bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness, safety and acceptability of self‐assessment of the outcome of first‐trimester medical abortion: a systematic review and meta‐analysis
Authors: Baiju N , Acharya G , D'Antonio F , Berg RC
Published: August 2019

Background

For many women, the need for multiple clinical visits is a barrier to medical abortion.

Objectives

We assessed the effectiveness, safety, and acceptability of self‐assessment of the outcome of medical abortion completed at home versus routine clinic follow up after medical abortion.

Search strategy

We searched databases such as MEDLINE, Embase, and CENTRAL to find studies published in 1991–2018.

Selection criteria

Eligible studies included women of reproductive age who had undergone a medical abortion that was completed at home. The intervention and self‐assessment of the outcome of medical abortion done by urine pregnancy tests kits by women at home was compared with routine medical follow up at a clinic.

Data collection and analysis

Two researchers completed the study selection, data extraction, critical appraisal, and assessment of the evidence. The outcomes were successful complete abortions, side effects and complications, and acceptability. We performed meta‐analyses when possible and GRADE to ascertain the certainty of the evidence. The protocol was registered in PROSPERO (CRD42017055316).

Main results

Four randomised controlled trials (RCTs; n = 5493) met our inclusion criteria. The pooled analysis from all studies showed no significant difference in complete abortion rates between self‐assessment and routine clinic follow up: RR = 1.00, 95% CI 0.99–1.01. The ongoing pregnancy rates were similar and the pooled results for the safety outcomes showed no significant differences between the groups. There was a significantly greater preference for self‐assessment as the follow‐up method.

Conclusions

The effectiveness, safety, and acceptability of self‐assessment of the outcome of medical abortion completed at home are not inferior to routine clinic follow up.

Tweetable abstract

The effectiveness, safety, and acceptability of self‐assessment of the outcome of medical abortion are not inferior to routine clinic follow up.
High commitment work system and firm performance: impact of psychological capital and environmental uncertainty
Authors: Chen Chih‐Chieh , Wang Yanxia , Chen Shyh‐Jer , Fosh Patricia , Wang Rui
Published: August 2019

Our study of a northern China sample of CEOs, middle managers and frontline employees matched across 114 firms investigates the relationship between a high commitment work system and firm performance from an organizational perspective by considering the mediating role of collective psychological capital (PsyCap) and the moderating role of environmental uncertainty. The effect of a high commitment work system on firm performance was fully mediated by collective PsyCap, while environmental uncertainty moderated the effect of collective PsyCap on firm performance such that firm performance was stronger when environmental uncertainty was higher. We contribute to the developing body of work using collective PsyCap as a mediator for the high commitment work system–performance relationship at the organizational level. Our selection of environmental uncertainty as a moderator responds to the call for research on potential moderators and more consideration of context. We discuss our study's managerial implications and limitations.
Fructose tolerance test in obese people with and without type 2 diabetes
Authors: Al‐Ozairi Ebaa , Rivard Christopher J. , Sanchez Lozada Laura Gabriela , Lanaspa Miguel A. , Bjornstad Petter , Al Salem Danah , Alhubail Asma , Megahed Amira , Kuwabara Masanari , Johnson Richard J. , Asad Reem A.
Published: August 2019

Background

Fructose is distinct among common sugars in its ability to raise serum uric acid, and some studies suggest fructose‐induced uric acid production may have a role in the ability of this sugar to induce metabolic syndrome. A fructose tolerance test has been previously developed to evaluate the relative ability of fructose to raise uric acid in individuals. However, the effect of fructose to raise uric acid in people with diabetes has not been studied.

Methods

People with type 2 diabetes (n = 143) and without diabetes controls (n = 132) with similar body mass index (BMI) underwent an oral fructose tolerance test. As a comparison, participants also had their uric acid levels measured after an oral glucose tolerance test on a different day.

Results

Serum uric acid was lower in people with type 2 diabetes compared to controls with a similar BMI, especially those with poor glucose control (glycosylated hemoglobin [HbA1c] ≥ 8%). Fructose administration raised serum uric acid in both groups, with a lower absolute rise in people with diabetes. People with diabetes with a blunted rise in serum uric acid had higher baseline serum uric acid concentrations and a higher BMI. People without diabetes with a higher BMI also showed a blunted serum uric acid response. Oral glucose administration lowered serum uric acid in both participants, with a greater fall in those with diabetes.

Conclusion

Both the presence of diabetes and obesity blunt the serum uric acid response to fructose ingestion. These data demonstrate altered fructose‐dependent urate metabolism in type 2 diabetes.
Implications of the Joint Provision of CSR Assurance and Financial Audit for Auditors' Assessment of Going‐Concern Risk
Authors: Maso Lorenzo Dal , Lobo Gerald J. , Mazzi Francesco , Paugam Luc
Published: August 2019

ABSTRACT

We examine whether the joint provision of corporate social responsibility (CSR) assurance services and financial audit by the same audit firm influences auditors' assessment of going‐concern risk. We predict that the provision of CSR assurance and financial audit by the same audit firm creates CSR‐related knowledge spillovers from the CSR assurance team to the financial audit engagement team, which helps in the auditor's assessment of going‐concern risk. Using more than 28,000 firm‐year observations from 55 countries, we document that, relative to audit firms that provide only the financial audit, audit firms that provide both CSR assurance and financial audit for the same client (i) issue more frequent going‐concern opinions and have lower Type II going‐concern errors, (ii) have clients that book larger environmental and litigation provisions, (iii) report earnings that are more persistent and value‐relevant and are less likely to book income‐decreasing earnings restatements, and (iv) do not charge higher audit fees or total fees. Our results are important especially because of firms' increasing exposure to CSR risks and the growing number of countries that require assurance of CSR reports.
Randomized Clinical Trial Examining Cognitive Behavioral Therapy for Individuals With a First‐Time DUI Offense
Authors: Osilla Karen Chan , Paddock Susan M. , McCullough Colleen M. , Jonsson Lisa , Watkins Katherine E.
Published: August 2019

Background

Driving under the influence (DUI) programs are a unique setting to reduce disparities in treatment access to those who may not otherwise access treatment. Providing evidence‐based therapy in these programs may help prevent DUI recidivism.

Methods

We conducted a randomized clinical trial of 312 participants enrolled in 1 of 3 DUI programs in California. Participants were 21 and older with a first‐time DUI offense who screened positive for at‐risk drinking in the past year. Participants were randomly assigned to a 12‐session manualized cognitive behavioral therapy (CBT) or usual care (UC) group and then surveyed 4 and 10 months later. We conducted intent‐to‐treat analyses to test the hypothesis that participants receiving CBT would report reduced impaired driving, alcohol consumption (drinks per week, abstinence, and binge drinking), and alcohol‐related negative consequences. We also explored whether race/ethnicity and gender moderated CBT findings.

Results

Participants were 72.3% male and 51.7% Hispanic, with an average age of 33.2 (SD = 12.4). Relative to UC, participants receiving CBT had lower odds of driving after drinking at the 4‐ and 10‐month follow‐ups compared to participants receiving UC (odds ratio [OR] = 0.37, p = 0.032, and OR = 0.29, p = 0.065, respectively). This intervention effect was more pronounced for females at 10‐month follow‐up. The remaining 4 outcomes did not significantly differ between UC versus CBT at 4‐ and 10‐month follow‐ups. Participants in both UC and CBT reported significant within‐group reductions in 2 of 5 outcomes, binge drinking and alcohol‐related consequences, at 10‐month follow‐up (p < 0.001).

Conclusions

In the short‐term, individuals receiving CBT reported significantly lower rates of repeated DUI than individuals receiving UC, which may suggest that learning cognitive behavioral strategies to prevent impaired driving may be useful in achieving short‐term reductions in impaired driving.
Life in linear habitats: the movement ecology of an endangered mammal in a peri‐urban landscape
Authors: Maclagan S. J. , Coates T. , Hradsky B. A. , Butryn R. , Ritchie E. G.
Published: August 2019

Animal movement can be significantly altered in human‐dominated landscapes such as urban and peri‐urban areas, where habitat is often fragmented and/or linear. Knowledge regarding how wildlife respond to anthropogenic change is vital for informing conservation efforts in such landscapes, including the design of nature reserves and wildlife corridors. To better understand how threatened species persist and behave within human‐dominated landscapes, we examined the home range and space use of the nationally endangered southern brown bandicoot Isoodon obesulus obesulus in peri‐urban Melbourne, Australia’s second‐largest city. Specifically, we examined whether: (1) bandicoots were confined to linear strips of remnant vegetation or also made use of the broader highly modified landscape matrix; (2) the configuration of the linear vegetated strips affected home range shape; and (3) home range area differed between bandicoots living in linear strips and those in larger remnant habitat patches. We found that: (1) 71% of adult males and 33% of adult females used the matrix, but non‐dispersing juveniles were entirely confined to the linear strips; males also travelled greater distances into the matrix (away from the vegetated strips) than females; (2) bandicoots had longer home ranges in narrower strips and males had longer home ranges than females; and (3) home range area for both sexes was smaller in linear strips than has been recorded in other studies in larger remnant habitats. Our study highlights the importance of retaining narrow, fragmented and modified vegetation to accommodate threatened biodiversity within human‐dominated landscapes, but suggests the surrounding matrix may also offer important resources for adaptable species, such as bandicoots. Supporting off‐reserve conservation of biodiversity in novel ecosystems is increasingly pertinent in our rapidly urbanizing world.
A bibliometric analysis of the conversion and reporting of pilot studies published in six anaesthesia journals
Authors: Charlesworth M. , Klein A. A. , White S. M.
Published: August 2019

Pilot and feasibility studies are preliminary investigations undertaken before a larger study. We hypothesised that only a small proportion of pilot or feasibility studies published in anaesthesia journals were correctly labelled as such. We searched for papers published between 2007 and 2017 in six anaesthesia journals using the text words ‘pilot’ OR ‘feasibility’ and included 266 original articles with 26,682 human participants. Only 34 (12.8%) were correctly labelled as a pilot or feasibility study. They were more likely to: have more median (IQR [range]) participants, 73 (40–130 [4–2716]) vs. 27 (15–60 [2–3305], p < 0.001; report feasibility outcomes, 82.4% vs. 4.3%, p < 0.001; and report an intention to convert, 100% vs. 39.7%, p < 0.001. They were less likely to test the efficacy of the primary outcome, 50% vs. 72.8%, p = 0.009; and report firm clinical conclusions 41.2% vs. 67.7%, p = 0.004. Of the studies published more than 5 years ago, correctly labelled pilot or feasibility studies were more likely to precede a published conversion study, 53.8% vs. 16%, p = 0.004. There was no difference between the number of citations 18 (9–44 [2–216]) vs. 20 (7–47 [0–251]), p = 0.865. These results have important consequences for patients, trialists, researchers and funders. We argue that correctly labelled pilot studies enhance the quality of scientific research by encouraging methodological rigour, ensuring scientific validity and reducing research waste. Authors, reviewers, editors and publishers should ensure they adhere to the contents of the 2016 CONSORT extension for pilot and feasibility studies.
Meta‐analysis found that studies may have overestimated Caesarean section risks for attention‐deficit hyperactivity disorder by ignoring confounding factors
Authors: Xu Lian‐lian , Zhang Xue , Zhou Guo‐lin , Jiang Chun‐min , Jiang Hai‐yin , Zhou Yuan‐yue
Published: August 2019

Aim

Epidemiological studies on associations between Caesarean sections (C‐sections) and attention‐deficit hyperactivity disorder (ADHD) have been inconsistent, and we performed a meta‐analysis.

Methods

We systematically searched PubMed and Embase to December 2018 and included nine hospital‐based and population registry studies published in 2011‐2018. These covered a total study cohort of more than 2.5 million people in eight countries: Australia, Brazil, Denmark, Finland, Germany, Sweden, Turkey and the UK. The analysis provided summary odds ratios (ORs) and 95% confidence intervals (CI) while taking heterogeneity into account.

Results

We found that that C‐sections were associated with a small increase in the risk of ADHD (OR 1.14, 95% CI 1.11, 1.17, I2 0%) in offspring. In subgroup analyses, the association remained for both infants born after elective C‐sections (OR, 1.15, 1.11, 1.19, I2 0%) and emergency C‐sections (OR, 1.13, 1.1, 1.17, I2 45.4%). However, these were only marginally significant when we pooled data from siblings from other pregnancies (OR, 1.06, 1.00‐1.13, I2 0%), implying that the association was due to confounding.

Conclusion

The statistically significant association between C‐sections and ADHD in children can be partially explained by unmeasured confounding. Further research controlling for important confounders is required before firm conclusions can be drawn.
Survey of less Invasive Surfactant Administration in England, slow adoption and variable practice
Authors: Bhayat Sadaf , Kaur Avineet , Premadeva Irnthu , Reynolds Peter , Gowda Harsha
Published: August 2019

Aim

National survey to evaluate the uptake of Less Invasive Surfactant Administration (LISA) in neonatal units across England.

Methods

A web‐based survey was sent out by email to all 150 neonatal units in England. It consisted of questions regarding indications for LISA, the practicalities of the procedure and reasons for not using this technique.

Results

The response rate was 96% (144/150 units). Only 11% of units are using LISA, but majority (78%) would consider implementing LISA on their unit. 56% would also consider LISA on delivery suite. Challenges identified are having a guideline and staff training. 61% of units have set the target population ≥27 weeks. On sub‐analysis, for tertiary units, the trend for LISA is ≥26 weeks. The median FiO2 threshold for LISA is 0.3 (IQR 0.3‐0.4) in less than 28 weeks gestational age (GA), and 0.4 in higher gestations. The most common suggestion for premedication is fentanyl (32%).

Conclusion

The uptake of LISA in England is low comparing to the rest of Europe. Even though many units are considering implementing LISA, there is lack of training and national guidelines. There is urgent need for standardisation of practice and clear indications for LISA.
Is the use of metformin in patients undergoing dialysis hazardous for life? A systematic review of the safety of metformin in patients undergoing dialysis
Authors: Abdel Shaheed Christina , Carland Jane E. , Graham Garry G. , Stocker Sophie L. , Smith Greg , Hicks Mark , Williams Kenneth M. , Furlong Timothy , Macdonald Peter , Greenfield Jerry R. , Smith Felicity C. , Chowdhury Gina , Day Richard O.
Published: August 2019

Aims

Metformin may have clinical benefits in dialysis patients; however, its safety in this population is unknown. This systematic review evaluated the safety of metformin in dialysis patients.

Methods

MEDLINE, Embase, CENTRAL, PsycINFO and the Cochrane Library were searched for randomised controlled trials and observational studies evaluating metformin use in dialysis patients. Three authors reviewed the studies and extracted data. The primary outcomes were mortality, occurrence of lactic acidosis and myocardial infarction (MI) in patients taking metformin during dialysis treatment for ≥12 months (long term). Risk of bias was assessed using Risk Of Bias In Nonrandomised Studies of Interventions (ROBINS‐1). Overall quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results

Fifteen observational studies were eligible; 7 were prospective observational studies and 8 were case reports/case series. No randomised controlled trials were identified. The 7 prospective observational studies (n = 194) reported on cautious metformin use in patients undergoing maintenance dialysis. Only 3 provided long‐term follow‐up data. In 2 long‐term studies of metformin therapy (≤1000 mg/d) in patients undergoing peritoneal dialysis (PD), 1 reported 6 deaths (6/83; 7%) due to major cardiovascular events (3 MI) and the other reported no deaths (0/35). One long‐term study of metformin therapy (250 mg to 500 mg thrice weekly) in patients undergoing haemodialysis reported 4 deaths (4/61; 7%) due to major cardiovascular events (2 MI). These findings provide very low‐quality evidence as they come from small observational studies.

Conclusion

The evidence regarding the safety of metformin in people undergoing dialysis is inconclusive. Appropriately designed randomised controlled trials are needed to resolve this uncertainty.
Impact of a targeted monitoring on data‐quality and data‐management workload of randomized controlled trials: A prospective comparative study
Authors: Fougerou‐Leurent Claire , Laviolle Bruno , Tual Christelle , Visseiche Valérie , Veislinger Aurélie , Danjou Hélène , Martin Amélie , Turmel Valérie , Renault Alain , Bellissant Eric
Published: August 2019

Aims

Monitoring risk‐based approaches in clinical trials are encouraged by regulatory guidance. However, the impact of a targeted source data verification (SDV) on data‐management (DM) workload and on final data quality needs to be addressed.

Methods

MONITORING was a prospective study aiming at comparing full SDV (100% of data verified for all patients) and targeted SDV (only key data verified for all patients) followed by the same DM program (detecting missing data and checking consistency) on final data quality, global workload and staffing costs.

Results

In all, 137 008 data including 18 124 key data were collected for 126 patients from 6 clinical trials. Compared to the final database obtained using the full SDV monitoring process, the final database obtained using the targeted SDV monitoring process had a residual error rate of 1.47% (95% confidence interval, 1.41–1.53%) on overall data and 0.78% (95% confidence interval, 0.65–0.91%) on key data. There were nearly 4 times more queries per study with targeted SDV than with full SDV (mean ± standard deviation: 132 ± 101 vs 34 ± 26; P = .03). For a handling time of 15 minutes per query, the global workload of the targeted SDV monitoring strategy remained below that of the full SDV monitoring strategy. From 25 minutes per query it was above, increasing progressively to represent a 50% increase for 45 minutes per query.

Conclusion

Targeted SDV monitoring is accompanied by increased workload for DM, which allows to obtain a small proportion of remaining errors on key data (<1%), but may substantially increase trial costs.
A review of the prescribing trend of thiazide‐type and thiazide‐like diuretics in hypertension: A UK perspective
Authors: McNally Ryan J. , Morselli Franca , Farukh Bushra , Chowienczyk Philip J. , Faconti Luca
Published: August 2019

Thiazide diuretics have been the cornerstone of hypertension treatment for >5 decades. Most recent European and American guidelines recommend both thiazide‐type and thiazide‐like diuretics as first‐line drugs for all patients with hypertension. In contrast, diuretics are not regarded as first‐line treatment in the UK and in patients who are to be initiated on a diuretic treatment, thiazide‐like molecules, such as chlortalidone and indapamide are the preferred option. This review examines the prescribing trend of the 4 most commonly prescribed thiazide diuretics for the treatment of hypertension in the UK. Prescription cost analysis data were obtained for both 2010 and 2016/2017 for each region of the UK to analyse the impact of the 2011 National Institute for Health and Care Excellence hypertension guidelines on the trend in thiazide diuretic prescribing. Overall, the prescriptions of thiazide diuretics declined over the years. Bendroflumethiazide is the most commonly prescribed diuretic in the UK and despite some geographical differences, thiazide‐type diuretics are more widely used than thiazide‐like. The use of indapamide increased significantly between 2010 and 2016/2017 while chlortalidone was rarely employed. Of the many factors affecting trends in prescriptions, clinical inertia, treatment adherence, availability of the products and the lack of fixed dose combinations may play a role.
Immune‐mediated adverse reactions to vaccines
Authors: Stone Cosby A. , Rukasin Christine R.F. , Beachkofsky Thomas M. , Phillips Elizabeth J.
Published: August 2019

Vaccination continues to be the single most important and successful public health intervention, due to its prevention of morbidity and mortality from prevalent infectious diseases. Severe immunologically mediated reactions are rare and less common with the vaccine than the true infection. However, these events can cause public fearfulness and loss of confidence in the safety of vaccination. In this paper, we perform a systematic literature search and narrative review of immune‐mediated vaccine adverse events and their known and proposed mechanisms, and outline directions for future research. Improving our knowledge base of severe immunologically mediated vaccine reactions and their management drives better vaccine safety and efficacy outcomes.
Clinoforms as paleogeographic tools: Development of the Danube catchment above the deep Paratethyan basins in Central and Southeast Europe
Authors: Magyar Imre , Krezsek Csaba , Tari Gabor
Published: August 2019

The Miocene marine basins of Central and Southeast Europe, once comprising the Paratethys Sea, were gradually filled with sediments during the Neogene and turned to be the catchment area of the proto‐Danube and finally that of the modern Danube. Seismic data from various parts of the large Danube catchment area show that these several hundred meter deep basins were filled by lateral accretion of river‐transported sediments, appearing as shelf edge scale clinoform sets in seismic profiles. The direction of shelf edge progradation is NW to SE (N to S, W to E) in each basin, except for the Dacian basin where NE to SW direction prevails. The age of the clinoform sets is generally younging downstream: 19–18 Ma in the North Alpine Foreland basin, 14–13 Ma in the Vienna basin, 10–9 Ma in the Danube (Kisalföld) basin, 8.6–4 Ma in the Central Pannonian basin (Alföld), ?9–5 Ma in the Dacian basin, and 6–0 Ma in the Euxinian (Black Sea) basin. In spite of this geographical and temporal pattern, only the Danube (Kisalföld) and the western and central part of the Central Pannonian basin were filled by the proto‐Danube shelf accretion. Formation of the Danube, as a longitudinal river of the Alpine foreland that gradually elongated to the east and followed the retreating shoreline of the Paratethys, most probably took place at the beginning of the Late Miocene, ca. 11 Ma ago, thus the Early and Middle Miocene shelf advance in the North Alpine Foreland and Vienna basins, respectively, cannot be attributed to a „paleo‐Danube”. The clinoform systems of the Dacian basin are coeval with those of the upstream Central Pannonian basin, indicating that by the time the Danube sedimentary system reached the Dacian basin, it was already a shallow basin. The vast clinoforms of the northwestern Euxinian shelf also significantly overlap in age with the Pannonian basin ones; only the <4 Ma part of the shelf accretion can be attributed to the Danube sensu stricto.
Minibasin depocentre migration during diachronous salt welding, offshore Angola
Authors: Ge Zhiyuan , Gawthorpe Rob L. , Rotevatn Atle , Zijerveld Leo , A.‐L. Jackson Christopher , Oluboyo Ayodeji
Published: August 2019

Salt tectonics is an important part of the geological evolution of many continental margins, yet the four‐dimensional evolution of the minibasins, the fundamental building block of these and many other salt basins, remains poorly understood. Using high‐quality 3D seismic data from the Lower Congo Basin, offshore Angola we document the long‐term (>70 Myr) dynamics of minibasin subsidence. We show that, during the Albian, a broadly tabular layer of carbonate was deposited prior to substantial salt flow, diapirism, and minibasin formation. We identify four subsequent stages of salt‐tectonics and related minibasin evolution: (i) thin‐skinned extension (Cenomanian to Coniacian) driven by basinward tilting of the salt layer, resulting in the formation of low‐displacement normal faults and related salt rollers. During this stage, local salt welding led to the along‐strike migration of fault‐bound depocentres; (ii) salt welding below the eastern part of the minibasin (Santonian to Paleocene), causing a westward shift in depocentre location; (iii) welding below the minibasin centre (Eocene to Oligocene), resulting in the formation of a turtle and an abrupt shift of depocentres towards the flanks of the bounding salt walls; and (iv) an eastward shift in depocentre location due to regional tilting, contraction, and diapir squeezing (Miocene to Holocene). Our study shows that salt welding and subsequent contraction are key controls on minibasin geometry, subsidence and stratigraphic patterns. In particular, we show how salt welding is a protracted process, spanning > 70 Myr of the salt‐tectonic history of this, and likely other salt‐rich basins. The progressive migration of minibasin depocentres, and the associated stratigraphic architecture, record weld dynamics. Our study has implications for the tectono‐stratigraphic evolution of minibasins.
Comparative assessment of anterior maxillary alveolar ridge preservation with and without adjunctive use of enamel matrix derivative: A randomized clinical trial
Authors: Lee Jae‐Hong , Kim Do‐Hyung , Jeong Seong‐Nyum
Published: August 2019

Objectives

The aim of this randomized, controlled, parallel‐arm study was to evaluate the (a) radiographic bone dimensional changes, (b) postoperative discomfort, and (c) early soft tissue wound healing outcomes, following extraction of maxillary anterior teeth (central and lateral incisors) and treatment with alveolar ridge preservation (ARP) with and without the adjunctive use of enamel matrix derivative (EMD).

Methods

Thirty extraction sockets were randomly assigned to two groups: deproteinized bovine bone mineral with 10% collagen covered with collagen membrane with the adjunctive use of EMD (test group) and without EMD (control group). Bone dimensional changes were measured using cone beam computed tomography at 3 and 5 months after ARP. The severity and duration of pain and swelling were evaluated using self‐reported questionnaires, and soft tissue wound healing outcomes were assessed clinically. Chi‐square tests and t tests were conducted to compare differences between the two groups.

Results

Radiographic and clinical analyses showed no significant differences in horizontal and vertical bone dimensional changes and soft tissue wound healing outcomes (including spontaneous bleeding, persistent swelling, and ulceration) between the two groups. There were no significant differences in the severity of pain and swelling between the two groups, but the durations of pain (difference [df] = 1.20, 95% CI = 0.33–2.06; p = .008) and swelling (df = 1.06, 95% CI = 0.11–2.01; p = .029) were significantly reduced in the test group.

Conclusion

Alveolar ridge preservation with the adjunctive use of EMD reduced the durations of postoperative pain and swelling following maxillary anterior teeth extraction.
Metabolomics analysis reveals perturbations of cerebrocortical metabolic pathways in the Pahenu2 mouse model of phenylketonuria
Authors: Lu Li‐Hua , Xia Zheng‐Xiang , Guo Jia‐Lin , Xiao Ling‐Ling , Zhang Yong‐Jun
Published: August 2019

Aims

Phenylketonuria (PKU), which is caused by mutations in the phenylalanine hydroxylase (PAH) gene, is one of the most common inherited diseases of amino acid metabolism. Phenylketonuria is characterized by an abnormal accumulation of phenylalanine and its metabolites in body fluids and brain tissues, subsequently leading to severe brain dysfunction. Various pathophysiological and molecular mechanisms underlying brain dysfunction in PKU have been described. However, the metabolic changes and their impacts on the function of cerebral cortices of patients with PKU remain largely unknown.

Methods

We measured the levels of small molecule metabolites in the cerebrocortical tissues of PKU mice and wild‐type control mice using liquid chromatography‐mass spectrometry (LC‐MS)‐based metabolome analysis. Differential metabolites were further subjected to metabolic pathway and enrichment analysis.

Results

Metabolome analysis revealed 35 compounds among 143 detected metabolites were significantly changed in PKU mice as compared to those in their wild‐type littermates. Metabolic pathway and enrichment analysis of these differential metabolites showed that multiple metabolic pathways, including phenylalanine, tyrosine, and tryptophan biosynthesis; valine, leucine, and isoleucine biosynthesis; alanine, aspartate, and glutamate metabolism; purine metabolism; arginine and proline metabolism and methionine metabolism, were impacted in the cerebral cortices of PKU mice.

Conclusions

The data revealed that multiple metabolic pathways in cerebral cortices of PKU mice were disturbed, suggesting that the disturbances of the metabolic pathways might contribute to neurological or neurodevelopmental dysfunction in PKU, which could thus provide new insights into brain pathogenic mechanisms in PKU as well as mechanistic insights for better understanding the complexity of the metabolic mechanisms of the brain dysfunction in PKU.
Evaluation of subvalvular pannus formation in mechanical aortic valve by transesophageal echocardiography
Authors: Karaduman Ahmet , Balaban İsmail , Keskin Berhan , Kalkan Semih , Keten Mustafa Ferhat , Kafkas Çağrı , Ayturk Mehmet , Kahveci Gökhan
Published: August 2019

Subvalvular pannus formation is a rare but clinically important complication with prosthetic valves. Transthoracic echocardiography still plays a role in the initial assessment of mechanical aortic valve dysfunction. But evaluation with transesophageal echocardiography is more useful. Subvalvular area may be a blind spot of echocardiography due to acoustic shadowing. The case presented herein underlines the significant role of transgastric plane and three‐dimensional TEE in the assessment of subvalvular pannus formation in mechanical aortic valves.
Right aortic arch with mirror image branching accompanied by absent pulmonary valve syndrome and tricuspid stenosis: Prenatal echocardiographic diagnosis of an unusual congenital heart defect
Authors: Yang Zexuan , Zhou Liuying
Published: August 2019

Right aortic arch (RAA) with mirror image branching (RAMI) accompanied by absent pulmonary valve syndrome (APVS), tricuspid stenosis, and hypoplastic right ventricle is an extremely rare combination of congenital heart anomalies. This combination might result in severe cardiac failure and respiratory compromise, indicating a poor prognosis. Here, we describe a detailed prenatal echocardiographic diagnosis of RAMI accompanied by APVS and tricuspid stenosis. These anomalies were further confirmed by autopsy. This case could be helpful in improving our understanding of this abnormal combination and the development of an early therapeutic strategy.
Immediate post‐operative rehabilitation after decoronation. A systematic review
Authors: Einy Shmuel , Kridin Khalaf , Kaufman Arieh Y. , Cohenca Nestor
Published: August 2019

Background/Aims

Decoronation is currently considered the best treatment option for ankylosed teeth and discrepancies in the alveolar bone, particularly in childhood and adolescence. The loss of a front tooth creates aesthetic, functional, and psychological distress in patients and their parents. The aim of this study was to analyze the types of restorations provided after decoronation, their suitability, durability, and follow up until insertion of the final restoration.

Materials and methods

A literature review was conducted using Ovid MEDLINE, Embase, and Web of Science to identify eligible articles. English language publications until August 9, 2018, were searched independently and cross‐checked by two researchers online, in print, and in press.

Results

Of 618 articles screened, 10 included reports on 11 patients with detailed descriptions of 13 provisional restorations. Patients' ages at the time of decoronation were 8‐15 years. Seven underwent avulsion and four intrusion. Removable partial denture (nine cases) was the most common restoration. In two cases, the restoration was provisional with a lingual bar with prosthetic crown and in two other cases with an adhesive bridge. Follow up ranged from 3 months to 5 years in nine patients. Two cases were followed until the permanent restoration was placed.

Conclusions

The importance of long‐term provisional restorations was disregarded by most authors. A multidisciplinary approach should take into consideration immediate‐, mid‐, and long‐term rehabilitation of the decoronated tooth.
Single housing‐induced effects on cognitive impairment and depression‐like behavior in male and female mice involve neuroplasticity‐related signaling
Authors: Liu Na , Wang Yulu , An Aerin Y. , Banker Christopher , Qian Yi‐Hua , O'Donnell James M.
Published: August 2019

Single‐housed stress elicits a range of social isolation‐related behavioral and neurobiological abnormalities. To investigate single housing‐induced behavioral changes and sex differences on stress outcomes, we examined single‐housed stress‐induced learning and memory impairment, depression‐like behaviors, neuroplasticity abnormalities and underlying mechanism. The results showed that male and female mice socially isolated for 8 weeks had significantly decreased memory acquisition, as demonstrated in the learning curve of the Morris water maze task. Memory consolidation and retrieval were also decreased in both the single‐housed male and female mice. These findings were corroborated further by the two classical animal models, Y‐maze and novel object recognition tests, as demonstrated by reduced spontaneous alternation and recognition index in both sexes of single‐housed mice. Subsequent studies suggested that single‐housed male mice exhibited increased immobility time in both the forced swim and tail suspension tests, while the female mice only exhibited increased immobility time in the tail suspension test. Moreover, single‐housed stress significantly decreased the apical and basal branch points, dendritic length, and spine density in the CA1 of hippocampal neurons in both male and female mice. These effects were consistent with decreased neuroplasticity and neuroprotective‐related molecules such as synaptophysin, PSD95, PKA, pCREB and BDNF expression. These findings suggest that loss of neuronal remodeling and neuroprotective mechanisms due to single housing are involved in behavioral changes in both male and female mice. The results provide further evidence that neuroplasticity‐related signaling plays a crucial role in isolation‐induced effects on neuropsychiatric behavioral deficits in both sexes.
When can we trust responders? Serious concerns when using 50% response rate to assess clinical trials
Authors: Karoly Philippa J. , Romero Juan , Cook Mark J. , Freestone Dean R. , Goldenholz Daniel M.
Published: August 2019

Individual seizure rates are highly volatile, with large fluctuations from month‐to‐month. Nevertheless, changes in individual mean seizure rates are used to measure whether or not trial participants successfully respond to treatment. This study aims to quantify the challenges in identifying individual treatment responders in epilepsy. A power calculation was performed to determine the trial duration required to detect a significant 50% decrease in seizure rates (P < .05) for individuals. Seizure rate simulations were also performed to determine the number of people who would appear to be 50% responders by chance. Seizure rate statistics were derived from long‐term seizure counts recorded during a previous clinical trial for an implantable seizure monitoring device. We showed that individual variance in monthly seizure rates can lead to an unacceptably high false‐positive rate in the detection of individual treatment responders. This error rate cannot be reduced by increasing the trial population; however, it can be reduced by increasing the duration of clinical trials. This finding suggests that some drugs may be incorrectly evaluated as effective; or, conversely, that helpful drugs could be rejected based on 50% response rates. It is important to pursue more nuanced approaches to measuring individual treatment response, which consider the patient‐specific distributions of seizure rates.
A novel taxon selection method, aimed at minimizing recombination, clarifies the discovery of a new sub‐population of Helicobacter pylori from Australia
Authors: Lamichhane Binit , Wise Michael J. , Chua Eng Guan , Marshall Barry J. , Tay Chin Yen
Published: August 2019

We present a novel method for taxon selection, the aim being to minimize problems arising from highly recombinant species such as Helicobacter pylori. Helicobacter pylori has accompanied modern‐human migration out of Africa and is marked by a phylogeographic strain distribution, which has been exploited to add an extra layer of information about human migrations to that obtained from human sources. However, H. pylori's genome has high sequence heterogeneity combined with a very high rate of recombination, causing major allelic diversification across strains. On the other hand, recombination events that have become preserved in sub‐populations are a useful source of phylogenetic information. This creates a potential problem in selecting representative strains for particular genetic or phylogeographic clusters and generally ameliorating the impact on analyses of extensive low‐level recombination. To address this issue, we perform multiple population structure‐based analyses on core genomes to select exemplar strains, called ‘quintessents’, which exhibit limited recombination. In essence, quintessent strains are representative of their specific phylogenetic clades and can be used to refine the current MLST concatenation‐based population structure classification system. The use of quintessents reduces the noise due to local recombination events, while preserving recombination events that have become fixed in sub‐populations. We illustrate the method with an analysis of core genome concatenations from 185 H. pylori strains, which reveals a recent speciation event resulting from the recombination of strains from phylogeographic clade hpSahul, carried by Aboriginal Australians, and hpEurope, carried by some of the people who arrived in Australia over the past 200 years. The signal is much clearer when based on quintessent strains, but absent from the analysis based on MLST concatenations.
Real‐time telehealth using ultrasonography is feasible in equine practice
Authors: Navas de Solis C. , Bevevino K. , Doering A. , O'Gan D. , Teller L. , Underwood C.
Published: August 2019

Telehealth allows health care professionals to evaluate patients in remote locations using telecommunications technology. This manuscript presents a pilot experience with the goal of testing the feasibility and exploring the benefits for patients and veterinarians, technological challenges and perceived value of telehealth in ultrasound. In phase 1, experienced equine private practitioners and a sonographer performed diagnostic ultrasound examinations in collaboration using telecommunications technology. In phase 2, horses underwent two consecutive ultrasound examinations. One examination was performed by an inexperienced sonographer assisted by a remote expert, and all horses were then scanned by an expert sonographer on‐site. Information about each interaction was collected, and a questionnaire was used at the end of the project to summarise practitioners’ and trainees’ experiences and perceptions. Thirty‐six cases were evaluated using telecommunications technology. There were technological problems that were minor in 11 occasions, and in one case, the remote assistance had to be cancelled. Sonograms were longer when performed by an inexperienced sonographer aided remotely (40 ± 19, [9–73] min) than when performed by a sonographer (24 ± 12, [4–43 min], P = 0.02). Telehealth for ultrasound was feasible, and technological challenges could be solved. Telehealth for ultrasound was well received by private practitioners, house officers and sonography experts. The perceived benefits were the addition of clinically useful information, reassurance to practitioners and horse owners and education for practitioners. The results of this study support generating the hypothesis that telehealth could in the future increase the quality of equine medicine, and prospective studies are needed to confirm this. Rigorous care will be needed to ensure that implementation of telehealth technology prioritises equine health and the veterinary profession.
Refugia under threat: Mass bleaching of coral assemblages in high‐latitude eastern Australia
Authors: Kim Sun W. , Sampayo Eugenia M. , Sommer Brigitte , Sims Carrie A. , Gómez‐Cabrera Maria del C. , Dalton Steve J. , Beger Maria , Malcolm Hamish A. , Ferrari Renata , Fraser Nicola , Figueira Will F. , Smith Stephen D. A. , Heron Scott F. , Baird Andrew H. , Byrne Maria , Eakin C. Mark , Edgar Robert , Hughes Terry P. , Kyriacou Nicole , Liu Gang , Matis Paloma A. , Skirving William J. , Pandolfi John M.
Published: August 2019

Environmental anomalies that trigger adverse physiological responses and mortality are occurring with increasing frequency due to climate change. At species' range peripheries, environmental anomalies are particularly concerning because species often exist at their environmental tolerance limits and may not be able to migrate to escape unfavourable conditions. Here, we investigated the bleaching response and mortality of 14 coral genera across high‐latitude eastern Australia during a global heat stress event in 2016. We evaluated whether the severity of assemblage‐scale and genus‐level bleaching responses was associated with cumulative heat stress and/or local environmental history, including long‐term mean temperatures during the hottest month of each year (SSTLTMAX), and annual fluctuations in water temperature (SSTVAR) and solar irradiance (PARZVAR). The most severely‐bleached genera included species that were either endemic to the region (Pocillopora aliciae) or rare in the tropics (e.g. Porites heronensis). Pocillopora spp., in particular, showed high rates of immediate mortality. Bleaching severity of Pocillopora was high where SSTLTMAX was low or PARZVAR was high, whereas bleaching severity of Porites was directly associated with cumulative heat stress. While many tropical Acropora species are extremely vulnerable to bleaching, the Acropora species common at high latitudes, such as A. glauca and A. solitaryensis, showed little incidence of bleaching and immediate mortality. Two other regionally‐abundant genera, Goniastrea and Turbinaria, were also largely unaffected by the thermal anomaly. The severity of assemblage‐scale bleaching responses was poorly explained by the environmental parameters we examined. Instead, the severity of assemblage‐scale bleaching was associated with local differences in species abundance and taxon‐specific bleaching responses. The marked taxonomic disparity in bleaching severity, coupled with high mortality of high‐latitude endemics, point to climate‐driven simplification of assemblage structures and progressive homogenisation of reef functions at these high‐latitude locations.
The responses of soil organic carbon mineralization and microbial communities to fresh and aged biochar soil amendments
Authors: Liu Zhiwei , Zhu Mengtao , Wang Jiameng , Liu Xiuxia , Guo Wenjie , Zheng Jufeng , Bian Rongjun , Wang Genmei , Zhang Xuhui , Cheng Kun , Liu Xiaoyu , Li Lianqing , Pan Genxing
Published: August 2019

While biochar soil amendment has been widely proposed as a soil organic carbon (SOC) sequestration strategy to mitigate detrimental climate changes in global agriculture, the SOC sequestration was still not clearly understood for the different effects of fresh and aged biochar on SOC mineralization. In the present study of a two‐factorial experiment, topsoil samples from a rice paddy were laboratory‐incubated with and without fresh or aged biochar pyrolyzed of wheat residue and with and without crop residue‐derived dissolved organic matter (CRM) for monitoring soil organic matter decomposition under controlled conditions. The six treatments included soil with no biochar, with fresh biochar and with aged biochar treated with CRM, respectively. For fresh biochar treatment, the topsoil of a same rice paddy was amended with wheat biochar directly from a pyrolysis wheat straw, the soil with aged biochar was collected from the same soil 6 years following a single amendment of same biochar. Total CO2 emission from the soil was monitored over a 64 day time span of laboratory incubation, while microbial biomass carbon and phospholipid fatty acid (PLFA) were determined at the end of incubation period. Without CRM, total organic carbon mineralization was significantly decreased by 38.8% with aged biochar but increased by 28.9% with fresh biochar, compared to no biochar. With CRM, however, the significantly highest net carbon mineralization occurred in the soil without biochar compared to the biochar‐amended soil. Compared to aged biochar, fresh biochar addition significantly increased the total PLFA concentration by 20.3%–33.8% and altered the microbial community structure by increasing 17:1ω8c (Gram‐negative bacteria) and i17:0 (Gram‐positive bacteria) mole percentages and by decreasing the ratio of fungi/bacteria. Furthermore, biochar amendment significantly lowered the metabolic quotient of SOC decomposition, thereby becoming greater with aged biochar than with fresh biochar. The finding here suggests that biochar amendment could improve carbon utilization efficiency by soil microbial community and SOC sequestration potential in paddy soil can be enhanced by the presence of biochar in soil over the long run.