bluuebunny/crossref_metadata_2025 huggingface dataset:
Innate and adaptive immunity in human epilepsies
Authors: Bauer Jan , Becker Albert J. , Elyaman Wassim , Peltola Jukka , Rüegg Stephan , Titulaer Maarten J. , Varley James A. , Beghi Ettore
Published: July 2017

Inflammatory mechanisms have been increasingly implicated in the origin of seizures and epilepsy. These mechanisms are involved in the genesis of encephalitides in which seizures are a common complaint. Experimental and clinical evidence suggests different inflammatory responses in the brains of patients with epilepsy depending on the etiology. In general, activation of both innate and adaptive immunity plays a role in refractory forms of epilepsy. Epilepsies in which seizures develop after infiltration of cells of the adaptive immune system in the central nervous system (CNS) include a broad range of epileptic disorders with different (known or unknown) etiologies. Infiltration of lymphocytes is observed in autoimmune epilepsies, especially the classical paraneoplastic encephalitides with antibodies against intracellular tumor antigens. The presence of lymphocytes in the CNS also has been found in focal cerebral dysplasia type 2 and in cortical tubers. Various autoantibodies have been shown to be associated with temporal lobe epilepsy (TLE) and hippocampal sclerosis of unknown etiology, which may be due to the presence of viral DNA. During the last decade, an increasing number of antineuronal autoantibodies directed against membranous epitopes have been discovered and are associated with various neurologic syndromes, including limbic encephalitis. A major challenge in epilepsy is to define biomarkers, which would allow the recognition of patient populations who might benefit from immune‐modulatory therapies. Some peripheral inflammatory markers appear to be differentially expressed in patients with medically controlled and medically refractory and, as such, could be used for diagnostic, prognostic, or therapeutic purposes. Establishing an autoimmune basis in patients with drug‐resistant epilepsy allows for efficacious and targeted immunotherapy. Although current immunotherapies can give great benefit to the correctly identified patient, there are limitations to their efficacy and they may have considerable side effects. Thus the identification of new immunomodulatory compounds remains of utmost importance.
Neurobehavioral comorbidities of epilepsy: Role of inflammation
Authors: Mazarati Andrey M. , Lewis Megan L. , Pittman Quentin J.
Published: July 2017

Epilepsy is associated with a high incidence of comorbid neurologic and psychiatric disorders. This review focuses on the association of epilepsy with autism spectrum disorder (ASD) and depression. There is high concordance of these behavioral pathologies with epilepsy. We review data that unambiguously reveal that epilepsy, ASD, and depression are associated with elevated brain inflammatory markers and that these may interact with serotoninergic pathways. Interference with inflammatory pathways or actions can reduce the severity of seizures, depression, and ASD‐like behavior. Inflammation in the brain can be induced by seizure activity as well as by behavioral, environmental, and physiologic stressors. Furthermore, induction of inflammation at an early time point during gestation and in early neonatal life can precipitate both an ASD‐like phenotype as well as a more excitable brain. It appears likely that priming of the brain due to early inflammation could provide a means by which subsequent inflammatory processes associated with epilepsy, ASD, and depression may lead to comorbidity.
Warmer winters increase the rhizosphere carbon flow to mycorrhizal fungi more than to other microorganisms in a temperate grassland
Authors: Birgander Johanna , Rousk Johannes , Olsson Pål Axel
Published: July 2017

A decisive set of steps in the terrestrial carbon (C) cycle is the fixation of atmospheric C by plants and the subsequent C‐transfer to rhizosphere microorganisms. With climate change winters are expected to become milder in temperate ecosystems. Although the rate and pathways of rhizosphere C input to soil could be impacted by milder winters, the responses remain unknown. To address this knowledge‐gap, a winter‐warming experiment was established in a seminatural temperate grassland to follow the C flow from atmosphere, via the plants, to different groups of soil microorganisms. In situ 13CO2 pulse labelling was used to track C into signature fatty acids of microorganisms. The winter warming did not result in any changes in biomass of any of the groups of microorganisms. However, the C flow from plants to arbuscular mycorrhizal (AM) fungi, increased substantially by winter warming. Saprotrophic fungi also received large amounts of plant‐derived C—indicating a higher importance for the turnover of rhizosphere C than biomass estimates would suggest—still, this C flow was unaffected by winter warming. AM fungi was the only microbial group positively affected by winter warming—the group with the closest connection to plants. Winter warming resulted in higher plant productivity earlier in the season, and this aboveground change likely induced plant nutrient limitation in warmed plots, thus stimulating the plant dependence on, and C allocation to, belowground nutrient acquisition. The preferential C allocation to AM fungi was at the expense of C flow to other microbial groups, which were unaffected by warming. Our findings imply that warmer winters may shift rhizosphere C‐fluxes to become more AM fungal‐dominated. Surprisingly, the stimulated rhizosphere C flow was matched by increased microbial turnover, leading to no accumulation of soil microbial biomass.
Five‐year survival after surgery in nonagenarian patients
Authors: Fariña‐Castro Roberto , Roque‐Castellano Cristina , Marchena‐Gómez Joaquín , Rodríguez‐Pérez Aurelio
Published: July 2017

Aim

In countries with longer life expectancies, the nonagenarian population is increasing. Therefore, there is greater demand for healthcare, including surgical procedures. The aim of the present study was to determine the outcomes of surgery carried out on nonagenarians in terms of long‐term survival after the procedure.

Methods

We carried out a cross‐longitudinal study on a cohort of 159 nonagenarian patients, who underwent a non‐cardiac, non‐traumatic surgical procedure in our institution between January 1999 and December 2011. The following variables were recorded: sociodemographic characteristics, American Society of Anesthesiologists score, Charlson Comorbidity Index, surgical site, postoperative complications, operative mortality and long‐term survival. The output variable was long‐term survival.

Results

Of the 159 patients,99 women (62%) and 60 men (38%), with a mean age of 91.8 years (SD ± 2.0 years), 44 cases were operations for malignant disorders (28%), 117 cases (74%) under emergency conditions and 42 cases (26%) were elective treatments. The operative mortality was 29%, 4.8% for elective surgery and 37.6% for emergency surgery (P < 0.001). The postoperative complication rate, including death, was 60%. The probability of survival at 1, 3, and 5 years was 59.6%, 35.8% and 24.1%, respectively. In multivariate analysis, American Society of Anesthesiologists score (HR 2.07, 95% CI 1.58–2.72), emergency surgery (HR 1.64, 95% CI 1.05–2.57) and postoperative medical complications (HR 2.58, 95% CI 1.73–3.85) were independently related to 5‐year survival.

Conclusions

These findings support the perioperative safety of elective general surgery in nonagenarian patients. In selected nonagenarian patients with no cognitive impairment, surgery must not be denied. These data might be useful for surgical decision‐making or informed consent for nonagerians. Geriatr Gerontol Int 2017; 17: 2389–2395.
Effects of two different glutamine‐containing enteral supplements on stool frequency and density in elderly patients recovering from acute critical illness
Authors: Fushimi Nobutoshi , Yamada Munenori , Hachiya Hiroki , Ito Shun , Shibuya Takashi , Ohashi Noritsugu , Mori Akihiro
Published: July 2017

Aim

Glutamine has various beneficial functions in the gastrointestinal tract. The present study was designed to investigate the effect of two different glutamine supplements on bowel movement at the start of enteral feeding in elderly inpatients.

Methods

This was a double‐blind, prospective, randomized comparison study. A total of 25 patients aged >75 years recovering from a critical illness in a non‐intensive care unit and scheduled for tube feeding were recruited. Of them, 22 consenting patients were randomly assigned to two groups: glutamine‐fiber‐oligosaccharide treatment group (n = 11) and glutamine F treatment group (n = 11). They were given glutamine three times daily at a dosage of 9 g/day. Enteral nutrition was given at the same dosage to both groups for the duration of the study. The end‐points were stool frequency, Bristol Scale Form Score, bowel function index (Bristol Scale Form Score × stool frequency), the percentage of patients with stool frequency over three per day and those with a BSFS of 6 or 7 in each group.

Results

There were no significant differences between the two groups in terms of patient characteristics before the study. All the end‐points in the glutamine F group were significantly lower than those in the glutamine‐fiber‐oligosaccharide group.

Conclusions

Compared with glutamine‐fiber‐oligosaccharide, glutamine F administration resulted in stool hardening and reduced stool frequency in elderly inpatients recovering from acute critical illness in non‐intensive care units. The effects might be caused by the different additive components of glutamine supplements. Geriatr Gerontol Int 2017; 17: 2514–2519.
Parentage Identification of Differentiated Achondritic Meteorites by Hand‐held Energy Dispersive X‐Ray Fluorescence Spectrometry
Authors: Gemelli Maurizio , Di Rocco Tommaso , Folco Luigi , D'Orazio Massimo
Published: July 2017

We evaluate the potential of a hand‐held energy dispersiveXRFspectrometer for the preliminary classification of non‐chondritic differentiated meteorites. The studied achondrites include nine lunar meteorites, seventeen Martian meteorites, five angrites and eighteen meteorites from asteroid 4 Vesta. Analytical precision and accuracy was tested on thirty‐nine terrestrial igneous rock slabs with a wide range of composition. Replicate analyses, performed on the studied meteorites, show that Fe/Mn values together with Si and Ca/K ratio can be used in the discrimination of different achondrite groups. Fusion crust's Fe/Mn values of meteorites from Vesta and Mars are indistinguishable from those of the interior implying that even measurements on the fusion‐crusted external surface could be sufficient to pigeonhole non‐chondritic meteorites. Hand‐held energy dispersiveXRFspectrometer is a non‐destructive but very effective technique for preliminary classification of achondrites in the field and in laboratory and for the identification of mislabelled meteorites in museum collections.
Challenges and difficulties in pathological diagnosis of autoimmune hepatitis
Authors: Harada Kenichi , Hiep Nguyen Canh , Ohira Hiromasa
Published: July 2017

Autoimmune hepatitis (AIH) with acute presentation is widely recognized as a distinct clinical entity, and its clinicopathology has been extensively studied. In most cases, AIH with acute presentation is merely acute exacerbation of classical chronic AIH, but pure acute‐onset AIH without previous symptoms of chronic liver disease is also encountered. Rapid diagnosis and initiation of immunosuppressive treatment are necessary for both acute exacerbation and acute‐onset to prevent fatal liver failure. The diagnostic criteria commonly used for classical AIH are generally applicable to acute exacerbation, but acute‐onset AIH may present with additional pathological features. These features include an acute hepatitis phase characterized by centrilobular necrosis. However, centrilobular necrosis is also a feature of drug‐induced liver injury, and there are no known histological characteristics exclusive to acute‐onset AIH. Moreover, the possibilities of drug‐induced AIH and immune‐mediated drug‐induced liver injury make diagnosis even more difficult. At present, liver biopsy is mandatory for the diagnosis of AIH with acute presentation, but careful consideration of all clinicopathological signs is necessary for differential diagnosis.
Research priorities about stoma‐related quality of life from the perspective of people with a stoma: A pilot survey
Authors: Hubbard Gill , Taylor Claire , Beeken Becca , Campbell Anna , Gracey Jackie , Grimmett Chloe , Fisher Abi , Ozakinci Gozde , Slater Sarah , Gorely Trish
Published: July 2017

Background

There is a recognized need to include patients in setting research priorities. Research priorities identified by people with a stoma are rarely elicited.

Objectives

To improve the quality of life of people with a stoma through use of evidence‐based practice based on research priorities set by patients.

Design and Methods

Online pilot survey publicized in 2016 via United Kingdom stoma charities. People ranked nine stoma‐related quality of life topics in order of research priority.

Participants

People 16 years of age and over who currently have or have had a stoma for treatment for any medical condition.

Analysis

Distributions of the priority scores for each of the nine research topics were examined. Group differences were explored using either the Mann–Whitney U‐test or the Kruskal–Wallis test depending on the number of groups.

Results

In total, 225 people completed the survey. The most important research priority was pouch leak problems and stoma bag/appliance problems followed by hernia risk. There were statistically significant differences in ranking research priorities between males and females, age, underlying disease that led to a stoma, stoma type and length of time with a stoma.

Conclusion

People with a stoma are willing to engage in and set research priorities. The results should contribute towards future research about setting the research agenda for the study of stoma‐related concerns that impact quality of life.
The use of in vivo microscopy to image the cnidarian stress response in three octocoral species
Authors: Parrin Austin P. , Somova Emily L. , Kern Peter M. , Millet Therese A. , Bross Lori S. , Blackstone Neil W.
Published: July 2017

Energy‐converting symbionts and organelles may be central to the cnidarian stress response. Stress may damage photochemistry in the endosymbiotic dinoflagellate Symbiodinium spp., leaving photosystems I and II relatively reduced and increasing reactive oxygen species (ROS). Alternatively, ROS may emanate from mitochondria of either the host or the symbiont, or both. These sources of ROS can be distinguished by using microscopy to examine the effects of light on stressed cnidarians incubated in the dark with a fluorescent, ROS‐detecting probe. Experiments were carried out with three species of alcyonacean octocoral, Phenganax parrini, Sarcothelia sp., and Sympodium sp. After incubation of colonies for 1 h at elevated temperature, imaging and illumination (excitation 450–490 nm, emission 515–565 nm) were begun simultaneously. Formation of ROS largely corresponded to the onset of illumination. On the other hand, chlorophyll fluorescence (excitation 530–580 nm, emission 620–690 nm) did not conform to this pattern. This difference is consistent with the expected rates of reaction. Remarkably, treatment with the inhibitor 3‐(3,4‐dichlorophenyl)‐1,1‐dimethylurea (DCMU) resulted in dramatically higher levels of light‐induced ROS. Chlorophyll fluorescence was higher in the DCMU treatment but not significantly so. By controlling for variation between individual symbionts, however, DCMU produced significantly greater levels of chlorophyll fluorescence, indicating the expected greater reduction of photosystem II. A brief exposure to light and thermal stress produced a similar effect in all three species. In addition to ROS being initiated by light, these results indicate that: (1) a brief period of stress shifts photosystem redox state toward reduction, (2) photosystem II can donate electrons to oxygen when blocked with DCMU, and (3) chlorophyll fluorescence is highly variable among individuals of Symbiodinium. Imaging of individual symbionts in hospite thus provides a powerful method for understanding the initial steps of the cnidarian stress response.
Chronic total occlusion in an infarct‐related coronary artery and the risk of appropriate ICD therapies
Authors: Di Marco Andrea , Anguera Ignasi , Teruel Luis , Muntane Guillem , Campbell Niall G. , Fox David J. , Brown Benjamin , Skene Chris , Davidson Neil , Leon Valentina , Dallaglio Paolo , Elzein Hind , Garcia‐Romero Elena , Gomez‐Hospital Joan Antoni , Cequier Angel
Published: July 2017

Introduction

Risk stratification for ventricular arrhythmias in patients with ischemic cardiomyopathy needs to be improved. Coronary chronic total occlusions in an infarct‐related artery (IRA‐CTOs) have been associated with an increased arrhythmic risk. This study aimed to evaluate the association between IRA‐CTOs and appropriate implantable cardioverter‐defibrillator (ICD) therapies.

Methods and results

Observational cohort study that included 342 patients with ischemic cardiomyopathy, an ICD implanted for primary or secondary prevention, and a coronary angiography performed shortly before ICD implantation. The ICD was implanted for primary prevention in 163 patients (48%). IRA‐CTO was found in 161 patients (47%). During a median follow‐up of 33 months, 41% of patients experienced at least one appropriate ICD therapy. Patients with IRA‐CTO had higher proportions of appropriate ICD therapies (57% vs. 26%, P < 0.001) and appropriate ICD shocks (40% vs. 17%, P < 0.001). At multivariate Cox regression, IRA‐CTO was the only variable that consistently resulted as independent predictor of appropriate ICD therapies and shocks both in the global population of the study (HR 2.3, P < 0.001 and HR 3, P < 0.001, respectively) and when analyzing separately patients with primary or secondary prevention ICD.

Conclusions

IRA‐CTO is an independent predictor of appropriate ICD therapies, including appropriate ICD shocks. This association is consistent across all the subgroups analyzed. Patients with IRA‐CTO have a very high risk of appropriate ICD therapies. These findings may help improving risk stratification as well as the management of ventricular arrhythmias in patients with ischemic cardiomyopathy.
Implicit identification with death predicts change in suicide ideation during psychiatric treatment in adolescents
Authors: Glenn Catherine R. , Kleiman Evan M. , Coppersmith Daniel D.L. , Santee Angela C. , Esposito Erika C. , Cha Christine B. , Nock Matthew K. , Auerbach Randy P.
Published: July 2017

Background

Suicidal thoughts and behaviors are major public health concerns in youth. Unfortunately, knowledge of reliable predictors of suicide risk in adolescents is limited. Promising research using a death stimuli version of the Implicit Association Test (Death IAT) indicates that stronger identification with death differs between adults with and without a history of suicidal thoughts and behaviors and uniquely predicts suicide ideation and behavior. However, research in adolescents is lacking and existing findings have been mixed. This study extends previous research by testing whether implicit identification with death predicts changes in suicide ideation during psychiatric treatment in adolescents.

Methods

Participants included 276 adolescents, ages 13–19, admitted to a short‐term residential treatment program. At hospital admission and discharge, adolescents completed the Death IAT and measures of recent suicidal thoughts.

Results

At admission, implicit identification with death was associated with recent suicide ideation, but did not differ between those who engaged in prior suicidal behavior and those who did not. Prospectively, adolescents' implicit identification with death at admission significantly predicted their suicide ideation severity at discharge, above and beyond explicit suicide ideation. However, this effect only was significant for adolescents with longer treatment stays (i.e., more than 13 days).

Conclusions

Implicit identification with death predicts suicidal thinking among adolescents in psychiatric treatment. Findings clarify over what period of time implicit cognition about death may predict suicide risk in adolescents.
Experimental evolution reveals differences between phenotypic and evolutionary responses to population density
Authors: McNamara K. B. , Simmons L. W.
Published: July 2017

Group living can select for increased immunity, given the heightened risk of parasite transmission. Yet, it also may select for increased male reproductive investment, given the elevated risk of female multiple mating. Trade‐offs between immunity and reproduction are well documented. Phenotypically, population density mediates both reproductive investment and immune function in the Indian meal moth, Plodia interpunctella. However, the evolutionary response of populations to these traits is unknown. We created two replicated populations of P. interpunctella, reared and mated for 14 generations under high or low population densities. These population densities cause plastic responses in immunity and reproduction: at higher numbers, both sexes invest more in one index of immunity [phenoloxidase (PO) activity] and males invest more in sperm. Interestingly, our data revealed divergence in PO and reproduction in a different direction to previously reported phenotypic responses. Males evolving at low population densities transferred more sperm, and both males and females displayed higher PO than individuals at high population densities. These positively correlated responses to selection suggest no apparent evolutionary trade‐off between immunity and reproduction. We speculate that the reduced PO activity and sperm investment when evolving under high population density may be due to the reduced population fitness predicted under increased sexual conflict and/or to trade‐offs between pre‐ and post‐copulatory traits.
Full‐spectrum versus standard colonoscopy for improving polyp detection rate: A systematic review and meta‐analysis
Authors: Facciorusso Antonio , Del Prete Valentina , Buccino Vincenzo , Valle Nicola Della , Nacchiero Maurizio Cosimo , Muscatiello Nicola
Published: July 2017

Background and Aim

Full‐spectrum endoscopy represents a new endoscopic platform allowing a panoramic 330 degree view of the colon, but evidence of its superiority over standard colonoscopy is still lacking. Our study is the first meta‐analysis comparing the efficacy of full‐spectrum endoscopy with standard colonoscopy.

Methods

Through a systematic literature review until May 2017, we identified eight randomized‐controlled trials. Primary outcomes were polyp detection rate and adenoma detection rate, while cecal intubation time and total colonoscopy time were secondary outcomes. Direct meta‐analysis was performed using a random effects model.

Results

No difference in terms of polyp detection rate and adenoma detection rate was found (risk ratio: 1.00, 95% confidence interval 0.89–1.12, P = 0.96, and 1.05, 0.94–1.17, P = 0.40, respectively). Adenoma miss rate resulted significantly in favor of full‐spectrum endoscopy (risk ratio: 0.35, 0.25–0.48, P < 0.01), although the difference was not significant for greater (>5 mm) and pedunculated lesions (risk ratio: 0.38, 0.09–1.60, P = 0.19, and risk ratio: 0.15, 0.01–3.00, P = 0.21, respectively). Cecal intubation time was not different between the two techniques (mean standardized difference: 0.22 min, −1.18 to 1.62, P = 0.76), while total colonoscopy time was significantly shorter when adopting full‐spectrum endoscopy (mean difference: −2.60, −4.60 to −0.61, P = 0.01). Sensitivity analysis confirmed all the findings.

Conclusions

Full‐spectrum endoscopy appears as a promising and reliable technology able to significantly decrease the number of adenomas missed and procedural times, while its superiority over standard colonoscopy in terms of adenoma detection rate results is still unclear.
Prevalence of hypertension and prehypertension in children and adolescents with intellectual disability in southeastern Poland
Authors: Wyszyńska J. , Podgórska‐Bednarz J. , Leszczak J. , Mazur A.
Published: July 2017

Background

There is insufficient information on the prevalence of hypertension (HPT) among children and adolescents with ID.

Aim

The aim of this study was to determine the prevalence of HPT in children and adolescents with ID in comparison with the control group, which accounted for children and adolescents without ID.

Methods

The study included 568 students with ID, aged from 7 to 18, attending special education institutions in southeastern Poland. The control group consisted of 568 students (matched to the study group for age and gender) without ID, attending randomly selected elementary and secondary schools located in the same area. Blood pressure was measured in compliance with the European Society of Hypertension recommendations.

Results

The overall prevalence of HPT and pre‐HPT in children and adolescents with ID were 18.5 and 20.6% respectively. Prevalence of HPT and pre‐HPT in children and adolescents without ID were 5.8 and 18.5% respectively. Children and adolescents with a higher level of ID were found to be at a greater risk of HPT. An excessive body mass and older age were predisposing factors to a significantly higher prevalence of HPT in children and adolescents with ID.

Conclusion

The prevalence of HPT among students with ID was more than three times higher than in the general population. The level of ID, age, sex and body mass significantly correlated with HPT in the study group.
Restoring jawline contour with calcium hydroxylapatite: A prospective, observational study
Authors: Baspeyras Martine , Dallara Jean‐Marie , Cartier Hugues , Charavel Marie‐Hélène , Dumas Laurent
Published: July 2017

Background

Jawline reshaping by replacing volume has become an indispensable component of modern facial rejuvenation.

Aim

To evaluate calcium hydroxylapatite (CaHA) for the treatment of an aging jawline in a routine setting.

Methods

Five investigators enrolled 35 subjects requesting jawline rejuvenation with CaHA. Injections were performed according to investigators usual practice. Baseline and post‐treatment scores were evaluated using Merz Aesthetics Scales®. Follow‐up visits took place at Day 30 (Day 60 for those with touch‐up at Day 30), 180, and 360. Physician and patient satisfaction, esthetic impact of treatment, and adverse events were recorded.

Results

Improvements in jawline contour compared with baseline were statistically significant at each visit, with scores of 2.42 (moderate to severe sagging) at baseline, 1.02 (mild) at Day 30/60 (P≤.0001), 1.11 at Day 180 (P≤.0001), and 1.45 at Day 360 (P=.0015). Statistically significant improvements in marionette line scores were also observed. Investigators rated results as “improved” to “very much improved” in all subjects up to Day 180, and in 81% of subjects at Day 360. Satisfaction with treatment was very high. Adverse events were mostly mild and related to either the procedure or injection technique.

Conclusion

CaHA is a very effective agent for restoring jawline contour in routine practice and is associated with high levels of physician and patient satisfaction.
Termite mounds vary in their importance as sources of vegetation heterogeneity across savanna landscapes
Authors: Muvengwi Justice , Witkowski Edward T. F. , Davies Andrew B. , Parrini Francesca
Published: July 2017

Questions

Termite mounds are known to host a suite of unique plants compared with the surrounding savanna matrix. However, most studies testing the significance of mounds for ecosystem heterogeneity have been conducted at single sites. Mound effects on savanna heterogeneity across varying landscapes are less well understood, and how effects might vary across geological types and mounds of different sizes is as yet unknown.

Location

Gonarezhou National Park, Zimbabwe.

Methods

We studied effects of termite mounds on vegetation spatial heterogeneity across two geologies (granite and basalt), including effects of mound size and the spatial extent of termite influence. Herbaceous vegetation was sampled on mounds and savanna matrix plots, and along distance transects away from mounds. Soil nutrients on mounds and in the matrix were also compared between geologies.

Results

Soil nutrients were more concentrated in large mounds compared with the matrix on granite, but not on basalt, with mounds therefore acting as nutrient hotspots only on nutrient‐poor granite. Large‐ and medium‐sized mounds hosted compositionally different grass species to the matrix on granite, but not on basalt. Large mounds on granite also had significantly lower grass and forb species richness compared with the matrix. However, small mounds on granite, and all mound size categories on basalt, did not have an effect on grass and forb species richness or assemblage composition, an observation attributed to a lack of difference in soil nutrients between the mounds and matrix.

Conclusion

Our study shows that the significance of termite mounds to ecosystem spatial heterogeneity is strongly influenced by geology and mound size, with mound effects on herbaceous plant species heterogeneity more pronounced in dystrophic geologies and around large mounds. Future studies should take greater cognisance of landscape context and mound size when seeking to understand the contribution of termite mounds to ecosystem structure and function.
Erwinia amylovora catalases KatA and KatG are virulence factors and delay the starvation‐induced viable but non‐culturable (VBNC) response
Authors: Santander Ricardo D. , Figàs‐Segura Àngela , Biosca Elena G.
Published: July 2017

The life cycle of the plant pathogen Erwinia amylovora comprises periods inside and outside the host in which it faces oxidative stress caused by hydrogen peroxide (H2O2) and other compounds. The sources of this stress are plant defences, other microorganisms and/or exposure to starvation or other environmental challenges. However, the functional roles of H2O2‐neutralizing enzymes, such as catalases, during plant–pathogen interactions and/or under starvation conditions in phytopathogens of the family Erwiniaceae or closely related families have not yet been investigated. In this work, the contribution of E. amylovora catalases KatA and KatG to virulence and survival in non‐host environments was determined using catalase gene mutants and expression, as well as catalase activity analyses. The participation of E. amylovora exopolysaccharides (EPSs) in oxidative stress protection was also investigated. Our study revealed the following: (i) a different growth phase regulation of each catalase, with an induction by H2O2 and host tissues; (ii) the significant role of E. amylovora catalases as virulence and survival factors during plant–pathogen interactions; (iii) the induction of EPSs by H2O2 despite the fact that apparently they do not contribute to protection against this compound; and (iv) the participation of both catalases in the detoxification of the starvation‐induced intracellular oxidative stress, favouring the maintenance of culturability, and hence delaying the development of the viable but non‐culturable (VBNC) response.
Ultrasound assessment of gastric emptying after breakfast in healthy preschool children
Authors: Sümpelmann Anne E. , Sümpelmann Robert , Lorenz Michael , Eberwien Ilona , Dennhardt Nils , Boethig Dietmar , Russo Sebastian G.
Published: July 2017

Background

In current guidelines, 6 hours of fasting is recommended for solids to limit the risk of pulmonary aspiration during anesthesia in children. Ultrasonography has recently been introduced to evaluate gastric volumes in children in the context of preanesthetic fasting. Therefore, in this study, we firstly evaluated the precision of ultrasound assessment of gastric volume in an experimental setting and secondly studied gastric emptying times after a normal breakfast in healthy preschool children using ultrasound.

Methods

In a preliminary experiment, a pear‐shaped elastic balloon was filled and emptied in 50 mL steps from 0 to 500 mL with water. After each step, the balloon antral area was measured using ultrasonography. Thereafter, gastric emptying was examined in healthy preschool children after normal breakfast by sonographic measurements of the gastric antral area in right lateral decubitus position at two consecutive timepoints. Correlation coefficients (Pearson, 95% CI) between the balloon antral area and the balloon volume or gastric antral area and fasting time were calculated and gastric emptying time was extrapolated by linear regression. Data are presented as mean (range).

Results

In the balloon experiment, the balloon volume correlated significantly with the balloon antral area (63 measurements, r=.96, P<.0001, 95% CI 0.93 to 0.97). In the preschool child measurements, a total of 30 children (age 47 (36‐66) months) were included. The gastric antral area correlated significantly with fasting time (r=−.69, P<.0001, 95% CI −0.8 to −0.51). The first gastric antral area after breakfast was significantly higher when compared to the second gastric antral area before lunch (10.4 ± 3.7 (1.7‐17.8) vs 5.5 ± 2.6 (1.4‐11.8) cm2; mean difference −5.04, 95% CI −6.3 to −3.8, P<.0001). The calculated mean gastric emptying time was 236 minutes.

Conclusion

The results of the balloon experiment showed a high correlation between balloon antral area and balloon volume. In the preschool child measurements, gastric antral area correlated with fasting time, and the mean gastric emptying time was lower than 4 hours after breakfast. These results support a more liberal perioperative fasting regimen after a light meal or breakfast in routine pediatric anesthesia.
Using quality improvement methods to reduce clear fluid fasting times in children on a preoperative ward
Authors: Newton Richard J. G. , Stuart Grant M. , Willdridge Daniel J. , Thomas Mark
Published: July 2017

Objectives

We applied quality improvement (QI) methodology to identify the different aspects of why children fasted for prolonged periods in our institution. Our aim was for 75% of all children to be fasted for clear fluid for less than 4 hours.

Background

Prolonged fasting in children can increase thirst and irritability and have adverse effects on haemodynamic stability on induction. By reducing this, children may be less irritable, more comfortable and more physiologically stable, improving the preoperative experience for both children and carers.

Methods

We conducted a QI project from January 2014 until August 2016 at a large tertiary pediatric teaching hospital. Baseline data and the magnitude of the problem were obtained from pilot studies. This allowed us to build a key driver diagram, a process map and conduct a failure mode and effects analysis. Using a framework of Plan‐Do‐Study‐Act cycles our key interventions primarily focused on reducing confusion over procedure start times, giving parents accurate information, empowering staff and reducing variation by allowing children to drink on arrival (up to one hour) before surgery.

Results

Prior to this project, using the 6,4,2 fasting rule for solids, breast milk, and clear fluids, respectively, 19% of children were fasted for fluid for less than 4 hours, mean fluid fasting time was 6.3 hours (SD 4.48). At the conclusion 72% of patients received a drink within 4 hours, mean fluid fasting reduced to 3.1 hours (SD 2.33). The secondary measures of aspiration (4.14:10 000) and cancellations have not increased since starting this project.

Conclusions

By using established QI methodology we reduced the mean fluid fasting time for day admissions at our hospital to 3.1 hours and increased the proportion of children fasting for less than 4 hours from 19% to 72%.
Impact of anesthesiologists on parental perioperative satisfaction scores
Authors: Ehwerhemuepha Louis , Feaster William , Kain Zeev
Published: July 2017

Background

While the focus on patient experience as an important outcome has significantly increased over the past decade, there is paucity of data on predictive factors associated with parental recommendation of a surgical facility to friends and family.

Methods

Data for this report were obtained from a Hospital Information System and Picker Health validated surveys completed by 538 parents whose children underwent outpatient surgery from July 2014 to March 2016. Bivariate, chi‐squared, and multivariate logistic regression analysis were carried out using the Picker Health item “Would you recommend this outpatient surgical facility to your friends and family?” as the primary outcome. Demographic data and 53 Picker Health items were used as potential predictors.

Results

Multivariate logistic regression analysis found the following variables as independent predictors for parental recommendation: quality of perioperative communication by anesthesiologists (odds ratio [95% confidence interval]=0.23 [0.09, 0.58]); provision of information on whom to call for help after discharge (0.22 [0.07, 0.64]); child's perceived baseline health (0.37 [0.15, 0.90]); and ill‐informed staff about child's procedure (0.30 [0.21, 0.79]). Variables such as child's pain and child's nausea and vomiting were not predictive for referral pattern.

Conclusion

Parental recommendation of a surgical facility to friends and family depends on a number of variables with the quality of perioperative communication with the anesthesiologist being the most predictive item.
RNA sequencing in post‐mortem human brains of neuropsychiatric disorders
Authors: Wu Chun , Bendriem Raphael M. , Garamszegi Susanna P. , Song Lei , Lee Chun‐Ting
Published: July 2017

RNA sequencing (RNA‐Seq), a revolutionary tool for transcriptome profiling, is becoming increasingly important for neuroscientists in studying the transcriptional landscape of the human brain. Studies using this next‐generation sequencing technique have already revealed novel insights into the complexity of neurons in the human brain and pathogenesis of complex neurological diseases. In clinical neuroscience, RNA‐Seq provides exciting opportunities for improving diagnosis and treatment of neurological diseases by facilitating the development of pharmacotherapies able to modulate gene expression. Furthermore, integrative whole genome sequencing and transcriptome sequencing can provide additional information for the functional role of mutated genes, prioritization of variants, and intron/exon splicing. This review describes the current state of RNA‐Seq studies in neuropsychiatric disorders using post‐mortem human brains, a brief survey of best practices for experimental design and sequencing data analysis, and the challenges associated with its application in the human brain.
Incidence, Treatment Patterns, and Health Care Costs of Infantile Hemangioma: Results of a Retrospective German Database Analysis
Authors: Seiffert Anna , Schneider Markus , Roessler Jochen , Larisch Katharina , Pfeiffer Dunja
Published: July 2017

Objectives

To determine the incidence, effect (defined according to treatment rate), and health care costs of infantile hemangiomas (IHs) in Germany from 2007 to 2012 by analyzing patient data of German statutory health insurances.

Methods

A retrospective analysis using data from a database matched with the overall population covered by German statutory health insurance was performed. To describe the treatment rate and costs of IHs, a search algorithm was developed dividing the study population into three groups (patients with IHs, patients with IHs possibly requiring treatment, and patients with IHs receiving treatment).

Results

The incidence of IHs was 2.0% to 3.2%, with a slight increase during the later years of the study period and a female:male ratio of 1.4:1. IH incidence was lower and girls were less likely to present with IHs than in previous reports. The mean treatment rate of IHs was 11.3%. Mean health care costs during first year of life for infants diagnosed with IHs in 2012 were slightly lower (€2,396) than for all infants (€2,649), whereas costs for infants diagnosed and treated for IHs were considerably higher (€10,550). The majority of these costs were due to hospitalization (€8,658).

Conclusion

This retrospective study is the first to analyze the incidence and sex ratio of IHs based on German claims data. The treatment rate of IHs was consistent with previous reports. The mean health care costs for treated patients with IHs were substantially higher than those for all newborns. Limitations of this study are coding bias, a limited sample size, and claims perspective (nonclinical approach).
Meloidogyne luci, a new root‐knot nematode parasitizing potato in Portugal
Authors: Maleita C. , Esteves I. , Cardoso J. M. S. , Cunha M. J. , Carneiro R. M. D. G. , Abrantes I.
Published: July 2017

In 2013, during a field survey conducted in Portugal on potato, Solanum tuberosum, an unusual esterase (EST) phenotype was detected in a root‐knot nematode (RKN) from potato roots collected in Coimbra. This Portuguese isolate was purified and maintained on tomato, S. lycopersicum, and morphological, biochemical and molecular characteristics were studied. Perineal pattern morphology was highly variable, similar to Meloidogyne ethiopica and not useful for identification. The EST phenotype, from young egg‐laying females, displayed three bands similar to the Brazilian M. luci (L3) and distinct from M. ethiopica (E3). Phylogenetic analyses of mitochondrial cytochrome oxidase subunit I and the mitochondrial DNA region between COII and 16S rRNA genes revealed that the Portuguese isolate grouped with M. luci isolates close to M. ethiopica isolates. However, considering the ITS1‐5.8S‐ITS2 region, the Portuguese isolate grouped with isolates of M. luci, M. ethiopica and M. hispanica, which limits the confidence of this region for M. luci diagnosis, and its differentiation from other species with morphological similarities. The M. luci pathogenicity to potato was also assessed in 16 commercial cultivars and compared with M. chitwoodi, considered to be a quarantine RKN species by EPPO. All potato cultivars were susceptible to both Meloidogyne species with gall indices of 5 and higher reproduction factor values ranging from 12.5 to 122.3, which suggests that M. luci may constitute a potential threat to potato production. In the present study, M. luci is reported for the first time attacking potato in Portugal.
Assessment of skin conductance in African American and Non–African American participants in studies of conditioned fear
Authors: Alexandra Kredlow M. , Pineles Suzanne L. , Inslicht Sabra S. , Marin Marie‐France , Milad Mohammed R. , Otto Michael W. , Orr Scott P.
Published: July 2017

Skin conductance (SC) is a psychophysiological measure of sympathetic nervous system activity that is commonly used in research to assess conditioned fear responses. A portion of individuals evidence very low or unmeasurable SC levels (SCL) and/or response (SCR) during fear conditioning, which precludes the use of their SC data. The reason that some individuals do not produce measurable SCL and/or SCR is not clear; some early research suggested that race may be an influencing factor. In the current article, archival data from five fear conditioning samples collected from four different laboratories were examined to explore SCL and SCR magnitude in African American (AA) and non–African American (non‐AA) participants. Across studies, the aggregate group difference for exclusion due to unmeasurable SCL or no measurable SCR to an unconditioned stimulus reflected a significant medium effect size (d = 0.54). Furthermore, 24.3% (range: 0–48.3%) of AA participants met SC exclusion criteria versus 14.3% (range: 4.3–24.2%) of non‐AA participants. AA participants also displayed significantly lower SCL during habituation (d = 0.58). The low SC levels and responses in AA individuals and the consequent exclusion of their contributions to fear conditioning study results impacts the generalizability of findings across races. Given higher rates of posttraumatic stress disorder (PTSD) and chronic anxiety in AA individuals, it is important that AA individuals not be excluded from fear conditioning research, which informs the treatment of anxiety and PTSD. Examination of the basis of very low SCL and/or SCR is a potentially informative direction for future research.
Comparative advantage and strategic specialization
Authors: Kang Minwook
Published: July 2017

This paper shows that a strong comparative advantage is necessary for free trade and specialization in a 2 × 2 symmetric Ricardian model to be achieved in a Nash equilibrium. Governments strategically control labor distribution across industries, and representative agents maximize Cobb–Douglas utilities. A Nash equilibrium with complete specialization is achieved if and only if relative productivity exceeds a key value of 3, which is considered a very large number based on previous empirical studies. This paper also introduces a two‐stage game where each government chooses labor distribution first and then tariffs. In this two‐stage game, complete specialization is never achieved for any relative productivity level. Finally, by generalizing the Cobb–Douglas model into constant elasticity of substitution (CES) preferences, I show that if immiserizing growth effects exist, complete specialization could not be achieved for any level of relative productivity.
Registered Nurses’ experiences of patient participation in hospital care: supporting and hindering factors patient participation in care
Authors: Oxelmark Lena , Ulin Kerstin , Chaboyer Wendy , Bucknall Tracey , Ringdal Mona
Published: July 2017

Background

Promoting patient participation in care is an international priority identified by the World Health Organization and various national bodies around the world and an important aspect of person‐centred care.

Aim

The aim of this study was to describe Registered Nurses’ experiences with patient participation in nursing care including their barriers and facilitators for participation.

Method

The study setting was a University Hospital in Sweden. Interviews were conducted with twenty Registered Nurses working at medical wards in 2013. Thematic data analysis was used to analyse the transcribed interview data.

Results

Twenty nurses from four wards in two hospitals were included. Five themes emerged from the analysis including listening to the patient, engaging the patient, relinquishing some responsibility, sharing power and partnering with patients. The core theme ‘partnering with patients’ was enacted when nurses listened to and engaged patients and when they relinquished responsibility and shared power with patients. In addition, hindering and facilitating factors to participation were identified, such as patients wanted to take on a passive role, lack of teamwork which participants understood would enhance interprofessional understanding and improve patient safety. Patient participation was hindered by medical jargon during the ward round, there was a risk of staff talking over patients’ heads but sometimes inevitable having conversations at the patient's bedside. However, nurses preferred important decisions to be made away from bedside.

Conclusions

It all came down to partnering with the patient and participants described how they made an effort to respect the patients’ view and accept patient as a part of the care team. Identified hindering factors for participation were lack of teamwork, patients’ taking on passive roles and communication during ward rounds having conversations at the patient's bedside. Nurses wished for a change but lacked strategies on how. Nurses preferred important decisions to be made away from bedside.