bluuebunny/crossref_metadata_2025 huggingface dataset:
Intranasal Oxytocin Does Not Modulate Responses to Alcohol in Social Drinkers
Authors: Vena Ashley , King Andrea , Lee Royce , de Wit Harriet
Published: June 2018

Background

Preclinical and clinical evidence suggest that the neuropeptide oxytocin may be of value in treating alcohol use disorder, by either reducing the rewarding effects of alcohol or reducing negative affect induced by alcohol withdrawal. However, the effect of a single dose of oxytocin on subjective and psychomotor responses to alcohol in social drinkers is not known.

Methods

This study examined the effect of intranasal oxytocin on subjective, behavioral, and physiological responses to a moderate dose of alcohol (0.8 g/kg) in young adult social drinkers. Participants (N = 35) completed 2 study sessions at which they consumed beverages containing alcohol (ALC; N = 20) or placebo (NoALC; N = 15) in combination with intranasal oxytocin (40 IU with a 20 IU booster) or placebo. They received oxytocin at one session and placebo at the other session (order counterbalanced) 20 minutes before consuming beverages. Subjective mood and drug effects ratings, heart rate and blood pressure, and 4 behavioral tasks (flanker task, digit span, go/no‐go, and pursuit rotor) were the primary outcome measures.

Results

ALC produced its expected subjective and behavioral effects; including feeling intoxicated and impaired performance on the digit span and go/no‐go tasks. Oxytocin alone had no significant subjective or physiological effects, and it did not affect responses to alcohol on any measure.

Conclusions

We can conclude that, under these conditions, a single dose of intranasal oxytocin does not alter the effects of acute alcohol in healthy young adult social drinkers. Further research is needed to determine whether oxytocin alters responses to alcohol under different conditions, and to determine its potential as an aid in treatment for substance use disorders.
Carbonyl emissions from a novel heated tobacco product (IQOS): comparison with an e‐cigarette and a tobacco cigarette
Authors: Farsalinos Konstantinos E. , Yannovits Nikoletta , Sarri Theoni , Voudris Vassilis , Poulas Konstantinos , Leischow Scott J.
Published: June 2018

Aims

To measure carbonyl emissions from a heated tobacco product (IQOS) in comparison with an e‐cigarette (Nautilus Mini) and a commercial tobacco cigarette (Marlboro Red).

Design

Regular and menthol variants of the heated tobacco product were tested. A tank‐type atomizer was tested with a tobacco‐flavoured liquid at 10 and 14 W. Aerosol and smoke were collected in impingers containing 2,4‐dinitrophenylhydrazine. Health Canada Intense and two more intense puffing regimens were used.

Setting

Analytical laboratory in Greece.

Measurements

Carbonyl levels in the aerosol and smoke.

Findings

At the Health Canada Intense regimen, heated tobacco products emitted 5.0–6.4 μg/stick formaldehyde, 144.1–176.7 μg/stick acetaldehyde, 10.4–10.8 μg/stick acrolein, 11.0–12.8 μg/stick propionaldehyde and 1.9–2.0 μg/stick crotonaldehyde. Compared with the tobacco cigarette, levels were on average 91.6% lower for formaldehyde, 84.9% lower for acetaldehyde, 90.6% lower for acrolein, 89.0% lower for propionaldehyde and 95.3% lower for crotonaldehyde. The e‐cigarette emitted 0.5–1.0 μg/12 puffs formaldehyde, 0.8–1.5 μg/12 puffs acetaldehyde and 0.3–0.4 μg/12 puffs acrolein, but no propionaldehyde and crotonaldehyde. At more intense puffing regimens, formaldehyde was increased in heated tobacco products, but levels were three–fourfold lower compared with the tobacco cigarette. Based on the findings from Health Canada Intense puffing regimen, use of 20 heated tobacco sticks would result in approximately 85% to 95% reduced carbonyl exposure compared with smoking 20 tobacco cigarettes; the respective reduction in exposure from use of 5 g e‐cigarette liquid would be 97% to > 99%.

Conclusions

The IQOS heated tobacco product emits substantially lower levels of carbonyls than a commercial tobacco cigarette (Marlboro Red) but higher levels than a Nautilus Mini e‐cigarette.
Integrating smoking cessation care in alcohol and other drug treatment settings using an organizational change intervention: a systematic review
Authors: Skelton Eliza , Tzelepis Flora , Shakeshaft Anthony , Guillaumier Ashleigh , McCrabb Sam , Bonevski Billie
Published: June 2018

Background and Aims

Organizational change interventions involve systems and cultural change within health‐care services to make smoking cessation care delivery part of usual treatment. Six strategies for organizational change have been proposed. This study examined the evidence for organizational change interventions in the alcohol and other drug (AOD) setting on: (a) smoking cessation care; and (b) smoking cessation and cessation‐related outcomes.

Methods

A systematic review with narrative synthesis was conducted. MEDLINE, PsycINFO, CINAHL, EMBASE and Scopus were searched using keywords and MeSH terms from database inception to 1 June 2018. Interventions were assessed against the six organizational change strategies.

Results

Of the 5155 papers identified, 14 publications from seven unique studies were included. Most studies employed four or fewer organizational change strategies. The majority (n = 11) were rated weak to moderate in methodological quality. Nine published papers, four unique studies, examined staff reported provision of smoking cessation care; eight reported an increase, one found no change. Three papers, two unique studies, examined client receipt of care; all found significant increases. Three papers, two unique studies, assessed staff smoking prevalence from pre‐ to post‐intervention. Only one study reported a significant reduction in staff smoking prevalence (35.2 versus 21.8%, P = 0.005). Nine papers, six unique studies, assessed client smoking cessation and smoking‐related outcomes. Seven papers reported on client smoking prevalence; two found a significant decrease and five found no change to smoking. Four papers reported on number of cigarettes per day, three found a significant decrease and one found no change. Two papers reported on smoking cessation finding a 10% and a 25% seven‐day point prevalence abstinence post‐discharge from the AOD service.

Conclusions

Organizational change interventions within health‐care services to make smoking cessation care delivery part of usual treatment offer promise for increasing smoking cessation care and reducing smoking prevalence.
Comparison of the accuracy of multiparametric magnetic resonance imaging (mpMRI) results with the final pathology findings for radical prostatectomy specimens in the detection of prostate cancer
Authors: Lee Chan Ho , Ku Ja Yoon , Park Won Young , Lee Nam Kyung , Ha Hong Koo
Published: June 2018

Aims

To assess the accuracy of multiparametric magnetic resonance imaging (mpMRI), used in conjunction with the Prostrate Imaging Reporting and Data System (PI‐RADS), version 2, in the detection of prostate cancer (PCa), and to determine the extent of the efficacy of mpMRI as a screening test in biopsy‐naïve patients.

Methods

Retrospective analysis was conducted in 107 patients who underwent mpMRI prior to radical prostatectomy (RP) at a single institution. The mpMRI findings were reassessed using PI‐RADS, version 2. A comparison was made between the histological findings for the RP specimens and the mpMRI results.

Results

Unique histologically confirmed PCa foci (237) were identified in 107 patients. Overall, mpMRI sensitivity of 46% was found for PCa detection (110/237). The sensitivity, specificity and negative predictive value of mpMRI was 75.5%, 77.0% and 79.8%, respectively, for clinically significant cancer, and 75.7%, 77.7% and 79.5%, for pathological index tumors. A moderate and significant correlation was observed between a high PI‐RADS score and a high pathological grade, tumor volume, index tumor status and clinically significant cancer status (all, P < 0.001, respectively). Pathological tumor volume was a significant predictor of PCa detection using mpMRI according to multivariate analysis. Using a cut‐off value of 0.89 cc, the sensitivity and specificity of mpMRI for PCa detection were 0.87 and 0.65, respectively.

Conclusion

The mpMRI, used in conjunction with PI‐RADS, was useful in detecting PCa and in predicting tumor aggressiveness. However, the detection of 20% of clinically significant cancer was missed using mpMRI. Thus, its inclusion in a triage test should be limited to selected biopsy‐naïve patients.
Lichen sclerosus in pregnancy: A review of 33 cases
Authors: Nguyen Yvonne , Bradford Jennifer , Fischer Gayle
Published: June 2018

Vulval lichen sclerosus (VLS) is a chronic inflammatory skin condition affecting the anogenital area in women. Serious long‐term consequences of VLS include the risk of developing squamous cell carcinoma of the vulva as well as of scarring and alteration of vulval architecture. The treatment of choice for genital lichen sclerosus in females is potent to very potent topical corticosteroids. There are few published data on the course of VLS in pregnancy. We present our experience of managing 33 pregnancies in 29 women with VLS.
A 10‐year review found increasing incidence trends of emergency egg allergy reactions and food‐induced anaphylaxis in children
Authors: Österlund J , Winberg A , West C E
Published: June 2018

Aim

International reports have suggested that food allergies and food‐induced anaphylaxis have increased in children. We investigated the incidence of emergency food reactions over a 10‐year period.

Methods

This study retrospectively reviewed the medical records of children presenting to Umeå University hospital, Sweden, with an emergency food reaction from January 1, 2006 to December 31, 2015. Cases were identified using discharge codes for allergies and anaphylaxis. Anaphylaxis cases were included if they fulfilled the international criteria.

Results

We found emergency food allergy reactions in 519 children (58% boys) from 2006–2015 at a median age of 1.3 years. One‐third were hospitalised (32%) including 71/99 cases of anaphylaxis. Milk and eggs were the most commonly identified triggers. Emergency reactions to eggs increased during the study period with a Spearman rank correlation coefficient of 0.770 (p < 0.01) and the figures for anaphylaxis were 0.745 (p = 0.013). The incidence of food‐induced anaphylaxis increased and was 30 per 100 000 person‐years for the study period.

Conclusion

Most of the emergency reactions, treated by secondary care paediatricians and emergency physicians, were to milk and eggs. Allergic reactions to eggs increased from 2006 to 2015, as did food‐related anaphylaxis.
Higher daily doses of caffeine lowered the incidence of moderate to severe neurodevelopmental disabilities in very low birth weight infants
Authors: Ravichandran Saranya , Chouthai Nitin Shashikant , Patel Bhavyata , Sharma Amit , Gupte Avanti , Ma Mia Michelle , Mamilla Divya , Lulic‐Botica Mirjana , Thomas Ronald , Kamat Deepak
Published: June 2018

Aim

We determined the influence of cumulative dosing of caffeine citrate on the neurodevelopmental outcomes of low birth weight (VLBW) infants at 18–22 months of postmenstrual age.

Methods

This retrospective chart analysis was conducted at Detroit Medical Center, Michigan, USA. The 181 infants we included were born between January 2006 and December 2016, were less than 32 weeks of gestational age and weighed less than 1500 grams. Data on their perinatal and postnatal characteristics were retrieved from their medical records and they were assessed using the Bayley Scales of Infant Development – Third Edition.

Results

The 64 infants with no neurodevelopmental disability or a mild disability received a significantly higher average daily dose (mg/kg/day) of caffeine citrate with a median of 7.58 (range 2.7–12.2) mg/kg/day, than the 79 infants with a moderate to severe disability, who received a median of 6.47 (range 3.1–12.5, p = 0.01). The total cumulative dose had no effect on bronchopulmonary dysplasia or neurodevelopmental outcomes.

Conclusion

A higher average daily dose of caffeine citrate was associated with better neurodevelopmental outcomes of VLBW infants. However, the cumulative dose did not have an impact on their short‐term or long‐term outcomes. Further research is needed to confirm our findings.
Dorsal striatum dopamine oscillations: Setting the pace of food anticipatory activity
Authors: de Lartigue Guillaume , McDougle Molly
Published: June 2018

Predicting the uncertainties of the ever‐changing environment provides a competitive advantage for animals. The need to anticipate food sources has provided a strong evolutionary drive for synchronizing behavioural and internal processes with daily circadian cycles. When food is restricted to a few hours per day, rodents exhibit increased wakefulness and foraging behaviour preceding the arrival of food. Interestingly, while the master clock located in the suprachiasmatic nucleus entrains daily rhythms to the light cycle, it is not necessary for this food anticipatory activity. This suggests the existence of a food‐entrained oscillator located elsewhere. Based on the role of nigrostriatal dopamine in reward processing, motor function, working memory and internal timekeeping, we propose a working model by which food‐entrained dopamine oscillations in the dorsal striatum can enable animals maintained on a restricted feeding schedule to anticipate food arrival. Finally, we summarize how metabolic signals in the gut are conveyed to the nigrostriatal pathway to suggest possible insight into potential input mechanisms for food anticipatory activity.
Systematic review and network meta‐analysis: first‐ and second‐line biologic therapies for moderate‐severe Crohn's disease
Authors: Singh S. , Fumery M. , Sandborn W. J. , Murad M. H.
Published: June 2018

Background

There are limited data to inform positioning of agents for treating moderate‐severe Crohn's disease (CD).

Aim

We assessed comparative efficacy and safety of first‐line (biologic‐naïve) and second‐line (prior exposure to anti‐tumour necrosis factor [TNF]‐α) agents) biologic therapy for moderate‐severe CD, through a systematic review and network meta‐analysis, and appraised quality of evidence (QoE) using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Methods

We identified randomised controlled trials (RCTs) in adults with moderate‐severe CD treated with approved anti‐TNF agents, anti‐integrin agents and anti‐IL12/23 agents, first‐line or second‐line, and compared with placebo or another active agent. Efficacy outcomes were induction and maintenance of clinical remission; safety outcomes were serious adverse events and infections. Network meta‐analyses were performed, and ranking was assessed using surface under the cumulative ranking (SUCRA) probabilities.

Results

No head‐to‐head trials were identified. In biologic‐naïve patients, infliximab (SUCRA,0.93) and adalimumab (SUCRA,0.75) were ranked highest for induction of clinical remission (moderate QoE). In patients with prior anti‐TNF exposure, adalimumab (SUCRA, 0.91; low QoE, in patients with prior response or intolerance to anti‐TNF agents) and ustekinumab (SUCRA, 0.71) were ranked highest for induction of clinical remission. In patients with response to induction therapy, adalimumab (SUCRA, 0.97) and infliximab (SUCRA, 0.68) were ranked highest for maintenance of remission. Ustekinumab had lowest risk of serious adverse events (SUCRA, 0.72) and infection (SUCRA, 0.71; along with infliximab, SUCRA, 0.83) in maintenance trials.

Conclusion

Indirect comparisons suggest that infliximab or adalimumab may be preferred first‐line agents, and ustekinumab a preferred second‐line agent, for induction of remission in patients with moderate‐severe CD. Head‐to‐head trials are warranted.
Laparoscopic repair of a large perineal hernia after laparoscopic abdominoperineal resection: A case report
Authors: Kakiuchi Daiki , Saito Kenichiro , Mitsui Takeshi , Munemoto Yoshinori , Takashima Yoshihiro , Amaya Susumu , Shimada Masanari , Kato Yosuke
Published: June 2018

A 75‐year‐old woman underwent laparoscopic abdominoperineal resection. Four months after abdominoperineal resection, the patient complained of a perineal bulge and urination disorder. Abdominal CT showed protrusion of the small intestine and bladder to the perineum. The patient underwent laparoscopic hernia repair with mesh. The size of the hernial orifice was 7.0 × 9.0 cm, and it had no solid rim. The mesh was tacked ventrally to the pectineal ligament and dorsally to the sacrum, and then sutured on the lateral side. The hernia has not recurred 10 months after the operation. Laparoscopic repair is a good treatment choice for secondary perineal hernia and fixing the mesh to the pectineal ligament, and the sacrum prevents the mesh from sagging.
Coadministration of probenecid and cimetidine with mirogabalin in healthy subjects: A phase 1, randomized, open‐label, drug–drug interaction study
Authors: Tachibana Masaya , Yamamura Naotoshi , Atiee George J. , Hsu Ching , Warren Vance , He Ling , Dishy Victor , Zahir Hamim
Published: June 2018

Aims

The primary aim of this study was to assess the individual effects of probenecid and cimetidine on mirogabalin exposure.

Methods

This phase 1, open‐label, crossover study randomized healthy adults to receive three treatment regimens, each separated by ≥5‐day washout: a single oral dose of mirogabalin 15 mg on day 2, mirogabalin 15 mg on day 2 plus probenecid 500 mg every 6 h from days 1 to 4, and mirogabalin 15 mg on day 2 plus cimetidine 400 mg every 6 h from days 1 to 4.

Results

Coadministration of mirogabalin with probenecid or cimetidine increased the maximum and total mirogabalin exposure. The geometric mean ratios of Cmax and AUC(0‐t) (90% CI) with and without coadministration of probenecid were 128.7% (121.9–135.7%) and 176.1% (171.9–180.3%), respectively. The geometric mean ratios of Cmax and AUC(0‐t) (90% CI) with and without coadministration of cimetidine were 117.1% (111.0–123.6%) and 143.7% (140.3–147.2%), respectively. Mean (standard deviation) renal clearance of mirogabalin (l h–1) was substantially slower after probenecid [6.67 (1.53)] or cimetidine [7.17 (1.68)] coadministration, compared with mirogabalin alone [11.3 (2.39)]. Coadministration of probenecid or cimetidine decreased mirogabalin mean (standard deviation) apparent total body clearance [10.5 (2.33) and 12.8 (2.67) l h–1, respectively, vs. 18.4 (3.93) for mirogabalin alone].

Conclusions

A greater magnitude of change in mirogabalin exposure was observed when coadministered with a drug that inhibits both renal and metabolic clearance (probenecid) vs. a drug that only affects renal clearance (cimetidine). However, as the increase in exposure is not clinically significant (>2‐fold), no a priori dose adjustment is recommended.
Comprehensive comparison of monotherapies for psychiatric hospitalization risk in bipolar disorders
Authors: Nestsiarovich Anastasiya , Mazurie Aurélien J , Hurwitz Nathaniel G , Kerner Berit , Nelson Stuart J , Crisanti Annette S , Tohen Mauricio , Krall Ronald L , Perkins Douglas J , Lambert Christophe G
Published: June 2018

Objectives

This study compared 29 drugs for risk of psychiatric hospitalization in bipolar disorders, addressing the evidence gap on the >50 drugs used by US patients for treatment.

Methods

The Truven Health Analytics MarketScan® database was used to identify 190 894 individuals with bipolar or schizoaffective disorder who filled a prescription for one of 29 drugs of interest: lithium, first‐ or second‐generation antipsychotics, mood‐stabilizing anticonvulsants, and antidepressants. Competing risks regression survival analysis was used to compare drugs for risk of psychiatric hospitalization, adjusting for patient age, sex, comorbidities, and pretreatment medications. Other competing risks were ending monotherapy and non‐psychiatric hospitalization.

Results

Three drugs were associated with significantly lower risk of psychiatric hospitalization than lithium: valproate (relative risk [RR] = 0.80, P = 3.20 × 10−4), aripiprazole (RR = 0.80, P = 3.50 × 10−4), and bupropion (RR = 0.80, P = 2.80 × 10−4). Eight drugs were associated with significantly higher risk of psychiatric hospitalization: haloperidol (RR = 1.57, P = 9.40 × 10−4), clozapine (RR = 1.52, P = .017), fluoxetine (RR = 1.17, P = 3.70 × 10−3), sertraline (RR = 1.17, P = 3.20 × 10−3), citalopram (RR = 1.14, P = .013), duloxetine (RR = 1.24, P = 5.10 × 10−4), venlafaxine (RR = 1.33; P = 1.00 × 10−6), and ziprasidone (RR = 1.25; P = 6.20 × 10−3).

Conclusions

This largest reported retrospective observational study on bipolar disorders pharmacotherapy to date demonstrates that the majority of patients end monotherapy within 2 months after treatment start. The risk of psychiatric hospitalization varied almost two‐fold across individual medications. The data add to the evidence favoring lithium and mood stabilizer use in short‐term bipolar disorder management. The findings that the dopaminergic drugs aripiprazole and bupropion had better outcomes than other members of their respective classes and that antidepressant outcomes may vary by baseline mood polarity merit further investigation.
Conscientious objection and compromising the patient: Response to Hughes
Authors: Savulescu Julian , Schuklenk Udo
Published: June 2018

Hughes offers a consequentialist response to our rejection of accommodation of conscientious objection in medicine. We argue here that his compromise proposition has been tried in many jurisdictions and has failed to deliver unimpeded access to care for eligible patients. The compromise position, entailing an accommodation of conscientious objection provided there is unimpeded access, fails to grasp that the objectors are both determined not to provide services they object to as well as to subvert patient access to the objected to services. Unpredictable future developments in drug R&D and resulting treatment and prevention options in medicine make the compromise position unrealistic.
Animal models of allergen‐specific immunotherapy in food allergy: Overview and opportunities
Authors: Larsen Jeppe Madura , Bøgh Katrine Lindholm
Published: June 2018

Food allergy is an adverse reaction to otherwise harmless proteins in food. The disease is a major health problem of growing concern, affecting approximately 5%‐8% of young children and 2%‐4% of adults. No accepted strategy exists for prevention and treatment of food allergy, and strict avoidance of the offending food is presently the only viable management option. Living with food avoidance may have a huge impact on the quality of life of food allergic patients, with daily fear of serious or even fatal reactions. The urgent need for safe and efficient food allergy treatment options has led to massive research efforts to develop and improve strategies for food allergy immunotherapeutic approaches. A first step in developing new and improved strategies of immunotherapy often involves the use of animal models. In present review, we provide an overview of animal studies of allergen‐specific immunotherapy highlighting opportunities and challenges for each approach. The presented models, almost exclusively performed in mice, assess therapeutic efficacy and immunological outcomes following oral, intraperitoneal, subcutaneous, epicutaneous, and sublingual administration of native allergens, or preparations of hydrolyzed allergen, T‐cell‐directed peptides, or allergen with immunomodulatory adjuvants. Recently, approaches using immune cell therapy have demonstrated efficacy. Current models mainly assess anaphylaxis as the primary clinical outcome. With the increased appreciation that food allergy is a heterogeneous disease presenting different phenotypes, there is a continued need to develop new disease‐relevant therapeutic models of food allergy.
Genetic contribution of suppressor of cytokine signalling polymorphisms to the susceptibility to infection after traumatic injury
Authors: Zhang A , Gu W , Lu H , Zeng L , Zhang L , Du D , Hao J , Wen D , Wang X , Jiang J
Published: June 2018

Suppressor of cytokine signalling (SOCS) proteins are crucial negative regulators in many signalling pathways and are implicated in the pathogenesis of infectious diseases. The purpose of this study was to uncover possible associations of common polymorphisms within SOCS genes with infectious outcomes after traumatic injury. A total of 1087 trauma patients (Chongqing cohort 806 and Yunnan cohort 281) were recruited and followed-up for the development of infectious outcomes, such as sepsis and multiple organ dysfunction syndrome (MODS). Twelve selected single nucleotide polymorphisms (SNPs) were screened by pyrosequencing to determine their genotypes and associations with infectious complications. Among the 12 selected SNPs, only the cytokine-inducible Src homology (SH2) domain protein (CISH) promoter rs414171 polymorphism was found consistently to be associated statistically with the incidence of sepsis and MOD score in the two cohorts, despite analysing the SNPs independently or in combination. Further, patients with a T allele had significantly lower CISH expression and lower production of tumour necrosis factor (TNF)-α, but higher production of interleukin (IL)-10. Luciferase assay confirmed that the A→T variant in the rs414171 polymorphism inhibited the transcriptional activities of the CISH gene significantly. The CISH rs414171 polymorphism is associated significantly with susceptibility to sepsis and MODS in traumatic patients, which might prove to be a novel biomarker for indicating risk of infectious outcomes in critically injured patients.
Masticatory efficiency of implant‐supported removable partial dental prostheses in patients with free fibula flap reconstructed mandibles: A split‐mouth, observational study
Authors: Kumar Vinay V. , Srinivasan Murali
Published: June 2018

Objectives

The aim of this split‐mouth study was to evaluate the masticatory efficiency in patients with segmentally reconstructed mandibles using free fibula flaps, with and without stabilizing osteosynthesis material in‐situ during implant placement for rehabilitation with implant‐supported removable partial dental prostheses (ISRPDPs).

Methods

Ten participants (n = 10; ♀ = 2, ♂ = 8; mean age = 38.1 years) consented to participate in this study. The participants’ normal side (Side N) of the mandible served as the control side, for comparing the masticatory efficiency of the segmentally reconstructed and rehabilitated side (Side R). Masticatory efficiency was evaluated using the two‐colored chewing gum test, measured as subjective assessment (SA) and electronically evaluated variance of hue (VOH). Data were checked for normal distribution and statistically analyzed with the level of significance set to p < 0.05.

Results

Thirty‐four tissue‐level implants were placed in reconstructed mandibles of 10 participants. There was no significant difference observed in the masticatory efficiencies between Side N and Side R, in both subjective and electronic assessments. No implant loss was observed after a post‐rehabilitated mean follow‐up period of 42.7 months, revealing an implant survival rate of 100%.

Conclusions

In patients with surgically reconstructed mandibles, a normal masticatory function can be successfully achieved with a rehabilitation of the reconstructed side with implant‐supported removable partial dental prostheses. Implant‐supported prostheses should be actively advocated in patients with reconstructive surgeries to restore their masticatory function, extend their food choices, and improve their overall oral health‐related quality of life.
A qualitative study of the development of a multidisciplinary case conference review methodology to reduce involved margins in pelvic exenteration surgery for recurrent rectal cancer
Authors: van Ramshorst G. H. , O'Shannassy S. , Brown W. E. , Kench J. G. , Solomon M. J.
Published: June 2018

Aim

Pelvic exenteration surgery remains the only curative option for recurrent rectal cancer. Microscopically involved surgical margins (R1) are associated with a higher risk of local recurrence and decreased survival. Our study aimed to develop a post hoc multidisciplinary case conference review and investigate its potential for identifying areas for improvement.

Method

Patients who underwent pelvic exenteration surgery for recurrent rectal cancer with R1 resections at a tertiary referral centre between April 2014 and January 2016 were retrospectively reviewed from a prospectively maintained database. Patients with non‐rectal cancers or who underwent palliative surgery were excluded. Cases, imaging and histopathology were evaluated by a dedicated panel including colorectal surgeons, an abdominal radiologist and a gastrointestinal pathologist.

Results

R1 resections were reported in 32 of 110 pelvic exenterations. Patients with other tumours were excluded and one patient had a palliative resection. Nine male patients with 11 exenterations were included with a median age of 56 years. All patients had positive soft tissue margins, and one patient also had an involved bony margin. Failures were due to (interdisciplinary) communication problems, specific management of tumour biology (multifocality, spiculated tumours), which can lead to radiological undercalling, and inadequate surgical technical planning. In hindsight, surgery would have been withheld from one patient.

Conclusion

A retrospective multidisciplinary case evaluation of pelvic exenteration patients with involved surgical margins led to a list of recommendations which included the need to plan for wider surgical soft tissue resections and improvement in interdisciplinary communication. Lessons learned may increase clear margin rates in future resections.
Giant panda distributional and habitat‐use shifts in a changing landscape
Authors: Wei Wei , Swaisgood Ronald R. , Dai Qiang , Yang Zhisong , Yuan Shibin , Owen Megan A. , Pilfold Nicholas W. , Yang Xuyu , Gu Xiaodong , Zhou Hong , Han Han , Zhang Jindong , Hong Mingsheng , Zhang Zejun
Published: June 2018

Long‐term data on populations, threats, and habitat‐use changes are fundamentally important for conservation policy and management decisions affecting species, but these data are often in short supply. Here, we analyze survey data from 57,087 plots collected in approximately three‐fourths of the giant panda's (Ailuropoda melanoleuca) distributional range during China's national surveys conducted in 1999–2003 and 2011–2014. Pandas associated preferentially with several ecological factors and avoided areas impacted by human activities, such as roads, livestock, mining, and tourism. Promise is shown by dramatic declines in logging rates, but is counterbalanced with recently emerging threats. Pandas have increasingly utilized secondary forest as these forests recovered under protective measures. Pandas have undergone a distributional shift to higher elevations, despite the elevational stability of their bamboo food source, perhaps in response to a similar upward shift in the distribution of livestock. Our findings showcase robust on‐the‐ground data from one of the largest‐scale survey efforts worldwide for an endangered species and highlight how science and policy have contributed to this remarkable success story, and help frame future management strategies.
Epidemiology, risk factors, and impact of bacterial infections on outcomes for pancreatic grafts
Authors: Bodro Marta , Ferrer Joana , Ricart María José , Sanclemente Gemma , Linares Laura , Cervera Carlos , Cofan Frederic , Ventura‐Aguiar Pedro , Lopez‐Boado Miguel Ángel , Marco Francesc , Fuster Josep , García‐Valdecasas Juan Carlos , Moreno Asunción
Published: June 2018

We aimed to determine the epidemiology, risk factors, and impact of bacterial infection on pancreatic function after pancreas transplantation. Data for pancreas transplant recipients were retrospectively reviewed between 2000 and 2014 for at least 1 year. We collected and analyzed post‐transplant data for bacterial infection, morbidity, and mortality. During the study period, 312 pancreas transplants were performed. In total, 509 episodes of bacterial infection were diagnosed in 191 patients (61%). Multidrug‐resistant (MDR) organisms were present in 173 of the 513 isolated microorganisms (33%). Risk factors independently associated with bacterial infection were acute allograft rejection (OR 1.7, 95%CI 1.1‐3), the need for post‐transplant hemodialysis, (OR 5.3, 95%CI 1.8‐15.7) and surgical re‐intervention (OR 2.8, 95%CI 1.5‐5.1), which was also considered a risk factor for infections caused by MDR bacteria. Graft survival was associated with the occurrence of one or more episodes of bacterial infection (log‐rank test = 0.009). Surgical re‐intervention was independently associated with graft loss (OR 2.5, 95%CI 1.3‐4.7). To conclude, pancreas recipients frequently experienced bacterial infections associated with the need for hemodialysis or surgical re‐intervention. Infection by MDR organisms is a growing concern in these patients and was related to graft survival. Graft loss was independently associated with surgical re‐intervention.
Diagnostic accuracy of immunohistochemical markers in differentiation between basal cell carcinoma and trichoepithelioma in small biopsy specimens
Authors: Mostafa Naglaa A. , Assaf Magda , Elhakim Sami , Abdel‐Halim Mona R. E. , El‐Nabarawy Eman , Gharib Khaled
Published: June 2018

Background

The distinction of trichoepithelioma from basal cell carcinoma in small superficial biopsies is important but often challenging. This has inspired many scientists to test the validity of immunohistochemical markers in the differential diagnosis.

Objectives

To develop an immunohistochemical protocol that helps in differentiation between both trichoepithelioma (TE) and basal cell carcinoma (BCC) with higher sensitivity and specificity.

Methods

Using standard immunohistochemical techniques, we examined 10 TEs and 19 BCCs for the expression of CK19, Ki‐67, androgen receptors (AR), CD10, and PHLDA1.

Results

Immunoreactivity of AR, Ki‐67, and CD10 in tumor cells was significantly higher in BCC than TE with a diagnostic accuracy in BCC of 75.5%, 75.8%, and 79.3% respectively, whereas immunoreactivity of PHLDA1 in tumor cells and stromal CD10 was significantly higher in TE than BCC with a diagnostic accuracy in TE of 100% and 82.8%, respectively. In contrast, immunoreactivity for CK19 showed no statistically significant differences between both tumors.

Conclusion

The analysis of CD10, Ki‐67, and PHLDA1 can be used as a helpful immunohistochemical panel in the distinction between TE and BCC especially in small and superficial biopsies.
The Decline of Gangsters and Politicization of Violence in Urban Bangladesh
Authors: Jackman David
Published: June 2018

Contrary to the Weberian ideal of a central state monopolizing the means of violence, political order in many societies requires a balance of interests between diverse ‘violence specialists’. In urban Bangladesh, gangsters have been identified as powerful actors, closely linked to politicians and the state. Often called mastan, they are portrayed as mediating access to work and public services, as running extortion networks and providing political muscle. Since the early 2000s Dhaka has seen radical change, largely undocumented to date: these gangsters are in significant decline. Many of the roles associated with these gangs continue, but now under the direct control of lower‐level factions associated with the ruling political party — a transition that has brought a greater degree of stability to the urban context. These arguments are developed through ethnographic research from a large marketplace in the centre of Dhaka, examining the rise and fall of an infamous local gangster. In developing this case, it is argued that closer attention should be given to changes in the organization of violence within societies.
Syntactical regularities of action sequences in the infant brain: when structure matters
Authors: Maffongelli Laura , Antognini Katharina , Daum Moritz M.
Published: June 2018

Throughout life, actions and language are inherent to social interactions. A long‐standing research question in cognitive neuroscience concerns the interrelation between verbal and non‐verbal forms of social interactions, that is, language and action. Perceiving how actions are performed and why they are performed in a certain way is crucial for the observer to anticipate the actor’s goal and to prepare an appropriate response. It is suggested that predicting upcoming events in a given action sequence can be compared to the way we process the language information flow. Goal‐directed actions can be sequenced in small units, which are organized according to a hierarchical plan, resembling the hierarchical organization of language. Research on adults suggests that manipulating the action structure (i.e., action syntax) leads to analogous cortical signatures as a similar manipulation of a sentence structure (i.e., language syntax). Whereas in adults language and action knowledge are based on life‐time experience, in infants both domains are still developing. The current study examined the neural processing of structural violations of observed goal‐directed action sequences in infants at 6–7 months, using event‐related potentials (ERPs). Results showed that a structural violation of the action sequence elicited bilateral frontal positivity effects. This suggests that infants capture structural regularities, and it adds a crucial element to the understanding of general syntactic regularities and their violation from an ontogenetic perspective.
Relation of mitral valve morphology to surgical repair results in patients with mitral valve prolapse: A three‐dimensional transesophageal echocardiography study
Authors: Pardi Mirian M. , Pomerantzeff Pablo M. A. , Sampaio Roney Orismar , Abduch Maria C. , Brandão Carlos M. A. , Mathias Wilson , Grinberg Max , Tarasoutchi Flavio , Vieira Marcelo L. C.
Published: June 2018

Background

The identification of predictors of mitral valve (MV) repair results is important for quality improvement in cardiac surgery. The aim of this study was to evaluate the relationship between MV morphological quantification by three‐dimensional (3D) transesophageal echocardiography and mitral repair results.

Methods

Fifty‐four patients with MV prolapse who were submitted to surgical repair were divided into 2 groups according to their postoperative mitral regurgitation (MR) degree (group 1, grade 0‐I MR; group 2, ≥grade II MR). Morphological parameters related to the mitral ring, dimension of leaflets and prolapse, coaptation line, distance from papillary muscles to the leaflet border and valve angles were analyzed by 3D MV quantification. Cardiac remodeling and MR quantitative parameters were also evaluated.

Results

There was no correlation between 3D MV quantification and surgical results; a multivariate analysis did not show an association between morphological parameters and surgical outcome. The distance from the posteromedial papillary muscle to the leaflet border was higher (P = .038) in patients with ≥grade II postoperative MR. The left atrial diameter, left ventricular end‐systolic diameter, left ventricular end‐diastolic and end‐systolic volumes were larger in patients with a significant residual MR (P < .05).

Conclusion

Three‐dimensional MV quantification did not predict the postoperative MR grade; however, the distance from the posteromedial papillary muscles to the leaflet border may be related to suboptimal repair results. Furthermore, excessive cardiac remodeling was related to postoperative MR ≥ grade II, what could suggest a potential benefit of early surgical treatment.
Normal reference values of diastolic strain rate in healthy individuals: Chronological trends and the comparison according to genders
Authors: Sun Byung Joo , Park Jae‐Hyeong , Kim Jeongai , Choi Jin‐Oh , Lee Ju‐Hee , Shin Mi‐Seung , Kim Mi‐Jeong , Jung Hae Ok , Park Jeong Rang , Sohn Il Suk , Kim Hyungseop , Kim Hyung‐Kwan , Cho Goo‐Yeong , Park Jin‐Sun , Shim Chi Young , Shin Sung Hee , Kim Kye Hun , Kim Woo‐Shik , Park Seung Woo
Published: June 2018

Purpose

Recently, the diastolic strain rate (DSR) utilizing speckle‐tracking echocardiography has been proposed as a novel parameter for left ventricular diastolic function. We aimed to present normal reference data for those in a large‐sized, selected group of healthy individuals.

Methods

The current study was a part of the Normal echOcardiogRaphic Measurements in KoreAn popuLation (NORMAL), a prospective nationwide survey from 23 centers in Korea. We analyzed 447 subjects (age 48 ± 15 years, 234 females) without any history of cardiovascular disease and presented the early and late DSRs (SRe and SRa, respectively) in a total and gender‐/age‐specified groups.

Results

Among the total subjects, the mean SRe and SRa were 1.6 ± 0.4 S−1 and 0.8 ± 0.3 S−1, respectively. With increasing age, there were significant trends of decreasing SRe and increasing SRa. Although both gender groups showed comparable age, the female group presented significantly higher SRe compared to male subjects with age of 20–59 years, which diminished after the age of 60 years. However, the SRa was comparable between genders in all age groups. On multiple linear regression, age showed independent associations with both SRe (β = −0.132, P = .010) and SRa (β = 0.440, P < .001), whereas gender did not show any association with SRe or SRa.

Conclusion

We present normal reference data of a novel parameter, DSR, in a large‐sized selected group with healthy Korean subjects. Additionally, we present significant age‐related changes both in SRe and SRa without the impact of their gender.
An unusual case of giant aneurysm of the noncoronary sinus of Valsalva with rupture into the left ventricular outflow tract along with distortion of the mitral valve
Authors: Tan Yuying , Xu Hui , Gao Yongsheng , Zhang Chengbin , Wang Baogang , Wang Xiaocong
Published: June 2018

Aneurysms of the aortic sinus are well‐known clinical entities that can bulge into adjacent heart chambers or vessels. They usually reside in the right ventricle and very rarely bulge into the left ventricle causing mitral valve deformation. A 47‐year‐old man was admitted for shortness of breath and chest pain after exertion. He was diagnosed with a noncoronary sinus of Valsalva aneurysm bulging into the mitral valve's anterior leaflet. The aortic valve and mitral valve annulus were severely damaged and irreparable. A Bentall procedure and mechanical mitral valve replacement were performed. The patient recovered uneventfully and was discharged 11 days later.
Aerial dispersal ability does not drive spider success in a crop landscape
Authors: Hogg Brian N. , Daane Kent M.
Published: June 2018

1. Although spiders can colonise ecosystems by air, dispersal capabilities differ among spider species. Web‐building spiders are thought to balloon at higher rates than hunting spiders. Spider success in agricultural systems may also depend on habitat preferences. Few studies have examined the success of aerially dispersing spiders in crop systems, and information about the dispersal capabilities of spiders in putative source habitats is limited.

2. Spiders were monitored in the air and on the foliage of vineyards and adjacent oak woodland in order to compare the aerial spider faunas between these disparate habitats and to determine whether highly dispersive species contributed disproportionately to the spider community in vineyards.

3. The results show that most aerially dispersing spiders in both habitats were web‐building dwarf spiders, Erigone spp. (Linyphiidae), although hunting spiders were also well represented in the air, especially in oak woodland. Most woodland spiders in the air appeared to be residents of oak woodland and probably dispersed only short distances.

4. Conversely, only a subset of the aerial spider fauna established in vineyards in high numbers. Spiders that dominated the aerial fauna were under‐represented on vineyard foliage, whereas several hunting spiders dispersed aerially at low rates but dominated vineyard spider composition.

5. These results suggest that aerial dispersal ability may allow spiders to reach crop systems, but that establishment depends on habitat preferences and/or competitive ability.
Morphology and biology of the flower‐visiting water scavenger beetle genus Rygmodus (Coleoptera: Hydrophilidae)
Authors: Minoshima Yûsuke N. , Seidel Matthias , Wood Jamie R. , Leschen Richard A. B. , Gunter Nicole L. , Fikáček Martin
Published: June 2018

Hydrophilidae (water scavenger beetles) is well known as an aquatic beetle family; however, it contains ca. 1,000 secondarily terrestrial species derived from aquatic ancestors. The New Zealand endemic genus Rygmodus White is a member of the hydrophilid subfamily Cylominae, which is the early‐diverging taxon of the largest terrestrial lineage (Cylominae + Sphaeridiinae) within the Hydrophilidae. In this paper we report that Rygmodus beetles are pollen‐feeding flower visitors as adults, but aquatic predators as larvae. Based on analyses of gut contents and a summary of collecting records reported on museum specimen labels, adult Rygmodus beetles are generalists feeding on pollen of at least 13 plant families. Rygmodus adult mouthparts differ from those of other (saprophagous) hydrophilid beetles in having the simple scoop‐like apex and mola with roughly denticulate surface, resembling the morphology found in pollen‐feeding staphylinid beetles. Larvae were found along the sides of streams, under stones and in algal mats and water‐soaked moss; one collected larval specimen was identified using DNA barcoding of two molecular markers, mitochondrial cytochrome oxidase 1 (cox1) and nuclear histone 3 (H3). Larvae of two species, Rygmodus modestus and Rygmodus sp., are described in detail and illustrated; they closely resemble ambush‐type predatory larvae of the hydrophilid tribe Hydrophilini in the head morphology. Rygmodus is the only known hydrophilid beetle with adults and larvae inhabiting different environments.
Elevated cerebrospinal fluid protein in POLG‐related epilepsy: Diagnostic and prognostic implications
Authors: Hikmat Omar , Naess Karin , Engvall Martin , Klingenberg Claus , Rasmussen Magnhild , Tallaksen Chantal M. E. , Brodtkorb Eylert , Fiskerstrand Torunn , Isohanni Pirjo , Uusimaa Johanna , Darin Niklas , Rahman Shamima , Bindoff Laurence A.
Published: June 2018

Objective

Epilepsy is common in individuals with mutations in POLG, the gene encoding the catalytic subunit of the mitochondrial DNA polymerase gamma. Early recognition and aggressive seizure management are crucial for patient survival. Disruption of the blood‐brain barrier (BBB) is implicated in various neurological disorders including epilepsy. The aim of this study was to assess whether POLG‐related disease is associated with BBB dysfunction and what clinical implications this has for patients.

Methods

Our retrospective study used data from 83 patients with pathogenic POLG mutations from 4 countries––Norway, Sweden, Finland, and the United Kingdom. Data were collected using a structured questionnaire. We used the presence of raised cerebrospinal fluid (CSF) protein and a raised CSF/serum ratio of albumin (Q‐alb) to evaluate the integrity of the blood‐CSF barrier.

Results

Raised CSF protein was found in 70% of patients (n = 58/83) and appeared to be associated with the most severe phenotypes. In those in whom it was measured, the Q‐alb ratio was markedly elevated (n = 18). The majority of those with epilepsy (n = 50/66, 76%) had raised CSF protein, and this preceded seizure debut in 75% (n = 15/20). The median survival time from symptom onset for those with raised CSF protein was decreased (13 months) compared to those with normal CSF protein (32 months).

Significance

Our results indicate that there is disruption of the BBB in POLG‐related disease, as evidenced by a raised CSF protein and Q‐alb ratio. We also find that raised CSF protein is a common finding in patients with POLG disease. Our data suggest that the presence of BBB dysfunction predicts a poorer outcome, and elevated CSF protein may therefore be an additional biomarker both for early diagnosis and to identify those at high risk of developing epilepsy.