bluuebunny/crossref_metadata_2025 huggingface dataset:
Is the first urinary albumin/creatinine ratio (ACR) in women with suspected preeclampsia a prognostic factor for maternal and neonatal adverse outcome? A retrospective cohort study
Authors: Elia Eleni G. , Robb Amy O. , Hemming Karla , Price Malcolm J. , Riley Richard D. , French‐Constant Anna , Denison Fiona C. , Kilby Mark D. , Morris Rachel K. , Stock Sarah J.
Published: March 2017

Introduction

The aim of this study was to determine the prognostic value of the first urinary albumin/creatinine ratio (ACR) for adverse maternal and neonatal outcomes and how it relates to other prognostic factors.

Material and methods

We performed a retrospective cohort study from December 2009 to February 2012 with analysis of demographic, clinical and biochemical data from two obstetric day assessment units in hospitals in Southeast Scotland. We included 717 pregnant women, with singleton pregnancies after 20 weeks’ gestation, referred for evaluation of suspected preeclampsia and having their first ACR performed. The ability of ACR to predict future outcomes was assessed in both univariable and multivariable logistic regression models. The latter assessed its prognostic value independent of (adjusting for) existing prognostic factors. Primary outcome measures were maternal and neonatal composite adverse outcomes, and a secondary outcome was gestation at delivery.

Results

In all, 204 women (28.5%) experienced a composite adverse maternal outcome and 146 women (20.4%) experienced a composite adverse neonatal outcome. Multivariate analysis of log‐transformed ACR demonstrated that a 1‐unit increase in log ACR is associated with an increased odds of adverse maternal [odds ratio 1.60, 95% confidence interval (CI) 1.45–1.80] and adverse neonatal (odds ratio 1.15, 95% CI 1.02–1.29) composite outcomes, and with reduced gestational age at delivery (coefficient: −0.46, 95% CI −0.54 to −0.38).

Conclusions

ACR is an independent prognostic factor for maternal and neonatal adverse outcomes in suspected preeclampsia. ACR may be useful to inform risk predictions within a prognostic model.
Large population study shows that adolescents with celiac disease have an increased risk of multiple autoimmune and nonautoimmune comorbidities
Authors: Assa Amit , Frenkel‐Nir Yael , Tzur Dorit , Katz Lior H , Shamir Raanan
Published: March 2017

Aim

Celiac disease (CD) is a systemic disorder that is associated with various autoimmune disorders and a higher prevalence of other diagnoses and complications. This large, cross‐sectional, population‐based study investigated the associations between CD and various medical conditions during late adolescence.

Methods

We included 2 001 353 Jewish Israeli adolescents who underwent a general health examination at a median age of 17.1 (16.9–17.4) years from 1988 to 2015. Comprehensive data regarding medical status were available for 1 588 041 (79%) subjects. A definite diagnosis of CD was based on accepted criteria. Covariate data included demographic measures and data on associated medical conditions.

Results

Overall, data on 7145 subjects with CD and 1 580 896 controls were analysed. Multivariate analyses showed that autoimmune diseases were significantly more common in subjects with CD, including insulin dependent diabetes, with an odds ratio (OR) of 5.5, inflammatory bowel diseases (OR = 3.8), arthritis (OR = 2.4), thyroid diseases (OR = 1.8) and psoriatic skin disorders (OR = 1.6). Further associations included asthma (OR = 1.5), bile stones (OR = 3.6), migraine (OR = 2.3), anaemia (OR = 1.7) and menstrual abnormalities (OR = 1.5). Long bone fractures and axial fractures were no more common in adolescents with CD than controls.

Conclusion

CD was already associated with multiple comorbidities by adolescence, and these were not limited to autoimmune disorders.
On absence and abundance: biography as method in archival research
Authors: Hodder Jake
Published: March 2017

Geographical scholarship has rightly problematised the act of archival research, showing how the practice of archiving is not only concerned with how a society collectively remembers, but also forgets. As such, the dominant motif for discussing historical methods in geography has been through the lens of absence: the archive is a space of ‘traces’, ‘fragments’ and ‘ghosts’. In this paper I suggest that the focus on incompleteness and partiality, while true, may also belie what many geographers working in archives find their greatest difficulty: an overwhelming volume of source materials. I reflect on my own research experiences in the pacifist archive to suggest that the growing scale and scope of many collections, along with the taxing research demands of transnational perspectives, pose immediate practical challenges for geographers characterised as much by abundance as by absence. In the second half of the paper, drawing on recent scholarship in history and geography, I argue that the method of biography offers one possible strategy for navigating archival abundance, allowing geographers to tell stories that are wider, deeper and more revealingly complex within the existing time and financial constraints of humanities research.
Regulation of endothelial Fas expression as a mechanism of promotion of vascular integrity by mural cells in tumors
Authors: Kamei Ryosuke , Tanaka Hiroyoshi Y. , Kawano Takao , Morii Chiharu , Tanaka Sayaka , Nishihara Hiroshi , Iwata Caname , Kano Mitsunobu R.
Published: March 2017

Angiogenesis is a multi‐step process that culminates in vascular maturation whereby nascent vessels stabilize to become functional, and mural cells play an essential role in this process. Recent studies have shown that mural cells in tumors also promote and maintain vascular integrity, with wide‐reaching clinical implications including the regulation of tumor growth, metastases, and drug delivery. Various regulatory signaling pathways have been hitherto implicated, but whether regulation of Fas‐dependent apoptotic mechanisms is involved has not yet been fully investigated. We first compared endothelial FAS staining in human pancreatic ductal adenocarcinomas and colon carcinomas and show that the latter, characterized by lower mural cell coverage of tumor vasculature, demonstrated higher expression of FAS than the former. Next, in an in vitro coculture system of MS‐1 and 10T1/2 cells as endothelial and mural cells respectively, we show that mural cells decreased endothelial Fas expression. Then, in an in vivo model in which C26 colon carcinoma cells were inoculated together with MS‐1 cells alone or with the further addition of 10T1/2 cells, we demonstrate that mural cells prevented hemorrhage. Finally, knockdown of endothelial Fas sufficiently recapitulated the protection against hemorrhage seen with the addition of mural cells. These results together suggest that regulation of endothelial Fas signaling is involved in the promotion of vascular integrity by mural cells in tumors.
Language Use Contributes to Expressive Language Growth: Evidence From Bilingual Children
Authors: Ribot Krystal M. , Hoff Erika , Burridge Andrea
Published: March 2017

The unique relation of language use (i.e., output) to language growth was investigated for forty‐seven 30‐month‐old Spanish–English bilingual children (27 girls, 20 boys) whose choices of which language to speak resulted in their levels of English output differing from their levels of English input. English expressive vocabularies and receptive language skills were assessed at 30, 36, and 42 months. Longitudinal multilevel modeling indicated an effect of output on expressive vocabulary growth only. The finding that output specifically benefits the development of expressive language skill has implications for understanding effects of language use on language skill in monolingual and bilingual development, and potentially, for understanding consequences of cultural differences in how much children are expected to talk in conversation with adults.
Toll‐like receptor‐induced expression of epithelial cytokine receptors on haemopoietic progenitors is altered in allergic asthma
Authors: Tworek D. , Heroux D. , O'Byrne S. N. , Mitchell P. , O'Byrne P. M. , Denburg J. A.
Published: March 2017

Background

Haemopoietic progenitor cells (HPC) migrate to sites of allergic inflammation where, upon stimulation with epithelial cytokines, they produce Th2 cytokines and differentiate into mature eosinophils and basophils. They also express Toll‐like receptors (TLR) involved in antimicrobial responses.

Objective

The objective of this study was to compare TLR expression on peripheral blood HPC and TLR‐induced responses, in particular changes in epithelial cytokine receptors, in healthy and asthmatic subjects at baseline and following allergen challenge.

Methods

Ten healthy and 11 allergic asthmatic subjects were studied. HPC‐enriched cell populations were stimulated with TLR‐2, TLR‐4 or TLR‐9 ligands. TLR expression by circulating HPC and interleukin (IL)‐25 (IL‐17RB), IL‐33 (ST2) and thymic stromal lymphopoietin receptor (TSLPR) expression after TLR ligation were examined by flow cytometry at baseline and, in asthmatics, following allergen challenge. The effects of dexamethasone (Dex) on TLR‐induced responses were also assessed.

Results

Asthmatics had significantly lower circulating HPC expressing TLR‐2 and TLR‐9 with a similar trend for TLR‐4. TLR‐4 stimulation of HPC yielded higher numbers of TSLPR+ cells in asthmatics compared with healthy subjects. A similar trend was seen for TLR‐9 ligation, an effect further augmented by allergen inhalation. Allergen challenge also enhanced TLR‐induced ST2 expression on HPC. Treatment with Dex in vitro increased TLR‐4‐induced TSLPR expression but had no effect on other epithelial cytokine receptors.

Conclusions and Clinical Relevance

These data demonstrate an interaction between allergen and TLR ligand exposure in asthmatics. Allergen inhalation augments the TLR‐induced inflammatory response by HPC, possibly leading to increased “in situ haemopoiesis” through up‐regulation of TSLPR. These findings show that HPC may be a part of the pro‐inflammatory cascade in pathogen‐induced asthma exacerbation through their increased responsiveness to TLR stimulation.
Progressive multi-focal leucoencephalopathy – driven from rarity to clinical mainstream by iatrogenic immunodeficiency
Authors: Misbah S A
Published: March 2017

Advances in immune-mediated targeted therapies have proved to be a double-edged sword for patients by highlighting the risk of iatrogenic infective complications. This has been exemplified by progressive multi-focal leucoencephalopathy (PML), a hitherto rare devastating viral infection of the brain caused by the neurotrophic JC polyoma virus. While PML achieved prominence during the first two decades of the HIV epidemic, effective anti-retroviral treatment and restitution of T cell function has led to PML being less prominent in this population. HIV infection as a predisposing factor has now been supplanted by T cell immunodeficiency induced by a range of immune-mediated therapies as a major cause of PML. This review focuses on PML in the context of therapeutic immunosuppression and encompasses therapeutic monoclonal antibodies, novel immunomodulatory agents such as Fingolimod and dimethyl fumarate, as well as emerging data on PML in primary immune deficiency.
Autoantibodies to box A of high mobility group box 1 in systemic lupus erythematosus
Authors: Schaper F , de Leeuw K , Horst G , Maas F , Bootsma H , Heeringa P , Limburg P C , Westra J
Published: March 2017

Autoantibodies to nuclear structures are a hallmark of systemic lupus erythematosus (SLE), including autoantibodies to nuclear protein high mobility group box 1 (HMGB1). HMGB1 consists of three separate domains: box A, box B and an acidic tail. Recombinant box A acts as a competitive antagonist for HMGB1 and might be an interesting treatment option in SLE. However, antibodies to box A might interfere. Therefore, levels of anti-box A were examined in SLE patients in association with disease activity and clinical parameters. Serum anti-box A was measured in 86 SLE patients and 44 age- and sex-matched healthy controls (HC). Serum samples of 28 patients with primary Sjögren's syndrome and 32 patients with rheumatoid arthritis were included as disease controls. Anti-HMGB1 and anti-box B levels were also measured by enzyme-linked immunosorbent assay during quiescent disease [SLE Disease Activity Index (SLEDAI) ≤ 4, n = 47] and active disease (SLEDAI ≥ 5, n = 39). Anti-box A levels in active SLE patients were higher compared to quiescent patients, and were increased significantly compared to HC and disease controls. Anti-box A levels correlated positively with SLEDAI and anti-dsDNA levels and negatively with complement C3 levels. Increased levels of anti-box A antibodies were present in the majority of patients with nephritic (73%) and non-nephritic exacerbations (71%). Antibodies to the box A domain of HMGB1 might be an interesting new biomarker, as these had a high specificity for SLE and were associated with disease activity. Longitudinal studies should be performed to evaluate whether these antibodies perform better in predicting an exacerbation, especially non-nephritic exacerbations.
Production of complement components by cells of the immune system
Authors: Lubbers R , van Essen M F , van Kooten C , Trouw L A
Published: March 2017

The complement system is an important part of the innate immune defence. It contributes not only to local inflammation, removal and killing of pathogens, but it also assists in shaping of the adaptive immune response. Besides a role in inflammation, complement is also involved in physiological processes such as waste disposal and developmental programmes. The complement system comprises several soluble and membrane-bound proteins. The bulk of the soluble proteins is produced mainly by the liver. While several complement proteins are produced by a wide variety of cell types, other complement proteins are produced by only a few related cell types. As these data suggest that local production by specific cell types may have specific functions, more detailed studies have been employed recently analysing the local and even intracellular role of these complement proteins. Here we review the current knowledge about extrahepatic production and/or secretion of complement components. More specifically, we address what is known about complement synthesis by cells of the human immune system.
The clinical significance and biological function of large tumour suppressor 2 in hepatocellular carcinoma
Authors: Liang Rong , Lin Yan , Yuan Chun‐Ling , Liu Zhi‐Hui , Li Yong‐Qiang , Luo Xiao‐Ling , Ye Jia‐Zhou , Ye Hai‐Hong
Published: March 2017

Objectives

Present evidence has suggested that large tumour suppressor 2 (LATS2) is abnormally expressed in most human cancer. However, the clinical and prognostic value in hepatocellular carcinoma (HCC) is still unknown.

Materials and methods

Large tumour suppressor 2 mRNA and protein expression levels in HCC tissues and cell lines were detected by qRT‐PCR, immunohistochemistry or Western blot. The correlation between LATS2 expression and clinicopathological factors was analysed through immunohistochemistry. The function of LATS2 on HCC cell growth and mobility was explored through MTT, colony formation, Transwell migration and invasion assays. The molecular mechanism of LATS2 was screened and confirmed by qRT‐PCR and Western blot.

Results and conclusion

In this study, LATS2 mRNA and protein expressions were decreased in HCC tissues and cell lines compared with normal hepatic tissues and hepatic cell line. Low LATS2 expression was oppositely corrected with tumour stage, vascular invasion and metastasis. The univariate and multivariate analyses suggested that low LATS2 expression was an independent poor prognostic factor for HCC patients. The in vitro experiments showed that LATS2 regulated HCC cells migration and invasion, but had no effect on HCC cells proliferation. Meanwhile, LATS2 modulated metastasis‐associated genes expression including E‐cadherin, vimentin, snail, slug, MMP2 and MMP9. In conclusion, LATS2 is a prognostic biomarker and a tumour metastasis suppressor in HCC.
Positive pleural cytology is an indicator for visceral pleural invasion in metastatic pleural effusions
Authors: Froudarakis Marios E. , Plojoux Jerôme , Kaspi Elise , Anevlavis Stavros , Laroumagne Sophie , Karpathiou Georgia , Roca Elisa , Adler Dan , Dutau Hervé , Astoul Philippe
Published: March 2017

Introduction

In case of undiagnosed pleural effusions, it is necessary to conduct thoracentesis with pleural fluid (PF) cytology. Yet, sensitivity of PF cytology is widely variable as a result of sample size, experience, and preparation method.

Objectives

The aim of this study was to assess whether pleural fluid (PF) cytology is correlated to visceral or parietal pleural invasion as assessed by thoracoscopy in metastatic pleural effusions.

Methods

All records of patients with pleural effusion were reviewed. The inclusion criteria were as follows: PF cytology, reported appearance of macroscopic pleural invasion during thoracoscopy and malignant diagnosis. Patients with mesothelioma were excluded. Finally, 287 patients who met all criteria were selected. According to the thoracoscopy findings, the extent of the disease on the pleura was analyzed in relation to the PF cytology.

Results

In this study, 160 patients (55.7%) had a positive PF cytology (Group A) while 127 (44.3%) recorded negative PF cytology (Group B). From Group A, patients with visceral pleural invasion were 120 (75%) while only 49 patients (38.5%) were found from Group B and the difference was statistically significant (P < .00001). In univariate analysis, visceral pleural invasion was strongly associated with positive PF cytology (P < .001). Other significant associations with positive PF cytology included PF bloody aspect (P = .012), and endoscopic mixed pattern of pleural invasion (P = .0039). Only visceral pleural invasion was statistically significant in multivariate analysis (P < .001).

Conclusions

In patients with pleural metastatic disease, visceral pleural invasion is the only significant factor associated with positive pleural fluid cytology.
An unusual presentation of papillary fibroelastoma originating from right ventricular outflow tract
Authors: Erdogan Mehmet , Guney Murat Can , Ayhan Hüseyin , Kasapkara Hacı Ahmet , Uğuz Emrah , Durmaz Tahir , Keleş Telat , Bozkurt Engin
Published: March 2017

Papillary fibroelastomas (PFEs) are primary cardiac tumors with a benign and avascular nature. Majority of the PFEs are originated from the valvular endocardium, while the most common site is aortic valve. In this case, we present a patient with multiple PFEs originating from the right ventricular outflow tract who was admitted to our clinic with exertional dyspnea. As far as we know, this is the first case of this unusual presentation of multiple PFEs and also had a history of breast cancer and permanent pacemaker reported in the literature.
Association of left atrial enlargement with ventricular remodeling in hypertensive Chinese elderly
Authors: Peng Jing , Laukkanen Jari A. , Zhao Qianping , Wang Liping , Zhang Xu , Li Gang
Published: March 2017

Background

It is not well known whether left atrial (LA) enlargement is associated with left ventricular (LV) remodeling in Asian subjects with preserved LV ejection fraction (LVEF ≥50%). Therefore, we studied whether LA enlargement is related to ventricular remodeling in hypertensive Chinese elderly with preserved LVEF.

Methods

Data of 480 hypertensive Chinese elderly (age from 65 to 94 years) with LVEF ≥50% were consecutively included in the study.

Results

We observed a total of 248 patients (51.7%) with increased LA size. Univariate analysis showed that LA size was positively related to duration of hypertension, prevalence of coronary heart disease and atrial fibrillation, interventricular septal thickness, LV posterior wall thickness, LV end‐diastolic and end‐systolic diameter, LV mass index, right ventricular (RV) diameter and aortic diameter; meanwhile, LA size was inversely related to LVEF and relative wall thickness of LV. Multivariate regression analysis showed that LA enlargement was positively related to duration of hypertension (P=.012) and RV diameter (P<.001).

Conclusions

Left atrial enlargement is independently associated with a longer duration of hypertension and RV dilative remodeling in hypertensive elderly with preserved LVEF. LA enlargement is an early sign of RV eccentric remodeling in hypertensive elderly.
Atrioventricular dyssynchrony from empiric device settings is common in cardiac resynchronization therapy and adversely impacts left ventricular morphology and function
Authors: Sinner Gregory J. , Gupta Vedant A. , Seratnahaei Arash , Charnigo Richard J. , Darrat Yousef H. , Elayi Samy C. , Leung Steve W. , Sorrell Vincent L.
Published: March 2017

Background

Echocardiographic atrioventricular (AV) optimization after cardiac resynchronization therapy (CRT) is uncommon due to time constraints and the use of vendor‐specific device algorithms. It remains unclear whether optimization of mitral inflow velocities can still be useful. We aimed to investigate post implantation left ventricular (LV) inflow patterns to determine the incidence of AV dyssynchrony from empirically set devices.

Methods

This was a retrospective study of patients undergoing CRT using empiric device settings. Forty‐eight patients with clinical, echocardiographic, and pacemaker follow‐up were grouped by their post implantation LV filling pattern. Baseline characteristics and echocardiographic measurements were compared with post implantation findings at median 6.3 months (interquartile range [IQR], 3.9–17.0).

Results

Twenty‐four patients demonstrated AV dyssynchrony (Group 1) after CRT, and 24 patients did not (Group 2). Group 1 patients had less LV reverse remodeling compared to Group 2 patients (ΔLV end‐diastolic volume: −3.6 mL vs −49.5 mL, P<.05; ΔLV end‐systolic volume: −16.9 mL vs −53.5 mL, P<.05) and did not experience significant improvements in LV outflow tract velocity time integral, stroke volume, or LV ejection fraction. There were no differences in new‐onset atrial fibrillation, heart failure readmissions, or mortality between groups.

Conclusion

Our study suggests that up to 50% of patients with empiric device settings have AV dyssynchrony at 6 months despite atrioventricular delay optimization (AVO) algorithms. As AV dyssynchrony is common and has proven to be modifiable, a strategic approach to Doppler echocardiography‐guided AVO after CRT is warranted, particularly in nonresponders where the LV filling pattern is fused or truncated.
Natural history of severe aortic stenosis: Diastolic wall strain as a novel prognostic marker
Authors: Obasare Edinrin , Bhalla Vikas , Gajanana Deepakraj , Rodriguez Ziccardi Mary , Codolosa Jose N. , Figueredo Vincent M. , Morris Dennis Lynn , Pressman Gregg S.
Published: March 2017

Background and Aim

Diastolic wall strain (DWS) has been proposed as a simple noninvasive measure of left ventricular (LV) stiffness. This study investigated DWS as a possible predictor of mortality in severe aortic stenosis (AS).

Methods

138 patients with severe AS (indexed aortic valve area [AVA]<0.6 cm2/m2) and normal ejection fraction (>55%) were included. 52 patients (38%) had aortic valve interventions or poor image quality (n=5) and were excluded leaving 86 in the study group (84±8 years, 70% female, 69% African American). DWS was defined as (LVPWs−LVPWd)/LVPWs where LVPWs=left ventricular posterior wall thickness in systole and LVPWd=left ventricular wall thickness in diastole.

Results

Follow‐up extended 2.0±1.9 years (median 1.6 years). Mean DWS for the group was 0.21±0.11 (normal=0.4±0.07). In patients who died, DWS was significantly lower than in survivors (0.18±0.09 vs 0.24±0.11, P=.02). By contrast, traditional measures of diastolic dysfunction did not predict death. Regression analysis showed DWS predicted death even after adjusting for age, sex, race, indexed AVA, symptoms (angina, shortness of breath, dizziness, syncope), and clinical factors (creatinine, smoking, diabetes, hypertension, hyperlipidemia) (HR 2.5 [95% CI 1.02‐5.90], P<.05). The best cutoff value for DWS of 0.25 had a sensitivity of 42% and specificity of 83% for predicting death.

Conclusions

DWS is an independent predictor of all‐cause mortality in patients with severe AS, even after accounting for traditional clinical and echocardiographic parameters.
Amphibian sensitivity to habitat modification is associated with population trends and species traits
Authors: Nowakowski A. Justin , Thompson Michelle E. , Donnelly Maureen A. , Todd Brian D.
Published: March 2017

Aim

Habitat modification is causing widespread declines in biodiversity and the homogenization of biotas. Amphibians are especially threatened by habitat modification, yet we know little about why some species persist or thrive in the face of this threat whereas others decline. Our aim was to identify intrinsic factors that explain variation among amphibians in their sensitivity to habitat modification (SHM), factors that could help target groups of species for conservation.

Location

Global.

Time period

1986–2015

Major taxon studied

Amphibians.

Methods

We quantified SHM using species abundances in natural and altered habitats as reported in published field surveys. We first examined associations between local SHM and range‐wide threatened status, population trends and invasiveness. We then evaluated the importance of intrinsic and extrinsic variables in explaining species SHM using multiple comparative methods. Our analyses included over 200 species that could be ranked with confidence from 47 studies across five continents.

Results

Amphibians species varied considerably in local SHM. High SHM was associated with elevated range‐wide extinction risk and declining population trends. Species that were tolerant of habitat modification were most likely to be invasive outside their native range. Geographical range size was the most important intrinsic predictor and was negatively associated with SHM. Larval habitat was also an important predictor, but was tightly coupled with phylogenetic position.

Main conclusions

Narrowly distributed species whose larvae develop on land or in lotic habitats are most sensitive to habitat modification. However, other unmeasured, phylogenetically constrained traits could underlie the effect of larval habitat. Species range size is frequently correlated with global extinction risk in vertebrates, and our analysis extends this macroecological pattern to the sensitivity of amphibians to local habitat loss, a proximate driver of extinction. These general patterns of SHM should help identify those groups of amphibians most at risk in an era of rapid habitat loss and scarce conservation resources.
Lichen Simplex Chronicus Among Filipinos
Authors: Bocobo Florante C.
Published: March 2017

Of 1,256 Filipino patients seen in the author's dermatologie practice in Manila, 103 (8.2 percent) had lichen simplex chronicus. This was a relatively high incidence, comparable to that of Orientals residing in the United States.

Of the 103 cases of lichen simplex chronicus, 61 were females and 42 males, for a ratio of 3 :2.

The average age of the patients was 42 years.

The ankle was unquestionably the site of predilection.
Clinical Evaluation Of Triamcinolone Spray In Dermatologic Conditions
Authors: Christianson Herbert B. , Derbes Vincent J.
Published: March 2017

A variety of dermatologie conditions encountered in 163 patients was treated with triamcinolone acetonide spray. Among the 155 patients who were followed, results were excellent in 57 (36.8 percent), good in 60 (38.7 percent), fair in 21 (13.5 percent) and poor in 17 (11 percent). Localized neurodermatitis, contact dermatitis and eczematous conditions responded well to treatment. Poor responses were noted in patients with alopecia areata, herpes zoster, mycosisfungoides and granuloma annulare.

The only undesirable reaction reported was a burning sensation after application of the spray. Usually this was slight and transient, but treatment was discontinued in one patient because of excessive burning, despite clinical improvement.
Griseofulvina Y Lepra
Authors: Bile Tomás
Published: March 2017

Durante cuatro meses, aunque en forma saltuaria, se experimenta la griseofulvina en siete casos lepromatosos de los cuales cinco se encontraban en fase reaccional con tratamiento previo y uno sin tratamiento alguno. Las dosis fueron de tres pastillas repartidas durante el día. En todos hubo recuperación rápida tanto desde el punto de vista subjetivo como objetivo. El autor supone que la interrelación de causa a efecto entre la griseofulvina y la lepra se debería a una acción antibiótica directa y específica del medicamento sobre el Mycobacterium y sugiere una experimentación más amplia en éste campo, destacando además la buena tolerancia de la droga durante todos los ensayos terapéuticos realizados.

Es necesario tener presente que los interesantísimos hallazgos del Dr. Bile se basaron en una investigación preliminar llevada a cabo en sólo siete pacientes estudiados durante cuatro meses, sin ceñirse a un esquema formal de investigación. Según lo señala el Dr. Bile mismo, se requiere una investigación mucho más amplia antes de que se puedan sacar conclusiones definitivas. —Editor.
Ablacion Ungueal‐Su Uso En La Onicomicosis
Authors: Fernando A. , Cordero C.
Published: March 2017

Se presenta la modalidad terapéutica de asociar el uso de la griseofulvina con la ablación quirúrgica de las uñas en eltratamiento de la onicomicosis.

A su vez, se describe la nueva técnica quirúrgica creada por el autor, para la resección de las uñas, poniéndo énfasis en la sencillez y facilidad de su ejecuten, ya que cualquier uña enferma de los pies o manos, puede ser resecada con sólo el uso de una pequeña cucharilla de bordes romos. Es una operación de cirugía menor, fácil, sencilla, practica y accesible para cualquier medico y aún para el dermatólogo no familiarizado con la cirugía de piel.

Con la combinación de ambos métodos, prácticamente se elimina la posibilidad de las reacciones colaterales, de intolerancia o intoxicación consecutivas al uso del antibiótico, ya que se reduce en más de un 40% la dosis total que se administra; se detiene el proceso invasivo de los hongos; además, estos se enlinan mecánicamente al resecar la una enferma y se previene su recurrencia, con la administración postoperatoria del antibiótico. El tiempo de tratamiento, se reduce en más de la mintad y lacuración se obtiene en el lapso de un mes.

Se trataron 200 enfermos y se resecaron 217 uñas en total, tanto de los pies como de las manos; la infección que predominó fué consecutiva al Trichophyton rubrum; los resultados terapéuticos obtenidos fueron muy satisfactorios, ya que se observó un 95% de curación; las recaídas se deben más que todo al uso deficiente de la griseofulvina en el período post‐operatorio y a que el enfermo regresaba a su ocupación anterior.
The Peculiar Demarcation of Pigmentation along the So‐called Voigt's Line among the Japanese
Authors: Ito Kasuke
Published: March 2017

Rare cases of a phenomenon in which there is a sharp demarcation between the hyperpigmented surface of the extensors and the less pigmented skin of the flexors, rather than the normal gradual transition, have been observed among the Japanese. This demarcation may be found on various parts of the body but is most commonly seen on the extremities, where it follows the direction of the so‐called Voigt's line.

This phenomenon appears to affect females ten times as frequently as males; it is found in all age groups.

Three interesting questions are posed—does this phenomenon occur among peoples other than the Japanese? Does it serve as a barrier against the spread of other skin disorders which occur of along its line? Finally, what is the mechanism underlying this condition?
Keratoacanthoma and Its Incidence as Affected by Sunlight in the Tropical and Subtropical Areas of Australia
Authors: Belisario John C.
Published: March 2017

The author briefly traces the history of keratoacanthoma since its description by Hutchinson in 1899, and discusses its incidence according to age and affected body areas as well as its possible aetiology.

The role of sunlight in the causation of keratoacanthoma is examined. The clinical features of this condition, including its possible role as a precursor of malignant processes, and its diagnosis are discussed. The author also suggests a therapeutic approach.
Inhibition of Hypophysial Activity by Paraoxypropiophenone in Acne Vulgaris
Authors: Kantner A.
Published: March 2017

The administration of paraoxypropiophenone failed to influence theso–called sebotrophic factor.

Paraoxypropiophenone, in fact,inhibited at least the production of the gonadotrophic hormone(FSH).

Results favor the hormonal theory of the origin of acne—a relative increase in the androgen level.

Experiments will have to be continued and results will have to be followed longer after administration of gonadotrophic hormone in acne.
Dermatitis Herpetiformis and Thyrotoxicosis
Authors: Callen Jeffrey P. , Weston William F. , Chanda Joseph J.
Published: March 2017

Dermatitis herpetiformis has been associated with a variety of thyroid abnormalties. A case of thyrotoxicosis in a patient with pre‐existing dermatitis herpetiformis is reported. Thyroid antibodies were present in the serum. This may suggest an immunologic relationship between dermatitis herpetiformis and thyroid disorders, that may be more than fortuitous.
Volar Melanotic Macules
Authors: Chapel Thomas A. , Taylor Robert M. , Pinkus Hermann
Published: March 2017

Asymptomatic light brown or tannish‐gray macules are seen on palms and/or soles of black patients, and occsionally on the volar surfaces of whites. They may be mistaken for lesions of secondary syphilis or other postinflammatory hyperpigmented dermatoses. Histologic examination of 14 specimens obtained at necropsy showed purely epidermal hyperpigmentation of all epidermal layers; or β) melanin restricted to large dendritic melanocytes without appreciable transfer to keratinocytes. The number of melanocytes was not significantly increased, and with one exception, there were no nevus cells. These volar melanotic macules have close clinical and histologic resemblance to melanotic macules observed occasionally on the vermillion area of the lips.
Three odorant binding proteins may regulate the behavioural response of Chrysopa pallens to plant volatiles and the aphid alarm pheromone (E)‐β‐farnesene
Authors: Li Z.‐Q. , Zhang S. , Cai X.‐M. , Luo J.‐Y. , Dong S.‐L. , Cui J.‐J. , Chen Z.‐M.
Published: March 2017

Artificial Chrysopa pallens release is a well‐known method for suppressing aphids, but it is difficult to establish lacewing populations in the field. Understanding the functions of C. pallens odorant‐binding proteins (CpalOBPs) and behavioural responses of C. pallens to plant volatiles and aphid alarm pheromone (E)‐ß‐farnesene has important implications for population establishment after lacewing release. Based on our previous study, five antennae‐enriched CpalOBPs were selected. Sequence alignment and phylogenetic analysis revealed that these five CpalOBPs were Classic OBPs and separated into different clades. Of them, CpalOBP10 clustered in the same clade with aphid OBP7, which mediates the perception of green leaf volatiles and (E)‐ß‐farnesene. Ligand‐binding assays showed 31 compounds, including plant‐derived compounds, pest‐induced volatiles and (E)‐ß‐farnesene, had high binding affinities for at least one of these five CpalOBPs. Of the 31 compounds, the pest‐induced volatiles (Z)−3‐hexenyl hexanoate and 2‐hexyl‐1‐decanol, used in host location by the black bean aphid, elicited significant attractive behavioural responses from C. pallens. Conversely, (E)‐ß‐farnesene elicited strongly repellent behavioural responses. It is conceivable that C. pallens utilizes plant‐derived compounds, pest‐induced volatiles and (E)‐ß‐farnesene as foraging cues. Our studies provide new insights into the interrelationships amongst C. pallens, its prey and the host plants. Compounds that elicited significant behavioural responses from C. pallens were also identified.
The first permanent molar: spontaneous eruption after a five‐year failure
Authors: Mistry Vinay N. , Barker Christopher S. , James Spencer R.
Published: March 2017

Background

It is rare for a first permanent molar (FPM) to temporarily exhibit clinical features of failure of eruption, followed by regeneration of full eruptive capacity 5 years later. Indeterminate failure of eruption (IFE) is a diagnosis of exclusion where the distinction between primary failure of eruption (PFE) and mechanical failure of eruption (MFE) is unclear, including patients too young to specify.

Case report

An 11‐year‐old girl attended the orthodontic clinic at Mid Yorkshire Hospitals NHS Trust regarding an unerupted lower right FPM. Her medical and dental trauma history was unremarkable. She presented with a Class II division 2 malocclusion in the mixed dentition, with all other FPMs fully erupted.

Conclusion

This report documents that an unerupted FPM in an 11‐year‐old patient may still have the eruptive potential to become functional within the dentition. The period spent monitoring the FPM's outcome prior to surgical intervention has avoided an operation under general anaesthetic and potentially unnecessary orthodontic treatment, as the tooth subsequently erupted without treatment.
Email adaptation for conflict handling: A case study of cross‐border inter‐organisational partnership in East Asia
Authors: Lee Joyce Yi‐Hui , Panteli Niki , Bülow Anne Marie , Hsu Carol
Published: March 2017

This paper explores the context of email‐based communication in an established but fragile, inter‐organisational partnership, which was often overlain with conflict. Drawing upon adaptation theory, this study explores how participants adapt to the use of email to handle conflict. Extensive data were obtained during a 6‐month field study of a case of cross‐border inter‐organisational collaboration in East Asia. We observed that the individuals involved in the cross‐border partnership used email as a lean form of communication to stop covert conflict from explicitly emerging. In contrast to prior research on the leanness of email in managing conflict, we found that under the described conflict situation the very leanness of email was appreciated and thus, exploited by those concerned to manage the conflict situation. Specifically, we identified 4 key conflict‐triggered adaptation strategies, namely, interaction avoidance, disempowering, blame‐protection, and image‐sheltering that drove the ways in which email was adapted to maintain organisational partnerships under conflict.
Nonlinear scalarization in multiobjective optimization with a polyhedral ordering cone
Authors: Gutiérrez César , Huerga Lidia , Novo Vicente
Published: March 2017

In this work, we consider a multiobjective optimization problem in which the ordering cone is assumed to be polyhedral. In this framework, we characterize proper efficient solutions through nonlinear scalarization and a kind of polyhedral dilating cones. The main results are based on a characterization of weak efficient solutions, for which no convexity hypotheses are required. Moreover, the construction of these dilating cones allows us to obtain scalarization results that are easier to handle, and attractive from a computational point of view, since they are formulated in terms of a perturbation of the matrix that defines the ordering cone. Finally, when the feasible set is given by a cone constraint, we derive necessary and sufficient optimality conditions via a kind of scalar nonlinear Lagrangian.
Low bone mineral density risk factors and testing patterns in institutionalized adults with intellectual and developmental disabilities
Authors: Hess Mailee , Campagna Elizabeth J , Jensen Kristin M
Published: March 2017

Background

Adults with intellectual or developmental disability (ID/DD) have multiple risks for low bone mineral density (BMD) without formal guidelines to guide testing. We sought to identify risk factors and patterns of BMD testing among institutionalized adults with ID/DD.

Methods

We evaluated risk factors for low BMD (Z‐/T‐score < −1) and patterns of BMD testing among adults with ID/DD receiving care at a state‐run residential facility. Kruskal–Wallis, Fisher's exact and Pearson's chi‐squared tests were used as appropriate.

Results

Of the 140 eligible patients, only 44% ever had BMD testing of which 89% had low BMD. Median age at diagnosis was 42 years old. Individuals with low BMD were more likely to be older, non‐weight bearing, Caucasian and have severe cognitive delay.

Conclusions

Adults with ID/DD in this facility had a high prevalence of low BMD. Further studies are needed to better characterize risk factors and inform screening within this high‐risk population.
Developmental changes in the cognitive and educational profiles of children and adolescents with 22q11.2 deletion syndrome
Authors: Tobia Valentina , Brigstocke Sophie , Hulme Charles , Snowling Margaret J
Published: March 2017

Background

22q11.2 deletion syndrome (22q11DS) is the most common microdeletion syndrome in humans. The presence of learning difficulty is reported in the majority of individuals with 22q11DS, but there is considerable heterogeneity in cognitive and educational profiles and in the age‐related changes.

Method

Verbal, non‐verbal and spatial abilities, and educational attainment of 18 children and adolescents with 22q11DS were assessed at two time points 5 years apart.

Results

There was a decline in full‐scale IQ, with a sharper decline in verbal than non‐verbal skills, whereas spatial abilities remained stable over time. Individual profile analysis revealed discrepancies between full‐scale IQ and reading skills, suggestive of “hyperlexia,” for more than two‐thirds of participants.

Conclusions

The relative strength in verbal ability observed in 22q11DS is more apparent when children are younger, and a more even cognitive profile is observed in older children and adolescents. Educational attainments keep pace with development, and literacy skills are globally higher than might be expected from full‐scale IQ.
Extra‐Judicial Conferences in Child Welfare Cases: Reassessing their Role and Implications for Practice and Policy
Authors: Finck Kara R.
Published: March 2017

Child welfare agencies increasingly utilize family team decision‐making conferences in cases where there is a pending child protection matter in family court. The simultaneous proceedings present critical questions for all practitioners and judges about the relationship between the court and the agency, and implications for the rights of parents and children. This article discusses the critical tensions raised when the agency pursues extra‐judicial conferences in the absence of coordination with and recognition of the court process, including expectations of confidentiality, the role of attorneys in conferences and the perception of fairness in both forums.
Variations in primary sclerosing cholangitis across the age spectrum
Authors: Eaton John E , McCauley Bryan M , Atkinson Elizabeth J , Juran Brian D , Schlicht Erik M , de Andrade Mariza , Lazaridis Konstantinos N
Published: March 2017

Background and Aim

Primary sclerosing cholangitis (PSC) typically develops in middle‐age adults. Little is known about phenotypic differences when PSC is diagnosed at various ages. Therefore, we sought to compare the clinical characteristics of a large PSC cohort based on the age when PSC was diagnosed.

Methods

We performed a multicenter retrospective review to compare the features of PSC among those diagnosed between 1–19 (n = 95), 20–59 (n = 662), and 60–79 years (n = 102).

Results

Those with an early diagnosis (ED) of PSC were more likely to have small‐duct PSC (13%) than those with a middle‐age diagnosis (MD) (5%) and late diagnosis (LD) groups (2%), P < 0.01, and appeared to have a decrease risk of hepatobiliary malignancies: ED versus MD: hazard ratio (HR), 0.25; 95% confidence interval (CI) 0.06–1.03, and ED versus LD: HR, 0.07; 95% CI 0.01–0.62. Cholangiocarcinoma was diagnosed in 78 subjects (ED n = 0, MD n = 66, and LD n = 12) and was more likely to be diagnosed within a year after the PSC diagnosis among those found to have PSC late in life: ED 0% (0/95), MD 2% (14/662), and LD 6% (6/102), P = 0.02. Similarly, hepatic decompensation was more common among those with LD‐PSC versus younger individuals: LD versus MD: HR, 1.64; 95% CI 0.98–2.70, and LD versus ED: HR, 2.26; 95% CI 1.02–5.05.

Conclusions

Those diagnosed with PSC early in life are more likely to have small‐duct PSC and less likely to have disease‐related complications. Clinicians should be vigilant for underlying cholangiocarcinoma among those with PSC diagnosed late in life.
About the information depth of backscattered electron imaging
Authors: PIŇOS J. , MIKMEKOVÁ Š. , FRANK L.
Published: March 2017

The information depth of imaging with backscattered electrons in the scanning electron microscope was measured directly by comparison of a planar view of a steel sample with buried precipitates with an image of a section cut through precipitates by means of a Focused Ion Beam attachment. The information depth was determined across the electron energy range of units of keV and the results were compared with information depths calculated from two published equations and simulated using widely available Monte Carlo‐based software. Recommendations are given for routine estimations of BSE information depths.
Calcium hydroxylapatite: A review on safety and complications
Authors: Kadouch J.A.
Published: March 2017

Background

Radiesse®, or calcium hydroxylapatite (CaHA), is a biodegradable, biostimulatory soft tissue filler suitable for deeper folds and wrinkles. In the literature, good results have been documented with the use of CaHA and patient satisfaction scores are high. This study reviews the current literature on safety and complications of CaHA.

Methods

A literature search in MEDLINE/PubMed electronic database was conducted. A total of 21 articles were included and screened for reports of adverse events (AEs).

Results

Twenty‐one peer‐reviewed articles, published between 2004 and 2015, were included. A total of 5081 treatments with CaHA were performed on 2779 patients. A total of 173 (3%) AEs were reported. The assessed types of AEs consisted of nodules (n=166, 96%), persistent inflammation/swelling (n=4, 2%), persistent erythema (n=2, 1%), and overcorrection (n=1, 1%).

Conclusion

Based on the results in this study, CaHA appears to have a good safety profile. Nodules are by far the most common AE. Of the reported nodules, 49% occurred in “dynamic” areas currently known for having a higher tendency for nodules. Several treatment approaches exist for managing CaHA nodules; however, in most cases, CaHA nodules are not visible and resolve without intervention.