bluuebunny/crossref_metadata_2025 huggingface dataset:
An empirical investigation of the relationship between TSR, value-based and accounting-based performance measures
Authors: Makhija Harnesh , Trivedi Pankaj
Published: June 2020

Purpose

The paper aims to find out the information content of performance measures from accounting and value-based measures that best explain the total shareholder return.

Design/ methodology/ approach

To achieve this aim, static and dynamic panel data regression analysis is applied to the sample of 56 Indian companies taken from the Nifty Midcap 100 Index, between 2012 and 2019.

Findings

It is found that accounting-based measures have more relative information content in predicting total shareholder return as compared to value-based measures. Economic value added (EVA) and cash value added (CVA) do not add to the information content provided by accounting-based measures. A combination of accounting-based measures and value-added intellectual coefficient (VAIC) adds marginally to the information content provided by accounting-based measures in explaining the total shareholder return. Dynamic panel regression analysis shows that return on assets (ROA), return on capital employed (ROCE), return on equity (ROE) and EVA have a significant impact on total shareholder return.

Originality/value

In this study, along with EVA, other measures from value-based measures, i.e. CVA are empirically tested to explain the total shareholder return. Intellectual capital efficiency computed by VAIC is also empirically tested along with accounting-based measures, EVA, CVA and market value added (MVA). To bring robustness to findings, data are tested by using dynamic panel regression analysis.
Mate‐finding dispersal reduces local mate limitation and sex bias in dispersal
Authors: Mishra Abhishek , Tung Sudipta , Shree Sruti V. R. , Srivathsa Sahana , Dey Sutirth
Published: June 2020

Sex‐biased dispersal (SBD) often skews the local sex ratio in a population. This can result in a shortage of mates for individuals of the less‐dispersive sex. Such mate limitation can lead to Allee effects in populations that are small or undergoing range expansion, consequently affecting their survival, growth, stability and invasion speed.

Theory predicts that mate shortage can lead to either an increase or a decrease in the dispersal of the less‐dispersive sex. However, neither of these predictions have been empirically validated.

To investigate how SBD‐induced mate limitation affects dispersal of the less‐dispersive sex, we used Drosophila melanogaster populations with varying dispersal propensities. To rule out any mate‐independent density effects, we examined the behavioural plasticity of dispersal in the presence of mates as well as same‐sex individuals with differential dispersal capabilities.

In the presence of high‐dispersive mates, the dispersal of both male and female individuals was significantly increased. However, the magnitude of this increase was much larger in males than in females, indicating that the former shows greater mate‐finding dispersal. Moreover, the dispersal of either sex did not change when dispersing alongside high‐ or low‐dispersive individuals of the same sex. This suggested that the observed plasticity in dispersal was indeed due to mate‐finding dispersal, and not mate‐independent density effects.

Strong mate‐finding dispersal can diminish the magnitude of sex bias in dispersal. This can modulate the evolutionary processes that shape range expansions and invasions, depending on the population size. In small populations, mate‐finding dispersal can ameliorate Allee effects. However, in large populations, it can dilute the effects of spatial sorting.
Characterization and functional analysis of chitinase family genes involved in nymph–adult transition of Sogatella furcifera
Authors: Yang Xibin , Zhou Cao , Long Guiyun , Yang Hong , Chen Chen , Jin Daochao
Published: June 2020

Chitinase degrades chitin in the old epidermis or peritrophic matrix of insects, which ensures normal development and metamorphosis. In our previous work, we comprehensively studied the function of SfCht7 in Sogatella furcifera. However, the number and function of chitinase genes in S. furcifera remain unknown. Here, we identified 12 full‐length chitinase transcripts from S. furcifera, which included nine chitinase (Cht), two imaginal disc growth factor (IDGF), and one endo‐β‐N‐acetylglucosaminidase (ENGase) genes. Expression analysis results revealed that the expression levels of eight genes (SfCht3, SfCht5, SfCht6‐1, SfCht6‐2, SfCht7, SfCht8, SfCht10, and SfIDGF2) with similar transcript levels peaked prior to molting of each nymph and were highly expressed in the integument. Based on RNA interference (RNAi), description of the functions of each chitinase gene indicated that the silencing of SfCht5, SfCht10, and SfIDGF2 led to molting defects and lethality. RNAi inhibited the expressions of SfCht5, SfCht7, SfCht10, and SfIDGF2, which led to downregulated expressions of chitin synthase 1 (SfCHS1, SfCHS1a, and SfCHS1b) and four chitin deacetylase genes (SfCDA1, SfCDA2, SfCDA3, and SfCDA4), and caused a change in the expression level of two trehalase genes (TRE1 and TRE2). Furthermore, silencing of SfCht7 induced a significant decrease in the expression levels of three wing development‐related genes (SfWG, SfDpp, and SfHh). In conclusion, SfCht5, SfCht7, SfCht10, and SfIDGF2 play vital roles in nymph–adult transition and are involved in the regulation of chitin metabolism, and SfCht7 is also involved in wing development; therefore, these genes are potential targets for control of S. furcifera.
Mass spectrometry of urinary β2 microglobulin oligomer in patients with proteinuria
Authors: Akizuki Setsuko , Kawano Katsumi , Iwamoto Takeo , Nakada Koji , Ohnishi Akihiro
Published: June 2020

Urinary β2 microglobulin (β2‐m) is a marker of renal tubule dysfunction; however, β2‐m might become degraded under acidic conditions. To confirm the degradation and consequent deactivation of β2‐m under acidic conditions, we used matrix‐assisted laser desorption ionization‐time‐of‐flight mass spectrometry (MALDI‐TOF MS) to detect the levels and forms of β2‐m in the urine samples of patients with high proteinuria (n = 21) and healthy subjects (n = 6). β2‐m was purified in crude form using immunoprecipitation. A signal of 11.74 kDa, corresponding to the molecular weight of β2‐m, was detected in all samples. In addition, several high‐molecular‐weight proteins were detected in a patient as integrals of the intensity at 11.74 kDa. These results indicate that posttranslational modifications of β2‐m might be involved in the pathological process of proteinuria. Therefore, MS can be used for monitoring proteinuria and predicting the risk of progression.
Lysophosphatidylserine induces eosinophil extracellular trap formation and degranulation: Implications in severe asthma
Authors: Kim Hye Jeong , Sim Myeong Seong , Lee Dong Hyun , Kim Chun , Choi Youngwoo , Park Hae‐Sim , Chung Il Yup
Published: June 2020

Background

Recent evidence demonstrates that activated eosinophils undergo a distinct form of lytic cell death, accompanied by formation of DNA‐based eosinophil extracellular trap (EET) and degranulation, enhancing inflammatory immune responses in asthmatic airways. We previously showed that human blood eosinophils undergo degranulation in response to lysophosphatidylserine (LysoPS), an inflammatory lipid mediator, and strongly express P2Y10, a LysoPS receptor.

Methods

We evaluated EET, degranulation, and cell death of eosinophils in response to various concentrations of LysoPS. We also compared responsiveness to LysoPS between eosinophils from severe and nonsevere asthmatics.

Results

Extensive EET formation was elicited from a substantial fraction of stimulated eosinophils in response to 50 μmol/L LysoPS. Analyses for LDH and eosinophil‐derived neurotoxin release showed that both lytic cell death and degranulation accompanied EET formation in response to LysoPS. Cytological analyses demonstrated that citrullinated histone 3 was present in the extracellular, filamentous DNA structure embedded with eosinophil granules. The LysoPS‐induced EET was independent of ROS production and irrelevant to several signaling pathways examined, but dependent on protein arginine deiminase 4. A low concentration of LysoPS (5 μmol/L) did not induce EET or degranulation, but significantly increased platelet‐activating factor‐induced degranulation. Eosinophils from severe asthmatics exhibited greater degranulation, but not EET formation, in response to LysoPS (50 μmol/L), than those from nonsevere asthmatics, along with great expression of surface P2Y10.

Conclusions

We identified a novel function of LysoPS, namely induction of EET in association with cytolysis and degranulation. LysoPS‐dependent EET or degranulation plays a potential role in eosinophilic inflammation of severe asthma.
Rates of hypogonadism forms in Klinefelter patients undergoing testicular sperm extraction: A multicenter cross‐sectional study
Authors: Pozzi Edoardo , Boeri Luca , Capogrosso Paolo , Palmisano Franco , Preto Mirko , Sibona Mattia , Franceschelli Alessandro , Ruiz‐Castañé Eduard , Sarquella‐Geli Joaquim , Bassas‐Arnau Lluís , Scroppo Fabrizio I. , Gentile Giorgio , Falcone Marco , Timpano Massimiliano , Ceruti Carlo , Gadda Franco , Colombo Fulvio , Rolle Luigi , Gontero Paolo , Montorsi Francesco , Sánchez‐Curbelo Josvany , Montanari Emanuele , Salonia Andrea
Published: June 2020

Introduction and objectives

Adult patients with Klinefelter syndrome (KS) may present with testicular volume loss and a decrease in circulating testosterone (T) levels. However, the actual rate of hypogonadism in adult KS men is unknown. We aimed to (a) assess the prevalence of different forms of hypogonadism in a cohort of KS patients with non‐obstructive azoospermia (NOA); and (b) investigate potential preoperative predictor of positive sperm retrieval (SR) at surgery in the same cohort of men.

Methods

Complete data from 103 KS men with NOA who underwent testicular sperm extraction (TESE) between 2008 and 2019 at five centers were analyzed. Comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients were categorized into four groups of hypogonadism as follows: eugonadism [normal total T (tT) (≥3.03 ng/mL) and normal luteinizing hormone (LH) (≤9.4 mUI/mL)], secondary hypogonadism [low tT (≤3.03 ng/mL) and low/normal LH (≤9.4 mUI/mL)], primary hypogonadism [low tT (≤3.03 ng/mL) and elevated LH (≥9.4 mUI/mL)], and compensated hypogonadism [normal tT (≥3.03 ng/mL) and elevated LH (≥9.4 mUI/mL)]. Descriptive statistics tested the association between clinical characteristics and laboratory values among the four groups.

Results

Median (IQR) patients age was 32 (24, 37) years. Baseline follicle‐stimulating hormone and tT levels were 29.5 (19.9, 40.9) mUI/mL and 3.8 (2.5, 11.0) ng/mL, respectively. Eugonadism, primary hypogonadism, and compensated hypogonadism were found in 16 (15.6%), 34 (33.0%), and 53 (51.4%) men, respectively. No patients had secondary hypogonadism. Positive SR rate at TESE was 21.4% (22 patients); of 22, 15 (68.2%) patients underwent assisted reproductive technology and five (22.7%) ended in live birth children. Patients’ age, BMI, CCI, FSH levels, and positive SR rates were comparable among hypogonadism groups. No preoperative parameters were associated with positive SR at logistic regressions analysis.

Conclusions

Findings from this cross‐sectional study showed that 15.6% of adult KS men have normal tT values at presentation in the real‐life setting. Most KS patients presented with either compensated or primary hypogonadism. Sperm retrieval rates were not associated with different forms of hypogonadism.
Unsuspected choledocholithiasis found by routine intra‐operative cholangiography during laparoscopic cholecystectomy
Authors: O'Neill Robert S. , Wennmacker Sarah Z. , Bhimani Nazim , van Dijk Aafke H. , de Reuver Philip , Hugh Thomas J.
Published: June 2020

Background

The true incidence of unsuspected choledocholithiasis found during laparoscopic cholecystectomy (LC) is unknown. Untreated ‘silent’ stones may be associated with significant long‐term risks. The aim of this study was to establish the incidence of unsuspected common bile duct stones (CBDS) and to determine the management and associated risk factors for unsuspected CBDS.

Methods

Retrospective review of a large consecutive series of patients from Australia who underwent LC in a tertiary referral setting. Percentages of unsuspected CBDS, management and complications were reported. Pre‐operative and intra‐operative factors associated with unsuspected CBDS were determined using multivariable logistic regression analysis.

Results

From a total of 1998 patients who underwent LC, 747 (37.4%) patients with no pre‐operative suspicious factors were the subject of this study. CBDS were detected in 24 (3.2%) patients and all were managed either laparoscopically or endoscopically. Risk factors independently associated with unsuspected CBDS included patients >55 years of age (odds ratio 2.93, P = 0.038) and a large cystic duct size (odds ratio = 3.13, P < 0.001) on multivariable analysis.

Conclusion

The incidence of patients with unsuspected CBDS on intra‐operative cholangiography is low. Complete clearance of these stones can be achieved using a combination of laparoscopic and endoscopic methods.
Resource‐related variables drive individual variation in flowering phenology and mediate population‐level flowering responses to climate in an asynchronously reproducing palm
Authors: Ramirez‐Parada Tadeo , Cabrera Domingo , Diaz‐Martin Zoe , Browne Luke , Karubian Jordan
Published: June 2020

Many tropical plant species show wide intra‐population variation in reproductive timing, resulting in the protracted presence of flowering and fruiting individuals. Various eco‐evolutionary drivers have been proposed as ultimate causes for asynchronous phenology, yet little is known about the proximate factors that control reproductive onset among individuals or that influence the proportion of trees producing new inflorescences within a population. We employed a nine‐year phenological record from 178 individuals of the hyperdominant, asynchronously flowering canopy palm, Oenocarpus bataua (Arecaceae)¸ to assess whether resource‐related variables influence individual‐ and population‐level flowering phenology. Among individuals, access to sunlight increased rates of inflorescence production, while the presence of resource sinks related to current investment in reproduction—developing infructescences—reduced the probability of producing new inflorescences. At the population level, climate anomalies induced by El Niño Southern Oscillation (ENSO) affected the proportion of the population producing inflorescences through time. Moreover, the effects of ENSO anomalies on flowering patterns depended on the prevalence of developing infructescences in the population, with stronger effects in periods of low developing‐infructescence frequency. Taken together, these results suggest that resource‐related variables can drive phenological differences among individuals and mediate population‐level responses to larger‐scale variables, such as climate anomalies. Consequently, a greater focus on the role of resource levels as endogenous cues for reproduction might help explain the frequent aseasonal phenological patterns observed among tropical plants, particularly those showing high intra‐population asynchrony.

Abstract in Spanish is available with online material.
FBXO22, an epigenetic multiplayer coordinating senescence, hormone signaling, and metastasis
Authors: Johmura Yoshikazu , Harris Alexander S. , Ohta Tomohiko , Nakanishi Makoto
Published: June 2020

Ubiquitin‐dependent protein degradation has been implicated in the control of various cellular processes such as cell cycle control, transcriptional regulation, DNA damage repair, and apoptosis, many of which are involved in the initiation, progression, metastasis, and drug resistance of cancers. E3 ubiquitin ligases are known to be the second most prevalent cancer‐related functional gene family next to protein kinases. Of these, FBXO22, an F‐box receptor subunit of SCF E3 ligase, has recently been proposed to play a critical role in multiple aspects related to cancer development and therapy response. Firstly, FBXO22 is a key regulator of senescence induction through ubiquitylation of p53 for degradation. FBXO22 also acts as a molecular switch for the antagonistic and agonistic actions of selective estrogen receptor modulators (SERM) and determines the sensitivity of breast cancer to SERM by ubiquitylating KDM4B complexed with unliganded or SERMs‐bound estrogen receptor (ER). Furthermore, FBXO22 binds to Bach1, a pro‐metastatic transcription factor, suppressing Bach1‐driven metastasis of lung adenocarcinoma, and loss of FBXO22 facilitates metastasis. These findings, as well as other reports, unveiled strikingly important roles of FBXO22 in cancer development and therapeutic strategy. In this review, we summarize recent findings of how FBXO22 regulates major cancer suppression pathways.
A Forward Bias in Human Profile‐Oriented Portraits
Authors: Miton Helena , Sperber Dan , Hernik Mikołaj
Published: June 2020

The spatial composition of human portraits obeys historically changing cultural norms. We show that it is also affected by cognitive factors that cause greater spontaneous attention to what is in front rather in the back of an agent. Scenes with more space in front of a directed object are both more often produced and judged as more aesthetically pleasant. This leads to the prediction that, in profile‐oriented human portraits, compositions with more space in front of depicted agents (a “forward bias”) should be over‐represented. By analyzing a large dataset (total N of 1,831 paintings by 582 unique identified European painters from the 15th to the 20th century), we found evidence of this forward bias: Painters tended to put more free space in front of, rather than behind, the sitters. Additionally, we found evidence that this forward bias became stronger when cultural norms of spatial composition favoring centering became less stringent.
Land‐use history determines ecosystem services and conservation value in tropical agroforestry
Authors: Martin Dominic Andreas , Osen Kristina , Grass Ingo , Hölscher Dirk , Tscharntke Teja , Wurz Annemarie , Kreft Holger
Published: June 2020

Agroforestry is widely promoted as a potential solution to address multiple UN Sustainable Development Goals, including Zero Hunger, Responsible Consumption and Production, Climate Action, and Life on Land. Nonetheless, agroforests in the tropics often result from direct forest conversions, displacing rapidly vanishing and highly biodiverse forests with large carbon stocks, causing undesirable trade‐offs. Scientists thus debate whether the promotion of agroforestry in tropical landscapes is a sensible policy. So far, this debate typically fails to consider land‐use history, that is, whether an agroforest is derived from forest or from open land. Indeed, 57% of papers which we systematically reviewed did not describe the land‐use history of focal agroforestry systems. We further find that forest‐derived agroforestry supports higher biodiversity than open‐land‐derived agroforestry but essentially represents a degradation of forest, whereas open‐land‐derived agroforestry rehabilitates formerly forested open land. Based on a conceptual framework, we recommend to (a) promote agroforestry on suitable open land, (b) maintain tree cover in existing forest‐derived agroforests, and (c) conserve remaining forests. Land‐use history should be incorporated into land‐use policy to avoid incentivizing forest degradation and to harness the potential of agroforestry for ecosystem services and biodiversity.
Stenotic double‐orifice mitral valve after surgical repaired partial atrioventricular septal defect
Authors: Duran Karaduman Bilge , Torun Ayşe Nur , Ayhan Hüseyin , Keleş Telat , Bozkurt Engin
Published: June 2020

Double‐orifice mitral valve (DOMV) is an uncommon congenital anomaly account for 1% of congenital heart disease. However, accurate diagnosis and evaluation of valve stenosis or regurgitation and other concomitant congenital anomalies due to DOMV are required to obtain suitable treatment. Two‐ and three‐dimensional echocardiography can contribute valuable functional and anatomic information that can support to reach this goal. Here, we present a case of complete bridge‐type DOMV that causes mitral stenosis after surgical repair of the partial atrioventricular septal defect in childhood.
Impact of inferior caval valve implantation on severity of tricuspid regurgitation and right heart function
Authors: Mattig Isabel , Knebel Fabian , Hewing Bernd , Stangl Verena , Stangl Karl , Laule Michael , Dreger Henryk
Published: June 2020

Aims

Severe tricuspid regurgitation (TR) is a common finding in heart failure patients and associated with increased mortality. New interventional therapeutic options are needed as many heart failure patients are unfit for surgery. The TRICAVAL study compared valve implantation into the inferior vena cava (CAVI) with optimal medical therapy (OMT) in patients with severe TR. Here, we report details on the impact of CAVI on TR severity as well as right heart function and morphology.

Methods and results

We randomized 28 patients with severe TR to CAVI (n = 14) with transfemoral implantation of an Edwards Sapien XT valve into the inferior vena cava or OMT (n = 14). Inclusion and exclusion criteria were based on anatomical and clinical parameters. Echocardiographic measurements were performed at baseline, at the first postoperative day and one, three, and twelve months after randomization. As proof of concept of an effective sealing of the inferior vena cava, we detected a significant decrease in systolic hepatic vein reflux volume (11.0 [6.2–21.9] mL vs 3.5 [0.6–8.5] mL, P = .016) and hepatic vein diameter (11.5 [10.0–14.8] mm vs 10.0 [9.3–11.8] mm, P = .034) at thirty‐day follow‐up. However, CAVI had no significant impact on TR, cardiac function, and morphology.

Conclusions

Caval valve implantation significantly reduced systolic reflux into the hepatic veins but was not associated with an improvement in cardiac function, morphology, or TR severity.
Mitral annular plane systolic excursion and tricuspid annular plane systolic excursion for risk stratification of acute pulmonary embolism
Authors: Matos Jason D. , Balachandran Isabel , Heidinger Benedikt H. , Mohebali Donya , Feldman Stephanie A. , McCormick Ian , Litmanovich Diana , Manning Warren J. , Carroll Brett J.
Published: June 2020

Introduction

Risk stratification for acute pulmonary embolism (PE) incorporates metrics of right ventricle (RV) function. Significant RV dysfunction influences left ventricular (LV) function, though LV function metrics are not utilized for stratifying outcomes in patients with PE. Mitral annular plane systolic excursion (MAPSE) is a linear echocardiographic (TTE) measure that evaluates longitudinal LV function and may aid in risk stratification for acute PE.

Methods

Using a single‐center database of patients with PE from 2007 to 2014, MAPSE was calculated for all TTE’s available with sufficient quality (n = 362). A MAPSE of ≥11 mm was used as a normal reference. Thirty‐day adverse outcomes were defined as administration of vasopressor, fibrinolytic therapy, open embolectomy, or 30‐day PE‐related mortality. Odds ratios (OR) and adjusted OR (AOR) were calculated using logistic regression analysis. Tricuspid annular plane systolic excursion (TAPSE) measurements were incorporated to determine the additive benefit of MAPSE.

Results

Compared with the reference MAPSE ≥ 11 mm and LVEF > 50%, patients with MAPSE < 11 mm and an LVEF > 50% had worse outcomes (AOR 2.94 [95% CI: 1.08–7.98], P = 0.035). Among patients with LVEF > 50%, the presence of both a MAPSE < 11 mm and TAPSE < 16 mm was associated with greater odds of adverse outcomes compared with isolated depressed TAPSE (AOR 10.75 [95% CI: 3.06–37.8], P < 0.01 vs AOR 1.68 [95% CI: 0.18–15.6], P = 0.65).

Conclusion

A depressed MAPSE, in patients with preserved LVEF, is associated with worse outcomes in patients with acute PE. The addition of MAPSE to TAPSE appears to have a greater prognostic value than either alone and may further aid in risk stratification, but for confirmation further prospective data are needed.
High mortality in COVID‐19 patients with mild respiratory disease
Authors: Masetti Chiara , Generali Elena , Colapietro Francesca , Voza Antonio , Cecconi Maurizio , Messina Antonio , Omodei Paolo , Angelini Claudio , Ciccarelli Michele , Badalamenti Salvatore , Canonica G. Walter , Lleo Ana , Aghemo Alessio ,   the for the Humanitas Covid‐19 Task Force
Published: June 2020

Introduction

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has infected 189 000 people in Italy, with more than 25 000 deaths. Several predictive factors of mortality have been identified; however, none has been validated in patients presenting with mild disease.

Methods

Patients with a diagnosis of interstitial pneumonia caused by SARS‐CoV‐2, presenting with mild symptoms, and requiring hospitalization in a non‐intensive care unit with known discharge status were prospectively collected and retrospectively analysed. Demographical, clinical and biochemical parameters were recorded, as need for non‐invasive mechanical ventilation and admission in intensive care unit. Univariate and multivariate logistic regression analyses were used to identify independent predictors of death.

Results

Between 28 February and 10 April 2020, 229 consecutive patients were included in the study cohort; the majority were males with a mean age of 60 years. 54% of patients had at least one comorbidity, with hypertension being the most commonly represented, followed by diabetes mellitus. 196 patients were discharged after a mean of 9 days, while 14.4% died during hospitalization because of respiratory failure. Age higher than 75 years, low platelet count (<150 × 103/mm3) and higher ferritin levels (>750 ng/mL) were independent predictors of death. Comorbidities were not independently associated with in‐hospital mortality.

Conclusions

In‐hospital mortality of patients with COVID‐19 presenting with mild symptoms is high and is associated with older age, platelet count and ferritin levels. Identifying early predictors of outcome can be useful in the clinical practice to better stratify and manage patients with COVID‐19.
Short‐term anticoagulation after acute cardioversion of early‐onset atrial fibrillation
Authors: Saglietto Andrea , De Ferrari Gaetano Maria , Gaita Fiorenzo , Anselmino Matteo
Published: June 2020

Background

Controversy exists regarding anticoagulation management following acute cardioversion in patients with early‐onset (<48 hours) atrial fibrillation without class I guideline indication for long‐term oral anticoagulation (CHA2DS2‐VASc 0‐1).

Methods and results

A random‐effect meta‐analysis of observational studies reporting 30‐day incidence of thromboembolic complications after cardioversion without post‐procedural oral anticoagulation therapy in patients at low‐moderate thromboembolic risk (CHA2DS2‐VASc 0‐1) was performed. Four studies were included, encompassing 3276 cardioversions. The analysis revealed that the pooled risk of 30‐day incidence of thromboembolic complications in this subset of patients is low (0.10%, 95% confidence interval: 0.00%‐0.30%).

Conclusions

Given these data, considering the bleeding risk unavoidably conferred by OAT, which is known to be higher in the first month from treatment onset, short‐term anticoagulation limited to 4 weeks post‐cardioversion of early‐onset (<48 hours) atrial fibrillation in patients with low‐moderate risk of stroke (CHA2DS2‐VASc 0‐1) may be omitted, at least in patients with high‐bleeding risk.
Impact of atrial fibrillation in critically ill patients admitted to a stepdown unit
Authors: Falsetti Lorenzo , Proietti Marco , Zaccone Vincenzo , Guerra Federico , Nitti Cinzia , Salvi Aldo , Viticchi Giovanna , Riccomi Francesca , Sampaolesi Mattia , Silvestrini Mauro , Moroncini Gianluca , Lip Gregory Y. H. , Capucci Alessandro
Published: June 2020

Background

Limited data are available on the clinical course of patients with history of atrial fibrillation (AF) when admitted in an intensive care environment. We aimed to describe the occurrence of major adverse events in AF patients admitted to a stepdown care unit (SDU) and to analyse clinical factors associated with outcomes, impact of dicumarolic oral anticoagulant (OAC) therapy impact and performance of clinical risk scores in this setting.

Materials and methods

Single‐centre, observational retrospective analysis on a population of subjects with AF history admitted to a SDU. Therapeutic failure (composite of transfer to ICU or death) was considered the main study outcome. Occurrence of stroke and major bleeding (MH) was considered as secondary outcomes. The performance of clinical risk scores was evaluated.

Results

A total of 1430 consecutive patients were enrolled. 194 (13.6%) reported the main outcome. Using multivariate logistic regression, age (odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.01‐1.05), acute coronary syndrome (OR:3.10, 95% CI: 1.88‐5.12), cardiogenic shock (OR:10.06, 95% CI: 5.37‐18.84), septic shock (OR:5.19,95%CI:3.29‐18.84), acute respiratory failure (OR:2.49, 95% CI: 1.67‐3.64) and OAC use (OR: 1.61, 95% CI: 1.02‐2.55) were independently associated with main outcome. OAC prescription was associated with stroke risk reduction and to both MH and main outcome risk increase. CHA2DS2‐VASc (c‐index: 0.545, P = .117 for stroke) and HAS‐BLED (c‐index:0.503, P = .900 for MH) did not significantly predict events occurrence.

Conclusions

In critically ill AF patients admitted to a SDU, adverse outcomes are highly prevalent. OAC use is associated to an increased risk of therapeutic failure, clinical scores seem unhelpful in predicting stroke and MH, suggesting a highly individualized approach in AF management in this setting.
Impact of adrenomedullin levels on clinical risk stratification and outcome in subarachnoid haemorrhage
Authors: Gracia Arnillas Maria Pilar , Alvarez‐Lerma Francisco , Masclans Jose‐Ramón , Roquer Jaume , Soriano Carolina , Manzano Demian , Zapatero Ans , Diaz Yolanda , Duran Xavi , Castellví Andrea , Cuadrado Elisa , Ois Angel
Published: June 2020

Purpose

To use classification tree analysis to identify risk factors for nonsurvival in a neurological patients with subarachnoid haemorrhage (SAH) and to propose a clinical model for predicting of mortality.

Methods

Prospective study of SAH admitted to a Critical Care Department and Stroke Unit over a 2‐year period. Middle region of pro‐ADM plasma levels (MR‐proADM) was measured in EDTA plasma within the first 24 hours of hospital admission using the automatic immunofluorescence test. A regression tree was made to identify prognostic models for the development of mortality at 90 days.

Results

Ninety patients were included. The mean MR‐proADM plasma value in the samples analysed was 0.78 ± 0.41 nmol/L. MR‐proADM plasma levels were significantly associated with mortality at 90 days (1.05 ± 0.51 nmol/L vs 0.64 ± 0.25 nmol/L; P < .001). Regression tree analysis provided an algorithm based on the combined use of clinical variables and one biomarker allowing accurate mortality discrimination of three distinct subgroups with high risk of 90‐day mortality ranged from 75% to 100% (AUC 0.9; 95% CI 0.83‐0.98).

Conclusions

The study established a model (APACHE II, MR‐proADM and Hunt&Hess) to predict fatal outcomes in patients with SAH. The proposed decision‐making algorithm may help identify patients with a high risk of mortality.
Multi‐parametric system for risk stratification in mitral regurgitation: A multi‐task Gaussian prediction approach
Authors: Tse Gary , Zhou Jiandong , Lee Sharen , Liu Yingzhi , Leung Keith Sai Kit , Lai Rachel Wing Chuen , Burtman Anthony , Wilson Carly , Liu Tong , Li Ka Hou Christien , Lakhani Ishan , Zhang Qingpeng
Published: June 2020

Background

We hypothesized that a multi‐parametric approach incorporating medical comorbidity information, electrocardiographic P‐wave indices, echocardiographic assessment, neutrophil‐to‐lymphocyte ratio (NLR) and prognostic nutritional index (PNI) calculated from laboratory data can improve risk stratification in mitral regurgitation (MR).

Methods

Patients diagnosed with mitral regurgitation between 1 March 2005 and 30 October 2018 from a single centre were retrospectively analysed. Outcomes analysed were incident atrial fibrillation (AF), transient ischemic attack (TIA)/stroke and mortality.

Results

This study cohort included 706 patients, of whom 171 had normal inter‐atrial conduction, 257 had inter‐atrial block (IAB) and 266 had AF at baseline. Logistic regression analysis showed that age, hypertension and mean P‐wave duration (PWD) were significant predictors of new‐onset AF. Low left ventricular ejection fraction (LVEF), abnormal P‐wave terminal force in V1 (PTFV1) predicted TIA/stroke. Age, smoking, hypertension, diabetes mellitus, hypercholesterolaemia, ischemic heart disease, secondary mitral regurgitation, urea, creatinine, NLR, PNI, left atrial diameter (LAD), left ventricular end‐diastolic dimension, LVEF, pulmonary arterial systolic pressure, IAB, baseline AF and heart failure predicted all‐cause mortality. A multi‐task Gaussian process learning model demonstrated significant improvement in risk stratification compared to logistic regression and a decision tree method.

Conclusions

A multi‐parametric approach incorporating multi‐modality clinical data improves risk stratification in mitral regurgitation. Multi‐task machine learning can significantly improve overall risk stratification performance.
Environmental persistence of equid herpesvirus type‐1
Authors: Saklou Nadia T. , Burgess Brandy A. , Ashton Laura V. , Morley Paul S. , Goehring Lutz S.
Published: June 2020

Background

Equid herpesvirus type 1 (EHV‐1) is ubiquitous in equine populations causing respiratory disease, and complications including late‐term abortion and neurological disease. Eradication of EHV‐1 from housing environments that typically contain unsealed wood and porous bedding materials can be challenging. However, consideration should be given to take advantage of the viral envelope's susceptibility to environmental conditions.

Objective

To determine environmental persistence of EHV‐1 on materials and in environmental conditions commonly found in equine facilities. We hypothesised that environmental conditions and materials would limit environmental persistence of EHV‐1 in horse housing environments.

Study design

Experimental study.

Methods

Standard inoculum of EHV‐1 strain OH03 was applied to leather, polyester‐cotton fabric, two bedding materials (pinewood shavings and wheat straw) and polystyrene (plastic), and placed under three different environmental conditions (4°C, indoors and outdoors). Virus titration and quantitative PCR (qPCR) were performed at six time points between 0 and 48 hours and the number of plaque‐forming units (PFUs) was determined.

Results

Viable EHV‐1 was recovered up to 48 hours from all material‐environmental condition combinations, with persistence decreasing over time. In general, outdoor environment had the greatest impact, irrespective of material tested, followed by indoor environment and 4°C. On average, wood shavings had the greatest impact on persistence, followed by leather, straw, fabric and polystyrene.

Main limitations

The inoculum used in this study was not in a milieu consistent with nasal secretions. As such, virus particles may have been more sensitive to the materials and/or environmental conditions evaluated.

Conclusions

Environmental factors had variable effects on environmental persistence. Although there were significant reductions in PFUs within the first 3 hours, irrespective of environment‐material evaluated, viable virus was still recovered at 48 hours likely representing a transmission risk. Barrier precautions should be used to prevent spread of EHV‐1 from unrecognised environmental reservoirs.
Phosphorylation status of BolA affects its role in transcription and biofilm development
Authors: Galego Lisete , Barahona Susana , Romão Célia V. , Arraiano Cecília M.
Published: June 2020

BolA has been characterized as an important transcriptional regulator, which is induced in stationary phase of growth, and in response to several stresses. In Escherichia coli, its cellular function is associated with cell wall synthesis and division, morphology, permeability, motility and biofilm formation. Phosphorylation has been widely described as one of the most important events involved in the modulation of the activity of many transcription factors. In the present work, we have demonstrated in vivo and by mass spectrometry that BolA is phosphorylated in four highly conserved protein positions: S26, S45, T81 and S95. S95 is located in the C terminus unstructured region of the protein, and the other three sites are in the DNA‐binding domain. These positions were mutated to nonphosphorylated residues, and their effects were investigated on different known BolA functions. Using northern blot experiments, we showed that the regulation of the expression of these Ser/Thr BolA mutants is performed at the post‐translational level. Western blot results revealed that the stability/turnover of the mutated BolA proteins is differently affected depending on the dephosphorylated residue. Moreover, we provide evidences that phosphorylation events are crucial in the modulation of BolA activity as a transcription factor and as a regulator of cell morphology and biofilm development. Here, we propose that phosphorylation affects BolA downstream functions and discuss the possible significance of these phosphoresidues in the protein structure, stability, dimerization and function as a transcription factor.
Legacy of Amazonian Dark Earth soils on forest structure and species composition
Authors: de Oliveira Edmar Almeida , Marimon‐Junior Ben Hur , Marimon Beatriz Schwantes , Iriarte José , Morandi Paulo S. , Maezumi S. Yoshi , Nogueira Denis S. , Aragão Luiz E. O .C. , da Silva Izaias Brasil , Feldpausch Ted R.
Published: June 2020

Aim

Amazonian forests predominantly grow on highly weathered and nutrient poor soils. Anthropogenically enriched Amazonian Dark Earths (ADE), traditionally known as Terra Preta de Índio, were formed by pre‐Columbian populations. ADE soils are characterized by increased fertility and have continued to be exploited following European colonization. Here, we evaluated the legacy of land‐use and soil enrichment on the composition and structure in ADE and non‐ADE (NDE) forests.

Location

Eastern and southern Amazonia.

Time period

Pre‐Columbia – 2014.

Methods

We sampled nine pairs of ADE and adjacent NDE forest plots in eastern and southern Amazonia. In each plot, we collected soil samples at 0–10 and 10–20 cm depth and measured stem diameter, height, and identified all individual woody plants (palms, trees and lianas) with diameter ≥ 10 cm. We compared soil physicochemical properties, vegetation diversity, floristic composition, aboveground biomass, and percentage of useful species.

Results

In the nine paired plots, soil fertility was significantly higher in ADE soil. We sampled 4,191 individual woody plants representing 404 species and 65 families. The floristic composition of ADE and NDE forests differed significantly at both local and regional levels. In southern Amazonia, ADE forests had, on average, higher aboveground biomass than other forests of the region, while in eastern Amazonia, biomass was similar to that of NDE forests. Species richness of both forest types did not differ and was within the range of existing regional studies. The differences in composition between large and small diameter tree recruits may indicate long‐term recovery and residual effects from historical land‐use. Additionally, the proportion of edible species tended to be higher in the ADE forests of eastern and southern Amazonia.

Main conclusions

The marked differences in soil fertility, floristic composition and aboveground biomass between ADE and NDE forests are consistent with a small‐scale long‐term land‐use legacy and a regional increase in tree diversity.
What are Headache Smartphone Application (App) Users Actually Looking for in Apps: A Qualitative Analysis of App Reviews to Determine a Patient Centered Approach to Headache Smartphone Apps
Authors: Minen Mia T. , Gumpel Tyler , Ali Seher , Sow Fatoumata , Toy Kaitlyn
Published: June 2020

Background

Many headache smartphone applications (apps) are commercially available. A Modified Delphi Study aimed to determine specialists’ expectations of what a headache app should entail but consumer expectations of headache apps have not been evaluated extensively.

Objective

To evaluate publicly available reviews of headache apps to understand app features that motivate the consumers to use apps.

Methods

The Google Play and Apple App Stores were systematically searched for headache/migraine diary apps with 10+ consumer reviews. A maximum of 300 “Most Helpful” reviews for each app were extracted. Four coders coded reviews and resolved discrepancies. Themes and subthemes were created based on codes used 5+ times.

Results

About 15 apps met the study criteria (9 Android, 6 IOS). 945 reviews were coded. Four themes emerged: (1) App allows users to track headache characteristics, potential triggers, and treatments; (2) App usability; (3) Personalization and features to assess trends in data are key motivators for app use; (4) Ease with exportation and viewing data is critical.

Discussion

A user‐centered design with the ability to (1) customize key features including headache characteristics, potential triggers, and treatments, (2) assess trends in data, and (3) view and export data would best optimize headache smartphone applications based on consumer preference.
Influence of adjacent teeth restored with metal posts in the detection of simulated internal root resorption using CBCT
Authors: Gaêta‐Araujo H. , Nascimento E. H. L. , Oliveira‐Santos N. , Pinheiro M. C. R. , Coelho‐Silva F. , Oliveira‐Santos C.
Published: June 2020

Aim

To assess the influence of artefacts generated by metal posts on the detection of simulated internal root resorption (IRR) in adjacent teeth using cone‐beam computed tomography (CBCT) and to verify the impact of metal artefact reduction (MAR) on these cases.

Methodology

CBCT images of 14 premolar teeth were acquired before and after IRR simulation using chemical and mechanical procedures, in an OP300 Maxio unit, with and without MAR. Each tooth was placed in the socket of a human mandible and scanned under three different conditions: (i) without adjacent teeth – control group; (ii) distal adjacent tooth restored with metal post; and (iii) with both adjacent teeth restored with metal post. Five oral radiologists scored the IRR detection using a 5‐point scale. Diagnostic values were obtained for the tested groups and compared using two‐way analysis of variance (α = 0.05).

Results

The presence of a single adjacent tooth restored with metal post did not significantly influence the diagnostic values for IRR detection (P > 0.05). The presence of both adjacent teeth with metal posts, without MAR application, was associated with a significantly lower area under the ROC curve (Az) compared to the control (P = 0.0182). In this case, the application of MAR increased Az, leading to nonsignificant differences from the control group and the group with one adjacent restored tooth (P > 0.05). Sensitivity decreased significantly when two adjacent restored teeth were present, regardless of MAR application (P = 0.0379). Specificity was not affected by the conditions tested (P > 0.05).

Conclusion

CBCT detection of IRR was impaired by artefacts only when both adjacent teeth restored with metal posts were present. In such cases, activation of MAR improved the performance on this diagnostic task.
High TUBB2A expression in childhood T‐ALL is correlated with the clinical outcome
Authors: Khodzhaev Khusan , Ng Ozden Hatirnaz , Tugcu Deniz , Erbilgin Yucel , Ng Yuk Yin , Celkan Tiraje , Timur Cetin , Karakas Zeynep , Ozdemir Gul Nihal , Yıldırmak Yıldız , Sayitoglu Muge
Published: June 2020

Introduction

Microtubules are polymers that perform functions such as mitosis, intracellular transport, cell morphology, and ciliary and flagellar motility. Since microtubules are taking active part in cell division, they are among direct targets of several antimitotic drugs.

Methods

Expression levels of tubulin isotypes were analyzed in microarray data of childhood diagnostic T‐ALL samples (n = 31) and healthy thymocytes (n = 7). Findings were validated with qPCR in separate T‐ALL cohort (n = 48), and clinical correlation analyses were performed. TUBB2A's effects were tested with siRNA‐mediated knockdown in MOLT4 cell line, and apoptosis assay was carried out at 24, 48, and 72 hours time points.

Results

In microarray data, TUBB2A was found to be the only differentially expressed tubulin isotype (adj. P value = .01), which was validated by qPCR (P = .02). Samples representing differentiation stages of T cell showed an increasing trend of TUBB2A toward mature T‐cell stage. TUBB2A expression was significantly higher in high‐risk group patients (P = .026) and in a group with WBC counts >100 (×109cells/L) (P = .029). High TUBB2A was also found to be a predictor of shorter OS (P = .029) and RFS (P = .042).

Conclusion

Aberrant expression of TUBB isotypes can affect the balance of microtubules or microtubule‐associated proteins, which might lead to drug resistance/relapse. Contribution of cytoskeleton proteins to drug resistance needs further investigation, and understanding aberrant expression and mode of action of microtubules will improve therapy strategies.
A comparative evaluation of the CN‐6000 haemostasis analyser using coagulation, amidolytic, immuno‐turbidometric and light transmission aggregometry assays
Authors: Gardiner Chris , Lane Philip , Langley Katy , Tailor Hitesh , Machin Samuel J. , Mackie Ian J.
Published: June 2020

Background

The CN‐6000 (Sysmex Corp.) is a new haemostasis analyser with blood coagulation, amidolytic, immuno‐turbidometric and light transmission aggregometry (LTA) capabilities. Transmitted light is monitored at multiple wavelengths (340, 405, 575, 660, 800 nm), from an LED light source.

Aims

To evaluate the performance of the CN‐6000 against a predicate device.

Methods

The CN‐6000 was evaluated against the CS‐5100 (Sysmex) for 14 different tests, using 880 samples from normal subjects, anticoagulated patients, critically ill patients, plasmas with high or low fibrinogen content or abnormal levels of interfering substances. Between‐day assay imprecision was assessed using commercial QC materials (n = 10 replicates on each of 5 days).

Results

Acceptable levels of imprecision were obtained for all assays. Agreement between the two analysers was excellent for all assays. Throughput was 35% higher using the CN‐6000 (337 vs 250 tests per hour for PT, aPTT and fibrinogen). The CN‐6000 also demonstrated improved clot detection in plasmas with high levels of interfering substances as demonstrated by a 29% reduction in “vote‐outs” due to low light transmission (24 vs 34).

Conclusions

The CN‐6000 demonstrated excellent comparability with the predicate instrument and acceptable levels of imprecision in all assays. Improvements in throughput and clot detection in the presence of interfering substances were also shown.
Frontex: A Literature Review
Authors: Kalkman Jori Pascal
Published: June 2020

Frontex is the EU agency in charge of managing the external borders of the European Union. Its budget and tasks have expanded dramatically since it was founded in 2004. Academic attention for Frontex has likewise increased. This article provides an overview of the existing literature on Frontex. In total, 72 articles were selected and analysed. Five dominant themes of research emerged from this review: Frontex’ activities, the agency’s characteristics, its operational effects, the issue of human rights and its position in the EU bureaucracy. Recurring debates and relevant findings in these research strands are reported. In the final section, a research agenda with recommendations for future studies is formulated.