bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential Discrimination of Belgian Black Marbles Using Petrography, Magnetic Susceptibility and Geochemistry
Authors: Boulvain F. , Poulain G. , Tourneur F. , Yans J.
Published: December 2019

Five varieties of Belgian black marbles are investigated in order to discriminate them. Their age ranges from Frasnian (Golzinne) to Visean (Dinant, Theux, Basècle, Lives). Three methods were used: petrography, magnetic susceptibility and geochemistry of major elements and Rare Earth Elements (REE). The petrographic analyze reveals 16 microfacies reflecting very quiet environments, sporadically perturbed by more energetic phenomena like turbidites or storms. These microfacies are integrated in two depositional models: a quiet offshore setting, below or close to the storm wave base (Salet, Basècles) and a shallow but very restricted zone, protected from waves and currents (Lives and Golzinne). The magnetic susceptibility results show that all the black marbles are characterized by very low, even slightly negative values, except the Golzinne one which shows higher values. Geochemical data allow to discriminate between the Theux black marble (low SiO2 content), and the Basècles samples (low Al2O3, K2O and REE contents). These methods could be useful to determine/refine the origin of archaeological stones, even if all these analyses are destructive. Two archeologic samples were investigated in order to identify their possible origin.
Checkpoint inhibitors in AML: are we there yet?
Authors: Ghosh Arnab , Barba Pere , Perales Miguel‐Angel
Published: December 2019

Immunotherapy is distinct from traditional chemotherapy in that it acts on immune cells rather than cancer cells themselves. Monoclonal antibodies targeting immune checkpoints on T cells – CTLA‐4 and PD‐1 – and PD‐L1 on the cells of immune microenvironment are now approved for clinical use in several solid tumors and hematological malignancies. This article provides a general overview of the use of checkpoint inhibitors in hematologic malignancies with a special focus in acute myeloid leukemia.
Glycogen synthase kinase 3β as a potential therapeutic target in synovial sarcoma and fibrosarcoma
Authors: Abe Kensaku , Yamamoto Norio , Domoto Takahiro , Bolidong Dilireba , Hayashi Katsuhiro , Takeuchi Akihiko , Miwa Shinji , Igarashi Kentaro , Inatani Hiroyuki , Aoki Yu , Higuchi Takashi , Taniguchi Yuta , Yonezawa Hirotaka , Araki Yoshihiro , Aiba Hisaki , Minamoto Toshinari , Tsuchiya Hiroyuki
Published: December 2019

Soft tissue sarcomas (STSs) are a rare cancer type. Almost half are unresponsive to multi‐pronged treatment and might therefore benefit from biologically targeted therapy. An emerging target is glycogen synthase kinase (GSK)3β, which is implicated in various diseases including cancer. Here, we investigated the expression, activity and putative pathological role of GSK3β in synovial sarcoma and fibrosarcoma, comprising the majority of STS that are encountered in orthopedics. Expression of the active form of GSK3β (tyrosine 216‐phosphorylated) was higher in synovial sarcoma (SYO‐1, HS‐SY‐II, SW982) and in fibrosarcoma (HT1080) tumor cell lines than in untransformed fibroblast (NHDF) cells that are assumed to be the normal mesenchymal counterpart cells. Inhibition of GSK3β activity by pharmacological agents (AR‐A014418, SB‐216763) or of its expression by RNA interference suppressed the proliferation of sarcoma cells and their invasion of collagen gel, as well as inducing their apoptosis. These effects were associated with G0/G1‐phase cell cycle arrest and decreased expression of cyclin D1, cyclin‐dependent kinase (CDK)4 and matrix metalloproteinase 2. Intraperitoneal injection of the GSK3β inhibitors attenuated the growth of SYO‐1 and HT1080 xenografts in athymic mice without obvious detrimental effects. It also mitigated cell proliferation and induced apoptosis in the tumors of mice. This study indicates that increased activity of GSK3β in synovial sarcoma and fibrosarcoma sustains tumor proliferation and invasion through the cyclin D1/CDK4‐mediated pathway and enhanced extracellular matrix degradation. Our results provide a biological basis for GSK3β as a new and promising therapeutic target for these STS types.
Pragmatic Trials in Genomic Medicine: The Integrating Pharmacogenetics In Clinical Care (I‐PICC) Study
Authors: Brunette Charles A. , Miller Stephen J. , Majahalme Nilla , Hau Cynthia , MacMullen Lauren , Advani Sanjay , Ludin Sophie A. , Zimolzak Andrew J. , Vassy Jason L.
Published: December 2019

Pragmatic clinical trials (PCTs) have an established presence in clinical research and yet have only recently garnered attention within the landscape of genomic medicine. Using the PRagmatic‐Explanatory Continuum Indicator Summary 2 (PRECIS‐2) as a framework, this paper illustrates the application of PCT principles to The Integrating Pharmacogenetics In Clinical Care (I‐PICC) Study, a trial of pharmacogenetic testing prior to statin initiation for cardiovascular disease prevention in primary care. The trial achieved high engagement with providers (85% enrolled of those approached) and enrolled a representative sample of participants for which statin therapy would be recommended. The I‐PICC Study has a high level of pragmatism, which should enhance the generalizability of its findings. The PRECIS‐2 may be useful in the design and evaluation of PCTs of genomic medicine interventions, contributing to the generation of evidence that can bridge the gap between genomics innovation and clinical adoption.
Dual glucagon‐like peptide‐1 receptor/glucagon receptor agonist SAR425899 improves beta‐cell function in type 2 diabetes
Authors: Visentin Roberto , Schiavon Michele , Göbel Britta , Riz Michela , Cobelli Claudio , Klabunde Thomas , Dalla Man Chiara
Published: December 2019

Aim

To evaluate the change in insulin sensitivity, β‐cell function and glucose absorption after 28 days of treatment with high and low doses of SAR425899, a novel dual glucagon‐like peptide‐1 receptor/glucagon receptor agonist, versus placebo.

Materials and Methods

Thirty‐six overweight to obese subjects with type 2 diabetes were randomized to receive daily subcutaneous administrations of low‐dose SAR425899 (0.03, 0.06 and 0.09 mg) and high‐dose SAR425899 (0.06, 0.12 and 0.18 mg) or placebo for 28 days; dose escalation occurred after days 7 and 14. Mixed meal tolerance tests were conducted before treatment (day −1) and on days 1 and 28. Oral glucose and C‐peptide minimal models were used to quantify metabolic indices of insulin sensitivity, β‐cell responsiveness and glucose absorption.

Results

With low‐dose SAR425899, high‐dose SAR425899 and placebo, β‐cell function from day −1 to day 28 increased by 163%, 95% and 23%, respectively. The change in area under the curve for the rate of meal glucose appearance between 0 and 120 minutes was −32%, −20% and 8%, respectively.

Conclusions

After 28 days of treatment, SAR425899 improved postprandial glucose control by significantly enhancing β‐cell function and slowing glucose absorption rate.
Flipped classroom in dental education: A scoping review
Authors: Vanka Amit , Vanka Shanthi , Wali Othman
Published: December 2019

Introduction

There is a pressing need to explore strategies which adopt and incorporate contemporary teaching methods to keep abreast with technological advances. Flipped classroom is a type of blended learning approach that has received considerable attention as an alternative to traditional lectures. The purpose of this scoping review is to explore the characteristics of the flipped classroom model implemented in undergraduate dental education.

Materials and Methods

The scoping review has been reported under the PRISMA extension for scoping review guidelines. Systematic search of databases culminated in full‐text papers that were evaluated for quality.

Results

A systematic search on flipped classroom in dental education identified a total of 30 papers for full‐text evaluation. After further exclusion, 17 studies were selected for data charting.

Discussion

The student satisfaction, learning resources, pre‐class and/or in‐class activities, and academic scores are analysed and discussed.

Conclusion

Flipped classroom improves student satisfaction in majority of the studies, whilst its effect on academic scores, particularly for skill development, needs more research.
Effects of bilingualism on white matter atrophy in mild cognitive impairment: a diffusion tensor imaging study
Authors: Marin‐Marin L. , Costumero V. , Belloch V. , Escudero J. , Baquero M. , Parcet M.‐A. , Ávila C.
Published: December 2019

Background and purpose

Previous investigations show that bilinguals exhibit the first symptoms of dementia 4–5 years later than monolinguals. Therefore, bilingualism has been proposed as a cognitive reserve mechanism. Recent studies have advanced towards an understanding of the brain mechanisms underlying bilingualism’s protection against dementia, but none of them deals with white matter (WM) diffusion.

Methods

In this study, the topic was investigated by measuring WM integrity in a sample of 35 bilinguals and 53 passive bilinguals with mild cognitive impairment.

Results

No significant differences were found between the groups in cognitive level, education, age or sex. However, bilinguals showed higher mean diffusivity in the fornix, but higher fractional anisotropy, lower mean diffusivity, axial diffusivity and radial diffusivity in the parahippocampal cingulum, and lower radial diffusivity in the right uncinate fasciculus. Significant correlations were also found between WM integrity in the left parahippocampal cingulum and the Boston Naming Test in passive bilinguals.

Conclusions

These results suggest that bilingualism contributes to a differential pattern of WM disintegration due to mild cognitive impairment in fibers related to bilingualism and memory.
Changing policy to treat foals withRhodococcus equipneumonia in the later course of disease decreases antimicrobial usage without increasing mortality rate
Authors: Arnold‐Lehna Denise , Venner Monica , Berghaus Londa J. , Berghaus Roy , Giguère Steeve
Published: December 2019

Background

There is a lack of data on the efficacy of treatment ofRhodococcus equipneumonia in association with an optimised selection of foals.

Objectives

To evaluate whether targeted treatment protocols resulting in decreased antimicrobial use impact foal mortality rates.

Study design

Retrospective study.

Methods

Three hundred and thirty foals with pneumonia per year were randomly selected from 2008 to 2016. All foals were examined once weekly from birth until weaning. A physical examination of the respiratory tract, body temperature, haematology and an ultrasonographic examination of the lungs was included. Sonography areas with visible consolidation were measured and added to calculate an ‘abscess score’ which represents the extent of pulmonary damage. All weekly medical data were analysed retrospectively.

Results

In the period from 2008 to 2011, every foal with pulmonary abscesses was treated. The treatment protocol was changed in 2012 when only foals with larger lesions were treated. Between the two time periods 2008‐2011 and 2012‐2016, the abscess score at the beginning of treatment increased from a median of 4‐11.5 cm. From all foals that developedR equipneumonia, 81.5% received antibiotic treatment in 2008‐2011 (n = 1215) compared with 50.9% in 2012‐2016 (n = 1541). The percentage of foals that died from pneumonia orR equiinfections did not differ significantly between 2008‐2011 and 2012‐2016 (0.4% vs 0.6% respectively;P = .6).

Main limitations

There was some lack of clarity in old data because this was a retrospective study; therefore, some foals had to be excluded from data analysis.

Conclusions

Alteration of treatment criteria, to exclude antibiotic treatment of foals with smaller lesions, has significantly decreased the number of foals being treated without a significant increase in mortality fromR equipneumonia.
How Does Family Connectedness Contribute to Youths’ Health? The Mediating Role of Coping Strategies
Authors: Gervais Christine , Jose Paul E.
Published: December 2019

Family connectedness has important implications for adolescents’ well‐being, contributing to their physical, psychological, and social health. However, little is known about the mechanisms underlying these effects. The present longitudinal study examined the process by which family connectedness, as perceived by adolescents, predicted greater positive and fewer negative health behaviors in adolescents over time. In particular, we sought to determine whether adaptive and maladaptive coping strategies mediated the link between family connectedness and adolescents’ self‐reported health status. Data were obtained from 1,774 New Zealand adolescents aged 10–17 years, who completed a self‐report survey three times at one‐year intervals. With longitudinal mediation path models, we tested whether maladaptive and adaptive coping strategies at T2 functioned as mediators between family connectedness at T1 and overall health, vitality, sleep sufficiency, body satisfaction, substance use, and self‐harm at T3. Findings revealed that family connectedness predicted greater levels of adaptive coping, which, in turn, predicted better health indicators but not decreases in ill‐health indicators. Furthermore, family connectedness predicted lower maladaptive coping, which, in turn, predicted higher levels of positive health outcomes and fewer negative health outcomes. Results showed that the positive effect of family connectedness on adolescents’ health occurred through increased use of adaptive coping strategies, decreased use of maladaptive coping strategies, or both. These results have important implications for practitioners working with adolescents and parents, as well as for health promotion program developers.
Drivers of long‐term invertebrate community stability in changing Swedish lakes
Authors: Fried‐Petersen Hannah B. , Araya‐Ajoy Yimen G. , Futter Martyn N. , Angeler David G.
Published: December 2019

Research on ecosystem stability has had a strong focus on local systems. However, environmental change often occurs slowly at broad spatial scales, which requires regional‐level assessments of long‐term stability. In this study, we assess the stability of macroinvertebrate communities across 105 lakes in the Swedish “lakescape.” Using a hierarchical mixed‐model approach, we first evaluate the environmental pressures affecting invertebrate communities in two ecoregions (north, south) using a 23 year time series (1995–2017) and then examine how a set of environmental and physical variables affect the stability of these communities. Results show that lake latitude, size, total phosphorus and alkalinity affect community composition in northern and southern lakes. We find that lake stability is affected by species richness and lake size in both ecoregions and alkalinity and total phosphorus in northern lakes. There is large heterogeneity in the patterns of community stability of individual lakes, but relationships between that stability and environmental drivers begin to emerge when the lakescape, composed of many discrete lakes, is the focal unit of study. The results of this study highlight that broad‐scale comparisons in combination with long time series are essential to understand the effects of environmental change on the stability of lake communities in space and time.
Palatogingival groove and root canal instrumentation
Authors: Pinheiro T. N. , Cintra L. T. A. , Azuma M. M. , Benetti F. , Silva C. C. , Consolaro A.
Published: December 2019

Aim

To evaluate the morphology and impact of root canal preparation in maxillary incisors with palatogingival grooves (PGG).

Methodology

Twenty extracted human maxillary incisors with PGG were subjected to macroscopic analysis and scanning electron microscopy analysis (SEM). The following characteristics of the PGG were evaluated: depth, point of origin in the cingulum, extension and position on the lingual surface. Furthermore, the presence of calculus, communications between the root canal system and the PGG, and root resorptions were investigated. The root canals were subsequently instrumented with K‐files of three consecutive sizes. The teeth were sectioned, and the axial plane of each tooth section was imaged using SEM before and after instrumentation. The distance between the root canal walls and the PGG was calculated according to the location. Additionally, the distance between canal walls and cementum was measured at three different sites, to verify if instrumentation influenced dentine removal on a specific wall in teeth with PGG. Statistical analysis was performed using the Mann–Whitney or Student’s t‐test (P < 0.05).

Results

Macroscopic analysis revealed that a deep groove was most frequently observed (75%), followed by a depression/shallow groove (25%) (P < 0.05). PGG typically originated in the distal margin ridge of the cingulum (65%) (P < 0.05), extending only to the middle (45%) or up to the apical (50%) third of the root (P < 0.05). Additionally, PGGs were typically located on the distal aspect of the lingual surface (70%) (P < 0.05). Calculus was concentrated on the surface of the crown and cementum–enamel junction (P < 0.05). Communication between the root canal and PGG was present in 35% of teeth, and root resorptions were noted in 50% of teeth. The distance between the external root surface and the pulp cavity was significantly narrower after instrumentation (P < 0.05); however, root canal preparation did not influence dentine removal on the specific wall associated with the groove (P > 0.05).

Conclusions

Palatogingival grooves were characteristically deep and originated from the distal margin of the cingulum. Although it has been associated with a thinner root wall, root canal preparation did not influence the thickness of the specific wall in the maxillary incisors with PGG.
RET‐rearranged non‐small‐cell lung cancer and therapeutic implications
Authors: Loh Zoe , Mitchell Paul , John Thomas , Arulananda Surein
Published: December 2019

First‐line tyrosine kinase inhibitors are standard of care for non‐small‐cell lung cancers (NSCLC) harbouring an epidermal growth factor receptor mutation, anaplastic lymphoma kinase fusion or c‐ros oncogene 1 rearrangement. Other targetable oncogenic drivers have been identified but testing for these is neither funded nor commonly performed in Australia. Using a case example, we discuss the importance of considering several other genomic aberrations in our population, such as rearrangements in the RET proto‐oncogene, which occur in 1–2% of lung adenocarcinoma. New oncogenic drivers and corresponding targeted agents are constantly being discovered; these will continue to refine the treatment of non‐small‐cell lung cancer in the era of precision medicine.
Effectiveness of a psychoeducational intervention for caregivers of People With Dementia with regard to burden, anxiety and depression: A systematic review
Authors: Frias Cindy E. , Garcia‐Pascual Marta , Montoro Mercedes , Ribas Nuria , Risco Ester , Zabalegui Adelaida
Published: December 2019

Aim

To assess the effectiveness of psychoeducational interventions with respect to burden, anxiety and depression in family caregivers of People With Dementia living at home.

Background

In dementia, the family assumes the role of main caregiver, maintaining the patient in a good state of health. Nevertheless, burden, anxiety and depression may have negative repercussions in caregivers. Therefore, professional supports through psychoeducational programmes are recommended as interventions for improving caregivers' health.

Design

A quantitative systematic review.

Data Sources

Electronic searches were performed in CINAHL/AMED/CENTRAL/Web of Science/LILACS/PUBMED from January 2005–August 2018.

Review Methods

The review was conducted using the JADAD scale to assess bias risk and the quality of the randomized controlled trials (RCTs) and the CONSORT instrument to assess study quality report. The extracted data were reviewed by independent reviewer pairs. The review was reported using PRISMA.

Results

A total of 18 RCTs met inclusion criteria. Seven were classified as Technology‐based Interventions and 11 as Group‐based Interventions.

Conclusion

Psychoeducational interventions for caregivers allow them to increase their knowledge of the illness, develop problem‐solving skills and facilitate social support. Technology‐based Interventions significantly affect burden while Group‐based Interventions affect anxiety, depression, insomnia and burden and quality of life and self‐efficacy.

Impact

Research findings can be used to classify caregivers in future interventions according to illness stage to obtain more precise results.
Association of suboptimal health status with intestinal microbiota in Chinese youths
Authors: Sun Qi , Xu Xizhu , Zhang Jie , Sun Ming , Tian Qiuyue , Li Qihuan , Cao Weijie , Zhang Xiaoyu , Wang Hao , Liu Jiaonan , Zhang Jinxia , Meng Xiaoni , Wu Lijuan , Song Manshu , Liu Hongqi , Wang Wei , Wang Youxin
Published: December 2019

Suboptimal health status (SHS), a physical state between health and disease, is a subclinical and reversible stage of chronic disease. Previous studies have shown alterations in the intestinal microbiota in patients with some chronic diseases. This study aimed to investigate the association between SHS and intestinal microbiota in a case‐control study with 50 SHS individuals and 50 matched healthy controls. Intestinal microbiota was analysed by MiSeq 250PE. Alpha diversity of intestinal microbiota in SHS individuals was higher compared with that of healthy controls (Simpson index, W = 2238, P = .048). Beta diversity was different between SHS and healthy controls (P = .018). At the phylum level, the relative abundance of Verrucomicrobia was higher in the SHS group than that in the controls (W = 2201, P = .049). Compared with that of the control group, nine genera were significantly higher and five genera were lower in abundance in the SHS group (all P < .05). The intestinal microbiota, analysed by a random forest model, was able to distinguish individuals with SHS from the controls, with an area under the curve of 0.79 (95% confidence interval: 0.77‐0.81). We demonstrated that the alteration of intestinal microbiota occurs with SHS, an early stage of disease, which might shed light on the importance of intestinal microbiota in the primary prevention of noncommunicable chronic diseases.
European Dermatology Forum guidelines on topical photodynamic therapy 2019 Part 2: emerging indications – field cancerization, photorejuvenation and inflammatory/infective dermatoses
Authors: Morton C.A. , Szeimies R.‐M. , Basset‐Séguin N. , Calzavara‐Pinton P.G. , Gilaberte Y. , Hædersdal M. , Hofbauer G.F.L. , Hunger R.E. , Karrer S. , Piaserico S. , Ulrich C. , Wennberg A.‐M. , Braathen L.R.
Published: December 2019

In addition to approved indications in non‐melanoma skin cancer in immunocompetent patients, topical photodynamic therapy (PDT) has also been studied for its place in the treatment of, as well as its potential to prevent, superficial skin cancers in immune‐suppressed patients, although sustained clearance rates are lower than for immune‐competent individuals. PDT using a nanoemulsion of ALA in a daylight or conventional PDT protocol has been approved for use in field cancerization, although evidence of the potential of the treatment to prevent new SCC remained limited. High‐quality evidence supports a strong recommendation for the use of topical PDT in photorejuvenation as well as for acne, refractory warts, cutaneous leishmaniasis and in onychomycosis, although these indications currently lack approvals for use and protocols remain to be optimized, with more comparative evidence with established therapies required to establish its place in practice. Adverse events across all indications for PDT can be minimized through the use of modified and low‐irradiance regimens, with a low risk of contact allergy to photosensitizer prodrugs, and no other significant documented longer‐term risks with no current evidence of cumulative toxicity or photocarcinogenic risk. The literature on the pharmacoeconomics for using PDT is also reviewed, although accurate comparisons are difficult to establish in different healthcare settings, comparing hospital/office‐based therapies of PDT and surgery with topical ointments, requiring inclusion of number of visits, real‐world efficacy as well as considering the value to be placed on cosmetic outcome and patient preference. This guideline, published over two parts, considers all current approved and emerging indications for the use of topical photodynamic therapy in Dermatology prepared by the PDT subgroup of the European Dermatology Forum guidelines committee. It presents consensual expert recommendations reflecting current published evidence.
Ecological divergence and speciation in common bottlenose dolphins in the western South Atlantic
Authors: Costa Ana P. B. , Fruet Pedro F. , Secchi Eduardo R. , Daura‐Jorge Fábio G. , Simões‐Lopes Paulo C. , Di Tullio Juliana C. , Rosel Patricia E.
Published: December 2019

Coastal and offshore ecotypes of common bottlenose dolphins have been recognized in the western South Atlantic, and it is possible that trophic niche divergence associated with social interactions is leading them to genetic and phenotypic differentiation. The significant morphological differentiation observed between these ecotypes suggests they represent two different subspecies. However, there is still a need to investigate whether there is congruence between morphological and genetic data to rule out the possibility of ecophenotypic variation accompanied by gene flow. Mitochondrial DNA (mtDNA) control region sequence data and 10 microsatellite loci collected from stranded and biopsied dolphins sampled in coastal and offshore waters of Brazil as well as 106 skulls for morphological analyses were used to determine whether the morphological differentiation was supported by genetic differentiation. There was congruence among the data sets, reinforcing the presence of two distinct ecotypes. The divergence may be relatively recent, however, given the moderate values of mtDNA nucleotide divergence (dA = 0.008), presence of one shared mtDNA haplotype and possibly low levels of gene flow (around 1% of migrants per generation). Results suggest the ecotypes may be in the process of speciation and reinforce they are best described as two different subspecies until the degree of nuclear genetic divergence is thoroughly evaluated: Tursiops truncatus gephyreus (coastal ecotype) and T. t. truncatus (offshore ecotype). The endemic distribution of T. t. gephyreus in the western South Atlantic and number of anthropogenic threats in the area reinforces the importance of protecting this ecotype and its habitat.
Diagnosis of Attention Deficit Hyperactivity Disorder in Intellectual Disability: Diagnostic and Statistical Manual of Mental Disorder V versus clinical impression
Authors: Perera B. , Courtenay K. , Solomou S. , Borakati A. , Strydom A.
Published: December 2019

Background

Diagnosing Attention Deficit Hyperactivity Disorder (ADHD) in people with intellectual disability (ID) remains challenging. The Diagnostic and Statistical Manual of Mental Disorder V (DSM V) classification system is often used to diagnose ADHD in the general population; however, the presence of ID and other associated conditions such as autism and communication difficulties can make it difficult to apply the DSM V criteria in people with ID. Therefore, diagnosing ADHD in people with ID is often made using clinical judgement and/or the application of diagnostic criteria. There are no studies comparing the diagnostic accuracy of clinical judgement and the use of DSM V criteria in people with ID and ADHD.

Method

The aims of the study were to compare the accuracy of the diagnosis of ADHD in people with ID according to the DSM V criteria versus clinical judgement and to determine which criteria are more reliable. A questionnaire was developed using five fictional case scenarios of people with ID. Questionnaires were presented to practising psychiatrists chosen as a convenience sample in the United Kingdom over a period of 12 months. Case scenarios were developed and agreed to be positive or negative for ADHD by the study authors prior to rating by clinicians.

The clinicians were asked to read the scenarios and to make a judgement on the cases regarding the symptoms of ADHD. They were then presented with the 18 DSM V criteria of ADHD and asked to select the criteria they considered were present in each scenario. Sensitivity, specificity, likelihood ratios and predictive values for both the DSM V criteria and clinical opinions were calculated for correctly identifying the exemplar cases.

Results

The data showed strong sensitivity [0.82 95% confidence interval (CI) 0.74–0.89] and high specificity (1.00 95% CI 0.95–1.00) for the raters' clinical opinion. In contrast, the DSM V criteria alone, as assessed by the raters, did not reliably provide ADHD diagnoses, with a sensitivity of only 0.23 (95% CI 0.15–0.31). This difference in sensitivity between the two was statistically significant at P < 0.001.

Conclusion

The study results suggest that clinical opinion is the ‘gold standard’ at present in diagnosing ADHD in adults with ID in the absence of a validated diagnostic tool in this group. Further studies are needed to understand how symptoms of ADHD can be presented differently in people with ID. DSM V criteria for ADHD may need to be adapted according to the severity of ID and other neurodevelopmental disorders.
Phytochemical screening and cytotoxicity evaluation of crude extracts: Toxicity comparison of crude extracts and its ethosomal formulations
Authors: Sasindran Saranya , Easwaran Madhunithya , Shyamala Govindarajan , Karuppaiah Arjunan , Siram Karthik , Veintramuthu Sankar
Published: December 2019

Background

Combined plant extracts ofPhyllanthus niruri,Croton tiglium, andZingiber officinaleare reported to have potential pharmacological applications. Ethosomes have a unique ability of encapsulating drugs or plant extracts with varying hydrophobicities in the phospholipid bilayer.

Aim

To explore cytotoxicity of the combined plant extracts and ethosome loaded combined plant extracts for topical delivery. To study effect of ethosomes loaded combined plant extracts using HaCaT cells model treated with testosterone.

Methods

Dried powder of plant was extracted with ethanol using Soxhlet and cold macerations. Total phenolic and flavonoid contents were also determined using established methods. The combined extract loaded ethosome formulation was prepared by solvent dispersion method.

Results

The plant extracts loaded ethosomes formulation with a vesicle size range 1524.6‐167.7 nm was prepared. HaCaT cells treated with testosterone negative control showed an IC50value of 27 ± 1.0. Thw standard marketed topical minoxidil (1% solution) treated cells with testosterone showed an IC50value 33 ± 1.0 and the combined plant extracts loaded ethosomes with testosterone showed an IC50value 30 ± 1.0. Morphological alterations of rat skin exposed to the combined plant extract loaded ethosomes solution were assessed and compared with untreated skin and negative control.

Conclusion

The preclinical safety was investigated employing an in vitro cytotoxicity and histopathological study. The cell line study results confirmed that the combined plant extracts loaded ethosomes inhibits testosterone and increase cell viability closer to that of standard drug minoxidil. According to our histopathological study, the combined plant extract loaded ethosomal formulations did not cause any damage to the rat skin layer.
A 3‐year prospective clinical and patient‐centered trial on subepithelial connective tissue graft with or without enamel matrix derivative in Class I‐II Miller recessions
Authors: Mercado Faustino , Hamlet Stephen , Ivanovski Sašo
Published: December 2019

Background and Objective

The study compared clinical and patient‐centered outcomes of subepithelial connective tissue graft (CTG) with and without enamel matrix derivative (EMD) in the treatment of Class I‐II Miller periodontal recession defects.

Material and Methods

This prospective clinical study evaluated 80 patients over a 3 years follow‐up in a private periodontal practice. A total of 144 maxillary and mandibular anterior teeth were divided into two groups: group 1 (CTG with EMD—80 teeth) and group 2 (CTG only—64 teeth). Recession (REC), keratinized tissue (KT) width, % root overage, patient‐centered outcomes, and pain visual analog scale (P‐VAS) were compared between the two groups.

Results

At 3 years follow‐up at a patient level, statistically significant changes in REC were achieved in both group 1 (4.65 ± 1.84 to 0.39 ± 0.19 mm) and group 2 (4.43 ± 1.11 to 0.92 ± 0.43 mm). Complete root coverage (CRC) was achieved in 66.4% of group 1 and 50.1% of group 2. At both patient and tooth level, the 3‐year outcomes were superior for group 1 compared with group 2 in terms of % root coverage, REC, and KT width. Clinical attachment loss (CAL) was reduced in group 1 compared with group 2 at the tooth level analysis only (<.01). Significantly less pain was reported using the pain visual analog Scale (P < .001) at the two weeks follow‐up post‐surgery in group 1.

Conclusions

Addition of EMD results in improved root coverage outcomes and higher amounts of keratinized tissue width 36 months after treatment of multiple adjacent recessions on maxillary and mandibular anterior teeth. The adjunctive use of EMD also resulted in significantly reduced pain 14 days after the surgery.
Community Treatment for Opioid Use Disorders in Urban and Rural Veterans
Authors: Turvey Carolyn L. , Lund Brian C. , Jones DeShauna , Arndt Stephan
Published: December 2019

Purpose

The recent opioid crisis is characterized by a relatively greater increase in opioid use disorder and related mortality in rural populations when compared with urban populations.1‐5 As almost a quarter of our nation's veterans reside in rural settings, the United States Veterans Health Administration (VHA) is interested in the impact of this epidemic on rural veterans. This study aims to develop a comprehensive understanding of the trends in substance use disorders (SUD) in veterans seeking treatment from community, non‐VHA providers.

Methods

Using Substance Abuse and Mental Health Services Administration (SAMHSA)’s Treatment Episode Data Set (TEDS), this study presents the prevalence of treatment for veterans seeking initial admission into publicly funded non‐VHA SUD treatment centers for years 2011‐2016. Comparisons were made for all SUD types. Multivariate trend analysis based on annual data from 2011 to 2016 compared urban and rural veterans for opioid use disorder treatment.

Findings

Both urban and rural veterans had comparable rates of treatment for SUD, though rural veterans had slightly higher rates of injectable (11.2% vs 8.7%; P < .001) and opiate drug use disorder admissions (20.7% vs 18.1%; P = .014). Both urban and rural showed an increase in admissions for opioid, heroin, and injectable drug use disorders between 2011 and 2016 (P < .001).

Conclusions

Comprehensive understanding of veteran SUD and treatment should include national‐level data on community non‐VHA treatment. SAMHSA's TEDS for years 2011‐2016 provides clinical information for more than 90,000 veterans and indicates continued increase in treatment seeking for opioid use disorders, particularly for rural veterans.
Cerebral small vessel disease with hemorrhagic stroke related to COL4A1 mutation: A case report
Authors: Nandeesh Bevinahalli N. , Bindu Parayil Sankaran , Narayanappa Gayathri , Chickabasaviah Yasha T. , Mahadevan Anita , Kulanthaivelu Karthik , Santosh Vani
Published: December 2019

Stroke is a major cause of mortality and morbidity with a wide variety of etiological risk factors. Cerebral small vessel disease (SVD) is an important cause of stroke in the young with several hereditary disorders affecting these small blood vessels. Mutations in the COL4A1 gene (COL4A1) have been shown to be associated with a broad range of disorders including hemorrhagic stroke, myopathy, glaucoma and others. We report a rare case of stroke in an intellectually disabled 18‐year‐old girl with radiological evidence of basal ganglia microbleeds, periventricular white matter signal changes and porencephalic cyst. Ophthalmic examination revealed bilateral microcornea and Axenfeld–Rieger anomaly. At autopsy there were hemorrhagic lesions at multiple sites within the brain. Histology revealed thickened small‐caliber vessels which demonstrated disruption and fragmentation of the basement membrane by collagen type IV alpha 1 immunohistochemistry and by electron microscopy. A missense COL4A1 mutation involving glycine residue was detected in the patient. The present case illustrates the clinicopathological spectrum of COL4A1‐related cerebral SVD presenting as hemorrhagic stroke in the young with porencephaly, intellectual disability, and Axenfield–Rieger anomaly and thus adds to the clinical heterogeneity of this genetic disorder.
Metatropic Dysplasia of Nonlethal Variant in a Chinese Child – A Case Report
Authors: Tchio Tchoumba Michele A , Bai Yan , Jin Runming , Yu Xianying , Male Musa
Published: December 2019

Metatropic dysplasia (MD), is a rare skeletal dysplasia occurring predominantly in infants characterized by a distinctive long torso and short limbs; it is as a result of mutations in the TRPV4 gene. However, a clear distinction between various forms of skeletal dysplasias caused by the transient receptor potential vanilloid 4 (TRPV4) gene is difficult but could be achieved by a combination of gene sequencing, medical and radiological criteria. We hereby report a case of a 14‐month old girl who presented with an abnormal stature. The diagnosis of nonlethal MD was confirmed by X‐ray with dumbbell‐shaped long bones, platyspondyly, and delayed carpal ossification, as well as broadened pelvis with marginally widened ilia, epiphyseal plates, and slightly flattened acetabula. Furthermore, gene sequencing confirmed gene mutation on exon 15 of the TRPV4 gene with a heterozygous missense mutation (c.2396C > T), but no mutation was present in her parents. Our findings recorded metatropic dysplasia with the c.2396C > T mutation in the TRPV4 gene in China. This mutation caused changes in amino acid of TRPV4, which can induce growth retardation in children.
Nested‐association mapping (NAM)‐based genetic dissection uncovers candidate genes for seed and pod weights in peanut (Arachis hypogaea)
Authors: Gangurde Sunil S. , Wang Hui , Yaduru Shasidhar , Pandey Manish K. , Fountain Jake C. , Chu Ye , Isleib Thomas , Holbrook C. Corley , Xavier Alencar , Culbreath Albert K. , Ozias‐Akins Peggy , Varshney Rajeev K. , Guo Baozhu
Published: December 2019

Multiparental genetic mapping populations such as nested‐association mapping (NAM) have great potential for investigating quantitative traits and associated genomic regions leading to rapid discovery of candidate genes and markers. To demonstrate the utility and power of this approach, two NAM populations, NAM_Tifrunner and NAM_Florida‐07, were used for dissecting genetic control of 100‐pod weight (PW) and 100‐seed weight (SW) in peanut. Two high‐density SNP‐based genetic maps were constructed with 3341 loci and 2668 loci for NAM_Tifrunner and NAM_Florida‐07, respectively. The quantitative trait locus (QTL) analysis identified 12 and 8 major effect QTLs for PW and SW, respectively, in NAM_Tifrunner, and 13 and 11 major effect QTLs for PW and SW, respectively, in NAM_Florida‐07. Most of the QTLs associated with PW and SW were mapped on the chromosomes A05, A06, B05 and B06. A genomewide association study (GWAS) analysis identified 19 and 28 highly significant SNP–trait associations (STAs) in NAM_Tifrunner and 11 and 17 STAs in NAM_Florida‐07 for PW and SW, respectively. These significant STAs were co‐localized, suggesting that PW and SW are co‐regulated by several candidate genes identified on chromosomes A05, A06, B05, and B06. This study demonstrates the utility of NAM population for genetic dissection of complex traits and performing high‐resolution trait mapping in peanut.
Tumour mutation burden of non‐small cell lung cancer with pre‐existing ILD
Authors: Liam Chong‐Kin
Published: December 2019

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Zooming in on labor market cooperation: A study of a failed project to support unemployed young people
Authors: Strindlund Lena , Dahlgren Madeleine Abrandt , Ståhl Christian
Published: December 2019

Purpose

The aim was to study the relational dynamics of interorganizational cooperation over the life of a labor market project supporting unemployed young people.

Methods

The methodological process followed the practice theory toolkit described by Nicolini (2012). Data were collected by ethnographical methods through the initiation, development and closing down of the project. Data analysis was performed in relation to three focus areas: (a) tensions between creativity and normativity, (b) processes of legitimation and stabilization and (c) interactional order.

Results

The results visualized how a lack of consensus and the presence of two divergent rationalities, a coordinating rationality and an empowerment rationality, within the project organization had major influences on the initiation, development and closing down of the project.

Conclusions

The study has, by using a practice theory approach, illuminated the complex dynamics of cooperative projects. The study highlights four central and relative conditions when setting up cooperative projects: (a) to enable open and clear communication, (b) to create an adequate structure for the project and clarify assignments and roles in the project organization, (c) to build trustful relationships within the project organization and towards cooperative actors, and (d) to prioritize steering and monitoring in cooperative projects in order to avoid the project deviating from its purpose.
Assessing durum wheat ear and leaf metabolomes in the field through hyperspectral data
Authors: Vergara‐Diaz Omar , Vatter Thomas , Kefauver Shawn Carlisle , Obata Toshihiro , Fernie Alisdair R. , Araus José Luis
Published: December 2019

Hyperspectral techniques are currently used to retrieve information concerning plant biophysical traits, predominantly targeting pigments, water, and nitrogen‐protein contents, structural elements, and the leaf area index. Even so, hyperspectral data could be more extensively exploited to overcome the breeding challenges being faced under global climate change by advancing high‐throughput field phenotyping. In this study, we explore the potential of field spectroscopy to predict the metabolite profiles in flag leaves and ear bracts in durum wheat. The full‐range reflectance spectra (visible (VIS)‐near‐infrared (NIR)‐short wave infrared (SWIR)) of flag leaves, ears and canopies were recorded in a collection of contrasting genotypes grown in four environments under different water regimes. GC‐MS metabolite profiles were analyzed in the flag leaves, ear bracts, glumes, and lemmas. The results from regression models exceeded 50% of the explained variation (adj‐R2 in the validation sets) for at least 15 metabolites in each plant organ, whereas their errors were considerably low. The best regressions were obtained for malate (82%), glycerate and serine (63%) in leaves; myo‐inositol (81%) in lemmas; glycolate (80%) in glumes; sucrose in leaves and glumes (68%); γ‐aminobutyric acid (GABA) in leaves and glumes (61% and 71%, respectively); proline and glucose in lemmas (74% and 71%, respectively) and glumes (72% and 69%, respectively). The selection of wavebands in the models and the performance of the models based on canopy and VIS organ spectra and yield prediction are discussed. We feel that this technique will likely to be of interest due to its broad applicability in ecophysiology research, plant breeding programmes, and the agri‐food industry.
Between unemployment and enterprise in neoliberal India: Educated youth creating work in the private education sector
Authors: Deuchar Andrew , Dyson Jane
Published: December 2019

This paper draws on ethnographic material to analyse how unemployed youth create work in the private educational sector. It shows how a set of educated young men, who moved from rural areas to a north Indian city to find work, are seeking to create jobs after an extended period of unemployment. Having attended coaching clinics and private tuition centres to prepare for white‐collar jobs, they draw on the experience, knowledge, and skills they have gained to create work in those same institutions. They do so by running errands and creating services for institutions, as well as undertaking administrative duties and teaching classes. Our main argument is that young men creatively engage with notions of enterprise to make an income and acquire a measure of respect. Studies of enterprise culture and neoliberal subjectivity formation often emphasise how individuals shore up their own value by competing with others and promoting their own interests. But we highlight how youth also maintain their value by making sense of their strategies in terms of assisting other young people. At the same time, however, their practises work to reproduce gender norms and class inequalities.
Directed Energy Deposition of Zirconia-Toughened Alumina Ceramic: Novel Microstructure Formation and Mechanical Performance
Authors: Hu Yingbin , Wang Hui , Cong Weilong , Zhao Bo
Published: December 2019

Over the past two decades, a considerable amount of work has been done on zirconia-toughened alumina (ZTA) to take advantage of the recognized toughening effect induced by ZrO2. In fabricating customized or complex-shaped ZTA parts, conventional manufacturing processes, including slip casting and powder metallurgy, are regarded as time-consuming and cost-intensive. In response to these problems, directed energy deposition (DED) has been proposed and utilized to fabricate customized ZTA parts with highly flexible features in a shorter cycle time at a lower cost. Investigations have been reported on studying effects of input variables (such as laser power) in DED of ZTA parts, however, there are very limited investigations on effects of the ZrO2 content. In this investigation, the effects of the ZrO2 content on microstructures and mechanical properties of DED-fabricated ZTA parts are studied. Experimental results show that at lower levels of ZrO2 contents (5 wt%, 10 wt%, and 20 wt%), a novel three-dimensional quasi-continuous network (3DQCN) microstructure is tailored, whereas at higher levels of ZrO2 contents (30 wt%, 35 wt%, and 41.5 wt%), eutectic microstructure dominates the whole part. Both the 3DQCN microstructure and the eutectic microstructure are beneficial for toughening ZTA parts. In addition, the 3DQCN microstructure contributes to hardening ZTA parts.