bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of genetic maladaptation due to climate change in three major European tree species
Authors: Frank Aline , Howe Glenn T. , Sperisen Christoph , Brang Peter , Clair J. Bradley St. , Schmatz Dirk R. , Heiri Caroline 
Published: July 2017

AbstractTree populations usually show adaptations to their local environments as a result of natural selection. As climates change, populations can become locally maladapted and decline in fitness. Evaluating the expected degree of genetic maladaptation due to climate change will allow forest managers to assess forest vulnerability, and develop strategies to preserve forest health and productivity. We studied potential genetic maladaptation to future climates in three major European tree species, Norway spruce (Picea abies), silver fir (Abies alba), and European beech (Fagus sylvatica). A common garden experiment was conducted to evaluate the quantitative genetic variation in growth and phenology of seedlings from 77 to 92 native populations of each species from across Switzerland. We used multivariate genecological models to associate population variation with past seed source climates, and to estimate relative risk of maladaptation to current and future climates based on key phenotypic traits and three regional climate projections within the A1B scenario. Current risks from climate change were similar to average risks from current seed transfer practices. For all three climate models, future risks increased in spruce and beech until the end of the century, but remained low in fir. Largest average risks associated with climate projections for the period 2061–2090 were found for spruce seedling height (0.64), and for beech bud break and leaf senescence (0.52 and 0.46). Future risks for spruce were high across Switzerland. However, areas of high risk were also found in drought‐prone regions for beech and in the southern Alps for fir. Genetic maladaptation to future climates is likely to become a problem for spruce and beech by the end of this century, but probably not for fir. Consequently, forest management strategies should be adjusted in the study area for spruce and beech to maintain productive and healthy forests in the future.
The association between patient activation and self‐care practices: A cross‐sectional study of an Australian population with comorbid diabetes and chronic kidney disease
Authors: Zimbudzi Edward , Lo Clement , Ranasinha Sanjeeva , Kerr Peter G , Polkinghorne Kevan R , Teede Helena , Usherwood Timothy , Walker Rowan G , Johnson Greg , Fulcher Greg , Zoungas Sophia 
Published: July 2017

AbstractObjectiveThis study aimed to examine the association between performance of self‐care activities and patient or disease factors as well as patient activation levels in patients with diabetes and chronic kidney disease (CKD) in Australia.MethodsA cross‐sectional study was conducted among adults with diabetes and CKD (eGFR <60 mL/min/1.73m2) who were recruited from renal and diabetes clinics of four tertiary hospitals in Australia. Demographic and clinical data were collected, as well as responses to the Patient Activation Measure (PAM) and the Summary of Diabetes Self‐Care Activities (SDSCA) scale. Regression analyses were performed to determine the relationship between activation and performance of self‐care activities.ResultsA total of 317 patients (70% men) with a mean age of 66.9 (SD=11.0) years participated. The mean (SD) PAM and composite SDSCA scores were 57.6 (15.5) % (range 0‐100) and 37.3 (11.2) (range 0‐70), respectively. Younger age, being male, advanced stages of CKD and shorter duration of diabetes were associated with lower scores in one or more self‐care components. Patient activation was positively associated with the composite SDSCA score, and in particular the domains of general diet and blood sugar checking (P<.05), but not specific diet, exercising and foot checking.ConclusionIn people with diabetes and CKD, a high level of patient activation was positively associated with a higher overall level of self‐care. Our results identify subgroups of people who may benefit from tailored interventions to further improve their health outcomes. Further prospective studies are warranted to confirm present findings.
Prevalence and associations of psychological distress in Australian junior medical officers
Authors: Lau Michelle W. , Li Wenlong E. , Llewellyn Anthony , Cyna Allan M. 
Published: July 2017

AbstractBackground/AimsTo determine the prevalence of psychological distress in Australian junior medical officers (JMO) and investigate the determinants associated with psychological distress over a 3‐year (2014–2016) period.MethodsJMO were surveyed using the 2014–2016 JMO Census (n = 220, 399 and 466 each year; response rate approximately 15%). Levels of psychological distress were assessed using the Kessler Psychological Distress Scale (K10). A K10 ≥ 25 was chosen to indicate high psychological distress, and this determinant was compared to various demographic and work‐related factors.ResultsAustralian JMO experience a high level of psychological distress (mean: 18.1, median 16.0). There were no differences in demographical variables, such as age, gender, marital status, dependants and between postgraduate years 1 and 2. Increasing hours worked per week was associated with a higher K10, with every hour worked increasing odds by 3%. Attitudinal items, including feeling unwilling to study medicine again, feeling poorly trained and experiences of bullying, were related to high psychological distress. Coping strategies like exercise and spending time with friends correlated positively with lower distress, while time off work, frequent alcohol use, smoking and drug use were associated with increased distress levels. Of those with a high K10, 54.5% indicated that they did not use any form of professional support; 17.83% expressed that given their time again, they would not choose to study medicine.ConclusionA focused approach to JMO support and education regarding significant risk factors identified is likely to assist health policies that aim to improve the mental well‐being of Australian JMO.
Two‐year audit of outcomes of pituitary surgery at an Australian teaching hospital
Authors: Davis Timothy M. E. , Badshah Imran , Drinkwater Jocelyn , Kusich Emily , Latkovic Erin , Knuckey Neville 
Published: July 2017

AbstractBackgroundThere is evidence that cure rates and complications are influenced by the caseload in neurosurgical centres performing transsphenoidal pituitary surgery. Although Australian centres may perform relatively small numbers of these procedures, there have been few published audits of their performance.AimsTo conduct an audit of surgery for pituitary tumours between 2012 and 2014 in the only public hospital neurosurgical unit in the state of Western Australia.MethodsA retrospective chart review was conducted, with standardised extraction of data relating to indications for surgery, tumour type, procedure and postoperative endocrinological and other outcomes.ResultsOf 53 patients identified, most (91%) underwent transsphenoidal surgery. Most tumours were non‐functioning (71.7%), and most of these extended outside the sella turcica (86.8 vs 73.3% of functioning tumours). There was complete removal in 43.4% of patients and evidence of biochemical cure in 33.3% of functioning tumours, but readmission for further surgery was infrequent (5.7%). Persistent cerebrospinal fluid leakage, photophobia and deep venous thrombosis occurred in <4% of patients. There were no deaths. There was a relatively high rate of permanent diabetes insipidus (DI) (13.2 vs <5% in published series), while the frequency of new postoperative anterior pituitary dysfunction (9.4%) was within the range reported in the literature (3–14%).ConclusionThe outcomes of pituitary surgery in this audit were largely comparable to those reported from other neurosurgical units in Australia and other countries. The increased risk of permanent postoperative DI may reflect the high proportion of non‐functioning tumours with extension outside the sella turcica.
Understanding the legacy of widespread population translocations on the post‐glacial genetic structure of the European beech, Fagus sylvatica L.
Authors: Sjölund M. Jennifer , González‐Díaz Patricia , Moreno‐Villena Jose J. , Jump Alistair S. 
Published: July 2017

AbstractAimHuman impacts have shaped species ranges throughout the Holocene. The putative native range of beech, Fagus sylvatica, in Britain was obscured by its late post‐glacial arrival and subsequent extensive management. We sought to differentiate the interacting effects of post‐glacial colonization and anthropic impacts on the current genetic structure and diversity of beech by contrasting phylogeographical signals from putatively natural and translocated populations.LocationSamples were obtained from 42 sites throughout Great Britain.MethodsChloroplast and nuclear microsatellite marker data were interpreted alongside palynological, historical and anecdotal evidence. Genetic structure was analysed using individual‐based Bayesian assignment methods and colonization history was analysed using an approximate Bayesian computation framework.ResultsPhylogeographical patterns suggested contemporary forests originated from putative native south‐eastern populations. High haplotypic diversity was found near the entry point of beech into Britain. Cryptic signals of isolation‐by‐distance persisted in the putative native range, together with higher levels of gene diversity in nuclear markers. Weak regional nuclear genetic structure suggested high levels of contemporary gene flow throughout the country.Main conclusionsGenetic patterns driven by natural colonization persist despite widespread anthropic intervention. Forests in northerly regions were established from forests in the putative native range, diminishing the credibility of any present boundary between the native and non‐native range of beech in Britain.
Electrophysiological relation between the superior vena cava and right superior pulmonary vein in patients with paroxysmal atrial fibrillation
Authors: Yoshida Kentaro , Hattori Ai , Tsuneoka Hidekazu , Tsumagari Yasuaki , Yui Yoshiaki , Kimata Akira , Ito Yoko , Ebine Mari , Uehara Yoshiko , Koda Naoya , Misaki Masako , Abe Daisuke , Takeyasu Noriyuki , Aonuma Kazutaka , Nogami Akihiko 
Published: July 2017

AbstractIntroductionThe superior vena cava (SVC) is a main source of nonpulmonary vein (PV) ectopies initiating atrial fibrillation (AF). Empiric SVC isolation may improve rhythm outcomes after catheter ablation of AF. Because the SVC passes immediately adjacent to the right superior PV (RSPV), an electrophysiological relation could be present between the two structures. The present study aimed to estimate the interrelation between the SVC and RSPV by evaluating arrhythmogenic activities observed during catheter ablation of AF.Methods and resultsStudy subjects comprised 121 consecutive patients referred for catheter ablation of paroxysmal AF. Isoproterenol infusion was used to induce ectopies and AF. Patients were divided into two groups depending on the presence of arrhythmogenic SVC: arrhythmogenic‐SVC (A‐SVC) and nonarrhythmogenic SVC (Non‐A‐SVC) groups. The prevalence of females was higher and body surface area was smaller in the A‐SVC group (N = 22) than Non‐A‐SVC group (N = 99). Arrhythmogenic activities were observed in 60 (49%) RSPVs, 24 (20%) right inferior PVs, 72 (59%) left superior PVs, and 31 (25%) left inferior PVs. Arrhythmogenic RSPVs were more prevalent in the A‐SVC group than Non‐A‐SVC group (86% vs. 41%, P = 0.0001), whereas these prevalences in the other three PVs were not different between groups (P >0.3). In multivariable analysis, arrhythmogenic RSPV was the only independent predictor of arrhythmogenicity of the SVC (OR, 8.53; 95% CI 2.31–31.46; P = 0.001).ConclusionsAn electrophysiological interrelation may be present between the SVC and RSPV in patients with paroxysmal AF. Semiempiric SVC isolation limited to patients with an arrhythmogenic RSPV may be a more efficient treatment strategy.
Long‐term follow‐up after left atrial appendage occlusion with comparison of transesophageal echocardiography versus computed tomography to guide medical therapy and data about postclosure cardioversion
Authors: Berte Benjamin , Jost Christine Attenhofer , Maurer Dominik , Fäh‐Gunz Anja , Pillois Xavier , Naegeli Barbara , Pfyffer Monica , Sütsch Gabor , Scharf Christoph 
Published: July 2017

AbstractAimsThe use of left atrial appendage (LAA) occluders in atrial fibrillation is increasing. There are few data on the comparison between transesophageal echocardiography (TEE) and computed tomography (MDCT) assessing peridevice flow and outcome of electrical cardioversion (ECV) in these patients.Methods and resultsSingle‐center prospective registry from 2009 to 2015 including all LAA occluders to analyze success and complications during implantation and follow‐up. Patients having ≥1 ECV were further analyzed. TEE was performed during implantation and at 6 weeks. In a subgroup of 77 patients, we compared MDCT with TEE at 6 weeks.Overall, 135 patients (69 ± 9 years; 70% male; CHA2DS2‐VASc score: 3.6 ± 1.4; HAS‐BLED score: 2.5 ± 0.6) received a LAA occluder (Watchman, n = 73; ACP‐1, n = 59; Amulet, n = 3; PVI + LAA occluder, n = 91; and LAA occluder only, n = 44). Device implantation was successful in 131 (97%). Eight patients (5.9%) had major periprocedural complications (ischemic stroke/transient ischemic attacks, n = 4, tamponade, n = 2, device thrombosis, n = 2, Dressler syndrome, n = 1). The periprocedural complication rate was similar between concomitant procedure and LAA occluder only (8/91 vs. 5/44; P = 0.6). Twelve patients (9%) died (procedure‐related, n = 2; 1%) during follow‐up of 44 months (IQR: 43). MDCT (n = 77) at 6 weeks showed similar peridevice flow compared to TEE (TEE: 1.5 ± 1.9 mm vs. MDCT: 1.1 ± 2.2 mm, P = 0.25). Thromboembolic events occurred in 3 patients (CVA, n = 1; TIA, n = 2) during follow‐up. In total, 41 ECV were performed in 26 patients (1.6 ± 0.9/patient), 13 months (IQR: 24) after implantation (<1 month: n = 8). No ECV‐related clinical complications were observed.ConclusionLAA occlusion is feasible with an acceptable safety profile and few events during long‐term follow‐up. ECV after LAA occlusion is feasible. MDCT could help to evaluate peridevice flow.
Independent Fiscal Councils: Neglected Siblings of Independent Central Banks? An EU Perspective
Authors: Larch Martin , Braendle Thomas 
Published: July 2017

AbstractGovernance of monetary and fiscal policy have followed diverging paths. Since the late 1980s monetary policy has been delegated to independent central banks. By contrast, fiscal stabilization remained in political hands but has progressively been constrained by rules; the Stability and Growth Pact in the EU is a prominent case in point. While delegation and independence eliminated the inflation bias, fiscal policy still suffers from a deficit bias as enforcement of rules remains difficult. A logical extension of all attempts to progressively tie the hands of politics would be to carve out the stabilization function from the broader field of fiscal policy and to delegate it to national independent fiscal councils. Apart from addressing the political economy behind the deficit bias, such a step would facilitate a better co‐ordination of macroeconomic policies in Economic and Monetary Union.
Associations Between Self‐Reported Physical Activity and Physical Performance Measures Over Time in Postmenopausal Women: The Women's Health Initiative
Authors: Laddu Deepika R. , Wertheim Betsy C. , Garcia David O. , Brunner Robert , Groessl Erik , Shadyab Aladdin H. , Going Scott B. , LaMonte Michael J. , Cannell Brad , LeBoff Meryl S. , Cauley Jane A. , Thomson Cynthia A. , Stefanick Marcia L. 
Published: July 2017

ObjectivesTo examine prospective associations between changes in physical activity (PA) and changes in physical performance measures (PPMs) over 6 years in older women.DesignProspective cohort study.SettingForty clinical centers in the United States.ParticipantsWomen aged 65 and older (mean age 69.8) enrolled in the Women's Health Initiative Clinical Trials with gait speed, timed chair stand, grip strength, and self‐reported recreational PA data assessed at baseline (1993–98) and follow‐up Years 1, 3, and 6 (N = 5,092).MeasurementsMixed‐effects linear regression models were used to determine the association between time‐varying PA and change in each PPM. Potential interactions between time‐varying PA and age (<70, ≥70) were also tested.ResultsSignifican, dose‐response associations between PA and improvements in all PPMs were observed over the 6 years of follow‐up after adjusting for important covariates. High PA groups (≥1,200 metabolic equivalent (MET)‐min/wk) had stronger grip strength (0.48 kg greater; P < .01), more chair stands (0.35 more; P < .001), and faster gait speeds (0.06 m/s faster; P < .001) than sedentary women (<100 MET‐min/wk). Higher PA levels were associated with a greater increase in chair stands over time in women aged 70 and older (P < .001) than in those younger than 70 (Pinteraction for age = .01).ConclusionIn postmenopausal women, maintaining high PA levels over time is associated with better lower extremity function. These data support the view that regular PA plays an important role in maintaining functional status during aging in older women.
Eicosapentaenoic acid and docosahexaenoic acid containing supplements modulate risk factors for cardiovascular disease: a meta‐analysis of randomised placebo‐control human clinical trials
Authors: AbuMweis S. , Jew S. , Tayyem R. , Agraib L. 
Published: July 2017

AbstractBackgroundOver 200 clinical trials have examined the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplements on risk factors associated with cardiovascular disease. However, an updated analysis of the evidence is lacking. The aim of the present meta‐analysis was to quantify the effect of supplements containing EPA and DHA on risk factors for cardiovascular disease.MethodsAn analysis was carried on 171 clinical trials with acceptable quality (Jadad score ≥3) that were identified from a comprehensive electronic search strategy of two databases (Pubmed and Cochrane Library). A random effect model was used to obtain an overall estimate on outcomes of interest. Heterogeneity between trial results was tested for using a standard chi‐squared test.ResultsCompared with control, EPA and DHA supplements produced significant reductions of triglycerides of 0.368 mmol L−1 [95% confidence interval (CI) = −0.427 to −0.309], systolic blood pressure of 2.195 mmHg (95% CI = −3.172 to −1.217), diastolic blood pressure of 1.08 mmHg (95% CI = −1.716 to −0.444), heart rate of 1.37 bpm (95% CI = −2.41 to −0.325) and C‐reactive protein of 0.343 mg L−1 (95% CI = −0.454 to −0.232). This analysis indicates an increase in both low‐density lipoprotein cholesterol (mean difference = 0.150 mmol L−1; 95% CI = 0.058–0.243) and high‐density lipoprotein cholesterol (mean difference = 0.039 mmol L−1; 95% CI = 0.024–0.054). The triglyceride‐lowering effect was dose‐dependent.ConclusionsThe lipid‐lowering, hypotensive, anti‐arrhythmic and anti‐inflammatory actions of EPA and DHA supplements were confirmed in this analysis of randomised placebo‐control blinded clinical trials.
The mitral‐to‐aortic flow‐velocity integral ratio in the real world echocardiographic evaluation of functional mitral regurgitation before and after percutaneous repair
Authors: Palmiero Giuseppe , Ascione Luigi , Briguori Carlo , Carlomagno Guido , Sordelli Chiara , Ascione Raffaele , Pisacane Francesca , Monda Vittorio , Severino Sergio , Caso Pio 
Published: July 2017

IntroductionPercutaneous mitral valve repair (PMVR) using MitraClip system has emerged as a therapeutic option for patients with functional severe mitral regurgitation (FMR) at prohibitive risk for surgery. In this setting, the echocardiographic assessment of FMR severity is challenging because the traditional echocardiographic methods have important limitations. The aim of this study was to assess the accuracy and reliability of a simple Doppler index, the mitral/aortic flow velocity integral ratio (MAVIR), to evaluate residual FMR severity after PMVR.MethodsEighty‐five heart failure patients with functional MR and LV dysfunction (LVEF ≤ 40%) were included. FMR was quantified on the basis of traditional quantitative parameters of MR severity. MAVIR was expressed as the ratio of mitral and aortic time velocity integral (TVI) values. According to MR severity, 25 patients underwent MC implantation and at 6 months a complete echocardiographic follow‐up was performed.ResultsA significant linear relationship was found between MAVIR and both VC and EROA. A MAVIR ≥1.02 identified pts with severe MR with a sensitivity of 86.7% and a specificity of 90.9%. At the 6 months echocardiographic follow‐up after the MitraClip implantation, we observed a significant reduction of LAVI, LVED and LVES volume, while LVEF improved. Furthermore, MAVIR significantly decreased its decrease showed a significant linear relationship with LAVI reduction.ConclusionOur data show a close relationship between MAVIR and traditional indexes of MR severity in patients with FMR. This Doppler‐derived index seems applicable after PMVR where traditional echocardiographic index of MR severity shows significant limitations.
Neopuff T‐piece resuscitator mask ventilation: Does mask leak vary with different peak inspiratory pressures in a manikin model?
Authors: Maheshwari Rajesh , Tracy Mark , Hinder Murray , Wright Audrey 
Published: July 2017

AimThe aim of this study was to compare mask leak with three different peak inspiratory pressure (PIP) settings during T‐piece resuscitator (TPR; Neopuff) mask ventilation on a neonatal manikin model.MethodsParticipants were neonatal unit staff members. They were instructed to provide mask ventilation with a TPR with three PIP settings (20, 30, 40 cm H2O) chosen in a random order. Each episode was for 2 min with 2‐min rest period. Flow rate and positive end‐expiratory pressure (PEEP) were kept constant. Airway pressure, inspiratory and expiratory tidal volumes, mask leak, respiratory rate and inspiratory time were recorded. Repeated measures analysis of variance was used for statistical analysis.ResultsA total of 12 749 inflations delivered by 40 participants were analysed. There were no statistically significant differences (P > 0.05) in the mask leak with the three PIP settings. No statistically significant differences were seen in respiratory rate and inspiratory time with the three PIP settings. There was a significant rise in PEEP as the PIP increased. Failure to achieve the desired PIP was observed especially at the higher settings.ConclusionsIn a neonatal manikin model, the mask leak does not vary as a function of the PIP when the flow rate is constant. With a fixed rate and inspiratory time, there seems to be a rise in PEEP with increasing PIP.