bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of transcranial pulsed electromagnetic field stimulation on quality of life in Parkinson's disease
Authors: Morberg B. M. , Malling A. S. , Jensen B. R. , Gredal O. , Bech P. , Wermuth L.
Published: March 2018

Background and purpose

Pulsed electromagnetic fields induce a protective and anti‐inflammatory effect in the nervous system primarily due to growth factor upregulation that possibly abates neurodegeneration in Parkinson's disease (PD). This study investigated treatment effects of transcranial pulsed electromagnetic fields (T‐PEMFs) on quality of life in PD and the feasibility and safety of this treatment.

Methods

In this double‐blinded clinical study, 97 participants with idiopathic PD (Hoehn & Yahr stage I–IV), on optimal medical anti‐parkinsonian treatment, were block randomized (3:3) to either active (n = 49) or placebo treatment (n = 48). Treatment with T‐PEMFs entailed one daily 30‐min home treatment for eight consecutive weeks. The 39‐item Parkinson's Disease Questionnaire (PDQ‐39) was assessed at baseline and endpoint. A special questionnaire was used to profile adverse events by interviewing the participants over the full treatment period. Treatment compliance was accounted for by daily treatment registration.

Results

The active group improved with respect to clinical effect size for the two dimensions, i.e. mobility and activities of daily living, compared with the placebo group. No between‐group differences were found for the remaining PDQ‐39 dimensions. There were no between‐group difference in adverse events. Treatment compliance was 97.9%.

Conclusion

Treatment with T‐PEMFs improved mobility and activities of daily living scores for clinical effect size only in the active group, indicating a positive treatment response for motor symptoms. No difference was found between the two groups for the remaining PDQ‐39 dimensions. The treatment had no or only mild adverse events and was performed with high compliance.
Molecular and morphological evidence for new genera in the click‐beetle subfamily Cardiophorinae (Coleoptera: Elateridae)
Authors: Douglas Hume B. , Kundrata Robin , Janosikova Dominika , Bocak Ladislav
Published: March 2018

The Cardiophorinae is consistently at the subfamily rank in recent classifications. Conversely, generic limits and relationships remain unstable. Here, we use two nuclear (18S and 28S) and three mitochondrial (rrnL, cox1–3′ and cox1–5′) markers to test phylogenetic hypotheses for the Cardiophorinae. We investigate the positions of Paracardiophorus buettikeri Chassain from the Arabian Peninsula and a simple‐clawed Argentinian Horistonotus Candèze species, neither of which matches the diagnoses of their assigned genera. Additionally, we test the monophyly of the widely defined Cardiophorus Eschscholtz by including representatives of Cardiophorus (Cardiophorus), Cardiophorus (Coptostethus Wollaston) and the former subgenus Zygocardiophorus Iablokoff‐Khnzorian and Mardjanian. Molecular analyses recover three clades, which are also supported by morphological traits. Using inferred relationships we propose three new genera: Arandelater Douglas and Kundrata gen. nov., Chassainphorus Douglas and Kundrata gen. nov., and Huarpelater Douglas and Kundrata gen. nov. for Horistonotus canescens Steinheil, P. buettikeri and an undescribed species perhaps historically mistaken for H. canescens.Horistonotus tumidicollis Schwarz is synonymized under H. canescens.Coptostethus is raised from a subgenus of Cardiophorus to the genus level with revision of its definition. Eighteen Cardiophorus (Cardiophorus) and Dicronychus Brullé species are newly assigned to Coptostethus. All species currently included in Coptostethus are listed. All Coptostethus species from South Africa are transferred to Cardiophorus (Cardiophorus). Huarpelater cordobae Douglas and Kundrata sp. nov. is described, and Horistonotus quillu Aranda is transferred to Huarpelater gen. nov. The replacement name Coptostethus cobosi nom. nov. and comb. nov. is proposed for Cardiophorus inflatus Cobos. We provide diagnoses and illustrated descriptions for the new genera and their types.
The face of risk: CEO facial masculinity and firm risk
Authors: Kamiya Shinichi , Kim Y. Han (Andy) , Park Soohyun
Published: March 2018

We examine whether a male CEO's facial masculinity, measured by facial width‐to‐height ratio (fWHR), predicts the riskiness of his firm. Using the face pictures of 1,162 CEOs in the Execucomp database, we find supporting evidence. Firms with more masculine‐faced CEOs have higher stock return volatility and higher financial leverage and are more acquisitive. Their frequency of acquisitions, the dollar amount spent on acquisitions, and the takeover premium are all higher. We find that more masculine‐faced CEOs’ compensation is more sensitive to the risk of the firm. The result is robust when we use AI (artificial intelligence)‐measured fWHR of the CEOs.
Digital analysis yields more reliable and accurate measures of dermal and epidermal thickness in histologically processed specimens compared to traditional methods
Authors: Turin Sergey Y. , Ledwon Joanna K. , Bae Hanna , Buganza‐Tepole Adrian , Topczewska Jolanta , Gosain Arun K.
Published: March 2018

Changes in the thickness of the dermis and epidermis have been described in the scenario of tissue expansion as well as inflammatory skin processes (psoriasis, contact hypersensitivity and so on). These changes have previously been quantified using ocular micrometers to obtain and then average a limited number of spot measurements, leading to suboptimal accuracy. We describe a rapid method of using freely available ImageJ software to analyze digitized images of fixed skin specimens. By determining the cross‐sectional area and surface length of a skin layer, a simple calculation produces more accurate and reproducible measurements of its thickness compared to historical methods, with excellent inter‐rater reliability.
Friction stir welds in aluminium: Design S‐N curves from statistical analysis of literature data
Authors: Maggiolini E. , Benasciutti D. , Susmel L. , Hattingh D.G. , James M.N. , Tovo R.
Published: March 2018

Appropriate S‐N fatigue design curves for friction stir welded joints in aluminium alloys are currently not specified in design codes and standards. The present paper is intended to assist in enabling standardised fatigue design for such joints, through a comprehensive statistical analysis of more than 500 individual sets of data gathered from published literature. These data are used to establish the usual design fatigue curves for welds that give a 97.7% survival probability with 95% confidence. Experimental fatigue data represent defect‐free butt joints and include both flat plate and tubular joints between similar aluminium alloys (across the range of 2xxx, 5xxx, 6xxx, and 7xxx series). Weld conditions include as‐welded, machined, and postweld heat treated under constant amplitude cyclic loading at various stress ratios in the range from R = −1 to 0.5. A systematic comparison is presented by categorising the data according to the alloy type, temper condition, postweld heat treatment, and stress ratio and the correlation with the S‐N design curves from Eurocode 9 is also considered. The fatigue curves presented in this paper will serve as a useful guideline for engineers involved in design of friction stir aluminium joints subjected to in‐service fatigue loading.
The influence of landscape and environmental factors on ranavirus epidemiology in a California amphibian assemblage
Authors: Tornabene Brian J. , Blaustein Andrew R. , Briggs Cheryl J. , Calhoun Dana M. , Johnson Pieter T. J. , McDevitt‐Galles Travis , Rohr Jason R. , Hoverman Jason T.
Published: March 2018

A fundamental goal of disease ecology is to determine the landscape and environmental processes that drive disease dynamics at different biological levels to guide management and conservation. Although ranaviruses (family Iridoviridae) are emerging amphibian pathogens, few studies have conducted comprehensive field surveys to assess potential drivers of ranavirus disease dynamics.

We examined the factors underlying patterns in site‐level ranavirus presence and individual‐level ranavirus infection in 76 ponds and 1,088 individuals representing five amphibian species within the East Bay region of California.

Based on a competing‐model approach followed by variance partitioning, landscape and biotic variables explained the most variation in site‐level presence. However, biotic and individual‐level variables explained the most variation in individual‐level infection.

Distance to nearest ranavirus‐infected pond (the landscape factor) was more important than biotic factors at the site level; however, biotic factors were most influential at the individual level. At the site level, the probability of ranavirus presence correlated negatively with distance to nearest ranavirus‐positive pond, suggesting that the movement of water or mobile taxa (e.g., adult amphibians, birds, reptiles) may facilitate the movement of ranavirus between ponds and across the landscape.

Taxonomic richness associated positively with ranavirus presence at the site level, but vertebrate richness associated negatively with infection prevalence in the host population. This might reflect the contrasting influences of diversity on pathogen colonisation versus transmission among hosts.

Amphibian host species differed in their likelihood of ranavirus infection: American bullfrogs (Rana catesbeiana) had the weakest association with infection while rough‐skinned newts (Taricha granulosa) had the strongest. After accounting for host species effects, hosts with greater snout–vent length had a lower probability of infection.

Our study demonstrates the array of landscape, environmental, and individual‐level factors associated with ranavirus epidemiology. Moreover, our study helps illustrate that the importance of these factors varies with biological level.
Formation of stromatolite lamina at the interface of oxygenic–anoxygenic photosynthesis
Authors: Pace A. , Bourillot R. , Bouton A. , Vennin E. , Braissant O. , Dupraz C. , Duteil T. , Bundeleva I. , Patrier P. , Galaup S. , Yokoyama Y. , Franceschi M. , Virgone A. , Visscher P. T.
Published: March 2018

In modern stromatolites, mineralization results from a complex interplay between microbial metabolisms, the organic matrix, and environmental parameters. Here, we combined biogeochemical, mineralogical, and microscopic analyses with measurements of metabolic activity to characterize the mineralization processes and products in an emergent (<18 months) hypersaline microbial mat. While the nucleation of Mg silicates is ubiquitous in the mat, the initial formation of a Ca‐Mg carbonate lamina depends on (i) the creation of a high‐pH interface combined with a major change in properties of the exopolymeric substances at the interface of the oxygenic and anoxygenic photoautotrophic layers and (ii) the synergy between two major players of sulfur cycle, purple sulfur bacteria, and sulfate‐reducing bacteria. The repetition of this process over time combined with upward growth of the mat is a possible pathway leading to the formation of a stromatolite.
Tree mycorrhizal type predicts within‐site variability in the storage and distribution of soil organic matter
Authors: Craig Matthew E. , Turner Benjamin L. , Liang Chao , Clay Keith , Johnson Daniel J. , Phillips Richard P.
Published: March 2018

Forest soils store large amounts of carbon (C) and nitrogen (N), yet how predicted shifts in forest composition will impact long‐term C and N persistence remains poorly understood. A recent hypothesis predicts that soils under trees associated with arbuscular mycorrhizas (AM) store less C than soils dominated by trees associated with ectomycorrhizas (ECM), due to slower decomposition in ECM‐dominated forests. However, an incipient hypothesis predicts that systems with rapid decomposition—e.g. most AM‐dominated forests—enhance soil organic matter (SOM) stabilization by accelerating the production of microbial residues. To address these contrasting predictions, we quantified soil C and N to 1 m depth across gradients of ECM‐dominance in three temperate forests. By focusing on sites where AM‐ and ECM‐plants co‐occur, our analysis controls for climatic factors that covary with mycorrhizal dominance across broad scales. We found that while ECM stands contain more SOM in topsoil, AM stands contain more SOM when subsoil to 1 m depth is included. Biomarkers and soil fractionations reveal that these patterns are driven by an accumulation of microbial residues in AM‐dominated soils. Collectively, our results support emerging theory on SOM formation, demonstrate the importance of subsurface soils in mediating plant effects on soil C and N, and indicate that shifts in the mycorrhizal composition of temperate forests may alter the stabilization of SOM.
Reconstructing deep‐time palaeoclimate legacies in the clusioid Malpighiales unveils their role in the evolution and extinction of the boreotropical flora
Authors: Meseguer Andrea S. , Lobo Jorge M. , Cornuault Josselin , Beerling David , Ruhfel Brad R. , Davis Charles C. , Jousselin Emmanuelle , Sanmartín Isabel
Published: March 2018

Aim

During its entire history, the Earth has gone through periods of climate change similar in scale and pace to the warming trend observed today in the Anthropocene. The impact of these ancient climatic events on the evolutionary trajectories of organisms provides clues on the organismal response to climate change, including extinction, migration and persistence. Here, we examine the evolutionary response to climate cooling/warming events of the clusioid families Calophyllaceae, Podostemaceae and Hypericaceae (CPH clade) and the genus Hypericum as test cases.

Location

Holarctic.

Time period

Late Cretaceous–Cenozoic.

Major taxa studied

Angiosperms.

Methods

We use palaeoclimate simulations, species distribution models and phylogenetic comparative approaches calibrated with fossils.

Results

Ancestral CPH lineages could have been distributed in the Holarctic 100 Ma, occupying tropical subhumid assemblages, a finding supported by the fossil record. Expansion to closed‐canopy tropical rain forest habitats occurred after 60 Ma, in the Cenozoic, in agreement with earlier ideas of a post‐Cretaceous origin of current tropical rain forest. Posterior Cooling during the Eocene triggered diversification declines in CPH tropical lineages, and was associated with a climatic shift towards temperate affinities in Hypericum. Hypericum subsequently migrated to tropical mountains, where it encountered different temperate conditions than in the Holarctic.

Main conclusions

We hypothesize that most clusioid CPH lineages failed to adapt to temperate regimes during periods of Cenozoic climate change, and went extinct in the Holarctic. In contrast, boreotropical descendants including Hypericum that underwent niche evolution demonstrated selective advantages as climates became colder. Our results point toward macroevolutionary trajectories involving the altering fates of closely related clades that adapt to periods of global climate change versus those that do not. Moreover, they suggest the hypothesis that potentially many clades, particularly inhabitants of boreotropical floras, were likely extirpated from the Holarctic and persist today (if at all) in more southern tropical locations.
A global test of the cold‐climate hypothesis for the evolution of viviparity of squamate reptiles
Authors: Ma Liang , Buckley Lauren B. , Huey Raymond B. , Du Wei‐Guo
Published: March 2018

Aim

The evolution of viviparity in squamate reptiles has attracted considerable scientific attention since the beginning of last century. The cold‐climate hypothesis posits that cold regions favor viviparity (and therefore the incidence of viviparous squamates is increased in these regions) because viviparous females can use thermoregulatory behavior to shorten embryonic developmental time and to reduce exposure of embryos to stressful temperatures. However, a rigorous global‐scale test of the impact of viviparity on the developmental time and viability of embryos is still absent. Recently developed biophysical models and climate databases enable us to conduct a mechanistic test of this hypothesis.

Location

Global.

Time period

Summer.

Major taxa studied

Squamata.

Methods

We integrated global climate data, a biophysical model, and developmental functions to quantify the effects of temperature on embryo developmental time, developmental viability, and energy consumption of oviparous versus viviparous embryos. To examine the accuracy of our predictions, we calculated the percentage of squamate reptiles that were viviparous in each region and assessed developmental temperature of gravid females, latitude and elevation as predictors for the percentage of squamate reptiles.

Results

Compared with oviparous embryos, viviparous embryos develop faster in cold regions, and experience similar embryonic developmental viability. Across most latitudes and elevations, the total energetic cost of development is lower for viviparous embryos than for oviparous embryos. Cold regions contain a higher proportion of viviparous species than do hot regions. By comparing the distribution pattern of viviparity and temperature effects on embryonic development, we found that shortened development time provided the strongest benefit of viviparity.

Main conclusions

Our global and biophysical model based comparison generally supports the cold‐climate hypothesis. Moreover, viviparity in cold climates appears beneficial primarily by shortening developmental time.
The labor between farm and table: Cultivating an urban political ecology of agrifood for the 21st century
Authors: Coplen Amy K.
Published: March 2018

The variegated landscape of food production and consumption reveals a great deal about socionatural relations and processes of urbanization and globalization under capitalism. Food production has changed dramatically over time, shifting away (but never fully divorced) from the rural agrarian landscape to spaces that are characterized as industrial and/or urban. Workers transform nature at each stage in the food production process, not only on farms but also in processing plants, grocery stores, restaurants, and other spaces. This paper draws on urban political ecology (UPE) to position labor as central to understanding the socioecological relations embodied in food systems. It puts UPE in conversation with agrarian political economy, a decidedly un‐urban body of literature that nevertheless offers critical insight into the obstacles (and opportunities) that nature and labor pose to food systems development in an urbanizing world. Employing UPE's dialectic conception of humans and nature, this paper highlights the role that non‐agricultural and urban‐based food labor plays in an increasingly complex global political economy of agrifood. Seeing both the “labor” and “nature” of food from the farm all the way to the table can reveal the myriad transformations, exchanges, and socioecological relations operating within the food system.
Impacts of persistent general and site‐specific pain on activities of daily living and physical performance: A prospective analysis of the English Longitudinal Study of Ageing
Authors: Yiengprugsawan Vasoontara , Steptoe Andrew
Published: March 2018

Aim

Pain is an increasingly common phenomenon as people age; pain over a long period can result in limited functioning. The present study investigated the impacts of general and multisite‐specific pain on activities of daily living and physical performance among older adults.

Methods

Data were analyzed from the English Longitudinal Study of Ageing, a representative sample of the population aged ≥50 years. Face‐to‐face interview and nurse records were used from waves 2–6 (2004–2012) for analyses. General and site‐specific pain (back, hip and knee) were measured biennially between 2004 and 2008 (n = 5010). Impaired activity of daily living and physical performance measures (chair rise and grip strength) between 2008 and 2012 were aggregated across assessments as outcomes. Multinomial logistic regressions were used for the former and linear regression for the latter, adjusting for potential covariates.

Results

General pain (moderate‐to‐severe) was prevalent, with close to one‐quarter of participants reporting pain at least twice during the follow‐up period. Multisite pain reports were strong predictors of subsequent limited activities of daily living (adjusted odds ratio range 1.86–3.97 for back and hip, 2.04–4.19 for back and knee, and 2.08–5.16 for hip and knee). Persistent pain was also strongly associated with worse physical performance outcomes.

Conclusions

Our data confirm the longitudinal impacts of persistent pain among older adults. The findings highlight the value of monitoring and management of both general and site‐specific pain in order to promote sustained independence at older ages. Geriatr Gerontol Int 2018; 18: 1051–1057.
Determining discharge destination in geriatric evaluation and management units: Is progressive goal attainment a better early indicator of discharge destination than improvement in functional independence measure scores?
Authors: Black Susan , Nicholas Caitlin , Cotton Susan , Brock Kim
Published: March 2018

Aim

To determine whether progress in goal attainment is a more responsive measure of functional improvement than the Functional Independence Measure, and whether it is a more accurate predictor of discharge destination in the early phase of a Geriatric Evaluation and Management episode.

Methods

The present study was a prospective audit of goal achievement, functional ability and discharge destination. A total of 83 patients were included in this study. Logistic regression was carried out with the outcome variable discharge destination (home vs residential care), and the predictors being goal attainment, age at admission and change in the Functional Independence Measure motor function scale from admission to 2 weeks.

Results

Of the predictors, goal attainment was the only significant predictor. The overall amount of variability in the discharge destination explained by the predictors was 25% (Nagelkerke pseudo R2).

Conclusions

Progressive goal attainment might be a better predictor of improvement in function and discharge destination than change in the Functional Independence Measure. Geriatr Gerontol Int 2018; 18: 1058–1063.
Quartz‐Helium Method to Estimate Fluid Flow in Thick Aquitards, Gunnedah Basin, Australia
Authors: Smith Stanley D. , Mathouchanh Emeline , Mallants Dirk
Published: March 2018

The hydraulic integrity of aquitards is generally assumed and relies on a few core‐scale permeability measurements, drill‐stem tests, or textbook values. This approach is because hydraulic data across the full aquitard thickness is generally lacking. Proper assessment of aquitard integrity should be studied at the formation (spanning its entire thickness at a single point) or regional (formation properties at multiple locations throughout the basin) scale. One formation‐scale approach uses environmental tracers and advection‐dispersion modeling to constrain fluid flow rates. This study demonstrates the use of helium concentrations in quartz as a method of constraining the rate of fluid flow in a 520‐m thick aquitard in the Gunnedah Basin, NSW, Australia. Quartz was separated from existing core samples in the Watermark and Porcupine Formations at depths from 750 to 1200 m. The helium was released from these samples by heating and select samples were impregnated with helium to determine the rate of helium diffusion through the quartz. One‐dimensional advection‐dispersion modeling of the helium profile accounting for diffusive helium exchange between quartz and pore water revealed, that (1) vertical fluid velocity has been on the order of 0.02 mm/year or less for tens to thousands of years, (2) helium is in equilibrium between quartz and pore water, and (3) the helium profile is transient indicating that helium concentrations in the underlying Maules Creek Formation has varied over geological time. Further modeling identified aquitard conditions (thickness and temperature) for which equilibrium exists, a precondition for deriving formation‐scale permeability.
Arteriovenous shunts as venous access in children with haemophilia
Authors: Thom K. E. , Hölzenbein T. , Jones N. , Zwiauer K. , Streif W. , Gattringer S. , Male C.
Published: March 2018

Introduction

Venous access is essential in patients with haemophilia for administration of factor concentrates. Peripheral venipuncture may be challenging, particularly in young children or during immune tolerance induction (ITI). Central venous access devices (CVADs) carry a significant risk for complications. An alternative for venous access is peripheral arteriovenous shunts (AVSs), but there is sparse documentation in the literature. The aim of this study was to document our experience with AVS over 12 years in 27 boys with severe haemophilia.

Methods

For AVS creation, a subcutaneous vein is connected end‐to‐side with an artery at the wrist (Cimino) or at the forearm (Gracz shunt). Factor concentrates were substituted as for intermediate size surgery. To prevent shunt occlusion, heparin (5 units/kg/h) was given during the first 3 days.

Results

Indications for AVS creation were prophylaxis start (n = 20) and ITI (n = 7). Age at shunt insertion was median 1.5 years (minimum 8 months; maximum 11.7 years). Shunt maturation was achieved within a median of 3 weeks after surgery (1.5 weeks; 18 weeks). Age when home treatment was established was median 2.1 years (9 months; 11.7 years). Four patients required AVS revisions due to stenosis, but 26 of 27 patients (96%) achieved good long‐term shunt function. There were few other complications.

Conclusion

Arteriovenous shunts provide a good alternative to CVAD and carry a lower risk of complications. AVSs allow earlier start of prophylaxis and home therapy with an improved quality of life for patients and families.
Where are the wild things? Animals in western medieval European History
Authors: Taylor Anna Lisa
Published: March 2018

Despite the humanities' “animal turn,” the historiography of western European medieval animals is limited. Social historians have examined specific (usually economically important) species, and cultural historians have analyzed the symbolism of animals in the Middle Ages, but few are interested in the animals themselves. Drawing on the highly interdisciplinary field of Critical Animal Studies and other fields of history, I suggest ways that medieval historians could embrace the animal turn to study the experiences of real animals and animal–human entanglements of the Middle Ages.
Loss to follow‐up and mortality among HIV‐infected adolescents receiving antiretroviral therapy in Pune, India
Authors: Nimkar S , Valvi C , Kadam D , Rewari BB , Kinikar A , Gupte N , Suryavanshi N , Deluca A , Shankar A , Golub J , Bollinger R , Gupta A , Marbaniang I , Mave V
Published: March 2018

Objectives

India has the highest number of HIV‐infected adolescents in Asia, but little is known about their treatment outcomes. We assessed rates and factors associated with loss to follow‐up (LTFU) and mortality among Indian adolescents.

Methods

The analysis included adolescents (10–19 years old) starting antiretroviral therapy (ART) between 2005 and 2014 at BJ Government Medical College, Pune, India. LTFU was defined as missing more than three consecutive monthly visits. The competing‐risks method was used to calculate subdistribution hazard ratios (SHRs) of predictors for LTFU, with death as the competing risk. Cox proportional hazard models were used to identify predictors of mortality.

Results

Of 717 adolescents starting ART, 402 with complete data were included in the analysis. Of these, 61% were male and 80% were perinatally infected, and the median baseline CD4 count was 174 cells/μL. LTFU and mortality rates were 4.4 and 4.9/100‐person years, respectively. Cumulative LTFU incidence increased from 6% to 15% over 6 years. Age ≥ 15 years [adjusted SHR (aSHR) 2.44; 95% confidence interval (CI) 1.18–5.02] was a risk factor for LTFU. Cumulative mortality increased from 9.5% to 17.9% over 6 years. World Health Organization (WHO) stages III and IV [adjusted hazard ratio (aHR) 2.26; 95% CI: 1.14–4.48] and an increase in CD4 count by 100 cells/μL (aHR: 0.59; 95% CI: 0.43–0.83) were associated with mortality.

Conclusions

A third of adolescents had been lost to follow‐up or died by follow‐up year 6. Older age was a risk factor for LTFU and advanced clinical disease for death. Strategies to improve retention counselling for older adolescents and closer clinical monitoring of all adolescents must be considered.
The challenge of discriminating between HIV‐1, HIV‐2 and HIV‐1/2 dual infections
Authors: Hønge BL , Jespersen S , Medina C , Té DS , da Silva ZJ , Christiansen M , Kjerulff B , Laursen AL , Wejse C , Krarup H , Erikstrup C ,   the Bissau HIV Cohort study group
Published: March 2018

Objectives

Discrimination between HIV‐1 and HIV‐2 is important to ensure appropriate antiretroviral treatment (ART) and epidemiological surveillance. However, serological tests have shown frequent mistyping when applied in the field. We evaluated two confirmatory tests, INNO‐LIA HIV I/II Score and ImmunoComb HIV 1/2 BiSpot, for HIV type discriminatory capacity.

Methods

Samples from 239 ART‐naïve HIV‐infected patients from the Bissau HIV Cohort in Guinea‐Bissau were selected retrospectively based on the initial HIV typing performed in Bissau, ensuring a broad representation of HIV types. INNO‐LIA results were interpreted by the newest software algorithm, and three independent observers read the ImmunoComb results. HIV‐1/HIV‐2 RNA and DNA were measured for confirmation.

Results

INNO‐LIA results showed 123 HIV‐1 positive samples, 69 HIV‐2 positive and 47 HIV‐1/2 dually reactive. There was agreement between INNO‐LIA and HIV‐1/HIV‐2 RNA and DNA detection, although not all HIV‐1/2 dually reactive samples could be confirmed by the nucleic acid results. Overall, the observers found that the ImmunoComb results differed from the INNO‐LIA results, with agreements of 90.4, 91.2 and 92.5%, respectively, for HIV‐1, HIV‐2 and HIV‐1/2. The combined kappa‐score for agreement between the three observers was 0.955 (z‐score 35.1; P < 0.01). Of the HIV‐2 mono‐reactive samples (INNO‐LIA), the three observers interpreted 24.6–31.9% as HIV‐1/2 dually infected by ImmunoComb. None of these samples had detectable HIV‐1 RNA or DNA.

Conclusions

There was accordance between INNO‐LIA calls and nucleic acid results, whereas ImmunoComb overestimated the number of HIV‐1/2 dually infected patients. Confirmatory typing is needed for patients diagnosed with HIV‐1/2 dual infection by ImmunoComb.
Secular trends in opportunistic infections, cancers and mortality in patients with AIDS during the era of modern combination antiretroviral therapy
Authors: Sezgin E , Van Natta ML , Thorne JE , Puhan MA , Jabs DA ,   the Longitudinal Studies of the Ocular Complications of AIDS (SOCA) Research Group
Published: March 2018

Objectives

The aim of the study was to estimate the incidence of, determine risk factors for, and investigate the consequences of opportunistic infections (OIs) and malignancies among patients with the acquired immune deficiency syndrome (AIDS) in the era of modern combination antiretroviral therapy (cART).

Methods

Three enrolment periods (1998–2002, 2003–2005 and 2006–2012), corresponding to changes in predominant cART regimens, were compared among 1889 participants enrolled in a prospective cohort study, the Longitudinal Study of Ocular Complications of AIDS (LSOCA). Incidences of AIDS‐related OIs and cancers were estimated. Multivariate logistic and Cox regression models were used to determine the effect of demographic and clinical characteristics on OIs and mortality.

Results

Between participants enrolled in the 1998–2002 and 2006–2012 enrolment periods, the incidence of OIs decreased from 27 per 1000 person‐years (PY) to 11 per 1000 PY (P < 0.001), and mortality decreased from 41 per 1000 PY to 18 per 1000 PY (P < 0.0001), corresponding to improvements in cART regimens.

Conclusions

Improvements in cART regimens led to a progressive decline in the incidence of OIs and mortality between 1999 and 2013 among patients with AIDS in the era of modern cART.
Efficacy and tolerability of lamivudine plus dolutegravir as a switch strategy in a multicentre cohort of patients with suppressed HIV‐1 replication
Authors: Borghetti A , Baldin G , Lombardi F , Ciccullo A , Capetti A , Rusconi S , Sterrantino G , Latini A , Cossu MV , Gagliardini R , De Luca A , Di Giambenedetto S
Published: March 2018

Objectives

We evaluated the efficacy and tolerability of lamivudine + dolutegravir in a cohort of HIV‐1 infected, treatment‐experienced patients with undetectable HIV‐RNA.

Methods

Time to treatment discontinuation (TD) and virological failure (VF) and their predictors were assessed in a multicenter cohort of HIV‐1 infected patients, starting lamivudine + dolutegravir after reaching viral suppression. Secondary objective was the evaluation of changes in lipid profile, renal and immunological functions at week 48.

Results

We enrolled 206 patients (72.8% male, with 51 years median age), who mainly switched their antiretroviral therapy for simplification (32.5%) or drug toxicity (54.5%). The estimated probability of maintaining virological suppression at 48 and 96 weeks was 98.2% and 95.1%, respectively. VF was independently predicted by cumulative time on antiretroviral therapy. The estimated probability of remaining on lamivudine plus dolutegravir was 86.7% and 80.5% at week 48 and 96, respectively. A significant improvement in immunological function (CD4 count and CD4/CD8 ratio) was evidenced at week 48, as well as a decrease in total cholesterol/HDL ratio, triglycerides and estimated glomerular filtration rate.

Conclusions

Lamivudine plus dolutegravir was effective in maintaining viral suppression in our cohort and led to an improvement in metabolic and immunologic functions.
A new approach to assess the effect of photodamage on corneocyte envelope maturity using combined hydrophobicity and mechanical fragility assays
Authors: Guneri D. , Voegeli R. , Gurgul S. J. , Munday M. R. , Lane M. E. , Rawlings A. V.
Published: March 2018

Background

The maturity of the corneocyte envelope (CE) provides information about the barrier functionality of the stratum corneum (SC). Corneocytes are enclosed by the CE, a protein‐lipid matrix, contributing to mechanical resistance and hydrophobicity of the SC.

Objectives

The aim of the work was to develop a novel and robust approach to characterize CE maturity based on rigidity, hydrophobicity and surface area. This offers an alternative approach to the Nile red staining and antigenicity of involucrin to characterize the CE. The photoexposed (PE) cheek and photoprotected (PP) post‐auricular sites were selected for investigation.

Methods

Nine tape strips were obtained from the cheek and post‐auricular sites of healthy Caucasians. CEs on the first and last tape strip were subjected to sonication to assess rigidity, and Nile red staining to determine hydrophobicity per unit surface area. In addition, the presence of involucrin and lipids was assessed to determine CE maturity by examination of the red/green pixel ratio, percentage of involucrin expressing CEs and alternatively the ratio of fluorescence density.

Results

The CE rigidity was lower in the deeper SC layers of the cheek, whereas post‐auricular CEs were mechanically more resistant. Post‐auricular CEs from the superficial SC had a larger surface area with a stronger fluorescence signal than those from the cheek. Interestingly, those CEs from the deeper SC layers had similar surface areas in both anatomical sites but were significantly different in hydrophobicity. These three parameters can be summarized as a relative CE maturity index that expresses CE maturity more precisely with a higher sensitivity than the conventional involucrin and Nile red staining approach. CEs of the cheek surface are more mature than CEs in the deeper SC layer, whereas CEs obtained from the post‐auricular surface are more mature than those from the cheek surface.

Conclusion

The combined method developed allows characterization of CE maturity based on hydrophobicity per unit surface area and rigidity rather than a simple ratio of lipid to involucrin. A more robust and sensitive measurement has therefore been developed addressing the limitations of earlier protocols.
Influence of the velocity and impact angle on the distribution of the surface defects of a sandblasted glass
Authors: Barka Brahim , Faci Abdelaziz , Bouaouadja Noureddine , Bousbaa Chaabane , Benachour Djaafar , Fatmi Messaoud
Published: March 2018

Sandblasting erosion tests were simulated in laboratory to study the size distribution of defects generated by sandstorms in the Saharan regions on soda lime glass, considering different velocities (V = 15, 25, 35 m/s) and different impact angles (α = 30°, 60°, 90°). The influence of these 2 parameters on the defect sizes and the defects number was studied. The defect sizes were measured on a surface of 1 cm2 in the central zone of the damaged surfaces. The damaged surfaces show that the defects with varying sizes are randomly distributed. The surface degradation increases as the velocity and the impact angle increase. Weibull analysis was introduced to characterize the size distribution of surface defects for different test conditions. Weibull plots indicate that the behavior is presented following 2 aspects: The first aspect is unimodal which exists only in 2 extreme conditions, and the second aspect is bimodal, but only for intermediate cases.
Flow cytometric osmotic fragility test and eosin‐5’‐maleimide dye‐binding tests are better than conventional osmotic fragility tests for the diagnosis of hereditary spherocytosis
Authors: Arora R. D. , Dass J. , Maydeo S. , Arya V. , Radhakrishnan N. , Sachdeva A. , Kotwal J. , Bhargava M.
Published: March 2018

Introduction

Hereditary spherocytosis (HS) is the most common inherited hemolytic anemia with heterogeneous clinico‐laboratory manifestations. We evaluated the flow‐cytometric tests: eosin‐5’‐maleimide (EMA) and flow‐cytometric osmotic fragility test (FOFT) and the conventional osmotic fragility tests (OFT) for the diagnosis of hereditary spherocytosis (HS).

Methods

One hundred two suspected HS patients underwent EMA, FOFT, incubated OFT (IOFT), and room temperature OFT (RT‐OFT). In addition, 10 cases of immune hemolytic anemia (IHA) were included, and performance of the above 4 tests was evaluated. For EMA and FOFT, 5 normal controls were assessed together with the patients and cutoffs were calculated using receiver‐operator‐characteristics curve (ROC) analysis.

Results

The best cutoff for %EMA decrease was 12.5%, and for FOFT, %residual red cells (%RRC) was 25.6%. The sensitivity and specificity of RT‐OFT was 62.06% and 86.3%, respectively, while that of IOFT was 79.31% and 87.67%, respectively. Both flow cytometric tests performed better. Sensitivity and specificity of EMA was 86.2% and 93.9% respectively, and that of FOFT was 96.6% and 98.63%, respectively. The combination of the FOFT with IOFT or EMA dye‐binding test yields a sensitivity of 100%, but with EMA, it had a higher specificity. Hb/MCHC was a predictor of the severity of the disease while %EMA decrease and %RRC did not correlate with severity of the disease.

Conclusion

Flow‐cytometric osmotic fragility test is the best possible single test followed by EMA for diagnosis of HS. A combination of FOFT and EMA can correctly diagnose 100% patients. These tests are likely to replace conventional OFTs in future.
Mutation profile and associated clinical features in Chinese patients with cytogenetically normal acute myeloid leukemia
Authors: Wang S. , Zhang Y.‐X. , Huang T. , Sui J.‐N. , Lu J. , Chen X.‐J. , Wang K.‐K. , Xi X.‐D. , Li J.‐M. , Huang J.‐Y. , Chen B.
Published: March 2018

Introduction

Cytogenetically normal acute myeloid leukemia (CN‐AML), which accounted for nearly half of total AML patients, is a highly heterogeneous subset of AML. The specific genetic profile and the ethnic features of CN‐AML are worth to be studied.

Methods

Using deep sequencing technology, we detected the mutation pattern of 39 genes in 152 Chinese CN‐AML patients and analyzed their clinical features.

Results

A total of 503 mutations of 39 genes were identified in 145 (95.4%) patients, with the median number of 3 mutations per case. Nine genes (NPM1, CEBPA, DNMT3A, GATA2, NRAS, TET2, FLT3, IDH2, and WT1) mutated in more than 10% patients. Function groups of myeloid transcription factors, activated signaling, and DNA methylation were most affected. The distribution of variant allele frequencies (VAF) of recurrent genes was different among functional groups. High mutation rates of CEBPA and GATA2 together with the low frequency of FLT3‐ITD mutation seemed to be the distinct characteristics of Chinese patients. Furthermore, CEBPAbi and GATA2 were found to mutate most in M2 subtype, while NPM1 and DNMT3A mutated more in M4 and M5. The prognostic analysis identified CEBPAmo mutation as an inferior factor. FLT3‐ITD, TP53, DNMT3A, CEBPAmo, and WT1 mutations were selected as high‐risk markers to identify the CN‐AML patients with poor prognosis.

Conclusion

Our study provided the valuable information of ethnic genetic characteristics and the clinical relevance of Chinese CN‐AML patients.
The adsorption of dabigatran is as efficient as addition of idarucizumab to neutralize the drug in routine coagulation assays
Authors: Jacquemin M. , Toelen J. , Feyen L. , Schoeters J. , Van Horenbeeck I. , Vanlinthout I. , Debasse M. , Vanassche T. , Peerlinck K. , Verhamme P.
Published: March 2018

Introduction

The direct thrombin inhibitor dabigatran interferes with thrombophilia screening and with the diagnosis of hemostasis disorders that develop during treatment with the anticoagulant. In vitro addition of idarucizumab, a humanized antibody fragment that binds dabigatran, to plasma samples containing dabigatran fully neutralizes the drug. This study was carried out to determine whether binding of dabigatran on selected insoluble commercial adsorbent material, DOAC‐STOPR, was as efficient as idarucizumab to neutralize the anticoagulant activity of the drug in vitro.

Methods

Coagulation assays sensitive to dabigatran were carried out with patient and control plasma samples spiked with dabigatran and supplemented with idarucizumab or incubated with adsorbent material.

Results

In samples containing upto 10 000 ng/mL dabigatran, the adsorption procedure was at least as efficient as the addition of idarucizumab to neutralize the activity of the anticoagulant drug. Neither the adsorption procedure nor the addition of idarucizumab did impair routine coagulation assays carried out with plasma devoid of dabigatran, such as the activated partial thromboplastin time, prothrombin time, fibrinogen Clauss, and the thrombophilia screening assays used to detect antiphospholipid antibodies or activated protein C resistance. In addition, the adsorption procedure did not interfere with the detection of lupus anticoagulant samples.

Conclusions

Adsorption of dabigatran in plasma samples containing the drug neutralizes its activity as efficiently as the addition of idarucizumab. This method allows the evaluation of thrombophilia markers without interruption of anticoagulation therapy or the detection of hemostasis disorders in patients treated with the drug.
Knowledge expectations of orthopaedic patients
Authors: Cano‐Plans Sara , Lacueva‐Pérez Laia , Cabrera Esther , Zabalegui Adelaida
Published: March 2018

Aim

To describe and compare knowledge expectations and received knowledge in elective orthopaedic surgery patients.

Background

Population aging, increasing incidence of osteoarthritis, the growing number of surgical procedures, and reduced clinical stays underline the need for a new approach to patient education.

Design

This study has a descriptive, comparative design.

Methods

Data were collected from 263 patients who had total hip and knee replacement elective surgery during 3 years (2009‐2012) in 5 public hospitals in Spain. The Knowledge Expectation of Hospital Patients and the Received Knowledge of Hospital Patients Scales were used to collect data. The questionnaires were filled before hospital admission, at discharge and at follow‐up 6 to 7 months later.

Results

Surgical patients received less knowledge than they expected. Patients' expectations were only met in the functional dimension. At follow‐up, patients reported that they perceived having acquired more knowledge during their hospital stay than they reported at the time of discharge. Knowledge expectations and knowledge received were related to employment status, gender, and previous contact experience with the hospital.

Conclusion

Knowledge expectations were not met, and results showed the need to improve education for orthopaedic patients throughout the perioperative process, not only during hospitalization.
Changes in self‐efficacy associated with success in quitting smoking in participants in Japanese smoking cessation therapy
Authors: Taniguchi Chie , Tanaka Hideo , Saka Hideo , Oze Isao , Tachibana Kazunobu , Nozaki Yasuhiro , Suzuki Yukio , Sakakibara Hisataka
Published: March 2018

Aims

To identify the strength of self‐efficacy during 12‐week smoking cessation therapy (SCT) that consisted of 5 sessions and its association with the success of smoking cessation at the end of SCT.

Background

Few studies showed to what level self‐efficacy should be reinforced to facilitate success in smoking cessation.

Design

Prospective cohort study.

Methods

We enrolled 488 smokers who received SCT from 6 Japanese smoking cessation clinics between October 2008 and October 2014. In each smoker, the self‐efficacy of quitting smoking was assessed at each session of SCT. The association of the strength of self‐efficacy with the success of smoking cessation was investigated by logistic regression analysis adjusting for age, gender, having a present illness, prescription, and nicotine dependence score.

Results

The self‐efficacy of the 398 abstainers was significantly higher than that of the 90 nonabstainers at the first to fifth sessions of the SCT (P < .001 each). Participants with self‐efficacy scores of greater than 60% were significantly more likely to attain abstinence than those with scores of 40% and less.

Conclusion

During SCT, nurses' counselling to maintain patients' self‐efficacy scores of smoking cessation in the range from 61% to 100% may be important for assisting patients in achieving smoking cessation.