bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatial evaluation of switchgrass productivity under historical and future climate scenarios in Michigan
Authors: Liu Lin , Basso Bruno
Published: December 2016

Switchgrass (Panicum virgatum) productivity on marginal and fertile lands has not been thoroughly evaluated in a systematic manner that includes soil–crop–weather–management interactions and to quantify the risk of failure or success in growing the crop. We used the Systems Approach to Land Use Sustainability (SALUS) model to identify areas with low risk of failing to having more than 8000 kg ha−1 yr−1 switchgrass aboveground net primary productivity (ANPP) under rainfed and unfertilized conditions. In addition, we diagnosed constraining factors for switchgrass growth, and tested the effect of nitrogen fertilizer application on plant productivity across Michigan for 30 years under three climate scenarios (baseline climate in 1981–2010, future climate with emissions using RCP 2.6 and RCP 6.0). We determined that <16% of land in Michigan may have at least 8 Mg ha−1 yr−1 ANPP under rainfed and unfertilized management with a low risk of failure. Of the productive low‐risk land, about 25% was marginal land, with more than 80% of which was affected by limited water availability due to low soil water‐holding capacity and shallow depth. About 80% of the marginal land was N limited under baseline conditions, but that percentage decreased to 58.5% and 42.1% under RCP 2.6 and RCP 6.0 climate scenarios, respectively, partly due to shorter growing season, smaller plants and less N demand. We also found that the majority of Michigan's land could have high switchgrass ANPP and low risk of failure with no more than 60 kgN ha−1 fertilizer input. We believe that the methodology used in this study works at different spatial scales, as well as for other biofuel crops.
A Case Report About Cluster‐Tic Syndrome Due to Venous Compression of the Trigeminal Nerve
Authors: de Coo Ilse , van Dijk J. Marc C. , Metzemaekers Jan D.M. , Haan Joost
Published: December 2016

Background

The term “cluster‐tic syndrome” is used for the rare ipsilateral co‐occurrence of attacks of cluster headache and trigeminal neuralgia. Medical treatment should combine treatment for cluster headache and trigeminal neuralgia, but is very often unsatisfactory.

Case

Here, we describe a 41‐year‐old woman diagnosed with cluster‐tic syndrome who underwent microvascular decompression of the trigeminal nerve, primarily aimed at the “trigeminal neuralgia” part of her pain syndrome. After venous decompression of the trigeminal nerve both a decrease in trigeminal neuralgia and cluster headache attacks was seen. However, the headache did not disappear completely. Furthermore, she reported a decrease in pain intensity of the remaining cluster headache attacks.

Discussion

This case description suggests that venous vascular decompression in cluster‐tic syndrome can be remarkably effective, both for trigeminal neuralgia and cluster headache.
Effect of sodium glucose cotransporter 2 inhibitor on liver function tests in Japanese patients with non‐alcoholic fatty liver disease and type 2 diabetes mellitus
Authors: Seko Yuya , Sumida Yoshio , Tanaka Saiyu , Mori Kojiroh , Taketani Hiroyoshi , Ishiba Hiroshi , Hara Tasuku , Okajima Akira , Umemura Atsushi , Nishikawa Taichiro , Yamaguchi Kanji , Moriguchi Michihisa , Kanemasa Kazuyuki , Yasui Kohichiroh , Imai Shunsuke , Shimada Keiji , Itoh Yoshito
Published: December 2016

Aim

No pharmacological therapies have been established for non‐alcoholic fatty liver disease (NAFLD). Sodium glucose cotransporter 2 inhibitor (SGLT2I) was developed for the treatment of adults with type 2 diabetes mellitus (T2DM). The aim of this retrospective study is to evaluate the efficacy of SGLT2I in NAFLD patients with T2DM.

Methods

Twenty‐four biopsy‐proven NAFLD patients with T2DM who received SGLT2I for 24 weeks were retrospectively enrolled as the SGLT2I group. Another 21 NAFLD patients with T2DM treated with dipeptidyl peptidase‐4 inhibitor (DPP4I) for 24 weeks were selected as the DPP4I group. Clinical data were evaluated at baseline and at 4, 12, and 24 weeks. Seventeen patients in the SGLT2I group were evaluated by body composition before and after therapy.

Results

Not only body weight and hemoglobin A1c but also transaminase activities were significantly decreased in the SGLT2I group. Reductions in transaminase activities were similar between SGLT2I and DPP4I groups. In the SGLT2I group, body mass index and fasting plasma glucose also decreased after the treatment.

Conclusion

Sodium glucose cotransporter 2 inhibitor can be a novel promising agent for the treatment for NAFLD patients with T2DM. Prospective randomized controlled trials are warranted to confirm this efficacy of SGLT2I on NAFLD with T2DM.
Characterization of the oropharynx: anatomy, histology, immunology, squamous cell carcinoma and surgical resection
Authors: Fossum Croix C , Chintakuntlawar Ashish V , Price Daniel L , Garcia Joaquin J
Published: December 2016

Understanding the structure and function of the oropharynx is paramount for providing excellent patient care. In clinical oncology, the oropharynx is generally divided into four distinct components: (i) the base of the tongue; (ii) the soft palate; (iii) the palatine tonsillar fossa; and (iv) the pharyngeal wall. The oropharyngeal mucosa is distinct from other mucosal surfaces in the body, as it is composed of a reticulated epithelium with a discontinuous basement membrane, also known as lymphoepithelium. This review describes the anatomy, histology, immunology and surgical resection of the oropharynx as they relate to oncological care.
Spleen Australia guidelines for the prevention of sepsis in patients with asplenia and hyposplenism in Australia and New Zealand
Authors: Kanhutu Kudzai , Jones Penelope , Cheng Allen C. , Grannell Louise , Best Emma , Spelman Denis
Published: December 2016

People with asplenia/hyposplenism are at increased risk of fulminant sepsis, which carries a high mortality rate. A range of preventive measures is recommended although there is ongoing evidence that knowledge of and adherence to these strategies is poor. There have been significant changes in recommended vaccinations since the previously published recommendations in 2008. We provide current recommendations to help Australian and New Zealand clinicians in the prevention of sepsis in patients with asplenia and hyposplenia. The guideline includes Australian epidemiological data, preferred diagnostic techniques and recommendations for optimal antimicrobial prophylaxis and vaccination protocols.
Moving beyond ‘not enough time’: factors influencing paediatric clinicians’ participation in research
Authors: Paget Simon P. , Caldwell Patrina H. Y. , Murphy Joyce , Lilischkis Kimberley J. , Morrow Angie M.
Published: December 2016

Background

Increasing the amount of clinical research that occurs in healthcare settings has been identified as an important mechanism to improve healthcare outcomes. While clinicians are key persons in achieving this aim, research participation amongst clinicians is generally limited.

Aims

To identify the factors (barriers and facilitators) influencing clinician research participation and determine how professional culture impacts on these factors.

Methods

Forty clinicians working at a tertiary children's hospital participated in six discipline‐specific focus groups. Thematic analysis was performed using an inductive process based in grounded theory.

Results

Four major themes (cultural factors, personal factors, resources and solutions) and 16 subthemes were identified. Participants described how the current health system discourages clinician research. They reported that their research participation requires personal sacrifice of their own time; income or career progression. Research participation was seen to compete with other priorities in clinicians’ workload and is disadvantaged because of the primacy of clinical work and the lack of immediate tangible benefit from research projects. Solutions suggested by our participants included better alignment of clinical and research goals, improved availability of research mentors and collaborative opportunities. Nurses and allied health professionals reported a changing professional culture that values research. Only doctors identified research participation to be important for career progression.

Conclusions

For clinician research participation to flourish, significant changes in healthcare structure and priorities will be required that result in research becoming more embedded in healthcare delivery. Initiatives to improve collaboration between clinicians and universities may also support these aims.
An extended TODIM approach with intuitionistic linguistic numbers
Authors: Yu Su‐min , Wang Jing , Wang Jian‐qiang
Published: December 2016

In many practical problems, multiple alternatives are ranked with respect to related criteria, and the criteria's weights are usually unknown. In order to solve this kind of multicriteria decision making (MCDM) problem, this paper proposes an interactive MCDM approach based on an acronym in Portuguese of interactive and multicriteria decision‐making (TODIM) method and nonlinear programming (NLP) with intuitionistic linguistic numbers (ILNs). First, by comparing the existing operations and comparison methods for ILNs, new operations and a new comparison method are defined based on linguistic scale functions to obtain rational results. Second, considering their linguistic terms, membership degrees, and nonmembership degrees as a whole, the generalized distance between ILNs is defined with an adjustable parameter. Third, the total ranking of alternatives is obtained using the proposed NLP‐based TODIM approach based on the generalized ILN distance. Finally, an example of selecting hotels from a tourism website is presented to verify the validity and feasibility of the proposed approach. A comparison with existing methods is also conducted and analyzed.
Development and Testing of a Screener for Intelligence and Learning Disabilities (SCIL)
Authors: Nijman Henk , Kaal Hendrien , van Scheppingen Lesley , Moonen Xavier
Published: December 2016

Background

Many clients in contact with social services and (mental) health care have mild to borderline intellectual disabilities (MBID). Yet, administering a full intelligence test may not be feasible.

Method

In 318 adults and 305 juveniles, the scores on 14 questions that comprise the screener for intelligence and learning disabilities (SCIL) were analysed in relation to the IQs of the participants.

Results

The SCIL score had good predictive validity for detecting MBID in adults (AUC = 0.93). A cut‐off score of 19 or lower is recommended to detect (a suspicion of) MBID. Test–retest reliability of the SCIL was 0.92. In juveniles, AUC values were 0.91 for 16‐ to 17‐year‐olds, 0.90 for 14‐ to 15‐year‐olds and 0.83 for 12‐ to 13‐year‐olds.

Conclusions

The SCIL appears to be a time‐efficient tool for screening for MBID in adults (18+) and juveniles of 14 years or older.
Left Atrial Appendage Closure With the New Occlutech® Device: First in Man Experience and Neurological Outcome
Authors: BELLMANN BARBARA , SCHNUPP STEFFEN , KÜHNLEIN PETER , JAVERNIK CHRISTIAN , KLEINECKE CAROLINE , RILLIG ANDREAS , LANDMESSER ULF , BRACHMANN JOHANNES , PARK JAI‐WUN
Published: December 2016

Left Atrial Appendage Closure With the New Occlutech® Device

Aims

Percutaneous left atrial appendage closure (LAAC) is a valuable treatment option for stroke prevention in patients with atrial fibrillation and a HAS‐BLED‐Score ≥3. Determinants of procedural safety events and neurological outcome of the patients with the Occlutech device (OD) are not established yet.

Methods and Results

Between 2012 and 2016, 30 patients underwent LAAC using the OD. This is a prospective study. Neurological examination and transesophageal echocardiography was performed directly before and after the procedure and after 1, 3, and 12 months. The OC was successfully implanted in 28 of the 30 enrolled patients (93%). Two patients presented a hemodynamic relevant pericardial effusion. A leak <3 mm could be documented direct after implantation in 4 patients. After 3 months, there were only 2/4 patients with persistent LAA leakage with a maximum leakage of <3 mm. The correct position of the device was confirmed in 27/28 patients during 3‐month follow‐up. In 2 patients, there was a thrombus at the OC. In 12 patients, a transoesophageal echocardiography was performed after 12 months. All patients (12/12) showed a correct placement of the device. None of the patients developed a clinically apparent stroke or died during follow‐up.

Conclusion

In this uncontrolled, nonrandomized study, acute and 3‐month follow‐up success of LAAC using OD was high. No patient showed significant neurological deficits.
Complication Rates of Catheter Ablation of Atrial Fibrillation in Patients Aged ≥75 Years versus <75 Years—Results from the German Ablation Registry
Authors: MOSER JULIA M. , WILLEMS STEPHAN , ANDRESEN DIETRICH , BRACHMANN JOHANNES , ECKARDT LARS , HOFFMANN ELLEN , KUCK KARL‐HEINZ , LEWALTER THORSTEN , SCHUMACHER BURGHARD , SPITZER STEFAN G. , HOCHADEL MATTHIAS , SENGES JOCHEN , HOFFMANN BORIS A.
Published: December 2016

Age‐Related Complication Rates in AF Ablation

Introduction

Despite a rising demand for catheter ablation (CA) of atrial fibrillation (AF) in an elderly population, complication and success rates are not fully elucidated. We sought to compare complication rates of CA of AF in patients ≥75 versus <75 years of age.

Methods and Results

Patients with symptomatic, drug‐refractory AF were prospectively enrolled from January 2007 to 2010 in this multicenter study. A total of 4,449 patients, group 1 ≥75 years and group 2 <75 years (n = 227, age 77.3 ± 2.2 vs. 59.7 ± 9.8 years, 52.0% vs. n = 4,222, 68.9% male, CHA2DS2‐VASc‐Score 3.7 ± 1.0 vs. 1.7 ± 1.2; P < 0.001, respectively), with paroxysmal AF (59.9% in group 1 vs. 63.3% in group 2, P = 0.30), and persistent AF (34.8% in group 1 vs. 29.4% in group 2, P = 0.082) underwent CA of AF. A centralized follow‐up was obtained in 4,347 patients by the Institute for Myocardial Infarction Research (IHF, Ludwigshafen). There was a significant difference between periprocedural stroke rates in the elderly versus the younger cohort (1.3% vs. 0.1%, P < 0.01). In‐hospital severe nonfatal complications did not differ significantly between the groups (4.4% vs. 2.7%, P = 0.14). Other procedure‐related, in‐hospital complications were not significantly different. After a mean follow‐up of 472 ± 99 days (group 1) and 477 ± 94 days (group 2), no differences were found in complication rates.

Conclusion

CA of AF in patients ≥75 years is associated with higher in‐hospital stroke rates. In a 1‐year follow‐up, complication rates do not differ between the groups.
Integrated biomarker profiling of smokers with periodontitis
Authors: Nagarajan Radhakrishnan , Al‐Sabbagh Mohanad , Dawson Dolph , Ebersole Jeffrey L.
Published: December 2016

Background

In the context of precision medicine, understanding patient‐specific variation is an important step in developing targeted and patient‐tailored treatment regimens for periodontitis. While several studies have successfully demonstrated the usefulness of molecular expression profiling in conjunction with single classifier systems in discerning distinct disease groups, the majority of these studies do not provide sufficient insights into potential variations within the disease groups.

Aim

The goal of this study was to discern biological response profiles of periodontitis and non‐periodontitis smoking subjects using an informed panel of biomarkers across multiple scales (salivary, oral microbiome, pathogens and other markers).

Material & Methods

The investigation uses a novel ensemble classification approach (SVA‐SVM) to differentiate disease groups and patient‐specific biological variation of systemic inflammatory mediators and IgG antibody to oral commensal and pathogenic bacteria within the groups.

Results

Sensitivity of SVA‐SVM is shown to be considerably higher than several traditional independent classifier systems. Patient‐specific networks generated from SVA‐SVM are also shown to reveal crosstalk between biomarkers in discerning the disease groups. High‐confidence classifiers in these network abstractions comprised of host responses to microbial infection elucidated their critical role in discerning the disease groups.

Conclusions

Host adaptive immune responses to the oral colonization/infection contribute significantly to creating the profiles specific for periodontitis patients with potential to assist in defining patient‐specific risk profiles and tailored interventions.
Ecological diversification associated with the benthic‐to‐pelagic transition by North American minnows
Authors: Burress E. D. , Holcomb J. M. , Tan M. , Armbruster J. W.
Published: December 2016

Ecological opportunity is often regarded as a key factor that explains why diversity is unevenly distributed across life. Colonization of novel environments or adaptive zones may promote diversification. North American minnows exhibit an ancestral benthic‐to‐pelagic habitat shift that coincided with a burst in diversification. Here, we evaluate the phenotypic and ecological implications of this habitat shift by assessing craniofacial and dietary traits among 34 species and testing for morphology–diet covariation, convergence and adaptive optima. There were several instances of morphology–diet covariation such as correlations between mouth angle and the consumption of terrestrial insects and between relative gut length and the consumption of algae. After accounting for size and phylogenetic nonindependence, benthic species had longer heads, longer snouts, eyes positioned higher on their head, smaller mouth angles and longer digestive tracts than pelagic minnows. Benthic minnows also consumed more algae but less terrestrial insects, by volume, than pelagic minnows. Lastly, there were three distinct evolutionary regimes and more convergence in morphology and dietary characteristics than expected under a Brownian motion model of evolution. These findings indicate that colonization of the pelagic zone by minnows involved myriad phenotypic and dietary changes associated with exploitation of terrestrial subsidies. Thus, minnows exhibit phenotype–dietary covariation, an expansion of ecological roles and a burst in diversification rates in response to the ecological opportunity afforded by the colonization of a novel habitat.
Bailing on the Car That Was Not Bailed Out: Bounding Consumer Reactions to Financial Distress
Authors: Huse Cristian , Koptyug Nikita
Published: December 2016

We examine how consumers react to the financial distress of durable goods manufacturers by studying the Swedish new car market. We employ a difference‐in‐differences matching methodology whereby we compare sales of carmaker Saab with those of a control group of substitute products. To account for possible substitution between products in the treatment and control groups, we propose and apply bounds to our difference‐in‐differences matching estimator. We then refine the bounds and provide conditions under which they depend only on product elasticities. We find that there was a significant decrease in the sales of Saab following its filing for administration.
Therapists’ Assessments in Treating “Sex Addiction” and Their Relationship to Clients’ Gender, Relationship Status, and Exclusivity Status
Authors: Reddick Geoffrey T. , Heiden‐Rootes Katie M. , Brimhall Andrew S.
Published: December 2016

A total of 208 therapists and therapists‐in‐training were surveyed to better understand if clinical assessments and recommendations regarding “sex addiction” changed based upon a client's gender, relationship status, or exclusivity status. Using clinical vignettes, this study examined the clinical assessment and recommendations of licensed mental health providers (n = 92) and mental health providers in‐training (n = 116). Results indicated that professional ratings differed based on relationship exclusivity and gender; specifically, female nonmonogamous behavior was rated more negatively than male nonmonogamous behavior, while male monogamous behavior was rated more negatively than female monogamous behavior. Recommendations for treatment varied, with higher addiction ratings leading to greater odds of recommending individual, group, and community support over relational therapy. Clinical and training implications are discussed.

Video abstract accessible by clicking here.
Symplectite formation in the presence of a reactive fluid: insights from hydrothermal experiments
Authors: Spruzeniece L. , Piazolo S. , Daczko N. R. , Kilburn M. R. , Putnis A.
Published: December 2016

This study describes the microstructural and chemical development of symplectites, obtained in fluid‐mediated mineral replacement experiments. During the experiments polymineralic feldspar‐rich samples were exposed to aqueous Na–SiO2 solution at 600 °C and 2 kbar confining pressures for durations of 12 h to 20 days. The resulting reaction rims display high mineralogical and structural complexity and contain two varieties of symplectites, represented by nanometre‐scale intergrowths of gehlenite–zeolite and grossular–zeolite grains. The experimental fluid was enriched in 18O isotope in order to trace oxygen redistribution during the reaction. The elevated 18O concentration in the reaction products and the heterogeneity in its distribution suggest that symplectite formation was controlled by dissolution–precipitation mechanisms rather than volume‐diffusion processes. Microstructural and chemical observations suggest that symplectite formation occurred in multiple stages in response to spatially heterogeneous and temporarily evolving fluid composition at the reaction interfaces. Hence, our results shed light on the fundamental processes involved in symplectite formation improving our ability to interpret symplectite microstructures.
Vascular inter‐regulation of inflammation: molecular and cellular targets for CNS therapy
Authors: Machado‐Pereira Marta , Santos Tiago , Bernardino Liliana , Ferreira Raquel
Published: December 2016

Angiogenesis and inflammation are clearly interconnected and interdependent processes that are dysregulated in a series of systemic and brain pathologies. Herein, key aspects regarding endothelial cell function and tissue remodelling that are particularly affected or aggravated by inflammation are presented. Most importantly, the cellular and molecular mechanisms involved in the vascular regulation of the inflammatory processes occurring in several brain disorders and how they impact on disease/injury progression are detailed, highlighting potential targets for therapy. Finally, nanomedicine‐based approaches designed to overcome limitations pertaining to low systemic bioavailability, light, pH and temperature sensitivity and/or rapid degradation of these targets, and to optimize their mode of action are discussed. Ultimately, we expect this review to provide new insight and to suggest novel approaches for the treatment of blood–brain barrier dysfunction per se or as a means to treat the injured or diseased central nervous system.

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Acetate metabolism does not reflect astrocytic activity, contributes directly to GABA synthesis, and is increased by silent information regulator 1 activation
Authors: Rowlands Benjamin D. , Klugmann Matthias , Rae Caroline D.
Published: December 2016

[13C]Acetate is known to label metabolites preferentially in astrocytes rather than neurons and it has consequently been used as a marker for astrocytic activity. Recent discoveries suggest that control of acetate metabolism and its contributions to the synthesis of metabolites in brain is not as simple as first thought. Here, using a Guinea pig brain cortical tissue slice model metabolizing [1‐13C]D‐glucose and [1,2‐13C]acetate, we investigated control of acetate metabolism and the degree to which it reflects astrocytic activity. Using a range of [1,2‐13C]acetate concentrations, we found that acetate is a poor substrate for metabolism and will inhibit metabolism of itself and of glucose at concentrations in excess of 2 mmol/L. By activating astrocytes using potassium depolarization, we found that use of [1,2‐13C]acetate to synthesize glutamine decreases significantly under these conditions showing that acetate metabolism does not necessarily reflect astrocytic activity. By blocking synthesis of glutamine using methionine sulfoximine, we found that significant amount of [1,2‐13C]acetate are still incorporated into GABA and its metabolic precursors in neurons, with around 30% of the GABA synthesized from [1,2‐13C]acetate likely to be made directly in neurons rather than from glutamine supplied by astrocytes. Finally, to test whether activity of the acetate metabolizing enzyme acetyl‐CoA synthetase is under acetylation control in the brain, we incubated slices with the AceCS1 deacetylase silent information regulator 1 (SIRT1) activator SRT 1720 and showed consequential increased incorporation of [1,2‐13C]acetate into metabolites. Taken together, these data show that acetate metabolism is not directly nor exclusively related to astrocytic metabolic activity, that use of acetate is related to enzyme acetylation and that acetate is directly metabolized to a significant degree in GABAergic neurons. Changes in acetate metabolism should be interpreted as modulation of metabolism through changes in cellular energetic status via altered enzyme acetylation levels rather than simply as an adjustment of glial–neuronal metabolic activity.

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Small molecule modulator of sigma 2 receptor is neuroprotective and reduces cognitive deficits and neuroinflammation in experimental models of Alzheimer's disease
Authors: Yi Bitna , Sahn James J. , Ardestani Pooneh Memar , Evans Andrew K. , Scott Luisa L. , Chan Jessica Z. , Iyer Sangeetha , Crisp Ashley , Zuniga Gabriella , Pierce Jonathan T. , Martin Stephen F. , Shamloo Mehrdad
Published: December 2016

Accumulating evidence suggests that modulating the sigma 2 receptor (Sig2R) can provide beneficial effects for neurodegenerative diseases. Herein, we report the identification of a novel class of Sig2R ligands and their cellular and in vivo activity in experimental models of Alzheimer's disease (AD). We report that SAS‐0132 and DKR‐1051, selective ligands of Sig2R, modulate intracellular Ca2+ levels in human SK‐N‐SH neuroblastoma cells. The Sig2R ligands SAS‐0132 and JVW‐1009 are neuroprotective in a C. elegans model of amyloid precursor protein‐mediated neurodegeneration. Since this neuroprotective effect is replicated by genetic knockdown and knockout of vem‐1, the ortholog of progesterone receptor membrane component‐1 (PGRMC1), these results suggest that Sig2R ligands modulate a PGRMC1‐related pathway. Last, we demonstrate that SAS‐0132 improves cognitive performance both in the Thy‐1 hAPPLond/Swe+ transgenic mouse model of AD and in healthy wild‐type mice. These results demonstrate that Sig2R is a promising therapeutic target for neurocognitive disorders including AD.

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Prognostic Factors in Patients With Stemi Undergoing Primary PCI in the Clopidogrel Era: Role of Dual Antiplatelet Therapy at Admission and the Smoking Paradox on Long‐Term Outcome
Authors: Ciccarelli Giovanni , Barbato Emanuele , Golino Marco , Cimmino Giovanni , Bartunek Jozef , Di Serafino Luigi , Di Girolamo Domenico , De Bruyne Bernard , Wijns William , Golino Paolo
Published: December 2016

Background

Several clinical and laboratory variables have an impact on the prognosis of STEMI patients undergoing PPCI; however, little is known about the role of ongoing DAPT at the time of the event and the smoking status as prognostic factors affecting the outcome of these patients.

Methods and Results

Seven‐hundred and thirteen consecutive STEMI patients undergoing PPCI, admitted to the S. Anna and S. Sebastiano Hospital (Caserta, Italy) and to the OLV Clinic (Aalst, Belgium), between March 2009 and December 2011, were retrospectively enrolled. Rescue PCI was the only exclusion criterion. Primary end‐point was the combination of death for all causes, re‐infarction, stroke, and target lesion revascularization (TLR). Patients already on DAPT at admission (26.4%) showed a significant increase in the event rate at univariate analysis (HR 2.34, CI 1.62–3.75, P < 0.05), while current smokers (56.5%) had a lower event rate, as compared to non‐smokers (HR 0.67, CI 0.46–0.96, P < 0.05). In smoking patients already on DAPT at admission, a lower event rate was observed than in non‐smoking patients on DAPT. Although, patients already on DAPT had a higher‐risk profile (renal impairment, ongoing statin treatment, ST resolution <50%, and Killip class >1 were more frequently present than in patients not on DAPT), Cox regression analysis confirmed that both DAPT (HR 1.74, 95%CI 1.20–2.53, P < 0.01) and smoking status (HR 0.69, 95%CI 0.48–1.00, P < 0.05) retained their statistical significance, as they and were significantly associated with a worse and a better outcome, respectively, underlying their role as independent prognostic factors.

Conclusions

Not being a current smoker and ongoing DAPT at admission, in patients with STEMI undergoing PPCI, represent independent negative prognostic value.
Prevalence of Sjögren's syndrome in Brazilian patients infected with human T‐cell lymphotropic virus
Authors: Vale Daniela Assis do , Casseb Jorge , de Oliveira Augusto César Penalva , Bussoloti Filho Ivo , de Sousa Suzana Cantanhede Orsini Machado , Ortega Karem López
Published: December 2016

Background

Human T‐lymphotropic virus type I (HTLV‐I) is known to be associated with neoplastic and neurodegenerative changes, and it is believed to be associated with various systemic inflammatory diseases, including Sjögren's syndrome (SS). Although HTLV‐I infection is endemic in Brazil, there is no information regarding the association between HTLV‐I infection and SS in the Brazilian population. The objective of this study was to determine the prevalence of SS in HTLV‐I‐infected individuals and the prevalence of HTLV‐I infection in individuals diagnosed with SS.

Methods

Serology for HTLV‐I was performed in 50 patients presenting with complaints consistent with SS (the SS group). The HTLV‐I group comprised 129 HTLV‐I‐infected patients who were screened for SS.

Results

None of the patients in the SS group tested positive for HTLV‐I. Of the 129 patients in the HTLV‐I group, 46 (35.7%) had xerostomia, 18 (13.95%) had xerophthalmia, eight (6.2%) had hyposalivation, two (1.55%) showed impaired tear secretion, and one (0.77%) was positive for autoantibodies (anti‐SSB). In addition, six underwent minor salivary gland biopsy, and the histopathological findings were consistent with SS. Only two (1.55%) met the diagnostic criteria for SS.

Conclusions

The prevalence of SS was found to be three times as high in HTLV‐I‐infected individuals as it was in those without HTLV‐I infection. However, given the small number of HTLV‐seropositive patients with SS, it is impossible to state that HTLV acts as an immune‐activating pathogen for SS.
Rehospitalization of preterm infants according to the discharge risk level
Authors: Aykanat Girgin Burcu , Cimete Güler
Published: December 2016

Purpose

The rehospitalization rate of preterm infants is between 22 and 52% within the first year after discharge. The purpose of this study was to investigate the rehospitalization of preterm infants within 2 months following discharge, considering the level of risks originating from the infant, parents, and the social factors.

Design and Methods

The sample was composed of 238 preterm infants and their parents. The data were collected with a Descriptive Information Form, the Post‐Discharge Infant Follow‐up Form, and the Neonatal Discharge Assessment Tool (N‐DAT). Before discharge, the preterm infants were evaluated in terms of risky discharge via N‐DAT consisting of the subscales Medical, Competencies, Risk factors, Resources, and Parenting. Discharge was determined as low, moderate, and high risk according to N‐DAT total score. Two months after the discharge, rehospitalization of the infants was assessed. The data were evaluated via chi‐square, Mann–Whitney U‐test, and Fisher's exact test.

Results

In the study, 39.9% of the preterm infants were rehospitalized within the 8 weeks following the discharge, with medical and/or surgical reasons. Medical problems such as pneumonia and acute bronchiolitis were ranked as the first cause for rehospitalization. As expected, according to the N‐DAT scores, the rates of rehospitalization of infants who had been discharged with intermediate and high risk levels were found to be higher (p < .001) than the rates of those with low risk levels. Also, N‐DAT Medical, Competencies, Risk factors, Resources, and Parenting subscale scores of the infants who were rehospitalized with medical problems were found to be higher at a statistically significant level than infants who were not rehospitalized (p < .001).

Practice Implications

Nurses can help to minimize rehospitalization of infants by parental education, telephonic counseling, frequent observation, and home care support.
Development of a simple and objective evaluation method for thickened liquids using funnels
Authors: Watanabe Emi , Yamagata Yoshie , Kogirima Miho , Miyamoto Ken‐ichi , Kayashita Jun
Published: December 2016

Some patients with dysphagia are prone to aspiration of low‐viscosity liquids. Thickened liquids are often used in attempts to prevent aspiration. The patients should be given thickened liquids with suitable thickness, and the thickness should be constant at all time. While rotational and cone‐and‐plate viscometers are used for the evaluation of thickened liquids, they are high‐precision and expensive equipment. To control the thickness of liquids, a simple and objective evaluation method is thus necessary. We developed a method to evaluate thickened liquids using funnels, and verified the appropriateness of this method. We measured the outflow times of five thickened liquids through funnels. One of the thickened liquids was a commercially available nutritional supplement, another was made with a thickening agent that contained guar gum, and all others were made with a thickening agent that contained xanthan gum. Four funnels with different stem sizes were tested. We found that the outflow time of thickened liquids through a funnel depended on their viscosities at a shear rate between 10 and 50 s−1, when the average inner diameter of the stem was in the range of 5.3–9.0 mm, and the volume of the liquid poured into the funnel was 30 mL. The correlation coefficient between the value of the sensory evaluation and the outflow time of the funnel with an average stem ID of 5.3 mm was 0.946. Therefore, this method may be useful in hospital and nursing home kitchens for evaluating thickened liquids.

Practical applications

The findings of this study will help develop a new method for the evaluation of thickened liquids. Funnels made from polypropylene, which are inexpensive and light, were used in this method. The process for measuring the outflow time of thickened liquids through a funnel is simple, and we can obtain quantitative data that are objective. Even though line spread test (LST) is well known as a simple measurement method, nutritional supplements and liquids thickened using a thickening agent containing guar gum have not been evaluated accurately. The funnel method was found to have a stronger correlation with sensory evaluation compared to LST. This method is useful in hospital and nursing home kitchens for evaluating thickened liquids.
More improvement than progression of liver fibrosis following antiretroviral therapy in a longitudinal cohort of HIV‐infected patients with or without HBV and HCV co‐infections
Authors: Ding Y. , Duan S. , Ye R. , Yang Y. , Yao S. , Wang J. , Cao D. , Liu X. , Lu L. , Jia M. , Wu Z. , He N.
Published: December 2016

We examined the effect of combination antiretroviral therapy (cART) on liver fibrosis among HIV‐infected patients with or without hepatitis B (HBV) or C virus (HCV) co‐infection. This was a retrospective cohort study of HIV‐infected patients receiving cART during 2004‐2016. Liver fibrosis was assessed using Fibrosis‐4 (FIB‐4) score with three classifications: Class 1, <1.45; Class 2, 1.45‐3.25; Class 3, >3.25. Of 3900 participants, 68.6% were HIV mono‐infected, 5.3% were HIV/HBV co‐infected, 23.8% were HIV/HCV co‐infected and 2.3% were HIV/HBV/HCV co‐infected. Participants received follow‐up treatment (median was 3.3 years). Improvement to a lower class was observed in Class 2 (52.6%) and Class 3 (74.2%), respectively. Progression to a higher class was observed in 12.8% and 5.0% in Class 1 and Class 2, respectively, and with a median time of 5.7 months. For improvement to lower classes, older age, male, Dai ethnicity, injection drug use, HCV co‐infection and tenofovir for treatment were negative predictors, but in Class 3 of FIB‐4 and time‐updated increases in CD4 count from baseline were positive predictors. For progression to higher classes, older age, male, Jingpo ethnicity and HCV co‐infection were positive predictors, while baseline CD4 count and in Class 2 of FIB‐4 were negative predictors. Improvement to lower class linked with decreased mortality risk among patients in Class 3. Early cART initiation for HIV‐infected patients with and without hepatitis co‐infections may mitigate or slow down some of liver fibrosis, but special attention should be given to those who are older, male, co‐infected with HCV.
Hepatitis C infection and other drug‐related harms among inpatients who injected drugs in Turkey
Authors: Alaei A. , Alaei K. , Waye K. , Tracy M. , Nalbandyan M. , Mutlu E. , Cetin M. K.
Published: December 2016

Hepatitis C virus (HCV) is easily spread among those who share drug injection equipment. Due to the ease of contraction and growing prevalence of HCV in Eastern Europe, the aims of this study focused on describing risky injection practices as well as the prevalence of HCV, HIV and hepatitis B virus (HBV) among people who inject drugs (PWID) who were admitted to public and private drug treatment centres in Turkey from 2012 to 2013. Other aims included identifying correlates of needle sharing and HCV infection. Of the 4694 inpatients who ever injected drugs and the 3914 who injected in the past 30 days, nearly all (98%) reported heroin as their drug of choice, the vast majority reported ever sharing a needle (73.4% and 79.3%), and the mean age at first injection was 23 years. Of current PWID, 51.9% were HCV‐positive, 5.9% were HBV‐positive and only 0.34% of lifetime PWID were HIV‐positive. Predictors of increased needle sharing include younger age, being unemployed, having lesser education and reporting heroin as a drug of choice. Significant predictors of HCV infection included being 40 years or older, receiving treatment in the Mediterranean region of Turkey, reporting heroin as a primary substance, a longer duration of drug use and sharing needles. With this information, it is essential to improve access to clean injection equipment in Turkey, to focus on improving education on clean injection practices and to enhance efforts in testing and treating HCV‐positive PWID.
Heavier females produce more sons in a low‐density population of red deer
Authors: Borowik T. , Jędrzejewska B.
Published: December 2016

According to the Trivers‐Willard hypothesis, females of polygynous mammal species can adaptively modify offspring sex ratio, which would provide them evolutionary benefits in terms of a higher number of grand‐offspring. In red deer (Cervus elaphus), a species where the reproductive success of males is significantly more variable than that of females, mothers that are in good condition are expected to have a male‐biased offspring sex ratio but only in a population below carrying capacity. We aimed at testing the Trivers‐Willard hypothesis on a low‐density population of red deer in large woodlands of north‐eastern Poland. The overall foetal sex ratio did not differ from parity. The mother's probability of having male offspring increased with her body mass independently of age and population density. Such condition‐based adjustment of the offspring sex ratio in female red deer from a low‐density population conforms to the Trivers–Willard hypothesis. However, full support of Trivers–Willard predictions would require further investigations comparing survival and reproductive output of male and female offspring.
The impact of home fortification with multiple micronutrient powder on vitamin A status in young children: A multicenter pragmatic controlled trial in Brazil
Authors: Silva Lara Livia Santos , Augusto Rosângela Aparecida , Tietzmann Daniela Cardoso , Sequeira Leopoldina Augusta Souza , Hadler Maria Claret Costa Monteiro , Muniz Pascoal Torres , de Lira Pedro Israel Cabral , Cardoso Marly Augusto ,   for the ENFAC Working Group
Published: December 2016

Home fortification with multiple micronutrient powder (MNP) is effective in the prevention of anemia in young children. However, the impact on their vitamin A status remains controversial. This study aimed to evaluate the effect of MNP on vitamin A status in young Brazilian children. A multicenter pragmatic, controlled trial was carried out in primary health centers in four Brazilian cities. In the beginning of the study, the control group (CG) consisted of children 11–14 months old (n = 395) attending in routine pediatric health care. In parallel, the intervention group (IG) was composed of children 6–8 months old (n = 399), in the same health centers, who followed the intervention with MNP for 2–3 months. The analysis of the effect of MNP on vitamin A status was performed by comparing the IG with the CG after a 4‐ to 6‐month follow‐up when IG children had reached the age of the controls. The prevalence of vitamin A deficiency (VAD; serum retinol <0.70 μmol/L) in the CG was 16.2%, while in the IG was 7.5%—a 55% reduction in the VAD [prevalence ratio (95% confidence interval) = 0.45 (0.28; 0.72)]. This reduction was also significant when stratifying the study centers by coverage of the Brazilian Vitamin A Supplementation Program. The adjusted mean of vitamin A serum concentrations improved in the IG compared with CG children, with a shift to the right in the vitamin A distribution. Home fortification with MNP was effective in reducing VAD among young Brazilian children.
Dickeya dadantii pectic enzymes necessary for virulence are also responsible for activation of the Arabidopsis thaliana innate immune system
Authors: Expert Dominique , Patrit Oriane , Shevchik Vladimir E. , Perino Claude , Boucher Virginie , Creze Christophe , Wenes Estelle , Fagard Mathilde
Published: December 2016

Soft‐rot diseases of plants attributed to Dickeya dadantii result from lysis of the plant cell wall caused by pectic enzymes released by the bacterial cell by a type II secretion system (T2SS). Arabidopsis thaliana can express several lines of defence against this bacterium. We employed bacterial mutants with defective envelope structures or secreted proteins to examine early plant defence reactions. We focused on the production of AtrbohD‐dependent reactive oxygen species (ROS), callose deposition and cell death as indicators of these reactions. We observed a significant reduction in ROS and callose formation with a bacterial mutant in which genes encoding five pectate lyases (Pels) were disrupted. Treatment of plant leaves with bacterial culture filtrates containing Pels resulted in ROS and callose production, and both reactions were dependent on a functional AtrbohD gene. ROS and callose were produced in response to treatment with a cellular fraction of a T2SS‐negative mutant grown in a Pels‐inducing medium. Finally, ROS and callose were produced in leaves treated with purified Pels that had also been shown to induce the expression of jasmonic acid‐dependent defence genes. Pel catalytic activity is required for the induction of ROS accumulation. In contrast, cell death observed in leaves infected with the wild‐type strain appeared to be independent of a functional AtrbohD gene. It was also independent of the bacterial production of pectic enzymes and the type III secretion system (T3SS). In conclusion, the work presented here shows that D. dadantii is recognized by the A. thaliana innate immune system through the action of pectic enzymes secreted by bacteria at the site of infection. This recognition leads to AtrbohD‐dependent ROS and callose accumulation, but not cell death.
Estimating the sensitivity of stomatal conductance to photosynthesis: a review
Authors: Miner Grace L. , Bauerle William L. , Baldocchi Dennis D.
Published: December 2016

A common approach for estimating fluxes of CO2 and water in canopy models is to couple a model of photosynthesis (An) to a semi‐empirical model of stomatal conductance (gs) such as the widely validated and utilized Ball–Berry (BB) model. This coupling provides an effective way of predicting transpiration at multiple scales. However, the designated value of the slope parameter (m) in the BB model impacts transpiration estimates. There is a lack of consensus regarding how m varies among species or plant functional types (PFTs) or in response to growth conditions. Literature values are highly variable, with inter‐species and intra‐species variations of >100%, and comparisons are made more difficult because of differences in collection techniques. This paper reviews the various methods used to estimate m and highlights how variations in measurement techniques or the data utilized can influence the resultant m. Additionally, this review summarizes the reported responses of m to [CO2] and water stress, collates literature values by PFT and compiles nearly three decades of values into a useful compendium.
Attitudes toward driver's licenses for people with epilepsy: 2012 versus 2014
Authors: Okumura Akihisa , Abe Shinpei , Nakazawa Mika , Ikeno Mitsuru , Igarashi Ayuko , Takasu Michihiko , Shimizu Toshiaki
Published: December 2016

Background

We compared knowledge about and attitudes toward epilepsy and the issuing of driver's licenses to people with epilepsy among non‐medical students before and after media controversies.

Methods

The survey was performed in 2012 and 2014 using a structured questionnaire. Participants were non‐medical students who attended a lecture on neurological diseases in children. The proportion of positive answers to each question in 2012 was compared with that in 2014. In addition, questions regarding attitudes toward driver's licenses were compared according to knowledge about car accidents linked to people with epilepsy.

Results

More participants were familiar with epilepsy and had a favorable attitude toward epilepsy in 2014 than in 2012. In contrast, the proportion of participants who knew of car accidents linked to people with epilepsy was reduced in 2014 compared with 2012. The proportion of participants who did not think that severe punishment should be given to people with epilepsy if they caused a car accident decreased in 2014 among those without knowledge of car accidents.

Conclusions

Familiarity with and attitudes toward epilepsy were improved in 2014, whereas the decrease in proportion of positive answers on punishment among participants unfamiliar with car accidents suggests a latent worsening of public attitudes.
Helminths, hygiene hypothesis and type 2 diabetes
Authors: de Ruiter K. , Tahapary D. L. , Sartono E. , Soewondo P. , Supali T. , Smit J. W. A. , Yazdanbakhsh M.
Published: December 2016

Worldwide, there is little overlap between the prevalence of soil‐transmitted helminths and type 2 diabetes (T2D). Helminth‐induced type 2 immune responses and immune regulatory network might modulate the obesity‐induced activation of inflammatory pathways that are associated with the development of insulin resistance, a strong predictor of the development of T2D. However, other factors such as helminth‐associated changes in adiposity and gut microbiome might also contribute to improved metabolic outcomes. In this review, we summarize epidemiological evidence for the link between helminths and T2D and discuss the potential mechanisms, based on findings from experimental studies as well as the limited number of studies in humans.