bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatial Variability of Nitrate and Ammonium in Pleistocene Aquifer of Central Yangtze River Basin
Authors: Du Yao , Deng Yamin , Ma Teng , Shen Shuai , Lu Zongjie , Gan Yiqun
Published: April 2019

It becomes increasingly important and challenging for nitrogen pollution prevention to identify key controls for spatial variability of nitrogen in groundwater that could be affected by multiple factors, including anthropogenic input, groundwater flow, and local geochemistry. This study characterized spatial variability of both nitrate and ammonium in the Pleistocene aquifer of central Yangtze River Basin and assessed the effect of various factors in controlling nitrate and ammonium levels based on multiple statistical approaches (correlation, geostatistics, multiple liner regression). The results indicate that nitrate is mostly influenced by Cl− that represents anthropogenic input, while Eh representing local redox state is a secondary variable influencing nitrate concentrations. The groundwater with elevated nitrate concentrations are estimated to occur mainly in areas with higher‐permeability near‐surface sediments which can facilitate more anthropogenic nitrate transport and less nitrate removal owing to more oxidized state. Ammonium is mostly correlated to Eh, followed by dissolved organic carbon (DOC), but only DOC improves significantly the accuracy of co‐kriging prediction model. The groundwater with elevated ammonium concentrations are estimated to occur mainly in areas with more organic‐rich sediments within or around the aquifer which can facilitate more ammonium release owing to natural organic matter consumption accompanying strong reducing conditions. The regional groundwater flow is not a factor significantly controlling nitrate or ammonium levels owing to flat topography and sluggish lateral flow.
Assessment of 10‐year changes in liver stiffness using vibration‐controlled transient elastography in non‐alcoholic fatty liver disease
Authors: Nogami Asako , Yoneda Masato , Kobayashi Takashi , Kessoku Takaomi , Honda Yasushi , Ogawa Yuji , Suzuki Kaori , Tomeno Wataru , Imajo Kento , Kirikoshi Hiroyuki , Koide Tomoko , Fujikawa Hirotoshi , Saito Satoru , Nakajima Atsushi
Published: April 2019

Aim

Although liver biopsy is the gold standard for the diagnosis and staging of non‐alcoholic fatty liver disease (NAFLD), repeated assessment of patients’ liver tissue conditions are impractical. We assessed the 10‐year changes in liver stiffness measurements (LSM) utilizing vibration‐controlled transient elastography in NAFLD patients.

Methods

From January 2006 to September 2007, LSM was carried out for 97 biopsy‐proven NAFLD patients. Of these, 34 patients underwent 10‐year LSM reassessments (14 of them with paired biopsies).

Results

We evaluated the changes in the fibrosis stage as estimated using LSM (FS‐LSM). Over a 10‐year period, 32.4% had FS‐LSM progression, 50% had static disease, and 17.6% had FS‐LSM improvement. From among the initially diagnosed non‐alcoholic steatohepatitis patients, 18% had progressed to considerable stage 4 (cirrhosis) 10 years later. In this cohort, none of the patients who had been initially diagnosed as FS‐LSM stage 0 had progressed to cirrhosis 10 years later. The changes in LSM were correlated with the change in the histological fibrosis stage, the NAFLD activity score, and the change in the sum of the steatosis, activity, and fibrosis score. Improving more than 1 body mass index (kg/m2) and having a higher initial aspartate aminotransferase, alanine aminotransferase (ALT), or ALT responder (>30% improvement or reduction to less than 40 IU/L) were factors contributing to LSM improvements (≥2 kPa).

Conclusions

Vibration‐controlled transient elastography is likely to become a more clinically important tool for the long‐term monitoring of NAFLD patients.
Improving patient‐centred care for persons with Parkinson's: Qualitative interviews with care partners about their engagement in discussions of “off” periods
Authors: Rastgardani Tara , Armstrong Melissa J. , Marras Connie , Gagliardi Anna R.
Published: April 2019

Objective

This study explored how care partners (CPs) of persons with Parkinson's (PwP) are engaged in discussions of “off” symptoms.

Methods

During qualitative interviews, CPs of PwP sampled by convenience through the Michael J Fox Foundation online clinical trial matching service were asked to describe their familiarity with “off” symptoms, how “off” symptoms were discussed with clinicians, and the impact of “off” symptoms on them. Data were analysed using constant comparative technique by all members of the research team.

Results

A total of 20 CPs were interviewed. Compared with PwP, they were more likely to describe “off” symptoms to clinicians. CPs identified important aspects of patient‐centred care for PD: establishing a therapeutic relationship, soliciting and actively listening to information about symptoms, and providing self‐management support to both PwP and CPs. CPs said that clinicians did not always engage CPs, ask about “off” symptoms or provide self‐management guidance, limiting their ability to function as caregivers.

Conclusion

By not engaging and educating CPs, “off” symptoms may not be identified or addressed, leading to suboptimal medical management and quality of life for PwP. These findings must be confirmed on a broader scale through ongoing research but suggest the potential need for interventions targeted at clinicians and at CPs to promote patient‐centred care for PwP.
Drug survival of biological therapy is showing class effect: updated results from Slovenian National Registry of psoriasis
Authors: Lunder Tomaz , Zorko Mateja S. , Kolar Natasa K. , Suhodolcan Aleksandra B. , Marovt Maruska , Leskovec Nada K. , Marko Pij B.
Published: April 2019

Background

Drug survival is an important measure of successful treatment of patients with chronic diseases such as psoriasis. Therefore, the objective was to calculate drug survival and examine safety profile of biologics and immunomodulators (adalimumab, apremilast, etanercept, ixekizumab, infliximab, secukinumab, and ustekinumab) from the Slovenian National Registry of patients with moderate‐to‐severe psoriasis.

Methods

Data about the patients with moderate‐to‐severe plaque psoriasis treated with biologics were collected from 2005 until July 2018. Kaplan‐Meier survival curves and Cox regression were used to calculate drug survival, where ustekinumab was selected as a reference.

Results

Overall, 1,606 patients were analyzed within 2,241 treatment episodes; adalimumab N = 831, apremilast N = 94, etanercept N = 101, ixekizumab N = 98, infliximab N = 164, secukinumab N = 340, and ustekinumab N = 613, respectively. Loss of efficacy was the most frequent reason for treatment discontinuation (contributing to 66.1% of all discontinuations). Ustekinumab was associated with the highest drug survival, meanwhile apremilast was the drug with the lowest survival rate compared to all others. Both IL‐17 inhibitors, secukinumab and ixekizumab, showed similar survival rate.

Conclusions

Ustekinumab was associated with the highest drug survival and most favorable safety profile compared to other biologics. Drug survival rates can be associated with the class effect of biological targets. Highest survival rate was observed for IL‐12/23 inhibitor, followed by IL‐17 and TNF‐α inhibitors, and last by an immunomodulator such as apremilast. Adverse events occurred most frequently with TNF‐α inhibitors.
Genetic risk scores demonstrate the cumulative association of single nucleotide polymorphisms in gut microbiome‐related genes with obesity phenotypes in preschool age children
Authors: Wang Anthony A. , Harrison Kristen , Musaad Salma , Donovan Sharon M. , Teran‐Garcia Margarita ,   the STRONG Kids Research Team
Published: April 2019

Background

Childhood obesity is a nutrition‐related disease with multiple underlying aetiologies. While genetic factors contribute to obesity, the gut microbiome is also implicated through fermentation of nondigestible polysaccharides to short‐chain fatty acids (SCFA), which provide some energy to the host and are postulated to act as signalling molecules to affect expression of gut hormones.

Objective

To study the cumulative association of causal, regulatory, and tagged single nucleotide polymorphisms (SNPs) within genes involved in SCFA recognition and metabolism with obesity.

Design

Study participants were non‐Hispanic White (NHW, n = 270) and non‐Hispanic Black (NHB, n = 113) children (2‐5 years) from the Synergistic Theory and Research on Obesity and Nutrition Group (STRONG) Kids 1 Study. SNP variables were assigned values according to the additive, dominant, or recessive inheritance models. Weighted genetic risk scores (GRS) were constructed by multiplying the reassigned values by independently generated β‐coefficients or by summing the β‐coefficients. Ethnicity‐specific SNPs were selected for inclusion in GRS by cohort.

Results

GRS were directly associated with body mass index (BMI) z‐score. The models explained 3.75%, 12.9%, and 26.7% of the variance for NHW/NHB, NHW, and NHB (β = 0.89 [CI: 0.43‐1.35], P = 0.0002; β = 0.78 [CI: 0.54‐1.03], P < 0.0001; β = 0.74 [CI: 0.51–0.97], P < 0.0001).

Conclusion

This analysis supports the cumulative association of several candidate genetic variants selected for their role in SCFA signalling, transport, and metabolism with early‐onset obesity. These data strengthen the concept that microbiome influences obesity development through host genes interacting with SCFA.
Knowns and unknowns of tissue‐resident memory T cells
Authors: Altmann Daniel M.
Published: April 2019

Advances in transcriptomics and other approaches are shedding considerable light on tissue‐resident immune cells as distinct from recirculating cells. The advances encompass antigen‐presenting cell subsets, Tregs and importantly, tissue‐resident memory cells (TRM). What are the transcriptional programmes and functional properties that distinguish the requirements for an effective tissue resident cell in brain relative to lung, skin, adipose tissue or the genital tract? Another important conundrum has been the extent to which TRM cells are specialized either as a ‘sense and alarm’ population or as a local, primed, effector cell population in themselves. These are questions that challenge immunologists to stop thinking in terms of a generic, model, immune response and focus instead on events in the tissue in question.
Cell circuits and niches controlling B cell development
Authors: Zehentmeier Sandra , Pereira João P.
Published: April 2019

Studies over the last decade uncovered overlapping niches for hematopoietic stem cells (HSCs), multipotent progenitor cells, common lymphoid progenitors, and early B cell progenitors. HSC and lymphoid niches are predominantly composed by mesenchymal progenitor cells (MPCs) and by a small subset of endothelial cells. Niche cells create specialized microenvironments through the concomitant production of short‐range acting cell‐fate determining cytokines such as interleukin (IL)‐7 and stem cell factor and the potent chemoattractant C‐X‐C motif chemokine ligand 12. This type of cellular organization allows for the cross‐talk between hematopoietic stem and progenitor cells with niche cells, such that niche cell activity can be regulated by the quality and quantity of hematopoietic progenitors being produced. For example, preleukemic B cell progenitors and preB acute lymphoblastic leukemias interact directly with MPCs, and downregulate IL‐7 expression and the production of non‐leukemic lymphoid cells. In this review, we discuss a novel model of B cell development that is centered on cellular circuits formed between B cell progenitors and lymphopoietic niches.
Exploring the complex role of chemokines and chemoattractants in vivo on leukocyte dynamics
Authors: David Bruna A. , Kubes Paul
Published: April 2019

Chemotaxis is fundamental for leukocyte migration in immunity and inflammation and contributes to the pathogenesis of many human diseases. Although chemokines and various other chemoattractants were initially appreciated as important mediators of acute inflammation, in the past years they have emerged as critical mediators of cell migration during immune surveillance, organ development, and cancer progression. Such advances in our knowledge in chemokine biology have paved the way for the development of specific pharmacological targets with great therapeutic potential. Chemoattractants may belong to different classes, including a complex chemokine system of approximately 50 endogenous molecules that bind to G protein‐coupled receptors, which are expressed by a wide variety of cell types. Also, an unknown number of other chemoattractants may be generated by pathogens and damaged/dead cells. Therefore, blocking chemotaxis without causing side effects is an extremely challenging task. In this review, we focus on recent advances in understanding how the chemokine system orchestrates immune cell migration and positioning at the whole organ level in homeostasis, inflammation, and infection.
Meaning in life of older adults in daily care: A qualitative analysis of participant observations of home nursing visits
Authors: Hupkens Susan , Goumans Marleen , Derkx Peter , Oldersma Annechien , Schutter Trudy , Machielse Anja
Published: April 2019

Aim

To explore situations in daily home nursing regarding meaning in life of older adults.

Design

Qualitative research design.

Methods

In total, 197 participant observations were conducted during home nursing visits between September 2015–May 2018. Descriptions were thematically analysed. The themes of this analysis were subsequently linked to dimensions of meaning in life. Dialogue in research groups expanded understanding.

Results/Findings

Four main themes were found namely: being in a private environment; nurse–patient encounter embedded in a relationship; personal care; and conversation.

Conclusion

Meaning in life of older adults may come to light in every situation during daily care. Hence there are many opportunities for nurses to attune their work to patients' meaning in life. Nurse education and health management should enable them to do so.
Long noncoding RNA LINC00511 induced by SP1 accelerates the glioma progression through targeting miR‐124‐3p/CCND2 axis
Authors: Li Chen , Liu Hongjiang , Yang Jipeng , Yang Jiankai , Yang Liang , Wang Yuanyu , Yan Zhongjie , Sun Yuchen , Sun Xiaofeng , Jiao Baohua
Published: April 2019

Mounting evidence suggests the vital roles of long noncoding RNA (lncRNAs) in the glioma. However, the role of LINC00511 in gliomagenesis is still uncovered. Here, in this study, we aim to investigate the effects of LINC00511 on the glioma cancer phenotype and its deepgoing mechanism. Results indicated that LINC00511 was up‐regulated in glioma tissues and cell lines, moreover its overexpression positively correlated with the poor prognosis and advanced pathological stages. For the upstream regulation, LINC00511 was epigenetically up‐regulated by transcription factor specificity protein 1 (SP1). Gain and loss of functional experiments demonstrated that LINC00511 promoted the proliferation and invasion of glioma cells in vitro. The knockdown of LINC00511 repressed the tumour growth in vivo. Mechanistically, LINC00511 positively regulated the CCND2 expression via competitively sponging with miR‐124‐3p. Overall, our finding illuminates that LINC00511 is induced by SP1 and accelerates the glioma progression through targeting miR‐124‐3p/CCND2 axis, constructing the SP1/LINC00511/miR‐124‐3p/CCND2 axis.
Distinguishing melanocytic nevi from melanomas using static and dynamic infrared thermal imaging
Authors: Magalhaes C. , Vardasca R. , Rebelo M. , Valenca‐Filipe R. , Ribeiro M. , Mendes J.
Published: April 2019

Background

The incidence rates of melanoma have risen to worrying levels over the last decade. Delayed diagnosis, due to faults on the detection stage, indicates the necessity of new aiding diagnosis techniques. Since metabolic activity is highly connected to neoplasia formation, a detection technique that focuses its results on vascular responses, as Infrared thermal (IRT), seems to be a viable option.

Materials and methods

Static and dynamic (cooling) thermal images of melanoma and melanocytic nevi lesions were collected and analysed to retrieve thermal parameters characteristic of this skin lesion types. The steady‐state and dynamic variables were tested separately with different machine learning classifiers to verify whether the distinction of melanoma and nevi lesions was achievable.

Results

The differentiation of both types of skin tumours was doable, achieving an accuracy of 84.2% and a sensitivity of 91.3% with the implementation of a learner based on support vector machines and an input vector composed by static variables.

Conclusion

The use of IRT for skin tumour classification is achievable, but some improvement is needed to raise the metrics of sensitivity and specificity. For future work, it is recommended the study of dynamic parameters for the classification of other types of skin neoplasia.
Dermoscopy use in UK primary care: a survey of GPs with a special interest in dermatology
Authors: Jones O.T. , Jurascheck L.C. , Utukuri M. , Pannebakker M.M. , Emery J. , Walter F.M.
Published: April 2019

Background

Melanoma accounts for 90% of skin cancer mortality and typically presents in primary care, where it can be challenging to distinguish from benign lesions. Dermoscopy is a tool for skin visualization that is routinely used for melanoma diagnosis in secondary care. However, the role of dermoscopy in primary care remains unclear.

Objectives

To determine views on, and use of, dermoscopy by dermatology‐interested general practitioners (GPs).

Methods

An online questionnaire was emailed to the UK Primary Care Dermatology Society members in February 2018, and responses collected over the following 4 weeks.

Results

A total of 205 responses were analysed. Most respondents were GPs (94%), aged over 50 (53%), had a postgraduate dermatological qualification (67%) and used dermoscopy regularly when reviewing pigmented skin lesions (97%). Dermoscopy use was commoner amongst GPs who had worked longer in primary care and had experience of secondary care dermatology. Most had undertaken training in dermoscopy (91%), although one‐fifth (20%) had not updated their training in over 5 years. Most of those who had received only 1 day of face‐to‐face training reported feeling confident using a dermatoscope. Few respondents (11%) reported access to teledermatology or teledermoscopy for urgent or routine referrals.

Conclusions

UK GPs with a special interest in dermatology are routinely using dermoscopy in the primary care setting. More research is needed to establish optimal approaches to training and updating GP dermoscopy skills. When dermoscopy has been shown to be safe, effective, acceptable and cost‐effective in this setting, more GPs may also be able to gain and maintain the skills to implement dermoscopy into routine primary care. Technological advances, including incorporation of artificial intelligence (AI) and algorithms to guide GPs, could also contribute to widening use of dermoscopy among GPs.
Increased incidence of ischaemic heart disease and cerebrovascular disease in psoriasis patients with depression: a nationwide retrospective cohort study
Authors: Hu S.C.‐S. , Yuan S.‐S.F. , Chen G.‐S. , Tu H.‐P.
Published: April 2019

Background

Psoriasis is known to confer a higher risk of cardiovascular and cerebrovascular diseases. However, very few studies have investigated whether the development of depression in psoriasis patients may further increase this vascular risk.

Objective

We investigated the risk of ischaemic heart disease and cerebrovascular disease in Taiwanese psoriasis patients with and without depression.

Methods

A nationwide population‐based retrospective cohort study was performed using the National Health Insurance Research Database. We included 604 psoriasis patients with depression, who were matched to 2416 psoriasis patients without depression (1 : 4 ratio). Relative risks (RR) with 95% confidence intervals (CI) were determined using the Cox proportional hazards regression model, with adjustment for demographic characteristics and comorbidities.

Results

Compared with psoriasis patients without depression, psoriasis patients with depression had greater risk of developing incident ischaemic heart disease (19.5% vs. 8.3%, adjusted RR 1.98, 95% CI 1.57–2.49), cerebrovascular disease (15.6% vs. 5.9%, adjusted RR 2.29, 95% CI 1.76–2.98), and either ischaemic heart disease or cerebrovascular disease (28.3% vs. 12.5%, adjusted RR 1.94, 95% CI 1.60–2.35). Subgroup analysis showed that in psoriasis patients with depression, a higher risk of incident ischaemic heart disease or cerebrovascular disease was present in age groups 30–100 years, in both males and females, and in both lower and higher income categories.

Conclusion

Depression is an independent risk factor for incident ischaemic heart disease and cerebrovascular disease in patients with psoriasis. Therefore, clinicians need to be vigilant for the increased vascular risk in psoriasis patients with depression.
Morphology and Phylogeny of Three Pseudovorticella Species (Ciliophora: Peritrichia) from Brackish Waters of China
Authors: Jiang Mengmeng , Hu Tao , Wang Zhaoyi , Liang Ziyao , Li Jiqiu , Lin Xiaofeng
Published: April 2019

The biodiversity of peritrich ciliates from brackish biotopes is rarely investigated, especially members of the genus Pseudovorticella. Here, the morphology of three species of Pseudovorticella, i.e. P. cf. vestita (Stokes, 1883) Jankowski, 1976, P. spathulata sp. n., and P. qinghaiensis sp. n. isolated from brackish waters were studied. Pseudovorticella cf. vestita is characterized by inverted bell‐shaped cell; a J‐shaped macronucleus; a single contractile vacuole ventrally located; P3 three‐rowed; pellicle striated with highly developed pellicular vesicles; 18–22 transverse silverlines between peristome and aboral trochal band, and 9–13 between aboral trochal band and scopula. Pseudovorticella spathulata sp. n. differs from its congeners by the following combination of characters: elongate‐elliptical cell; a single contractile vacuole near ventral wall of infundibulum; a J‐shaped macronucleus; P3 three‐rowed; 24–34 silverlines between oral area and aboral trochal band and 6–10 between aboral trochal band and scopula. Pseudovorticella qinghaiensis sp. n. is characterized by: cell with an oval outline; a single contractile vacuole near ventral wall of infundibulum; a C‐shaped macronucleus; P3 three‐rowed; 30–35 and 9–11 transverse silverlines above and below the trochal band, respectively. The SSU rDNA sequences of five Pseudovorticella species, namely P. annulata, P. monilata, P. parakenti, P. spathulata sp. n., and P. cf. vestita, plus that of Zoothamnium hartwigi, are reported for the first time and their evolutionary relationships are investigated. Five undefined Pseudovorticella forms are considered might be conspecific with P. monilata. Two congeners are conspecific with P. spathulata sp. n. Phylogenetic analyses based on SSU rDNA sequences reveal that Pseudovorticella is not monophyletic and Z. hartwigi clusters with its congeners as expected.
The Significance of Vitamin D Status in Breast Cancer: A State of the Science Review
Authors: McNamara Mary , Rosenberger Kelly D.
Published: April 2019

The potential role of vitamin D in the development of breast cancer has been the subject of considerable interest. Laboratory and genetic studies demonstrate promising anticarcinogenic effects of vitamin D. However, inconsistencies persist in results of human studies that have assessed vitamin D supplementation for the prevention of primary and secondary cancers. Despite these discrepancies, screening for vitamin D deficiency and vitamin D supplementation have increased dramatically in the past decade. No official institutional guidelines recommend vitamin D supplementation for cancer prevention, and yet these newly adopted practice norms have outpaced rigorous scientific study. Higher circulating levels of vitamin D [25‐hydroxyvitamin D, or 25(OH)D] appear to be associated with reduced risk and improved survivorship of certain malignancies. However, the association has not been found for all cancers. This state of the science review examines the association between vitamin D supplementation, circulating 25(OH)D level, vitamin D receptor polymorphisms, and the risk and mortality of breast cancer. The review addresses the role of supplementation and optimal 25(OH)D levels.
Revisiting the infracardiac bursa using multimodal methods: topographic anatomy for surgery of the esophagogastric junction
Authors: Nakamura Tatsuro , Shinohara Hisashi , Okada Tomoaki , Hisamori Shigeo , Tsunoda Shigeru , Obama Kazutaka , Kurahashi Yasunori , Takai Akihiro , Shimokawa Tetsuya , Matsuda Seiji , Makishima Haruyuki , Takakuwa Tetsuya , Yamada Shigehito , Sakai Yoshiharu
Published: April 2019

Abstract

In embryology, the infracardiac bursa (ICB) is a well‐known derivative separated from the omental bursa. During surgeries around the esophagogastric junction (EGJ), surgeons often encounter a closed space considered to be equivalent to the ICB, but the macroscopic anatomy in adults is hardly known. This study aimed to revisit the ICB using multimodal methods to show its development from the embryonic to adult stage and clarify its persistence and topographic anatomy. Histological sections of 79 embryos from Carnegie stage (CS) 16 to 23 and magnetic resonance (MR) images of 39 fetuses were examined to study the embryological development of the ICB. Horizontal sections around the EGJ obtained from three adult cadavers were examined to determine the topographic anatomy and histology of the ICB. Further, 32 laparoscopic surgical videos before (n = 16) and after (n = 16) the start of this study were reviewed to confirm its remaining rate and topographic anatomy in surgery. The ICB was formed in 1 out of 10 CS17 samples, and in 8 out of 10 CS18 samples. Further, it was observed in all CS19–23 except one CS23 sample and in 25 (64%) out of 39 fetus samples. Three‐dimensional reconstructed MR images of fetuses revealed that the ICB was located at the right alongside the esophagus and the cranial side of the diaphragmatic crus. In one adult cadaver, the caudal end of the ICB arose from the level of the esophageal hiatus and the cranial end reached up to the level of the pericardium. The inner surface cells of the space consisted of the mesothelium. In laparoscopic surgery, the ICB was identified in only 11 (69%) out of 16 surgeries before. However, subsequently we were able to identify the ICB reproducibly in 15 (94%) out of 16 surgeries. Thus, the ICB is the structure commonly remaining in almost all adults as a closed space located at the right alongside the esophagus and the cranial side of the diaphragmatic crus. It may be available as a useful landmark in surgery of the EGJ.
Development and evaluation of a cervical cancer screening system in Cambodia: A collaborative project of the Cambodian Society of Gynecology and Obstetrics and Japan Society of Obstetrics and Gynecology
Authors: Ueda Yutaka , Kawana Kei , Yanaihara Nozomu , Banno Kouji , Chhit Maryan , Uy Kyna , Kruy Leangsim , Sann Chan S. , Ishioka‐Kanda Miwa , Akaba Hiroki , Matsumoto Yasuyo , Fujita Noriko , Yano Testu , Koum Kanal , Okamoto Aikou , Kimura Tadashi
Published: April 2019

Aim

In Cambodia, the Japan Society of Obstetrics and Gynecology and the Cambodian Society of Gynecology and Obstetrics have an on‐going project, started in 2015, for cervical cancer prevention and treatment. The project, currently aimed at factory workers, includes a women’s health education program that leads into cervical cancer prevention by establishment of a system for early detection and treatment. It begins by health education, screening for human papillomavirus (HPV), followed by colposcopy and quicker treatment of earlier precursor lesions.

Methods

Rates for participant screening, HPV test positivity, cervical intraepithelial neoplasia (CIN) detection and distribution of HPV types were compared between two screening programs, factory‐based and hospital‐based. Some HPV test samples were divided into two, one of which was sent to Japan for a quality‐control check of the Cambodian testing.

Results

The factory‐based participant screening rate was 19% (128/681). HPV was detected more frequently in the factory‐based program participants (12%) than in the hospital‐based program participants (5%). Unfortunately, however, the rate of receiving proper secondary colposcopy screening among the HPV‐positive females was significantly higher in the hospital‐based program (94%) than the factory‐based program (40%) (P < 0.001). The Cambodian laboratory HPV testing accuracy was 92.6%. HPV types demonstrated no significant difference between the two prevention programs.

Conclusion

We could successfully introduce HPV‐based screening, starting from health education. However, low rate of screening, especially secondary screening for HPV positive factory workers was identified. Also, HPV testing could be further improved for accuracy through close monitoring.
Diversity of Menispermaceae from the Paleocene and Eocene of South China
Authors: Han Meng , Wu Xin‐Kai , Tu Ming , Kodrul Tatiana M. , Jin Jian‐Hua
Published: April 2019

We present here the earliest known Asian fossil records of the Menispermaceae based on fossil fruits from Paleocene and Eocene localities in South China. A new genus and species, Paleoorbicarpum parvum sp. nov., and two new species of Stephania Loureiro, S. ornamenta sp. nov. and S. geniculata sp. nov., are recognized from Paleocene deposits of the Sanshui Basin, Guangdong, and a new occurrence of the widespread Eocene species Stephania auriformis (Hollick) Han & Manchester is recognized from the Maoming Basin, Guangdong. The Paleocene Stephania specimens described here represent the earliest fossil endocarp record of the Menispermaceae in eastern Asia. This discovery shows that the moonseed family had arrived in tropical and humid South China by at least the middle Paleocene, which provides important evidence for the origin and phytogeographic history of the family.
Species delimitation and phylogeography of Abies delavayi complex: Inferred from morphological, molecular, and climatic data
Authors: Shao Yi‐Zhen , Chen Yun , Zhang Xian‐Chun , Xiang Qiao‐Ping
Published: April 2019

The species delimitation within Abies delavayi complex, consisting of A. delavayi Franch., A. fabri (Mast.) Craib, A. nukiangensis W. C. Cheng & L. K. Fu, and A. delavayi subsp. fansipanensis (Q. P. Xiang, L. K. Fu & Nan Li) Rushforth, has been a subject of long‐term dispute. We combined different lines of evidence, including morphological characters, population‐based mitochondrial DNA and chloroplast DNA sequences, and plastome data to assess its species delimitation. These four independent datasets revealed a consistent result that the four taxa of A. delavayi complex were hardly separated and could be regarded as one species. Our results further suggested that these four taxa might have experienced rapid morphological diversification, following a common expansion triggered by climate oscillations during the Pleistocene. In addition, we surveyed the phylogeographical history of A. delavayi complex as a whole based on ecological niche models and molecular data. These results consistently revealed that this high‐mountain fir complex had experienced glacial expansion and interglacial contraction. Therefore, we propose that A. delavayi complex probably has undergone the phalanx expansion model in response to climate change during the Quaternary. Such expansion patterns demand consideration when establishing conservation strategies for threatened fir species.
Age, race and viral genotype are associated with the prevalence of hepatitis B e antigen in children and adults with chronic hepatitis B
Authors: Di Bisceglie Adrian M. , King Wendy C. , Lisker‐Melman Mauricio , Khalili Mandana , Belle Steven H. , Feld Jordan J. , Ghany Marc G. , Janssen Harry L. A. , Lau Daryl , Lee William M. , Ling Simon C. , Cooper Stewart , Rosenthal Philip , Schwarz Kathleen B. , Sterling Richard K. , Teckman Jeffrey H. , Terrault Norah ,   the Hepatitis B Research Network (HBRN)
Published: April 2019

Hepatitis B e antigen (HBeAg) is an important serological marker of hepatitis B virus (HBV) infection and is associated with higher levels of viraemia, increased risk of infectivity to others and increased risk of hepatocellular carcinoma. We analysed HBeAg status in a large cohort of adults and children enrolled in Cohort Studies of the Hepatitis B Research Network, long‐term natural history studies of chronic HBV infection. A cross‐sectional analysis examined factors associated with HBeAg positivity, including demographic and virologic data, across the age spectrum. Among 2241 enrolled participants who met criteria for this analysis, 825 (37%) were seropositive for HBeAg. The prevalence of HBeAg was lower in those with older age, ranging from 85% among those up to 10 years of age to only 12% among those older than 50 years. In addition to age, both race and HBV genotype were independently associated with HBeAg positivity. There was a significant interaction between age and race; the prevalence of HBeAg was significantly higher among Asians > 10‐30 years old vs Whites or Blacks who were >10 to 30 years old and those infected with HBV genotype C. Conversely, the presence of the basal core promoter and precore variants was associated with significantly lower prevalence of HBeAg, even when adjusted for age, race and genotype. These data will provide a better understanding of factors associated with seropositivity for HBeAg and may lead to better strategies for preventing HBV infection and broader indications for antiviral therapy.
Is immunoglobulin A nephropathy different in different ethnic populations?
Authors: Yeo See Cheng , Goh Su Mein , Barratt Jonathan
Published: April 2019

Immunoglobulin A nephropathy (IgAN) is one of the commonest global patterns of primary glomerulonephritis and remains a leading cause of chronic kidney disease and end‐stage renal disease. The sole diagnostic criterion of IgAN remains the presence of dominant mesangial immunoglobulin A deposits on kidney biopsy. Beyond this defining feature, there is significant heterogeneity in the epidemiology, clinical presentation, renal progression and long‐term outcomes of IgAN in different ethnic populations. Mirroring this heterogeneity in clinical phenotypes, there is also marked ethnic variation in the extent of histopathological lesions observed on kidney biopsy, which may partly explain the well‐documented differences in response to immunomodulatory agents reported in different regions of the world. In parallel, disparities have been identified in genetic association studies and key pathogenic pathways in different ethnic populations. Understanding the basis for these differences in IgAN has important implications for both clinical care and future research. In this review, we will examine the impact of ethnicity on the epidemiology, clinical presentation and outcomes, pathogenesis and genetic associations in IgAN.
Comparison of Mid‐term Survivorship and Clinical Outcomes between Bipolar Hemiarthroplasty and Total Hip Arthroplasty with Cementless Stem: A Multicenter Retrospective Study
Authors: Lin Chen‐Chiang , Yang Chang‐Chen , Yu Tzai‐Chiu
Published: April 2019

Objectives

To compare the clinical outcome between bipolar hemiarthroplasty (BHA) and total hip arthroplasty (THA) using a U2 HA cementless hip stem, and the results of elderly femoral neck fracture patients who underwent BHA with a cementless hip stem.

Methods

A multicenter retrospective study enrolled 96 BHA and 115 THA cases using U2 HA cementless hip stems with mean age (BHA: 67.9 years; THA: 64.1 years), body height (BHA: 160.4 cm; THA: 160.7 cm) and weight (BHA: 62.7 kg; THA: 64.5 kg) recorded. Mean follow‐up durations were, respectively, 7.1 (BHA) and 7.8 (THA) years. Survivorship analyses and Oxford hip scores were compared.

Results

Both the BHA and the THA groups revealed high survival rates at 5‐year (100%) and 10‐year (100.0% and 90.1%) follow‐up. The THA group achieved better joint performance and pain relief. The cementless HA stems had survived perfectly for 10 years for elderly femoral neck fracture patients following BHA.

Conclusions

The U2 HA cementless hip stem provides an effective solution for both BHA and THA surgeries, and for elderly femoral neck fracture patients undergoing BHA. According to the findings of the current study, THA may be inadequate for addressing avascular necrosis, and pain control is a considerable concern for patients who have undergone BHA.
Cardiac conduction abnormalities associated with pacemaker implantation after transcatheter aortic valve replacement
Authors: Cresse Stephen , Eisenberg Trevor , Alfonso Carlos , Cohen Mauricio G. , DeMarchena Eduardo , Williams Donald , Carrillo Roger
Published: April 2019

Background

Complete heart block is a known complication after transcatheter aortic valve replacement (TAVR), often requiring pacemaker implantation within 24 hours of the procedure. However, clinical markers for delayed progression to complete heart block after TAVR remain unclear.

Objectives

We examined electrocardiographic data that may correlate with delayed progression to complete heart block and need for pacemaker.

Methods

This is a single‐center retrospective study of 608 patients who underwent TAVR between April 2008 and June 2017. We excluded 164 (27.0%) patients due to having a pacemaker before the procedure or expiring within 24 hours of the procedure (8, 1.3%). We excluded an additional 50 (8.2%) patients who received a pacemaker within 24 hours of the procedure. Electrocardiograms (EKGs) obtained after the procedure were compared to the preprocedural EKG to detect new changes.

Results

Left bundle branch block, intraventricular conduction delay, left anterior fascicular block, and right bundle branch block were the most commonly seen conduction abnormalities after TAVR (25.1%, 10.9%, 7.5%, and 3.6%, respectively). Both left bundle branch block (odds ratio [OR] = 2.77 [95% confidence interval (CI): 1.24–6.22]) and right bundle branch block (OR = 13.2 [95% CI: 4.18–41.70]) carried an increased risk of pacemaker implantation after TAVR. Additionally, ΔPR greater than 40 ms from baseline also carried an increased risk of pacemaker implantation (OR = 3.53 [95% CI: 1.49–8.37]).

Conclusion

Left bundle branch block, right bundle branch block, and ΔPR greater than 40 ms were all associated with delayed progression to complete heart block and need for pacemaker implantation after TAVR.
Reactive atrial‐based antitachycardia pacing therapy reduces atrial tachyarrhythmias
Authors: Crossley George H. , Padeletti Luigi , Zweibel Steven , Hudnall J. Harrison , Zhang Yan , Boriani Giuseppe
Published: April 2019

Background

Reactive atrial‐based antitachycardia pacing (rATP) aims to terminate atrial tachyarrhythmia/atrial fibrillation (AT/AF) episodes when they spontaneously organize to atrial flutter or atrial tachycardia; however, its effectiveness in the real‐world has not been studied. We used a large device database (Medtronic CareLink, Medtronic, Minneapolis, MN, USA) to evaluate the effects of rATP at reducing AT/AF.

Methods

Pacemaker, defibrillator, and resynchronization device transmission data were analyzed. Eligible patients had device detected AT/AF during a baseline period but were not in persistent AT/AF immediately preceding first transmission. Note that 1:1 individual matching between groups was conducted using age, sex, device type, pacing mode, AT/AF, and percent ventricular pacing at baseline. Risks of AT/AF events were compared between patients with rATP‐enabled versus control patients with rATP‐disabled or not available in the device. For matched patients, AT/AF event rates at 2 years were estimated by Kaplan‐Meier method, and hazard ratios (HRs) were calculated by Cox proportional hazard models.

Results

Of 43,440 qualifying patients, 4,203 had rATP on. Matching resulted in 4,016 pairs, totaling 8,032 patients for analysis. The rATP group experienced significantly lower risks of AT/AF events lasting ≥1 day (HR 0.81), ≥7 days (HR 0.64), and ≥30 days (HR 0.56) compared to control (P < 0.0001 for all). In subgroup analysis, rATP was associated with reduced risks of AT/AF events across age, sex, device type, baseline AT/AF, and preventive atrial pacing.

Conclusions

Among real‐world patients from a large device database, rATP therapy was significantly associated with a reduced risk of AT/AF. This association was independent of whether the patient had a pacemaker, defibrillator, or resynchronization device.
Brain neurochemistry in unmedicated obsessive–compulsive disorder patients and effects of 12‐week escitalopram treatment: 1H‐magnetic resonance spectroscopy study
Authors: Parmar Arpit , Sharan Pratap , Khandelwal Sudhir Kumar , Agarwal Khushbu , Sharma Uma , Jagannathan Naranamanglam Raghunathan
Published: April 2019

Aim

The purpose of this study was to examine treatment‐related neurochemical changes in 28 unmedicated obsessive–compulsive disorder (OCD) patients using 1H‐magnetic resonance spectroscopy (1H‐MRS).

Methods

We included subjects diagnosed with OCD (n = 28), each with a total duration of illness of less than 5 years, as a study group and age‐ and sex‐matched healthy controls (n = 26). The inclusion criteria for the OCD group were right‐handed individuals aged 18 years or older who had not been on any specific treatment for OCD for the last at least 8 weeks and who had no other psychiatric comorbidity. A pre–post and case–control design was employed in which OCD patients underwent 1H‐MRS at baseline and 12 weeks after treatment with escitalopram (n = 21). Clinical assessment was carried out using a semi‐structured pro forma Yale–Brown Obsessive Compulsive Scale and the World Health Organization Disability Assessment Scale 2.0 before and after treatment. Volume‐localized 1H‐MRS was carried out with a 3‐Tesla Philips MR scanner.

Results

Our data suggested higher levels of myoinositol (mI), total choline (tCho), and glutamate+glutamine (Glx) in the medial thalamus at pre‐assessment in OCD subjects as compared to healthy controls and a significant reduction in tCho and Glx after treatment in OCD subjects. The mI levels in the caudate nucleus and Glx levels in the anterior cingulate cortex were significantly correlated with disease severity on the Yale–Brown Obsessive Compulsive Scale.

Conclusion

Our study supports the hypothesis of a hyper‐glutaminergic state (as suggested by increased Glx levels) and neurodegeneration (as suggested by increased tCho and mI in the thalamus) in cortico‐striato‐thalamocortical circuitry in OCD patients as suggested by previous studies using MRS as well as other functional imaging studies.
Plasma electrolyte imbalance in pediatric kidney transplant recipients
Authors: Hayes Wesley , Longley Catherine , Scanlon Nicola , Bryant William , Stojanovic Jelena , Kessaris Nicos , Van’t Hoff William , Bockenhauer Detlef , Marks Stephen D.
Published: April 2019

Background

In current practice, pediatric kidney transplant recipients receive large volumes of intravenous fluid intraoperatively to establish allograft perfusion, and further fluid to replace urinary and insensible losses postoperatively. Acute electrolyte imbalance can result, with potential for neurological sequelae. We aimed to determine the incidence and severity of postoperative plasma electrolyte imbalance in pediatric kidney transplant recipients managed with the current standard intravenous crystalloid regimen.

Methods

A retrospective analysis of plasma electrolytes in the first 72 hours post‐kidney transplant in 76 children transplanted between January 1, 2015, and January 31, 2018, managed with a standard intravenous fluid strategy used in most UK pediatric transplant centers.

Results

Of 76 pediatric transplant recipients of median age 9.9 (range 2.2‐17.9) years predominantly managed with 0.45% sodium chloride 5% glucose, 45 (59%) developed acute hyponatremia, 23 (30%) hyperkalemia, and 43 (57%) non‐anion‐gap acidosis in the postoperative period. Hyperglycemia occurred in 74 (97%) patients. Hyperkalemia was more prevalent in deceased than live donor recipients (P = 0.003) and was significantly associated with non‐anion‐gap acidosis (P < 0.001). Recipient weight was not associated with overt electrolyte imbalance.

Conclusion

Postoperative plasma electrolyte imbalance is common in pediatric kidney transplant recipients. Current clinical care strategies mitigate the associated risks of neurological sequelae to some degree. Further studies to optimize intravenous fluid therapy and minimize electrolyte disturbance in this group of patients are needed.
Extracorporeal membrane oxygenation use in the first 24 hours following pediatric heart transplantation: Incidence, risk factors, and outcomes
Authors: Godown Justin , Bearl David W. , Thurm Cary , Hall Matt , Feingold Brian , Soslow Jonathan H. , Mettler Bret A. , Smith Andrew H. , Profita Elizabeth L. , Singh Tajinder P. , Dodd Debra A.
Published: April 2019

Primary graft dysfunction following HTx is associated with significant morbidity and mortality. This study aimed to assess the incidence of, risk factors for, and outcomes of children requiring ECMO within 24 hours of HTx. This study utilized a linked PHIS/SRTR database of pediatric HTx recipients (2002‐2016). Post‐HTx ECMO was identified using inpatient billing data. Logistic regression assessed risk factors for post‐HTx ECMO. Kaplan‐Meier analyses assessed in‐hospital mortality and post‐discharge survival. A total of 2820 patients were included with 224 (7.9%) requiring ECMO. Independent risk factors for post‐HTx ECMO include age <1 year (aOR: 2.2, 95% CI: 1.3‐3.7, P = 0.006) or 1‐5 years (aOR: 2.1, 95% CI: 1.3‐3.4, P = 0.002), and ECMO support at HTx (aOR: 27.4, 95% CI: 15.2‐49.6, P < 0.001). Survival to discharge decreased with increasing duration of post‐HTx ECMO support; 89% for 1‐3 days, 79.1% for 4‐6 days, 63.2% for 7‐9 days, and 18.8% for ≥10 days. There was no difference in long‐term survival for patients requiring post‐HTx ECMO who survived to hospital discharge (P = 0.434). There are identifiable risk factors associated with the need for ECMO in the post‐HTx period. Length of time on ECMO post‐HTx is strongly associated with the risk of in‐hospital mortality. Patients who require ECMO early post‐HTx and survive to discharge have comparable outcomes to patients who did not require ECMO.
Double benefits of mechanical wounding in enhancing chilling tolerance and lodging resistance in wheat plants
Authors: Si T. , Wang X. , Huang M. , Cai J. , Zhou Q. , Dai T. , Jiang D.
Published: April 2019

Chilling and lodging are major threats to wheat production. However, strategies that can be used to effectively mitigate the adverse effects of these threats are still far from clear. Mechanical wounding is a traditional agronomic measure, whereas information about the role it plays in wheat chilling and lodging is scant.

The aim of the present study was to investigate mechanisms underlying the protective roles of mechanical wounding in alleviating damage from chilling at jointing stage and enhancing lodging resistance after anthesis of winter wheat (Triticum aestivum L.).

Our data show that net photosynthesis rate, maximum photochemical efficiency of photosystem II, activity of the antioxidant enzymes and osmolytes were significantly increased in the latest fully expanded leaves of wounded plants under chilling. Wounding also reduced hydrogen peroxide accumulation, electrolyte leakage and water loss in wounded plants. Moreover, mechanical wounding significantly reduced the length but increased the diameter and wall thickness of the basal second internode of the main stem. Quantitative and histochemical analysis further indicated that wounding increased lignin accumulation and activity of enzymes involved in lignin synthesis, which resulted in increased mechanical strength and the lodging resistance index in the main stem.

We conclude from our data that mechanical wounding confers both cold tolerance by alleviating the damage caused by chilling at jointing stage and lodging resistance after anthesis of wheat plants.