bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do hotspots fall within protected areas? A Geographic Approach to Planning analysis of regional freshwater biodiversity
Authors: Walters Ashley D. , Brown Madelyn A. , Cerbie Gina M. , Williams Marsha G. , Banta Joshua A. , Williams Lance R. , Ford Neil B. , Berg David J. 
Published: September 2019

Abstract

Identification of biodiversity hot spots is necessary for developing conservation strategies. The south‐eastern U.S.A. harbours high aquatic biodiversity; however, this diversity is threatened as a result of anthropogenic activities. We report patterns of fish and mussel biodiversity, locate hotspots of diversity and endemism, and identify gaps in protection of these hotspots.

Maxent was used to generate species distribution models for native fish and mussel species in river basins throughout east Texas. Stacked species distribution models were used to assess spatial patterns of biodiversity and examine the concordance between fish and mussel hotspots. A Geographic Approach to Planning analysis was used to identify areas of high conservation concern.

Predicted geographical variation in species richness of mussels corresponds to patterns shown in fish; however, there was discordance among endemicity hotspots between the two taxa. Because overall endemicity was low in both groups, species richness is likely to be the more informative measure of biodiversity at these regional scales.

While hotspots represent a small percentage of the study area, almost all richness and endemicity hotspots (>95%) in east Texas occur outside of protected areas. The results of this study suggest that protected areas designated based on terrestrial habitat may fail to protect aquatic biodiversity. Studies such as this provide a baseline for development of conservation and management strategies for protection of regional freshwater biodiversity, while also suggesting that designating conservation lands should include consideration of both terrestrial and aquatic biodiversity.
The impact of drought spells on forests depends on site conditions: The case of 2017 summer heat wave in southern Europe
Authors: Rita Angelo , Camarero Jesus Julio , Nolè Angelo , Borghetti Marco , Brunetti Michele , Pergola Nicola , Serio Carmine , Vicente‐Serrano Sergio M. , Tramutoli Valerio , Ripullone Francesco 
Published: September 2019

AbstractA major component of climate change is an increase in temperature and precipitation variability. Over the last few decades, an increase in the frequency of extremely warm temperatures and drought severity has been observed across Europe. These warmer and drier conditions may reduce productivity and trigger compositional shifts in forest communities. However, we still lack a robust, biogeographical characterization of the negative impacts of climate extremes, such as droughts on forests. In this context, we investigated the impact of the 2017 summer drought on European forests. The normalized difference vegetation index (NDVI) was used as a proxy of forest productivity and was related to the standardized precipitation evapotranspiration index, which accounts for the temperature effects of the climate water balance. The spatial pattern of NDVI reduction in 2017 was largely driven by the extremely warm summer for parts of the central and eastern Mediterranean Basin (Italian and Balkan Peninsulas). The vulnerability to the 2017 summer drought was heterogeneously distributed over Europe, and topographic factors buffered some of the negative impacts. Mediterranean forests dominated by oak species were the most negatively impacted, whereasPinus pinasterwas the most resilient species. The impact of drought on the NDVI decreased at high elevations and mainly on east and north‐east facing slopes. We illustrate how an adequate characterization of the coupling between climate conditions and forest productivity (NDVI) allows the determination of the most vulnerable areas to drought. This approach could be widely used for other extreme climate events and when considering other spatially resolved proxies of forest growth and health.
Assessing hypoglycemia frequency using flash glucose monitoring in older Japanese patients with type 2 diabetes receiving oral hypoglycemic agents
Authors: Abe Hironori , Shikuma Junpei , Suwanai Hirotsugu , Sano Koji , Okumura Takako , Kan Kenshi , Takahashi Tomono , Miwa Takashi , Suzuki Ryo , Odawara Masato 
Published: September 2019

AimIt is important to consider hypoglycemia for glycemic control in elderly patients with type 2 diabetes. Continuous blood glucose monitoring system is an effective method to investigate blood glucose fluctuation. This study examined hypoglycemia frequency using continuous blood glucose monitoring system in older patients with type 2 diabetes.MethodsA total of 70 patients with type 2 diabetes aged >65 years, receiving oral treatment only and having a glycated hemoglobin (HbA1c) level of <8% were enrolled. Flash glucose monitoring system was used for the device. Patients were classified into three groups according to the type of medicine administered, in addition to other oral hypoglycemics, and were compared: (i) those taking sulfonylureas (SU); (ii) those taking glinides; and (iii) those who did not take either SU or glinides.ResultsThere was a significant positive correlation between the coefficient of variation and hypoglycemic frequency in all the patients, and a significant negative correlation between HbA1c and hypoglycemia in those receiving SU. When hypoglycemia was defined as glucose levels <54 mg/dL and <70 mg/dL, the cut‐off HbA1c values for developing hypoglycemia were 6.3% and 6.7%, sensitivity was 75.0% and 76.2%, and specificity was 90.9% and 77.6%, respectively.ConclusionsIn older patients with type 2 diabetes receiving SU, hypoglycemic frequency increases with decreases in HbA1c level. In particular, in patients with HbA1c levels of <6.3% receiving SU, it is necessary to consider medication modification. Geriatr Gerontol Int 2019; 19: 1030–1035.
Forty‐five years on home hemodialysis, a case of exceptional longevity
Authors: Abdul Salim Sohail , Cheungpasitporn Wisit , Echols Vonda , Monga Divya , Davidson Jamie , Juncos Luis A. , Fülöp Tibor 
Published: September 2019

AbstractEnd‐stage renal disease is associated with dismal long‐term survival in general. Home hemodialysis (HHD) has been advocated as a modality affirming better quality of life and longer survival. We report a 62‐year‐old Caucasian female with end‐stage renal disease who has been exclusively on HHD for a total of 45 years, utilizing various platforms over the years. She has been one of the first home dialysis patients of the founding father of renal dialysis in the state of Mississippi, John D. Bower and cared by him throughout his career. Throughout this period, her life bore witness to the evolving technology of dialysis accesses, platforms, and evolution of HHD in its entirety. After review of the literature, we find that the longest vintage time on HHD documented to date was around 35 years. This extraordinary longevity bears testimony to the extraordinary self‐motivation of the patient, the dedication of her providers and the true potential of HHD in motivated subjects.
Review: Gastric malignancies: Basic aspects
Authors: Camargo M. Constanza , Figueiredo Ceu , Machado Jose C. 
Published: September 2019

AbstractGastric cancer is the third deadliest cancer in the world, and the absolute number of cases is increasing every year due to aging and growing of high‐risk populations. This disease is a consequence of the complex interaction of microbial agents, with environmental and host factors, resulting in the dysregulation of multiple oncogenic and tumor‐suppressing signaling pathways. Despite the advances in our understanding of carcinogenesis, there are still reduced therapeutic options for patients with gastric cancer. In recent years, genomic analyses of gastric tumors have emphasized their molecular heterogeneity. The distinction of gastric cancer molecular subtypes may be a key to identify novel therapeutic targets, to predict patient outcome and response to therapy, and to guide early diagnosis strategies. In this review, we summarize the most recent updates on the relationship between microbial agents and gastric cancer, in particular, Helicobacter pylori, the non‐H pylori microbiome, and Epstein‐Barr virus. We also highlight the main advances made in the past year regarding the molecular characterization of gastric cancer, especially the signatures with potential clinical utility.
Review: Other Helicobacter species
Authors: Ménard Armelle , Smet Annemieke 
Published: September 2019

AbstractThis article is a review of the most important, accessible, and relevant literature published between April 2018 and April 2019 in the field of Helicobacter species other than Helicobacter pylori. The initial part of the review covers new insights regarding the presence of gastric and enterohepatic non‐H. pylori Helicobacter species (NHPH) in humans and animals, while the subsequent section focuses on the progress in our understanding of the pathogenicity and evolution of these species. Over the last year, relatively few cases of gastric NHPH infections in humans were published, with most NHPH infections being attributed to enterohepatic Helicobacters. A novel species, designated “Helicobacter caesarodunensis,” was isolated from the blood of a febrile patient and numerous cases of human Helicobacter cinaedi infections underlined this species as a true emerging pathogen. With regard to NHPH in animals, canine/feline gastric NHPH cause little or no harm in their natural host; however they can become opportunistic when translocated to the hepatobiliary tract. The role of enterohepatic Helicobacter species in colorectal tumors in pets has also been highlighted. Several studies in rodent models have further elucidated the mechanisms underlying the development of NHPH‐related disease, and the extra‐gastric effects of a Helicobacter suis infection on brain homeostasis was also studied. Comparative genomics facilitated a breakthrough in the evolutionary history of Helicobacter in general and NHPH in particular. Investigation of the genome of Helicobacter apodemus revealed particular traits with regard to its virulence factors. A range of compounds including mulberries, dietary fiber, ginseng, and avian eggs which target the gut microbiota have also been shown to affect Helicobacter growth, with a potential therapeutic utilization and increase in survival.
Usability and feasibility of multimedia interventions for engaging patients in their care in the context of acute recovery: A narrative review
Authors: McDonall Jo , Hutchinson Anastasia F. , Redley Bernice , Livingston Patricia M. , Botti Mari 
Published: September 2019

AbstractPurposeThe purpose of this narrative review was to examine the usability and feasibility of multimedia intervention as a platform to enable patient participation in the context of acute recovery and to discover what outcomes have been measured.Data sourcesA narrative review of primary research articles identified through a search of four electronic databases (MEDLINE, CINAHL, EMBASE and PsycInfo) identified peer‐reviewed research evidence published in English language with no limitation placed on time period or publication type. Two authors independently assessed articles for inclusion. From the 277 articles identified through the search, 10 papers reporting the outcomes of seven studies were included in this review.Review methodsArticles were independently assessed for quality and relevance by two authors. The most appropriate method for data synthesis for this review was a narrative synthesis.ResultsFrom the narrative synthesis of study outcomes, two findings emerged as follows: (a) multimedia interventions are feasible and usable in the context of acute care, and (b) multimedia interventions can improve patients’ perception of care‐related knowledge. Identified gaps included a lack of evidence in relation to the effect of interventions on enhancing patients’ ability to participate in their care and the impact on patients’ health‐related outcomes.ConclusionsIn conclusion, there is some evidence of the feasibility and usability of multimedia interventions in acute care. That is, patients can use these types of platforms in this context and are satisfied with doing so. Multimedia platforms have a role in the delivery of information for patients during acute recovery; however, the effectiveness of these platforms to engage and enhance patients’ capability to participate in their recovery and the impact on outcomes needs to be rigorously evaluated.
A mixed‐methods exploration of non‐attendance at diabetes appointments using peer researchers
Authors: Eades Claire , Alexander Helen 
Published: September 2019

AbstractBackgroundNon‐attendance at diabetes appointments is costly to the health service and linked with poorer patient outcomes.ObjectivePeer researchers aimed to conduct interviews and survey people who miss appointments about their beliefs and perceptions regarding their diabetes and diabetes appointments.DesignA mixed‐methods cross‐sectional design with interviews conducted by peer researchers with diabetes and a questionnaire was used.Setting and participantsPeer researchers conducted semi‐structured telephone interviews in one health board in Scotland with ten people who had missed diabetes appointments. A further 34 people who had missed appointments completed a questionnaire. The study was informed by two psychological theories (the Theory of Planned Behaviour and the Self‐Regulation Model), and interviews were analysed using thematic analysis.ResultsInterviewees planned to attend appointments but practical barriers, low perceived value of appointments and the feeling that diabetes had little impact upon their lives’ emerged as key reasons for missing appointments. Questionnaire data supported these findings and showed that respondents perceived diabetes to have only mildly serious consequence and cause limited concern and emotional impact. Participants’ understanding of their condition and perceptions of personal control and treatment control were low. Gender, perceived behavioural control and emotional representations were significantly associated with the number of appointments missed in the previous year.ConclusionsThese findings highlight the importance of psychological variables in predicting non‐attendance at diabetes appointments and provide avenues for how non‐attendance might be tackled.
Lupus anticoagulant diagnosis in patients receiving direct oral FXa inhibitors at trough levels: A real‐life study
Authors: Gay Juliette , Duchemin Jérôme , Imarazene Meriem , Fontenay Michaela , Jourdi Georges 
Published: September 2019

AbstractIntroductionDirect oral factor Xa inhibitors (xabans) induce false positive results for lupus anticoagulant (LA) diagnosis. Consequently, it is suggested not to perform LA testing in xabans patients although it may be useful in selected patients. In this monocentric study, we evaluated xabans impact at trough levels (ie, just before the next intake) on LA diagnosis in treated patients using dilute Russell viper venom time (dRVVT) and two LA sensitive activated partial thromboplastin time (aPTT).MethodsSixty patients receiving rivaroxaban (30) or apixaban (30) were included. Plasma concentrations were measured using specific anti‐Xa assays. LA testing was performed using one dRVVT (LAC‐Screening®/Confirm®; Siemens) and two LA sensitive aPTT‐based assays (Hemosil® Silica Clotting Time (SCT) Screen/Confirm; Werfen and Dade® Actin® Factor Sensitivity FSL/FS (Actin F); Siemens).ResultsMedian [min‐max] concentrations were 23 [<18‐68] for rivaroxaban and 42 ng/mL [19‐99] for apixaban. dRVVT was positive in 93% of rivaroxaban and 40% of apixaban samples. SCT was positive in 40 and 30% and Actin F in 17 and 20% of samples respectively. Xabans affected more significantly dRVVT than aPTT‐based assays (P < .001) with less false positive results with apixaban than with rivaroxaban samples irrespective of the assay used.Conclusionlupus anticoagulant diagnosis in rivaroxaban and apixaban samples drawn at trough levels remains questionable whenever positive results are obtained. If LA testing in apixaban samples might be useful to rule‐out LA using dRVVT and/or aPTT‐based assays, the wide majority of rivaroxaban samples would give false positive results.
Effects of Epichloë endophyte infection on growth, physiological properties and seed germination of wild barley under saline conditions
Authors: Wang Zhengfeng , Li Chunjie , White James 
Published: September 2019

AbstractWild barley (Hordeum brevisubulatum) is a grass that inhabits alkalized meadows in northern China. An asexual Epichloë bromicola endophyte was detected in seeds and leaf sheaths in all wild barley samples from Gansu Province, China. In this research, we determined the effects of the E. bromicola endophyte on growth, physiological properties and seed germination of wild barley under salt stress through a set of experiments. Our results demonstrate that endophyte‐infected (E+) plants produced more tillers, higher biomass and yield, higher chlorophyll content and superoxide dismutase activity than endophyte‐free (E−) plants under high salt stress. Seed germination parameters of E+ biotype were significantly higher than those of E− plants when NaCl concentration reached 200 and 300 mM. Our results demonstrate that E. bromicola endophytes increased tolerance to salt stress in wild barley by increasing seed germination and growth, and altering plant physiology.
The mental health needs and concerns of older people who identify as LGBTQ+: A narrative review of the international evidence
Authors: McCann Edward , Brown Michael John 
Published: September 2019

AbstractAimsTo synthesize the best available evidence on the experiences and perceptions of older people who identify as LGBTQ + regarding their mental health needs and concerns.DesignA narrative review and critical appraisal of qualitative, quantitative, and mixed methods studies.Data sourcesA systematic search was undertaken across all of the databases including PsycINFO, MEDLINE, CINAHL, and Sociological Abstracts. International studies published in academic journals in the English language, from January 1995 ‐ January 2019 were appraised. Studies had to involve older people identifying as LGBTQ + and who had experiences mental health issues.Review methodsFourteen papers were selected for inclusion in the systematic review. A narrative analysis of the papers was used by synthesizing the key findings and organizing them into themes and concepts.ResultsFollowing analysis of the data, the identified themes were: (a) LGBTQ + identity issues (b) risk and vulnerability factors, (c) coping strategies and resilience, (d) interventions and supports.ConclusionThis review highlights key mental health‐related issues that need to be taken into account in the creation and provision of appropriate, responsive and inclusive supports and services.ImpactWhat were the main findings? Some older people who identify as LGBTQ + have experienced stigma, discrimination, and minority stress. However, many have developed coping strategies and resilience while others have developed mental health issues. It is necessary to have in place appropriate interventions and supports to effectively meet the needs of this population.Where and on whom will the research have impact? The review has significant implications for health and nursing policy and inform developments in nursing practice and nurse education.
Inactivation kinetics of inoculated Escherichia coli and Listeria innocua in fresh‐cut Chinese cabbage using sweeping frequency ultrasound
Authors: Alenyorege Evans A. , Ma Haile , Ayim Ishmael 
Published: September 2019

AbstractSweeping frequency ultrasound washing is a recent technology of applying varying ultrasound frequencies in the decontamination of fresh produce. Ultrasound inactivation of Escherichia coli and Listeria innocua inoculated on fresh‐cut Chinese cabbage was investigated at sweeping frequencies of 28 ± 2 to 68 ± 2 kHz for washing time of 5–40 min. The survival ratio of E. coli and L. innocua decreased with the time of exposure to ultrasound washing and varying frequencies. E. coli were more sensitive to ultrasound washing than L. innocua, achieving >3.0 log reductions after 10 min of washing with 40 ± 2 kHz. A nonlinear Weibull model was used to describe the experimental data, and the fitness of the model was evaluated by the coefficient of determination (R2) and the root mean square error (RMSE). The model used provided a good fit with R2 ≥ .98 for both bacteria and RMSE values in the range of 0.03–0.21 and 0.02–0.32 for E. coli and L. innocua, respectively.Practical ApplicationUltrasound decontamination is an alternative nonthermal technology that has been applied in recent years to improve the microbial safety of fresh produce. The bacterial inactivation is predominantly attributed to cavitation, an occurrence that interrupts cellular arrangement and function. With the known significance of sanitization in the processing of vegetables, it is imperative to develop and appraise novel approaches that contribute to the microbial safety of these fresh produce. Largely, the results of our study could guide the design of new ultrasonic fresh produce wash systems in addition to current industrial practice related to frequency selection and use of ultrasound during fresh produce sanitation.
Low‐Value Proton Pump Inhibitor Prescriptions Among Older Adults at a Large Academic Health System
Authors: Mafi John N. , May Folasade P. , Kahn Katherine L. , Chong Michelle , Corona Edgar , Yang Liu , Mongare Margaret M. , Nair Vishnu , Reynolds Courtney , Gupta Reshma , Damberg Cheryl L. , Esrailian Eric , Sarkisian Catherine 
Published: September 2019

BACKGROUNDOlder adults are particularly vulnerable to complications from proton pump inhibitor (PPI) drugs. We sought to characterize the prevalence of potentially low‐value PPI prescriptions among older adults to inform a quality improvement (QI) intervention.METHODSWe created a cohort of patients, aged 65 years or older, receiving primary care at a large academic health system in 2018. We identified patients currently prescribed any PPI using the electronic health record (EHR) medication list (current defined as September 1, 2018). A geriatrician, a gastroenterologist, a QI expert, and two primary care physicians (PCPs) created multidisciplinary PPI appropriateness criteria based on evidenced‐based guidelines. Supervised by a gastroenterologist and PCP, two internal medicine residents conducted manual chart reviews in a random sample of 399 patients prescribed PPIs. We considered prescriptions potentially low value if they lacked a guideline‐based (1) short‐term indication (gastroesophageal reflux disease [GERD]/peptic ulcer disease/Helicobacter pylori gastritis/dyspepsia) or (2) long‐term (>8 weeks) indication (severe/refractory GERD/erosive esophagitis/Barrett esophagus/esophageal adenocarcinoma/esophageal stricture/high gastrointestinal bleeding risk/Zollinger‐Ellison syndrome). We used the Wilson score method to calculate 95% confidence intervals (CIs) on low‐value PPI prescription prevalence.RESULTSAmong 69 352 older adults, 8729 (12.6%) were prescribed a PPI. In the sample of 399 patients prescribed PPIs, 63.9% were female; their mean age was 76.2 years, and they were seen by 169 PCPs. Of the 399 prescriptions, 143 (35.8%; 95% CI = 31.3%‐40.7%) were potentially low value—of which 82% began appropriately (eg, GERD) but then continued long term without a guideline‐based indication. Among 169 PCPs, 32 (18.9%) contributed to 59.2% of potentially low‐value prescriptions.CONCLUSIONOne in eight older adults were prescribed a PPI, and over one‐third of prescriptions were potentially low‐value. Most often, appropriate short‐term prescriptions became potentially low value because they lacked long‐term indications. With most potentially low‐value prescribing concentrated among a small subset of PCPs, interventions targeting them and/or applying EHR‐based automatic stopping rules may protect older adults from harm. J Am Geriatr Soc 67:2600–2604, 2019