bluuebunny/crossref_metadata_2025 huggingface dataset:
How to Advance Social Rights without Jeopardising the Human Rights Act 1998
Authors: Hunt Paul
Published: May 2019

When the 1948 Universal Declaration of Human Rights (UDHR) was drafted, governments grasped that human rights are needed as safeguards, not only against authoritarianism but also against the causes of authoritarianism. For this reason, the UDHR encompasses civil, political, economic, social and cultural rights. This holistic vision of human rights was obscured during the Cold War and more recently by economic neo‐liberalism. The UK government neglects social rights, which have a very low public profile, although there is evidence that the profile of these human rights is increasing. UK domestic law and practice is inconsistent with the holistic vision of human rights and the government's binding international social rights obligations. The UN Special Rapporteur on extreme poverty and human rights recommends that the UK provides for ‘the legislative recognition of social rights’ which can be approached in various ways. One way is to proceed social right by social right (for example, the rights to housing, health and education), and sector by sector (for example, the sectors of housing, health and education). This administrative law approach advances explicit social rights without implicating or jeopardising the Human Rights Act 1998.
The Political Economy of Facebook Advertising: Election Spending, Regulation and Targeting Online
Authors: Dommett Katharine , Power Sam
Published: May 2019

Political advertising on Facebook is the latest in a long line of developments in campaign practice, and is a tool that has been mobilised extensively in elections around the world. In this article, we explore what we know about Facebook advertising at elections and ask what existing data from the UK Electoral Commission can reveal about current usage. Highlighting the principles behind Facebook advertising, we argue that existing metrics offer little insight into current campaign trends—posing analytical, methodological and normative challenges for academics and electoral regulators alike. Moreover, we argue that these challenges strike at the heart of debates about democratic responsibility and the degree to which governments should cede responsibility to commercial actors who may have differing understandings of fundamental democratic norms.
Impact of haemostatic sealant versus electrocoagulation on ovarian reserve after laparoscopic ovarian cystectomy of ovarian endometriomas: a randomised controlled trial
Authors: Chung JPW , Law TSM , Chung CHS , Mak JSM , Sahota DS , Li TC
Published: May 2019

Objective

To evaluate the effect of haemostatic sealant compared with bipolar coagulation on ovarian reserve after laparoscopic cystectomy for ovarian endometriomas.

Design

Patient‐blinded, randomised controlled trial.

Setting

University‐affiliated tertiary hospital.

Population

Women aged 18–40 years with 3–8 cm unilateral or bilateral endometriomas.

Methods

Ninety‐four patients were randomised to receive haemostasis by the application of haemostatic sealant (n = 47) or standard care (n = 47).

Main outcome measures

Primary outcome was the effect on the antral follicular count 3 months after the operation as it captures the effect on the ovary subjected to treatment. Secondary outcomes included the change in anti‐Mullerian hormone, follicular‐stimulating hormone and peri‐operative outcomes including haemostasis, complications, pain, and satisfaction scores.

Results

A total of 94 patients aged 32.36 ± 4.92 years underwent laparoscopic cystectomy for ovarian endometriomas. The average diameter of the endometrioma was 4.21 ± 1.38 cm. The increase in antral follicle count of the affected ovaries at 3 months in the intervention group (+2.36 ± 0.37) was significantly (P = 0.013) higher than that in the control group (+1.08 ± 0.36). Repeated measures analysis of variance revealed significant effect with time (P < 0.001) and of interaction of group × time (P = 0.029) for affected ovary antral follicle count. No significant difference was noted between the two groups with regard to follicular‐stimulating hormone, anti‐Mullerian hormone, and other secondary outcomes.

Conclusions

Applying haemostatic sealant after laparoscopic cystectomy of ovarian endometriomas produced a greater increase in antral follicle count 3 months after surgery compared with the control group.

Tweetable abstract

RCT: Haemostatic sealant in laparoscopic cystectomy of endometriomas increase in the antral follicle count after surgery.
Association of Medicare's Bundled Payments for Care Improvement initiative with patient‐reported outcomes
Authors: Trombley Matthew J. , McClellan Sean R. , Kahvecioglu Daver C. , Gu Qian , Hassol Andrea , Creel Alisha H. , Joy Susan M. , Waldersen Brian W. , Ogbue Christine
Published: May 2019

Objective

To determine whether the Bundled Payments for Care Improvement (BPCI) initiative affected patient‐reported measures of quality.

Data Sources

Surveys of Medicare fee‐for‐service beneficiaries discharged from acute care hospitals participating in BPCI Model 2 and comparison hospitals between October 2014 and June 2017. Variables from Medicare administrative data and the Provider of Services file were used for sampling and risk adjustment.

Study Design

We estimated risk‐adjusted differences in patient‐reported measures of care experience and changes in functional status, for beneficiaries treated by BPCI and comparison hospitals.

Data Collection

We selected a stratified random sample of BPCI and matched comparison beneficiaries. We fielded nine waves of surveys using a mail and phone protocol, yielding 29 193 BPCI and 29 913 comparison respondents.

Principal Findings

Most BPCI and comparison survey respondents reported a positive care experience and high satisfaction. BPCI respondents were slightly less likely than comparison respondents to report positive care experience or high satisfaction. Despite these differences in care experience, there was no difference between BPCI and comparison respondents in self‐reported functional status approximately 90 days after hospital discharge.

Conclusions

These findings reduce concerns that BPCI may have unintentionally harmed patient health but suggest room for improvement in patient care experience.
The Influences of Foreclosure Factors on the Value, Yield, Duration and Convexity of a Mortgage
Authors: Chiang Shu Ling , Tsai Ming Shann , Jiang Shan
Published: May 2019

This article presents a theoretical model that considers the influence of foreclosure factors, including foreclosure lag, foreclosure costs and the ratio of the auction price to the unpaid balance of a mortgage (APUPB ratio), on that mortgage's value, yield, duration and convexity. We used data obtained by the Federal Housing Administration (FHA) to perform the numerical analyses. The results indicate that the average default period and the average foreclosure lag are 2.5 years and 1.9 years, respectively. For each percentage increase in the APUPB ratio, the foreclosure lag decreases by about 4.6 days as we specify a linear relationship between the foreclosure lag and APUPB. The lender's opportunity cost is greater than the foreclosure settlement costs, and the total foreclosure costs are 25% of the house's auction price. Moreover, the foreclosure lag, foreclosure costs and the discounted auction price (i.e., 1‐ APUPB ratio) are negatively correlated with the mortgage's value, duration and convexity, but they are positively correlated with the yield. In addition, a change in the default probability has the greatest influence on mortgage's convexity and the next greatest on the yield. Our study provides a useful tool for portfolio managers and lenders to more appropriately measure the yield, duration and convexity of a mortgage.
Principles of Hyperspectral Microscope Imaging Techniques and Their Applications in Food Quality and Safety Detection: A Review
Authors: Pu Hongbin , Lin Lian , Sun Da‐Wen
Published: May 2019

Hyperspectral imaging (HSI) techniques play an important role in the food industry for providing rapid, nondestructive, and chemical‐free detection method, whereas a microscope can provide detailed information about the microstructure of a food item. As an emerging imaging spectroscopy technique, hyperspectral microscope imaging (HMI) technique combines the advantages of HSI with microscopic imaging and has been gradually applied in the food industry. This review introduces the principles of different kinds of HMI techniques, such as fluorescence HMI, visible/near‐infrared HMI, Raman HMI, and infrared HMI. Moreover, detailed applications of HMI techniques are summarized, including evaluation of structures of nutrients, and detection of microorganisms and residues. On the other hand, some challenges and future trends in the applications of these techniques are also discussed. It is concluded that by integrating HSI with microscopy, HMI can not only provide both spectral and spatial information about food substances but also provide their chemical information at the molecular or cellular level. Therefore, HMI techniques have great potentials in nondestructive evaluation of structures of nutrients, and detection of microorganisms and residues for the food industry.
Solid Self‐Emulsifying Delivery System (S‐SEDS) of Dihydromyricetin: A New Way for Preparing Functional Food
Authors: Wang Dantong , Ma Yudi , Wang Qiang , Huang Juan , Sun Rui , Xia Qiang
Published: May 2019

The present study was aimed at formulating and evaluating a novel solid self‐emulsifying delivery system (S‐SEDS) for the application in functional foods of dihydromyricetin (DMY). First, solubility study and pseudo‐ternary phase diagram analysis were adopted to optimize the formulation of liquid self‐emulsifying delivery system (L‐SEDS). And the thermodynamic stable L‐SEDS with 5% content of DMY was fabricated and further developed into a solid form via vacuum rotary evaporation with Aerosil 300 as the solid adsorbent. Solid state characterization of the S‐SEDS was performed by scanning electron microscopy, Fourier‐transform infrared spectroscopy, and X‐ray powder diffraction. Furthermore, studies proved that the antioxidant activity and bioaccessibility of DMY were improved after incorporated into S‐SEDS formulation compared to pure DMY. The S‐SEDS showed good resistance against various storage conditions investigated for 10 weeks.

Practical Application

Solid self‐emulsifying delivery system (S‐SEDS) combined the advantages of liquid self‐emulsifying delivery system with those of a solid dosage form to overcome the disadvantages associated with liquid formulations is more convenient for storage and transportation in practical application. Furthermore, the technology of producing S‐SEDS is simple and can be realized in industrial production. Hence, S‐SEDS could be a promising strategy to overcome the poor water solubility and short biological half‐life of dihydromyricetin for further application in functional foods and beverage industry.
Composite Gels Containing Whey Protein Fibrils and Bacterial Cellulose Microfibrils
Authors: Peng Jinfeng , Calabrese Vincenzo , Geurtz Julia , Velikov Krassimir P. , Venema Paul , van der Linden Erik
Published: May 2019

In this study, we investigated the gelation of WPI fibrils in the presence of bacterial cellulose (BC) microfibrils at pH 2 upon prolonged heating. Rheology and microstructure were investigated as a function of BC microfibril concentration. The presence of BC microfibrils did not influence the gelation dynamics and resulting overall structure of the WPI fibrillar gel. The storage modulus and loss modulus of the mixed WPI‐BC microfibril gels increased with increasing BC microfibril concentration, whereas the ratio between loss modulus and storage modulus remained constant. The WPI fibrils and BC microfibrils independently form two coexisting gel networks. Interestingly, near to the BC microfibrils more aligned WPI fibrils seemed to be formed, with individual WPI fibrils clearly distinguishable. The level of alignment of the WPI fibrils seemed to be dependent on the distance between BC microfibrils and WPI fibrils. This also is in line with our observation that with more BC microfibrils present, WPI fibrils are more aligned than in a WPI fibrillar gel without BC microfibrils. The large deformation response of the gels at different BC microfibril concentration and NaCl concentration is mainly influenced by the concentration of NaCl, which affects the WPI fibrillar gel structures, changing form linear fibrillar to a particulate gel. The WPI fibrillar gel yields the dominant contribution to the gel strength.
RH‐Temperature Stability Diagram of the Dihydrate, β‐Anhydrate, and α‐Anhydrate Forms of Crystalline Trehalose
Authors: Allan Matthew , Chamberlain Mary Claire , Mauer Lisa J.
Published: May 2019

Trehalose crystals exhibit polymorphic, deliquescent, and hydrate‐forming traits and can exist in dihydrate, β‐anhydrate, or α‐anhydrate (isomorphic desolvate) forms. The objective of this study was to identify the relative humidity (RH) and temperature boundaries for phase changes of these different trehalose crystal forms. The deliquescence points (RH0s) of the anhydrate and dihydrate trehalose crystals were determined from 20 to 50 °C using a combination of water activity and dynamic vapor sorption measurement techniques. Increasing temperatures from 20 to 50 °C resulted in decreases in RH0 from 95.5% to 90.9% RH for the dihydrate and 69.9% to 62.0% RH for the β‐anhydrate. The effects of temperature on the anhydrate–hydrate RH boundaries were also determined, using a combination of equilibration in controlled water activity solutions, powder X‐ray diffraction, and Fourier‐transform infrared spectroscopy techniques. Increasing temperatures resulted in increases in the anhydrate–hydrate RH boundaries. The irreversible β‐anhydrate to dihydrate boundary increased from 44.9% to 57.8% RH, and the reversible α‐anhydrate to dihydrate boundary increased from 10% to 25% RH, as temperature increased from 20 to 50 °C. This is the first report of an RH–temperautre stability map for crystalline trehalose.

Practical Application

The manuscript addresses the issue of the physical stability and phase transformations of crystalline trehalose stored in different temperature and relative humidity environments. Unwanted hydrate formation or dehydration of crystal hydrates can lead to other undesirable water–solid interactions and/or physical modifications that have the potential to influence product quality and delivery traits. Therefore, this study identified relative humidity and temperature stability boundaries of the different trehalose crystal forms, using a variety of established and novel techniques to create a relative humidity–temperature stability map of crystalline trehalose from 20 to 50 °C.
Electronic Tongue and Consumer Sensory Evaluation of Spicy Paneer Cheese
Authors: Schlossareck Courtney , Ross Carolyn F.
Published: May 2019

Evaluating sensory properties of spicy foods can be challenging due to how quickly individuals experience fatigue. Analytical methods, such as HPLC quantification of capsaicin, are accurate. However, they may not always be interchangeable with perception of spiciness by consumers. The electronic tongue (e‐tongue) offers a unique opportunity to simulate human perception of capsaicin pungency with an analytical method. This study evaluated consumer's and the e‐tongue ability to discriminate among paneer cheese samples containing different levels of capsaicin (1.875, 3.75, 7.5, 15, and 30 ppm). Over 2 days, using a blocked design to minimize fatigue, consumers (n = 110) evaluated samples using a difference from control sensory test. Consumers distinguished the spicy paneer sample from the control (0 ppm) at 3.75, 7.5, 15, and 30 ppm (P < 0.05). Differences were found among sample 3.75, 7.5, and 15 ppm (P < 0.05). However, no significant differences were found between control and 1.875 ppm or between samples 15 and 30 ppm. Although these high and low concentrations were challenging for consumers, the e‐tongue resulted in a high degree of discrimination of 93% among all samples. On the principal component analysis plot created by the e‐tongue, PC1 explained 85.6% of the variability and was associated with spicy, sweet, salty, sour, and umami sensors. PC2 explained 7.96% and was associated with the bitter and metallic sensors. The 3.75 and 15 ppm samples were defined by PC1, while PC2 defined samples 1.875 and 30 ppm. These results conclude that the e‐tongue may be useful in qualitative discrimination among spicy paneer along with sensory evaluation.

Practical Application

As the market for spicy foods continues to grow, methods for rapid, accurate analysis of the sensory qualities of the food products is needed. As the electronic tongue discriminated effectively among spicy paneer cheese samples, the method could be used alongside sensory testing to evaluate spicy food samples without encountering the typical issues of fatigue common with evaluating spicy foods.
Needle tip tracking for ultrasound‐guided peripheral nerve block procedures—An observer blinded, randomised, controlled, crossover study on a phantom model
Authors: Kåsine Trine , Romundstad Luis , Rosseland Leiv Arne , Ullensvang Kyrre , Fagerland Morten Wang , Hol Per Kristian , Kessler Paul , Sauter Axel Rudolf
Published: May 2019

Background

The Onvision needle tip tracking (NTT) is a new technology consisting of a needle with an ultrasound sensor close to the needle tip and a console for computerised signal processing. The aim of the study was to evaluate NTT technology during ultrasound‐guided simulated peripheral nerve block procedures in a porcine phantom model.

Methods

Forty anaesthesiologists performed in‐plane and out‐of‐plane simulated nerve blocks with and without NTT guidance. The primary outcome measure was procedure time. Secondary outcomes were hand movements and the path length travelled by the hands measured by motion analysis, precision of the needle tip related to the target structure, success rates and violations of the target structure, and the participants confidence whether their procedure would be successful or not.

Results

Procedure time was reduced from 66.7 (SD = 47.5) seconds to 43.8 (SD = 29.2) seconds when NTT was used for out‐of‐plane procedures (P = 0.002). The number of movements of the needle hand was 13.9 (SD = 30.2) with NTT and 24.8 (SD = 30.0) without NTT (P = 0.019). No significant differences were registered during the performance of in‐plane procedures. The participants confidence in a presumed block success was increased with both in‐plane procedures (8.50 (SD = 1.18) with NTT vs 7.65 (SD = 1.96), P = 0.004) and out‐of‐plane procedures (8.50 (SD = 1.09) vs 7.10 (SD = 1.89), P = 0.0001).

Conclusions

The new NTT technology significantly reduced the procedure time and the number of hand movements for ultrasound‐guided out‐of‐plane PNB procedures. No significant differences were found for the in‐plane procedures.
Estimating the rank of a beta matrix: a GMM approach1
Authors: Ren Yu , Wang Qin
Published: May 2019

A full‐rank beta matrix is a necessary condition for correctly estimating the risk premia in linear asset pricing models. However, the true values of betas are unobserved in practice and must be estimated. In this paper, we propose a straightforward testing method based on the generalised method of moments to assess whether the beta matrix is of full rank. We show that our method has desirable finite sample properties and performs better than available alternatives. We apply our method to several popular factor models and find that most models have rank deficiency in several datasets.
Making measurement‐based care for addictions a reality in primary care
Authors: Bradley Katharine A. , Caldeiro Ryan M. , Hallgren Kevin A. , Kivlahan Daniel R.
Published: May 2019

Commentary to: Measurement-based care using DSM-5 for opioid use disorder: can we make opioid medication treatment more effective?
Predictors of Substance Use Latent Classes Among American Indian Youth Attending Schools On or Near Reservations
Authors: Swaim Randall C. , Stanley Linda R.
Published: May 2019

Background and Objectives

Identical latent classes of substance use for 7 to 8 grade and 9 to 12 grade American Indian (AI) youth living on or near reservations suggest that patterns of substance use are established early among these youth. This study examines relationships of substance‐related factors to latent class membership and whether these relationships differ by grade group.

Methods

In‐school surveys were administered to 1503 7 to 8 grade and 1995 9 to 12 grade students from 46 schools on or near reservations during the 2009/2010 to 2012/2013 school years. Four‐class latent class models of substance use were specified and five classes of substance‐related factors (peers, substance availability, perceived harm, family, early initiation), plus grade level and gender, were evaluated as predictors.

Results

For 7 to 8 grade students, substance‐related factors differentiated nonusers from users, while for 9 to 12 graders, these factors also differentiated types of users. Early initiation and peer factors were strongly related to class membership, while other factors were less strongly related.

Discussion and Conclusions

Early initiation of alcohol or marijuana is strongly related to being in a substance‐using class for AI youth. Because these youth tend to initiate use earlier that other US youth, prevention resources should be targeted to reaching them and their families before age 12.

Scientific Significance

Predictors of latent classes of substance use were identified for reservation‐based AI youth. While the classes were identical for 7 to 8 grade and 9 to 12 grade youth, predictors varied across grade group, which may inform how best to develop prevention efforts unique to middle and high school AI youth.
Screening for delirium after surgery: validation of the 4 A's test (4AT) in the post‐anaesthesia care unit
Authors: Saller T. , MacLullich A. M. J. , Schäfer S. T. , Crispin A. , Neitzert R. , Schüle C. , von Dossow V. , Hofmann‐Kiefer K. F.
Published: May 2019

Postoperative delirium is common and has multiple adverse consequences. Guidelines recommend routine screening for postoperative delirium beginning in the post‐anaesthesia care unit. The 4 A's test (4AT) is a widely used assessment tool for delirium but there are no studies evaluating its use in the post‐anaesthesia care unit. We evaluated the performance of the 4AT in the post‐anaesthesia care unit in a tertiary German medical centre. Adults who were able to provide informed consent, were not scheduled for postoperative intensive care, and who did not have dementia or severe neuropsychiatric disorders underwent screening by trained research staff with the Nurse Delirium Screening Scale and a new German translation of the 4AT in a random order at the point of discharge from the post‐anaesthesia care unit. Reference standard assessment of delirium was psychiatric evaluation by experienced clinicians. Five hundred and forty‐three patients (mean age (SD) 52 (18) years) were analysed; 22 (4.1%) patients developed delirium. The sensitivity and specificity of the 4AT were 95.5% (95%CI 77.2–99.9) and 99.2% (95%CI 98.1–99.8), respectively. The area under the receiver operator characteristic curve was 0.998 (95%CI 0.995–1.000). The Nursing Delirium Screening Scale had a sensitivity of 27.3% (95%CI 10.7–50.2) and specificity of 99.4% (95%CI 98.3–99.9), with an area under the curve of 0.761 (95%CI 0.629–0.894). These findings suggest that the 4AT is an effective and robust instrument for delirium detection in the post‐anaesthesia care unit.
Presence of Giardia lamblia in stools of six‐ to 18‐month old asymptomatic Malawians is associated with children's growth failure
Authors: Lehto Kirsi‐Maarit , Fan Yue‐Mei , Oikarinen Sami , Nurminen Noora , Hallamaa Lotta , Juuti Rosa , Mangani Charles , Maleta Kenneth , Hyöty Heikki , Ashorn Per
Published: May 2019

Aim

Despite high pathogen burden and malnutrition in low‐income settings, knowledge on relationship between asymptomatic viral or parasitic infections, nutrition and growth is insufficient. We studied these relationships in a cohort of six‐month‐old Malawian infants.

Methods

As part of a nutrient supplementation trial for 12 months, we documented disease symptoms of 840 participant daily and anthropometric measurements every three months. Stool specimens were collected every six months and analysed for Giardia lamblia, Cryptosporidium species and enterovirus, rotavirus, norovirus, parechovirus and rhinovirus using polymerase chain reaction (PCR). The prevalence of the microbes was compared to the children's linear growth and the dietary.

Results

The prevalence of the microbes was similar in every intervention group. All age groups combined, children negative for G. lamblia had a mean standard deviation (SD) of −0.01 (0.49) change in length‐for‐age Z‐score (LAZ), compared to −0.12 (0.045) among G. lamblia positive children (difference −0.10, 95% CI −0.21 to −0.00, p = 0.047). The LAZ change difference was also statistically significant (p = 0.042) at age of 18–21 months but not at the other time points.

Conclusion

Asymptomatic G. lamblia infection was mainly associated with growth reduction in certain three‐month periods. The result refers to the chronic nature of G. lamblia infection.
Exploring educators’ professional learning ecologies in a blended learning environment
Authors: Ranieri Maria , Giampaolo Mario , Bruni Isabella
Published: May 2019

In recent years the concept of learning ecology has been interpreted in different ways to highlight its potential for learning and professional development. However, there are several aspects that still deserve to be understood such as, eg, the role that the different contexts come to play within a learning ecology. For this purpose, this paper presents and discusses the results of a study exploring the learning ecologies of educators in a blended programme delivered in higher education. The participants in the study were 85 professionals in the field of education aged between 28 and 58 years. The research design adopted here can be defined as a convergent mixed method where both quantitative and qualitative data were collected through an e‐portfolio. The study found that educators in the sample had different postures, of whom some more aware of their professional roles or Self than others. Moreover, different professional identities seemed to be linked to different learning ecologies, where elements like formal or informal education, cultural artefacts, personal experiences, colleagues or work experiences played a different role. Formal education emerged as having a questionable function, while colleagues came up as a crucial resource.
A hard binary to shake: The limitations and possibilities of teaching GIS critically
Authors: Anderson Matthew B. , Radil Steven M.
Published: May 2019

This paper builds upon studies employing a syllabi‐based methodology that suggest a tendency for critical geographic information science (GIS) courses to emphasize reading/discussion about GIS without actually doing GIS, and for traditional GIS instruction courses to emphasize the technical capacities of GIS software without incorporating critical theory in substantive ways. However, through ethnographic evidence we reveal that there is likely more innovative theory‐practice transcending pedagogies being utilized than would necessarily show up in such a syllabi‐based methodology. There are also very real and differentially manifest pragmatic, departmental, and institutional barriers in place to effectively incorporating critical social theory into courses that actually do GIS. We first catalogue these barriers as a means of ascertaining what can (and cannot) be done to overcome them through GIS pedagogic innovation. We then outline the (often‐veiled) pedagogic strategies deployed by critical GIS scholars today to navigate and circumvent these barriers.
Clinical and radiographic indices around narrow diameter implants placed in different glycemic‐level patients
Authors: Alsahhaf Abdulaziz , Alshiddi Ibraheem F. , Alshagroud Rana Saud , Al‐Aali Khulud Abdulrahman , Vohra Fahim , Abduljabbar Tariq
Published: May 2019

Background

Studies assessing peri‐implant clinical and marginal bone resorption (MBR) around narrow diameter implants (NDIs) placed in different glycemic levels are uninvestigated.

Objective

The present 3‐year retrospective follow‐up investigation was designed to explore clinical and radiographic status of NDIs placed in individuals with different glycemic control levels.

Materials and Methods

Patients with serum hemoglobin A1c (HbA1c) levels ≥6.5% (Group‐1), 5.7%‐6.4% (Group‐2), and 4.0%‐5.0% (Group‐3) were included. Clinical indices evaluating bleeding on probing (BOP), plaque scores (PI), peri‐implant probing depth (PD), and MBR were recorded around NDIs at 1‐, 2‐, and 3‐year follow‐up. Serum HbA1c test was carried out for all patients to assess the profile of glycosylated hemoglobin at 1 and 3 years of follow‐up.

Results

A significant reduction in mean HbA1c levels from year 1 to year 3 follow‐up period was seen in Group‐1 only. PI varied from 0.40 in Group 1 at 2 year and 0.42 at 3‐year follow‐up to 0.18 at 2‐year (P = 0.032) and 0.17 at 3‐year (P = 0.018) follow‐up, respectively. Greater BOP was noted in Group 1 (0.53) as compared with Group 2 (0.42) and Group 3 (0.21) (P = 0.048) at 3‐year follow‐up. PD after 3 year ranged from 2.04 mm in Group 3 to 2.32 mm in Group 1 that showed statistically significant difference (P = 0.037). No statistical significant differences were observed in MBR at any time point between the groups.

Conclusion

The results of this short‐term follow‐up study indicate that NDIs show clinical and radiographic stability, provided oral cleanliness and glycemic levels are relatively maintained. Further long‐term clinical studies are needed to evaluate implant stability over the period along with controlled glycemic status.
Continuous craniofacial growth in adult patients treated with dental implants in the anterior maxilla
Authors: Cocchetto Roberto , Pradies Guillermo , Celletti Renato , Canullo Luigi
Published: May 2019

Background

In the Literature, there are several studies demonstrating that infraposition happens also in adult patients.

Purpose

To conduct a retrospective evaluation of infraocclusion of implant‐retained crowns in the anterior maxilla of adult patients and of the patient awareness and perception of the problem.

Material and Methods

From January to June 2017, all adult patients who in the last 5 to 20 years had received in the same clinic implant restorations in the upper anterior maxilla were recalled to assess the presence of crown infraocclusion. Ninety‐four patients were recalled. Twenty‐six males, 34 females, with 76 implants were included in the study. According to the age, patients were divided into group I (<30 years: 12 males, 14 female) and group II (>30 years: 14 males, 20 females). Digital photographs, taken at the time of final prosthesis delivery (T0) and at time of the study examination (T1) were compared by three blinded previously calibrated examiners. Cast models of the dental arches were taken at T1 and served as a reference for infraocclusion measurements. According to the Literature, cases were included in three categories: infraocclusion <0.5 mm, infraocclusion 0.5‐1.0 mm, and infraocclusion >1 mm. An awareness and perception score (APS) was prepared to classify patients in: “unaware patients” (0), “aware but disinterested patients” (1), “aware patients requiring explications” (2), and “aware patients requiring treatment” (3).

Results

Infraocclusion was present in 73.3% of all cases, 65.4% among males, 79.4% among females. Infraocclusion was less than 1 mm in 88.2% of males and in 85.1% of females. No significant differences were found for sex (P = .223).

No significant differences were found for age: group I: 47.7%, group II: 52.2%, (P = .481).

The overall APS was: “unaware patients” = 38.6%, “aware but disinterested patients” = 27.3%, “aware patients requiring explications” = 15.9%, “aware patients requiring treatment” = 18.2%.

Conclusion

Within the limit of the study, infraocclusion might present a quite high prevalence. Data analysis failed to identify specific predisposing risk factors.
Osseointegration effect of biomimetic intrafibrillarly mineralized collagen applied simultaneously with titanium implant: A pilot in vivo study
Authors: Zhang Zhen , Zhang Shijian , Li Zheyi , Li Song , Liu Jiannan , Zhang Chenping
Published: May 2019

Objectives

To investigate the promoting effects of biomimetic intrafibrillarly mineralized collagen (IMC) bone scaffold material on the osseointegration of a titanium implant simultaneously grafted into a critical‐sized bone defect as well as the underlying mechanisms involved.

Materials and Methods

A critical‐sized bone defect was created in the rat femur, and a titanium (Ti) implant surrounded by IMC or extrafibrillarly mineralized collagen (EMC) bone scaffold material was placed in the defect. A blank group and a natural bone group were included as controls. Osseointegration was assessed by micro‐computed tomographic, histological, and biochemical evaluations at 12 weeks postoperatively. Microarray technology was applied for transcriptional profile analysis at days 7 and 14 postoperatively.

Results

Significant bone regeneration and osseointegration were observed in the IMC and EMC groups according to μ‐CT and histological analyses. The bone volume (BV)/total volume (TV) fraction, bone‐to‐implant contact percentage, and bone area percentage as well as ultimate shear strength and maximal pull‐out force were all significantly higher in the IMC group than in the EMC group (allp < 0.05). Transcriptional analysis revealed overexpression of genes mainly associated with cell proliferation, immuno‐inflammatory response, skeletogenesis, angiogenesis, neurogenesis, and skeletogenesis‐related pathways during the early process of osseointegration in the IMC group.

Conclusion

Our data suggest that IMC placed simultaneously with a Ti implant may be a promising strategy in jawbone defect reconstruction. Several candidate genes that were found to be differentially expressed in the IMC group may be responsible for the superior osseointegration effects in this model.
Local inflammatory reaction to benign, pre‐malignant and malignant glottic lesions: A matched case‐control study
Authors: Lahav Yonatan , Shats Maya , Huszar Monica , Haimovich Yaara , Warman Meir , Halperin Doron , Shoffel‐Havakuk Hagit
Published: May 2019

Objectives

To study the inflammatory infiltrates associated with the different stages of laryngeal carcinogenesis.

Design

Observational, matched case‐control study of histopathologic specimens.

Setting

An academic referral centre.

Participants

A total of 45 patients who underwent removal of glottic lesions between 2008 and 2015. Patients were enrolled and categorised into three matched groups according to lesions' histopathologic diagnoses, 15 patients in each group: benign, pre‐malignant and squamous cell carcinoma (SCC). Matching was based on age, gender and pack‐years.

Main outcome measures

Immunohistochemistry staining using monoclonal antibodies against CD4, CD8, CD68, CD20 and S100 representing T‐helper cells, cytotoxic T cells, macrophages, B cells and dendritic cells, respectively. Cell counts and distributions were measured and compared between groups. Correlations between the different cells were examined.

Results

The predominant cell type was CD8+, followed by CD68+ and CD4+. All inflammatory cells increased significantly in number in SCC (P‐value < 0.001), with no significant difference between benign and pre‐malignant groups. Strong correlations between the different cells were demonstrated only in the malignant group. S100+ cells correlated with both T‐cell subsets, CD4+ (rho = 0.769, P‐value = 0.001) and CD8+ (rho = 0.697, P‐value = 0.0004). Infiltrates exhibited more extensive distribution in SCC compared to pre‐malignant and benign; CD8+ and CD68+ cells were demonstrated in both intraepithelial and stromal regions in 93% of SCC lesions (P‐value = 0.0001).

Conclusions

Laryngeal carcinoma demonstrates a unique pattern of inflammatory infiltrates, with significant changes in cell counts and distribution. Leucocyte infiltrates increased significantly in the transition from laryngeal pre‐malignant lesion to malignancy while no significant differences were seen between benign and pre‐malignant lesions.
Ventriculo–arterial interaction may be assessed by Oscillatory Power Fraction
Authors: Tannvik Tomas Dybos , Rimehaug Audun Eskeland , Wigen Morten Smedsrud , Løvstakken Lasse , Kirkeby‐Garstad Idar
Published: May 2019

The rate of energy transfer from the left ventricle to the aorta is viewed in terms of mean power (MP) and total power (TP). The difference between MP and TP is due to the pulsatility of the circulation and is known as oscillatory power (OP). OP is considered the energy spent to accelerate the blood flow. The aim of this study was to investigate the baseline left ventricular oscillatory power fraction (OP/TP) and how this was affected by acute cardiovascular dysfunction and altered preload. Twenty‐eight patients undergoing elective coronary artery bypass graft surgery were included. Before administration of anaesthesia, we simultaneously recorded an arterial pressure curve and instantaneous cardiac outflow with pulsed wave Doppler. Postoperatively, prior to extubation, these measurements were repeated in neutral, Trendelenburg and reverse‐Trendelenburg position. The final measurements were taken on the awake patient the day after the operation. TP is the mean of the instantaneous product of the flow and pressure curves. MP was calculated by multiplying mean arterial pressure with mean cardiac output. The oscillatory power fraction is therefore calculated as (TP‐MP)/TP. The oscillatory power fraction in neutral position decreased from 23% preoperatively to 16% immediately postoperatively (P<0·001) and increased again to 19% the first postoperative day (P = 0·001). The oscillatory power fraction also increased from 16% in neutral to 19% in Trendelenburg (P = 0·001) and decreased comparing to neutral, to 14% in reverse‐Trendelenburg (P = 0·04). The oscillatory power fraction is situation‐dependent and is influenced by both the operation and the altered preload.
Growth differentiation factor 11 inhibits adipogenic differentiation by activating TGF‐beta/Smad signalling pathway
Authors: Luo Hongke , Guo Yuchen , Liu Yuting , Wang Yuan , Zheng Rixin , Ban Yu , Peng Lin , Yuan Quan , Liu Weiqing
Published: May 2019

Objectives

Growth differentiation factor 11 (GDF11), an emerging secreted member of the TGF‐beta superfamily, plays essential roles in development, physiology and multiple diseases; however, its role during adipogenic differentiation and the underlying mechanisms remains poorly understood.

Materials and methods

Bone marrow‐derived human mesenchymal stem cells (hMSCs) and 3T3‐L1 pre‐adipocytes were induced with adipogenic culture medium supplementing with different concentrations of recombinant GDF11 (rGDF11 0, 10, 50, 100 ng mL−1). Oil Red O staining, qRT‐PCR analysis, Western blot analysis and immunofluorescence staining were performed to assay adipogenesis.

Results

For both hMSCs and 3T3‐L1 pre‐adipocytes, the presence of rGDF11 leads to a dose‐dependent reduction of intracellular lipid droplet accumulation and suppressed adipogenic‐related gene expression. Mechanically, GDF11 inhibits adipogenesis by activating Smad2/3‐dependent TGF‐beta signalling pathway, and these inhibitory effects could be restored by SB‐431542, a pharmacological TGF‐beta type I receptor inhibitor.

Conclusions

Taken together, our data indicates that GDF11 inhibits adipogenic differentiation in both hMSCs and 3T3‐L1 pre‐adipocytes by activating Smad2/3‐dependent TGF‐beta signalling pathway.
Effect of bilateral lung transplantation on excessive dynamic airway collapse
Authors: Singh Jarmanjeet , Sese Denise , Lehr Carli J. , Pichurko Bohdan , McCurry Kenneth , Mehta Atul C.
Published: May 2019

Introduction

Excessive dynamic airway collapse (EDAC) is associated with significant respiratory morbidity. It has been hypothesized that EDAC may limit the benefits of lung transplantation in chronic obstructive pulmonary disease (COPD) patients. We aim to find the effect of bilateral lung transplantation on EDAC in COPD patients.

Methods

Retrospective chart review was performed to identify patients with concomitant presence of COPD and EDAC before undergoing bilateral lung transplantation from December 2011 to December 2014. Pre‐ and post‐transplant pulmonary function tests, flow‐volume (FV) loops, computed tomography (CT) of the chest, and flexible bronchoscopies were studied.

Results

A total of 165 patients underwent bilateral lung transplantation during the study period. Eight patients had COPD and EDAC prior to the transplant. Post‐transplantation, 7 out of 8 patients showed resolution of EDAC on expiratory CT chest and 1 patient did not have post‐transplant CT chest. All eight showed no EDAC on post‐transplant surveillance bronchoscopy. Post‐transplant, mean predicted FEV1/FVC increased from 37% to 117% and mean predicted FEV1 increased from 20% to 61%.

Conclusions

There is resolution of EDAC post‐bilateral lung transplantation in this retrospective COPD patient population. EDAC should not be considered as a benefit‐limiting factor to bilateral lung transplantation. However, prospective studies are required to explore potential indication.
Comparison of methods of providing analgesia after pancreas transplant: IV opioid analgesia versus transversus abdominis plane block with liposomal bupivacaine or continuous catheter infusion
Authors: Yeap Yar L. , Fridell Jonathan A. , Wu Derrick , Mangus Richard S. , Kroepfl Elizabeth , Wolfe John , Powelson John A.
Published: May 2019

Background

Current practices emphasize a multimodal approach to perioperative analgesia due to higher efficacy and decreased opioid usage. Analgesia for pancreas transplant (PT) has traditionally been managed with intravenous (IV) opioids, and reports of transversus abdominis plane (TAP) blocks are limited in this population.

Methods

Three interventions were compared in adult PT patients, including IV opioids, TAP catheter, and TAP block with liposomal bupivacaine. Time to return of intestinal function and oral diet, postoperative pain scores, opioid usage, and length of stay were recorded.

Results

Study included 197 PT patients: 62 (32%) standard care, 90 (45%) TAP catheters with continuous 0.2% ropivacaine, and 45 (23%) single liposomal bupivacaine TAP block. Pain scores were lowest for the IV opioid group (P < 0.001). The liposomal bupivacaine group had lower pain scores on postoperative days (POD) 1‐5 than the TAP catheter group. Opioid use during POD 1‐5 was lower for both TAP block groups (P = 0.03). Time to bowel function was faster for the TAP block groups (P < 0.05).

Conclusions

Compared with IV opioid analgesia, TAP block interventions were associated with lower overall use of opioids and a faster time to intestinal function following pancreas transplant.
The impact of high profile restrictions on support for alcohol control policies
Authors: Livingston Michael , Callinan Sarah , Wilkinson Claire
Published: May 2019

Introduction and Aims

Public support for restrictions on late night trading of licensed venues increased substantially between 2001 and 2013, a period with very few policy interventions in Australia. In early 2014 a set of high profile restrictions were introduced in Sydney, New South Wales. In this study, we examine whether these 2014 policy interventions affected public support for late trading restrictions.

Design and Methods

We use data from the National Drug Strategy Household Survey, focussing especially on the 2013 (n = 23 521) and 2016 (n = 23 425) waves. A series of regression models with interaction terms between socio‐demographic variable and year were used to examine how trends in support for late trading policies varied between different population groups.

Results

Support for late trading restrictions fell substantially between 2013 and 2016—from 2.58 to 2.35 on a 0‐4 point scale. In particular, support fell more in New South Wales than in other jurisdictions. Among New South Wales residents, support fell more for middle‐aged and older respondents and more for drinkers than non‐drinkers.

Discussion and Conclusion

Support for late trading restrictions fell sharply, especially among those affected in New South Wales. Advocates for public health‐oriented alcohol policy restrictions need to pay attention to public support in the aftermath of policy ‘wins’.
Underwater cold snare polypectomy for colorectal adenomas
Authors: Maruoka Daisuke , Kishimoto Takashi , Matsumura Tomoaki , Arai Makoto , Akizue Naoki , Ishikawa Kentaro , Ohta Yuki , Kasamatsu Shingo , Taida Takashi , Ishigami Hideaki , Okimoto Kenichiro , Saito Keiko , Nakagawa Tomoo , Kato Naoya
Published: May 2019

Background and Aim

Cold snare polypectomy (CSP) is a safe treatment for colorectal adenomas. However, the R0 resection rate is not sufficiently high because of inadequate resection of muscularis mucosa. We hypothesized that CSP in an underwater environment could improve this procedure by helping to safely achieve resection containing the muscularis mucosa. We have named this procedure underwater cold snare polypectomy (UCSP). We aimed to investigate the efficacy and safety of UCSP for colorectal adenomas.

Methods

Between May 2017 and April 2018, patients diagnosed with colorectal adenomas <9 mm underwent UCSP. After follow‐up colonoscopy 3 weeks later, the patients post‐UCSP scars were biopsied. Outcomes were compared with those of a historical control group who underwent conventional CSP in our previous study using propensity score‐matching methods.

Results

Overall, 224 lesions in 65 patients were prospectively resected by UCSP. Pathologically, 209 lesions were adenomas (4.5 ± 1.5 mm) including one intramucosal carcinoma. Only one pathological residual adenoma was identified, but there was no significant difference in the residual rate between the UCSP and CSP groups (both 1.0%). No complications were observed. R0 resection rate and rate of area containing the muscularis mucosa in the UCSP group were significantly higher than those in the CSP group (80.2% vs 32.7%, P < 0.001; 50.0% vs 35.3%, P = 0.015).

Conclusion

Underwater cold snare polypectomy for diminutive and small colorectal adenomas was safe and effective from the perspective of pathological complete resection, which is likely facilitated by achieving an adequate depth of resection.