bluuebunny/crossref_metadata_2025 huggingface dataset:
Myo‐inositol in health and disease: its impact on semen parameters and male fertility
Authors: Vazquez-Levin M.H. , Verón G.L.
Published: October 2019

Background

Myo‐inositol (cis‐1,2,3,5‐trans‐4,6‐cyclohexanehexol; MI) is the most prominent of nine inositol stereoisomers. MI, its phosphate derivatives, and associated lipids are widely found in vegetables and animal tissues and are known to participate in numerous biological processes.

Objectives

To perform a review analysis on MI presence, functions, and impact in male fertility.

Materials and Methods

A thorough search of listed publications in PubMed on MI and its derivatives was done.

Results

Published information was found and compiled on MI identification, natural dietary sources and absorption, biosynthesis, concentrations, as well as MI as its derivatives (PI, PIP, GPI, IPG) roles in several human tissues and body fluids in health and disease. A section was focused on MI presence, biosynthesis, and functions in the mammalian male genital tract and in spermatozoa, and summarized reports describing the impact of in vivo and in vitro MI supplementation on human semen quality and fertility. Studies reported a discrete improvement in sperm motility in fresh and frozen‐thawed semen, and a better sperm performance in natural and assisted fertility.

Discussion and Conclusion

MI was reported as an effective supplement for sperm quality. In any case, several study designs lack appropriate controls or data analysis to confirm the relevance of the findings. While promising, larger prospective randomized controlled studies will be required to confirm the positive effect of MI supplementation in male infertility management. Moreover, further investigations are encouraged to unravel MI roles in sperm physiology and the underlying molecular mechanisms.
Late‐onset hypogonadism: a concept comes of age
Authors: Nieschlag E.
Published: October 2019

The termLate‐onset hypogonadism(LOH) was coined in 2002 and defined as a disease entity in the ISA, ISSAM, EAU, EAA and ASA endorsed Recommendations for Investigation, Treatment and Monitoring of LOH (2005 and 2008) as ‘a clinicalandbiochemical syndrome associated with advancing age, characterized by symptomsanda deficiency in serum testosterone (T)’. LOH was classified as a combined primary and secondary hypogonadism since the endocrine capacity of the testes and the pituitary are impaired. Symptoms of LOH include loss of libido, erectile dysfunction, loss of muscle mass, increased body fat, anemia, osteoporosis, depressed mood, decreased vitality, sweating, and hot flushes. Since these symptoms may also have origins other than LOH, exclusion of other disease entities and subnormal serum T levels are considered prerequisites for the diagnosis and possible treatment of LOH. However, during following years these guidelines were often neglected and, especially in the USA, indiscriminate prescribing of T was widely practised so that the US FDA warned against such irresponsible behavior. In Europe, T prescribing remained largely restricted to LOH as defined above. Nevertheless, a discussion started whether LOH really exists or is only a consequence of age‐related comorbidities. Numerous studies have helped to clarify the situation, in particular, the European Male Aging Study (EMAS) and the US‐initiated7 T trials. Consequently, the newest US Endocrine Society Practice Guideline on T treatment (2018) includes advanced age as a cause of organic hypogonadism and recommends that ‘in men >65 years who have symptoms or conditions suggestive of T deficiency … and consistently and unequivocally low morning T concentrations we suggest that clinicians offer T therapy on an individualised basis after explicit discussion of the potential risks and benefits’. Thus, the concept of LOH as conceived two decades ago has weathered criticism and survived the times.
Opioid use prior to elective surgery is strongly associated with persistent use following surgery: an analysis of 14 354 Medicare patients
Authors: Catchpool Max , Knight Josh , Young Jesse T. , Clarke Philip , Barrington Michael J. , Choong Peter F. M. , Dowsey Michelle M.
Published: October 2019

Background

Persistent opioid use following total joint replacement (TJR) surgery is common; however, the association between pre‐surgical opioid use and surgery type has not been established. The objective of this study was to determine the association between pre‐surgery opioid use and persistent post‐surgery opioid use in TJR patients compared to other elective surgical patients.

Methods

This is a retrospective cohort study, of univariate and multinomial logistic regression of linked, de‐identified Medicare Benefits Schedule and Pharmaceutical Benefits Schedule data, adjusted for perioperative opioid use, age and sex. Oral morphine equivalents daily doses (OMEDD) were calculated and opioid use was categorized into three mutually exclusive categories for each observation window: low (0–5 OMEDD), moderate (5–10 OMEDD), high (10+ OMEDD). Persistent opioid use was defined as opioid use between 180 and 270 days after the date of surgery.

Results

Persistent opioid use was associated with older age, female gender and pre‐surgery opioid use. There was no increased risk for persistent opioid use for TJR patients compared to other surgical patients. The intensity of pre‐surgery opioid usage is strongly associated with persistent opioid use in all observed surgical patients.

Conclusions

Our results suggest that many patients who use opioids prior to surgery will persist in their opioid use following surgery. No association was found between persistent opioid use and TJR surgery, but rather a risk reduction compared to other elective surgeries when associations with opioid use are controlled for. Primary care clinicians and surgeons should monitor the duration and dosage of perioperative opioid use.
Lessons learned from relocating an acute surgical unit to a new quaternary referral centre in Adelaide, South Australia: a tale of two hospitals
Authors: Barnett Dylan R. , Lu Ha , Finlay Ben , Coventry Charlie , Granchi Nelson , Marshall‐Webb Matthew , Heitmann Paul , Dobbins Christopher
Published: October 2019

Background

On 4 September 2017, patient care was relocated from one quaternary hospital that was closing, to another proximate greenfield site in Adelaide, Australia, this becoming the new Royal Adelaide Hospital. There are currently no data to inform how best to transition hospitals. We conducted a 12‐week prospective study of admissions under our acute surgical unit to determine the impact on our key performance indicators. We detail our results and describe compensatory measures deployed around the move.

Methods

Using a standard proforma, data were collected on key performance indicators for acute surgical unit patients referred by the emergency department (ED). This was supplemented by data obtained from operative management software and coding data from medical records to build a database for analysis.

Results

Five hundred and eight patients were admitted during the study period. Significant delays were seen in times to surgical referral, surgical review and leaving the ED. Closely comparable was time spent in the surgical suite. Uptake of the Ambulatory Care Pathway fell by 67% and the Rapid Access Clinic by 46%. Overall mortality and patient length of stay were not affected.

Conclusion

We found the interface with ED was most affected. Staff encountered difficulties familiarizing with a new environment and an anecdotally high number of ED presentations. Delays to referral and surgical review resulted in extended patient stay in ED. Once in theatre, care was comparable pre‐ and post‐transition. This was likely from early identification of patients requiring an emergency operation, close consultant surgeon involvement and robust working relationships between surgeons, anaesthetists and nurses.
Examining perinatal subdural haematoma as an aetiology of extra‐axial hygroma and chronic subdural haematoma
Authors: Zahl Sverre Morten , Wester Knut , Gabaeff Steven
Published: October 2019

Aim

Benign external hydrocephalus (BEH), hygroma and chronic subdural haematoma are extra‐axial fluid collections in infants. MRI studies have shown that almost half of all new‐borns have perinatal subdural blood, generally referred to as subdural haematoma (SDH) or perinatal SDH. Epidemiologically there are striking similarities between chronic SDH and BEH in infants.

Methods

Discussion of pathophysiological mechanisms for BEH and chronic SDH, based on existing literature.

Results

Perinatal SDH is common, and we hypothesise that this condition in some infants develop into extra‐axial fluid collections, known as hygroma, BEH or chronic subdural haematoma. The mechanism seems to be an intradural bleeding that creates an obstructive layer preventing normal CSF absorption. The site where the bleeding originates from and those areas enveloped in blood from the primary damaged area are prone to later rebleeds, seen as ‘acute on chronic’ haematomas. With steady production of CSF and the blockage, increased intracranial pressure drives the accelerated skull growth seen in many of these children.

Conclusion

Perinatal SDH hampers CSF absorption, possibly leading to BEH and chronic SDH, with a high risk of false accusations of abuse. Close monitoring of head circumference could prove vital in detecting children with this condition.
Usability and acceptability of an automated respiratory rate counter to assess children for symptoms of pneumonia: A cross‐sectional study in Ethiopia
Authors: Ward Charlotte , Baker Kevin , Smith Helen , Maurel Alice , Getachew Dawit , Habte Tedila , McWhorter Cindy , LaBarre Paul , Karlstrom Jonas , Black Jim , Bassat Quique , Ameha Agazi , Tariku Abraham , Petzold Max , Källander Karin
Published: October 2019

Aim

Manually counting respiratory rate (RR) is commonly practiced by community health workers to detect fast breathing, an important sign of childhood pneumonia. Correctly counting and classifying breaths manually is challenging, often leading to inappropriate treatment. This study aimed to determine the usability of a new automated RR counter (ChARM) by health extension workers (HEWs), and its acceptability to HEWs, first‐level health facility workers (FLHFWs) and caregivers in Ethiopia.

Methods

A cross‐sectional study was conducted in one region of Ethiopia between May and August 2018. A total of 131 HEWs were directly observed conducting 262 sick child consultations after training and 337 after 2 months. Usability was measured as adherence to the WHO requirements to assess fast breathing and device manufacturer instructions for use (IFU). Acceptability was measured through semi‐structured interviews.

Results

After 2 months, HEWs were shown to adhere to the requirements in 74.6% consultations; an increase of 18.6% after training (P < .001). ChARM is acceptable to users and caregivers, with HEWs suggesting that ChARM increased client flow and stating a willingness to use ChARM in future.

Conclusion

Further research on the performance, cost‐effectiveness and implementation of this device is warranted to inform policy decisions in countries with a high childhood pneumonia burden.
Breaching the black box: The role of ramps in Thai sustainable palm oil certification
Authors: Degli Innocenti Elena , Oosterveer Peter , Mol Arthur
Published: October 2019

Certification of sustainable palm oil as organised through the Round Table on Sustainable Palm Oil is based on a simplified understanding of the global palm oil value chain – according to which instructions about production practices can be directly translated from the palm oil mill to the primary producer. The reality of palm oil provision is much more complex than this as is shown in the case of Thailand. On the basis of qualitative field study in Southern Thailand this paper clarifies that intermediary stages, such as the collection of oil palm fruit bunches at the ramp, play a key role in the organisation of the chain. The fluidity and complexity of the palm oil flow at the local level complicates the promotion of sustainability through certification. Global and national stakeholders, such as processing and trading firms, non‐governmental organisations and national governments, should therefore open this black box of local dynamics to more effectively contribute to sustainability in palm oil supply.
It is better to be ignorant of our moral enhancement: A reply to Zambrano
Authors: Crutchfield Parker
Published: October 2019

In a recent issue of Bioethics, I argued that compulsory moral bioenhancement should be administered covertly. Alexander Zambrano has criticized this argument on two fronts. First, contrary to my claim, Zambrano claims that the prevention of ultimate harm by covert moral bioenhancement fails to meet conditions for permissible liberty‐restricting public health interventions. Second, contrary to my claim, Zambrano claims that covert moral bioenhancement undermines autonomy to a greater degree than does overt moral bioenhancement. In this paper, I rebut both of these arguments, then finish by noting important avenues of research that Zambrano’s arguments motivate.
Investigation of the thermal history of the Delaware Basin (West Texas, USA) using carbonate clumped isotope thermometry
Authors: Naylor H. Nathan , Defliese William F. , Grossman Ethan L. , Maupin Christopher R.
Published: October 2019

We utilized carbonate clumped isotope thermometry to explore the thermal history of the Delaware Basin, West Texas, USA. Carbonate wellbore cuttings from five oil/gas wells across the basin yielded clumped isotope temperatures (T(Δ47)) ranging from 27°C to 307°C, interpreted to reflect a combination of initial precipitation/recrystallization temperature and solid‐state C‐O bond reordering during burial. Dolomite samples generally record lower apparent T(Δ47)s than calcite, reflecting greater resistance to reordering in dolomite. In all five wells, clumped isotope temperatures exceed modern downhole temperature measurements, indicating higher heat flow in the past. Using modelled burial curves based on sedimentological history, we created unique time‐temperature histories by linearly applying a geothermal gradient. Applying two different thermal history reordering models, we modelled the extent of solid‐state C–O bond reordering to iteratively find the time‐averaged best‐fit geothermal gradients for each of the five wells. Results of this modelling suggest that the shallower, southwestern portion of the study area experienced higher geothermal gradients throughout the sediment history (~45°C/km) than did the deeper, southeastern portion (~32°C/km), with the northern portion experiencing intermediate geothermal gradients (~35–38°C/km). This trend is in agreement with the observed gas/oil ratios of the Delaware Basin, increasing from east to west. Furthermore, our clumped isotope temperatures agree well with previously published vitrinite reflectance data, confirming previous observations and demonstrating the utility of carbonate clumped isotope thermometry to reconstruct basin thermal histories.
Autoimmune encephalomyelitis
Authors: Tanaka Keiko
Published: October 2019

Recent discoveries of several autoantibodies produced in patients with autoimmune encephalomyelitis have contributed largely to categorize new clinical entities in this field, and also provided a deep understanding of the background of neurological symptoms in these disorders together with new insights in the basic neuroscience. Most of these recently identified autoantibodies bind to the neuronal or glial cell surface synaptic receptors. They alter synaptic functions and develop characteristic clinical features depending on each target antigen. Among them, N‐methyl‐D‐aspartate receptor (NMDAR) is the most frequent antibody, causing NMDAR encephalitis syndrome, which has various characteristic clinical features including acute psychosis, memory disturbance, seizures, dyskinetic abnormal movements, conscious disturbance and respiratory dysfunction mainly in young women with ovarian teratoma. The next most frequently detected antibody is anti‐leucine‐rich glioma‐inactivated 1(LGI1) antibody, formerly designated as voltage‐gated potassium channel antibody. The anti‐LGI1 antibodies are detected in older patients of both sex and show symptoms related to the limbic system without having associated tumors. Patients with these cell‐surface antibodies show neurological symptoms closely related to the function of target synapse/channel antigens, which also bring new insights in signal transduction research. The triggers to develop specific antibody production and inducing encephalopathy are not known yet; however, they tend to respond to antigen‐removal treatment even if they have tumors. Thus, it is important to diagnose autoantibody production and initiate therapy as early as possible.
Impact of audiovisual information on anxiety and fear in patients undergoing dental implant treatment
Authors: Camacho‐Alonso Fabio , Vilaplana‐Vivo Jaime , Caballero‐Guerrero Pedro M. , Pato‐Mourelo Jesús , Sánchez‐Siles Mariano
Published: October 2019

Background

Few studies have reported the impact of audiovisual implant surgery information on anxiety and fear.

Purpose

To investigate the impact of audiovisual information on anxiety and fear in patients undergoing dental implant treatment.

Materials and Methods

This study included 300 patients due to undergo surgery to place a single implant. An interview topic guide and the Krantz Health Opinion Survey (KHOS) survey were used to assess the information patients already had about treatment and how much information they were seeking. Afterwards were randomized into two groups (n = 150): group 1 (verbal information) and group 2 (audiovisual information). Before surgery, anxiety and fear were assessed using State‐Trait Anxiety Inventory (STAI), Modified Corah Dental Anxiety Scale (MDAS), and Dental Fear Scale (DFS) scales. After treatment, all patients described their satisfaction with the information received with a VAS.

Results

Before receiving information, both groups were homogenous in their knowledge of the implant procedure (P = .825) and the quantity of information sought (KHOS; P = .080). After receiving information, group 2 patients presented more anxiety and fear than group 1 (STAI‐State, STAI‐Treat, MDAS, DFS; P < .001). After surgery, both groups were equally satisfied with the information received and the need for additional information (P = .689; P = .199, respectively).

Conclusions

Audiovisual information generated greater anxiety and fear than conventional verbal information in patients undergoing implant surgery.
CRYAB promotes osteogenic differentiation of human bone marrow stem cells via stabilizing β‐catenin and promoting the Wnt signalling
Authors: Zhu Bin , Xue Feng , Li Guangyi , Zhang Changqing
Published: October 2019

Objectives

The osteogenesis differentiation of human bone marrow stem cells (BMSCs) is essential for bone formation and bone homeostasis. In this study, we aim to elucidate novel molecular targets for bone metabolism diseases.

Materials and methods

The dataset GSE80614 which includes mRNA expression profile during BMSCs osteogenic differentiation was obtained from the GEO database (https://www.ncbi.nlm.nih.gov/geo/). The osteogenic differentiation of BMSCs was measured by ALP staining, AR staining and expression of osteogenic markers in vitro. For in vivo assay, we seeded BMSCs onto beta‐tricalcium phosphate (β‐TCP) and transplanted them into muscle pockets of nude mice. Luciferase assay, co‐immunoprecipitation assay and in vitro ubiquitination assay were carried out to investigate the molecular mechanism.

Results

We found that α‐B‐crystallin (CRYAB) expression was elevated during the process of BMSCs osteogenic differentiation. Further studies showed that upregulation of CRYAB significantly enhanced the osteogenic differentiation, while downregulation of CRYAB suppressed it. CRYAB regulated BMSCs osteogenic differentiation mainly through the canonical Wnt/β‐catenin signalling. In addition, we found that CRYAB could physically interact with β‐catenin and protect it from ubiquitination and degradation, which stabilized β‐catenin and promoted the Wnt signalling.

Conclusions

The present study provides evidences that CRYAB is an important regulator of BMSCs osteogenic differentiation by protecting β‐catenin from ubiquitination and degradation and promoting the Wnt signalling. It may serve as a potential therapeutic target for diseases related to bone metabolism.
Fournier's gangrene and sodium‐glucose co‐transporter‐2 inhibitors: A meta‐analysis of randomized controlled trials
Authors: Silverii Giovanni Antonio , Dicembrini Ilaria , Monami Matteo , Mannucci Edoardo
Published: October 2019

Fournier's gangrene (FG) is a rare, life‐threatening necrotizing fasciitis of the perineum. The US Food and Drug Administration (FDA) released a Drug Safety Communication regarding the risk of FG associated with sodium‐glucose co‐transporter‐2 inhibitors (SGLT2i), relying on the FDA Adverse Event Reporting System. To verify this association, we performed a meta‐analysis of all randomized controlled trials enrolling patients with type 2 diabetes, comparing SGLT2i with placebo or different therapies, collecting cases of FG reported as a serious adverse event. Risk of abscess, cellulitis and erysipela were secondary outcomes. We retrieved 84 trials enrolling 42 415 patients in the SGLT2i group and 27 158 patients in comparator groups. No difference was observed between SGLT2i and comparators in the risk of FG (Mantel‐Haenzel odds ratio [MH‐OR] 0.41 [0.09, 1.82]), abscess (MH‐OR 0.94 [0.54, 1.65]), cellulitis (MH‐OR 0.90 [0.71, 1.13] or erysipela (MH‐OR 0.89 [0.45, 1.77]). The number of events was small, leading to a wide confidence interval that does not allow ruling out an increase in FG or skin and subcutaneous tissue infections.
Ecological memory at millennial time‐scales: the importance of data constraints, species longevity and niche features
Authors: Benito Blas M. , Gil‐Romera Graciela , Birks H. John B.
Published: October 2019

Ecological memory describes how antecedent conditions drive the dynamics of an ecological system. Palaeoecological records are paramount to understand ecological memory at millennial time‐scales, but the concept is widely neglected in the literature, and a formal approach is lacking. Here, we fill such a gap by introducing a quantitative framework for ecological memory in palaeoecology, and assessing how data constraints and taxa traits shape ecological memory patterns.

We simulate the population dynamics and pollen abundance of 16 virtual taxa with different life and niche traits as a response to an environmental driver. The data is processed to mimic a realistic sediment deposition and sampled at increasing depth intervals. We quantify ecological memory with Random Forests, and assess how data properties and taxa traits shape ecological memory.

We find that life‐span and niche features modulate the relative importance of the antecedent values of the driver and the pollen abundance over periods of 240 yr and longer. Additionally, we find that accumulation rate and decreasing pollen‐sampling resolution inflate the importance of antecedent pollen abundance.

Our results suggest that: 1) ecological memory patterns are sensitive to varying accumulation rates. A better understanding on the numerical basis of this effect may enable the assimilation of ecological memory concepts and methods in palaeoecology; 2) incorporating niche theory and models is essential to better understand the nature of ecological memory patterns at millennial time‐scales. 3) Long‐lived generalist taxa are highly decoupled from the environmental signal. This finding has implications on how we interpret the abundance‐environment relationship of real taxa with similar traits, and how we use such knowledge to forecast their distribution or reconstruct past climate.
Individual tree context and contrast dictate tree physiological features and arthropod biodiversity patterns across multiple trophic levels
Authors: Swart Rudi C. , Samways Michael J. , Pryke James S. , Roets Francois
Published: October 2019

1. The present study tested the hypothesis that tree context (natural, semi‐natural or planted) and contrast (height of surrounding vegetation) affect tree physiological characters (leaf size, nutrient content, and stress‐related factors), and also alter the arthropod biodiversity patterns either directly or indirectly.

2. Arthropods were collected from tree canopies using chemical fogging from the ecologically important South African native tree Podocarpus elongatus.

3. Low contrast trees had significantly larger leaves than those in high contrast environments and harboured an overall higher richness, abundance, and biomass of arthropods, although this was guild‐dependent.

4. Trees in natural contexts had less foliar δ13C, suffered less from artificial nitrogen enrichment, and harboured significantly higher herbivore and predator arthropod richness and unique assemblages, compared with planted trees.

5. Semi‐natural trees supported natural levels of arthropod richness, although these were mostly generalist species.

6. Tree context and contrast can therefore dictate associated biota at multiple trophic levels and native trees may fail to maintain natural biodiversity in transformed landscapes.
Google search activity in early psychosis: A qualitative analysis of internet search query content in first episode psychosis
Authors: Kirschenbaum Michael A. , Birnbaum Michael L. , Rizvi Asra , Muscat Whitney , Patel Lalit , Kane John M.
Published: October 2019

Aim

Manually explore the Google search queries of individuals with first episode psychosis prior to their first hospitalization, in effort to identify common themes and search interests during the period of emerging illness.

Methods

Individuals hospitalized for psychosis between December 2016 and September 2017 provided access to their Google archive data for manual qualitative evaluation of search content. Searches conducted during the 6‐month time period prior to the participant's first hospitalization for psychosis were extracted and evaluated for search activity associated with mental health.

Results

Of 20 archives reviewed, 15 individuals (75%) searched for information classified by reviewers as related to mental health. Searches with content associated with delusions were found in 15 participant archives (75%). Searches related to negative symptoms including social withdrawal and decline in function were identified in 6 participant's search archives (30%). Four participants (20%) had searches that were associated with thought processes, and 2 participants (10%) searched for information on suicide. Four participants (20%) searched for information related to anxiety, whereas 3 participants (15%) had searches related to depressive symptoms.

Conclusions

Individuals with early psychosis appear to be using the Internet for obtaining information about their early symptoms and experiences prior to their first contact with psychiatric care. Improving our understanding of the ways by which individuals with emerging psychosis search for information about their experiences online may help mental health clinicians tailor online resources in hopes of improving pathways to care and reducing the duration of untreated psychosis.
The yield of long‐term electrocardiographic recordings in refractory focal epilepsy
Authors: van der Lende Marije , Arends Johan B. , Lamberts Robert J. , Tan Hanno L. , de Lange Frederik J. , Sander Josemir W. , Aerts Arnaud J. , Swart Henk P. , Thijs Roland D.
Published: October 2019

Objective

To determine the incidence of clinically relevant arrhythmias in refractory focal epilepsy and to assess the potential of postictal arrhythmias as risk markers for sudden unexpected death in epilepsy (SUDEP).

Methods

We recruited people with refractory focal epilepsy without signs of ictal asystole and who had at least one focal seizure per month and implanted a loop recorder with 2‐year follow‐up. The devices automatically record arrhythmias. Subjects and caregivers were instructed to make additional peri‐ictal recordings. Clinically relevant arrhythmias were defined as asystole ≥ 6 seconds; atrial fibrillation < 55 beats per minute (bpm), or > 200 bpm and duration > 30 seconds; persistent sinus bradycardia < 40 bpm while awake; and second‐ or third‐degree atrioventricular block and ventricular tachycardia/fibrillation. We performed 12‐lead electrocardiography (ECG) and tilt table testing to identify non–seizure‐related causes of asystole.

Results

We included 49 people and accumulated 1060 months of monitoring. A total of 16 474 seizures were reported, of which 4679 were captured on ECG. No clinically relevant arrhythmias were identified. Three people had a total of 18 short‐lasting (<6 seconds) periods of asystole, resulting in an incidence of 2.91 events per 1000 patient‐months. None of these coincided with a reported seizure; one was explained by micturition syncope. Other non–clinically relevant arrhythmias included paroxysmal atrial fibrillation (n = 2), supraventricular tachycardia (n = 1), and sinus tachycardia with a right bundle branch block configuration (n = 1).

Significance

We found no clinically relevant arrhythmias in people with refractory focal epilepsy during long‐term follow‐up. The absence of postictal arrhythmias does not support the use of loop recorders in people at high SUDEP risk.
Removal of a fragmented nasogastric tube from the transverse colon of a horse undergoing exploratory celiotomy for colic
Authors: Guerra M. , Kilcoyne I.
Published: October 2019

This report describes the clinical course and surgical findings of a 5‐year‐old Warmblood gelding referred for colic with a previous history of intermittent colic episodes, and gastric ulcers diagnosed by gastroscopy in the preceding months. The horse underwent medical treatment but remained painful and surgery was elected. The horse underwent an exploratory laparotomy during which an impaction was identified in the transverse colon that was associated with an approximately 1 metre segment of nasogastric tube. The foreign body was removed via an enterotomy in the left dorsal colon, and the horse recovered well from surgery. No complications were encountered post‐operatively.
Analysis of fatigue crack growth behavior of SS 316(N) welds using the unified approach
Authors: Nani Babu M. , Sasikala G. , Sadananda K.
Published: October 2019

Fatigue crack growth (FCG) behavior of SS 316(N) weld has been evaluated at different R‐ratios at room temperature and compared with that of the base metal. The FCG resistance of weld is better than that of the base material and is due to the residual stresses developed during the welding. The data were analyzed using the unified approach that considers the two‐parametric (ΔK and Kmax) nature of fatigue. The R‐ratio effects in both the base and weld metals are accounted for without invoking the extrinsic parameters, such as plasticity‐induced crack closure. Since the residual stresses are of the monotonic type, they affect the crack growth via the Kmax‐parameter. The crack growth trajectory plots were developed, and they show how the two crack tip driving forces, ΔK and Kmax, change to overcome the FCG resistance of the weld in relation to that of the base metal. The results also show that the effects from the compressive residual stresses are more dominant at low R‐values and occur via the Kmax parameter.
First application in Turkey of the European Non‐native Species in Aquaculture Risk Analysis Scheme to evaluate the farmed non‐native fish, striped catfish Pangasianodon hypophthalmus
Authors: Tarkan Ali Serhan , Yoğurtçuoğlu Baran , Ekmekçi Fitnat Güler , Clarke Stacey A. , Wood Louisa E. , Vilizzi Lorenzo , Copp Gordon
Published: October 2019

The European Non‐native Species in Aquaculture Risk Analysis Scheme (ENSARS) was used to assess one of the most popular aquaculture species in the world, the striped catfish Pangasianodon hypophthalmus (Sauvage, 1878), in two locations of southern Anatolia (Turkey). The overall mean risk score generated for P. hypophthalmus by the ENSARS Organism module (which assesses the risks of introduction, establishment, dispersal and impact) indicated that the species poses a medium risk under current climatic conditions. All other ENSARS modules rendered scores that indicated a moderately low risk under current climatic conditions. However, the risks of introducing novel diseases and the actual use (e.g. deliberate introduction to the natural habitats or food market) of the species both attracted scores indicating a medium risk. Confidence levels were medium or high for all modules except the Socio‐economic, with low confidence values also attributed to the risks for farming process of the organism, and its overall risk of spread into the wild during farming procedures and to marketing impacts. Recommendations are provided for further use of the ENSARS scheme, especially for a a priori assessment of potential aquaculture species in Turkey, where the sector has been remarkably developing in the last decades.
The role of floods and droughts on riverine ecosystems under a changing climate
Authors: Parasiewicz Piotr , King Elise L. , Webb J. Angus , Piniewski Mikołaj , Comoglio Claudio , Wolter Christian , Buijse Anthonie D. , Bjerklie David , Vezza Paolo , Melcher Andreas , Suska Katarzyna
Published: October 2019

Floods and droughts are key driving forces shaping aquatic ecosystems. Climate change may alter key attributes of these events and consequently health and distribution of aquatic species. Improved knowledge of biological responses to different types of floods and droughts in rivers should allow the better prediction of the ecological consequences of climate change‐induced flow alterations. This review highlights that in unmodified ecosystems, the intensity and direction of biological impacts of floods and droughts vary, but the overall consequence is an increase in biological diversity and ecosystem health. To predict the impact of climate change, metrics that allow the quantitative linking of physical disturbance attributes to the directions and intensities of biological impacts are needed. The link between habitat change and the character of biological response is provided by the frequency of occurrence of the river wave characteristic—that is the event's predictability. The severity of impacts of floods is largely related to the river wave amplitude (flood magnitude), while the impact of droughts is related to river wavelength (drought duration).
Predicting future climate at high spatial and temporal resolution
Authors: Maclean Ilya M. D.
Published: October 2019

Most studies on the biological effects of future climatic changes rely on seasonally aggregated, coarse‐resolution data. Such data mask spatial and temporal variability in microclimate driven by terrain, wind and vegetation, and ultimately bear little resemblance to the conditions that organisms experience in the wild. Here, I present the methods for providing fine‐grained, hourly and daily estimates of current and future temperature and soil moisture over decadal timescales. Observed climate data and spatially coherent probabilistic projections of daily future weather were disaggregated to hourly and used to drive empirically calibrated physical models of thermal and hydrological microclimates. Mesoclimatic effects (cold‐air drainage, coastal exposure and elevation) were determined from the coarse‐resolution climate surfaces using thin‐plate spline models with coastal exposure and elevation as predictors. Differences between micro and mesoclimate temperatures were determined from terrain, vegetation and ground properties using energy balance equations. Soil moisture was computed in a thin upper layer and an underlying deeper layer, and the exchange of water between these layers was calculated using the van Genuchten equation. Code for processing the data and running the models is provided as a series of R packages. The methods were applied to the Lizard Peninsula, United Kingdom, to provide hourly estimates of temperature (100 m grid resolution over entire area, 1 m for a selected area) for the periods 1983–2017 and 2041–2049. Results indicated that there is a fine‐resolution variability in climatic changes, driven primarily by interactions between landscape features and decadal trends in weather conditions. High‐temporal resolution extremes in conditions under future climate change were predicted to be considerably less novel than the extremes estimated using seasonally aggregated variables. The study highlights the need to more accurately estimate the future climatic conditions experienced by organisms and equips biologists with the means to do so.
Impact of loss of independence in basic activities of daily living on caregiver burden in patients with Alzheimer's disease: A retrospective cohort study
Authors: Kawaharada Rika , Sugimoto Taiki , Matsuda Naoka , Tsuboi Yamato , Sakurai Takashi , Ono Rei
Published: October 2019

Aim

To investigate the association between decline of basic activities of daily living (ADL) in each dimension and change in caregiver burden in patients with mild‐to‐moderate Alzheimer's disease.

Methods

This retrospective study included 117 outpatients with Alzheimer's disease who presented to the Memory Clinic at the National Center for Geriatrics and Gerontology in Japan between September 2010 and April 2014 (mean age 77.3 ± 6.4 years; 68.6% women). Patients and their caregivers completed comprehensive geriatric assessment at baseline and at the 3‐year follow up. Caregiver burden was assessed using the Japanese version of the Zarit Burden Interview. ADL were assessed by the Barthel Index. Among patients with full points on each subitem of the Barthel Index at baseline, incident ADL decline was defined as a loss of at least 5 points at the 3‐year follow up. Other confounding factors including demographic data, cognitive function, vitality, and behavioral and psychiatric symptoms of dementia were also assessed. The longitudinal relationship between incident ADL decline and changes in caregiver burden was evaluated by multivariate linear regression, adjusted for confounding variables.

Results

In descending order, declines in ADL at 3 years were noted in bathing (25.4%), bowel control (25.4%), grooming (22.9%) and bladder control (22.9%). On multivariate analyses, ADL declines in feeding (b = 17.2, P < 0.01) and bathing (b = 11.0, P = 0.02) were significantly associated with increased caregiver burden.

Conclusion

Incident ADL declines in feeding and bathing are significant risk factors for increased caregiver burden in patients with Alzheimer's disease. Geriatr Gerontol Int 2019; 19: 1243–1247.
Haemophilic arthropathy: A narrative review on the use of intra‐articular drugs for arthritis
Authors: Buccheri Enrico , Avola Marianna , Vitale Nicolò , Pavone Piero , Vecchio Michele
Published: October 2019

Introduction

Intra‐articular injections of various drugs are commonly used in patients with degenerative osteoarthritis and also in haemophilic patients. Haemophilic arthropathy is a particular type of secondary osteoarthritis (OA), but the degeneration of strong synovial, cartilaginous and subchondral constituents is provoked by the direct action of iron and blood in the joint.

Aim of the study

The aim of this study is to review the literature regarding the use of various intra‐articular drugs in joints affected by haemophilic arthropathy.

Methods

We reviewed the data from the literature; the search was performed on three medical electronic databases (PubMed, Cochrane Library and Scopus Web of Science) by three authors (B. E., A. M. and V. N.) from 3 December 2018 till 15 December 2018. The search string was as follows: (hyaluronic acid OR viscosupplementation OR platelet‐rich plasma OR corticosteroid OR mesenchymal stem cells) AND (haemophilia OR haemophilic arthropathy OR haemophilic arthritis).

Results

Once the research was performed, a total of 300 articles were identified. 47 selected articles were analysed by the reviewers, and the eligibility of the study inclusion was assessed independently. Twelve papers were included based on clear fulfilment of the inclusion criteria. Thirty‐five articles were excluded for the following reasons: no full text or accessible data for 14 of them, 15 involved surgery or rehabilitation therapy as the primary topic and 6 were systematic reviews (the main topics were beyond the haemophilic arthropathy).

Conclusion

Although the degree of scientific evidence of the publications on intra‐articular injections of various drugs (hyaluronic acid, corticosteriods, PRP and MSCs) in haemophilia is very low, it seems that intra‐articular injections of hyaluronic acid can relieve joint pain for months and can be repeated every 6‐12 months, which is why they can be recommended. Corticosteroid injections seem to relieve joint pain for a few weeks, but their routine use is not recommended in haemophilia. The efficacy of PRP and MSCs in haemophilic arthropathy is pending confirmation, which is why they are not currently recommended.
Communicating uncertainties when disclosing diagnostic test results for (Alzheimer's) dementia in the memory clinic: The ABIDE project
Authors: Visser Leonie N. C. , Pelt Sophie A. R. , Kunneman Marleen , Bouwman Femke H. , Claus Jules J. , Kalisvaart Kees J. , Hempenius Liesbeth , de Beer Marlijn H. , Roks Gerwin , Boelaarts Leo , Kleijer Mariska , van der Flier Wiesje M. , Smets Ellen M. A. , Hillen Marij A.
Published: October 2019

Background

The development of novel diagnostics enables increasingly earlier diagnosis of Alzheimer's disease (AD). Timely diagnosis may benefit patients by reducing their uncertainty regarding the cause of symptoms, yet does not always provide patients with the desired certainty.

Objective

To examine, using both quantitative and qualitative methods, uncertainty communicated by memory clinic clinicians in post‐diagnostic testing consultations with patients and their caregivers.

Methods

First, we identified all uncertainty expressions of 22 clinicians in audiotaped post‐diagnostic testing consultations with 78 patients. Second, we statistically explored relationships between patient/clinician characteristics and uncertainty expressions. Third, the transcribed uncertainty expressions were qualitatively analysed, determining the topic to which they pertained, their source and initiator/elicitor (clinicians/patients/caregivers).

Results

Within 57/78 (73%) consultations, clinicians expressed in total 115 uncertainties, of which 37% elicited by the patient or caregiver. No apparent relationships were found between patient/clinician characteristics and whether or not, and how often clinicians expressed uncertainty. Uncertainty expressions pertained to ten different topics, most frequently patient's diagnosis and symptom progression. Expressed uncertainty was mostly related to the unpredictability of the future and limits to available knowledge.

Discussion and conclusions

The majority of clinicians openly discussed the limits of scientific knowledge and diagnostic testing with patients and caregivers in the dementia context. Noticeably, clinicians did not discuss uncertainty in about one quarter of consultations. More evidence is needed on the beneficial and/or harmful effects on patients of discussing uncertainty with them. This knowledge can be used to support clinicians to optimally convey uncertainty and facilitate patients' uncertainty management.
The spatial analysis of biological interactions: morphological variation responding to the co‐occurrence of competitors and resources
Authors: Tovilla‐Sierra Rosa Daniela , Herrera‐Alsina Leonel , Bribiesca Rafael , Arita Héctor T.
Published: October 2019

By sharing geographic space, species are forced to interact with one another and the contribution of this process to evolutionary and ecological patterns of individual species is not fully understood. At the same time, species turnover makes that species composition varies from one area to another, so the analysis of biological interaction cannot be uncoupled from the spatial context. This is particularly important for clades that show high degree of specialization such as hummingbirds, where any variation in biotic pressures might lead to changes in morphology. Here, we describe the influence of biological interactions on the morphology ofHylocharis leucotisby simultaneously considering potential competition and diet resources. We characterized the extent of local potential competition and local available floral resources by correlating two measurements of hummingbird diversity, floral resources and the size of morphological space ofH. leucotisalong its geographic distribution. We found thatH. leucotisshows an important morphological variability across its range and two groups can be recognized. Surprisingly, morphological variation is not always linked to local hummingbird richness or the phylogenetic similarity of. Only in the southern part of its distribution,H. leucotisis morphologically more variable in those communities where it coexist with closely related hummingbird species. We also found that morphological variation inH. leucotisis independent from the availability of floral resources. Our results suggest that abiotic factors might be responsible for morphological differences across populations inHylocharis leucotisbeing biological interactions of minor importance.
Percutaneous left atrial appendage closure in the presence of thrombus: A feasibility report
Authors: Bordignon Stefano , Bologna Fabrizio , Chen Shaoje , Konstantinou Athanasios , Tsianakas Nikolaos , Tohoku Shota , Trolese Luca , Chun KR Julian , Schmidt Boris
Published: October 2019

Background

Patients with a left atrial appendage thrombus (LAAT) despite oral anticoagulation (OAC) are at high risk of thromboembolism (TE) and a relevant proportion of LAAT do not resolve under continued OAC. Left atrial appendage closure (LAAC) in the presence of LAAT was anecdotally described as a therapeutic option to prevent TE in the patients.

Objective

To describe the feasibility of LAAC despite LAAT in consecutive patients.

Methods

We searched the LAAC database of our center to identify patients in whom a LAAC was performed despite evidence of a thrombus in the LAA. All procedures were performed under transesophageal echocardiography guidance, no angiographies were performed to avoid LAAT dislocation. An Amulet Occluder device was preferred to allow proximal implantation and sealing of the LAA.

Results

Nine patients were identified. The mean age was 68.1 ± 10.7 years, four were female, mean CHADSVASC and HASBLED were 3.6 ± 1.7 and 3.0 ± 1.0. Eight of nine patients were on OAC, one patient was under lone aspirin therapy because of bleeding. The mean distance between the LAAT and the estimated landing zone was 18 ± 6 mm, the minimal distance was 11 mm. The mean landing zone was 21 ± 3 mm, devices with a mean size of 25 ± 4 mm were chosen for implantation. All implantation succeeded, only two patients required an intraprocedural replacement. No procedural complication nor short term thromboembolic complication during a follow up of 138 ± 149 days were recorded.

Conclusion

In the presented series a percutaneous LAAC despite a LAAT resulted to be feasible and safe.