bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a newly‐devised nutritional guide based on self‐efficacy for patients with type 2 diabetes in Japan over 2 years: 1‐year intervention and 1‐year follow‐up studies
Authors: Yamamoto Takuya , Moyama Shota , Yano Hideki
Published: August 2016

Aims/Introduction

We devised a new system called “Educational Guidance” (E‐Guide) for nutritional education based on self‐efficacy. The present study aimed to examine the effects of E‐Guide use on glycemic control among patients with type 2 diabetes.

Materials and Methods

We carried out an interventional and observational study that included 74 patients with type 2 diabetes. The extent of glycemic control in the 39 patients who received guidance through the E‐Guide (E‐Guide group) was compared with that of 35 patients who received conventional nutritional guidance (control group). We carried out a 1‐year follow‐up survey (subanalysis) based on the electronic health records of 18 patients from the E‐guide group and 19 patients from the control group. These patients continued treatment at Hikone Municipal Hospital, Hikone, Shiga, Japan. Changes in glycated hemoglobin levels, body mass index and medication dose were examined from time of enrollment to the end of the 1‐year intervention, and during the 1‐year follow‐up.

Results

Decreases in glycated hemoglobin levels were more pronounced in the E‐Guide group than in the control group during the intervention period (P < 0.05). The levels further decreased during the follow‐up period (P < 0.01). In the E‐Guide group, body mass index decreased significantly throughout the follow‐up period (P < 0.001). Additionally, increased medication doses were significantly less common in the E‐Guide group than in the control group (P < 0.01).

Conclusions

Intervention based on our “E‐Guide” is more useful and powerful than the conventional methods for glycemic control and self‐care behavior among patients with type 2 diabetes in Japan.
β‐Caryophyllene protects in vitro neurovascular unit against oxygen‐glucose deprivation and re‐oxygenation‐induced injury
Authors: Tian Xiaocui , Peng Jianhua , Zhong Jianjun , Yang Mei , Pang Jinwei , Lou Jie , Li Minghang , An Ruidi , Zhang Qian , Xu Lu , Dong Zhi
Published: August 2016

β‐Caryophyllene (BCP) mediates neuroprotection in cerebral ischemic animals. The neurovascular unit (NVU) acts as an intricate network to maintain the neuronal homeostatic microenvironment. However, the effects exerted by BCP on NVU remain unclear. Therefore, we established an in vitro NVU model to investigate the effects of BCP on oxygen‐glucose deprivation and re‐oxygenation (OGD/R)‐induced injury. This model involved the co‐culture of brain microvascular endothelial cells, neurons, and astrocytes. BCP (10 μmol/L) was applied for 24 h prior to OGD/R and maintained throughout OGD/R. Blood–brain barrier (BBB) integrity and neuronal apoptosis were analyzed. BCP pre‐treatment prior to the initiation of OGD/R significantly (i) decreased BBB permeability and neuronal apoptosis, (ii) mitigated oxidative stress damage and the release of inflammatory cytokines, (iii) down‐regulated Bax expression, metalloproteinase‐9 activity and expression, and (iv) up‐regulated claudin‐5, occludin, ZO‐1, growth‐associated protein‐43 and Bcl‐2 expression. Thus, BCP pre‐treatment exerted multiple protective effects on NVU in the context of OGD/R‐induced injury. These protective effects potentially occur via reductions in oxidative stress damage and inflammatory cytokines that induce BBB breakdown, subsequently resulting in reduced neuronal apoptosis. The NVU serves as putative therapeutic targets for cerebral ischemia, and the results of this study provide new insights for the application of BCP as a neuroprotective agent.

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C‐terminal of human histamine H1receptors regulates their agonist‐induced clathrin‐mediated internalization and G‐protein signaling
Authors: Hishinuma Shigeru , Nozawa Hiroki , Akatsu Chizuru , Shoji Masaru
Published: August 2016

It has been suggested that the agonist‐induced internalization of G‐protein‐coupled receptors from the cell surface into intracellular compartments regulates cellular responsiveness. We previously reported that Gq/11‐protein‐coupled human histamine H1receptors internalized via clathrin‐dependent mechanisms upon stimulation with histamine. However, the molecular determinants of H1receptors responsible for agonist‐induced internalization remain unclear. In this study, we evaluated the roles of the intracellular C‐terminal of human histamine H1receptors tagged with hemagglutinin (HA) at the N‐terminal in histamine‐induced internalization in Chinese hamster ovary cells. The histamine‐induced internalization was evaluated by the receptor binding assay with [3H]mepyramine and confocal immunofluorescence microscopy with an anti‐HA antibody. We found that histamine‐induced internalization was inhibited under hypertonic conditions or by pitstop, a clathrin terminal domain inhibitor, but not by filipin or nystatin, disruptors of the caveolar structure and function. The histamine‐induced internalization was also inhibited by truncation of a single amino acid, Ser487, located at the end of the intracellular C‐terminal of H1receptors, but not by its mutation to alanine. In contrast, the receptor‐G‐protein coupling, which was evaluated by histamine‐induced accumulation of [3H]inositol phosphates, was potentiated by truncation of Ser487, but was lost by its mutation to alanine. These results suggest that the intracellular C‐terminal of human H1receptors, which only comprises 17 amino acids (Cys471‐Ser487), plays crucial roles in both clathrin‐dependent internalization of H1receptors and G‐protein signaling, in which truncation of Ser487 and its mutation to alanine are revealed to result in biased signaling toward activation of G‐proteins and clathrin‐mediated internalization, respectively.

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Emotional stimuli facilitate time perception in children with attention‐deficit/hyperactivity disorder
Authors: Nazari Mohammad A. , Mirloo Mohammad M. , Rezaei Mazaher , Soltanlou Mojtaba
Published: August 2016

The aim of this study was to compare the effect of different emotional stimuli (neutral, positive, and negative) on time perception in children with attention‐deficit/hyperactivity disorder (ADHD) and normal children in dual‐task form. Five hundred and ninety‐nine students from primary schools were randomly selected. The Conner's Teacher Rating Scale (CTRS) questionnaire was completed by teachers. A total of 100 children with a score above the cut‐off point for the CTRS were further assessed using the Child Symptom Inventory‐4 (CSI‐4). A total of 34 children with ADHD and 31 controls completed an emotional time discrimination task in two blocks of 1000 and 2000 ms duration. Children were asked to compare three image groups: neutral with neutral, neutral with positive, and neutral with negative images. Children with ADHD had significantly better performance in the emotional time discrimination task across all conditions when compared with controls: On average, discrimination thresholds were approximately 35 ms shorter for the children with ADHD. Our results indicate that children with ADHD have higher sensitivity to time relative to controls in a situation in which they must distribute resources between temporal and emotional processing. On the basis of the interference effect and the working memory capacity hypothesis, this dividing of attention causes a decrease of time accuracy in normal children.
Epidemiology of fatal and hospitalised injuries among youth in Fiji (TRIP 15)
Authors: Herman Josephine , Peiris‐John Roshini , Wainiqolo Iris , Kafoa Berlin , Laginikoro Paul , McCaig Eddie , Ameratunga Shanthi
Published: August 2016

Aim

To determine the burden and characteristics of fatal and hospitalised injuries among youth in Fiji.

Methods

We conducted a cross‐sectional analysis of the Fiji Injury Surveillance in Hospitals database – a prospective population‐based trauma registry – to examine the incidence and epidemiological characteristics associated with injury‐related deaths and hospital admissions among youth aged 15–24 years. The study base was Viti Levu, Fiji, during the 12‐month period concluding on 30 September 2006.

Results

One in four injuries in the Fiji Injury Surveillance in Hospitals database occurred among youth (n = 515, incidence rate 400/100 000). Injury rates were higher among men, those aged 20–24 years compared with 15‐ to 19‐year‐olds, and indigenous Fijians (iTaukei) compared with Indians. The leading causes among indigenous Fijians were being hit by a person/object (men) and falls (women), whereas for Indians, it was road traffic injuries (men) and intentional poisoning (women). Most injuries occurred at home (39%) or on the road (22%). Of the 63 fatal events, 57% were intentional injuries, and most deaths (73%) occurred prior to hospitalisation. Homicide rates were four times higher among indigenous Fijians than Indians, whereas suicide rates were five times higher among Indians compared with indigenous Fijians.

Conclusions

Important ethnic‐specific differences in the epidemiology of fatal and serious non‐fatal injuries are apparent among youth in Fiji. Efforts to prevent the avoidable burden of injury among Fiji youth thus requires inter‐sectoral cooperation that takes account of important sociocultural, environmental and health system factors such as unmet mental healthcare needs and effective pre‐hospital trauma services.
Association of cord blood vitamin D with early childhood growth and neurodevelopment
Authors: Gould Jacqueline F , Anderson Amanda J , Yelland Lisa N , Smithers Lisa G , Skeaff C Murray , Zhou Shao J , Gibson Robert A , Makrides Maria
Published: August 2016

Aim

The association between fetal vitamin D [25‐hydroxyvitamin D (25(OH)D)] exposure and early child growth and neurodevelopment is controversial. The aim of this study was to investigate the association between cord blood 25(OH)D and birth size, childhood growth and neurodevelopment.

Methods

Cord blood samples from 1040 Australian women enrolled in a randomised trial of docosahexaenoic acid (DHA) supplementation during pregnancy were analysed for 25(OH)D using mass spectroscopy. Infant length, weight and head circumference were measured at delivery. A sub‐sample of 337 infants with cord blood samples were selected for growth and neurodevelopment assessment at 18 months and 4 years of age. Associations between standardised 25(OH)D and outcomes were assessed, taking into account DHA treatment, social and demographic variables.

Results

Standardised 25(OH)D in cord blood was not associated with length, weight or head circumference at birth, 18 months or 4 years of age. 25(OH)D was not associated with cognitive, motor, social‐emotional or adaptive behaviour scores at 18 months, or cognitive score at 4 years of age. A 10 nmol/L increase in cord blood 25(OH)D was associated with a modest increase in average Language scores of 0.60 points at 18 months (adjusted 95% CI 0.04–1.17, P = .04) and 0.68 points at 4 years (adjusted 95% CI 0.07–1.29, P = .03) of age.

Conclusions

Cord blood vitamin D was modestly, positively associated with language development in early childhood in our sample, although the magnitude of the association was small. Randomised controlled trials are needed to confirm a causal association and establish the potential clinical significance of the relationship between vitamin D status and language development.
Paediatric Staphylococcus aureus bacteraemia: A single‐centre retrospective cohort
Authors: Roediger Jessica C , Outhred Alexander C , Shadbolt Bruce , Britton Philip N
Published: August 2016

Aim

We aimed to describe the clinical epidemiology of Staphylococcus aureus bacteraemia (SAB) at a large, tertiary/quaternary children's hospital in Australia.

Methods

We performed a retrospective chart review of SAB cases at the Children's Hospital at Westmead (CHW) over 5 years; 2006–2011. We compared frequency, clinical profile and outcomes of SAB with published data from CHW; 1994–1998. We compared health‐care associated with community‐associated (HCA‐SAB and CA‐SAB; defined epidemiologically) and methicillin‐resistant with methicillin susceptible S. aureus (MRSA and MSSA).

Results

We identified 174 episodes of paediatric SAB with an average annual admission rate of 1.3/1000 which has not increased compared with a decade earlier. Half of the cases (49%) were CA‐SAB; 18% were MRSA. The proportion of CA‐MRSA bacteraemia (22%) has increased. The proportion of SAB associated with central venous access devices (CVADs; 40%) has increased. CA‐SAB cases were more likely to present with a tissue focus of disease (e.g. osteo‐articular, pneumonia) and often required surgery. HCA‐SAB less frequently required surgery, a minority is MRSA, and vascular device intervention (removal, sterilisation) is common. Six cases (4%) of infective endocarditis (IE) were identified; three with a history of congenital heart disease, two with CVADs in situ. There were no deaths in this cohort.

Conclusions

Over an 18‐year period, the proportion of SAB due to CA‐MRSA and SAB associated with CVADs has increased. Categorisation of SAB as HCA and CA reveals two broad phenotypes of paediatric SAB. SAB in children is infrequently associated with IE. The health‐care burden of paediatric SAB is considerable', but mortality is low.
Parents’ perception of quality of life in their sons with haemophilia
Authors: Williams Vaughan K , Antoniou Georgia , Jackson Anne , Atkins Andrew
Published: August 2016

Aim

Quality of life (QOL) in haemophilia involves both physical and psychological issues. This study was performed to determine parents’ perceptions of the QOL of their sons with haemophilia and compare this to their children's own assessment.

Methods

In this study, we used the Haemo‐QoL questionnaire for haemophilia, to compare the responses of 22 parents to the responses of their children within the age groups 4–7, 8–12 and 13–16 and also for the severity groups mild versus moderate–severe.

Results

In the 4–7 age group, the children considered their QOL to be less than that estimated by their parents for a number of areas, while in the 8–12 age group the parents considered the QOL for their children to be lower than that estimated by the children themselves. In the 13–16 age group, there was almost universal agreement on QOL between the children and their parents apart from the subscale of school and sport (P = 0.04). Within the severity groupings, there was much more concordance between the parents and children. The only significant difference between parents and children was for physical health in the mild group (P = 0.03). In the moderate–severe groups, no results were significant, however, five of the subscales showed borderline significant (P < 0.1) results.

Conclusions

Parental perceptions of QOL of their sons changes with the age of the child and the severity of the haemophilia. These perceptions need to be taken into account when developing an overall care strategy involving both the child and parent.
The cost impact of outreach testing and treatment for hepatitis C in an urban Drug Treatment Unit
Authors: Selvapatt Nowlan , Ward Thomas , Harrison Lorna , Lombardini Jody , Thursz Mark , McEwan Phil , Brown Ashley
Published: August 2016

Background & Aims

In developed countries persons who inject drugs (PWID) represents a significant risk for chronic hepatitis C virus (HCV). It is reported that up to half of persons with chronic HCV remain undiagnosed and reliance on attendance to specialist clinics remain a barrier to treatment. This study assesses the feasibility and cost‐effectiveness of outreach screening and treatment within a Drug Treatment Unit (DTU).

Methods

All persons attending a London DTU were offered HCV testing, and where appropriate follow‐up and treatment by a specialist nurse at the DTU. Three years of data informed a cost‐effective‐analysis using a validated Markov model. A hypothetical scenario in which only direct acting antiviral (DAA) treatments were used was also assessed.

Results

Of 321 persons eligible, 216 were screened, 89 were HCV positive and 66 had confirmatory evidence of viraemia. All were infected with either HCV genotype 1 or 3. Treatment was initiated in 29 persons, 22 with interferon based and 7 DAA only regimens. Following initial treatment 21 (72%) achieved SVR12. It is estimated that this programme represents an average per‐patient cost‐saving of £2498 and a quality‐adjusted life year (QALY) gain of 4.10 over a lifetime. In a hypothetical scenario of all oral DAA treatment, an incremental cost per QALY of £1029 was estimated.

Conclusion

This study demonstrates feasibility and cost effectiveness of outreach testing and treatment of hepatitis C within comparable DTU settings. Additional costs of newer DAA therapies would not be prohibitive when considering willingness‐to‐pay thresholds commonly used by policy makers.
Association between diabetes mellitus and cirrhosis mortality: the Singapore Chinese Health Study
Authors: Goh George Boon‐Bee , Pan An , Chow Wan‐Cheng , Yuan Jian‐Min , Koh Woon‐Puay
Published: August 2016

Background & Aim

Diabetes mellitus has been linked to cirrhosis‐related mortality in Western populations, but less is known about this relationship in Asian populations. We studied the impact of diabetes on the risk of cirrhosis mortality in a population‐based cohort among Chinese in Singapore.

Methods

We used data collected and analysed from the Singapore Chinese Health Study, a prospective community‐based cohort of 63 275 subjects aged 45–74 years during enrolment between 1993 and 1998. Information on diet, lifestyle and medical history was collected via structured questionnaire. Mortality cases from cirrhosis in the cohort were identified via linkage with nationwide death registry up to 31 December 2014. Cox proportional regression models were used to estimate the associations with adjustment for risk factors of cirrhosis.

Results

After a mean follow‐up of 16.9 years, there were 133 deaths from cirrhosis. Diabetes was associated with an increased risk of cirrhosis mortality (hazard ratio [HR]: 2.80; 95% confidence interval [CI]: 2.04–3.83), and for both viral (HR: 2.20; 95% CI: 1.18–4.11) and non‐viral hepatitis‐related cirrhosis mortality (HR: 3.06; 95% CI: 2.13–4.41). The association between diabetes and non‐viral hepatitis‐related cirrhosis mortality was stronger among participants of body mass index (BMI) less than 23 kg/m2 (HR: 7.11; 95% CI: 3.42–14.79) compared to heavier individuals (HR: 2.28; 95% CI: 1.20–4.35) (Pinteraction=0.02).

Conclusion

Diabetes is a risk factor for cirrhosis mortality, especially for non‐viral hepatitis‐related cirrhosis in population with BMI considered low or normal in Asia.
Identifying outlier loci in admixed and in continuous populations using ancestral population differentiation statistics
Authors: Martins Helena , Caye Kevin , Luu Keurcien , Blum Michael G. B. , François Olivier
Published: August 2016

Finding genetic signatures of local adaptation is of great interest for many population genetic studies. Common approaches to sorting selective loci from their genomic background focus on the extreme values of the fixation index, FST, across loci. However, the computation of the fixation index becomes challenging when the population is genetically continuous, when predefining subpopulations is a difficult task, and in the presence of admixed individuals in the sample. In this study, we present a new method to identify loci under selection based on an extension of the FST statistic to samples with admixed individuals. In our approach, FST values are computed from the ancestry coefficients obtained with ancestry estimation programs. More specifically, we used factor models to estimate FST, and we compared our neutrality tests with those derived from a principal component analysis approach. The performances of the tests were illustrated using simulated data and by re‐analysing genomic data from European lines of the plant species Arabidopsis thaliana and human genomic data from the population reference sample, POPRES.
Effects of everolimus on tuberous sclerosis complex‐associated renal angiomyolipoma: A preliminary report
Authors: Tsai Jeng‐Dau , Wei Chang‐Ching , Yang Sheng‐Hui , Fan Hueng‐Chuen , Hsu Chih‐Chuan , Tung Min‐Che , Tsai Min‐Ling , Sheu Ji‐Nan
Published: August 2016

Aim

Tuberous sclerosis complex (TSC) presents with multisystem benign neoplasm induced by dysregulation of the mammalian target of rapamycin pathway. This study aimed to examine the effects of oral everolimus at either 2.5 or 5.0 mg daily on the treatment of TSC‐associated renal angiomyolipoma (AML).

Methods

Between July 2012 and August 2015, patients with TSC‐associated renal AML were selected for everolimus therapy protocol. An oral everolimus starting dose at 2.5 mg was administered daily, and was gradually increased to 5.0 mg daily. All patients were evaluated using magnetic resonance imaging or computed tomography scanning at baseline, 12, 24, and 36 months after the start of treatment for measuring the changes of renal AML mass volume.

Results

Eight patients were finally enrolled for analysis in this study. Everolimus treatment had a statistically significant effect on the renal AML volume reduction during follow‐up (P < 0.05). Renal AML mass volume reduction rates were 10.5–45.3% in four patients with everolimus 2.5 mg and 40.7–73.1% in four patients with everolimus 5.0 mg daily; the difference was statistically significant between the two groups (P < 0.05). Longitudinal follow‐up for response to everolimus showed volume reduction rates to be around 10.5–73.1% in the initial 6–24 months after everolimus treatment, which remained stable during follow‐up up to 36 months.

Conclusion

The results suggest that an oral everolimus is effective and provides a non‐invasive way to treat TSC‐associated renal AML, and patients are likely to require maintenance therapy to continue to derive benefit.
Study Design and Cohort Description of DEFIB‐WOMEN: A National Danish Study in Patients with an ICD
Authors: PEDERSEN SUSANNE S. , NIELSEN JENS COSEDIS , RIAHI SAM , HAARBO JENS , VidebÆk Regitze , LARSEN MOGENS LYTKEN , SKOV OLE , KNUDSEN CHARLOTTE , JOHANSEN JENS BROCK
Published: August 2016

Background

Little systematic evidence is available on potential gender differences in patients with an implantable cardioverter defibrillator (ICD) from a real‐world cohort. We designed the DEFIB‐WOMEN (The Utilization of Implantable Cardioverter DEFIBrillator Therapy in the Treatment of Heart Disease: Clinical and Psychological outcomes in WOMEN) study to examine gender differences on (1) patient‐reported outcomes (PROs), (2) procedure‐ and device‐related complications, and (3) ventricular tachyarrhythmia and mortality. This presents the study design and baseline characteristics of the cohort.

Methods

DEFIB‐WOMEN is a national, multicenter, prospective, observational study. First‐time implanted patients are asked to complete PROs at several time points. Information on baseline and follow‐up characteristics are captured from patients’ medical records, purpose‐designed questions, and the Danish national registers. The DEFIB‐WOMEN cohort is composed of 1,790 (19% women; 343/1,790) patients implanted between June 2010 and April 2013.

Results

Women and men differed on several demographic and clinical baseline characteristics, including on the prescription of β‐blockers, statins, angiotensin‐converting enzyme inhibitors, and psychotropic agents. Although women generally had a healthier clinical profile, they reported significantly more symptoms of anxiety and depression and ICD concerns (fear of shock) as compared to men. These differences were not only statistically significant but also clinically relevant, with the magnitude of the differences in anxiety and ICD concerns being 0.44 and 0.42, respectively, as indicated by Cohen's effect size index.

Conclusions

These preliminary results indicate that women with an ICD experience particularly more anxiety and ICD concerns as compared to men at the time of implant. Future results of DEFIB‐WOMEN will show whether these gender differences persist and whether there are also gender differences in complications and survival.
Unanswered Questions in Complex Fractionated Atrial Electrogram Ablation
Authors: AKSU TOLGA , GULER TÜMER ERDEM , YALIN KIVANC , OTO ALI
Published: August 2016

Pulmonary vein isolation has been accepted as potential target for ablation of paroxysmal atrial fibrillation (AF) given that the pulmonary veins are the main source of AF triggers. However, ablation strategies for persistent AF are less well defined. Mapping and ablation of complex fractionated atrial electrograms (CFAEs) is one strategy that has been proposed as a strategy for substrate modification although there is no consensus on their definition and procedural end points. Results of clinical studies have been conflicting. In this review, we aimed to discuss yesterday, today, and tomorrow of CFAEs ablation in persistent AF ablation.
Use of Cardioplegia to Guide Alcohol Ablation for Incessant Ventricular Tachycardia
Authors: KIM SUN MOON , VIRGADAMO SEBASTIANO , GURLEY JOHN , ELAYI CLAUDE S.
Published: August 2016

Incessant scar‐related reentrant ventricular tachycardia is an important cause of morbidity and mortality. In patients not amenable to emergent radiofrequency catheter ablation, selective transcoronary alcohol ablation has been successfully performed. In our case study, we introduce the novel use of cardioplegia as a mapping technique for identification of the critical ventricular tachycardia isthmus to guide efficient transcoronary alcohol ablation and prevent unnecessary myocardial damage.
Long‐Term Outcome of Patients with Bifascicular Block and Unexplained Syncope Following Cardiac Pacing
Authors: KALSCHEUR MATTHEW M. , DONATEO PAOLO , WENZKE KEVIN E. , ASTE MILENA , ODDONE DANIELE , SOLANO ALBERTO , MAGGI ROBERTO , CROCI FRANCESCO , PAGE RICHARD L. , BRIGNOLE MICHELE , HAMDAN MOHAMED H.
Published: August 2016

Background

According to the ACC/AHA/HRS guidelines, cardiac pacing is reasonable in patients with bifascicular block (BF‐B) and syncope when other causes have been excluded. The purpose of this study was to assess the long‐term outcome of patients with BF‐B and unexplained syncope following cardiac pacing.

Methods and Results

Between 2009 and 2015, we identified 43 consecutive patients (mean age of 78 ± 12 years, 64% males) who presented with syncope and BF‐B and had received a pacemaker (PM). During a mean follow‐up period of 31 ± 21 months, syncope recurred in seven patients (16%): 7% (95% standard error [SE] ± 3%) at 1 year and 18% (95% SE ± 7%) at 5 years. At univariable analysis, the only predictor of syncope recurrence was empiric pacing (P = 0.03). There were no syncope recurrences in the 12 patients who received a PM following a positive electrophysiological study (EPS) and the five patients with documentation of paroxysmal atrioventricular block (AVB) during cardiac monitoring (insertable loop recorder [ILR]), (EPS/ILR Group, n = 17) compared to seven of 26 (27%) patients who received empiric pacing (Empiric Group, n = 26; P = 0.02). Progression to high‐degree AVB was documented during follow‐up in 16 (37%) patients: nine of 17 (53%) patients in the EPS/ILR Group and seven of 26 (27%) patients in the Empiric Group (P = 0.11). There were no injuries reported during ILR monitoring.

Conclusions

We have shown that syncope recurs not infrequently in patients with BF‐B who received pacing for syncope. Nearly one in four patients who had empiric pacing suffered syncope recurrence compared to no recurrences in patients who received a PM following a positive EPS or documentation of transient AVB.
Relationship between specific IgE to egg components and natural history of egg allergy in Danish children
Authors: Gradman Josefine , Mortz Charlotte G , Eller Esben , Bindslev‐Jensen Carsten
Published: August 2016

Background

The majority of egg‐allergic children develop tolerance over time. However, it may take numerous of consecutive egg challenges to get there as no good indices to predict tolerance exist.

Objective

To investigate whether serial measurements of specific IgE to egg white, ovomucoid, ovalbumin, conalbumin, lysozyme, and egg yolk could improve the specificity of the diagnostic workup and aid in the decision when to rechallenge egg‐allergic children.

Methods

The outcome of oral food challenges with hen's egg and corresponding specific IgE levels were evaluated in children referred to The Allergy Center within an 8‐year period. The egg‐allergic children were rechallenged and had specific IgE levels measured once a year.

Results

During a median follow‐up of 26 months, 287 challenges and corresponding 287 serum analyses were performed in 130 children. Of the 130 children, 99 were egg allergic and 82 of these were rechallenged. Based on the initial diagnostic challenges only, area under the curve (AUC) estimates of the ability of specific IgE titers to distinguish between egg sensitization and egg allergy were only modest (maximum 0.83) and provided no clinical meaningful decision points. Specific IgE levels at baseline did not differ between tolerant and persistent allergic children. However longitudinally, acquisition of tolerance was associated with a decrease in IgE to egg white and to ovomucoid. In all cases of an increase in IgE to ovomucoid, the rechallenge was positive.

Conclusion

The decision when to rechallenge egg‐allergic children should encounter the course of specific IgE.
Measuring cardiac output in children undergoing cardiac catheterization: comparison between the Fick method and PRAM (pressure recording analytical method)
Authors: Alonso‐Iñigo José M. , Escribá Francisco J. , Carrasco José I. , Fas María J. , Argente Pilar , Galvis José M. , Llopis José E.
Published: August 2016

Background

Pressure recording analytical method (PRAM) is a novel, arterial pulse contour method for measuring cardiac output (CO). Validation studies of PRAM in children are few, and have shown contradictory results. The aim of the study was to compare the MostCare®‐PRAM vs the Fick method of cardiac output estimation (reference method).

Methods

This is a single‐center, prospective observational study in 52 pediatric patients who underwent diagnostic right and left heart catheterization. Cardiac index (CI) measurements with the MostCare®‐PRAM vs the Fick method were obtained under hemodynamically stable conditions.

Results

Forty CI measurements were performed. The data showed good agreement between CIFick and CIPRAM: r2 = 0.90 (P < 0.001), mean bias −0.075, limits of agreement from −0.56 to 0.41. The percentage error was 17%. Comparable results were obtained for patients <20 kg (r2 = 0.87, P < 0.001), mean bias −0.135, limits of agreement from −0.35 to 0.62, percentage of error 17%.

Conclusions

In pediatric patients undergoing diagnostic right and left heart catheterization, the MostCare®‐PRAM was shown to estimate CI with a good level of agreement with the Fick method measurements.
An efficient viral vector for functional genomic studies of Prunus fruit trees and its induced resistance to Plum pox virus via silencing of a host factor gene
Authors: Cui Hongguang , Wang Aiming
Published: August 2016

RNA silencing is a powerful technology for molecular characterization of gene functions in plants. A commonly used approach to the induction of RNA silencing is through genetic transformation. A potent alternative is to use a modified viral vector for virus‐induced gene silencing (VIGS) to degrade RNA molecules sharing similar nucleotide sequence. Unfortunately, genomic studies in many allogamous woody perennials such as peach are severely hindered because they have a long juvenile period and are recalcitrant to genetic transformation. Here, we report the development of a viral vector derived from Prunus necrotic ringspot virus (PNRSV), a widespread fruit tree virus that is endemic in all Prunus fruit production countries and regions in the world. We show that the modified PNRSV vector, harbouring the sense‐orientated target gene sequence of 100‐200 bp in length in genomic RNA3, could efficiently trigger the silencing of a transgene or an endogenous gene in the model plant Nicotiana benthamiana. We further demonstrate that the PNRSV‐based vector could be manipulated to silence endogenous genes in peach such as eukaryotic translation initiation factor 4E isoform (eIF(iso)4E), a host factor of many potyviruses including Plum pox virus (PPV). Moreover, the eIF(iso)4E‐knocked down peach plants were resistant to PPV. This work opens a potential avenue for the control of virus diseases in perennial trees via viral vector‐mediated silencing of host factors, and the PNRSV vector may serve as a powerful molecular tool for functional genomic studies of Prunus fruit trees.
mlo‐based powdery mildew resistance in hexaploid bread wheat generated by a non‐transgenic TILLING approach
Authors: Acevedo‐Garcia Johanna , Spencer David , Thieron Hannah , Reinstädler Anja , Hammond‐Kosack Kim , Phillips Andrew L. , Panstruga Ralph
Published: August 2016

Wheat is one of the most widely grown cereal crops in the world and is an important food grain source for humans. However, wheat yields can be reduced by many abiotic and biotic stress factors, including powdery mildew disease caused by Blumeria graminis f.sp. tritici (Bgt). Generating resistant varieties is thus a major effort in plant breeding. Here, we took advantage of the non‐transgenic Targeting Induced Lesions IN Genomes (TILLING) technology to select partial loss‐of‐function alleles of TaMlo, the orthologue of the barley Mlo (Mildew resistance locus o) gene. Natural and induced loss‐of‐function alleles (mlo) of barley Mlo are known to confer durable broad‐spectrum powdery mildew resistance, typically at the expense of pleiotropic phenotypes such as premature leaf senescence. We identified 16 missense mutations in the three wheat TaMlo homoeologues, TaMlo‐A1, TaMlo‐B1 and TaMlo‐D1 that each lead to single amino acid exchanges. Using transient gene expression assays in barley single cells, we functionally analysed the different missense mutants and identified the most promising candidates affecting powdery mildew susceptibility. By stacking of selected mutant alleles we generated four independent lines with non‐conservative mutations in each of the three TaMlo homoeologues. Homozygous triple mutant lines and surprisingly also some of the homozygous double mutant lines showed enhanced, yet incomplete, Bgt resistance without the occurrence of discernible pleiotropic phenotypes. These lines thus represent an important step towards the production of commercial non‐transgenic, powdery mildew‐resistant bread wheat varieties.
Hydrogen isotopic differences between C3 and C4 land plant lipids: consequences of compartmentation in C4 photosynthetic chemistry and C3 photorespiration
Authors: Zhou Youping , Grice Kliti , Stuart‐Williams Hilary , Hocart Charles H. , Gessler Arthur , Farquhar Graham D.
Published: August 2016

The 2H/1H ratio of carbon‐bound H in biolipids holds potential for probing plant lipid biosynthesis and metabolism. The biochemical mechanism underlying the isotopic differences between lipids from C3 and C4 plants is still poorly understood. GC‐pyrolysis‐IRMS (gas chromatography‐pyrolysis‐isotope ratio mass spectrometry) measurement of the 2H/1H ratio of leaf lipids from controlled and field grown plants indicates that the biochemical isotopic fractionation (ε2Hlipid_biochem) differed between C3 and C4 plants in a pathway‐dependent manner: ε2HC4 > ε2HC3 for the acetogenic pathway, ε2HC4 < ε2HC3 for the mevalonic acid pathway and the 1‐deoxy‐D‐xylulose 5‐phosphate pathway across all species examined. It is proposed that compartmentation of photosynthetic CO2 fixation into C4 mesophyll (M) and bundle sheath (BS) cells and suppression of photorespiration in C4 M and BS cells both result in C4 M chloroplastic pyruvate – the precursor for acetogenic pathway – being more depleted in 2H relative to pyruvate in C3 cells. In addition, compartmentation in C4 plants also results in (i) the transferable H of NADPH being enriched in 2H in C4 M chloroplasts compared with that in C3 chloroplasts for the 1‐deoxy‐D‐xylulose 5‐phosphate pathway pathway and (ii) pyruvate relatively 2H‐enriched being used for the mevalonic acid pathway in the cytosol of BS cells in comparison with that in C3 cells.
Effectiveness of a sleep education program for pediatricians
Authors: Ersu Refika , Boran Perran , Akın Yasemin , Bozaykut Abdülkadir , Ay Pınar , Yazar Ahmet Sami
Published: August 2016

Background

The high prevalence of sleep problems in children and long‐term consequences point to the need for early effective interventions, but health‐care providers have limited training in pediatric sleep medicine. The aims of this study were therefore to assess the effectiveness of a sleep health‐care education program and to develop a Turkish acronym for brief sleep history taking for pediatric primary caregivers in the ambulatory setting.

Methods

This was a quasi‐experimental study. Four centers were randomly selected from eight training and research hospitals as the intervention group. The control group was recruited during training in subjects other than sleep. Education was provided to the intervention group. Knowledge and attitudes were evaluated in the short and long term.

Results

The intervention and the control groups consisted of 132 and 78 pediatricians, respectively. The intervention group scored significantly higher both in the short and the long term. The Turkish acronym (UYKU) was reported to be easy to remember and effective in prompting the correct questions to ask about sleep issues.

Conclusions

The Turkish acronym would be useful in the primary care setting to increase the frequency of screening of sleep problems in children. Although education significantly improved knowledge on sleep issues in children, the percentage of participants who lacked confidence in the management of sleep problems in children was still very high, even in the intervention group. We suggest that a broader educational program, carried out more than once, would be more beneficial.
A risk‐stratified approach to cytomegalovirus prevention in pediatric solid organ transplant recipients
Authors: Suresh Sneha , Lee Bonita E. , Robinson Joan L. , Akinwumi Michael S. , Preiksaitis Jutta K.
Published: August 2016

Optimal strategies to prevent cytomegalovirus (CMV) disease following pediatric solid organ transplantation remain controversial. The purpose of this study was to review the outcomes of a risk‐stratified strategy that uses a hybrid or prophylactic strategy for donor (D)+ recipient (R)− patients, a preemptive strategy for D+R+/D−R+, and clinical follow‐up alone for D−R+ patients. A retrospective chart review was undertaken at the Stollery Children's Hospital in Edmonton, Alberta for pediatric solid organ transplants 2004 through 2010. Transplants were risk‐stratified according to D/R CMV serostatus, organ group, and type of induction or rejection immunosuppression. The incidence of DNAemia and CMV disease and adverse effects from prophylaxis were analyzed. The study included 197 recipients. CMV DNAemia was detected in 49 of 197 recipients (24.8%), and CMV disease occurred in eight of 197 (4%) of which all but one were D+R−. All recovered. Seventeen of 142 recipients who received prophylaxis (12%) had hematologic toxicity. No other toxicities were identified. In conclusion, A risk‐stratified approach resulted in very low rates of CMV disease with minimal adverse effects. Lowering the dosage rather than stopping antivirals in the face of neutropenia has the potential to further lower the rate of CMV disease.
Automatic emotion regulation in response inhibition: The temporal dynamics of emotion counter‐regulation during a go/no‐go task
Authors: Zhang Jing , Feng Caixia , Mai Xiaoqin
Published: August 2016

Recent behavioral studies indicate that emotion counter‐regulation automatically allocates attention to events that are opposite in the valence to the experienced emotional state. The present study explored the effect of emotion counter‐regulation on response inhibition by using ERPs in a go/no‐go paradigm. We recruited 58 subjects and randomly assigned them to either the angry priming group (watching Nanjing Massacre movie clips) or the neutral priming group (watching “mending a computer” movie clips). The behavioral results revealed that participants in the angry priming group responded significantly more accurately to go happy and no‐go angry faces than go angry and no‐go happy faces. The analyses of ERPs revealed that the amplitudes of the no‐go N2 and no‐go P3 were significantly larger for the happy faces than for the angry faces in the angry priming group. However, no such effects were found in the neutral priming group. These results suggest that highly aroused angry emotion could prompt a priority response to happy emotion stimuli and restrict the responses to angry emotion stimuli through emotion counter‐regulation.
Higher resting heart rate variability predicts skill in expressing some emotions
Authors: Tuck Natalie L. , Grant Rosemary C. I. , Sollers John J. , Booth Roger J. , Consedine Nathan S.
Published: August 2016

Vagally mediated heart rate variability (vmHRV) is a measure of cardiac vagal tone, and is widely viewed as a physiological index of the capacity to regulate emotions. However, studies have not directly tested whether vmHRV is associated with the ability to facially express emotions. In extending prior work, the current report tested links between resting vmHRV and the objectively assessed ability to facially express emotions, hypothesizing that higher vmHRV would predict greater expressive skill. Eighty healthy women completed self‐reported measures, before attending a laboratory session in which vmHRV and the ability to express six emotions in the face were assessed. A repeated measures analysis of variance revealed a marginal main effect for vmHRV on skill overall; individuals with higher resting vmHRV were only better able to deliberately facially express anger and interest. Findings suggest that differences in resting vmHRV are associated with the objectively assessed ability to facially express some, but not all, emotions, with potential implications for health and well‐being.
Hormonal changes and follicular activity after treatment with intravaginal progesterone‐releasing devices in llamas
Authors: Cavilla MV , Bianchi CP , Aguilera F , Hermida M , Aba MA
Published: August 2016

Contents

Plasma progesterone (P4) concentrations and follicular activity after administration of different P4 doses were evaluated in 33 adult female llamas treated with intravaginal devices. In Study 1, a group of llamas (n = 10) was treated with an intravaginal device (IVD) containing 160 (n = 5) or 780 mg of P4 (n = 5). Based on the results from the first study, in Study 2, females with follicles at different stages of development were treated with the IVD containing 780 mg of P4 (n = 21) or remain untreated (control; n = 12) to evaluate the effect of P4 on follicular activity. In Study 1, the IVD containing 160 mg of P4 induced follicular turnover in 60% of females while the remaining 40% of llamas developed persistent follicles. Thus, this device controlled follicular activity in llamas, although it promotes the persistence of follicles present at start of treatment. Conversely, in both studies, the IVD containing 780 mg of P4 suppressed follicular development and hasten the emergence of a new follicular wave in all females regardless of the follicular phase at insertion. Additionally, in Study 2, this device effectively concentrated the appearance of follicles with ovulatory diameter at a definite time after treatment in comparison with control animals. In conclusion, treatment with an IVD containing 780 mg of P4 would be considered for the control of follicular activity in llamas as it ensures the presence of a young follicle with ovulatory diameter by day 6 after the end of treatment in all females.
Twin reduction by PGF2α intraluteal instillation in dairy cows
Authors: López‐Gatius F , Hunter RHF
Published: August 2016

Contents

The objective of this study was to determine whether induced luteolysis of one of the two corpora lutea in twin pregnancies would provoke spontaneous twin reduction. In Experiment 1, 12 post‐partum cows with two corpora lutea in the same ovary were assigned to (three cows per group): Group I, Group II, Group III or Group IV receiving into one of the corpora lutea puncture with no treatment, 0.5 mg dinoprost, 1.5 mg dinoprost and 2.5 mg dinoprost, respectively. One of the two corpora lutea showed clear signs of luteolysis on Day 2 and was practically non‐detectable on Day 7 after treatment in the three cows of the Group IV. In Experiment 2, 11 cows carrying live twins with two corpora lutea on Day 28 of gestation, eight bilateral and three unilateral, received 2.5 mg dinoprost into one of the corpora lutea. Corpus luteum reduction and embryo reduction after treatment were registered in 10 and 9 cows, respectively. In bilateral twin pregnancies, four cows suffering embryo reduction remained pregnant. In unilateral twin pregnancies, membrane detachment resulted in the death of both cotwins. In conclusion, although observations were based on few animals, there seems to be a mechanism that operates locally to transfer ovarian progesterone to the uterus, and also a quantitative relationship between the amount of progesterone secreted and support of conceptuses, resulting in death of one twin embryonic vesicle when one corpus luteum regresses.
Dose‐Response Modeling with Summary Data from Developmental Toxicity Studies
Authors: Fox John F. , Hogan Karen A. , Davis Allen
Published: August 2016

Dose‐response analysis of binary developmental data (e.g., implant loss, fetal abnormalities) is best done using individual fetus data (identified to litter) or litter‐specific statistics such as number of offspring per litter and proportion abnormal. However, such data are not often available to risk assessors. Scientific articles usually present only dose‐group summaries for the number or average proportion abnormal and the total number of fetuses. Without litter‐specific data, it is not possible to estimate variances correctly (often characterized as a problem of overdispersion, intralitter correlation, or “litter effect”). However, it is possible to use group summary data when the design effect has been estimated for each dose group. Previous studies have demonstrated useful dose‐response and trend test analyses based on design effect estimates using litter‐specific data from the same study. This simplifies the analysis but does not help when litter‐specific data are unavailable. In the present study, we show that summary data on fetal malformations can be adjusted satisfactorily using estimates of the design effect based on historical data. When adjusted data are then analyzed with models designed for binomial responses, the resulting benchmark doses are similar to those obtained from analyzing litter‐level data with nested dichotomous models.