bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantifying Importance of Major Risk Factors for Coronary Heart Disease
Authors: Pencina Michael J. , Navar Ann Marie , Wojdyla Daniel , Sanchez Robert J. , Khan Irfan , Elassal Joseph , D’Agostino Ralph B. , Peterson Eric D. , Sniderman Allan D.
Published: January 2019

Background:

To optimize preventive strategies for coronary heart disease (CHD), it is essential to understand and appropriately quantify the contribution of its key risk factors. Our objective was to compare the associations of key modifiable CHD risk factors—specifically lipids, systolic blood pressure (SBP), diabetes mellitus, and smoking—with incident CHD events based on their prognostic performance, attributable risk fractions, and treatment benefits, overall and by age.

Methods:

Pooled participant-level data from 4 observational cohort studies sponsored by the National Heart, Lung, and Blood Institute were used to create a cohort of 22 626 individuals aged 45 to 84 years who were initially free of cardiovascular disease. Individuals were followed for 10 years from baseline evaluation for incident CHD. Proportional hazards regression was used to estimate metrics of prognostic model performance (likelihood ratio, C index, net reclassification, discrimination slope), hazard ratios, and population attributable fractions for SBP, non–high-density lipoprotein cholesterol (non–HDL-C), diabetes mellitus, and smoking. Expected absolute risk reductions for antihypertensive and lipid-lowering treatment were assessed.

Results:

Age, sex, and race capture 63% to 80% of the prognostic performance of cardiovascular risk models. In contrast, adding either SBP, non–HDL-C, diabetes mellitus, or smoking to a model with other risk factors increases the C index by only 0.004 to 0.013. However, primordial prevention could have a substantial effect as demonstrated by population attributable fractions of 28% for SBP≥130 mm Hg and 17% for non–HDL-C≥130 mg/dL. Similarly, lowering the SBP of all individuals to <130 mm Hg or lowering low-density lipoprotein cholesterol by 30% would be expected to lower a baseline 10-year CHD risk of 10.7% to 7.0 and 8.0, respectively (absolute risk reductions: 3.7% and 2.7%, respectively). Prognostic performance decreases with age (C indices for age groups 45–54, 55–64, 65–74, 75–84 are 0.75, 0.72, 0.66, and 0.62, respectively), whereas absolute risk reductions increase (SBP: 1.1%, 2.3%, 5.4%, 10.3%, respectively; non–HDL-C: 1.1%, 2.0%, 3.7%, 5.9%, respectively).

Conclusions:

Although individual modifiable CHD risk factors contribute only modestly to prognostic performance, our models indicate that eliminating or controlling these individual factors would lead to substantial reductions in total population CHD events. Metrics used to judge importance of risk factors should be tailored to the research objectives.
Endothelial C-Type Natriuretic Peptide Is a Critical Regulator of Angiogenesis and Vascular Remodeling
Authors: Bubb Kristen J. , Aubdool Aisah A. , Moyes Amie J. , Lewis Sarah , Drayton Jonathan P. , Tang Owen , Mehta Vedanta , Zachary Ian C. , Abraham David J. , Tsui Janice , Hobbs Adrian J.
Published: January 2019

Background:

Angiogenesis and vascular remodeling are complementary, innate responses to ischemic cardiovascular events, including peripheral artery disease and myocardial infarction, which restore tissue blood supply and oxygenation; the endothelium plays a critical function in these intrinsic protective processes. C-type natriuretic peptide (CNP) is a fundamental endothelial signaling species that coordinates vascular homeostasis. Herein, we sought to delineate a central role for CNP in angiogenesis and vascular remodeling in response to ischemia.

Methods:

The in vitro angiogenic capacity of CNP was examined in pulmonary microvascular endothelial cells and aortic rings isolated from wild-type, endothelium-specific CNP
–/–
, global natriuretic peptide receptor (NPR)-B
–/–
and NPR-C
–/–
animals, and human umbilical vein endothelial cells. These studies were complemented by in vivo investigation of neovascularization and vascular remodeling after ischemia or vessel injury, and CNP/NPR-C expression and localization in tissue from patients with peripheral artery disease.

Results:

Clinical vascular ischemia is associated with reduced levels of CNP and its cognate NPR-C. Moreover, genetic or pharmacological inhibition of CNP and NPR-C, but not NPR-B, reduces the angiogenic potential of pulmonary microvascular endothelial cells, human umbilical vein endothelial cells, and isolated vessels ex vivo. Angiogenesis and remodeling are impaired in vivo in endothelium-specific CNP
–/–
and NPR-C
–/–
, but not NPR-B
–/–
, mice; the detrimental phenotype caused by genetic deletion of endothelial CNP, but not NPR-C, can be rescued by pharmacological administration of CNP. The proangiogenic effect of CNP/NPR-C is dependent on activation of G
i
, ERK1/2, and phosphoinositide 3-kinase γ/Akt at a molecular level.

Conclusions:

These data define a central (patho)physiological role for CNP in angiogenesis and vascular remodeling in response to ischemia and provide the rationale for pharmacological activation of NPR-C as an innovative approach to treating peripheral artery disease and ischemic cardiovascular disorders.
Influenza Vaccine in Heart Failure
Authors: Modin Daniel , Jørgensen Mads Emil , Gislason Gunnar , Jensen Jan Skov , Køber Lars , Claggett Brian , Hegde Sheila M. , Solomon Scott D. , Torp-Pedersen Christian , Biering-Sørensen Tor
Published: January 2019

Background:

Influenza infection is a serious event for patients with heart failure (HF). Little knowledge exists about the association between influenza vaccination and outcome in patients with HF. This study sought to determine whether influenza vaccination is associated with improved long-term survival in patients with newly diagnosed HF.

Methods:

We performed a nationwide cohort study including all patients who were >18 years of age and diagnosed with HF in Denmark in the period of January 1, 2003, to June 1, 2015 (n=134 048). We collected linked data using nationwide registries. Vaccination status, number, and frequency during follow-up were treated as time-varying covariates in time-dependent Cox regression.

Results:

Follow-up was 99.8% with a median follow-up time of 3.7 years (interquartile range, 1.7–6.8 years). The vaccination coverage of the study cohort ranged from 16% to 54% during the study period. In unadjusted analysis, receiving ≥1 vaccinations during follow-up was associated with a higher risk of death. After adjustment for inclusion date, comorbidities, medications, household income, and education level, receiving ≥1 vaccinations was associated with an 18% reduced risk of death (all-cause: hazard ratio, 0.82; 95% CI, 0.81–0.84;
P
<0.001; cardiovascular causes: hazard ratio, 0.82; 95% CI, 0.81–0.84;
P
<0.001). Annual vaccination, vaccination early in the year (September to October), and greater cumulative number of vaccinations were associated with larger reductions in the risk of death compared with intermittent vaccination.

Conclusions:

In patients with HF, influenza vaccination was associated with a reduced risk of both all-cause and cardiovascular death after extensive adjustment for confounders. Frequent vaccination and vaccination earlier in the year were associated with larger reductions in the risk of death compared with intermittent and late vaccination.
Loss of Endothelium-Derived Wnt5a Is Associated With Reduced Pericyte Recruitment and Small Vessel Loss in Pulmonary Arterial Hypertension
Authors: Yuan Ke , Shamskhou Elya A. , Orcholski Mark E. , Nathan Abinaya , Reddy Sushma , Honda Hiroaki , Mani Vigneshwaran , Zeng Yitian , Ozen Mehmet O. , Wang Lingli , Demirci Utkan , Tian Wen , Nicolls Mark R. , de Jesus Perez Vinicio A.
Published: January 2019

Background:

Pulmonary arterial hypertension (PAH) is a life-threatening disorder of the pulmonary circulation associated with loss and impaired regeneration of microvessels. Reduced pericyte coverage of pulmonary microvessels is a pathological feature of PAH and is caused partly by the inability of pericytes to respond to signaling cues from neighboring pulmonary microvascular endothelial cells (PMVECs). We have shown that activation of the Wnt/planar cell polarity pathway is required for pericyte recruitment, but whether production and release of specific Wnt ligands by PMVECs are responsible for Wnt/planar cell polarity activation in pericytes is unknown.

Methods:

Isolation of pericytes and PMVECs from healthy donor and PAH lungs was carried out with 3G5 or CD31 antibody–conjugated magnetic beads. Wnt expression profile of PMVECs was documented via quantitative polymerase chain reaction with a Wnt primer library. Exosome purification from PMVEC media was carried out with the ExoTIC device. Hemodynamic profile, right ventricular function, and pulmonary vascular morphometry were obtained in a conditional endothelium-specific Wnt5a knockout (
Wnt5a
ECKO
) mouse model under normoxia, chronic hypoxia, and hypoxia recovery.

Results:

Quantification of Wnt ligand expression in healthy PMVECs cocultured with pericytes demonstrated a 35-fold increase in Wnt5a, a known Wnt/planar cell polarity ligand. This Wnt5a spike was not seen in PAH PMVECs, which correlated with an inability to recruit pericytes in Matrigel coculture assays. Exosomes purified from media demonstrated an increase in Wnt5a content when healthy PMVECs were cocultured with pericytes, a finding that was not observed in exosomes of PAH PMVECs. Furthermore, the addition of either recombinant Wnt5a or purified healthy PMVEC exosomes increased pericyte recruitment to PAH PMVECs in coculture studies. Although no differences were noted in normoxia and chronic hypoxia,
Wnt5a
ECKO
mice demonstrated persistent pulmonary hypertension and right ventricular failure 4 weeks after recovery from chronic hypoxia, which correlated with significant reduction, muscularization, and decreased pericyte coverage of microvessels.

Conclusions:

We identify Wnt5a as a key mediator for the establishment of pulmonary endothelium-pericyte interactions, and its loss could contribute to PAH by reducing the viability of newly formed vessels. We speculate that therapies that mimic or restore Wnt5a production could help prevent loss of small vessels in PAH.
Erratum: BAÑON, R., VILLEGAS-RÍOS, D., SERRANO, A., MUCIENTES, G. & ARRONTE, J.C. (2010) Marine fishes from Galicia (NW Spain): an updated checklist. Zootaxa, 2667, 1–27.
Authors: BAÑON R. , VILLEGAS-RÍOS D. , SERRANO A. , MUCIENTES G. , ARRONTE J. C.
Published: January 2019

(Erratum)
Pyura gangelion and Pyura beta sp. nov. (Ascidiacea: Pyuridae): an exotic and a new tunicate from the West Atlantic
Authors: SKINNER LUÍS FELIPE , ROCHA ROSANA M. , COUNTS BAILEY K.
Published: January 2019

The genus Pyura is widely distributed with 99 valid species. Since 1961, Pyura vittata (Stimpson, 1852) has been reported to the Southwest Atlantic but new collections and a revision of the morphological characters of samples deposited in scientific collections revealed that samples had been confused with two other species: Pyura gangelion (Savigny, 1816) and Pyura beta sp. nov. present in the Caribbean sea and Brazil. In Brazil, P. vittata is not present south to Bahia, P. beta was found from Espírito Santo to São Paulo, while P. gangelion was only found in Espírito Santo, and we suggest that populations of both P. beta and P. gangelion are non-native in Brazil.
An atypical new species of Bothryonopa (Coleoptera, Chrysomelidae, Cassidinae, Bothryonopini) from south India
Authors: SHAMEEM K. M.
Published: January 2019

Bothryonopa sahyadrica n. sp., an atypical new species of the genus from southern Western Ghats biodiversity hot-spot in India is described and illustrated. The new species lacks ventral spine on all femora, in contrast to majority of the members of the genus, including the type species. Pronotum is anteriorly distinctly narrower than posteriorly with evenly curved anterolateral corners in the new species, while pronotum in the typical species is widest medially and not distinctly narrowed anteriorly. Host plant of B. sahyadrica n. sp. is Calamus gamblei Becc. & Hook. f. (Arecaceae).
Does Tourism Reduce Poverty in Sub-Saharan African Countries?
Authors: Folarin Oludele , Adeniyi Oluwatosin
Published: January 2019

To achieve the Sustainable Development Goals (SDGs), precisely the one of eradicating extreme poverty at the end of 2030, it is important to understand factors that can reduce poverty. This article examines the effects of tourism development on poverty in Sub-Saharan African countries. Because of the possibility of an endogeneity problem arising from a reverse causation that might exist between poverty and the explanatory variables, the system Generalized Method of Moments (system GMM) estimation technique was deployed. The findings showed that tourism development contributes to poverty reduction in Sub-Saharan African (SSA) countries. In other words, the results obtained provided ample support for the workability of a pro-poor tourism policy agenda. As a result, policies that are targeted at increasing the attractiveness and awareness of the existing SSA tourism sites in order to increase international tourism receipts and arrivals should be promoted since such interventions have considerable poverty reduction potential.
Histopathological Evaluation of Orthopedic Medical Devices: The State-of-the-art in Animal Models, Imaging, and Histomorphometry Techniques
Authors: Jackson Nicolette , Assad Michel , Vollmer Derick , Stanley James , Chagnon Madeleine
Published: January 2019

Orthopedic medical devices are continuously evolving for the latest clinical indications in craniomaxillofacial, spine, trauma, joint arthroplasty, sports medicine, and soft tissue regeneration fields, with a variety of materials from new metallic alloys and ceramics to composite polymers, bioresorbables, or surface-treated implants. There is great need for qualified medical device pathologists to evaluate these next generation biomaterials, with improved biocompatibility and bioactivity for orthopedic applications, and a broad range of knowledge is required to stay abreast of this ever-changing field. Orthopedic implants require specialized imaging and processing techniques to fully evaluate the bone-implant interface, and the pathologist plays an important role in determining the proper combination of histologic processing and staining for quality slide production based on research and development trials and validation. Additionally, histomorphometry is an essential part of the analysis to quantify tissue integration and residual biomaterials. In this article, an overview of orthopedic implants and animal models, as well as pertinent insights for tissue collection, imaging, processing, and slide generation will be provided with a special focus on histopathology and histomorphometry evaluation.
Organization Development for Improving Public Enterprises
Authors: De Nitish R.
Published: January 2019

Organization Development with its process focus, as developed in the West, may not be able to deal with several problems of social reality like alienation from work and life, tension ridden culture of consumerism, effects of future shocks, etc. The picture is complicated in developing countries where bureaucratic‐work orientation with concomitant values and attitudes dominate public enterprises. The need for the establishment of an effective system for the continuous rise in the quality of life is quite important in public enterprises. A new culture has to be developed. There is a need to internalize a larger “appreciative system” with OD strategies in terms of the process and design. This may lead to “eco-system,” a meaningful linkage of the past and the future through the present, an ideal-seeking approach to the future. Such an approach may free 00 from its narrow confines.
Expression of CUEDC2 in colorectal cancer with different invasion and migration abilities
Authors: Hu Shidong , Hu Zilong , Li Songyan , He Changzheng , Wu Youjun , Teng Da , Yan Yang , Li Hao , Xing Xiaowei , Zou Guijun , Li Yuxuan , Yang Yu , Wang Yufeng , Du Xiaohui
Published: January 2019

Objective

To investigate CUE domain containing 2 ( CUEDC2) expression in colorectal cancer with different invasion and migration abilities.

Methods

Fresh colon cancer tissues, obtained from patients with or without lymph node metastasis who were treated at the Department of General Surgery, Chinese People's Liberation Army General Hospital, and SW620 and HT29 colorectal cancer cell lines, were analysed for CUEDC2 expression.

Results

Real-time polymerase chain reaction showed significantly higher CUEDC2 mRNA levels in colon cancer tissue from patients with ( n = 8) versus without ( n = 8) lymph node metastasis, and in SW620 versus HT29 cells. Western blots revealed significantly higher CUEDC2 protein levels in colon cancer tissues from patients with versus without lymph node metastasis, and in SW620 versus HT29 cells. Colorectal cancer tissues from patients with lymph node metastasis showed more intense immunohistochemical staining and moderate staining of cell nuclei and cytoplasm versus less intense/weak staining in tissues from patients without lymph node metastasis.

Conclusions

CUEDC2 is highly expressed in colorectal cancer tissues and colorectal cancer cell lines with high invasion and migration ability. CUEDC2 may be involved in promoting invasion and metastasis in colorectal cancer.
Coupling Natural Hazard Estimates with Road Network Analysis to Assess Vulnerability and Risk: Case Study of Freetown (Sierra Leone)
Authors: Nelson Andrew , Lindbergh Sarah , Stephenson Lucy , Halpern Jeremy , Arroyo Fatima Arroyo , Espinet Xavier , González Marta C.
Published: January 2019

Many of the world’s most disaster-prone cities are also the most difficult to model and plan. Their high vulnerability to natural hazards is often defined by low levels of economic resources, data scarcity, and limited professional expertise. As the frequency and severity of natural disasters threaten to increase with climate change, and as cities sprawl and densify in hazardous areas, better decision-making tools are needed to mitigate the effects of near- and long-term extreme events. We use mostly public data from landslide and flooding events in 2017 in Freetown, Sierra Leone to simulate the events’ impact on transportation infrastructure and continue to simulate alternative high-risk disasters. From this, we propose a replicable framework that combines natural hazard estimates with road network vulnerability analysis for data-scarce environments. Freetown’s most central road intersections and transects are identified, particularly those that are both prone to serviceability loss due to natural hazard and whose disruption would cause the most severe immediate consequences on the entire road supply in terms of connectivity. Variations in possible road use are also tested in areas with potential road improvements, pointing to opportunities to harden infrastructure or reinforce redundancy in strategic transects of the road network. This method furthers network science’s contributions to transportation resilience under hydrometeorological hazard and climate change threats with the goal of informing investments and improving decision-making on transportation infrastructure in data-scarce environments.
Subsistence Marketplaces: Challenges and Opportunities
Authors: Viswanathan Madhu , Elaydi Raed , Gau Roland , Christensen Lisa Jones
Published: January 2019

This introductory article is a biennial exercise to reflect on the stream of subsistence marketplaces as a prelude to the special section on this topic following the Sixth Subsistence Marketplaces Conference in 2016. The call for papers was not restricted to conference presentations. At the end of the review process, the special section contained four articles spanning a diverse set of topics. The authors provide an overview of the subsistence marketplaces stream and a background of the conference series. This is followed by a brief introduction to the special issue. They then discuss the what, how, and why for past and future work on subsistence marketplaces.
Acellular dermal matrix contributes to epithelialization in patients with chronic sinusitis
Authors: Bing Zhong , Feng Liu , Wu Chun-Shu , Du Jin-Tao , Liu Ya-Feng , Liu Shi-Xi
Published: January 2019

Background

Nasal endoscopic surgery is widely used for nasal diseases, including sinusitis and tumors. However, scar hyperplasia, nasal irritation, scab, and nasal obstruction delay nasal mucosal recovery, with prolonged cleaning exacerbating the patient's financial burden. Here, we presented a novel approach for the treatment of nasal mucosal defects, termed acellular dermal matrix.

Methods

A total of 31 patients with bilateral chronic sinusitis (maxillary sinusitis and ethmoid sinusitis) underwent nasal surgery and nasal mucosal repair in September–October 2016. We divided the nasal cavities of each patient into control and acellular dermal matrix groups, randomly selected one side for nasal mucosal repair by surgery. A suitable acellular dermal matrix size was selected according to the defect in each patient. After pruning, the acellular dermal matrix was placed on the wound surface and filled with gelatin sponge. All patients were followed up for 14 weeks to compare nasal mucosal epithelialization between the control and acellular dermal matrix groups. Results：No obvious complications and adverse reactions were observed after nasal surgery. Lund-Kennedy scores in the acellular dermal matrix group were significantly decreased compared with the control group at 8 (0 (0, 1) vs. 2 (2, 4); P<0.05) weeks. Epithelialization time of eight weeks in the acellular dermal matrix groups was significantly decreased than the control group of 14 weeks.

Conclusion

Acellular dermal matrix provides a growth framework for the healthy mucosa on the wounded surface and reduces postoperative epithelialization time.
When the Muses Strike: Creative Ideas of Physicists and Writers Routinely Occur During Mind Wandering
Authors: Gable Shelly L. , Hopper Elizabeth A. , Schooler Jonathan W.
Published: January 2019

How often are creative ideas generated during episodes of mind wandering, and do they differ from those generated while on task? In two studies ( N = 98, N = 87), professional writers and physicists reported on their most creative idea of the day, what they were thinking about and doing when it occurred, whether the idea felt like an “aha” moment, and the quality of the idea. Participants reported that one fifth of their most significant ideas of the day were formed during spontaneous task-independent mind wandering—operationalized here as (a) engaging in an activity other than working and (b) thinking about something unrelated to the generated idea. There were no differences between ratings of the creativity or importance of ideas that occurred during mind wandering and those that occurred on task. However, ideas that occurred during mind wandering were more likely to be associated with overcoming an impasse on a problem and to be experienced as “aha” moments, compared with ideas generated while on task.
Health Disparities in Hospice Utilization and Length of Stay in a Diverse Population With Lung Cancer
Authors: Johnson Lee Ann , Blew Amy , Schreier Ann M.
Published: January 2019

Background:

Lung cancer is the leading cause of cancer deaths globally. Individuals are diagnosed at an advanced stage with limited life expectancy.

Objectives:

To explore potential health disparities in hospice utilization and length of stay (LOS) in a diverse sample of patients with lung cancer.

Methods:

Demographic and clinical information as well as data for hospice utilization and LOS was extracted from electronic health records. Data were analyzed using descriptive statistics, χ2 tests, and an analysis of variance test.

Results:

Data from 242 patients were analyzed. In the sample, 33% (n = 80) were Black and 51% (n = 124) lived in a rural county. At the time of data collection, 67% of the sample was deceased and 36% (n = 86) chose to enroll in hospice. No disparities were found for race, age, gender, or rural/urban dwellers in hospice enrollment. No disparities were found for race, gender, or rural/urban dwellers for hospice LOS. Age was associated with hospice LOS ( P = .004). Those who were older were more likely to have a longer LOS.

Conclusion:

Hospice utilization and LOS were low for all groups with lung cancer in a geographically and racially diverse region of the United States. Given the rates of mortality in lung cancer, discussions about the goals and benefits of hospice care may be beneficial and should be part of an ongoing dialogue throughout the disease trajectory.
Feedback Fundamentals: Interactions Flush With Frustration
Authors: Ophardt Hendrik , Jamieson Greg A.
Published: January 2019

Modern public restrooms are fitted with a wide range of automated fixtures that promote cleanliness and afford ease of use. Unfortunately, frustrations pervade from the lack of usable and effective restroom technologies. This feature critically examines poor designs encountered in typical public facilities in the Western world and suggests guidelines for future improvements.
Plausibility and probability in juridical proof
Authors: Di Bello Marcello
Published: January 2019

This note discusses three issues that Allen and Pardo believe to be especially problematic for a probabilistic interpretation of standards of proof: (1) the subjectivity of probability assignments; (2) the conjunction paradox; and (3) the non-comparative nature of probabilistic standards. I offer a reading of probabilistic standards that avoids these criticisms.
Dyspepsia: When to refer for endoscopy
Authors: Donnelly Hannah , Nolan Tom
Published: January 2019

Upper gastrointestinal endoscopy is used for diagnosis, surveillance, and management of a range of gastroenterological conditions. A common indication for endoscopy is dyspepsia. This article summarises the National Institute for Health and Care Excellence guidelines on when to refer patients with dyspepsia for endoscopy, focusing on non-urgent presentations where patients do not have alarm symptoms.
Recurrent mouth ulcers
Authors: Arwyn-Jones James , Kerai Ashwin
Published: January 2019

Mouth ulcers are common and produce a variety of symptoms, ranging from intermittent discomfort to debilitating pain with effects on speech, chewing and swallowing. Clinically, mouth ulcers can be challenging, as a wide range of diagnoses can give rise to lesions of similar appearance. Although the majority of lesions are benign and require little clinical input, others may signify undiagnosed systemic disease or malignancy, warranting prompt investigation and treatment. Separation of differential diagnoses is driven largely by a thorough history and identification of malignant features on examination. We provide an overview of mouth ulcers and a guide to management.
Coastal Land Use in Northeast Brazil: Mangrove Coverage Evolution Over Three Decades
Authors: Pelage Latifa , Domalain Gilles , Lira Alex S. , Travassos Paulo , Frédou Thierry
Published: January 2019

It is essential to monitor both the mangrove coverage and the encroachment of anthropogenic activities to assess the evolution of these highly valuable and threatened ecosystems. Using the grid technique, Landsat images of three estuaries in Pernambuco, northeast Brazil, were analyzed to track changes in land use over the past three decades. This study is the first time the grid technique has been used as a precise method to quantify and localize the mangrove coverage changes at local scale. We found that the technique was a synthetical and cost-effective way of observing land-use changes over the study period, and its precision was evident for local-scale study. An increasing trend of mangrove coverage was observed and can be related to the salinization. This increase in salinization is a result of anthropogenic activities and climate change. We also found that differences in geometrical properties influenced the spatiotemporal patterns of mangroves. To mitigate adequately the negative impacts induced by anthropization and climate change, the characteristics of mangrove forest configuration and human activities should therefore both be considered.
The impact of in hospital patient-education intervention on older people’s attitudes and intention to have their benzodiazepines deprescribed: a feasibility study
Authors: Gnjidic Danijela , Ong Hui Min Magdalene , Leung Celeste , Jansen Jesse , Reeve Emily
Published: January 2019

Background:

Long-term benzodiazepine use in the older population is common and is associated with significant harm. The provision of a patient-educational booklet during hospitalization may encourage patients to discuss review and possible deprescribing of benzodiazepine therapy with their health professionals. The aim of this study was to assess the feasibility and effect of a patient empowerment intervention in hospital inpatients on patient initiation of a discussion about deprescribing benzodiazepines versus usual care.

Methods:

A feasibility interventional study using a patient-empowerment education intervention was conducted at a Sydney teaching hospital. Patients aged ⩾ 65 years, prescribed a benzodiazepine, and able to provide consent were invited to participate in the study. Participants were randomly allocated to intervention or control group (1:1). Intervention participants received the patient-empowerment booklet and control received usual care. All participants received 1-month follow-up phone interviews to assess medication and attitudinal changes.

Results:

A total of 42 participants were recruited (20 intervention and 22 control). The average age was 71.5 (interquartile range: 69.0–80.3) and 54.8% were females. There was no difference in baseline characteristics between intervention and control groups ( p > 0.05). At baseline, 65.0% of participants (53.0% intervention, 86.0% control) were not concerned about the potential benzodiazepine side effects. Twenty-nine participants (15 intervention and 14 control) completed 1-month follow up; 22 participants (11 intervention and 11 control) were discharged on the benzodiazepine. Among these, 13 (59.1%) had ceased benzodiazepine at 1-month follow up [46.2% ( n = 6) intervention; 53.8% ( n = 7) control]. In the intervention group, 33.3% ( n = 5) of participants had initiated a discussion with their doctor or pharmacist about stopping the benzodiazepine compared with 35.7% ( n = 5) in the control group.

Conclusion:

Cessation of benzodiazepines 1 month following discharge was common. Future larger studies are required to confirm the effectiveness of providing a patient-empowerment booklet on reducing benzodiazepine use and other potentially inappropriate medications.
Altered enteric expression of the homeobox transcription factor Phox2b in patients with diverticular disease
Authors: Cossais François , Lange Christina , Barrenschee Martina , Möding Marie , Ebsen Michael , Vogel Ilka , Böttner Martina , Wedel Thilo
Published: January 2019

Background

Diverticular disease, a major gastrointestinal disorder, is associated with modifications of the enteric nervous system, encompassing alterations of neurochemical coding and of the tyrosine receptor kinase Ret/GDNF pathway. However, molecular factors underlying these changes remain to be determined.

Objectives

We aimed to characterise the expression of Phox2b, an essential regulator of Ret and of neuronal subtype development, in the adult human enteric nervous system, and to evaluate its potential involvement in acute diverticulitis.

Methods

Site‐specific gene expression of Phox2b in the adult colon was analysed by quantitative polymerase chain reaction. Colonic specimens of adult controls and patients with diverticulitis were subjected to quantitative polymerase chain reaction for Phox2b and dual‐label immunochemistry for Phox2b and the neuronal markers RET and tyrosine hydroxylase or the glial marker S100β.

Results

The results indicate that Phox2b is physiologically expressed in myenteric neuronal and glial subpopulations in the adult enteric nervous system. Messenger RNA expression of Phox2b was increased in patients with diverticulitis and both neuronal, and glial protein expression of Phox2b were altered in these patients.

Conclusions

Alterations of Phox2b expression may contribute to the enteric neuropathy observed in diverticular disease. Future studies are required to characterise the functions of Phox2b in the adult enteric nervous system and to determine its potential as a therapeutic target in gastrointestinal disorders.
Asset-Based Community Development: Narratives, Practice, and Conditions of Possibility—A Qualitative Study With Community Practitioners
Authors: Harrison Rebecca , Blickem Christian , Lamb Jonathan , Kirk Susan , Vassilev Ivaylo
Published: January 2019

Asset-Based Community Development (ABCD) is seen as a way of tackling the social determinants of health and reducing health inequalities. However, a better understanding of the mechanisms through which ABCD operates, and the environmental and relational conditions within which it is likely to be most effective, could increase its effectiveness at improving health and well-being and reducing inequalities. Interviews and focus groups were conducted with 25 people working in third sector and voluntary organizations to begin to improve understanding about ABCD approaches, how they are implemented, and how they are meeting the needs of disadvantaged populations. These individuals had local area knowledge of programs that follow an ABCD approach and which are currently running in the North West of England. The interviews were transcribed and thematically analyzed. Four overarching themes gave insight into the principles and practices of ABCD: Relationships and trust as mechanisms for change, Reciprocity and connectivity: “people not services,” Accountability and reducing dependency, and A socially sustainable model. ABCD focuses on identifying and developing individual capabilities, relationships, engagement within communities, and outcomes that are meaningful to people and consistent with relationships and support that are reciprocal and acceptable. ABCD is likely to be most effective in supporting vulnerable people where building trust is mirrored by an institutional and relational environment that is trustworthy and facilitative of developing people’s capabilities.
Measuring pedestrian volume by land use mix: Presenting a new entropy-based index by weighting walking generation units
Authors: Im Ha Na , Choi Chang Gyu
Published: January 2019

This study proposes an alternative to the conventional entropy-based land use mix index, which is generally used to measure the diversity of land use. Pedestrian volume was selected as the dependent variable as it represents the vitality of districts, which many recent urban studies now consider important. The study investigates an entropy-based weighted land use mix index, which is weighted by different land use types. For the index, different areas are needed to generate a unit of pedestrian volume, whose measure is m2/person/day. The study demonstrates that this alternative is more effective than the existing conventionally used entropy-based land use mix index for explaining pedestrian volume. The research confirms that the conventionally used entropy-based land use mix index can have a positive or negative impact depending on the land use characteristics of the survey points because the conventionally used entropy-based land use mix index has a non-linear relationship with pedestrian volume. By analysing 9727 surveyed locations of pedestrian volume in Seoul, Korea, the study demonstrates that the weighted land use mix index, rather than the conventionally used entropy-based land use mix index, can improve the explanatory power of the estimation model for the relationship between pedestrian volume and built environments, showing consistent results throughout the empirical analysis. In future built-environment studies, the utility of the weighted land use mix index is expected to improve if studies include how to find the accurate weighting of the land use in estimating the pedestrian volume.
Human neutrophils express low levels of FcγRIIIA, which plays a role in PMN activation
Authors: Golay Josée , Valgardsdottir Rut , Musaraj Gerta , Giupponi Damiano , Spinelli Orietta , Introna Martino
Published: January 2019

We have identified a rare healthy FcγRIIIB (CD16B)-null donor completely lacking FCGR3B RNA and protein expression and dissected the role of the different neutrophil Fcγ receptors in the response to therapeutic anti-CD20 monoclonal antibodies. We observed that polymorphonuclear neutrophils (PMNs) from FcγRIIIB wild-type (WT) individuals or the null donor were more effectively activated by chronic lymphocytic leukemia (CLL) B-cell targets opsonized with glycoengineered anti-CD20 antibodies compared with fully core-fucosylated anti-CD20 antibodies, suggesting the presence and role of FcγRIIIA (CD16A) on PMNs. Indeed, we demonstrated by reverse-transcription polymerase chain reaction, flow cytometry, and western blot analysis that PMNs from FcγRIIIB WT donors and the null individual express low levels of FcγRIIIA on their surfaces. FcγRIIIA is a functional and activating molecule on these cells, because anti-CD16 F(ab′)2 antibodies alone were able to activate highly purified PMNs from the FcγRIIIB-null donor. Use of blocking anti-CD16 and anti-CD32 antibodies showed that FcγRIIIA is also a major mediator of phagocytosis of CD20-opsonized beads by FcγRIIIB WT and null PMNs. In contrast, trogocytosis of antibody-opsonized CLL B cells by PMNs was mediated primarily by FcγRIIIB in WT PMNs and by FcγRIIA in null PMNs. We conclude that FcγRIIIA is an important player in PMN functions, whereas FcγRIIIB is dispensable for activation and phagocytosis. We discuss the clinical implications of these findings.
Targeting of cathepsin S reduces cystic fibrosis-like lung disease
Authors: Small Donna M. , Brown Ryan R. , Doherty Declan F. , Abladey Anthony , Zhou-Suckow Zhe , Delaney Rebecca J. , Kerrigan Lauren , Dougan Caoifa M. , Borensztajn Keren S. , Holsinger Leslie , Booth Robert , Scott Christopher J. , López-Campos Guillermo , Elborn J. Stuart , Mall Marcus A. , Weldon Sinéad , Taggart Clifford C.
Published: January 2019

Cathepsin S (CatS) is upregulated in the lungs of patients with cystic fibrosis (CF). However, its role in CF lung disease pathogenesis remains unclear.

In this study, β-epithelial Na+channel-overexpressing transgenic (βENaC-Tg) mice, a model of CF-like lung disease, were crossed with CatS null (CatS−/−) mice or treated with the CatS inhibitor VBY-999.

Levels of active CatS were elevated in the lungs of βENaC-Tg mice compared with wild-type (WT) littermates. CatS−/−βENaC-Tg mice exhibited decreased pulmonary inflammation, mucus obstruction and structural lung damage compared with βENaC-Tg mice. Pharmacological inhibition of CatS resulted in a significant decrease in pulmonary inflammation, lung damage and mucus plugging in the lungs of βENaC-Tg mice. In addition, instillation of CatS into the lungs of WT mice resulted in inflammation, lung remodelling and upregulation of mucin expression. Inhibition of the CatS target, protease-activated receptor 2 (PAR2), in βENaC-Tg mice resulted in a reduction in airway inflammation and mucin expression, indicating a role for this receptor in CatS-induced lung pathology.

Our data indicate an important role for CatS in the pathogenesis of CF-like lung disease mediated in part by PAR2 and highlight CatS as a therapeutic target.
What should be the protein target for adjustable Human Milk fortification in premature infants?
Authors: Dorum Bayram Ali , Ozkan Hilal , Cakir Salih Cagri , Koksal Nilgun , Sen Gizem Ezgi
Published: January 2019

Objective: To assess the short- and long-term effects of the adjustable fortification (ADJ) regimen on growth parameters in premature infants and to evaluate the amount of protein supplements given to reach the targeted blood urea nitrogen (BUN) levels.

Methods: In this retrospective study, preterm babies who were born at ≤32 weeks gestational age and fed with human milk, were evaluated in two groups. Infants in Group-I were fed only standard fortification (STD). Infants in Group-II were fed the ADJ regimen. The study was conducted between 2011 and 2016.

Results: There were 123 infants in the STD group and 119 in the ADJ group. The mean gestational age of the patients in Group-I was 29.7±1.8 weeks, and mean birth weight was 1266.1±347.1 g. The mean gestational age of the patients in Group-II was 29.5±1.9 weeks, and the mean birth weight was 1217.5±345.5 g. The daily increase in weight and weekly increase in HC were significantly higher in the ADJ group infants. Weight and HC of infants in the ADJ group were significantly higher at 40 weeks. At one year corrected age, weight, length, and HC measurements of both groups were similar. In Group-II, 63% of patients required additional protein supplementation up to 1.6 g/day to achieve the target BUN levels.

Conclusion: A higher protein intake through the ADJ regimen improves the physical growth rate of premature infants in the NICU and after discharge. However, sometimes, the targeted growth and BUN values ​​cannot be achieved despite the administration of protein at the recommended increased doses. Increasing protein supplementation up to 1.6 g/day is safe, feasible, and beneficial for these infants.

How to cite this:Dorum BA, Ozkan H, Cakir SC, Koksal N, Sen GE. What should be the protein target for adjustable Human Milk fortification in premature infants? Pak J Med Sci. 2019;35(1):277-281. doi: https://doi.org/10.12669/pjms.35.1.337

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Frequency and predictors of pulmonary hypertension in patients with Systemic Lupus Erythematosus
Authors: Asif Sadia , Rasheed Aflak , Mahmud Tafazzul-e-Haque , Asghar Ammad
Published: January 2019

Objective: To determine the frequency and predictors of pulmonary hypertension in patients with Systemic Lupus Erythematosus in a Pakistani population, presenting at a tertiary care hospital

Methods: This cross-sectional study was conducted at the Department of Rheumatology, Shiekh Zayed Hospital, Lahore from March to June 2018. A total of 97 patients, who fulfilled the Systemic Lupus Erythematosus (SLE) criteria of American College of Rheumatology (ACR) 1992 were enrolled. Pulmonary Arterial Hypertension (PAH) was measured by calculating pulmonary arterial systolic pressure through echocardiography by a single consultant cardiologist. Disease characteristics and demography was collected in a self-administered proforma. PAH was defined as mean pulmonary arterial pressure of 25mmHg or above by calculating with a formula. SPSS version 20 was used for analysis of data.

Results: Out of 97 patients, 89.7% (n=87) were females and 10.3% (n=10) were males, with mean age of 31.29±8.824 years. The mean disease duration was 24.21±30.46 months. PAH was found in 23.3% (n=23) patients, including 19 females and 4 males. On further analysis of data, Raynaud phenomenon, rheumatoid factor and nephritis were assessed as predictors of PAH and all of these showed statistical significance for presence of PAH as per Chi-square test (p<0.05).

Conclusion: In this study, 23.3% SLE patients showed evidence of PAH and positive statistical significance was found between predictors like Raynaud phenomenon, rheumatoid factor, nephritis and presence of PAH. So it is imperative to detect PAH early and start prompt treatment to achieve better quality of life.

How to cite this:Asif S, Rasheed A, Mahmud TH, Asghar A. Frequency and predictors of pulmonary hypertension in patients with Systemic Lupus Erythematosus. Pak J Med Sci. 2019;35(1):86-89. doi: https://doi.org/10.12669/pjms.35.1.405

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Million Migrants study of healthcare and mortality outcomes in non-EU migrants and refugees to England: Analysis protocol for a linked population-based cohort study of 1.5 million migrants
Authors: Burns Rachel , Pathak Neha , Campos-Matos Ines , Zenner Dominik , Katikireddi Srinivasa Vittal , Muzyamba Morris C. , Miranda J. Jaime , Gilbert Ruth , Rutter Harry , Jones Lucy , Williamson Elizabeth , Hayward Andrew C. , Smeeth Liam , Abubakar Ibrahim , Hemingway Harry , Aldridge Robert W.
Published: January 2019

Background: In 2017, 15.6% of the people living in England were born abroad, yet we have a limited understanding of their use of health services and subsequent health conditions. This linked population-based cohort study aims to describe the hospital-based healthcare and mortality outcomes of 1.5 million non-European Union (EU) migrants and refugees in England.

Methods and analysis: We will link four data sources: first, non-EU migrant tuberculosis pre-entry screening data; second, refugee pre-entry health assessment data; third, national hospital episode statistics; and fourth, Office of National Statistics death records. Using this linked dataset, we will then generate a population-based cohort to examine hospital-based events and mortality outcomes in England between Jan 1, 2006, and Dec 31, 2017. We will compare outcomes across three groups in our analyses: 1) non-EU international migrants, 2) refugees, and 3) general population of England.

Ethics and dissemination: We will obtain approval to use unconsented patient identifiable data from the Secretary of State for Health through the Confidentiality Advisory Group and the National Health Service Research Ethics Committee. After data linkage, we will destroy identifying data and undertake all analyses using the pseudonymised dataset. The results will provide policy makers and civil society with detailed information about the health needs of non-EU international migrants and refugees in England.
Government and business: the basics of interaction
Authors: Косов Михаил , Kosov Mihail , Сигарев Александр , Sigarev Aleksandr , Буздалина Ольга , Buzdalina Ol'ga , Горлова Оксана , Gorlova Oksana , Долина Ольга , Dolina Ol'ga , Васюнина Маргарита , Vasyunina Margarita , Фрумина Светлана , Frumina Svetlana
Published: January 2019

The textbook is devoted to theoretical and practical aspects of interaction between business and the state. Theoretical bases of interaction between business and the state are considered. The features of interaction between the state and business in the field of investment, public procurement, antitrust regulation, public-private partnership are analyzed, the social responsibility of the participants of this interaction is determined. Theoretical bases of adaptation of the state and business in the conditions of cyclic development of economy are given. The publication is intended for bachelors studying in the direction of "Economics", for undergraduates studying in different directions, for teachers.