bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between periodontitis and risk of Alzheimer′s disease, mild cognitive impairment and subjective cognitive decline: A case–control study
Authors: Holmer Jacob , Eriksdotter Maria , Schultzberg Marianne , Pussinen Pirkko J. , Buhlin Kåre
Published: October 2018

Aims

To test the hypothesis that periodontal disease contributes to increased risk of mild cognitive impairment (MCI), subjective cognitive decline (SCD) and Alzheimer′s disease (AD).

Materials and methods

This case–control study was conducted over a 3‐year period in the municipality of Huddinge, Sweden. In total, 154 cases were consecutively enrolled from the Karolinska Memory Clinic at the Karolinska University Hospital and allotted to three diagnostic groups: AD, MCI and SCD, collectively referred to as “cases.” Seventy‐six cognitively healthy age‐ and gender‐matched controls were randomly sampled through the Swedish population register. All cases and controls underwent clinical and radiographic oral examinations. Statistical analysis was based on logistic regression models adjusted for potential confounders.

Results

Poor oral health and marginal alveolar bone loss were more prevalent among cases than among controls. The cases group was associated with generalized marginal alveolar bone loss (odds ratio [OR] = 5.81; 95% confidence interval [CI] = 1.14–29.68), increased number of deep periodontal pockets (OR = 8.43; CI 4.00–17.76) and dental caries (OR = 3.36; CI 1.20–9.43).

Conclusion

The results suggest that marginal periodontitis is associated with early cognitive impairment and AD. However, the study design does not preclude noncausal explanations.
Prevalence and risk indicators of peri‐implant diseases in Spain
Authors: Rodrigo Daniel , Sanz‐Sánchez Ignacio , Figuero Elena , Llodrá Juan Carlos , Bravo Manuel , Caffesse Raul G. , Vallcorba Nuria , Guerrero Adrián , Herrera David
Published: October 2018

Aim

To evaluate the prevalence of peri‐implant diseases in Spain, as well as the associated risk indicators.

Material and Methods

This is a cross‐sectional study using a network of sentinel dentists, who randomly selected 10 patients with implants (placed, at least, 5 years before), which were clinically and radiographically evaluated. Case definitions were established for peri‐implant mucositis [bleeding on probing (BOP) and no bone level ≥2 mm] and peri‐implantitis (BOP plus bone level ≥2 mm). Potential predictor variables, at univariate and multivariate levels, were explored by means of binary logistic regression.

Results

A total of 49 sentinel dentists provided complete data from 474 implants in 275 patients. At implant level, prevalences for peri‐implant mucositis and peri‐implantitis were 27% (95% confidence interval [CI] 22–32) and 20% (95% CI: 15–24), respectively, with 17% of implants (14–21) with bone level ≥2 mm without BOP. At patient level, prevalences were 27% (22–32), 24% (19–29) and 18% (13–22), respectively. In the multiple regression analysis, statistically significant associations for peri‐implantitis (p < 0.10) were found for gender, peri‐implant supportive therapy, implant location, diameter and surface, type of prosthesis and access to interproximal hygiene.

Conclusions

In this representative subject sample across Spain, the prevalence of peri‐implant diseases was high (51%).
A 5‐year prospective study on the clinical and aesthetic outcomes of alveolar ridge preservation and connective tissue graft at the buccal aspect of single implants
Authors: Eghbali Aryan , Seyssens Lorenz , De Bruyckere Thomas , Younes Faris , Cleymaet Roberto , Cosyn Jan
Published: October 2018

Aim

To evaluate the 5‐year aesthetic outcome of single implants following alveolar ridge preservation (ARP) and connective tissue graft (CTG) at the buccal aspect.

Materials and Methods

Thirty‐seven periodontally healthy non‐smoking patients received flapless tooth extraction, ARP with a deproteinized bovine bone mineral with 10% collagen (DBBMC), implant placement (4–6 months later), a provisional screw‐retained crown and CTG at the buccal mucosa (3 months later) and a permanent crown (3 months later). The aesthetic results were the primary outcome and the clinical results the secondary outcome of the study. Both outcomes were compared to those after 1 year. Mucosal thickness (MT) was registered using a non‐invasive ultrasonic device.

Results

Thirty‐two patients attended the 5‐year re‐assessment, and all implants survived. Mean marginal bone loss was 0.53 mm at 1 year and 0.47 mm at 5 years (p = 0.439). Mesial Papilla showed a further re‐growth between 1 and 5 years (p = 0.043). Mid‐facial recession amounted to 0.05 mm and 0.12 mm at 1 and 5 years, respectively (p = 0.161). The Pink Esthetic Score was 11.00 and 11.17 at 1 and 5 years, respectively (p = 0.596). MT gain amounted to 0.97 mm (relative stability: 90.5%) and 0.91 mm (relative stability: 85%) at 1 and 5 years, respectively (p = 0.249).

Conclusion

ARP and CTG resulted in favourable clinical and aesthetic outcomes. CTG substantially increased MT with acceptable stability over a 5‐year period.
Psychotic experiences are associated with health anxiety and functional somatic symptoms in preadolescence
Authors: Rimvall Martin K. , Jespersen Cecilia Pihl , Clemmensen Lars , Munkholm Anja , Skovgaard Anne Mette , Verhulst Frank , van Os Jim , Rask Charlotte Ulrikka , Jeppesen Pia
Published: October 2018

Background

Health anxiety (HA) is an increasing public health problem related to increased health service costs, and associated with functional somatic symptoms (FSS) and considerable personal suffering. Abnormal bodily experiences which may resemble HA and FSS are common in psychotic disorders, but a potential link between HA and psychosis vulnerability in childhood is largely unexplored. The current study estimates the association between subclinical psychotic experiences (PE) and HA and FSS in a general population cohort of preadolescents.

Methods

The study population consisted of 1,572 11–12‐year‐old children from the Copenhagen Child Cohort 2000. PE were comprehensibly assessed as either present or not present using the Kiddie Schedule of Affective Disorders and Schizophrenia psychosis section. HA and FSS were assessed by self‐report on validated questionnaires. Additional variables on general psychopathology, puberty, and chronic somatic illness were also obtained.

Results

Psychotic experiences were associated with the top 10% high scores of HA (Odds Ratio (OR) 3.2; 95% CI: 2.1–4.8) and FSS (OR 4.6; 95% CI: 3.1–6.9) in univariate analyses. After mutual adjustment, the association was reduced to (HA: OR 2.3; 95% CI: 1.5–3.5; FSS: OR 3.7; 95% CI: 2.4–4.7), suggesting interdependence. Further adjustment for potential confounders and general psychopathology only reduced the associations slightly: HA OR 2.2 (95% CI: 1.4–3.4); FSS OR 3.3 (95% CI: 2.1–5.2). Secondary analyses of subdimensions of HA showed that PE were associated with fears (OR 3.0; 95% CI: 2.0–4.6) and daily impact of HA symptoms (OR 5.0; 95% CI: 3.4–7.5), but not help seeking (OR 1.2; 95% CI: 0.7–2.1).

Conclusions

This is the first study to investigate the associations between PE and HA and FSS, respectively. PE were significantly associated with HA and FSS over and above general psychopathology in preadolescence. Individuals with PE expressed high levels of health‐related fears and daily impact, but no corresponding help‐seeking behavior.
Restoration of myocardial glucose uptake with facilitated myocardial glucose transporter 4 translocation contributes to alleviation of diabetic cardiomyopathy in rats after duodenal‐jejunal bypass
Authors: Huang Xin , Wu Dong , Cheng Yugang , Zhang Xiang , Liu Teng , Liu Qiaoran , Xia Pingtian , Zhang Guangyong , Hu Sanyuan , Liu Shaozhuang
Published: October 2018

Aims/Introduction

Duodenal‐jejunal bypass (DJB) surgery has been reported to effectively relieve diabetic cardiomyopathy (DCM). However, the specific mechanisms remain largely unknown. The present study was designed to determine the alterations of myocardial glucose uptake (MGU) after DJB and their effects on DCM.

Materials and Methods

Duodenal‐jejunal bypass and sham surgeries were carried out in diabetic rats induced by a high‐fat diet and a low dose of streptozotocin, with chow‐diet fed rats as controls. Bodyweight, food intake, glucose homeostasis and lipid profiles were measured at indicated time‐points. Cardiac function was evaluated by transthoracic echocardiography and hemodynamic measurement. Cardiac remodeling was assessed by a series of morphometric analyses along with transmission electron microscopy. Positron‐emission tomography with fluorine‐18 labeled fluorodeoxyglucose was carried out to evaluate the MGU in vivo. Furthermore, myocardial glucose transporters (GLUT; GLUT1 and GLUT4), myocardial insulin signaling and GLUT‐4 translocation‐related proteins were investigated to elucidate the underlying mechanisms.

Results

The DJB group showed restored systolic and diastolic cardiac function, along with significant remission in cardiac hypertrophy, cardiac fibrosis, lipid deposit and ultrastructural disorder independent of weight loss compared with the sham group. Furthermore, the DJB group showed upregulated myocardial insulin signaling, hyperphosphorylation of AKT substrate of 160 kDa (AS160) and TBC1D1, along with preserved soluble N‐ethylmaleimide‐sensitive factor attachment protein receptor proteins, facilitating the GLUT‐4 translocation to the myocardial cell surface and restoration of MGU.

Conclusions

The present findings provide evidence that restoration of MGU is implicated in the alleviation of DCM after DJB through facilitating GLUT‐4 translocation, suggesting a potential choice for treatment of human DCM if properly implemented.
Brighter prospects? Assessing the franchise advantage using census data
Authors: Lafontaine Francine , Zapletal Marek , Zhang Xu
Published: October 2018

This paper uses Census microdata to examine how starting a business as a franchise rather than an independent business affects its survival and growth prospects. We assess factors that influence the decision to become a franchisee and use various empirical approaches to correct for selection bias in our performance analyses. We find that franchised businesses on average exhibit higher survival rates than independent businesses; but importantly, the difference is small compared with claims in the trade press. The effect is also short lived: conditional on surviving a year or two, we no longer find survival (or growth) differences. We then explore two potential sources for this small survival advantage, namely franchisors’ screening process and the benefits arising from the brand and business know‐how provided by franchisors. We find evidence that both of the sources contribute to the franchising advantage.
Mass‐rearing optimization of the parasitoid Psyttalia lounsburyi for biological control of the olive fruit fly
Authors: Chardonnet Floriane , Blanchet Arnaud , Hurtrel Beatrice , Marini Francesca , Smith Lincoln
Published: October 2018

The olive fruit fly, Bactrocera oleae (Tephritidae), is a direct pest of olives that has invaded the Mediterranean Region and California. Psyttalia lounsburyi (Braconidae), a larval parasitoid from Africa, has been approved for release in the USA as a classical biological agent. However, it has been difficult to rear the parasitoid in the laboratory because it is multivoltine, and the host develops only in fresh olives, which are not available for most of the year. A method to rear the parasitoid on the factitious host, Mediterranean fruit fly (Ceratitis capitata) was developed, but it was not very efficient for producing large numbers of parasitoids needed for release. We developed a number of ways to improve the efficiency of rearing, including the frequency and duration of exposure for oviposition, optimizing the density of adult parasitoids, host age, as well as methods to quickly standardize the number of larvae exposed and to count emerging adult parasitoids. We significantly improved the number of progeny produced per female and the sex ratio of progeny. Thanks to these improvements, we produced in 2017 over 119,000 adults and shipped over 53,900 for release in California.
Production and preference mapping of persimmon fruit leather: An optimization study by Box–Behnken
Authors: Dursun Derya , Dalgıç Ali Coşkun
Published: October 2018

New and additive‐free persimmon fruit leather was planned to produce and obtain a standard product. A Box–Behnken experimental design was employed to characterize the process including hydrocolloid preparation and drying, optimize and investigate the effects of the amount of starch (3, 5, and 7%), product thickness (1, 2, and 3 mm) and convective drying temperature (40, 50, and 60 °C) variables on moisture removal, color, texture profile and sensory attributes. The most preferred leather product was determined evaluating the sensory parameters with Duncan's test (p < .05). A multi‐criteria optimization based on sensory analysis results was achieved using response surface methodology. The optimum process conditions were 4.73% amount of starch, 1.11 mm thickness and 50.26 °C temperature. The amount of starch and its interaction with the other factors had an important effect on leather production. Pearson and principal component correlation analyses were performed to determine whether a correlation existed between the sensory and instrumental analysis parameters. Mutually supportive results were obtained from subjective and qualitative considerations.

Practical applications

The study presented the production of persimmon fruit leather as a healthy snack and optimization of the process conditions in the scope of an experimental design, which allowed of reducing the number of experiments. This approach enabled the evaluation of individual and interactional effects of each process parameter on important expectations of consumers for a new food product. It is necessary to discuss the results of instrumental and sensory analysis statistically to obtain a standard qualified product.
Declining in liver stiffness cannot indicate fibrosis regression in patients with chronic hepatitis B: A 78‐week prospective study
Authors: Dong Xiao‐Qin , Wu Zhao , Li Jun , Wang Gui‐Qiang , Zhao Hong ,   China HepB‐Related Fibrosis Assessment Research Group
Published: October 2018

Background and Aim

Little reliable data are available about the liver stiffness measurement (LSM) for fibrosis monitoring in chronic hepatitis B (CHB) patients on antiviral therapy. We aimed to assess the accuracy of LSM in fibrosis monitoring during 78‐week antiviral therapy in CHB patients.

Methods

Five hundred fifty‐six treatment‐naïve CHB patients with qualified LSM and liver biopsy at baseline were analyzed. Patients receiving entecavir‐based therapy were prospectively followed to 78 weeks for second LSM and liver biopsy. Serologic detection, LSM, and liver biopsy were performed on the same day. Necro‐inflammatory activity was also evaluated.

Results

Areas under receiver operating characteristics curves of LSM at baseline and week 78 for significant fibrosis (≥ F3), advanced fibrosis (≥ F4), and liver cirrhosis (≥ F5) was 0.84, 0.87, 0.83 and 0.76, 0.85, 0.88, respectively. Patients with the same fibrosis stage but higher histology activity index score tend to have higher LSM at baseline. Liver stiffness decreased rapidly (3.8 [1.6–8.6] kPa) in parallel with baseline histology activity index scores from 11.3 (7.8–16.7) kPa at baseline to 6.4 (5.1–8.8) kPa at week 78. Greater decline of LSM in patients with only inflammation improvement was observed as compared with those without inflammation improvement (5.2 [2.5–9.7] vs 1.8 [0.2–8.1] kPa, P = 0.013). Baseline Ishak fibrosis score was the only predictor of 78‐week fibrosis improvement (odds ratio, 1.859; P = 0.000).

Conclusions

In CHB patients receiving 78‐week antiviral treatment, LSM could diagnosis different liver fibrosis stages, decrease in absolute LSM value could reflect the remission of liver inflammation, and baseline Ishak fibrosis score was the only predictor for 78‐week fibrosis reversion.
When Asymptomatic Bacteriuria is not Asymptomatic or “Pseudo‐Urinary Tract Infection”
Authors: Gomolin Irving H.
Published: October 2018

See the Reply by Thomas Finucane.
Reply to: When Asymptomatic Bacteriuria Is Not Asymptomatic or “Pseudo‐Urinary Tract Infection”
Authors: Finucane Thomas E.
Published: October 2018

This letter comments on the letter by Irving H. Gomolin
Exnovation of Low Value Care: A Decade of Prostate‐Specific Antigen Screening Practices
Authors: Bynum Julie , Passow Honor , Carmichael Donald , Skinner Jonathan
Published: October 2018

Objectives

To examine prostate‐specific antigen (PSA) screening practice change in subgroups of men defined in guidelines and in various regions and to identify factors associated with change in screening practices.

Design

Observational study using serial cross‐sections, 2003 to 2013.

Setting

National fee‐for‐service Medicare.

Participants

Men aged 68 and older eligible for prostate cancer screening.

Measurements

National PSA screening practices in men aged 68 and older from 2003 to 2013 and change in regional screening rates in men aged 75 and older.

Results

The PSA screening rate in men aged 68 and older was 17.2% in 2003, 22.3% in 2008, and 18.6% in 2013 (p < .001 for all differences); rates ended slightly lower than rates in 2003 only in men 80 and older. Racial disparities in screening became less pronounced over this period. In men aged 75 and older, change in regional screening rates varied widely, with absolute rates growing by 15 per 100 enrollees in some areas and declining by the same amount in others. Areas with high social capital, a measure associated with diffusion of new ideas, were more likely to decline; malpractice intensity and managed care penetration had no effect.

Conclusion

Studying Medicare enrollees over time, we found little reduction in PSA screening and even increases according to race and in some regions. The heterogeneous changes across regions suggest that consistent reduction in the use of low‐value care may require change strategies that go beyond evidence and guidelines to include monitoring and feedback on performance. J Am Geriatr Soc 67:29–36, 2019.
Inhaler Technique Education and Exacerbation Risk in Older Adults with Asthma or Chronic Obstructive Pulmonary Disease: A Meta‐Analysis
Authors: Maricoto Tiago , Monteiro Luís , Gama Jorge M.R. , Correia‐de‐Sousa Jaime , Taborda‐Barata Luís
Published: October 2018

Objectives

To evaluate the effect of inhaler education programs on clinical outcomes and exacerbation rates in older adults with asthma or chronic obstructive pulmonary disease (COPD).

Design

Systematic review and meta‐analysis.

Setting and Participants

Older adults with asthma or COPD, either in primary or secondary health care and pharmacy setting.

Measurements

We searched the Medline, Embase, and Central databases according to the main eligibility criteria for inclusion: systematic reviews, meta‐analysis, clinical trials and quasi‐experimental studies; participants aged 65 and older; education on inhaler technique and reporting of disease control and exacerbation rates. We used the Grading of Recommendations, Assessment, Development and Evaluations scale for quality assessment and used a random‐effect model with Mantel–Haenszel adjustment to perform a meta‐analysis.

Results

We included 8 studies (4 randomized, 4 quasi‐experimental) with a total of 1,812 participants. The most frequent type of intervention was physical demonstration of inhaler technique, training with placebo devices. Five studies showed significant reduction in exacerbation rates (pooled risk ratio=0.71, 95% confidence interval=0.59–0.86; p < .001), although effect on disease control and quality of life showed high discrepancy in the reported results, and all randomized studies revealed uncertainty in their risk of bias assessment.

Conclusion

All interventions seemed to improve inhaler performance and clinically relevant outcomes, but a placebo device could be the most effective. There is evidence that interventions reduce exacerbation risk in older adults, although to an overall moderate degree. J Am Geriatr Soc 67:57–66, 2019.
Cause of Death and End‐of‐Life Experiences in Individuals with Dementia with Lewy Bodies
Authors: Armstrong Melissa J. , Alliance Slande , Corsentino Pamela , DeKosky Steven T. , Taylor Angela
Published: October 2018

Objectives

To investigate the natural history, cause of death, and end‐of‐life experiences of individuals diagnosed with dementia with Lewy bodies (DLB).

Design

Twenty‐question online survey administered through the Lewy Body Dementia Association.

Setting

United States.

Participants

Caregivers, family, and friends of individuals who died in the past 5 years with a diagnosis of DLB (survey respondents: n = 658, 89% female, median age 50–69).

Measurements

The survey included 3 questions about the respondent's background and 17 about the end‐of‐life experiences of the person with DLB. Topics included time from symptom onset and diagnosis to death, cause of death, advance directive completion, end‐of‐life education, hospice use, and location of death. Results were analyzed descriptively.

Results

Most individuals with DLB died within 5 years of diagnosis (median 3–4 years). Respondents indicated that physicians rarely discussed what to expect at the end of life (40% total, but only 22% to a helpful degree) and that the caregiver usually initiated such conversations. Death was usually expected, but fewer than half of respondents felt prepared for what to expect. Seventy‐eight percent used hospice, usually at home or in skilled care, with wide variations in duration. Failure to thrive was the most common cause of death (65%), followed by pneumonia and swallowing difficulties (23%), other medical conditions (19%), and complications from falling (10%) (multiple causes allowed).

Conclusion

Study results highlight a critical need for better prognostic counseling and education for persons and families living with DLB. The results of the current study can inform such counseling, but additional studies are needed to further explore expected prognosis of individuals diagnosed clinically with DLB and optimal use of palliative care services. J Am Geriatr Soc 67:67–73, 2019.
Comment on “Personality Changes During the Transition from Cognitive Health to Mild Cognitive Impairment”
Authors: Agϋera‐Ortiz Luis , Lyketsos Constantine , Ismail Zahinoor
Published: October 2018

See the Reply by Caselli et al.
Operational Perspectives on Extended Producer Responsibility
Authors: Atasu Atalay
Published: October 2018

We revisit three important assumptions about extended producer responsibility (EPR) that originate from academia, policy, or practice: (1) A central objective of EPR should be to induce product designs for the environment; (2) collective EPR implementations mute incentives to design for the environment; and (3) more stringent EPR policy parameters will generate better environmental outcomes. We discuss the potential shortcomings of these assumptions from an operations perspective and their implications for academic and policy research.
The Use of Video Calls in Early Labor Care: Exploring Midwives’ Views of the Potential Benefits and Challenges
Authors: Kennedy Holly Powell , Faucher Mary Ann , Roberts Julie , Divall Bernie , Spiby Helen
Published: October 2018

Introduction

This qualitative research study explored the research question of whether midwives in the United States and the United Kingdom see potential benefits and challenges of using video‐calling technology to assess and support women in early labor. Early labor calls to maternity units are a locus of dissatisfaction for childbearing women. Although staying at home has benefits for women, some feel uncared for or unwelcome when they are asked to delay traveling to the maternity unit and may struggle to manage their pain at home. Midwives must build rapport and make accurate assessments over the telephone, without the visual and non‐verbal cues they would use in face‐to‐face care. Admission to maternity units prior to establishment of active labor can lead to increased intervention and higher cesarean rates. Thus, it is important to identify innovative strategies to support women in early labor at home.

Methods

Qualitative data were gathered through audio‐recorded focus group and individual interviews in 3 UK sites (n = 21) and 2 US sites (n = 32). Data were managed with Atlas.ti qualitative software and thematic content analysis was conducted.

Results

Preliminary analysis shows that most of the midwives see potential benefits of a video‐calling service, including enhanced assessment capacity through visual cues and increased reassurance for women and their partners. However, some midwives had significant concerns about introducing video calls into early labor care, including doubts about the reliability of the technology and discordant phone types. Within the health care context, legal issues, confidentiality, privacy concerns, and appearing professional, empathic, and focused during video calls were raised. Discussion between midwives about which women had internet access raised concerns about equity. There were variations across types of practices and birth settings that reflected continuity of care and type of call coverage for labor that create challenges to integrating the technology within practices. In some settings, implementation would require consideration of documentation, dedicated call lines, and the development of new policies.

Discussion

Findings from the completed analysis will be discussed in the context of US and UK maternity care settings, drawing on evidence from the use of video calling in other specialties.
Perspectives from Providers and Mothers on the Benefits of and Barriers to Respectful Maternity Care in a Refugee Camp Setting in Thailand
Authors: Madeira Anjali , Avery Melissa , Buesseler Heather
Published: October 2018

Introduction

Recent evidence suggests the lack of respectful maternity care (RMC) may indirectly contribute to maternal morbidity and mortality. Compared to more stable settings, provision of RMC in emergency, conflict‐affected, and transitional contexts poses a greater challenge, though few studies have focused on RMC in these settings. This study aimed to describe providers’ and women's perspectives on benefits of and barriers to RMC in a conflict‐affected setting. An additional aim was to better understand the extent to which Burmese refugee women are experiencing disrespect and abuse during their maternity care, including care processes and interactions with providers.

Methods

In‐depth interviews and focus group discussions with maternity care providers and women giving birth in the previous 4 months were conducted at clinics in 2 refugee camps in Thailand and in a nearby Thai government referral hospital in August 2014. Participant observation occurred in the labor and postpartum wards and delivery rooms of these facilities. Recorded sessions were translated, transcribed, coded, and analyzed for common themes.

Results

Eleven mothers and 14 providers, including midwives, traditional birth attendants, nurses, and physician interns, participated in either a focus group discussion or in‐depth interview exploring experiences receiving or delivering maternity care. Major themes emerging from the data included patient‐centered care, care equity, and trust. Both providers and women shared numerous experiences of disrespectful or abusive care. Subthemes related to these experiences were lack of patient privacy or consent, verbal and physical abuse by providers, ethnic and religious discrimination, and lack of mutual trust between patient and provider. High caseloads, language barriers, and patient‐provider educational disparities were also identified by providers as major barriers to providing RMC.

Discussion

Refugee women are experiencing disrespectful and abusive care in both camp settings and a government referral facility. Challenges to RMC delivery in conflict‐affected settings include language and cultural barriers, provider stress, and lack of mutual trust. More research is needed among displaced women and their providers to fully characterize barriers to RMC and develop effective interventions to overcome them in emergency contexts around the world.
Implementing an Internet‐based Decision Aid in Ethnically Diverse Prenatal Care Settings: Reducing Disparities through Shared Decision Making about Birth after Cesarean
Authors: Shorten Allison , Shorten Brett , Fagerlin Angela , Illuzzi Jessica , Kennedy Holly Powell , Pettker Christian , Raju Dheeraj , Whittemore Robin
Published: October 2018

Introduction

Decision aids have been recommended for value‐sensitive health care decisions such as mode of birth after previous cesarean. However, effective strategies for widespread clinical implementation of decision aids, to reduce disparities and improve shared decision‐making experiences, are currently lacking. The purpose of this study was to evaluate the feasibility and acceptability of implementing an interactive internet‐based decision aid to support women making shared decisions about birth after previous cesarean in urban and racially and ethnically diverse outpatient clinic settings.

Methods

A before‐and‐after study design was used to assess the feasibility and acceptability of implementing an internet‐based decision aid designed to prepare women and providers for shared decision making about birth after cesarean. Changes in women's knowledge about their birth options and levels of decisional conflict about mode of birth were measured before and after access to the decision aid. Preferences for mode of birth and actual birth outcomes were compared to assess alignment with birth mode choice. Women who indicated they used the decision aid during pregnancy provided ratings on acceptability of content, features, and functions.

Results

Participants included 68 pregnant women (mean age 29.3 years) from ethno‐racially diverse backgrounds (black, 46.2%; Hispanic, 35.4%; white, 13.8%; Asian or other, 4.6%) who were eligible to choose between planned vaginal birth after cesarean (VBAC) and planned repeat cesarean. Knowledge of birth options scores increased by 2.58 points out of 15 (P < .001, d = 0.87) and decisional conflict scores reduced by 0.45 points out of 5 points (P < .001, d = 0.69). Forty‐four women (65.9%) attempted VBAC, of whom, 29 (65.7%) succeeded. Participants who used the decision aid during pregnancy rated its content, features, and functions as good or excellent and indicated they would recommend the decision aid to other women.

Discussion

It is potentially feasible to implement interactive internet‐based decision aids within ethnically and racially diverse prenatal care settings to address disparities in decision preparation. Strategies to improve timely decision aid access and promote consistent utilization of decision support for all women are needed. Seamless integration into workflow, including use of the electronic health record, is an important next step for future dissemination and implementation research.
Proteomics of neurodegenerative diseases: analysis of human post‐mortem brain
Authors: Li K. W. , Ganz Andrea B. , Smit August B.
Published: October 2018

Dementias are prevalent brain disorders in the aged population. Dementias pose major socio‐medical burden, but currently there is no cure available. Novel proteomics approaches hold promise to identify alterations of the brain proteome that could provide clues on disease etiology, and identify candidate proteins to develop further as a biomarker. In this review, we focus on recent proteomics findings from brains affected with Alzheimer's Disease, Parkinson Disease Dementia, Frontotemporal Dementia, and Amyotrophic Lateral Sclerosis. These studies confirmed known cellular changes, and in addition identified novel proteins that may underlie distinct aspects of the diseases.

image

This article is part of the special issue "Proteomics".
Reduced expression of the ferroptosis inhibitor glutathione peroxidase‐4 in multiple sclerosis and experimental autoimmune encephalomyelitis
Authors: Hu Che‐Lin , Nydes Mara , Shanley Kara L. , Morales Pantoja Itzy E. , Howard Tamara A. , Bizzozero Oscar A.
Published: October 2018

Glutathione peroxidase 4 (GPx4) is the only enzyme capable of reducing toxic lipid hydroperoxides in biological membranes to the corresponding alcohols using glutathione as the electron donor. GPx4 is the major inhibitor of ferroptosis, a non‐apoptotic and iron‐dependent programmed cell death pathway, which has been shown to occur in various neurological disorders with severe oxidative stress. In this study, we investigate whether GPx4 expression is altered in multiple sclerosis and its animal model experimental autoimmune encephalomyelitis (EAE). The results clearly show that mRNA expression for all three GPx4 isoforms (cytoplasmic, mitochondrial and nuclear) decline in multiple sclerosis gray matter and in the spinal cord of MOG35–55 peptide‐induced EAE. The amount of GPx4 protein is also reduced in EAE, albeit not in all cells. Neuronal GPx4 immunostaining, mostly cytoplasmic, is lower in EAE spinal cords than in control spinal cords, while oligodendrocyte GPx4 immunostaining, mainly nuclear, is unaltered. Neither control nor EAE astrocytes and microglia cells show GPx4 labeling. In addition to GPx4, two other negative modulators of ferroptosis (γ‐glutamylcysteine ligase and cysteine/glutamate antiporter), which are critical to maintain physiological levels of glutathione, are diminished in EAE. The decrease in the ability to eliminate hydroperoxides was also evidenced by the accumulation of lipid peroxidation products and the reduction in the proportion of the docosahexaenoic acid in non‐myelin lipids. These findings, along with presence of abnormal neuronal mitochondria morphology, which includes an irregular matrix, disrupted outer membrane and reduced/absent cristae, are consistent with the occurrence of ferroptotic damage in inflammatory demyelinating disorders.

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Use of a novel 589‐nm solid‐state laser for treatment of facial erythema
Authors: Cohen Diana K. , Gonzalez Noelani E. , Bloom Bradly S. , Goldberg David J.
Published: October 2018

Objective

To evaluate the efficacy and safety associated with use of a 589‐nm solid‐state laser for treatment of facial erythema.

Methods

A prospective, IRB‐approved study was conducted. Participants who were interested in treatment for facial erythema were recruited. They received four monthly treatments with the 589‐nm laser. Erythema of the right and left face was graded on a scale of 0‐4, 4 being most severe, by both investigators and participants prior to each treatment and at follow‐up. Safety was assessed by any reported side effects.

Results

Twenty‐four participants enrolled in the study, 16 women (67%) and 8 men (33%), with an average age of 51.1 years. Investigator grades showed a statistically significant improvement in erythema of 31% for both the right and left face. Participant grades showed a statistically significant improvement in erythema of 23.2% for the right face and 22.8% for the left face. Side effects were limited to transient erythema posttreatment.

Conclusion

A 589‐nm solid‐state laser achieved a modest improvement in facial erythema when evaluating results 1 month after four monthly treatments. No major safety issues were reported.
Phytochemical screening and antityrosinase activity of carvacrol, thymoquinone, and four essential oils of Lebanese plants
Authors: El Khoury Rindala , Michael Jubeli Rime , El Beyrouthy Marc , Baillet Guffroy Arlette , Rizk Toufic , Tfayli Ali , Lteif Roger
Published: October 2018

Objective

In our study, we aim to explore the ability of four essential oils (EO) of Lebanese plants to inhibit the tyrosinase activity and to correlate their efficiency level to their phytochemical compositions.

Methods

The EO have been extracted by hydrodistillation using a Clevenger apparatus and have been studied by GC‐MS analysis. Active compounds of Origanum species were identified and antityrosinase activities of EO and active molecules (carvacrol and thymoquinone) have been tested in tubo.

Results

Antityrosinase activities were obtained as follows: EO of Origanum syriacum (80.41% ± 2.00%), EO of Origanum ehrenbergii (45.33% ± 2.20%), EO of Salvia fruticosa (14.62% ± 2.30%), EO of Calamintha origanifolia (16.51% ± 5.80%), Carvacrol (56.55% ± 3.10%), and Thymoquinone (19.49% ± 1.50%).

Conclusion

Origanum essential oils resulted in the highest antityrosinase activity due to their high content in carvacrol. However, when present together with carvacrol, thymoquinone decreases the efficiency of carvacrol, which is the case of O. ehrenbergii essential oil. Thus, for improved antityrosinase activity, O. syriacum and O. ehrenbergii should be harvested during flowering stage where carvacrol is present at its highest dosage and thymoquinone at its lowest.
Impact of face proportions on face attractiveness
Authors: Przylipiak Mateusz , Przylipiak Jerzy , Terlikowski Robert , Lubowicka Emilia , Chrostek Lech , Przylipiak Andrzej
Published: October 2018

Background

Proportions of face components appear to play a role in facial attractiveness.

Aims

The aim of the study was to establish the best proportions of face components in relation to whole face shape for facial attractiveness.

Methods

Only one face component (eye, nose, or lips) of a model in a series of photographs was altered using a computer program. Alterations consisted of size reduction or augmentation by 5% or 10%. Each photograph depicted a particular face component altered to either 90%, 95%, 100%, 105%, or 110% of its original size. Collages of photographs were shown to 167 individuals (male and female) for a fixed period of 7 seconds. Their task was to indicate the most attractive photograph of a model in a presented collage.

Results

In total, 48.1% of individuals preferred enhanced eyes both in males and females. We found that the preferred mean eye size in women was statistically significantly higher than that in men. In total, 64.8% of respondents preferred reduced nose proportions in women (27.5% found a reduction to 90% of the original size more attractive while 37.3% preferred a reduction to 95%). It was demonstrated that the preferred mean nose size was statistically significantly lower in females in comparison with males. Respondents expressed a greater preference for nose reduction in women in comparison with men. 38.4% of respondents (in regard to both male and female mouth) preferred reduced mouth. 40.7% of respondents preferred reduced mouth in the female model.

Conclusions

Our work delivers statistically significant evidence that facial attractiveness increases together with the enlargement of the uncovered eye surface as well as the reduction in nose and lip size. Data were obtained using modern collective intelligence methods of validation.

Written consent was obtained from all study participants.
Clinical evaluation of the lightening effect of cytidine on hyperpigmented skin
Authors: Baswan Sudhir M. , Leverett Jesse , Pawelek John
Published: October 2018

Background

Melanocytes, which reside in the basal layer of the epidermis, produce the pigment melanin in cytoplasmic organelles known as melanosomes. Melanosomes are transferred to keratinocytes which provide the color in our skin. Recently, Diwakar et  al reported the crucial roles of protein glycosylation in both melanogenesis and melanosome transfer to keratinocytes, and each was inhibited by the nucleotide cytidine.

Objective

The main objective of this study was to determine the clinical effects of topical application of cytidine to the hyperpigmented regions of the face in a group of human volunteers.

Methods

A randomized, vehicle‐controlled study was conducted for 12 weeks on healthy Korean female subjects. Cytidine was formulated into the lotion at concentrations of 2%, 3%, and 4% (w/w) and compared to the vehicle control formulation. The clinical outcomes were evaluated by performing visual assessment grading, measuring melanin index, skin brightness, and skin color parameters. In vitro skin penetration studies were conducted using Franz cell chambers for the 2% cytidine test formulation.

Results

The test group showed significant improvements in the visual assessment scores, melanin index, skin brightness, and skin color compared to the control group. Although significant dose‐dependent improvements were seen in the clinical study, the in vitro Franz cell studies indicated that the clinical efficacy and potency of cytidine might be further enhanced by formulating a better topical delivery system, which will be the goal of our future studies.

Conclusions

This randomized, double‐blind, 12‐week clinical study successfully demonstrated the efficacy of cytidine on skin depigmentation in a dose‐dependent manner.
Transabdominal selective feticide in dichorionic twins: Ten years’ experience at a single center
Authors: Kim Mi Sun , Na Eun Duc , Kang Sukho , Shin So Yeon , Lim Bo Bae , Kim Hounyoung , Moon Myoung Jin
Published: October 2018

Aim

The present study investigates the procedure‐related fetal loss rate and obstetrical outcomes of selective feticide in dichorionic twins.

Methods

We retrospectively analyzed the data of 44 cases of dichorionic twins. Two different indications for selective feticide were set: (i) the presence of genetic or congenital anomaly; and (ii) an obstetrical indication specified as a past maternal history of preterm delivery that caused fetal death or cerebral palsy of the child. Primarily, data on procedure‐related fetal loss and obstetrical outcomes were retrieved. Additionally, data on obstetrical outcomes by reduction time and by indication of SF were obtained.

Results

Selective feticide was performed in 44 cases – specifically, in 23 cases with genetic or congenital anomaly and in 21 cases with obstetrical indications. The median gestational age at delivery was 38 + 4 weeks. One pregnancy loss (2.3%, 1/44) occurred within 4 weeks after the procedure. The overall pregnancy loss rate throughout the pregnancy term was 2.3% (1/44). When selective feticide was performed at 15 weeks and beyond, the birth weight was significantly decreased compared with when selective feticide was performed earlier than 15 weeks.

Conclusion

Transabdominal ultrasound‐guided selective feticide in dichorionic twins is an effective and safe procedure. If a patient desires to maximize her chances of having a healthy child and decrease the risk of prematurity, the option of selective feticide should be considered in certain cases of twin pregnancies. Selective feticide may be a reasonable alternative to expectant management or termination of the whole twin pregnancy.
Primary hyperparathyroidism: should surgery be performed on all patients? Current evidence and residual uncertainties
Authors: Nilsson I.‐L
Published: October 2018

Primary hyperparathyroidism (pHPT) is the third most common endocrine disease and is characterized by hypercalcaemia and elevated or inappropriately ‘normal’ levels of the parathyroid hormone (PTH). The main target organs of PTH are the skeletal system and the kidneys. Before the 1970s, pHPT was a rarely detected disease associated with notable morbidity and premature mortality. Introduction of biochemical screening, allowing for a wide range of indications, has contributed to the detection of the full spectrum of the disease. A new entity with an isolated elevation of PTH, normocalcaemic HP, has emerged and is currently being explored. The highest incidence of pHPT, 3–5%, is observed amongst women, and the prevalence increases with age. The female‐to‐male ratio is 3–4 : 1 except in younger patients where distribution is equal and known hereditary causes account for approximately 10% of the cases. In the last few decades, it has become evident that fewer patients than previously believed are truly asymptomatic. The cause of pHPT is often a benign tumour, a parathyroid adenoma, and the only definite treatment is parathyroidectomy (PTX). No medical treatment, single or combined, can achieve a curing of pHPT. Recent data indicate that PTX, despite being proven to be cost‐effective compared to conservative treatment, is underutilized, especially in elderly pHPT patients. The decision of PTX should always be based on a safe diagnosis, and the potential benefits of curative treatment should not be outweighed by the risks of surgery or anaesthesia.
Superselective endovascular tissue access using trans‐vessel wall technique: feasibility study for treatment applications in heart, pancreas and kidney in swine
Authors: Grankvist R. , Jensen‐Urstad M. , Clarke J. , Lehtinen M. , Little P. , Lundberg J. , Arnberg F. , Jonsson S. , Chien K. R. , Holmin S.
Published: October 2018

Objectives

With the emergence of targeted cell transplantation and gene therapy, there is a need for minimally invasive tissue access to facilitate delivery of therapeutic substrate. The objective of this study was to demonstrate the suitability of an endovascular device which is able to directly access tissue and deliver therapeutic agent to the heart, kidney and pancreas without need to seal the penetration site.

Methods

In vivo experiments were performed in 30 swine, including subgroups with follow‐up to evaluate complications. The previously described trans‐vessel wall (VW) device was modified to be sharper and not require tip detachment to seal the VW. Injections into targets in the heart (n = 13, 24‐h follow‐up n = 5, 72‐h follow‐up n = 3), kidney (n = 8, 14‐day follow‐up n = 3) and pancreas (n = 5) were performed. Some animals were used for multiple organ injections. Follow‐up consisted of clinical monitoring, angiography and necropsy. Transvenous (in heart) and transarterial approaches (in heart, kidney and pancreas) were used. Injections were targeted towards the subepicardium, endomyocardium, pancreas head and tail, and kidney subcapsular space and cortex.

Results

Injections were successful in target organs, visualized by intraparenchymal contrast on fluoroscopy and by necropsy. No serious complications (defined as heart failure or persistent arrhythmia, haemorrhage requiring treatment or acute kidney injury) were encountered over a total of 157 injections.

Conclusions

The trans‐VW device can achieve superselective injections to the heart, pancreas and kidney for delivery of therapeutic substances without tip detachment. All parts of these organs including the subepicardium, pancreas tail and renal subcapsular space can be efficiently reached.
Role of Noxa in proliferation, apoptosis, and autophagy in human adenoid cystic carcinoma
Authors: Liang Lizhong , Weng Junquan , You Yingying , He Qifen , Fan Yunping , Liao Guiqing
Published: October 2018

Background

Noxa, which is subset of the Bcl‐2 family of proteins, was previously reported to have considerable therapeutic potential in diverse cancers. However, its expression and role in salivary gland adenoid cystic carcinoma (ACC) have not been well studied. This study aimed to elucidate the expression and role of Noxa in salivary gland ACC.

Materials and Methods

The expression levels of NOXA and its association with overall survival in salivary gland ACC were analyzed by quantitative real‐time PCR. We next examined the effects of Noxa overexpression or inhibition on colony formation, proliferation, apoptosis, and autophagy of salivary gland ACC cells. Furthermore, promoter analysis was performed to identify the potential transcriptional activator of NOXA.

Results

NOXA was markedly down‐regulated and significantly correlated with a more aggressive phenotype and poor overall survival of salivary gland ACC. Ectopic expression of Noxa suppressed the viability and growth of ACC cells, which involved the induction of apoptosis and autophagy. Moreover, the transcriptional activity of NOXA gene could be enhanced by p53.

Conclusion

The findings of this study indicate that Noxa, activated transcriptionally by p53, suppress the progression of ACC, whereby it regulates proliferation, apoptosis, and autophagy.