bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Decomposition on the Efficacy of Biometrics for Positive Identification
Authors: Sauerwein Kelly , Saul Tiffany B. , Steadman Dawnie Wolfe , Boehnen Chris B.
Published: February 2017

Biometrics, unique measurable physiological and behavioral characteristics, are used to identify individuals in a variety of scenarios, including forensic investigations. However, data on the longevity of these indicators are incomplete. This study demonstrated that iris and fingerprint biometric data can be obtained up to four days postmortem in warmer seasons and 50 + days in the winter. It has been generally believed, but never studied, that iris recognition is only obtainable within the first 24 hours after death. However, this study showed that they remain viable for longer (2–34 days) depending upon the environmental conditions. Temperature, precipitation, insects, and scavenger activity were the primary factors affecting the retention of biometrics in decomposing human remains. While this study is an initial step in determining the utility of physiological biometrics across postmortem time, biometric research has the potential to make important contributions to human identification and the law enforcement, military, and medicolegal communities.
In vivo observation of metamorphosis of Plodia interpunctella Hübner using three‐dimensional optical coherence tomography
Authors: Choi Kwang Shik , Wijesinghe Ruchire Eranga , Lee Changho , Lee Seung‐Yeol , Jung Hee‐Young , Jeon Mansik , Kim Jeehyun
Published: February 2017

Morphological assessment and three‐dimensional reconstructions of internal structures of Plodia interpunctella Hübner during metamorphosis stages were experimentally demonstrated using optical coherence tomography (OCT) for the first time. The conventional, complex sectioning methods were significantly simplified owing to the non‐invasive three‐dimensional imaging capability of OCT. Further, this study demonstrates the use of OCT as a non‐invasive detection tool for in vivo morphological observation of metamorphosis stages to gain a better understanding about the growth of internal organs, which can be considered a useful discovery in the field of entomology. Thus, the metamorphosis stages starting from the larva, three pupa stages to the adult stage were periodically visualized to examine the development of internal organs at each specific stage. This study essentially offers real‐time morphological information by non‐destructive observation of the organism and can also be useful for the investigation of other agricultural pests.
Prevalence of in‐hospital nonsteroidal antiinflammatory drug exposure in patients with a primary diagnosis of heart failure
Authors: Alvarez Paulino A. , Putney David , Ogunti Richard , Puppala Mamta , Ganduglia Cecilia , Torre‐Amione Guillermo , Schutt Robert , Wong Stephen T. C. , Estep Jerry D.
Published: February 2017

Aim

To determine the prevalence of in‐hospital nonsteroidal antiinflammatory drug (NSAID) exposure and associated outcomes in patients admitted with a primary diagnosis of heart failure.

Methods

We performed a propensity‐matched cohort analysis of patients admitted to Houston Methodist Hospital System with a primary diagnosis of heart failure according to the International Classification of Diseases‐9‐Clinical Modification (ICD‐9‐CM) from January 1, 2011 to December 31, 2014.

Results

Of the 9742 patients admitted with a primary diagnosis of heart failure, 384 patients (3.9%) were exposed to NSAID. After applying propensity scores we matched 305 NSAID exposed with 915 unexposed patients. Patients with in‐hospital NSAID exposure had a longer length of stay (7.0±8.8 days vs 6.1±8.5; P=.003) and increased prevalence of worsening renal function (34.4% vs 27.9%; P=.030). There were not statically significant differences in in‐hospital mortality rate or 30‐day all‐cause readmission rate.

Conclusion

Exposure to NSAID in patients admitted with a primary diagnosis of heart failure was low but was associated with adverse outcomes including longer length of stay and higher prevalence or worsening renal function.
Does psychotherapy work? An umbrella review of meta‐analyses of randomized controlled trials
Authors: Dragioti E. , Karathanos V. , Gerdle B. , Evangelou E.
Published: February 2017

Objective

To map and evaluate the evidence across meta‐analyses of randomized controlled trials (RCTs) of psychotherapies for various outcomes.

Methods

We identified 173 eligible studies, including 247 meta‐analyses that synthesized data from 5157 RCTs via a systematic search from inception to December 2016 in the PubMed, PsycINFO and Cochrane Database of Systematic Reviews. We calculated summary effects using random‐effects models, and we assessed between‐study heterogeneity. We estimated whether large studies had significantly more conservative results compared to smaller studies (small‐study effects) and whether the observed positive studies were more than expected by chance. Finally, we assessed the credibility of the evidence using several criteria.

Results

One hundred and ninety‐nine meta‐analyses were significant at P‐value ≤ 0.05, and almost all (n = 196) favoured psychotherapy. Large and very large heterogeneity was observed in 130 meta‐analyses. Evidence for small‐study effects was found in 72 meta‐analyses, while 95 had evidence of excess of significant findings. Only 16 (7%) provided convincing evidence that psychotherapy is effective. These pertained to cognitive behavioural therapy (n = 6), meditation therapy (n = 1), cognitive remediation (n = 1), counselling (n = 1) and mixed types of psychotherapies (n = 7).

Conclusions

Although almost 80% meta‐analyses reported a nominally statistically significant finding favouring psychotherapy, only a few meta‐analyses provided convincing evidence without biases.
Review: Genetic research on alcohol use outcomes in African American populations: A review of the literature, associated challenges, and implications
Authors: Dick Danielle M. , Barr Peter , Guy Mignonne , Nasim Aashir , Scott Denise
Published: February 2017

Background and Objectives

There have been remarkable advances in understanding genetic influences on complex traits; however, individuals of African descent have been underrepresented in genetic research.

Methods

We review the limitations of existing genetic research on alcohol phenotypes in African Americans (AA) including both twin and gene identification studies, possible reasons for underrepresentation of AAs in genetic research, the implications of the lack of racially diverse samples, and special considerations regarding conducting genetic research in AA populations.

Results

There is a marked absence of large‐scale AA twin studies so little is known about the genetic epidemiology of alcohol use and problems among AAs. Individuals of African descent have also been underrepresented in gene identification efforts; however, there have been recent efforts to enhance representation. It remains unknown the extent to which genetic variants associated with alcohol use outcomes in individuals of European and African descent will be shared. Efforts to increase representation must be accompanied by careful attention to the ethical, legal, and social implications of genetic research. This is particularly true for AAs due to the history of abuse by the biomedical community and the persistent racial discrimination targeting this population.

Conclusions and Scientific Significance

Lack of representation in genetic studies limits our understanding of the etiological factors that contribute to substance use and psychiatric outcomes in populations of African descent and has the potential to further perpetuate health disparities. Involving individuals of diverse ancestry in discussions about genetic research will be critical to ensure that all populations benefit equally from genetic advances. (Am J Addict 2017;26:486–493)
Factors influencing cardiometabolic risk profile in patients with psoriasis
Authors: Curcó Neus , Barriendos Nuria , Barahona Maria José , Arteaga Carmen , García Mercedes , Yordanov Stanislav , De La Barrera Olimpia , Prat Carolina , Vives Pere , Giménez Nuria
Published: February 2017

Background

Psoriasis has been associated with metabolic syndrome and with an increased cardiovascular risk especially in patients with severe disease. The goal of this study was to estimate the prevalence of metabolic syndrome and other cardiovascular risk factors and its association with the psoriasis severity, sex and age.

Methods

Consecutive patients with psoriasis were enrolled in a prospective study over a 1‐year period. Blood samples were collected. Psoriasis area and severity index (PASI) and body surface area scores and two dermatology quality of life (DQOL) questionnaires were used to evaluate psoriasis severity and the impact of the disease.

Results

Altogether 178 patients were included, of whom 44% had moderate–severe psoriasis. The overall prevalence of metabolic syndrome was 30% (men 34%, women 26%) without significant differences between patients with severe and mild disease. Age and menopause appeared to increase the risk for metabolic syndrome. Patients with severe psoriasis smoked more heavily, were more likely to have diabetes or insulin resistance and had higher homocysteine and lower high density lipoprotein cholesterol (HDL‐C) levels than patients with mild psoriasis (P < 0.05). In women, a higher waist circumference was observed. Women had higher HDL‐C levels and lower smoking and alcohol consumption rates. In accordance with the systematic coronary risk evaluation system, 18% of the patients had a high 10‐year risk of fatal cardiovascular disease.

Conclusions

Psoriasis severity was associated with diabetes, insulin‐resistance, smoking habit and higher cardiovascular risk. Metabolic syndrome was related to age and menopause but not to psoriasis severity.
Analysis of early hepatic artery thrombosis after liver transplantation
Authors: Xue Zhicheng , Chen Maogen , Zhang Xuzhi , Wang Guodong , He Xiaoshun , Wu Linwei , Ma Yi
Published: February 2017

Background

Hepatic artery thrombosis (HAT) is one of the deadliest complications after orthotopic liver transplantation (OLT). This study aimed to identify risk factors and summarize the experience of HAT management after OLT.

Methods

Clinical data of 407 adult patients who received OLT in our centres from July 2011 to December 2015 were retrospectively investigated.

Results

The incidence rate of early HAT was 2.0% (8/407). Recipient/donor weight ratio ≥1.15 (P = 0.02), presence of hepatic arterial reconstruction (P < 0.001) and post‐operative blood transfusion (P = 0.001) were significantly associated with early HAT in the univariate analysis and the only independent risk factor (odds ratio = 28.49) in binary logistic regression was the presence of hepatic arterial reconstruction. Among patients with early HAT, five received interventional revascularization while two received surgical revascularization and the remaining one received re‐transplantation. Their liver grafts were functioning well with patent hepatic artery until their last follow‐up, whereas one died from tumor recurrence at 31st month after transplantation.

Conclusion

The presence of hepatic arterial reconstruction, recipient/donor weight ratio ≥1.15 and post‐operative blood transfusion were the main risk factors associated with early HAT. Prompt recognition of these factors, strict surveillance protocols and selective anticoagulation for patients at risk need to be evaluated. For patients with early HAT occurring within a week after transplantation, surgical re‐arterialization is preferential while interventional revascularization is recommended when it occurs beyond 7 days after transplantation.
Assessing the growth of preterm infants using detailed anthropometry
Authors: Ashton James J. , Johnson Mark J. , Pond Jenny , Crowley Philippa , Dimitrov Borislav D. , Pearson Freya , Beattie R. Mark
Published: February 2017

Aim

Preterm infants display altered body composition compared to term infants, and weight gain is a crude indicator body composition. Childhood mid‐upper arm circumference (MUAC) is a measure of nutritional status. This study investigates MUAC and mid‐thigh circumference (MTC) to monitor growth in preterm infants.

Methods

Preterm infants (<30‐week gestation) were recruited. MUAC, MTC, weight, length and head circumference (HC) were measured at recruitment and weekly intervals until discharge. Descriptive, correlation and regression analyses were used.

Results

Ninety‐three infants were recruited. Median measurement duration was eight weeks (1–19). Median gestational age was 27 weeks (23–29). Analysis by curve estimation displayed a mean increase of 2.58 mm/week (left MUAC) (p ≤ 0.0001), 2.56 mm/week (right MUAC) (p ≤ 0.0001), 4.16 mm/week (left MTC) (p ≤ 0.0001), 4.20 mm/week (right MTC) (p ≤ 0.0001). Coefficients of determination (R2) were calculated using a growth regression model for MUAC and MTC (0.866–0.917); measures were comparable to growth modelling of weight (0.913), length (0.945) and HC (0.928). High concordance between left and right MUAC and MTC generated a Pearson's correlation coefficient of 0.999 (MUAC) (p ≤ 0.001) and 0.994 (MTC) (p ≤ 0.001).

Conclusion

Data demonstrate the potential utility of MUAC and MTC as additional measures of growth in preterm infants that are reproducible over time. There is potential to gain insights to improve lean‐mass accretion in preterm infants.
Glucocorticoid‐deficient hypoadrenocorticism secondary to intravascular lymphoma in the adrenal glands of a dog
Authors: Buckley ME , Chapman PS , Walsh A
Published: February 2017

Case report

A 2‐year‐old neutered male German Shepherd dog was presented with weakness, poor appetite and weight loss. Glucocorticoid‐deficient hypoadrenocorticism was diagnosed with undetectable pre‐ and post‐ACTHcortisol concentrations but normal sodium and potassium concentrations. Despite appropriate supplementation with glucocorticoids, the patient's weakness progressed and neurological deficits developed. The patient was euthanased. Histopathological analysis of multiple organs, including the adrenal glands, showed an accumulation of neoplastic lymphocytes within blood vessels, consistent with a diagnosis of intravascular lymphoma. Histologically, in both adrenal glands, the architecture of the zona fasciculata and reticularis was disrupted by blood vessels congested with a neoplastic population of T‐lymphocytes; the zona glomerulosa remained intact.

Conclusion

This is the first report of intravascular lymphoma causing glucocorticoid‐deficient hypoadrenocorticism in a dog.
Population pharmacokinetics of rituximab in patients with diffuse large B‐cell lymphoma and association with clinical outcome
Authors: Rozman Samo , Grabnar Iztok , Novaković Srdjan , Mrhar Ales , Jezeršek Novaković Barbara
Published: February 2017

Aims

Pharmacokinetic (PK) studies suggest that there is a room for improvement in clinical use of rituximab through more individualized treatment. The objective of this study was to characterize rituximab PK in 29 newly diagnosed patients with diffuse large B‐cell lymphoma treated with rituximab in combination with cyclophosphamide, doxorubicin, vincristine and methylprednisolone every 3 weeks. We also evaluated the association of rituximab PK with clinical outcome.

Methods

Rituximab serum levels were determined by enzyme‐linked immunosorbent assay and evaluated by a population PK analysis applying nonlinear mixed effects modelling.

Results

The data were best described by a two‐compartment model comprising linear nonspecific clearance of 0.252 [95% confidence interval (CI): 0.227–0.279] l day–1 and time‐varying specific clearance of 0.278 (95% CI: 0.181–0.390) l day–1, corresponding to target‐mediated drug disposition of rituximab. Nonspecific clearance was lower in older patients and those with lower body weight. Additionally, volume of the central compartment was higher in males. A clear association of clinical response with rituximab PK has been observed. Rate constant of specific clearance decay was 0.143 day−1 (95% CI: 0.0478–0.418) in patients with no disease progression, while in patients with disease progression it was 82.2% lower (95% CI: 33.4–95.0).

Conclusions

This finding indicates that time‐changes in clearance could serve as a predictive marker of response to rituximab. Our report demonstrates the rationale for studies evaluating higher doses of rituximab in selected patients.
A systematic investigation of the link between rational number processing and algebra ability
Authors: Hurst Michelle , Cordes Sara
Published: February 2017

Recent research suggests that fraction understanding is predictive of algebra ability; however, the relative contributions of various aspects of rational number knowledge are unclear. Furthermore, whether this relationship is notation‐dependent or rather relies upon a general understanding of rational numbers (independent of notation) is an open question. In this study, college students completed a rational number magnitude task, procedural arithmetic tasks in fraction and decimal notation, and an algebra assessment. Using these tasks, we measured three different aspects of rational number ability in both fraction and decimal notation: (1) acuity of underlying magnitude representations, (2) fluency with which symbols are mapped to the underlying magnitudes, and (3) fluency with arithmetic procedures. Analyses reveal that when looking at the measures of magnitude understanding, the relationship between adults’ rational number magnitude performance and algebra ability is dependent upon notation. However, once performance on arithmetic measures is included in the relationship, individual measures of magnitude understanding are no longer unique predictors of algebra performance. Furthermore, when including all measures simultaneously, results revealed that arithmetic fluency in both fraction and decimal notation each uniquely predicted algebra ability. Findings are the first to demonstrate a relationship between rational number understanding and algebra ability in adults while providing a clearer picture of the nature of this relationship.
Buried amber finds in the coastal deposits of Saaremaa Island, eastern Baltic Sea – their sedimentary environment and possible use by Bronze Age islanders
Authors: Nirgi Triine , Rosentau Alar , Ots Mirja , Vahur Signe , Kriiska Aivar
Published: February 2017

Here, we present new sedimentary data of the amber bearing layer from the Holocene coastal plain on the SW Saaremaa Island where amber is not known in sedimentary successions but is common in Stone Age and Bronze Age archaeological sites. A layer of buried organic matter (BOM), sandwiched between sandy coastal deposits and containing pieces of natural amber, was discovered during fieldwork and analysed in detail. Results show that the BOM layer is buried under approximately 90‐cm‐thick sandy coastal deposits and consists of the remains of different coastal plants. Palaeogeographical reconstructions and sediment compositions indicate that the layer was deposited in the coastal zone and buried quickly by sandy marine sediments. According to AMS radiocarbon dating of knotgrass seeds (Polygonum lapathifolium), deposition of the BOM layer took place in the Late Bronze Age; about 2.7–2.5 cal. ka BP. Infrared spectra and isotopic composition of the analysed amber from the BOM layer indicate Baltic amber, also known as succinite. The stable isotope ratio indicates the origin of the amber to be south of Estonia. Therefore, it is proposed that the amber was probably transported to Saaremaa within organic matter (along the main SW–NE orientated current flows) from the SE coast of the Baltic Sea where secondary Baltic amber deposits are known to exist widely. Amber items are common in Late Bronze Age settlement sites and burials in Saaremaa and are considered to originate from present‐day Latvia, Lithuania, Kaliningrad district (Russia) and Poland. The current study shows that during the Late Bronze Age natural amber accumulated in the coastal zone of Saaremaa Island and that the islanders could collect it. Therefore, the possibility exists that some Bronze Age archaeological amber objects could be made of local material as opposed to being a result of trade with southern neighbours, as formerly thought.
Diversity and significance of core preparation in the Developed Oldowan technology: reconstructing the flaking processes at SHK and BK (Middle‐Upper Bed II, Olduvai Gorge, Tanzania)
Authors: Sánchez‐Yustos Policarpo , Diez‐Martín Fernando , Domínguez‐Rodrigo Manuel , Duque Javier , Fraile Cristina , Baquedano Enrique , Mabulla Audax
Published: February 2017

Core preparation has been documented in Developed Oldowan assemblages dated between 1.5–1.3 Ma. However, its correct identification and significance is a matter of debate. In order to shed light on this issue, this paper attempts to reconstruct the flake production processes of the lithic assemblages currently recovered in SHK and BK at Olduvai Gorge (Tanzania). The methodological approach applied for the study of these two classical Developed Oldowan sites is based on the analysis and classification of flaking cores through detailed diacritical and technological descriptions, regardless of aprioristic morphological considerations. The flake production processes identified in both assemblages exhibit great technological homogeneity. The most remarkable difference between them is linked with divergences in flake size production. Core rotation and elongation of the perimeter of the flaked surface were the main technical actions implemented to manage core reduction, and seem to be related to reduction intensity. Core preparation, specifically striking platform preparation, was also applied, but to a minor extent, and was linked with a more effective management of blank reduction. It was not carried out through rigid technical and geometric schemes, and the products obtained were not predetermined. Nevertheless, its mere presence in Developed Oldowan sites is very suggestive, as it confirms a strong relationship between the Developed Oldowan and early Acheulean assemblages.
Protein phosphatase 2A regulation of markers of extracellular matrix remodelling in hepatocellular carcinoma cells: functional consequences for tumour invasion
Authors: Ward M P , Spiers J P
Published: February 2017

Background and Purpose

A hallmark of tumour invasion is breakdown of the extracellular matrix due to dysregulation of the matrix metalloproteinase (MMP) system. While our understanding of how this is regulated by kinase signalling pathways is well established, its counter‐regulation by protein phosphatases (PP) is poorly understood. Therefore, we investigated the effect of PP inhibition on markers of extracellular remodelling and how PP2A activity modulated MMP‐9 abundance and function of Hep3B cells.

Experimental Approach

Cells were exposed to okadaic acid (OA), tautomycetin and cyclosporin A, and the expression profile determined using PCR. Effects of OA and a protein inhibitor of PP2A, CIP2A, on MMP‐9 abundance, PP2A activity and cell migration were investigated using ELISA, promoter constructs, siRNA knockdown and transwell migration assays.

Key Results

OA increased expression and abundance of MMP‐9 and the tissue inhibitor of MMP, TIMP‐1, without affecting other MMPs, TIMPs and ADAMs. The effect on MMP‐9 was mimicked by CIP2A overexpression and knockdown of the PPP2CA catalytic, but not PPP2R1A scaffolding, subunit. Cyclosporin A and PPP1CA silencing did not alter MMP‐9 expression, while tautomycetin transiently increased it. Mutation of AP‐1, but not NF‐κB, binding sites inhibited OA‐mediated MMP‐9 transcriptional activity. OA and CIP2A decreased PP2A activity and increased cell migration.

Conclusion and Implications

OA increased MMP‐9 by decreasing PP2A activity and PP2Ac, through AP‐1 binding sites on the MMP‐9 promoter. The functional consequence of this and CIP2A overexpression was increased cell migration. Hence, PP2A inhibition induced a metastatic phenotype through alterations in MMP‐9 in Hep3B cells.
Inhibition of 6‐phosphofructo‐2‐kinase suppresses fibroblast‐like synoviocytes‐mediated synovial inflammation and joint destruction in rheumatoid arthritis
Authors: Zou Yaoyao , Zeng Shan , Huang Mingcheng , Qiu Qian , Xiao Youjun , Shi Maohua , Zhan Zhongping , Liang Liuqin , Yang Xiuyan , Xu Hanshi
Published: February 2017

Background and Purpose

Abnormal glycolytic metabolism contributes to joint inflammation in rheumatoid arthritis (RA). The aims of this study were to investigate the role of 6‐phosphofructo‐2‐kinase/fructose‐2,6‐bisphosphatase 3 (PFKFB3), a bifunctional enzyme that controls the glycolytic rate, in regulating fibroblast‐like synoviocyte (FLS)‐mediated synovial inflammation and invasiveness in RA.

Experimental Approach

A specific inhibitor of PFKFB3, PFK15, and siRNA were used to evaluate the role of PFKFB3. Protein expression was measured by Western blotting or immunofluorescence staining. The expression of cytokines was determined by quantitative real‐time PCR. Migration and invasion were measured using a Boyden chamber assay. A mouse model of collagen‐induced arthritis (CIA) was used to evaluate the in vivo effect of PFK15.

Key Results

PFKFB3 expression was increased in the synovial tissue and FLSs from RA patients compared with osteoarthritis patients. PFKFB3 inhibition decreased the expression of IL‐8, IL‐6, CCL‐2 and CXCL‐10 and the proliferation, migration and invasion of RA FLSs. PFK15 suppressed TNF‐α‐induced activation of NF‐κB and p38, JNK and ERK MAPK signals in RA FLSs. PFK15 treatment also suppressed glucose uptake and lactate secretion. Lactate reversed the inhibitory effect of PFK15 or PFKFB3 siRNA on cytokine expression and migration of RA FLSs. Lactate was also involved in PFKFB3‐mediated activation of NF‐κB and MAPKs. Intraperitoneal injection of PFK15 in mice with CIA attenuated joint inflammation.

Conclusion and Implications

Elevated PFKFB3 expression might contribute to synovial inflammation and aggressive behaviours of RA FLSs, suggesting a novel strategy of targeting PFKFB3 to prevent synovial inflammation and joint destruction in RA.
Fathers' Infant‐Directed Speech in a Small‐Scale Society
Authors: Broesch Tanya , Bryant Gregory A.
Published: February 2017

When speaking to infants, mothers often alter their speech compared to how they speak to adults, but findings for fathers are mixed. This study examined interactions (N = 30) between fathers and infants (Mage ± SD = 7.8 ± 4.3 months) in a small‐scale society in Vanuatu and two urban societies in North America. Fundamental frequency (F0) and speech rate were measured in infant‐directed and adult‐directed speech. When speaking to infants, fathers in both groups increased theirF0range, yet only Vanuatu fathers increased their averageF0. Conversely, North American fathers slowed down their speech rate to infants, whereas Vanuatu fathers did not. Behavioral traits can vary across distant cultures while still potentially solving similar communicative problems.
The significance of blue color in dermatoscopy
Authors: Popadić Mirjana , Sinz Christoph , Kittler Harald
Published: February 2017

Background and objectives

Skin lesions with blue color are frequently excised to rule out malignancy. The objective of the present study was to investigate the significance of blue color.

Methods

We retrospectively scanned dermatoscopic images for blue color and classified them according to pattern analysis.

Results

Of 1,123 pigmented skin lesions, 144 (12.8 %) showed blue color, 92 of which (63.9 %) were malignant. Among lesions with blue color, the most common benign diagnoses were nevi (n = 35, 24.3 %) and seborrheic keratoses (n = 8, 5.6 %). Of 103 (71.5 %) lesions with a structureless blue pattern, eight (7.8 %) were entirely blue and 95 (92.2 %) were partly blue, of which 81 (78.6 %) showed peripheral or patchy and 14 (13.6 %) central blue color. Most lesions with peripheral or patchy blue color were melanomas (n = 47, 58 %), whereas most lesions with central blue color were nevi (n = 9, 64.3 %). Of 28 lesions with blue clods, 17 (60.7 %) were basal cell carcinomas. With respect to malignancy, the positive predictive value of blue color was 63.9 % (95 % CI: 56.0–71.8 %).

Conclusions

Among malignant lesions with blue color, structureless peripheral or patchy blue color is a clue for melanoma, while blue clods point to basal cell carcinoma. Pitfalls include seborrheic keratoses, which may show blue color, as well as some nevi, especially combined nevi.
Combining the G‐protein‐coupled receptor 40 agonist fasiglifam with sitagliptin improves glycaemic control in patients with type 2 diabetes with or without metformin: A randomized, 12‐week trial
Authors: Peng Xuejun V. , Marcinak John F. , Raanan Marsha G. , Cao Charlie
Published: February 2017

Aims

To evaluate the efficacy and safety of fasiglifam, an orally active G‐protein‐coupled receptor 40 agonist, in combination with the dipeptidyl peptidase‐4 inhibitor sitagliptin, in patients with type 2 diabetes inadequately controlled with diet/exercise (± metformin).

Materials and methods

In this randomized, double‐blind, phase II study, 368 patients received once‐daily placebo, sitagliptin 100 mg, fasiglifam 25 or 50 mg, or the combination of sitagliptin 100 mg plus fasiglifam 25 or 50 mg. The primary endpoint was change from baseline glycated haemoglobin (HbA1c) at 12 weeks; a key secondary endpoint was change in fasting plasma glucose (FPG).

Results

The fasiglifam 25 and 50 mg combination regimens produced significantly greater HbA1c reductions than sitagliptin (treatment differences of −0.45% and −0.61%; P < .01, respectively) or respective doses of fasiglifam monotherapy (−0.43% and −0.48%; P < .01) and significantly greater FPG reductions than sitagliptin (−1.1 mmol/L for both combination regimens; P < .01). Improved glycaemic control occurred by week 1 for FPG and week 4 for HbA1c in all groups. Hypoglycaemia rates were low (≤3.3%) and similar across treatments. Liver enzymes >3 × upper limit of normal occurred in four patients (fasiglifam 25 mg, n = 1; fasiglifam 50 mg, n = 2; 1 fasiglifam/sitagliptin 50/100 mg, n = 1).

Conclusions

Combination of fasiglifam and sitagliptin provided significant additional effects on glycaemic control, with hypoglycaemia rates similar to placebo with or without metformin. This study provides supportive clinical evidence for the complementary mechanism of actions of this GPR40 agonist and DPP‐4 inhibitor.
Poultry and policy in Ghana: Lessons from the periphery of an agricultural policy system
Authors: Sumberg James , Awo Martha , Kwadzo George T‐M.
Published: February 2017

We analyze poultry‐related policy documents from Ghana and ask how the problems identified and the actions proposed have changed over time. The analysis highlights the fact of limited and poor quality data, and associated uncertainty, ambiguity and poor specification of both problems and interventions. It also points to a long‐term commitment to intensive commercial production as the preferred pathway to deliver more animal protein. However, in the face of persistent feed constraints and economic liberalization, imports of frozen chicken have sky‐rocketed since the early 2000s, and a new pathway has come to dominate. We discuss this outcome and what it says more generally about policy around minor crops and livestock species.
Use of three‐dimensional transesophageal echocardiography to evaluate mitral valve morphology for risk stratification prior to mitral valvuloplasty
Authors: Francis Loren , Finley Alan , Hessami Walead
Published: February 2017

Mitral stenosis is often managed percutaneously with an interventional procedure such as balloon commissurotomy. Although this often results in an increased mitral valve area and improved clinical symptoms, this procedure is not benign and may have serious complications including the development of hemodynamically significant mitral valve regurgitation. Multiple scoring systems have been developed to attempt to risk stratify these patients prior to their procedure. Case: A 64‐year‐old patient underwent an emergent mitral valve replacement after having percutaneous mitral balloon commissurotomy complicated by development of severe mitral regurgitation. Prior to valvuloplasty, her mitral valve was evaluated by traditional methods including calculation of a Wilkins score. Her mitral valve was evaluated after valvuloplasty and preoperatively with three‐dimensional transesophageal echocardiography. This examination demonstrated heterogeneous distribution of calcification affecting the mitral valve commissures more than the leaflets, which is consistent with the noncommissural leaflet tearing that occurred during her procedure, causing severe mitral regurgitation. In the future, careful 3D evaluation of mitral valve morphology including leaflets, annular calcification, and subvalvular apparatus may help risk stratify patients prior to intervention.
A comparison of network and clustering methods to detect biogeographical regions
Authors: Bloomfield Nathaniel J. , Knerr Nunzio , Encinas‐Viso Francisco
Published: February 2017

Bioregions are an important concept in biogeography, and are key to our understanding of biodiversity patterns across the world. The use of networks in biogeography to produce bioregions is a relatively novel approach that has been proposed to improve upon current methods. However, it remains unclear if they may be used in place of current methods and/or offer additional biogeographic insights. We compared two network methods to detect bioregions (modularity and map equation) with the conventional distance‐based clustering method. We also explored the relationship between network and biodiversity metrics. For the analysis we used two datasets of iconic Australian plant groups at a continental scale, Acacia and eucalypts, as example groups. The modularity method detected fewer large bioregions produced the most succinct bioregionalisation for both plant groups corresponding to Australian biomes, while map equation detected many small bioregions including interzones at a natural scale of one. The clustering method was less sensitive than network methods in detecting bioregions. The network metric called participation coefficient from both network partition methods identified interzones or transition zones between bioregions. Furthermore, another network metric (betweenness) was highly correlated to richness and endemism. We conclude that the application of networks to biogeography offers a number of advantages and provides novel insights. More specifically, our study showed that these network partition methods were more efficient than the clustering method for bioregionalisation of continental‐scale data in: 1) the identification of bioregions and 2) the quantification of biogeographic transition zones using the participation coefficient metric. The use of network methods and especially the participation coefficient metric adds to bioregionalisation by identifying transition zones which could be useful for conservation purposes and identifying biodiversity hotspots.
The effect of viewing video clips of paediatric local anaesthetic administration on the confidence of undergraduate dental students
Authors: Kenny K. P. , Alkazme A. M. , Day P. F.
Published: February 2017

Introduction

Dental treatment for children requires not only technical skills, but also the knowledge and confidence to provide behaviour management to support children of differing ages and stages of development. It is not surprising then that dental students find treating children especially stressful. Paediatric dentistry training is therefore a vital element of the undergraduate dental curriculum.

Materials and Methods

Eighty‐six fourth‐year undergraduate dental students received standard lectures and seminars about behaviour management techniques for children having local anaesthetic. The students were then randomly divided into groups using cluster randomisation. The intervention group received an intervention‐based around video clips (VCs) demonstrating behaviour management techniques (BMTs) for children receiving local anaesthetic The intervention and control groups completed self‐administered questionnaires to determine their level of confidence in managing local anaesthetic for children.

Results

There was a statistically significant difference in the level of confidence between the groups immediately after the teaching intervention (P=.003) and at 4 months (P=.001) in favour of the video group.

Discussion

Previous studies on the use of video as a teaching aid have reported favourable results in terms of both student attitudes and learning outcomes. The results from this study confirm the benefits of this style of teaching paediatric behaviour skills in the undergraduate dental curriculum, and the benefits were maintained at 4 months.

Conclusion

This study has demonstrated that VCs as an additional teaching aid are an effective method in improving students’ confidence for BMTs when delivering local anaesthetic.
Community fluctuations and local extinction in a planktonic food web
Authors: Segura A. M. , Calliari D. , Lan B. L. , Fort H. , Widdicombe C. E. , Harmer R. , Arim M.
Published: February 2017

Determining statistical patterns irrespective of interacting agents (i.e. macroecology) is useful to explore the mechanisms driving population fluctuations and extinctions in natural food webs. Here, we tested four predictions of a neutral model on the distribution of community fluctuations (CF) and the distributions of persistence times (APT). Novel predictions for the food web were generated by combining (1) body size–density scaling, (2) Taylor's law and (3) low efficiency of trophic transference. Predictions were evaluated on an exceptional data set of plankton with 15 years of weekly samples encompassing c. 250 planktonic species from three trophic levels, sampled in the western English Channel. Highly symmetric non‐Gaussian distributions of CF support zero‐sum dynamics. Variability in CF decreased while a change from an exponential to a power law distribution of APT from basal to upper trophic positions was detected. Results suggest a predictable but profound effect of trophic position on fluctuations and extinction in natural communities.
Decrease in mortality of adult epilepsy patients since 1980: lessons learned from a hospital‐based cohort
Authors: Granbichler C. A. , Oberaigner W. , Kuchukhidze G. , Ndayisaba J.‐P. , Ndayisaba A. , Taylor A. , Bauer G. , Luef G. , Trinka E.
Published: February 2017

Background and purpose

Data on mortality in patients with epilepsy have been available since the 1800s. They consistently show a 2−3‐fold increase compared to the general population. Despite major advances in diagnostic tools and treatment options, there is no evidence for a decrease in premature deaths. The temporal trend of mortality in a hospital‐based epilepsy cohort over three decades was assessed.

Methods

A hospital‐based incidence cohort was recruited from a specialized epilepsy outpatient clinic at Innsbruck Medical University between 1980 and 2007, divided by decade into three cohorts and followed for 5 years after initial epilepsy diagnosis. Deaths and their primary causes were determined using probabilistic record linkage with the Austrian death registry. Age‐, sex‐ and period‐adjusted standardized mortality rates (SMRs) were computed in relation to the general population of the same area and grouped according to time of diagnosis.

Results

In all, 122 deaths in 4549.9 person‐years (1954.5 women, 2595.2 men) were identified. The overall SMR was 2.2 [95% confidence interval (CI) 1.8–2.6] and decreased from 3.0 (95% CI 2.1–4.3) in 1980–1989, to 2.7 (95% CI 2.0–3.5) in 1990–1999 and to 1.4 (95% CI 1.0–2.0) in 2000–2007.

Conclusions

This study indicates a decrease in mortality in newly diagnosed epilepsy patients over the last three decades. This may be due to advances in diagnosis and treatment over the past three decades, including early identification of drug resistance, introduction of new anti‐epileptic drugs and establishment of a comprehensive epilepsy surgery programme in this region.
Crack growth at fastener holes containing intergranular cracking
Authors: Lo M. , Jones R. , Bowler A. , Dorman M. , Edwards D.
Published: February 2017

This paper examines the growth of cracks at a fastener hole containing intergranular cracking with a focus on ‘dome nut hole’ coupons that are representative of a critical location in the Royal Australian Air Force AP‐3C Orion wing. It is shown that crack growth under operational flight loads can be captured using the NASGRO formulation and that the scatter in these various tests can also be captured by allowing for small variations in the value of the cyclic stress intensity fatigue threshold. In this context, it is shown that crack growth can be captured using both a cycle‐by‐cycle analysis and also a United States Air Force ‘characteristic K’ approach. We also see that, for the operational load spectra considered, the crack growth history is approximately exponential so that the United States Air Force risk assessment computer program (PRobability Of Fracture) can be used to assess the risk of failure by fracture. The results of this study also suggest that, provided that intergranular cracking does not turn and break through to a free surface, it should have little effect on crack growth at a fastener hole.
Fibrocartilaginous mesenchymoma of bone: a single‐institution experience with molecular investigations and a review of the literature
Authors: Gambarotti Marco , Righi Alberto , Vanel Daniel , Cocchi Stefania , Benini Stefania , Elli Francesca M , Mantovani Giovanna , Ruggieri Pietro , Boriani Stefano , Donati Davide M , Sbaraglia Marta , Dei Tos Angelo P , Picci Piero
Published: February 2017

Aims

Fibrocartilaginous mesenchymoma is a rare intraosseous lesion, with a total of 26 cases described in the literature. This study describes the clinical, radiological and histological features of eight new cases of fibrocartilaginous mesenchymoma collected at a single institution between 1982 and 2016. The presence of GNAS and IDH1/2 mutations and MDM2 amplification was explored to evaluate possible links between fibrocartilaginous mesenchymoma, fibrous dysplasia, de‐differentiated chondrosarcoma and low‐grade osteosarcoma.

Methods and results

Eight new cases of fibrocartilaginous mesenchymoma of bone identified in our archives, dating from 1982 to 2016, were reviewed. The diagnosis was not performed on the initial biopsy in any of these cases, due mainly to the absence of obvious cartilaginous differentiation. On imaging, the tumour contained cartilaginous calcifications and showed a very strong uptake of contrast medium after injection. Histologically, the tumour was characterized by spindle cell proliferation mimicking a low‐grade spindle cell sarcoma, associated with epiphyseal growth‐plate‐like nodules of cartilage and bone production. Molecularly, no GNAS and IDH1/2 mutations or MDM2 amplification were found in the cases analysed. Only one case recurred 1 year following intralesional resection. None died of disease.

Conclusions

This very rare bone tumour has a typical radiological and histological pattern and a favourable survival outcome after treatment. Local recurrences can be prevented with complete surgery. Fibrocartilaginous mesenchymoma does not seem to be related genetically to fibrous dysplasia, low‐grade osteosarcoma and de‐differentiated chondrosarcoma.
Epidemiology of rosacea in Colombia
Authors: Rueda Lili J. , Motta Adriana , Pabón Juan G. , Barona Maria I. , Meléndez Esperanza , Orozco Beatriz , Rojas Ricardo F.
Published: February 2017

Background

Prevalence of rosacea has been estimated around the world in the range of 0–22%. In Colombia, the prevalence of rosacea remains unknown. The aim of this study was to determine the prevalence of rosacea and the frequencies of its subtypes in Colombia.

Methods

This cross‐sectional, multicenter study was conducted in six outpatient dermatology clinics across Colombia. A total of 33 dermatologists conducted a comprehensive medical history and physical examination for all rosacea patients seen at their offices over the course of 2 months. All patients who accepted to participate were encouraged to answer a survey about the history of their illness.

Results

Of 10,204 outpatients evaluated for rosacea between July and August 2014, 291 rosacea patients were included in this study. The prevalence of rosacea subtypes in this cohort was: 45.3% erythematotelangiectatic (ETR) (n = 132), 48.7% papulopustular (PPR) (n = 142), 4.8% phymatous (n = 14), and 1% ocular (n = 3).

Conclusions

Overall, the prevalence in Colombia was 2.85%. Our data represent an important first step to understanding the current state of rosacea in Colombia. The prevalence of rosacea in Colombia is the highest in Latin America among a few reports published, which might be explained by geographic features. However, contrary to our expectations, the prevalence is lower than that in some European countries. We postulate that this finding may be due to methodological differences.
Secondary cutaneous peripheral T‐cell lymphoma, unspecified, with generalized benign‐looking dermatitis: a possibly distinct peripheral T‐cell lymphoma
Authors: Lee Woo Jin , Kang Hyun Ji , Won Chong Hyun , Chang Sung Eun , Choi Jee Ho , Lee Mi Woo
Published: February 2017

Background

Cutaneous lymphomas are a heterogeneous group of tumors with various clinical manifestations, histological features, and prognoses.

Methods

Among 425 cases of cutaneous lymphoma, we describe eight cases of peripheral T‐cell lymphoma, unspecified, presenting with generalized benign‐looking dermatitis.

Results

Our case series included eight cases of secondary cutaneous peripheral T‐cell lymphoma, unspecified. The observed clinical morphology features included drug eruption‐like generalized morbilliform maculopatches in two cases, generalized folliculitis‐like papules in two cases, and generalized eczematous dermatitis‐like papules and patches in four cases. Histopathological examination demonstrated tumor cell infiltrates of mainly atypical, small‐to‐medium lymphoid cells that were perivascularly or periadnexally distributed throughout the dermis. Immunohistochemical staining results for CD2, CD3, CD4, and CD8 revealed that the tumor cells were T‐cells.

Conclusion

This collection of cases and literature review emphasizes the need for clinical suspicion of peripheral T‐cell lymphoma, unspecified, in the differential diagnosis of adult patients with refractory eczematous or benign‐looking skin lesions.
Silk textile with antimicrobial AEM5772/5 (Dermasilk): a pilot study with positive influence on acne vulgaris on the back
Authors: Schaunig Caroline , Kopera Daisy
Published: February 2017

Background

The use of special silk textiles (Dermasilk) has shown positive effects on chronic inflammatory diseases like lichen sclerosus et atrophicus, atopic dermatitis, diabetic ulcerations, and vulvovaginal candidiasis.

Objective

Wearing T‐shirts of this particular fabric could be useful in the management of patients with acne vulgaris on the back and trunk.

Material and Methods

Dermasilk T‐shirts were given to 14 patients with acne vulgaris papulopustulosa on the back. The patients wore these shirts every night for 6 weeks, and their acne lesions were monitored. Dermasilk represents a polymerisate of fibroin, a silk protein, and antimicrobial AEM5772/5, an unsoluble colorless, odorless ammonium with antifungal and antibacterial ability.

Results

Photographic documentation before and after 6 weeks showed a clinically significant reduction in acne lesions on the back without any concomitant treatment or change in lifestyle and living conditions.

Discussion

The use of Dermasilk textiles in other subacute‐chronic inflammatory skin diseases has shown positive effects. This is the first report on their safe and effective use in the management of acne vulgaris papulopustulosa corporis.