bluuebunny/crossref_metadata_2025 huggingface dataset:
How to incorporate information on propagule pressure in the analysis of alien establishment success
Authors: Pigot Alex L. , Cassey Phillip , Blackburn Tim M.
Published: November 2017

Identifying the factors that determine the success of biological invasions has major consequences for both ecological theory and conservation decision‐making. Reliably inferring these factors depends on adequately accounting for the known effects of propagule pressure on establishment success, but detailed information on the size and number of introduced populations is often lacking.

Here, we conduct simulations to explore the effects of incomplete knowledge of propagule pressure on inferences regarding the correlates of establishment success. We compare situations where we have complete information on propagule number and propagule size across species, allowing success to be modelled at the population scale (population‐level analysis), with those where data for propagule size (species‐level analysis) and both propagule size and number (location‐level analysis) are unavailable. We assess the ability to correctly infer the effects of a covariate on establishment success when this covariate exhibits varying degrees of correlation with propagule pressure.

We show that when establishment success is modelled at the level of species, rather than populations, this leads to an elevated tendency to incorrectly infer the effects of species‐level traits on establishment success (higher type 1 error and lower power), particularly when traits in question are strongly associated with propagule pressure. These biases are magnified when using proxies for propagule pressure, such as the number of locations where species have been introduced, and are magnified further when these proxies are converted to binary variables.

Our results validate the current best practice for the analysis of establishment success in alien species at the population level, when the effects of propagule size and a covariate predicting establishment probability can both be reliably inferred. However, given the growing interest in understanding correlates of biological invasions, they strongly urge caution in interpreting results based on incomplete knowledge of propagule pressure.
Environmentally‐ and human‐induced body‐size responses in Macropus robustus and Macropus rufus, two widespread kangaroo species with largely overlapping distributions
Authors: Correll Rachel A. , Prowse Thomas A. A. , Prideaux Gavin J.
Published: November 2017

Progressive body‐size dwarfing of animal populations is predicted under chronic mortality stress, such as that inflicted by human harvesting. However, empirical support for such declines in body size due to elevated mortality is lacking. In fact, the size of three macropodid species ─ the two grey kangaroo species, Macropus fuliginosus and M. giganteus, and the Red‐necked Wallaby, M. rufogriseus ─ appears to have increased since European settlement in Australia, despite these species being subjected to size‐selective harvesting over this period. To test whether this unexpected trend also characterises other species, we sought evidence of human‐induced body‐size changes in the two most widely distributed kangaroo species, the Euro Macropus robustus and Red Kangaroo M. rufus, from the late 19th Century onwards. Spatial autoregressive models controlling for age, sex and island effects were first used to identify environmental predictors of body size and to evaluate multi‐causal explanations for spatial body‐size patterns. Primary productivity emerged as the key driver of body size in both species, while heat conservation was supported as a further mechanism explaining the large body size of M. robustus in cold climatic regions. After controlling for these environmental factors, we find that the size of M. rufus has been stable over time and limited support for a small increase in the size of M. robustus. Hence, there is no empirical evidence that contemporary size‐selective harvesting has reduced body size in these species. Rather, the latter result supports the possibility that pasture improvement and/or dingo control (and associated reduction in predation pressure) facilitated body‐size increases following European settlement in Australia.
Reproductive cycle of the oviparous lizard Sceloporus jalapae, from Zapotitlán Salinas, Puebla, Mexico
Authors: González‐Espinoza Jorge E. , Lemos‐Espinal Julio A. , Manríquez‐Morán Norma L. , Woolrich‐Piña Guillermo
Published: November 2017

Reproductive patterns vary widely among species and populations of squamates. In general, patterns can be divided into cyclic and acyclic. Cyclic patterns are common in tropical and temperate species of seasonal environments, while acyclic ones are characteristic of tropical species that inhabit less variable environments. We studied the reproductive cycle of Sceloporus jalapae, one of the smallest species of Sceloporus, in an arid environment at Zapotitlán Salinas, Puebla, Mexico. Both sexes mature in the first year following hatching and exhibit a seasonal reproductive pattern with maximum activity in spring and summer that appears to be influenced by temperature. Unlike small species of Sceloporus that inhabit pine–oak and tropical forests, S. jalapae exhibits an extended period of reproductive activity that allows females to produce at least two clutches of 3–7 eggs each, and contrary to other species of Sceloporus, in this species there is no correlation between female length and clutch size. The reproductive pattern of S. jalapae is like that shown by other oviparous species of the genus; nevertheless, some life history traits of this species are shared with oviparous and viviparous species of small size.
Improved Dynamic Predictions from Joint Models of Longitudinal and Survival Data with Time-varying Effects Using P-splines
Authors: Andrinopoulou Eleni-Rosalina , Eilers Paul H. C. , Takkenberg Johanna J. M. , Rizopoulos Dimitris
Published: November 2017

In the field of cardio-thoracic surgery, valve function is monitored over time after surgery. The motivation for our research comes from a study which includes patients who received a human tissue valve in the aortic position. These patients are followed prospectively over time by standardized echocardiographic assessment of valve function. Loss of follow-up could be caused by valve intervention or the death of the patient. One of the main characteristics of the human valve is that its durability is limited. Therefore, it is of interest to obtain a prognostic model in order for the physicians to scan trends in valve function over time and plan their next intervention, accounting for the characteristics of the data. Several authors have focused on deriving predictions under the standard joint modeling of longitudinal and survival data framework that assumes a constant effect for the coefficient that links the longitudinal and survival outcomes. However, in our case, this may be a restrictive assumption. Since the valve degenerates, the association between the biomarker with survival may change over time. To improve dynamic predictions, we propose a Bayesian joint model that allows a time-varying coefficient to link the longitudinal and the survival processes, using P-splines. We evaluate the performance of the model in terms of discrimination and calibration, while accounting for censoring.
The effect of technology choice on specialization and welfare in a two‐country model
Authors: Sawada Yukiko
Published: November 2017

This study presents a simple two‐country model in which firms in the manufacturing sector can choose a technology level (high or low). We show how trade costs and productivity levels affect technology choices by the firms in each country, where the fixed cost of adopting high technology differs between the two countries. This depends on the productivity level of the high technology. In particular, if the productivity of high technology is medium and trade costs are not too low, then a technology gap between countries arises. In this case, improving the productivity of the high technology country reduces the welfare level of consumers in the country in which low technology is adopted. To compensate for the welfare loss of the country from the technological improvement, trade costs should be reduced.
Torymidae (Hymenoptera, Chalcidoidea) revised: molecular phylogeny, circumscription and reclassification of the family with discussion of its biogeography and evolution of life‐history traits
Authors: Janšta Petr , Cruaud Astrid , Delvare Gérard , Genson Guénaëlle , Heraty John , Křížková Barbora , Rasplus Jean‐Yves
Published: November 2017

A phylogeny of the Torymidae (Chalcidoidea) is estimated using 4734 nucleotides from five genes. Twelve outgroups and 235 ingroup taxa are used, representing about 70% of the recognized genera. Our analyses do not recover Torymidae as monophyletic and we recognize instead two families: Megastigmidae (stat. rev.) and Torymidaes.s. (stat. rev.). Within Torymidaes.s., we recognize six subfamilies and six tribes, including Chalcimerinae, Glyphomerinae and Microdontomerinae (subf. nov.), and two new tribes: Boucekinini and Propalachiini (trib. nov.). Seven unclassified genera (i.e.Cryptopristus,Echthrodape,Exopristoides,Exopristus, part ofGlyphomerus,Thaumatorymus,Zaglyptonotus) are assigned to tribes within our new classification. Five genera are restored from synonymy—AmeromicrusandDidactyliocerusfrom underTorymoides(stat. rev.),IridophagaandIridophagoidesfrom underPodagrionella(stat. rev.) andNannocerusfrom underTorymus(stat. rev.)—and three genera are synonymized—AllotorymusunderTorymussyn. nov.,DitropinotusunderEridontomerussyn. nov.andPseuderimerusunderErimerussyn. nov.A Palaearctic or Eurasian origin for Torymidae is proposed. The ancestral area of Megastigmidae is indicated as the Australian region. The most probable ancestral life strategy for Torymidaes.s. is ectoparasitism on gall‐forming Cynipidae. The life strategy and putative hosts of the common ancestor of Megastigmidae remain uncertain.
Fracture behavior, marginal gap width, and marginal quality of vented or pre‐cemented CAD/CAM all‐ceramic crowns luted on Y‐TZP implants
Authors: Zaugg Lucia K. , Meyer Simon , Rohr Nadja , Zehnder Isabella , Zitzmann Nicola U.
Published: November 2017

Objectives

To investigate the fracture behavior and marginal gap region of CAD/CAM fabricated lithium disilicate (L) and zirconium dioxide (Z) crowns using palatal venting (PV), pre‐cementation with custom analogs (CA), or conventional cementation technique (SP) with adhesive cement (A) or resin‐modified glass ionomer cement (B).

Material and methods

Twelve groups (n = 6) were set according to material (L, Z), cement (A, B), and technique (PV, CA, SP). Specimens were thermo‐mechanical aged (TML), loaded until fracture (LF) and fracture patterns recorded. Marginal gap width and quality were assessed and compared to replicas obtained before and after TML.

Results

Crown material significantly influenced LF with a mean of 1037.6 ± 282.4 N in L and 5356.3 ± 1207.0 N in Z groups (p < .001). Neither cement material nor cementation method affected the outcome. Fractures occurred along the mesial‐distal central fissure in both materials. Gap width before TML was 22.04 ± 13.42 μm for L and 19.98 ± 12.72 μm for Z specimens, with overall no influence of crown material, cement type, or method. Marginal cleanliness just below the polished implant shoulder reached 66.7%–88.9% with A, and 91.7%–100% with B, and tended to increase in all groups during TML indicating a decrease in excess cement. Implant‐crown junctions were cleaner with B compared to A (p ≤ .001) and along Z crown surfaces compared to L (p ≤ .007).

Conclusions

Crown venting of lithium disilicate and zirconium dioxide crowns did not affect the fracture load and patterns. Complete cement removal was rare, and the observed particle ablation requires further clinical attention, particularly with submucosal margins.
Multicentre observational study of gastrointestinal recovery after elective colorectal surgery
Authors:   Yorkshire Surgical Research Collaborative
Published: November 2017

Aim

Postoperative ileus (POI) is characterised by delayed gastrointestinal recovery and is common after colorectal surgery. Numerous strategies to optimise POI have been proposed but its management remains an unmet clinical need. This study aimed to characterise the duration and management of gastrointestinal recovery in patients undergoing elective colorectal surgery.

Method

A snapshot, prospective, observational study was undertaken between November 2016 and January 2017 at 10 regional hospitals in the United Kingdom. Adult patients undergoing elective colorectal surgery with resection of bowel or reversal of stoma were included. Outcomes included time until return of gastrointestinal function, timing of nasogastric tube (NGT) insertion, uptake of targeted interventions and clinical outcomes. Data were validated for accuracy by independent investigators.

Results

204 patients met the eligibility criteria. The median time for gastrointestinal recovery was 3 days (IQR 2–4); right‐sided resections were associated with longer gastrointestinal recovery than left sided (4 days (2.75–5.25) vs 3 days (2–4); P = 0.002). The rate of NGT insertion was 22.5% at a median time of 4 (4–4.75) days. NGT insertion after vomiting was associated with a higher incidence of bronchopneumonia compared to early placement (13.3% vs 29.0%). Targeted interventions, such as chewing gum (4.4%), selective mu‐receptor antagonists (1.0%) and pro‐kinetic agents (13.7%) were infrequently used.

Conclusion

The average time to gastrointestinal recovery after elective colorectal surgery was three days. Late NGT insertion was associated with an increased incidence of bronchopneumonia. The clinical uptake of targeted interventions to improve gastrointestinal recovery was poor.
Utility of flexible bronchoscopy with polymerase chain reaction in the diagnosis and management of pulmonary infiltrates in allogeneic HSCT patients
Authors: Tang Fei‐Fei , Zhao Xiao‐Su , Xu Lan‐Ping , Zhang Xiao‐Hui , Chen Yu‐Hong , Mo Xiao‐Dong , Liu Kai‐Yan , Huang Xiao‐Jun
Published: November 2017

Objectives

Pulmonary infiltrates in allogeneic hematopoietic stem cell transplant (allo‐HSCT) patients are potentially life‐threatening and require early diagnosis and treatment. We aimed to retrospectively explore the clinical efficacy of polymerase chain reaction (PCR) in conjunction with flexible bronchoscopy (FB) in allo‐HSCT patients with pulmonary infiltrates.

Patients and methods

We retrospectively reviewed all patients undergoing FB after allo‐HSCT at the Peking University Institute of Hematology from January 2013 to December 2016. We used PCR to detect various viruses in FB specimens, particularly for 27 viruses.

Results

One hundred forty‐nine diagnostic FBs were performed in 130 patients. The overall diagnostic yield was 58%. Eighty‐nine percent of the patients with a positive FB result were diagnosed with a pulmonary infection. Viruses were the most common infectious diagnosis (70%), followed by fungi (48%), bacteria (38%), and Pneumocystis jirovecii (12%). Multivariate analyses showed that a chest computed tomography (CT) finding of diffuse pulmonary infiltrates (P = .012) and positive results in assisted microbiological and serological analyses (P = .000) predicted a positive FB result. FB results prompted a treatment modification in 61% of cases.

Conclusions

FB in conjunction with PCR is efficient in the rapid diagnosis and management of pulmonary infiltrates in allo‐HSCT patients.
Educational effects using a robot patient simulation system for development of clinical attitude
Authors: Abe S. , Noguchi N. , Matsuka Y. , Shinohara C. , Kimura T. , Oka K. , Okura K. , Rodis O. M. M. , Kawano F.
Published: November 2017

Introduction

The aim of this study was to assess the effectiveness of improving the attitude of dental students towards the use of a full‐body patient simulation system (SIMROID) compared to the traditional mannequin (CLINSIM) for dental clinical education.

Materials and methods

The participants were 10 male undergraduate dental students who had finished clinical training in the university hospital 1 year before this study started. They performed a crown preparation on an upper pre‐molar tooth using SIMROID and CLINSIM as the practical clinical trials. The elapsed time for preparation was recorded. The taper of the abutment teeth was measured using a 3‐dimensional shape‐measuring device after this trial. In addition, a self‐reported questionnaire was collected that included physical pain, treatment safety and maintaining a clean area for each simulator. Qualitative data analysis of a free format report about SIMROID was performed using text mining analysis. This trial was performed twice at 1‐month intervals.

Results

The students considered physical pain, treatment safety and a clean area for SIMROID significantly better than that for CLINSIM (P < .01). The elapsed time of preparation in the second practical clinical trial was significantly lower than in the first for SIMROID and CLINSIM (P < .01). However, there were no significant differences between the abutment tapers for both systems. For the text mining analysis, most of the students wrote that SIMROID was similar to real patients.

Conclusion

The use of SIMROID was proven to be effective in improving the attitude of students towards patients, thereby giving importance to considerations for actual patients during dental treatment.
Undergraduate dental students’ perceptions of head and neck anatomy teaching in Australia
Authors: Hassan N. M. , Akhter R. , Al‐Aubaidy H. , Flatau A.
Published: November 2017

Introduction

Most Australian universities have abbreviated the anatomy curriculum and modified its mode of delivery. This study examines dental student perceptions of different methods of head and neck anatomy teaching with respect to the adequacy of allocated time and the relative meaningfulness of the teaching methods.

Methods

All second‐year students in the School of Dentistry and Health Sciences at Charles Sturt University (CSU) were invited to complete a matrix‐grid questionnaire. Participants were asked to score four methods of teaching (lectures, study of prosected materials, tutorials and quizzes) using a 5‐point Likert scale. The questionnaire included questions about the time adequacy for anatomy lectures, tutorials and laboratory study, and the potential value of learning anatomy through the study of prosected materials. SPSS (Version 21.0) was used to analyse the data, and statistical significance was set at 0.05.

Results

Seventy‐two students (79.5%) responded to the survey. Overall, learning anatomy through the study of prosected materials was the single highest scored method, followed by lectures, tutorials and quizzes. Graduate entrants felt that not enough time was devoted to learning anatomy through the study of prosected materials, compared with school leavers (89.4% and 10.6%, respectively), having one extra session of learning in the anatomy laboratory (71.4% and 28.6%, respectively) and adding dissection (75.0% and 25.0%, respectively) would be helpful.

Conclusion

This study demonstrates that dental students perceive the study of prosected materials in the wet laboratory as the most valuable method of learning anatomy, but an extended anatomy curriculum would be even more effective and appreciated.
Individual choice or collective action? Exploring consumer motives for participating in alternative food networks
Authors: Zoll Felix , Specht Kathrin , Opitz Ina , Siebert Rosemarie , Piorr Annette , Zasada Ingo
Published: November 2017

Alternative food networks (AFNs) are growing in number and relevance in Germany. Those networks include new models of production and distribution, such as food cooperatives (FoodCoops), self‐harvest gardens or community‐supported agriculture (CSA) schemes. AFNs, as an alternative to conventional food supply systems, are characterized by a close producer‐consumer interaction. They are typically located within urban or peri‐urban areas. The study aims to identify the rationale and motivation of urban residents in participating in AFNs and developing a consumer typology. We also assess whether AFNs potentially lead to collective action with societal impact. Therefore, we conducted a qualitative content analysis based on 18 interviews with members of existing AFN projects in three German metropolitan regions. Our results revealed that the willingness of urban consumers to participate in AFNs is driven by a broad range of motives. They include personal desire for high‐quality food (in terms of taste or freshness) and health reasons, but also political or environmental motives (opposition to conventional agriculture or short transport distances). Furthermore, consumers often want to support a certain farmer and his/her philosophy or they appreciate the community‐building aspect. Three different consumer types were derived from the motive combinations. Many consumers communicated a sense of belonging to a societal movement, however, our study revealed a lack of organization and collective action. Although AFNs can influence the consumption patterns of individuals, their potential to induce social change and to challenge traditional models of consumption in the near future does not appear to be high.
Clinicopathologic characteristics of early‐onset Becker's nevus in Korean children and adolescents
Authors: Kim Young J. , Roh Mi R. , Lee Ji H. , Na Jung I. , Ko Joo Y. , Jung Joon M. , Lee Jong H. , Chang Sung E.
Published: November 2017

Background

Becker's nevus (BN) presents as a hairy patch or plaque with or without proliferation of the dermal smooth muscles. BN has been described as acquired as found in a similar entity, congenital smooth muscle hamartoma (CSMH). This study was aimed at evaluating the clinicopathological aspects of BN in Korean cases in differential diagnosis with CSMH.

Methods

We performed a retrospective study of 103 patients histopathologically diagnosed as having BN or CSMH. The cases included 40 cases diagnosed with BN or CSMH before the age of 10 years who had clinical monitoring and a second skin biopsy after puberty to determine the disease course.

Results

Among cases of children to adolescents (<18 years), we observed a slight male predominance. Among children aged <14 years, sex ratio converged at 1:1. Early‐onset BN showed a female predominance and hyperpigmented skin lesions. All BN cases showed hyperpigmentation, and face and neck involvement tended to make severe cosmetic concerns. In contrast, hypertrichosis was more frequent in CSMH. Either skin‐colored lesion or pseudo‐Darier's sign was not seen in early‐onset BN. BN showed less dermal smooth muscle than CSMH.

Conclusions

Androgens themselves do not seem to be related to the development of BN but play only an aggravating role especially in male patients. Considering high occurrence in exposed areas, BN may distress patients severely. As early laser treatment may be helpful in some patients with BN, early‐onset BN in comparison to CSMH should be diagnosed appropriately.
A narrative review of dermatologic protocols for primary care medical service trips in Latin America and the Caribbean
Authors: Dainton Christopher , Chu Charlene H.
Published: November 2017

Background

Skin disorders are prevalent on primary care medical service trips in Latin America and the Caribbean and commonly include scabies, superficial mycoses, and pyoderma. There have been no previous attempts to describe protocols that international volunteer clinicians use in managing these patients. The purpose of this study was to collect North American clinical protocols used by sending organizations in their volunteer operations in Latin America and the Caribbean, summarize the most common pharmacologic and nonpharmacologic management strategies, and compare these to published international practice recommendations.

Methods

A systematic web search was used to identify North American medical service trip‐sending organizations. Clinical protocols were downloaded from their websites, and organizations were directly contacted to request protocols that were not published online. The protocols obtained were summarized, analyzed thematically, and compared to existing international guidelines.

Results

Of 225 organizations contacted, 112 (49.8%) responded, and 31 of these (27.7%) claimed to possess protocols for their trips, of which 20 were obtained and analyzed. Ten (50%) protocols discussed scabies, eight (40%) discussed superficial mycoses, and five (25%) discussed pyoderma. The protocols discussed clinical assessment, pharmacologic and nonpharmacologic management with variable degrees of accuracy and thoroughness, and with important omissions when compared to international guidelines. None were the product of systematic literature searches, and most were not referenced.

Conclusions

To avoid ineffective treatment and related harms, context‐specific clinical guidelines are needed for volunteer clinicians practicing in remote international settings, and such guidelines should be based on best evidence and stakeholder consensus.
Duopolistic competition with multiple scenarios and different attitudes toward uncertainty
Authors: Monroy L. , Caraballo M.A. , Mármol A.M.
Published: November 2017

In this paper, we address duopolistic competition when the firms have to assess the results of the interaction at different scenarios. Specifically, we consider the case in which the scenarios are identified with several states of nature and, therefore, the firms face uncertainty on their results. The probability of occurrence of the scenarios is unknown by the firms and they make their output decision before uncertainty is resolved. Within this framework, we analyze competition between firms when these firms exhibit extreme and neutral attitudes toward uncertainty with respect to the final profits. For the variety of cases that can occur, we characterize the sets of equilibria, and provide procedures to determine them. The analysis proposed can also be applied to study situations in a deterministic setting with simultaneous multiple scenarios, and to the analysis of multiple criteria duopolistic competition.
Language Matters, So Geriatricians Should Talk of Declining Health and Death
Authors: Lynn Joanne
Published: November 2017

See the Reply by Lundebjerg et al.
Early electrophysiological findings in acute inflammatory demyelinating polyradiculoneuropathy variant of Guillain‐Barre syndrome in the Pakistani population – a comparison with global data
Authors: Wali Ahmad , Kanwar Dureshahwar , Khan Safoora A. , Khan Sara
Published: November 2017

Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy are the most common variants of Guillian‐Barre syndrome documented in the Asian population. However, the variability of early neurophysiologic findings in the Asian population compared to western data has not been documented. Eighty‐seven cases of AIDP were retrospectively reviewed for their demographic, clinical, electrophysiological, and laboratory data. Mean age of subjects was 31 ± 8 years with males more commonly affected. Motor symptoms (97%) at presentation predominated. Common early nerve conduction findings included low motor amplitudes (85%), recordable sural sensory responses (85%), and absent H‐reflex responses (65%). Prolonged F‐latencies were found most commonly in posterior tibial nerves (23%) in the lower limbs and median and ulnar nerves (18%) in the upper limbs. Blink reflex (BR) studies were performed in 57 patients and were abnormal in 80% of those with clinical facial weakness and in 17 of 52 patients (33%) with no clinical cranial nerve signs, suggesting subclinical cranial nerve involvement. Abnormal motor and sensory amplitudes are seen early. Prolonged distal latencies, temporal dispersion/conduction blocks and sural sparing pattern are other common early nerve conduction study findings of AIDP seen in the Pakistani population. There are no significant differences in abnormalities of conduction velocities and delayed reflex responses compared to published data. The BR can help in the early diagnosis of AIDP.
A multi‐centre randomised clinical trial of oral hygiene interventions following stroke—A 6‐month trial
Authors: Ab Malik N. , Mohamad Yatim S. , Abdul Razak F. , Lam O. L. T. , Jin L. , Li L. S. W. , McGrath C.
Published: November 2017

Maintaining good oral hygiene is important following stroke. This study aimed to evaluate the effectiveness of two oral health promotion (OHP) programmes to reduce dental plaque levels following stroke. A multi‐centre randomised clinical control trial was conducted among patients hospitalised following stroke in Malaysia. Patients were randomly allocated to two OHP groups: (i) control group who received the conventional method for plaque control—daily manual tooth brushing with a standardised commercial toothpaste, (ii) test group—who received an intense method for plaque control—daily powered tooth brushing with 1% Chlorhexidine gel. Oral health assessments were performed at baseline, at 3 months and 6 months post‐intervention. Within‐ and between‐group changes in dental plaque were assessed over time. Regression analyses were conducted on dental plaque levels at 6 months controlling for OHP group, medical, dental and socio‐demographic status. The retention rate was 62.7% (54 of 86 subjects). Significant within‐group changes of dental plaque levels were evident among the test group (P < .001) and the control group (P < .001). No significant between‐group changes of dental plaque levels were apparent (P > .05). Regression analyses identified that baseline plaque levels (adjusted ß = 0.79, P < .001) and baseline functional dependency level (adjusted ß = −0.34, P < .05) were associated with dental plaques levels at the end of the trial (6 months). Both, “Conventional” and “Intense” oral health promotion programmes may successfully reduce dental plaque during stroke rehabilitation and are of comparable effectiveness. Baseline dental plaque levels and functional dependency level were key factors associated with dental plaque levels at follow‐up at 6 months.
Formation and mosaicity of coccolith segment calcite of the marine algae Emiliania huxleyi
Authors: Yin Xiaofei , Ziegler Andreas , Kelm Klemens , Hoffmann Ramona , Watermeyer Philipp , Alexa Patrick , Villinger Clarissa , Rupp Ulrich , Schlüter Lothar , Reusch Thorsten B. H. , Griesshaber Erika , Walther Paul , Schmahl Wolfgang W.
Published: November 2017

Coccolithophores belong to the most abundant calcium carbonate mineralizing organisms. Coccolithophore biomineralization is a complex and highly regulated process, resulting in a product that strongly differs in its intricate morphology from the abiogenically produced mineral equivalent. Moreover, unlike extracellularly formed biological carbonate hard tissues, coccolith calcite is neither a hybrid composite, nor is it distinguished by a hierarchical microstructure. This is remarkable as the key to optimizing crystalline biomaterials for mechanical strength and toughness lies in the composite nature of the biological hard tissue and the utilization of specific microstructures.

To obtain insight into the pathway of biomineralization of Emiliania huxleyi coccoliths, we examine intracrystalline nanostructural features of the coccolith calcite in combination with cell ultrastructural observations related to the formation of the calcite in the coccolith vesicle within the cell. With TEM diffraction and annular dark‐field imaging, we prove the presence of planar imperfections in the calcite crystals such as planar mosaic block boundaries. As only minor misorientations occur, we attribute them to dislocation networks creating small‐angle boundaries. Intracrystalline occluded biopolymers are not observed. Hence, in E. huxleyi calcite mosaicity is not caused by occluded biopolymers, as it is the case in extracellularly formed hard tissues of marine invertebrates, but by planar defects and dislocations which are typical for crystals formed by classical ion‐by‐ion growth mechanisms. Using cryo‐preparation techniques for SEM and TEM, we found that the membrane of the coccolith vesicle and the outer membrane of the nuclear envelope are in tight proximity, with a well‐controlled constant gap of ~4 nm between them. We describe this conspicuous connection as a not yet described interorganelle junction, the “nuclear envelope junction”. The narrow gap of this junction likely facilitates transport of Ca2+ ions from the nuclear envelope to the coccolith vesicle. On the basis of our observations, we propose that formation of the coccolith utilizes the nuclear envelope–endoplasmic reticulum Ca2+‐store of the cell for the transport of Ca2+ ions from the external medium to the coccolith vesicle and that E. huxleyi calcite forms by ion‐by‐ion growth rather than by a nanoparticle accretion mechanism.
Disappearance of perihepatic lymph node enlargement after hepatitis C viral eradication with direct‐acting antivirals
Authors: Hikita H. , Sato Masaya , Endo Momoe , Sato Mamiko , Soroida Y. , Kobayashi T. , Gotoh H. , Iwai T. , Nakagomi R. , Tateishi R. , Komuro T. , Sone S. , Koike K. , Yatomi Y. , Ikeda H.
Published: November 2017

Perihepatic lymph node enlargement (PLNE) which has been shown to be negatively associated with hepatocellular carcinoma (HCC) occurrence is frequently observed in chronic liver disease; however, changes in the state of perihepatic lymph nodes after eradication of hepatitis C virus (HCV) have not been investigated yet. We aimed to evaluate this issue. We enrolled 472 patients with chronic HCV infection who achieved viral eradication with direct‐acting antivirals (DAA). We investigated whether the status of perihepatic lymph nodes changed before and after HCV eradication (primary endpoint). We also evaluated the association between PLNE and clinical findings such as liver fibrosis or hepatocellular injury before HCV eradication (secondary endpoint). Perihepatic lymph node enlargement was detected in 164 of 472 (34.7%) patients before DAA treatment. Surprisingly, disappearance of PLNE was observed in 23.8% (39 patients) of all PLNE‐positive patients after eradication of HCV. Disappearance of PLNE was not associated with baseline clinical parameters or changing rates of clinical findings before and after DAA treatment. At baseline, presence of PLNE was significantly associated with a lower serum HCV‐RNA level (P = .03), a higher serum AST level (P = .004) and a higher ALT level (P < .001) after adjustment for sex and age. In conclusion, PLNEs became undetectable after DAA treatment in 23.8% of PLNE‐positive patients. Further study with a longer follow‐up period is needed to clarify the clinical importance of this phenomenon especially in relationship with the risk of HCC development.
Unconventional T cells in chronic hepatitis B patients on long‐term suppressive therapy with tenofovir followed by a Peg‐IFN add‐on strategy: A randomized study
Authors: Cannizzo E. S. , Tincati C. , Binda F. , Ronzi P. , Cazzaniga F. A. , Antinori S. , d'Arminio Monforte A. , Marchetti G. , Milazzo L.
Published: November 2017

HBV eradication in chronic hepatitis B (CHB) subjects is rarely achieved with either nucleos(t)ide analogues (NA) or pegylated interferon (Peg‐IFN), which both have a limited effect in restoring immune responses. Thirty CHB subjects on long‐term treatment with tenofovir (TDF) and HBV suppression were enrolled and randomized 1:2 to either receive Peg‐IFN‐α‐2a add‐on therapy or continue TDF alone. We studied γδ T and iNKT frequency and function (by flow cytometry) at baseline, at 12 weeks and 12 weeks after the end of treatment. A higher reduction in qHBsAg occurred in the add‐on group compared with the NA group at W12 (P = .016) and at W24 (P = .012). A decline of qHBsAg ≥0.5 log10 at week 24 occurred in 4 of 10 patients in the add‐on arm and 1 of 20 in the NA arm, respectively (P = .03). HBsAg loss was seen in 20% of subjects in the add‐on group and in none of the NA group. Compared to HBV negative, CHB on TDF showed lower frequency of iNKT (P = .03) and γδ T cells (P = .03) as well as fewer γδ T cells expressing Vδ2 T‐cell receptors (P = .005). No changes in unconventional T‐cell frequency and function were shown in both add‐on and NA patients nor were differences detected between the two treatment groups. We report persistent impairment of unconventional T cells in CHB. Despite a greater qHBsAg decline of add‐on patients, our data failed to detect any effect of Peg‐IFN treatment on unconventional T cells.
Redemption for a Postsecular Age
Authors: Wells John
Published: November 2017

This essay examines how Theodor Adorno's criteria for aesthetic redemption provide the organizing principle within John Banville's Athena. By examining aesthetic theories by Sventlana Alpers, Ernst Gombrich, and Adorno himself as they appear within the narrator's descriptions of northern European seventeenth‐century paintings, the author illustrates how Banville's novel not only reflects debates about whether seventeenth‐century art proves descriptive or narrative but also compels the Adornian reflective process that attends to the nonidentity between one's own categories and the material before one. That process turns readers’ attention back to Banville's confessional narrative, which develops through vivid depictions of the narrator's meandering quest to atone for a murder committed in this trilogy's first novel. By undermining conventions for the confessional format, Banville's novel engages readers in reflection on the dissonance within the novel and provides a portrait of the conditions of contemporary subjectivity that carries guilt for historical suffering yet still aspires toward redemption.
Late potentials and their correlation with ventricular structure in patients with ventricular arrhythmias
Authors: Marstrand Peter , Axelsson Anna , Thune Jens Jakob , Vejlstrup Niels , Pehrson Steen , Bundgaard Henning , Theilade Juliane
Published: November 2017

Introduction

The presence of late potentials (LP) may indicate a predisposition to ventricular arrhythmias and sudden cardiac death. We investigated the association between presence of LP and structural cardiac anomalies assessed by magnetic resonance (CMR) in patients presenting with ventricular arrhythmias.

Methods

We included 42 patients admitted with ventricular tachycardia or fibrillation who had undergone both signal‐averaged ECG recording and CMR imaging. Clinical data and CMR findings were compared in patients with and without LP.

Results

The majority, 26 (62%) patients, were sudden cardiac death survivors and the remaining 16 (38%) were admitted with ventricular tachycardia. After full diagnostic work‐up, the most common diagnoses in the cohort were idiopathic ventricular tachycardia/ventricular fibrillation (25 patients, 60%) or cardiomyopathies (11 patients, 26%). LPs were positive in 29 (69%) when using the revised Task Force criteria. When comparing patients with and without late potentials, there were no significant differences in right ventricular size relative to body surface area (102 mL/m2 vs 92 mL/m2), right ventricular ejection fraction (55% vs 58%), or positive late gadolinium enhancement (29% vs 24%).

Conclusions

Among patients with malignant arrhythmias, the presence of LP does not distinguish between patients with normal and abnormal RV structure or function on CMR. LP may indicate the presence of an arrhythmic heart disease beyond what can be inferred from CMR. The frequent finding of late potentials indicates that the diagnostic value of LP as an ARVC criteria should be tested in larger studies comparing ARVC patients and controls.
The effect of an ultra‐low frame rate and antiscatter grid‐less radiation protocol for cardiac device implantations
Authors: Attanasio Philipp , Schreiber Tobias , Parwani Abdul , Lacour Philipp , Pieske Burkert , Haverkamp Wilhelm , Blaschke Florian , Huemer Martin
Published: November 2017

Background and aims

Antiscatter grids improve image contrast by absorbing scattered x‐ray beams, although by removing the antiscatter grid patient dose can be reduced as more x‐ray beams reach the image receptor. Additionally, there is a trend toward ultra‐low frame rates for radiation dose reduction during various electrophysiology procedures. As for most cardiac device implantations (CIED) image quality demands are usually modest, the purpose of this study was to assess the safety and efficacy of an ultra‐low frame rate and scatter grid‐less radiation protocol.

Methods/results

A total of 140 patients undergoing CIED implantation between 2014 and 2017 were included in the study. Seventy patients (50%) implanted after implementation of the antiscatter grid‐less and ultra‐low frame rate protocol were matched to controls before the dose‐reduction protocol was established. Forty patients (28.6%) had a one‐chamber pacemaker or one‐chamber implantable cardioverter defibrillator (ICD) implantation/revision, 60 (42.9%) had a two‐chamber pacemaker or two‐chamber ICD implantation/revision, and 40 (28.6%) patients had a cardiac resynchronization therapy device implantation/revision. Removing the antiscatter‐grid and lowering the frame rate led to a 73% reduction of the overall dose area product (1,206 ± 2,015 vs 324 ± 422 μGym, P < 0.001). Procedural duration (95 ± 51 minutes vs 82 ± 44 minutes, P  =  0.053) and rate of complications were not significantly different between the two groups.

Conclusion

The use of an ultra‐low frame rate and antiscatter grid‐less radiation protocol significantly reduced radiation dose for implantation of CIED and led to very low average patient doses, while procedural duration and complication rates did not increase.
Age of platelet concentrates and time to the next transfusion
Authors: Caram‐Deelder Camila , van der Bom Johanna G. , Putter Hein , Leyte Anja , Kerkhof Daan van de , Evers Dorothea , Beckers Erik A. , Weerkamp Floor , Hudig Francisca , Zwaginga Jaap Jan , Rondeel Jan M.M. , de Vooght Karen M.K. , Péquériaux Nathalie C.V. , Visser Otto , Wallis Jonathan P. , Middelburg Rutger A.
Published: November 2017

BACKGROUND

Storage time of platelet (PLT) concentrates has been negatively associated with clinical efficacy outcomes. The aim of this study was to quantify the association between storage time of PLT concentrates and interval to the next PLT transfusion for different types of PLT components, stored for up to 7 days and transfused to transfusion‐dependent hematooncology patients with thrombocytopenia.

STUDY DESIGN AND METHODS

From a cohort of patients from 10 major Dutch hospitals, patients were selected whose transfusion patterns were compatible with PLT transfusion dependency due to hematooncologic disease. Mean time to the next transfusion and mean differences in time to the next transfusion for different storage time categories (i.e., fresh, <4 days; intermediate, 4‐5 days; and old, >5 days) were estimated, per component type, using multilevel mixed‐effects linear models.

RESULTS

Among a cohort of 29,761 patients who received 140,896 PLT transfusions we selected 4441 hematooncology patients who had received 12,724 PLT transfusions during periods of PLT transfusion dependency. Transfusion of fresh, compared to old, buffy coat–derived PLTs in plasma was associated with a delay to the next transfusion of 6.2 hours (95% confidence interval [CI], 4.5‐8.0 hr). For buffy coat–derived PLTs in PAS‐B and ‐C this difference was 7.7 hours (95% CI, 2.2‐13.3 hr) and 3.9 hours (95% CI, –2.1 to 9.9 hr) while for apheresis PLTs in plasma it was only 1.8 hours (95% CI, –3.5 to 7.1 hr).

CONCLUSION

Our results indicate that the time to the next transfusion shortens with increasing age of transfused buffy coat–derived PLT concentrates. This association was not observed for apheresis PLTs.
Simulation of Multistage Compressor at Off-Design Conditions
Authors: Wang Feng , Carnevale Mauro , di Mare Luca , Gallimore Simon
Published: November 2017

Computational fluid dynamics (CFD) has been widely used for compressor design, yet the prediction of performance and stage matching for multistage, high-speed machines remains challenging. This paper presents the authors' effort to improve the reliability of CFD in multistage compressor simulations. The endwall features (e.g., blade filet and shape of the platform edge) are meshed with minimal approximations. Turbulence models with linear and nonlinear eddy viscosity models are assessed. The nonlinear eddy viscosity model predicts a higher production of turbulent kinetic energy in the passages, especially close to the endwall region. This results in a more accurate prediction of the choked mass flow and the shape of total pressure profiles close to the hub. The nonlinear viscosity model generally shows an improvement on its linear counterparts based on the comparisons with the rig data. For geometrical details, truncated filet leads to thicker boundary layer on the filet and reduced mass flow and efficiency. Shroud cavities are found to be essential to predict the right blockage and the flow details close to the hub. At the part speed, the computations without the shroud cavities fail to predict the major flow features in the passage, and this leads to inaccurate predictions of mass flow and shapes of the compressor characteristic. The paper demonstrates that an accurate representation of the endwall geometry and an effective turbulence model, together with a good quality and sufficiently refined grid, result in a credible prediction of compressor matching and performance with steady-state mixing planes.
Time-Dependent System Reliability Analysis for Bivariate Responses
Authors: Hu Zhen , Zhu Zhifu , Du Xiaoping
Published: November 2017

Time-dependent system reliability is computed as the probability that the responses of a system do not exceed prescribed failure thresholds over a time duration of interest. In this work, an efficient time-dependent reliability analysis method is proposed for systems with bivariate responses which are general functions of random variables and stochastic processes. Analytical expressions are derived first for the single and joint upcrossing rates based on the first-order reliability method (FORM). Time-dependent system failure probability is then estimated with the computed single and joint upcrossing rates. The method can efficiently and accurately estimate different types of upcrossing rates for the systems with bivariate responses when FORM is applicable. In addition, the developed method is applicable to general problems with random variables, stationary, and nonstationary stochastic processes. As the general system reliability can be approximated with the results from reliability analyses for individual responses and bivariate responses, the proposed method can be extended to reliability analysis of general systems with more than two responses. Three examples, including a parallel system, a series system, and a hydrokinetic turbine blade application, are used to demonstrate the effectiveness of the proposed method.