristic skin conditions. We propose that the SWC and TEWL ratio is a comprehensive parameter to assess skin conditions.
The relationship of delirium and risk factors for cardiology intensive care unit patients with the nursing workload
Authors: Öztürk Birge Ayşegül , Bedük Tülin
Published: March 2018

Aims and objectives

To evaluate the relationship of delirium and risk factors for cardiology intensive care unit (ICU) patients with the nursing workload.

Background

Delirium is a common syndrome in patients with cardiac problems. The risk factors causing delirium and the presence and type of delirium affect the nurse workload and patient care quality adversely.

Design

This cross‐sectional study was conducted with 133 patients staying at the cardiology ICU of a university hospital between 5 January–31 March 2017.

Method

The study data were collected using the Patient Information Form, Delirium Risk Factors' Form and Therapeutic Intervention Scoring System‐28 (TISS‐28) scale to identify the nurse workload. The statistical analysis of the data was performed using frequency, chi‐square, Mann–Whitney U, correlation and regression analyses.

Results

It was found that patients who developed delirium were 65 years or older, they had more nasogastric/total parenteral nutrition (NG/TPN), benzodiazepine and physical restraints in comparison with those with no delirium development, and that the prevalence of hypoxia and hypoalbuminemia were higher in these patients. The mean TISS‐28 score was higher in patients with delirium, compared with those without delirium. There was a positive correlation between the mean Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and the mean TISS‐28 score of the patients. The mean TISS‐28 score was found to significantly increase with being at the age of 65 and above and the administration of mechanical ventilation. The patients with delirium required a mean of 60‐min additional care.

Conclusions

Our study results suggest that the presence of delirium and the delirium risk factors, irrespective of delirium, increase the nurse workload.

Relevance to clinical practice

An effective management of delirium risk factors can improve the patient care quality by reducing delirium occurrence and nurse workload.
Factors associated with undiagnosed obstructive sleep apnoea among hypertensive patients: A multisite cross‐sectional survey study in Taiwan
Authors: Hsu Hsiu‐Chin , Chen Ning‐Hung , Ho Wan Jing , Lin Mei‐Hsiang
Published: March 2018

Aims and objectives

To investigate the distribution and risk factors associated with undiagnosed obstructive sleep apnoea among hypertensive patients.

Background

Obstructive sleep Apnoea has been deemed a cardinal risk factor affecting cardiovascular event, and the condition is still frequently overlooked clinically. The lack of advanced diagnosis often causes hypertensive patients with obstructive sleep apnoea to miss opportunities for preventing chronic diseases.

Design

A cross‐sectional design.

Methods

A total of 215 hypertensive participants were recruited from the cardiovascular outpatients of medical centre in northern and middle Taiwan. The Chinese version of Pittsburgh Sleep Quality Index, the Chinese version of the Epworth Sleep Scale and a portable sleep monitoring device were used for data collection. Logistic regression analysis was conducted to identify the factors affecting hypertensive patients with obstructive sleep apnoea, and a multinomial logistic regression analysis was used to examine the major influence factors for each obstructive sleep apnoea severity level.

Results

81.9% of the hypertensive participants were found having obstructive sleep apnoea. Concerning to the obstructive sleep apnoea severity, 50.0% of participants had mild obstructive sleep apnoea. After controlling the confounding variables, the supine position (odds ratio, 1.04; 95% CI, 1.01–1.07), SO2 (odds ratio, 0.58; 95% CI, 0.38–0.89) and oxygen desaturation index (odds ratio, 2.70; 95% CI, 1.18–6.18) were significantly associated with obstructive sleep apnoea. Furthermore, severe obstructive sleep apnoea was significantly correlated with gender (odds ratio, 0.04; 95% CI, 0.00–0.66), excessive daytime sleepiness (odds ratio, 20.27; 95% CI, 1.58–26.97) and oxygen desaturation index (odds ratio, 4.05; 95% CI, 1.86–8.81).

Conclusions

Nearly 82% of the hypertensive participants were found having undiagnosed obstructive sleep apnoea, and 80% of them were mild or moderate severity. Oxygen desaturation index, SO2 and the supine position were found to be major predictors for obstructive sleep apnoea. Remarkably, oxygen desaturation index was the most significant predictor for mild, moderate and severe obstructive sleep apnoea.

Relevance to clinical practice

Healthcare providers should enhance their sensitivities to hypertensive patients at a high risk for obstructive sleep apnoea by actively assessing common obstructive sleep apnoea symptoms and providing strategies to alleviate obstructive sleep apnoea symptoms.