bluuebunny/crossref_metadata_2025 huggingface dataset:
Line‐assisted complete closure for a large mucosal defect after colorectal endoscopic submucosal dissection decreased post‐electrocoagulation syndrome
Authors: Yamasaki Yasushi , Takeuchi Yoji , Iwatsubo Taro , Kato Minoru , Hamada Kenta , Tonai Yusuke , Matsuura Noriko , Kanesaka Takashi , Yamashina Takeshi , Arao Masamichi , Suzuki Sho , Shichijo Satoki , Nakahira Hiroko , Akasaka Tomofumi , Hanaoka Noboru , Higashino Koji , Uedo Noriya , Ishihara Ryu , Okada Hiroyuki , Iishi Hiroyasu
Published: March 2018

Background and Aim

The incidence of post‐endoscopic submucosal dissection (ESD) coagulation syndrome (PECS) can be decreased by closing mucosal defects. However, large mucosal defects after colorectal ESD cannot be closed endoscopically. We established line‐assisted complete clip closure (LACC), a novel technique for large mucosal defects after colorectal ESD. We evaluated the prophylactic efficacy of LACC for preventing PECS.

Methods

Sixty‐one consecutive patients on whom LACC after colorectal ESD was attempted from January 2016 to August 2016 were analyzed. After exclusion of patients with incomplete LACC and adverse events during ESD, 57 patients comprised the LACC group. In contrast, 495 patients who did not undergo closure of a mucosal defect comprised the control group. Propensity score matching was used to adjust for patients’ backgrounds. Treatment outcomes were evaluated between the groups.

Results

Median resected specimen size in the LACC‐attempted group was 35 mm (range, 20–72 mm), and LACC success rate was 95% (58/61). Median procedure time of LACC was 14 min. In the LACC group, incidence of PECS was only 2%, and no delayed bleeding or perforation occurred. Propensity score matching created 51 matched pairs. Adjusted comparisons between the LACC and control groups showed a lower incidence of PECS (0% vs 12%, respectively; P = 0.03) and shorter hospitalization (5 vs 6 days, respectively; P < 0.001) in the LACC group.

Conclusion

This study suggests that LACC can effectively reduce the incidence of PECS, although further large‐scale studies are warranted.
Correcting for prematurity with the Bayley Scales of Infant Development
Authors: Romeo Domenico M
Published: March 2018

This commentary is on the original article by Morsan et al. on pages 820–825 of this issue.
Towards a new generation of participation‐based interventions for adolescents with disabilities: the impact of the environment and the need for individual‐based designs
Authors: Anaby Dana
Published: March 2018

This commentary is on the original article by Kramer et al. on pages 801–809 of this issue.
Structured education using Dose Adjustment for Normal Eating (DAFNE) reduces long‐term HbA1c and HbA1c variability
Authors: Walker G. S. , Chen J. Y. , Hopkinson H. , Sainsbury C. A. R. , Jones G. C.
Published: March 2018

Aims

Previous evidence has demonstrated that participation in the Dose Adjustment for Normal Eating (DAFNE) education programme can reduce HbA1c and severe hypoglycaemia in people with Type 1 diabetes. In a number of studies, increased HbA1c variability has been associated with higher diabetic morbidity and mortality. No studies have examined the impact of structured education on HbA1c variability in Type 1 diabetes.

Methods

People with Type 1 diabetes who had attended DAFNE were identified for inclusion from the Scottish Care Information‐Diabetes dataset. HbA1c median and variability, expressed as coefficient of variation (CV) before and after DAFNE was calculated.

Results

Some 1061 individuals participated in DAFNE education and 687 met the inclusion criteria. A significant median reduction in HbA1c [−3.5 mmol/mol (−0.3%)] was seen at 12 months with a significant reduction [−1.5 mmol/mol (−0.1%)] still seen at 60 months of follow‐up. HbA1c variability as measured by CV was significantly lower during the post‐DAFNE period: 0.08 (IQR 0.05–0.12) reduced to 0.07 (IQR 0.05–0.10); P = 0.002.

Conclusion

The data confirm that DAFNE participation improves glycaemic control in Type 1 diabetes with benefits being sustained for 5 years. This study is the first to demonstrate reduced HbA1c variability after completion of structured education. This is new evidence of the beneficial impact of DAFNE on glycaemic profile.
Longitudinal medical resources and costs among type 2 diabetes patients participating in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS)
Authors: Reed Shelby D. , Li Yanhong , Leal Jose , Radican Larry , Adler Amanda I. , Alfredsson Joakim , Buse John B. , Green Jennifer B. , Kaufman Keith D. , Riefflin Axel , Van de Werf Frans , Peterson Eric D. , Gray Alastair M. , Holman Rury R. ,   for the TECOS Study Group
Published: March 2018

Aims

TECOS, a cardiovascular safety trial (ClinicalTrials.gov identifier: NCT00790205) involving 14 671 patients with type 2 diabetes and cardiovascular disease, demonstrated that sitagliptin was non‐inferior to placebo for the primary composite cardiovascular outcome when added to best usual care. This study tested hypotheses that medical resource use and costs differed between these 2 treatment strategies.

Materials and methods

Information concerning medical resource use was collected on case report forms throughout the trial and was valued using US costs for: Medicare payments for hospitalizations, medical procedures and outpatient visits, and wholesale acquisition costs (WAC) for diabetes‐related medications. Hierarchical generalized linear models were used to compare resource use and US costs, accounting for variable intercountry practice patterns. Sensitivity analyses included resource valuation using English costs for a UK perspective.

Results

There were no significant differences in hospitalizations, inpatient days, medical procedures, or outpatient visits during follow‐up (mean and median 3.0 years in both groups). Hospitalization rates appeared to diverge after 2 years, with lower rates among sitagliptin‐treated vs placebo patients after 2.5 years (relative rate, 0.90 [95% CI, 0.83‐0.97]; P = .01). Mean medical costs, exclusive of study medication, were 11 937 USD in the sitagliptin arm and 12 409 USD in the placebo arm (P = .06). Mean sitagliptin costs based on undiscounted WAC were 9978 USD per patient. Differential UK total costs including study drug costs were smaller (911 GBP), primarily because of lower mean costs for sitagliptin (1072 GBP).

Conclusions

Lower hospitalization rates across time with sitagliptin slightly offset sitagliptin treatment costs over 3 years in type 2 diabetes patients at high risk for cardiovascular events.
SGLT2 inhibitor plus DPP‐4 inhibitor as combination therapy for type 2 diabetes: A systematic review and meta‐analysis
Authors: Li Dandan , Shi Weilong , Wang Tiansheng , Tang Huilin
Published: March 2018

To assess the efficacy and safety of sodium‐glucose co‐transporter 2 (SGLT2) inhibitors plus a dipeptidyl peptidase‐4 (DPP‐4) inhibitor in patients with type 2 diabetes mellitus (T2DM), we performed a systematic review and meta‐analysis of 14 randomized controlled trials (RCTs) involving 4828 patients. Compared with a DPP‐4 inhibitor, SGLT2 inhibitor/DPP‐4 inhibitor combination therapy was significantly associated with a decrease in glycaemic control (HbA1c, −0.71%; fasting plasma glucose [FPG], −25.62 mg/dL; postprandial plasma glucose, −44.00 mg/dL), body weight (−2.05 kg) and systolic blood pressure (−5.90 mm Hg), but an increase in total cholesterol (TC) of 3.24%, high‐density lipoprotein of 6.15% and low‐density lipoprotein of 2.55%. Adding a DPP‐4 inhibitor to an SGLT2 inhibitor could reduce HbA1c by −0.31%, FPG by −8.94 mg/dL, TC by −1.48% and triglycerides by −3.25%. Interestingly, low doses of an SGLT2 inhibitor in the combination has similar or even better efficacy in some aspects than high doses. Similar adverse events were observed for the combination therapy, with the exception of genital infection vs DPP‐4 inhibitor (risk ratio [RR], 5.31) and consistent genital infection vs an SGLT2 inhibitor (RR, 0.61). Further studies are warranted to confirm these results.
Effects of the SGLT‐2 inhibitor dapagliflozin on glomerular and tubular injury markers
Authors: Dekkers Claire C. J. , Petrykiv Sergei , Laverman Gozewijn D. , Cherney David Z. , Gansevoort Ron T. , Heerspink Hiddo J. L.
Published: March 2018

The mechanisms by which SGLT‐2 inhibitors lower albuminuria are incompletely understood. We assessed in a post‐hoc analysis of a cross‐over trial the effects of the SGLT2 inhibitor dapagliflozin on glomerular markers (IgG to IgG4 and IgG to albumin), tubular markers (urinary KIM‐1, NGAL and LFABP) and inflammatory markers (urinary MCP‐1 and IL‐6) to provide more insight into kidney protective effects. Dapagliflozin decreased albuminuria by 43.9% (95% CI, 30.3%‐54.8%) and eGFR by 5.1 (2.0‐8.1) mL/min/1.73m2 compared to placebo. Dapagliflozin did not change glomerular charge or size selectivity index compared to placebo. Dapagliflozin decreased urinary KIM‐1 excretion by 22.6% (0.3%‐39.8%; P = .05) and IL‐6 excretion by 23.5% (1.4%‐40.6%; P = .04) compared to placebo, whereas no changes in NGAL, LFABP and MCP‐1 were observed. During dapagliflozin treatment, changes in albuminuria correlated with changes in eGFR (r = 0.36; P = .05) and KIM‐1 (r = 0.39; P = .05). In conclusion, the albuminuria‐lowering effect of 6 weeks of dapagliflozin therapy may be the result of decreased intraglomerular pressure or reduced tubular cell injury.
Three‐dimensional speckle tracking echocardiography–derived left atrial deformation analysis in acromegaly (Results from the MAGYAR‐Path Study)
Authors: Kormányos Árpád , Domsik Péter , Kalapos Anita , Valkusz Zsuzsanna , Lengyel Csaba , Forster Tamás , Nemes Attila
Published: March 2018

Introduction

Acromegaly is a chronic and disfiguring hormonal disease caused by a benign growth hormone‐secreting pituitary adenoma in most of the cases. The objective of this study was to investigate three‐dimensional (3D) speckle tracking echocardiography (3DSTE)‐derived left atrial (LA) volumetric and functional properties in patients with acromegaly. It was also examined whether the activity of acromegaly is associated with further alterations in these LA parameters.

Methods

A total of 23 patients with acromegaly were involved in this study. Due to inadequate image quality, 4 patients were excluded from the 3DSTE analysis. The mean age of the remaining acromegalic subjects was 58.5 ± 13.1 years (7 males). The control group consisted of 21 age‐ and gender‐matched healthy subjects (mean age 51.8 ± 10.3 years, 10 males).

Results

Maximum (44.8 ± 12.7 mL vs 78.7 ± 25.4 mL, P < .05), minimum (24.1 ± 9.0 mL vs 44.5 ± 15.5 mL, P < .05), and preatrial contraction (35.5 ± 11.2 mL vs 66.0 ± 22.8 mL, P < .05) LA volumes were significantly different between all acromegaly patients compared with controls. Increased peak global and mean segmental radial and 3D strains and decreased LA circumferential strain (CS) could be detected in all acromegaly patients as compared to healthy subjects. Significant correlation could be detected between insulin‐like growth factor 1 (IGF‐1) index and peak superior LA‐CS (r = .49, P = .05) in acromegaly.

Conclusion

Acromegaly is associated with increased LA volumes and changes in LA functional properties.
Fractional flow reserve‐CT assessment of coronary stenosis
Authors: Kerut Edmund K. , Turner Michael
Published: March 2018

Coronary computed tomography angiography (CCTA) has been an established noninvasive method for detection of coronary artery disease (CAD). Although CCTA has had a high sensitivity and negative predictive value for CAD detection, specificity for obstructive CAD has been relatively low, partly due to coronary calcium, imaging artifacts, and other factors leading to an overestimation of stenosis severity. A relatively new noninvasive method of calculation of fractional flow reserve (FFR) using CCTA (FFRCT) data has been developed. This noninvasive method yields similar results to invasive FFR measurement, improving specificity for noninvasively detecting lesion‐specific ischemia thus helping guide revascularization.
Effect of periodontal ligament removal with gauze prior to delayed replantation in rabbit incisors on rate of replacement resorption
Authors: Maslamani Manal , Joseph Bobby , Gabato Severino , Andersson Lars
Published: March 2018

Background/Aim

Delayed (dry storage > 60 minutes) replantation results in ankylosis and replacement resorption. It has been suggested to remove the non‐viable periodontal ligament before replantation to possibly reduce the rate of replacement resorption. However there has been no study on the rate of replacement resorption after such measures.

The aim of this study was to investigate if there was any difference in the rate of replacement resorption by either removing the periodontal ligament (PDL) with gauze or not removing PDL in teeth subjected to delayed replantation followed by healing for 2 or 6 weeks.

Materials and Methods

Maxillary central incisors were extracted in 8 rabbits. In the right central incisors, the necrotic PDL was removed by dry gauze over the root surface. In the left eight extracted teeth PDL was left on the root surface. All extracted teeth were left to dry for 60 minutes. Extra‐oral root canal treatment was performed before replantation. The rabbits were sacrificed after 2 weeks and 6 weeks respectively. Histologic processing and evaluation was done.

Results

In the 2 weeks group, all teeth showed ankylosis. The cementum was intact, and fusion of the bone and root was generally seen without resorption of the root, whereas in the 6 weeks group regardless of whether PDL had been kept or not, ankylosis and osseous replacement of the dentin was seen. There was no evidence of inflammatory infiltrate in the sections examined.

Conclusion

Removal of PDL prior to delayed replantation may result in some initial protection of the cementum during the first few weeks. However, over longer times there seems to be neither protection of the dentin from ankylosis and osseous replacement, nor any influence on the rate of replacement resorption.
Prey selectivity and ontogenetic diet shift of the globally invasive western mosquitofish (Gambusia affinis) in agriculturally impacted streams
Authors: Lee Finnbar , Simon Kevin S. , Perry George L. W.
Published: March 2018

The dietary breadth of invaders can influence their success, and having a wide dietary niche can facilitate the spread and survival of invaders under a variety of resource scenarios. The western mosquitofish (Gambusia affinis) is a globally distributed freshwater invasive fish. The spread of G. affinis is associated with agricultural land use, although the trophic role it plays in degraded systems is not well understood. We analysed the invertebrate community in 11 stream reaches in the North Island of New Zealand, in catchments spanning a range (45%–90%) of agricultural land use to determine how prey availability changes with land use. We then analysed the gut contents of 400 G. affinis from the 11 sites to determine how diet varied with prey availability and ontogeny. Invertebrate communities varied along the agricultural land‐use gradient, both in regard to taxonomic richness and community composition. G. affinis consumed a wide variety of food items with invertebrates being the most dominant, in particular Culicidae, Copepods and amphipods were the most commonly consumed invertebrates. There was also an ontogenetic diet shift from microinvertebrates (Cladocera, Copepods and diatoms) to larger invertebrates, including Culicidae, amphipods and terrestrial invertebrates. G. affinis are capable of consuming a wide variety of prey in agricultural streams; their preferred prey are generally pollution‐tolerant taxa commonly found in degraded streams. Having a large level of dietary plasticity coupled with preferring prey that are often associated with degraded systems likely facilitates to the spread of one of the most widely distributed freshwater invasive fish.
Do postlarval amphidromous fishes transport marine‐derived nutrients and pollutants to Caribbean streams?
Authors: Engman Augustin C. , Kwak Thomas J. , Cope W. Gregory
Published: March 2018

Diadromous fishes are known biotransport vectors that can move nutrients, energy and contaminants in an upstream direction in lotic ecosystems. This function has been demonstrated repeatedly in anadromous salmonids, but the role of other diadromous species, especially tropical taxa, as biotransport vectors is less studied. Amphidromous fish species exhibit potential to act as upstream vectors of nutrients and contaminants in their postlarval and juvenile stages, but this role is largely unknown because of limited understanding of larval growth habitats. Moreover, because some species are harvested in artisanal fisheries as postlarvae, and postlarvae are consumed by riverine and estuarine predators, heavy contaminant loads may present a human or wildlife health concern. This research incorporates stable isotope and contaminant analyses to infer larval habitats and contaminant accumulation of amphidromous fishes on the Caribbean island of Puerto Rico. The isotopic signatures of postlarval amphidromous fishes indicated marine basal sources and food web components, rather than those from riverine habitats. Additionally, postlarvae did not contain concentrations of anthropogenic pollutants that would be of ecological or human health concern. These findings are the first and strongest evidence that amphidromous fish postlarvae function as biotransport vectors of marine nutrients into and up river ecosystems without posing a health threat to the receiving food web or human consumers.
Lenalidomide treatment of myelodysplastic syndromes with chromosome 5q deletion: Results from the National Registry of the Italian Drug Agency
Authors: Arcioni Francesco , Roncadori Andrea , Di Battista Valeria , Tura Sante , Covezzoli Anna , Cundari Sante , Mecucci Cristina ,   MORE Study Centres
Published: March 2018

Objective

The most typical cytogenetic aberration in myelodysplastic syndromes is del(5q), which, when isolated, is associated with refractory anaemia and good prognosis. Based on high rates of erythroid response and transfusion independence, Lenalidomide (LEN) became the standard treatment. This multi‐centre study was designed to supplement Italian Registry data on LEN by addressing prescription, administration appropriateness, haematological and cytogenetic responses and disease evolution.

Methods

MORE study was an observational, non‐interventional, multi‐centre, retrospective and prospective study. Cases were recruited from 45 Haematological Centres throughout Italy. Data were collected from the Italian National Registry for Lenalidomide administration and supplemented by a MORE data form.

Results

Data from 190/213 patients were analysed. In all, 149 had been diagnosed by conventional cytogenetics (GROUP A) and 41 only by FISH (GROUP B). Overall erythroid response was obtained in 92.8% of cases. Overall cytogenetic remission was achieved in 22.6% of cases. Disease progression occurred in 15.6% of cases. Clonal cytogenetic evolution characterised progression to AML but not to higher risk MDS.

Conclusions

Erythroid response to Lenalidomide was similar in MDS with isolated del(5q) and with del(5q) plus one anomaly. Progression to AML or higher risk MDS showed different cytogenetic features.
Evidence for intragenic recombination and selective sweep in an effector gene of Phytophthora infestans
Authors: Yang Lina , Ouyang Hai‐Bing , Fang Zhi‐Guo , Zhu Wen , Wu E‐Jiao , Luo Gui‐Huo , Shang Li‐Ping , Zhan Jiasui
Published: March 2018

Effectors, a group of small proteins secreted by pathogens, play a critical role in the antagonistic interaction between plant hosts and pathogens through their dual functions in regulating host immune systems and pathogen infection capability. In this study, evolution in effector genes was investigated through population genetic analysis of Avr3a sequences generated from 96 Phytophthora infestans isolates collected from six locations representing a range of thermal variation and cropping systems in China. We found high genetic variation in the Avr3a gene resulting from diverse mechanisms extending beyond point mutations, frameshift, and defeated start and stop codons to intragenic recombination. A total of 51 nucleotide haplotypes encoding 38 amino acid isoforms were detected in the 96 full sequences with nucleotide diversity in the pathogen populations ranging from 0.007 to 0.023 (mean = 0.017). Although haplotype and nucleotide diversity were high, the effector gene was dominated by only three haplotypes. Evidence for a selective sweep was provided by (i) the population genetic differentiation (GST) of haplotypes being lower than the population differentiation (FST) of SSR marker loci; and (ii) negative values of Tajima's D and Fu's FS. Annual mean temperature in the collection sites was negatively correlated with the frequency of the virulent form (Avr3aEM), indicating Avr3a may be regulated by temperature. These results suggest that elevated air temperature due to global warming may hamper the development of pathogenicity traits in P. infestans and further study under confined thermal regimes may be required to confirm the hypothesis.
Pain management for laminitis in the horse
Authors: Hopster K. , van Eps A. W.
Published: March 2018

The inability to control pain is the most common reason for cessation of treatment and euthanasia in cases of laminitis, yet pain also serves a unique protective function in these cases, particularly in the acute phase when lamellar integrity is weakened. Successful analgesia requires an understanding of the disease pathophysiology, the sources of pain in laminitis, methods of serial pain evaluation, and methods of analgesia including systemic and regional techniques. This review discusses the approach to analgesia including detail of traditional and novel analgesic medications and techniques with specific reference to the laminitis case.
Theoretical framework for estimating a product's reliability using a variable‐amplitude loading spectrum and a stress‐based approach
Authors: Portalés R.M. , del Mar Bochons Sania M. , Klemenc J.
Published: March 2018

An innovative approach for predicting the reliability of a structure that is subject to a variable‐amplitude dynamic load is presented. In this approach, a Gassner durability curve with its scatter is modelled using a 2‐parametric Weibull's probability density function (PDF). The trend of the Gassner durability curve is modelled with a general hyperbola equation in a log‐log scale. The hyperbola equation is applied to represent the durability curve for the 63.2% probability of fatigue failure that describes the dependency of the Weibull's scale parameter on the loading spectrum's maximum stress. Equations are derived to link the parameters of the hyperbola curve to the material's S‐N curve and the loading spectrum. The Weibull's shape parameter is estimated from the scatter of the material's S‐N curve. The proposed Gassner‐curve model is applied to calculate the fatigue reliability from the PDF of the loading spectrum's maximum stress and the PDF of the durability‐curve's amplitude stress for the selected number of loading‐cycles‐to‐failure.
Predicting loneliness with polygenic scores of social, psychological and psychiatric traits
Authors: Abdellaoui A. , Nivard M. G. , Hottenga J.‐J. , Fedko I. , Verweij K. J. H. , Baselmans B. M. L. , Ehli E. A. , Davies G. E. , Bartels M. , Boomsma D. I. , Cacioppo J. T.
Published: March 2018

Loneliness is a heritable trait that accompanies multiple disorders. The association between loneliness and mental health indices may partly be due to inherited biological factors. We constructed polygenic scores for 27 traits related to behavior, cognition and mental health and tested their prediction for self‐reported loneliness in a population‐based sample of 8798 Dutch individuals. Polygenic scores for major depressive disorder (MDD), schizophrenia and bipolar disorder were significantly associated with loneliness. Of the Big Five personality dimensions, polygenic scores for neuroticism and conscientiousness also significantly predicted loneliness, as did the polygenic scores for subjective well‐being, tiredness and self‐rated health. When including all polygenic scores simultaneously into one model, only 2 major depression polygenic scores remained as significant predictors of loneliness. When controlling only for these 2 MDD polygenic scores, only neuroticism and schizophrenia remain significant. The total variation explained by all polygenic scores collectively was 1.7%. The association between the propensity to feel lonely and the susceptibility to psychiatric disorders thus pointed to a shared genetic etiology. The predictive power of polygenic scores will increase as the power of the genome‐wide association studies on which they are based increases and may lead to clinically useful polygenic scores that can inform on the genetic predisposition to loneliness and mental health.
The interaction of the Chrna5 D398N variant with developmental nicotine exposure
Authors: O'Neill H. C. , Wageman C. R. , Sherman S. E. , Grady S. R. , Marks M. J. , Stitzel J. A.
Published: March 2018

A single nucleotide polymorphism (SNP) in CHRNA5 (rs16969968, change from an aspartic acid [D] to asparagine [N] at position 398 of the human α5 nicotinic acetylcholine receptor subunit) has been associated with increased risk for nicotine dependence. Consequently, carriers of the risk variant may be at elevated risk for in utero nicotine exposure. To assess whether this gene‐environment interaction might impact nicotine intake in developmental nicotine‐exposed offspring, we utilized a mouse expressing this human SNP. D and N dams drank nicotine (100 μg/mL) in 0.2% saccharin water or 0.2% saccharin water alone (vehicle) as their sole source of fluid from 30 days prior to breeding until weaning of offspring. The nicotine (D Nic, N Nic) or vehicle (D Veh, N Veh) exposed offspring underwent a 2‐bottle choice test between postnatal ages of 30 to 46 days. N Nic offspring consumed the most nicotine at the highest concentration (400 μg/mL) compared with all other groups. In contrast, D Nic offspring drank the least amount of nicotine at all concentrations tested. Nicotine‐stimulated dopamine (DA) release measured from striatal synaptosomes was increased in D Nic offspring, while decreased in N Nic offspring relative to their genotype‐matched controls. These data suggest that the α5 variant influences the effect of developmental nicotine exposure on nicotine intake of exposed offspring. This gene‐environment interaction on striatal DA release may provide motivation for increased nicotine seeking in N Nic offspring and reduced consumption in D Nic offspring.
Anthropogenic disturbance equalizes diversity levels in arbuscular mycorrhizal fungal communities
Authors: García de León David , Davison John , Moora Mari , Öpik Maarja , Feng Huyuan , Hiiesalu Inga , Jairus Teele , Koorem Kadri , Liu Yongjun , Phosri Cherdchai , Sepp Siim‐Kaarel , Vasar Martti , Zobel Martin
Published: March 2018

The arbuscular mycorrhizal (AM) symbiosis is a key plant–microbe interaction in sustainable functioning ecosystems. Increasing anthropogenic disturbance poses a threat to AM fungal communities worldwide, but there is little empirical evidence about its potential negative consequences. In this global study, we sequenced AM fungal DNA in soil samples collected from pairs of natural (undisturbed) and anthropogenic (disturbed) plots in two ecosystem types (10 naturally wooded and six naturally unwooded ecosystems). We found that ecosystem type had stronger directional effects than anthropogenic disturbance on AM fungal alpha and beta diversity. However, disturbance increased alpha and beta diversity at sites where natural diversity was low and decreased diversity at sites where natural diversity was high. Cultured AM fungal taxa were more prevalent in anthropogenic than natural plots, probably due to their efficient colonization strategies and ability to recover from disturbance. We conclude that anthropogenic disturbance does not have a consistent directional effect on AM fungal diversity; rather, disturbance equalizes levels of diversity at large scales and causes changes in community functional structure.
Risk factors of adverse events in endoscopic retrograde cholangiopancreatography for patients aged ≥85 years
Authors: Takahashi Koji , Tsuyuguchi Toshio , Sugiyama Harutoshi , Kumagai Junichiro , Nakamura Masato , Iino Yotaro , Shingyoji Ayako , Yamato Mutsumi , Ohyama Hiroshi , Kusakabe Yuko , Yasui Shin , Mikata Rintaro , Kato Naoya
Published: March 2018

Aim

Little is known about the factors that contribute to the occurrence of adverse events in endoscopic retrograde cholangiopancreatography (ERCP) for people aged ≥85 years and safety for the super‐old. Therefore, we decided to identify these factors and to examine whether ERCP is safe in the super‐old.

Methods

This was a single‐center retrospective study. A total of 137 patients aged ≥85 years who underwent therapeutic ERCP at Chiba University Hospital from January 2012 to March 2017 were retrospectively reviewed.

Results

Four cases of Billroth II reconstruction and two cases of gastrectomy with Roux‐en‐Y reconstruction were excluded, and 131cases in total were examined in the present study. A total of 10 and 121 cases with and without adverse events, respectively, were present. Using univariate analysis, factors significantly contributing to the occurrence of adverse events in therapeutic ERCP were identified as aged ≥90 years (P = 0.0096), duodenal papilla cancer (P = 0.0012), gallbladder carcinoma (P = 0.023), and biliary metal stenting (P = 0.040). In multivariate analysis, only ≥90 years‐of‐age was a significant factor (P = 0.049). In addition, comparison between 25 cases of the super‐old and 106 cases aged 85–89 years was carried out. In the super‐old group, the average value of the American Society of Anesthesiologists physical status classification and Charlson’s Comorbidity Index were significantly better than those in 85–89‐year‐olds (P = 0.0035 and P < 0.0001, respectively).

Conclusions

Although the super‐old group had fewer comorbid diseases, they had significantly increased adverse events compared with patients aged 85–89 years. Geriatr Gerontol Int 2018; 18: 1038–1045.
Application of ERT, Saline Tracer and Numerical Studies to Delineate Preferential Paths in Fractured Granites
Authors: Sreeparvathy Vijay , Kambhammettu B.V.N.P. , Peddinti Srinivasa Rao , Sarada P.S.L.
Published: March 2018

Accurate quantification of in situ heterogeneity and flow processes through fractured geologic media remains elusive for hydrogeologists due to the complexity in fracture characterization and its multiscale behavior. In this research, we demonstrated the efficacy of tracer‐electrical resistivity tomography (ERT) experiments combined with numerical simulations to characterize heterogeneity and delineate preferential flow paths in a fractured granite aquifer. A series of natural gradient saline tracer experiments were conducted from a depth window of 18 to 22 m in an injection well (IW) located inside the Indian Institute of Technology Hyderabad campus. Tracer migration was monitored in a time‐lapse mode using two cross‐sectional surface ERT profiles placed in the direction of flow gradient. ERT data quality was improved by considering stacking, reciprocal measurements, resolution indicators, and geophysical logs. Dynamic changes in subsurface electrical properties inferred via resistivity anomalies were used to highlight preferential flow paths of the study area. Temporal changes in electrical resistivity and tracer concentration were monitored along the vertical in an observation well located at 48 m to the east of the IW. ERT‐derived tracer breakthrough curves were in agreement with geochemical sample measurements. Fracture geometry and hydraulic properties derived from ERT and pumping tests were further used to evaluate two mathematical conceptualizations that are relevant to fractured aquifers. Results of numerical analysis conclude that dual continuum model that combines matrix and fracture systems through a flow exchange term has outperformed equivalent continuum model in reproducing tracer concentrations at the monitoring wells (evident by a decrease in RMSE from 199 to 65 mg/L). A sensitivity analysis on model simulations conclude that spatial variability in hydraulic conductivity, local‐scale dispersion, and flow exchange at fracture‐matrix interface have a profound effect on model simulations.
Analysis of current perioperative management with Haemate® P/Humate P® in von Willebrand disease: Identifying the need for personalized treatment
Authors: Hazendonk H. C. A. M. , Heijdra J. M. , de Jager N. C. B. , Veerman H. C. , Boender J. , van Moort I. , Mathôt R. A. A. , Meijer K. , Laros‐van Gorkom B. A. P. , Eikenboom J. , Fijnvandraat K. , Leebeek F. W. G. , Cnossen M. H. ,   the “OPTI‐CLOT” and “WIN” study group
Published: March 2018

Introduction

Patients with Von Willebrand disease (VWD) are regularly treated with VWF‐containing concentrates in case of acute bleeding, trauma and dental or surgical procedures.

Aim

In this multicentre retrospective study, current perioperative management with a von Willebrand factor (VWF)/Factor VIII (FVIII) concentrate (Haemate® P) in patients with VWD was evaluated.

Patients/Methods

Patients with VWD undergoing minor or major surgery between 2000 and 2015, requiring treatment with a VWF/FVIII concentrate (Haemate® P), were included. Achieved VWF activity (VWF:Act) and FVIII during FVIII‐based treatment regimens were compared to predefined target levels in national guidelines.

Results

In total, 103 patients with VWD (148 surgeries) were included: 54 type 1 (73 surgeries), 43 type 2 (67 surgeries) and 6 type 3 (8 surgeries). Overall, treatment resulted in high VWF:Act and FVIII levels, defined as ≥0.20 IU/mL above predefined levels. In patients with type 1 VWD, respectively, 65% and 91% of trough VWF:Act and FVIII levels were higher than target levels. In patients with type 2 and type 3 VWD, respectively, 53% and 57% of trough VWF:Act and 72% and 73% of trough FVIII levels were higher than target level. Furthermore, FVIII accumulation over time was observed, while VWF:Act showed a declining trend, leading to significantly higher levels of FVIII than VWF:Act.

Conclusion

High VWF:Act and accumulation of FVIII were observed after perioperative FVIII‐based replacement therapy in patients with VWD, both underlining the necessity of personalization of dosing regimens to optimize perioperative treatment.
A study of skin disease spectrum occurring in Angola phototype V–VI population in Luanda
Authors: De Luca David A. , Maianski Ziv , Averbukh Michael
Published: March 2018

Background

Prevalence of skin diseases in Luanda (Angola) is unknown, and publications are barely found in the literature. We aim to describe, for the first time, the frequency of skin disease spectrum in phototype V‐VI Angolan population in Luanda City.

Methods

We included Fitzpatrick phototype V‐VI Angolan patients who consulted the Dermatology Unit in Luanda Medical Center during a 1‐year period. Medical information was recovered from the electronic database, and diagnoses were based on ICD‐10. Only the main complaint was registered, and the results were classified according to age and sex. Criteria exclusion consisted of incomplete clinical records, Fitzpatrick phototype I‐IV Angolan, or foreign patients from the study.

Results

From a total of 3938 patients, 3554 met the inclusion criteria, of which 2742 were adults 13 years or older. In this group, acne (23.6%), dermatophytosis (11.0%), and pityriasis versicolor (8.6%) were the main complaints. On the other hand, in the pediatric population (n = 812), atopic dermatitis (29.4%), tinea capitis (13.7%), and molluscum contagiosum (12.5%) were the most frequent disorders. In adult females, acne (31.3%) was the main condition, while in adult males, dermatophytosis (13.5%). In children, the frequency of atopic dermatitis was comparable: 29.1% and 28.6% in girls and boys, respectively.

Conclusions

We published for the first time the frequency of the skin disease spectrum in Fitzpatrick phototype V‐VI Angolan population in Luanda City, highlighting the prevalence of acne, dermatophytosis, and atopic dermatitis.
Adolescent preferences for weight terminology used by health care providers
Authors: Puhl R. M. , Himmelstein M. S.
Published: March 2018

Background

In light of high rates of obesity and weight stigma in youth, the American Academy of Paediatrics recommends that paediatric health care professionals use appropriate, sensitive and non‐stigmatizing language in communication about weight with youth. For these efforts to be effective, there is a need to identify weight‐based language preferences among youth with overweight and obesity, as research in this area is scarce.

Objectives

The present study provides a systematic assessment of youth perspectives of weight‐based language used by providers.

Methods

Adolescents (ages 13–18 years; N = 148) enrolled in a national weight loss camp were surveyed about their preferences for words that health providers use to refer to their body weight. Adolescents completed an online survey and responded to a list of 16 words describing excess body weight, as well as questions assessing demographics, body mass index, and experienced as well as internalized weight stigma.

Results

Adolescents assigned low ratings to words like ‘fat’, ‘large’, ‘obese’ and ‘extremely obese’, indicating that they would not want providers to use these words when discussing their body weight. In contrast, words like ‘weight problem’, ‘BMI’ and ‘plus size’ were rated among the most preferred words for providers to use. Word preferences varied across gender, body mass index and extent of internalized weight stigma.

Conclusions

These findings underscore the importance of acknowledging different word preferences among youth, and to avoid making assumptions about what words youth will feel most comfortable using in discussions about their body weight.
Local treatment for metastatic prostate cancer: A systematic review
Authors: Tilki Derya , Pompe Raisa S , Bandini Marco , Marchioni Michele , Kretschmer Alexander , Tian Zhe , Karakiewicz Pierre I , Evans Christopher P
Published: March 2018

The potential oncological benefit for radical treatment in the setting of oligometastatic prostate cancer has been under investigation and is frequently discussed. We carried out a systematic review of English language articles using the Medline database (January 2000 to May 2017) to identify studies reporting local treatment in men with metastatic prostate cancer at diagnosis. Primary end‐points were oncological outcomes, such as cancer‐specific and overall mortality. Secondary end‐points were non‐oncological outcomes, such as complications, operating room time, blood loss or length of hospital stay. Two independent authors reviewed and extracted all search results. Overall, 18 studies reporting on local treatment in metastatic prostate cancer patients were identified (14 original articles, three brief correspondences and one letter to the editor). All of them were retrospective; one partly included prospective data. All studies addressed oncological outcomes, 16 compared local treatment with no‐local treatment and 14 adjusted for confounders using multivariable regression models. All but one study concluded a survival benefit for local treatment in the metastatic setting. Due to heterogeneity of available data, a representative meta‐analysis could not be carried out. Five studies reported non‐oncological outcomes. Although local treatment in metastatic prostate cancer appears to be feasible, its oncological effect remains unclear due to high susceptibility of available studies to significant selection bias.
Involvement of microRNA miR‐2b‐3p in regulation of metabolic resistance to insecticides in Plutella xylostella
Authors: Etebari K. , Afrad M. H. , Tang B. , Silva R. , Furlong M. J. , Asgari S.
Published: March 2018

The diamondback moth, Plutella xylostella, has developed extremely high levels of resistance to chlorantraniliprole and other classes of insecticides in the field. As microRNAs (miRNAs) play important roles in various biological processes through gene regulation, we examined the miRNA profile of P. xylostella in response to chlorantraniliprole exposure. RNA sequencing analysis showed that insecticide treatment caused significant changes in the abundance of some miRNAs. Increasing exposure time and insecticide concentration induced more dysregulated miRNAs in P. xylostella larvae. We also screened potential target genes for some of the differentially expressed miRNAs (such as miR‐2b‐3p, miR‐14b‐5p and let‐7‐5p), which may play important roles in insecticide resistance development. Exposure of P. xylostella larvae to chlorantraniliprole caused considerable overexpression in the transcript levels of potential target genes cytochrome P450 9f2 (CYP9F2) and 307a1 (CYP307a1). Application of miR‐2b‐3p and miR‐14b‐5p mimics significantly suppressed the relative transcript levels of CYP9F2 and CYP307a1, respectively, in a P. xylostella cell line. Furthermore, enrichment of P. xylostella diet with miR‐2b‐3p mimics significantly increased mortality in deltamethrin‐resistant larvae when exposed to deltamethrin. The results suggest that miR‐2b‐3p may suppress CYP9F2 transcript levels in P. xylostella and consequently inhibit larval detoxification pathways. The findings provide an insight into possible role of miRNAs in regulation of metabolic resistance of insects to insecticides.
Characteristics of fall‐related traumatic brain injury in older adults
Authors: Teo Desmond B. , Wong Hung C. , Yeo Ai W. , Lai Yi W. , Choo Ee L. , Merchant Reshma A.
Published: March 2018

Background

Older adults admitted for falls and its complications, including traumatic brain injury (TBI), is increasing. Recent studies have shown that those with falls who presented to the emergency department (ED) had an increased frequency of ED revisits, especially those with head trauma.

Aim

To determine the characteristics and predictors of fall‐related traumatic brain injury (FRTBI) in older adults.

Methods

Retrospective medical chart review of 339 patients aged 65 years and older admitted for TBI in 2014 due to a fall. Characteristics analysed include demographics, fall circumstances, prior ED visits, polypharmacy, readmission, functional status and specialist outpatient clinic utilisation before and after FRTBI.

Results

A total of 339 (37.4%) patients admitted due to FRTBI was 65 years old and older; 112 (33.0%) for subdural haemorrhage (SDH); 227 (67.0%) for head injury (HI), with a mean age of 80 years. A total of 46 (41.1%) patients with SDH and 107 (47.1%) with HI had a previous ED visit within the last year, while 22 (19.6%) of SDH and 49 (21.6%) of HI had hospitalisation 3 months prior to FRTBI. FRTBI was associated with significant decline in activities of daily living, polypharmacy and increased specialist outpatient clinic appointments (P < 0.001). Mortality was 11 (3.2%). Mild cognitive impairment or dementia was significantly associated with admissions for FRTBI, 3.31 (95% confidence interval 1.68–6.51, P = 0.001) using adjusted logistic regression.

Conclusion

FRTBI is associated with significant functional decline and increased resource utilisation with almost half of the patients having had prior ED visits or hospitalisation. Future studies should focus on falls risk assessment and interventions for high‐risk older adults prior to discharge from ED and hospital, and its impact on readmissions due to FRTBI.
Under‐utilisation of β‐blockers in patients with acute coronary syndrome and comorbid chronic obstructive pulmonary disease
Authors: Kratzer Logan , Noakes Paul , Baumwol Jay , Wrobel Jeremy P.
Published: March 2018

Background

β‐blockers are an established mainstay of therapy in acute coronary syndrome (ACS). Despite substantial evidence of their safety and efficacy in chronic obstructive pulmonary disease (COPD) patients, their use in this population remains limited internationally, likely due to fears of inducing bronchospasm. In Australia, little is known about the use of β‐blockers in COPD patients hospitalised for ACS.

Aim

To determine if β‐blockers are under‐prescribed at discharge for patients with COPD hospitalised for ACS compared to patients without a diagnosis of COPD.

Methods

Retrospective analysis of a tertiary metropolitan hospital computer database was undertaken to identify the first 250 patients hospitalised with ACS from 1 March 2015.

Results

Of the 250 patients analysed, there were five in‐hospital fatalities, leaving 245 patients for final analysis. Patients with ACS and COPD received fewer β‐blockers at discharge than those with ACS alone (66.7% vs 86.2%, P < 0.05). After controlling for clinically meaningful confounding factors, a logistic regression analysis model determined that, for patients with ACS, the presence of COPD was the only significant predictor of receiving a β‐blocker at discharge.

Conclusion

Despite strong evidence supporting the use of β‐blockers in COPD patients with ACS, Australian patients with COPD remain under‐treated for ACS. More work is needed to alter prescribing attitudes.
Patient receipt of smoking cessation care in four Australian acute psychiatric facilities
Authors: Metse Alexandra P. , Wiggers John , Wye Paula , Bowman Jenny A.
Published: March 2018

This study aimed to report the receipt of smoking care, and associated clinical and smoking characteristics among smokers admitted to four public psychiatric inpatient facilities in New South Wales, Australia. Between October 2012 and July 2014, adult smokers (N = 236) were surveyed during admission to and 1 month following discharge from the facilities. Measures of smoking care receipt were reported descriptively, and logistic regression analyses were used to explore characteristics associated with care receipt. The majority of participants were offered (78%) and used (78%) nicotine replacement therapy (NRT), with 66% of NRT‐users reporting the amount provided was sufficient to reduce cravings. A minority of participants (16%) received information or advice to quit smoking, and 60% reported smoking throughout their admission. Patients not contemplating quitting and those with non‐psychotic disorders were more likely to receive an offer of NRT. The findings suggest the provision of smoking care in Australian acute psychiatric units is sub‐optimal overall, with an indication that care may be provided selectively to certain patients, rather than systematically to all. Development and dissemination of interventions to increase smoking care provision in inpatient psychiatry are needed.