bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diversity in genome size and GC content shows adaptive potential in orchids and is closely linked to partial endoreplication, plant life‐history traits and climatic conditions
Authors: Trávníček Pavel , Čertner Martin , Ponert Jan , Chumová Zuzana , Jersáková Jana , Suda Jan 
Published: June 2019

Summary

In angiosperms, genome size and nucleobase composition (GC content) exhibit pronounced variation with possible adaptive consequences. The hyperdiverse orchid family possessing the unique phenomenon of partial endoreplication (PE) provides a great opportunity to search for interactions of both genomic traits with the evolutionary history of the family.

Using flow cytometry, we report values of both genomic traits and the type of endoreplication for 149 orchid species and compare these with a suite of life‐history traits and climatic niche data using phylogeny‐based statistics. The evolution of genomic traits was further studied using the Brownian motion (BM) and Ornstein–Uhlenbeck (OU) models to access their adaptive potential.

Pronounced variation in genome size (341–54 878 Mb), and especially in GC content (23.9–50.5%), was detected among orchids. Diversity in both genomic traits was closely related to the type of endoreplication, plant growth form and climatic conditions. GC content was also associated with the type of dormancy. In all tested scenarios, OU models always outperformed BM models.

Unparalleled GC content variation was discovered in orchids, setting new limits for plants. Our study indicates that diversity in both genome size and GC content has adaptive consequences and is tightly linked with evolutionary transitions to PE.
The pan‐cancer mutational landscape of the PPAR pathway reveals universal patterns of dysregulated metabolism and interactions with tumor immunity and hypoxia
Authors: Chang Wai Hoong , Lai Alvina G. 
Published: June 2019

AbstractPeroxisome proliferator‐activated receptors (PPARs) are a family of nuclear receptors that regulate lipid metabolism and bioenergetic demands within living systems. Consequently, aberrant expression of PPAR genes could predispose individuals to diseases, including cancer. PPAR signaling exerts pleiotropic functions in cancer, yet little is known about the interactions between genetic and transcriptional events of pathway genes in a pan‐cancer context. Employing multidimensional datasets of over 18,000 patients involving 21 cancers, we performed systematic characterization on copy number alteration and differential transcript expression of 74 PPAR pathway genes. We identified 18 genes demonstrating mutually exclusive patterns of loss‐ and gain‐of‐function phenotypes. These genes successfully predicted patient survival rates in bladder, renal, glioma, liver, and stomach/esophageal cancers. Dysregulated PPAR signaling in these cancers converged on common downstream pathways associated with multiple metabolic processes. Moreover, clinically relevant relationships between PPARs and hypoxia were observed, where hypoxia further aggravates disease phenotypes in tumor subtypes with aberrant PPAR signaling. In glioma samples, including astrocytoma and oligoastrocytoma, PPAR hyperactivation is associated with immunosuppression through increased regulatory T cell expression. Our analysis reveals underappreciated levels of diversity and conservation in PPAR genes that could lay the groundwork for therapeutic strategies targeting tumor metabolism, immunity, and hypoxia.
Dental crown symmetry in unilateral cleft lip and palate patients: A three‐dimensional analysis on digital dental models
Authors: Dindaroğlu Furkan , Duran Gökhan Serhat , Doğan Servet 
Published: June 2019

AbstractObjectivesThe purpose of this study was to conduct a 3‐dimensional assessment of possible dental crown asymmetry in dental crown shape and/or size that was not clinically visible in unilateral cleft lip and palate (UCLP) patients on the maxilla and mandible and make a comparison to the control group without CLP.Setting and Sample PopulationThe maxillary and mandibular digital models of orthodontically treated 35 individuals with non‐syndromic UCLP (mean age: 14.6 ± 2.1 years) and 35 class I individuals without CLP (mean age 14.1 ± 1.5 years).Materials and MethodsThe crowns of the anterior and posterior teeth were segmented and the teeth on the cleft side were mirrored in UCLP patients considering the arbitrary midsagittal plane as reference. The first alignment was landmark‐based and it was followed by the best‐fit method. After aligning the images, millimetric differences (deviation analysis) between aligned surfaces were analysed. Independent Samples t test and Mann‐Whitney U test were used for statistical comparisons.ResultsThe highest difference between the cleft side and non‐cleft side in the UCLP group was observed in the central incisors (1.85 ± 0.79 mm). The mean difference between the groups in the central incisors was 1.20 mm (95% CI: −1.70; −0.69; P < 0.001). The mean of median values was found to be highest in the central incisors in the UCLP group as 0.72 ± 0.27 mm. It was 0.15 ± 0.05 mm in the control group.ConclusionThe difference between the cleft and non‐cleft side may exceed 1 mm in the maxillary central incisors of unilateral CLP patients.
Adverse health outcomes associated with fetal alcohol exposure: A systematic review focused on immune‐related outcomes
Authors: Reid Natasha , Moritz Karen M. , Akison Lisa K. 
Published: June 2019

AbstractPrenatal alcohol exposure (PAE) has well‐known teratogenic effects on the developing fetus, potentially resulting in neurologic impairments. However, there is increasing interest regarding other potential adverse health outcomes related to prenatal alcohol exposure. The objective of this study was to undertake a systematic review to identify all the available clinical and preclinical literature investigating immune‐related outcomes in offspring with PAE. A systematic review searching four electronic databases (PubMed, CINAHL, Web of Science, and Embase) was conducted. Potential articles were screened against strict inclusion/exclusion criteria. This review specifically focused on evaluating studies related to immune‐related outcomes following PAE. Twelve clinical studies were included in the current review. Six included allergy outcomes, four included infection outcomes, and two studies included both. Thirty‐nine preclinical studies were identified examining a wide range of immune outcomes. The current review provides some preliminary clinical evidence that PAE can influence immune function, including atopic allergy and infection outcomes. However, there was variability in results across studies, particularly in the atopy area. Preclinical studies demonstrated some changes in lymphocytes and cytokines in offspring following PAE. More research investigating the effects of PAE on immune responses is warranted.
Biliary reconstruction before clamp removal to avoid portal vein thrombosis in pediatric living‐donor liver transplantation using hyper‐reduced left lateral segment grafts: A novel technical strategy
Authors: Glinka Juan , de Santibañes Martin , Biagiola David , D´Agostino Daniel , Ardiles Victoria , Ciardullo Miguel , Mattera Juan , Pekolj Juan , de Santibañes Eduardo 
Published: June 2019

AbstractLT has become the treatment of choice for children with end‐stage liver disease. The scarcity of donors and the considerable mortality on waiting lists have propelled the related living‐donor techniques, especially in small children. This population need smaller and good quality grafts and are usually candidates to receive a LLS from a related donor. Many times this grafts are still large and do not fit in the receptor's abdomen, so a further hyper‐reduction may be required. Despite all advances in LT field, vascular complications still occur in a considerable proportion remaining as a significant cause of morbidity, graft loss, and mortality. Technical issues currently play an essential role in its genesis. The widely spread technique for biliary and vascular reconstruction in living donor LT (LDLT) nowadays implies removal of the portal vein (PV) clamp after the venous anastomosis, then the arterial reconstruction is done, followed by the biliary reconstruction. However, due to the posterior location of the LLS bile duct, for its reconstruction, a rotation of the liver is required risking a potential transient PV occlusion leading to thrombosis afterward. We describe a new technique that involves performing biliary reconstruction after the PV anastomosis and before removing the vascular clamp, thus allowing to freely rotate the liver with less risk of PV occlusion and thrombosis.
The genetic program at the root of the biological stock exchange
Authors: Law Simon R. 
Published: June 2019

Beneath the gardens, farmlands and forest floors that surround us, a hidden world blooms in careful cooperation and intense competition. The mutualistic symbiosis of the thread‐like hyphae of fungi and plant roots (collectively termed mycorrhizae from the Greek mýkēs – meaning ‘fungus’, and rhiza – for ‘root’) is present in the vast majority of plant species. As with most intimate relationships, this symbiosis functions on a principle of ‘give and take’. As an autotroph, the plant is able to synthesize all the sugars it requires through photosynthesis; however, its immobility hinders its capacity to forage for nutrients vital for its growth and survival. With an expansive network of hyphae, the heterotrophic fungus is able to locate and remobilize water and nutrients, such as phosphorus (P) and nitrogen (N), and barter them for precious sugars with the plant. An article in this issue of Physiologia Plantarum (Zhao et al. 2019) describes alterations in the genetic programming that takes place in the plant root upon the establishment of this fascinating relationship, which has profound implications for plant productivity and soil management methods.
The role of sediment supply in the adjustment of channel sinuosity across the Amazon Basin
Authors: Ahmed Joshua , Constantine José Antonio , Dunne Thomas 
Published: June 2019

AbstractSediment supplies are a fundamental component of alluvial river systems, but the importance of sustained supplies of externally derived sediments for the evolution of meandering planforms remains unclear. Here we demonstrate the importance of sediment supply in enhancing the growth of point bars that influence the rate of sinuosity increase through flow deflections in meander bends. We use an archive of Landsat images of 16 meandering reaches from across the Amazon Basin to show that rivers transporting larger sediment loads increase their sinuosity more rapidly than those carrying smaller loads. Sediment-rich rivers are dominated by downstream-rotating meanders that increase their sinuosity more rapidly than both extensional and upstream-rotating meanders. Downstream-rotating meanders appear to establish larger point bars that expand throughout the meander, in contrast to extensional meanders, which have smaller bars, and upstream rotating meanders, which are characterized by deposition over the bar head. These observations demonstrate that the size and position of point bars within meander bends influences flow routing and thus controls the dominant direction of meander growth. Rivers with low sediment supplies build smaller point bars, which reduces their capacity to increase meander curvature and the resulting sinuosity.
Latest Villafranchian climate and landscape reconstructions at Pirro Nord (southern Italy)
Authors: Blain Hugues-Alexandre , Fagoaga Ana , Ruiz-Sánchez Francisco Javier , Bisbal-Chinesta Josep Francesc , Delfino Massimo 
Published: June 2019

Abstract
Early Pleistocene terrestrial climate conditions in the Mediterranean region, especially between 1.3 and 1.7 Ma, are poorly understood. Here, the amphibian and reptile fossil record from 24 fissures (Cava Pirro) of the Pirro Nord karstic complex (southern Italy) is used to infer quantitative paleoclimatic and paleoenvironmental reconstructions. These numerical data indicate that the mean annual temperature may have been somewhat lower (–1.6 to –3.6 °C compared to modern temperatures) than that of today, and the mean annual precipitation slightly higher (+90 to +240 mm) than modern values. Seasonality was more pronounced, with cooler summers (–0.4 to –2.0 °C) and much colder winters (–1.2 to –6.0 °C). Rainfall distribution patterns during the year show more precipitation during the winter (+14 to +43 mm), with quantities of summer rainfall (–1.7 to +6.6 mm) being similar to modern values. The associated landscape comprised an open dry environment with scattered patches of woodland, locally along water courses or around swamps. This ecological scenario fits with early Pleistocene cold conditions, where the first occurrence of some eastern emigrants suggests a scenario of trans-Adriatic dispersal, as may have also occurred for the earliest European hominins.
O1 Use of a multi-disciplinary teaching platform for teaching paediatric prescribing
Authors: Paterson-Brown Lucy , Dore Eoin 
Published: June 2019

AimWe present a case study of the development of a structured, holistic, multidisciplinary prescribing teaching program for medical students in our paediatric department. The aim was to integrate theory and practise into one multidisciplinary delivered teaching session.MethodPrescribing is an area that medical students consistently report as challenging with poor teaching and minimal paediatric specific prescribing teaching as an undergraduate. After collaboration with our pharmacist colleagues the agreed objective was to design a teaching session run by doctors and pharmacists together in order to more accurately simulate paediatric prescribing in clinical practice for the inpatient environment. The method was based on Blooms Taxonomy,1 starting with a pharmacist delivering teaching on the theory of paediatric prescribing. Following this, junior doctors delivered case based prescribing scenarios to allow assimilation and application of theory. At the end of the 150 minute session feedback was collected from both session facilitators and students. These were evaluated to allow for revision and improvement of the session.ResultsBoth facilitators and students very enthusiastically received the session with phrases such as ‘amazing session thank- you!’ added to the feedback forms. Feedback was gathered from 32 students over the first 8-week cycle of the project. The majority of students stated that prior to this session they had little or no paediatric prescribing teaching. When asked the question ‘how prepared do you feel for prescribing in paediatrics?’ and asked to rank themselves from 1 (not at all) to 5 (very well) the average improved from 1.44 pre session to 3.55 post session. The feedback was consistent between sessions demonstrating no significant variation between facilitators. This highlights that the standardised, formal structure of the session allows it to be delivered by pharmacists and doctors of different grades and levels of experience without changing the success of the session for the students.ConclusionThis project demonstrates that there is a significant gap in undergraduate teaching on prescribing, especially paediatric prescribing. This teaching session is low cost, produces similar feedback despite variation in facilitators between sessions, and is easily transferable to multiple inpatient areas. Our students demonstrated that after one teaching session they felt more prepared for prescribing in paediatrics and following the feedback changes have been made to the session and ongoing feedback has further improved. We propose that this style of teaching session could be used across the country for both adult and paediatric prescribing undergraduate teaching sessions. We aim to compare our session with other universities approaches to prescribing teaching and establish whether this is a national area that requires focused educational attention.ReferenceBloom BS. Taxonomy of educational objectives: The classification of educational goals 1956.
P020 Vitamin supplementation survey: an audit of the usage of vitamin D supplementation in paediatric patients, pregnant women and breastfeeding mothers
Authors: Thomas Lowri , Patel Bhavee 
Published: June 2019

BackgroundA lack of vitamin D can lead to skeletal deformities and disturbances in growth.1 The Scientific Advisory Committee on Nutrition (SACN) published a report in July 2016 making new recommendations for vitamin D supplementation. Subsequently, our local guidelines were updated on the supplementation of vitamin D in the paediatric population, pregnant women, and breastfeeding mothers.AimIt is currently unknown whether these guidelines are being adhered to and as such, this audit was designed to assess the vitamin D supplementation status of these populations.ObjectivesEstablish current level of understanding around the routine use of vitamin supplements; Consider what advice is currently provided and who provides this advice; Determine the current use of vitamin D supplementation in children as well as the levels of vitamin D supplementation in breastfeeding mothers and pregnant women; Assess whether these groups are consuming appropriate quantities of vitamin D supplementation and identify reasons why they may not be.MethodsData collection was undertaken by pharmacists across two hospitals. Standards were based on the new guidelines published by SACN and local guidelines and were agreed by the clinical lead paediatric pharmacist. Data capture tools were designed in alignment with the standards and piloted. Modifications were made, exclusion criteria established and a total of 164 forms were distributed. All data collected was inputted to a database and analysed accordingly. Ethical approval was not required.ResultsOf the 164 questionnaires distributed, 93 were returned (57% response rate). Less than 30% of the parents surveyed stated they had received advice on childhood vitamin supplementation (n=16 of total n=54) and only 24.5% of children (n=25 of total n=102) were receiving a form of vitamin supplementation. A significantly higher percentage of pregnant/breastfeeding mothers 77% (n=30 of total n=39) stated they had received advice regarding vitamin supplementation. In these cases, midwives and health visitors most commonly provided the advice. Despite this, only 54% (n=21) confirmed that they were taking vitamin supplements.ConclusionWith such low rates of vitamin supplementation, the overall outcome shows poor adherence to current guidance. The results suggest a great need to improve public understanding and education of the risks associated with lack of vitamin D. Standardising practice, enhancing services and the advice provided to patients are ways to encourage compliance to guidelines and ultimately improve the health of those populations who are at risk.ReferenceScientific Advisory Committee on Nutrition (SACN). Vitamin D and health. London: TSO; 2016.
P024 The use of parenteral nutrition in paediatric haematology and oncology patients
Authors: Whiting Sam , Weerdenburg Heather 
Published: June 2019

IntroductionA trust wide Parenteral Nutrition (PN) guideline is available to advise the initiating, monitoring and stopping of PN.1 Following an increase in demand on the paediatric oncology, haematology and bone marrow transplant (BMT) ward the pharmacy and dietician team decided to audit how we use PN against these guidelines.ObjectivesIs PN being started and stopped appropriately according to the nutrition guidelines? Are patients being monitored on PN appropriately? Are there alternative sources of feeding that could be initiated by enteral route prior to starting PN?MethodologyThe pharmacy dispensing system was used to trace which BMT, haematology or oncology patients required parenteral nutrition. A combination of the medical notes and the electronic Medway system for those patients’ notes was used to collect data. Data was collected over a 12 month period from March 2017 until February 2018, a total of 29 patients were identified and audited.ResultsAlternative feeding routes to PN were deemed inappropriate in all 29 patients. A full plan had only been recorded in the patient notes in just 4% (1/29) of cases. Biochemistry was routinely provided prior to initiating PN but there was a failure to monitor patients needing long term biochemistry with only 11% (1/9) of patients having long term bloods reported. Only 38% (10/26) of patients had PN discontinued when the patient reached two-thirds of their target enteral intake.ConclusionA plan for PN is often omitted in the medical notes. There should be an expected duration, a desired outcome, IV access and a plan around what other (if any) nutrition can be given alongside. We plan to develop a PN plan proforma which can be used to stick into the notes which prompts the medical team responsible to enter this information. There is a lack of timely long term biochemistry bloods on those patients that have PN for longer than a month. This is important clinically because long term PN patients can develop deficiency in micronutrients which need replacement. We hope that educating the medical and nursing teams about this aspect of the clinical guideline will improve our practice. Lastly, the aim of PN must be to establish nutritional requirements where otherwise calorie input would not be met. Stopping early will lead to a calorie deficit and stopping too late would mean unnecessary extra clinical risk and potential inpatient stay. There were several instances where patients would have been discharged because they were otherwise clinically well but feeds were not adequate to stop PN. Other times PN is continued at 25% of requirements, where we should be stopping as soon as patients are established on 66% of oral calorie intake. This should be part of the wider team education about PNReferencePhipps A. April 2016, Total Parenteral Nutrition Guideline. Bristol Children’s Hospital.
Latitude continues to be significantly associated with the prevalence of multiple sclerosis: an updated meta-analysis
Authors: Simpson Steve , Wang Wendy , Otahal Peter , Blizzard Leigh , van der Mei Ingrid A F , Taylor Bruce V 
Published: June 2019

Objectives
Previous studies have demonstrated a strong latitudinal gradient in multiple sclerosis (MS) prevalence. Herein, we present a meta-analysis of the latitudinal gradient of MS prevalence including studies published since our 2011 review, seeking to assess the latitudinal gradient and whether it has changed since our previous analysis.

Methods
Studies published up to December 2018 were located via Embase, Web of Knowledge and PubMed, using standardised search terms; data were extracted from peer-reviewed studies and these studies added to those from our previous analysis. Where age-specific data were available, prevalence estimates were age-/sex-standardised to the 2009 European population. Prevalence estimates were adjusted for study prevalence year and ascertainment methods. The latitudinal association with MS prevalence was assessed by meta-regression.

Results
A total of 94 studies met inclusion criteria, yielding 230 new prevalence points and 880 altogether with those from the prior study. There was a significant positive gradient in time-corrected MS prevalence with increasing latitude (5.27/100 000 per degree latitude), attenuating slightly to 4.34/100 000 on age-standardisation, these associations persisting on adjustment for ascertainment method. Of note, the age-standardised gradient was consistently significantly enhanced from our previous study, regardless of whether it was as-measured, time-corrected or adjusted for ascertainment methods. Certain areas, such as the Scandinavian and Atlantic Coast/Central Europe regions, showed changes in MS prevalence gradient over time, but other regional gradients were similar.

Conclusions
This new meta-analysis confirms that MS prevalence is still strongly positively associated with increasing latitude and that the gradient is increasing, suggesting that potentially modifiable environmental factors, such as sun exposure, are still strongly associated with MS risk.