bluuebunny/crossref_metadata_2025 huggingface dataset:
Brain morphological changes in hypokinetic dysarthria of Parkinson's disease and use of machine learning to predict severity
Authors: Chen Yingchuan , Zhu Guanyu , Liu Defeng , Liu Yuye , Yuan Tianshuo , Zhang Xin , Jiang Yin , Du Tingting , Zhang Jianguo
Published: March 2020

Background

Up to 90% of patients with Parkinson's disease (PD) eventually develop the speech and voice disorder referred to as hypokinetic dysarthria (HD). However, the brain morphological changes associated with HD have not been investigated. Moreover, no reliable model for predicting the severity of HD based on neuroimaging has yet been developed.

Methods

A total of 134 PD patients were included in this study and divided into a training set and a test set. All participants underwent a structural magnetic resonance imaging (MRI) scan and neuropsychological evaluation. Individual cortical thickness, subcortical structure, and white matter volume were extracted, and their association with HD severity was analyzed. After feature selection, a machine‐learning model was established using a support vector machine in the training set. The severity of HD was then predicted in the test set.

Results

Atrophy of the right precentral cortex and the right fusiform gyrus was significantly associated with HD. No association was found between HD and volume of white matter or subcortical structures. Favorable and optimal performance of machine learning on HD severity prediction was achieved using feature selection, giving a correlation coefficient (r) of .7516 and a coefficient of determination (R2) of .5649 (P < .001).

Conclusion

The brain morphological changes were associated with HD. Excellent prediction of the severity of HD was achieved using machine learning based on neuroimaging.
The developmental trajectory of cognitive functioning in children with neurofibromatosis type 1 and plexiform neurofibromas
Authors: Barton Belinda
Published: March 2020

This commentary is on the original article by Hou et al. on pages 977–984 of this issue.
Pericardial hematoma mimicking pericardial abscess
Authors: Marques Ana , Fazendas Paula , João Isabel , Gomes Ana Catarina , Pereira Hélder
Published: March 2020

A 26‐year‐old man, with human immunodeficiency virus infection, on hemodialysis, was hospitalized due to infective endocarditis. A mechanical prosthetic mitral valve was implanted. During postoperative period, he maintained signs suggestive of infection. The transthoracic echocardiograms (TTE) revealed a pericardial effusion. One week later was visible a circumscribed collection compatible with a pericardial abscess. He was refused for cardiac surgery; however, inflammatory parameters elevation persisted. The TTE showed a periprosthetic mitral leak, and cardiac surgery was performed. The pericardial drainage revealed a hematoma. This case highlights the difficulty on echocardiographic differential diagnosis between a pericardial hematoma and pericardial abscess in clinical practice.
Diagnostic value of myocardial strain using two‐dimensional speckle‐tracking echocardiography in acute cardiac allograft rejection: A systematic review and meta‐analysis
Authors: Zhu Shuangshuang , Li Meng , Tian Fangyan , Wang Shuyuan , Li Yuman , Yin Ping , Zhang Li , Xie Mingxing
Published: March 2020

Background

Two‐dimensional speckle‐tracking echocardiography (2D STE) has been demonstrated to have certain diagnostic utility in heart transplantation (HTX) patients with acute cardiac allograft rejection (ACAR). The aim of the systematic review and meta‐analysis was to evaluate the diagnostic value of common strain parameters for ACAR in HTX patients.

Methods

After conducting a database search, we selected studies evaluating left ventricular global longitudinal strain (GLS), circumferential strain (CS), radial strain (RS), and free wall right ventricular longitudinal strain (RV FW) in rejection group vs rejection‐free group.

Results

After reviewing 886 publications, seven studies were finally included in the meta‐analysis, representing the data of 1173 pairs of endomyocardial biopsy and echocardiographic examination. Heart transplantation patients with rejection had significantly lower GLS than rejection‐free subjects (weighted mean difference −2.32 (95% CI, −3.41 to −1.23; P < .001). Heart transplantation patients with rejection had significantly lower CS than rejection‐free subjects (weighted mean difference −2.49 (95% CI, −4.05 to −0.91; P = .0019). In addition, HTX patients with rejection also had significantly lower RV FW (weighted mean difference −4.90 (95% CI, −6.15 to −3.65; P < .001).

Conclusions

The meta‐analysis and systematic review demonstrate that myocardial strain parameters derived from 2D STE may be useful in detecting ACAR in HTX patients. The present results provide encouraging evidence to consider the routine use of GLS, CS, and RV FW as markers of graft function involvement during ACAR.
Towards oilcane: Engineering hyperaccumulation of triacylglycerol into sugarcane stems
Authors: Parajuli Saroj , Kannan Baskaran , Karan Ratna , Sanahuja Georgina , Liu Hui , Garcia‐Ruiz Eva , Kumar Deepak , Singh Vijay , Zhao Huimin , Long Stephen , Shanklin John , Altpeter Fredy
Published: March 2020

Metabolic engineering to divert carbon flux from sucrose to oil in high biomass crop like sugarcane is an emerging strategy to boost lipid yields per hectare for biodiesel production. Sugarcane stems comprise more than 70% of the crops' biomass and can accumulate sucrose in excess of 20% of their extracted juice. The energy content of oils in the form of triacylglycerol (TAG) is more than twofold that of carbohydrates. Here, we report a step change in TAG accumulation in sugarcane stem tissues achieving an average of 4.3% of their dry weight (DW) in replicated greenhouse experiments by multigene engineering. The metabolic engineering included constitutive co‐expression of wrinkled1; diacylglycerol acyltransferase1‐2; cysteine‐oleosin; and ribonucleic acid interference‐suppression of sugar‐dependent1. The TAG content in leaf tissue was also elevated by more than 400‐fold compared to non‐engineered sugarcane to an average of 8.0% of the DW and the amount of total fatty acids reached about 13% of the DW. With increasing TAG accumulation an increase of 18:1 unsaturated fatty acids was observed at the expense of 16:0 and 18:0 saturated fatty acids. Total biomass accumulation, soluble lignin, Brix and juice content were significantly reduced in the TAG hyperaccumulating sugarcane lines. Overcoming this yield drag by engineering lipid accumulation into late stem development will be critical to exceed lipid yields of current oilseed crops.
Theorizing gender desegregation as political work: The case of the Welsh Labour Party
Authors: Smolović Jones Owain , Jones Sanela Smolović , Taylor Scott , Yarrow Emily
Published: March 2020

Organization studies offers a detailed understanding of the roots of gender segregation and the obstacles to its dismantling in practice but has not proposed a conceptual framework that can help us understand how radical forms of desegregation may be made sense of and approached, particularly within a hotly contested organizational context. We provide an empirical analysis of the UK's only positive discrimination intervention, in the British Labour Party, and offer a conceptual framework of desegregation as political work, contributing by expanding knowledge of the contestations and possibilities inherent in desegregating organizations. We argue that successful radical desegregation is based on disrupting and contesting the foundational ontological values and identifications of a profession or organization, as gender is intimately enmeshed in these. From this basis we propose two political practices of desegregation: ‘standing up’ and ‘walking with’.
Migraine Headache and Risk of Dementia in the Atherosclerosis Risk in Communities Neurocognitive Study
Authors: George Kristen M. , Folsom Aaron R. , Sharrett A. Richey , Mosley Thomas H. , Gottesman Rebecca F. , Hamedani Ali G. , Lutsey Pamela L.
Published: March 2020

Objective

We aimed to assess the association between migraine headache and incident dementia.

Background

Migraine is a risk factor for white matter hyperintensities and ischemic stroke, which are both associated with increased risk of dementia. However, it is unknown whether migraine is independently associated with dementia.

Methods

History of migraine was ascertained via questionnaire. Adjudicated cases of dementia were identified using cognitive tests, neuropsychological exams, and clinician review of suspected cases. Incident dementia was identified using adjudicated cases, follow‐up calls, and surveillance of hospital and death codes. We assessed hazards of incident dementia by migraine status. Sex differences were also examined and stratified results were presented.

Results

Analysis included 12,495 White and African American participants ages 51‐70 with a median follow‐up time of 21 years. Prevalence of dementia was 18.5% (1821/9955) among those with no migraine history, 15.8% (196/1243) among those with severe non‐migraine heading, and 16.7% (233/1397) among migraineurs. There was no association between migraine and incident dementia [hazard ratio: 1.04 (0.91, 1.20)]. There was also no statistically significant interaction between sex and migraine status on risk of dementia.

Conclusion

Despite evidence of brain abnormalities in migraineurs, there was no association between migraine and incident dementia in this prospective cohort.
Women's and peer supporters' experiences of an assets‐based peer support intervention for increasing breastfeeding initiation and continuation: A qualitative study
Authors: Ingram Jenny , Thomson Gill , Johnson Debbie , Clarke Joanne L. , Trickey Heather , Hoddinott Pat , Dombrowski Stephan U. , Jolly Kate ,   the ABA Study Team
Published: March 2020

Background and context

Breastfeeding peer support is valued by women, but UK trials have not demonstrated efficacy. The ABA feasibility trial offered proactive peer support underpinned by behaviour change theory and an assets‐based approach to women having their first baby, regardless of feeding intention. This paper explores women's and infant feeding helpers' (IFHs) views of the different components of the ABA intervention.

Setting and participants

Trained IFHs offered 50 women an antenatal meeting to discuss infant feeding and identify community assets in two English sites—one with a paid peer support service and the other volunteer‐led. Postnatally, daily contact was offered for the first 2 weeks, followed by less frequent contact until 5 months.

Methods

Interviews with 21 women and focus groups/interviews with 13 IFHs were analysed using thematic and framework methods.

Results

Five themes are reported highlighting that women talked positively about the antenatal meeting, mapping their network of support, receiving proactive contact from their IFH, keeping in touch using text messaging and access to local groups. The face‐to‐face antenatal visit facilitated regular text‐based communication both in pregnancy and in the early weeks after birth. Volunteer IFHs were supportive of and enthusiastic about the intervention, whereas some of the paid IFHs disliked some intervention components and struggled with the distances to travel to participants.

Conclusions

This proactive community assets‐based approach with a woman‐centred focus was acceptable to women and IFHs and is a promising intervention warranting further research as to its effect on infant feeding outcomes.
Undergraduate student nurses’ experience of mental health simulation pre‐clinical placement: A pre/post‐test survey
Authors: Olasoji Michael , Huynh Minh , Edward Karen‐Leigh , Willetts Georgina , Garvey Loretta
Published: March 2020

Undertaking a mental health clinical placement can be anxiety‐provoking for nursing students at times. There is a need to adequately prepare undergraduate nursing students for clinical placement in a mental health setting in relation to their skills and confidence. This study aimed to evaluate the effect of a mental health simulation workshop on the skills and confidence of nursing students in providing care to consumers living with a mental illness. The study also evaluated the design of the mental health simulation workshop from an educational perspective. A pre/post‐test survey was administered to a cohort of N = 89 Australian pre‐registration nursing students. Exploratory factor analysis identified three factors: Mental health therapeutic engagement, mental health assessment skills, and mental health placement preparedness. Analyses of pre–post differences indicated that all three factors were significantly different between the initial and follow‐up responses, with follow‐up responses being more favourable. The findings of this study demonstrate that there is value in including mental health simulated patient exercise as part of the learning strategies in the curriculum of pre‐registration nurses. This has implications for the quality of care in the clinical environment and level of preparedness of these students’ nurses for mental health clinical placement where they will be providing care to consumers living with a mental illness under direct supervision.
Impact of soil water content on maize responses to the plant growth‐promoting rhizobacterium Azospirillum lipoferum CRT1
Authors: Czarnes Sonia , Mercier Pierre‐Edouard , Lemoine Damien G. , Hamzaoui Jihane , Legendre Laurent
Published: March 2020

Members of the bacterial genus Azospirillum are root‐associated bacteria that increase yield in cereals by promoting growth and alleviating drought stress. How plants integrate the many bacterium‐derived growth‐promoting stimuli with other environmental factors to generate a coordinated response remains unresolved. Using a commercial Azospirillum strain, A. lipoferum CRT1 and two host maize cultivars, it was observed that bacterization reduced the drought‐induced increase in lateral root growth and enhanced the flood‐induced increase in lateral root growth in the more drought‐ and flood‐sensitive cultivar. In the other one, A. lipoferum CRT1 only elicited a moderate root growth response under low soil water potential. The photosynthetic potential and activity were increased in the earlier cultivar and decreased in the later one, irrespective of the soil water content. No impact of the bacterium was seen on the growth of the leaves of both cultivars under both stresses until the third leaf stage, therefore suggesting that it is a consequence of multiple primary adaptations to biotic and abiotic stresses. It is suggested that host–bacteria recognition leads to a stress‐specific modulation of the root response and a differential stress‐independent effect on photosynthesis. This is the first report of the impact of Azospirillum under flood conditions.
Drought stress in sunflower causes inhibition of seed filling due to reduced cell‐extension growth
Authors: Keipp Katrin , Hütsch Birgit W. , Ehlers Katrin , Schubert Sven
Published: March 2020

Cultivation of sunflower (Helianthus annuus L.) as one of the most important oil crops is of great importance, especially with focus on drought tolerance under the current climate change. Less precipitation and increasing temperatures lead to more regions with drought problems. In a container experiment, with two different sunflower cultivars, drought stress of 40% water‐holding capacity was applied at the seed‐filling phase and compared to a control group with regular irrigation to 70% water‐holding capacity. Four intermediate harvests during the seed‐filling phase and a final harvest at maturity were conducted. During the seed‐filling phase, sugar and α‐amino‐acid concentrations of seeds were not reduced by drought stress. Thus, assimilate availability was sufficient, pointing to no source limitation of seed development. The DNA content of the seeds was also not affected and pointed to no limitation of cell division. However, 40 days after flowering a reduction of cell extension was found. Consequently, a sink limitation occurred under drought stress. At final harvest, seed yield was significantly reduced under drought stress due to a lower single seed weight, whereas seed number per plant was unaffected. Oil concentration was not reduced by drought stress. Thus, oil synthesis did not limit oil yield. Consequently, a reduced oil yield under drought stress during the seed‐filling phase was caused by a lower seed weight, which resulted from a decreased cell extension.
Deficiency of DICER reduces the invasion ability of trophoblasts and impairs the pro‐angiogenic effect of trophoblast‐derived microvesicles
Authors: Tang Li , Yang Ming , Qin Lang , Li Xiaoliang , He Guolin , Liu Xinghui , Xu WenMing
Published: March 2020

DICER is a key rate‐limiting enzyme in the canonical miRNAs biogenesis pathway, and DICER and DICER‐dependent miRNAs have been proved to play essential roles in many physiological and pathological processes. However, whether DICER is involved in placentation has not been studied. Successful spiral artery remodelling is one of the key milestones during placentation, which depends mostly on the invasion of trophoblasts and the crosstalk between trophoblasts and endothelial cells. In the present study, we show that DICER knockdown impairs the invasion ability of both primary extravillous trophoblasts (EVT) and HTR8/SVneo (HTR8) cell lines. The decreased invasion of HTR8 cells upon DICER knockdown (sh‐Dicer) was partly due to the up‐regulation of miR‐16‐2‐3p, which led to a reduced expression level of the collagen type 1 alpha 2 chain (COL1A2) protein. Moreover, microvesicles (MVs) can be secreted by HTR8 cells and promote the tube formation ability of human umbilical cord vein endothelial cells (HUVECs). However, conditioned medium and MVs derived from sh‐Dicer HTR8 cells have an anti‐angiogenic effect, due to reduced angiogenic factors and increased anti‐angiogenic miRNAs (including let‐7d, miR‐1‐6‐2 and miR‐15b), respectively. In addition, reduced protein expression of DICER is found in PE placenta by immunoblotting and immunohistochemistry. In summary, our study uncovered a novel DICER‐miR‐16‐2‐COL1A2 mediated pathway involved in the invasion ability of EVT, and DICER‐containing MVs mediate the pro‐angiogenic effect of trophoblast‐derived conditioned medium on angiogenesis, implying the involvement of DICER in the pathogenesis of PE.
Outcome of Older Patients with Acute Neuropsychological Symptoms Not Fulfilling Criteria of Delirium
Authors: Zipprich Hannah M. , Arends Marie‐Christine , Schumacher Ulrike , Bahr Viola , Scherag André , Kwetkat Anja , Wedding Ulrich , Brunkhorst Frank M. , Witte Otto W. , Prell Tino , Redecker Christoph
Published: March 2020

OBJECTIVES

Although delirium is often investigated, little is known about the outcomes of patients having acute neuropsychological changes at a single time point without fulfilling the criteria of full delirium. Our aim was to determine point prevalence, predictors, and long‐term outcomes of delirium and acute neuropsychological changes in patients aged 60 years and older across different departments of a university hospital with general inpatient care.

DESIGN

Prospective observational study.

SETTING

University hospital excluding psychiatric wards.

PARTICIPANTS

At baseline, 669 patients were assessed, and follow‐ups occurred at months 6, 12, 18, and 36.

MEASUREMENTS

Measurements were obtained using the Confusion Assessment Method (CAM), comprehensive geriatric assessment, health‐related quality of life, functional state (month 6), and mortality rates (months 6, 12, 18, and 36). Subjects were classified into (1) patients with delirium according to the CAM, (2) patients with only two positive CAM items (2‐CAM state), and (3) patients without delirium.

RESULTS

Delirium was present in 10.8% and the 2‐CAM state in an additional 12.7% of patients. Highest prevalence of delirium was observed in medical and surgical intensive care units and neurosurgical wards. Cognitive restrictions, restricted mobility, electrolyte imbalance, the number of medications per day, any fixations, and the presence of a urinary catheter predicted the presence of delirium and 2‐CAM‐state. The mean Karnofsky Performance Score and EuroQol‐5D were comparable between delirium and the 2‐CAM state after 6 months. The 6‐, 12‐, 18‐, and 36‐month mortality rates of patients with delirium and the 2‐CAM state were comparable. The nurses’ evaluation of distinct patients showed high specificity (89%) but low sensitivity (53%) for the detection of delirium in wide‐awake patients.

CONCLUSION

Patients with an acute change or fluctuation in mental status or inattention with one additional CAM symptom (ie, disorganized thinking or an altered level of consciousness) have a similar risk for a lower quality of life and death as patients with delirium. J Am Geriatr Soc 68:1469‐1475, 2020.
GABAergic mechanisms in the suprachiasmatic nucleus that influence circadian rhythm
Authors: Ono Daisuke , Honma Ken‐ichi , Honma Sato
Published: March 2020

The mammalian central circadian clock is located in the suprachiasmatic nucleus (SCN) of the hypothalamus. The SCN contains multiple circadian oscillators which synchronize with each other via several neurotransmitters. Importantly, an inhibitory neurotransmitter, γ‐amino butyric acid (GABA), is expressed in almost all SCN neurons. In this review, we discuss how GABA influences circadian rhythms in the SCN. Excitatory and inhibitory effects of GABA may depend on intracellular Cl‐ concentration, in which several factors such as day‐length, time of day, development, and region in the SCN may be involved. GABA also mediates oscillatory coupling of the circadian rhythms in the SCN. Recent genetic approaches reveal that GABA refines circadian output rhythms, but not circadian oscillations in the SCN. Since several efferent projections of the SCN have been suggested, GABA might work downstream of neuronal pathways from the SCN which regulate the temporal order of physiology and behavior.

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A spectrophotometric approach for determining sporangium and zoospore viability of Plasmopara viticola
Authors: Hong Cheng‐Fang , Scherm Harald
Published: March 2020

A spectrophotometric method for determining the viability of sporangia and zoospores of the oomycete Plasmopara viticola (causal agent of grapevine downy mildew) is described and evaluated to overcome the limitations of currently available methods for assessing propagule viability. Sporangia produced on leaf discs in the laboratory were harvested at different days after the initiation of sporulation (DAS) to yield differences in sporangium viability. Sporangia were suspended in sterile water, the suspensions were placed in a cuvette, and sporangium germination was monitored in a spectrophotometer (λ = 600 nm) at 2‐ to 3‐min intervals for 5 hr. Absorbance started to increase after sporangia were suspended in water for ~30–60 min followed by major peak(s) for younger sporangia (1–3 DAS), whereas low to no increase in absorbance was observed for senescent sporangia (>7 DAS). Microscopic observation confirmed that the increase in absorbance corresponded to the release and active swimming of zoospores, whereas absorbance decreased when zoospores encysted and settled. A positive correlation (r = .839, p = .0365) was observed when the time to the initial increase in absorbance was plotted against the age of sporangia. The time to the absorbance peak (marking the time of maximum zoospore movement) was shortest for immature sporangia (0 DAS), longest for young sporangia (2 DAS) and decreased for mature and senescent sporangia. A similar pattern was observed for the standardized area under the absorbance curve (indicating the overall quantity of zoospores released), for which values were lowest for immature and senescent sporangia, highest for young sporangia and intermediate for mature sporangia. Consistent patterns obtained across two independent experiments suggest that the method is reproducible and may be further developed for other zoospore‐releasing pathogens.
Trentepohlialean Algae (Trentepohliales, Ulvophyceae) Show Preference to Selected Mycobiont Lineages in Lichen Symbioses
Authors: Kosecka Magdalena , Jabłońska Agnieszka , Flakus Adam , Rodriguez‐Flakus Pamela , Kukwa Martin , Guzow‐Krzemińska Beata
Published: March 2020

The main aims of this work were to assess phylogenetic relationships of the trentepohlialean photobionts in tropical, mainly sterile, lichens collected in Bolivia, to examine their genetic diversity, host specificity, and the impact of habitat factors on the occurrence of Trentepohliales. Based on rbcL marker analysis, we constructed a phylogenetic tree with eight major clades of Trentepohliales, of which seven free‐living species are intermingled with lichenized ones. Our analyses show that the studied photobionts are scattered across the phylogenetic tree and algae from temperate and tropical regions do not form monophyletic groups, except within one clade that seems to be restricted to the tropics. There is no significant occurrence pattern of lichenized Trentepohliaceae on a specific substratum, except Cephaleuros spp. and Phycopeltis spp., which are restricted to leaves, while some clades with lichenized algae may be specialized to tree bark and wood. Moreover, we found two patterns of associations: first, closely related algae can associate with distantly related mycobionts; second, some other trentepohlioid algae associate with selected lineages of fungi (e.g., Arthoniaceae or Graphidaceae). We also found that some lineages of photobionts are even more selective and associate exclusively with one species (e.g., Dichosporidium nigrocinctum, Diorygma antillarum) or closely related lichen‐forming fungi (Herpothallon spp.). Concluding, we found that occurrence of some trentepohlialean photobionts may correlate with the particular type of the mycobiont.
Temporal changes in clinical and radiographic variables in dogs with preclinical myxomatous mitral valve disease: The EPIC study
Authors: Boswood Adrian , Gordon Sonya G. , Häggström Jens , Vanselow Martin , Wess Gerhard , Stepien Rebecca L. , Oyama Mark A. , Keene Bruce W. , Bonagura John , MacDonald Kristin A. , Patteson Mark , Smith Sarah , Fox Philip R. , Sanderson Karen , Woolley Richard , Szatmári Viktor , Menaut Pierre , Church Whitney M. , O'Sullivan M. Lynne , Jaudon Jean‐Philippe , Kresken Jan‐Gerd , Rush John , Barrett Kirstie A. , Rosenthal Steven L. , Saunders Ashley B. , Ljungvall Ingrid , Deinert Michael , Bomassi Eric , Estrada Amara H. , Fernandez Del Palacio Maria J. , Moise N. Sydney , Abbott Jonathan A. , Fujii Yoko , Spier Alan , Luethy Michael W. , Santilli Roberto A. , Uechi Masami , Tidholm Anna , Schummer Christoph , Watson Philip
Published: March 2020

Background

The Evaluation of pimobendan in dogs with cardiomegaly caused by preclinical myxomatous mitral valve disease (EPIC) study monitored dogs with myxomatous mitral valve disease (MMVD) as they developed congestive heart failure (CHF).

Objectives

To describe the changes in clinical and radiographic variables occurring as dogs with MMVD and cardiomegaly develop CHF, compared to similar dogs that do not develop CHF.

Animals

One hundred and thirty‐five, and 73 dogs that did or did not develop CHF, respectively.

Materials and methods

The following variables were evaluated in 2 groups of dogs (dogs that did or did not develop CHF): Heart rate (HR), clinic respiratory rate (RR), home‐measured resting respiratory rate (RRR), rectal temperature (RT), body weight (BW), and vertebral heart sum (VHS). Absolute value and rate of change of each variable were calculated for each day a dog was in study. Daily means were calculated and plotted against time. The onset of CHF or last visit before leaving the study were set as reference time points.

Results

The most extreme values and rate of change occurred in variables immediately before onset of CHF. Vertebral heart sum increased earliest. Heart rate, RR, and RRR also increased. Rectal temperature and BW decreased. Increases in RR and RRR were most extreme and occurred immediately before CHF.

Conclusions and Clinical Importance

Dogs with MMVD and cardiomegaly experience increases in HR, RR, RRR, and VHS, and decreases in BW and RT as they develop CHF. The variables with highest absolute change and rate of change were RR and RRR. These findings reinforce the value of RR and RRR as indicators of impending or incipient CHF.
Effect of feline characteristics on plasma N‐terminal‐prohormone B‐type natriuretic peptide concentration and comparison of a point‐of‐care test and an ELISA test
Authors: Hanås Sofia , Holst Bodil S. , Höglund Katja , Häggström Jens , Tidholm Anna , Ljungvall Ingrid
Published: March 2020

Background

Increased plasma concentration of N‐terminal‐prohormone B‐type natriuretic peptide (NT‐proBNP) can be detected in cats with cardiac disease. Potential effects of feline characteristics on NT‐proBNP concentration may influence clinical usefulness.

Objectives

To evaluate potential effects of feline characteristics on NT‐proBNP plasma concentration and to compare NT‐proBNP plasma concentrations in healthy cats with results in hypertrophic cardiomyopathy (HCM) cats with or without left atrial enlargement (LAE) using an ELISA and a point‐of‐care test (POCT), and assess if POCT results reflect ELISA results.

Animals

One hundred healthy cats of 3 breeds and 39 HCM cats were included.

Methods

Diseases other than HCM were excluded by physical examination, blood pressure measurement, echocardiography, hematology, and serum biochemistry.

Results

Higher NT‐proBNP concentrations were found in males than in females in healthy (P = .005) and in HCM cats (P = .0021), but breed had no effect on NT‐proBNP concentrations. Using ≥100 pmol/L as a cutoff for abnormal samples, ELISA and POCT had similar sensitivity (SE; 72 and 74%) and specificity (SP; 97 and 98%) for detecting cats with HCM, cats with HCM and LAE (SE, both 100%; SP, 97 versus 98%), and cats with HCM without LAE (SE, both 69%; SP, 97 versus 98%), respectively, when compared to healthy cats.

Conclusions and Clinical Importance

Breed had no effect on plasma NT‐proBNP concentrations, but higher concentrations were found in male than in female cats. The ELISA and POCT had similar SE and SP for detecting HCM. Both tests could identify all HCM cats with LAE but not all HCM cats without LAE.
The influence of corporate governance and financial constraints on the speed of employment adjustment: An analysis using mixed‐effects models
Authors: Chen Ming‐Yuan , Kao Chun‐Lin
Published: March 2020

This paper proposes that the corporate governance structure and financial constraints determine the willingness and ability of firms to implement labor hoarding, and thus influence the speed of employment adjustment. Using Taiwanese manufacturing firms in the decade after the 2008 financial crisis as the sample and conducting a mixed‐effects analysis, our results confirm the presence of labor hoarding. The willingness of hoarding labor is higher for firms having a governance structure focusing less on shareholders’ interests, which leads to lower adjustment speeds. The ability of hoarding labor is stronger, so the adjustment is slower, for firms facing less pressure from financial constraints. Moreover, financial constraints have more impact than the governance structure, and impel firms to accelerate the adjustment throughout the decade. There is also evidence of asymmetric adjustment. The firms with job destruction have higher adjustment speeds than those with job creation, and the connections of adjustment speeds to corporate governance and financial constraints are more applicable to job destruction. We suggest that encouraging firms to adopt a governance structure of less shareholder concern, or more importantly helping them to obtain sufficient funds for retaining talent may be an effective policy to deal with brain drain in Taiwan.
Components of leaf‐trait variation along environmental gradients
Authors: Dong Ning , Prentice Iain Colin , Wright Ian J. , Evans Bradley J. , Togashi Henrique F. , Caddy‐Retalic Stefan , McInerney Francesca A. , Sparrow Ben , Leitch Emrys , Lowe Andrew J.
Published: March 2020

Leaf area (LA), mass per area (LMA), nitrogen per unit area (Narea) and the leaf‐internal to ambient CO2 ratio (χ) are fundamental traits for plant functional ecology and vegetation modelling. Here we aimed to assess how their variation, within and between species, tracks environmental gradients.

Measurements were made on 705 species from 116 sites within a broad north–south transect from tropical to temperate Australia. Trait responses to environment were quantified using multiple regression; within‐ and between‐species responses were compared using analysis of covariance and trait‐gradient analysis.

Leaf area, the leaf economics spectrum (indexed by LMA and Narea) and χ (from stable carbon isotope ratios) varied almost independently among species. Across sites, however, χ and LA increased with mean growing‐season temperature (mGDD0) and decreased with vapour pressure deficit (mVPD0) and soil pH. LMA and Narea showed the reverse pattern. Climate responses agreed with expectations based on optimality principles. Within‐species variability contributed < 10% to geographical variation in LA but > 90% for χ, with LMA and Narea intermediate.

These findings support the hypothesis that acclimation within individuals, adaptation within species and selection among species combine to create predictable relationships between traits and environment. However, the contribution of acclimation/adaptation vs species selection differs among traits.
Diagnostics and treatment of nerve agent poisoning—current status and future developments
Authors: Amend Niko , Niessen Karin V. , Seeger Thomas , Wille Timo , Worek Franz , Thiermann Horst
Published: March 2020

Although 193 states have committed to the Chemical Weapons Convention and 98% of the declared chemical weapons stockpiles have been destroyed so far, nerve agent poisoning remains a lingering threat. The recent dissemination of sarin in Syria, the assassination of Kim Jong‐Nam in Malaysia, and the assault on Sergei Skripal in the United Kingdom underline the need for effective treatment. The current therapeutic options of a muscarinic receptor antagonist, an oxime, and an anticonvulsant have been unchanged for decades. Therefore, new therapeutic strategies, for example, bioscavengers and receptor‐active substances, are promising concepts that have to be examined for their benefits and limitations. In order to facilitate rapid diagnosis in challenging clinical situations, point‐of‐care diagnostics and detection are of importance. Therapeutic guidance concerning the duration and success of the current oxime therapy via determination of the cholinesterase status can contribute to an optimal use of resources. In summary, the challenges of current and future therapies for nerve agent poisoning and key diagnostic devices will be discussed.
Noninvasive cardiac output measurement based optimization in nonresponders of cardiac resynchronization therapy
Authors: Yenerçağ Mustafa , Yüksel Serkan , Çoksevim Metin , Akçay Murat , Arslan Uğur
Published: March 2020

Background

Cardiac resynchronization therapy (CRT) is an important and effective therapy for end‐stage heart failure (HF). Nonresponse to CRT is one of the main obstacles to its application in clinical practice. Herein, we investigated the utilization of the optimization technique using noninvasive cardiac output measurement (NICOM) based Mobil‐O‐Graph device that measures several circulation parameters noninvasively.

Methods

Seventy‐five CRT nonresponder HF patients with an implanted CRT device were included. Patients were randomized equally to 3 groups: NICOM, echocardiographic, and empirical optimization groups. After 3 months of optimization, changes in six minutes walk test (6‐MWT), cardiac output (CO), left ventricular ejection fraction (LVEF), and end‐systolic volume (LVESV) were measured. New York Heart Association (NYHA) class and hospitalization for HF were also determined.

Results

There were no statistically significant differences among the three groups in terms of demographics, baseline characteristics. In the NICOM group, the 6‐MWT, LVEF, CO, and LVESV measurements showed significant improvements compared to baseline values (P < .05). There was no significant improvement in 6‐MWT, LVEF, CO, NYHA class, and LVESV in Echo and Empirical groups after 3 months (P > .05). 6‐MWT, CO, LVESV percentages, and hospitalization for HF were significantly different between the groups (P < .05). In post hoc analyzes, the percentages of the change in 6‐MWT, CO, LVESV, and hospitalization for HF were significantly higher in the NICOM group (P < .017).

Conclusions

This study suggests that Mobil‐O‐Graph device optimization according to CO measures does appear to have potential hemodynamic and clinical benefits in nonresponder CRT patients. Use of Mobil‐O‐Graph device as an option for optimization of CRT devices can be an attractive method of improving CRT outcomes.
Survival of patients with pacing‐induced cardiomyopathy upgraded to CRT does not depend on defibrillation therapy
Authors: Loboda Danuta , Gibinski Michal , Zietek Karolina , Wilczek Jacek , Gardas Rafal , Gladysz‐Wanha Sylwia , Golba Krzysztof S.
Published: March 2020

Background

Permanent right ventricular pacing (RVP) results in cardiac dyssynchrony that may lead to heart failure and may be an indication for the use of cardiac resynchronization therapy (CRT). The study aimed to evaluate predictors of outcomes in patients with pacing‐induced cardiomyopathy (PICM) if upgraded to CRT.

Methods

One hundred fifteen patients, 75.0 years old (IQR 67.0–80.0), were upgraded to CRT due to the decline in left ventricle ejection fraction (LVEF) caused by the long‐term RVP. A retrospective analysis was performed using data from hospital and outpatient clinic records and survival data from the National Health System.

Results

The prior percentage of RVP was 100.0% (IQR 97.0‐100.0), with a QRS duration of 180.0 ms (IQR 160.0‐200.0). LVEF at the time of the upgrade procedure was 27.0% (IQR 21.0‐32.75). The mean follow‐up was 980 ± 522 days. The primary endpoint, death from any cause, was met by 26 (22%) patients. Age > 82 years (HR 5.96; 95% CI 2.24‐15.89; P = .0004) and pre‐CRT implantation LVEF < 20% (HR 5.63; 95%CI 2.19‐14.47; P = .0003), but neither the cardioverter‐defibrillator (ICD) implantation (HR 1.00; 95%CI 0.45–2.22; P = 1.00), nor the presence of atrial fibrillation (HR 1.22; 95%CI 0.56–2.64; P = .62), were independently associated with all‐cause mortality.

Conclusion

Advanced age and an extremely low LVEF, but neither the presence of atrial fibrillation nor implanting an additional high voltage lead, influence the all‐cause mortality in patients after long‐term RVP, when upgraded to CRT.
The enigma and challenges of vitiligo pathophysiology and treatment
Authors: Abdel‐Malek Zalfa A. , Jordan Christian , Ho Tina , Upadhyay Parth Rajendrakumar , Fleischer Alan , Hamzavi Iltefat
Published: March 2020

Vitiligo is the most common acquired pigmentary disorder, which afflicts 0.5%–1% of the world population, and is characterized by depigmented skin patches resulting from melanocyte loss. Vitiligo has a complex etiology and varies in its manifestations, progression, and response to treatment. It presents as an autoimmune disease, evidenced by circulating melanocyte‐specific antibodies, and association with other autoimmune diseases. However, autoimmunity may be secondary to the high oxidative stress in vitiligo skin and to intrinsic defects in melanocytes and their microenvironment, which contribute to aberrant stress response, neo‐antigenicity, and susceptibility of melanocytes to immune attack and apoptosis. There is also a genetic predisposition to vitiligo, which sensitizes melanocytes to environmental agents, such as phenolic compounds. Currently, there are different treatment modalities for re‐pigmenting vitiligo skin. However, when repigmentation is achieved, the major challenge is maintaining the pigmentation, which is lost in 40% of cases. In this review, we present an overview of the clinical aspects of vitiligo, its pathophysiology, the intrinsic defects in melanocytes and their microenvironment, and treatment strategies. Based on lessons from the biology of human melanocytes, we present our perspective of how repigmentation of vitiligo skin can be achieved and sustained.
Caterpillar dermatitis: A brief report
Authors: Jadoo Arvin S. , Treat James R.
Published: March 2020

A 3 year‐old boy presented to our clinic with a 3‐day history of itchy rash involving the face and limbs and recent contact with a caterpillar. A diagnosis of caterpillar dermatitis was suspected. This condition has rarely been reported and may be underestimated in the pediatric population who may suffer more systemic symptoms associated with caterpillar contact.
Methylisothiazolinone in children’s nail polish
Authors: Kullberg Sara A. , Gupta Rachit , Warshaw Erin M.
Published: March 2020

Isothiazolinones, preservatives including methylisothiazolinone (MI), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI), benzisothiazolinone (BIT), and octylisothiazolinone (OIT), are notorious contact allergens. Pediatric dermatologists are familiar with these preservatives in personal care products, homemade slime recipes, and wet wipes. We present a novel source of MI declared in nail polish marketed to children.
Effects of donor cause of death, ischemia time, inotrope exposure, troponin values, cardiopulmonary resuscitation, electrocardiographic and echocardiographic data on recipient outcomes: A review of the literature
Authors: McCulloch Michael A. , Zuckerman Warren A. , Möller Thomas , Knecht Kenneth , Lin Kimberly Y. , Beasley Gary S. , Peng David M. , Albert Dimpna C. , Miera Oliver , Dipchand Anne I. , Kirk Richard , Davies Ryan R.
Published: March 2020

Background

Heart transplantation has become standard of care for pediatric patients with either end‐stage heart failure or inoperable congenital heart defects. Despite increasing surgical complexity and overall volume, however, annual transplant rates remain largely unchanged. Data demonstrating pediatric donor heart refusal rates of 50% suggest optimizing donor utilization is critical. This review evaluated the impact of donor characteristics surrounding the time of death on pediatric heart transplant recipient outcomes.

Methods

An extensive literature review was performed to identify articles focused on donor characteristics surrounding the time of death and their impact on pediatric heart transplant recipient outcomes.

Results

Potential pediatric heart transplant recipient institutions commonly receive data from seven different donor death‐related categories with which to determine organ acceptance: cause of death, need for CPR, serum troponin, inotrope exposure, projected donor ischemia time, electrocardiographic, and echocardiographic results. Although DITs up to 8 hours have been reported with comparable recipient outcomes, most data support minimizing this period to <4 hours. CVA as a cause of death may be associated with decreased recipient survival but is rare in the pediatric population. Otherwise, however, in the setting of an acceptable donor heart with a normal echocardiogram, none of the other data categories surrounding donor death negatively impact pediatric heart transplant recipient survival.

Conclusions

Echocardiographic evaluation is the most important donor clinical information following declaration of brain death provided to potential recipient institutions. Considering its relative importance, every effort should be made to allow direct image visualization.
Will rising atmosphericCO2concentration inhibit nitrate assimilation in shoots but enhance it in roots ofC3plants?
Authors: Andrews Mitchell , Condron Leo M. , Kemp Peter D. , Topping Jennifer F. , Lindsey Keith , Hodge Simon , Raven John A.
Published: March 2020

Bloom et al. proposed that rising atmospheric CO2concentrations ‘inhibit malate production in chloroplasts and thus impede assimilation of nitrate into protein of C3plants, a phenomenon that will strongly influence primary productivity and food security under the environmental conditions anticipated during the next few decades’. Previously we argued that the weight of evidence in the literature indicated that elevated atmospheric [CO2] does not inhibit NO3−assimilation in C3plants. New data for common bean (Phaseolus vulgaris) and wheat (Triticum aestivum) were presented that supported this view and indicated that the effects of elevated atmospheric [CO2] on nitrogen (N) assimilation and growth of C3vascular plants were similar regardless of the form of N assimilated. Bloom et al. strongly criticised the arguments presented in Andrews et al. Here we respond to these criticisms and again conclude that the available data indicate that elevated atmospheric [CO2] does not inhibit NO3−assimilation of C3plants. Measurement of the partitioning of NO3−assimilation between root and shoot of C3species under different NO3−supply, at ambient and elevated CO2would determine if their NO3−assimilation is inhibited in shoots but enhanced in roots at elevated atmospheric CO2.
Labour market institutions in open economy: Sectoral reallocations, aggregate adjustments, and spillovers
Authors: Lastauskas Povilas , Stakėnas Julius
Published: March 2020

We introduce frictional unemployment in a multiworker heterogeneous firm model with a dynamic matching process, one‐ and two‐sector equilibria, and international markets. A change in labour market policies transforms the share of exporters and affects average productivity. The closure of equilibrium with or without sectoral arbitrage plays an important role in generating macro‐level outcomes for employment subsidies. Unemployment benefits, on the other hand, make unemployment and openness rise, independently of sectoral reallocations. We also find that simultaneous implementation of labour market policies remove potential gain in the trade share, and, when it comes to unemployment benefits, may even be detrimental.
Family presence during paediatric resuscitation and invasive procedures: the parental experience: An integrative review
Authors: Mark Katarina
Published: March 2020

Background

The evolvement of family‐centred care has been an ongoing process since the Platt Report 1959. Family‐centred care has become the modern working model in paediatrics and obstetrics. Parental participation is central to family‐centred care. Whether it is applied consistently remains to be concluded.

Aim

The aim of the study was to describe the family experiences of being present during paediatric resuscitation and invasive procedures.

Method

The design used in this study is an integrative review by Whittemore & Knafl. Databases PubMed and CINAHL were searched for primary research concerning the parental experiences of participating in paediatric resuscitation and invasive procedures. Eighteen studies were included in the study. A quality assessment tool was applied.

Findings

A pro‐parental presence was the results of 17 of the 18 included studies. Six common themes were found: ‘Being there’, ‘Calming child’, ‘Calming parent’, ‘Having the right’, ‘Do it again’ and 'Seeing is believing'.

Conclusion

Including family in resuscitation and invasive procedures requires openness as a working model and demands organisational changes and the updating of guidelines. The inseparability of parent–child is attachment theory practised, an innate quality of being a child as well as a parent. Recommendations are to have a facilitator present during resuscitation and invasive procedures to alleviate stress on everyone’s part, enabling family participation.